I originally figured I could live with the opt-out plan because it's loosely modeled on Medicaid, "which originally allowed states to “opt-out” of the program and today enjoys the participation of all 50 states." And, as TPM pointed out, there was good reason to believe that the public option would have been a lot scarier as a GOP straw man than it would as a real world option for people who can't get private coverage.
And if the public option is available in North Carolina, just to pick a hypothetical, and not South Carolina, after a while, people in the South Carolina might start to wonder what the logic was of denying them a lower cost health insurance option. And if that's true, presumably, pressure will build in the opt-out states to opt-in. So even if a substantial number of people aren't covered at the start, there's good reason to believe that will change over time.There's just one tiny problem with the "presumably, pressure will build to opt-in" scenario. We're dealing with politicians who often put party ideology ahead of people. If pressuring our leaders worked, we would have had health care a long time ago.
And, as Cordelia mentioned, it's not exactly clear who gets to do the opting-out. Will governors be able to unilaterally make that decision or will it take action by both houses of the state legislature? As Jon Walker at FDL pointed out, depending on how the opt-out is written, millions of people in states controlled by Republicans could find themselves disenfranchised.
If a Republican becomes Michigan's next governor, or they manage to pick up any seats, we can kiss opting-in goodbye. Seriously. That makes the next election extremely important because there's just one thing standing between national health care and the 1.13 million uninsured adults in our state - Republicans (and DINO's like Dillon).
(Cross-posted at Blogging for MI.)