While I was against it all the way through the Senate Finance Committee vote, I have decided to now support a hard trigger for the public option. However, I want it to be a very robust public option that is based on Medicare rates and incorporates Senator Wyden's amendment (pdf), the full-fledged version open to all employees and not the watered-down version that Senators Reid and Baucus have agreed to support.
This is a move I've been contemplating making for a while. The recent release of the Urban Institute paper (pdf) finally pushed me over the edge.
I agree with the Urban Institute's analysis that a hard trigger that goes into effect in 3 or 4 years will likely result in a much better public option than anything that is going to pass in 2009. A big part of the reason why I am comfortable taking this stance is that the public option wouldn't start until 2014 anyway. So why not have a hard trigger based on affordability of health care coverage in 2013 that, if triggered, would result in a strong public option as of January 1, 2014? That gives the insurance companies three years to prove they can make health care affordable. If they can't, which I don't think they can, then we all get what we want on the same timeframe as what's currently being proposed. I don't think see how we lose anything and I think we gain an even better public option.
I should be very clear that by "hard trigger" I mean one that kicks in automatically based on independent and objective affordability measures. I don't want it to be left up to the HHS Secretary or any other person. I also think the trigger should remain active in perpetuity. So even if it's not triggered the first year, affordability should continue to be monitored and the trigger can be pulled at any time. I don't want the insurance companies to manipulate prices just until they get past the trigger date and then start raising prices without fear of reprisal.
I'm going to leave it there. I know there are plenty of Kossacks who could write much more detailed diaries on this subject. I just wanted to express my opinion and hopefully trigger (pun intended) a good discussion in the comments.
Thank you.