Last week about a dozen GOP governors announced they would not go forward with the construction of insurance exchanges in their states, as mandated by the Affordable Care Act, and since then another governor has joined them, while several others are thinking things over. Instead, these governors are leaving it to the feds to come up with a plan for insurance exchanges in these states.
Prominent among the refuseniks are Scott Walker (WI), Bobby Jindal (LA), John Kasich (OH), and Rick Perry (TX). They have just been joined by Mary Fallin (OK). Still debating the idea are Chris Christie (NJ), Rick Scott (FL), and Terry Branstad (IA). The refusenik governors are generally contending that the ACA does not give them sufficient flexibility in devising the exchanges or that exchanges are inappropriate for their states. Some are just flat pouting over the fact that with Obama's victory the ACA is now here to stay, while others are seeking political cover from challenges from their right if they appear to tea partiers to be cooperating with Obama, or capitulating to a law they, however irrationally, despise. They also want to be able to say, when any glitches arise with the start-up exchanges, that they had nothing to do with it and that it is all Obama's fault.
However, the upshot of all this is that the Obama administration now has a golden opportunity to devise a public option model and cram it down the throats of the GOP heel-draggers. If they don't want to do their jobs and create the insurance exchanges the law calls for, then lets take this opportunity to crush the private insurance monopolies in some of these states and replace them with a robust public option that cuts out the profit currently being gobbled up by insurance middle-men and provides better coverage.
More beneath the orange hernia scar.
If the GOP governors had taken the reins and developed their own insurance exchanges, the exchanges in their states likely would have favored private insurers and campaign contributors. However, by kicking the ball back to the feds, they lost the ability to shape exchanges biased toward profit and left it to HHS to devise a plan for them. Well, OK, let's give them one. Public option.
Public option is popular, even when you factor in the massive disinformation campaign waged by the GOP, Fox, and the insurance industry when Obamacare was under consideration. In 2010, Research 2000 surveyed likely voters in Nevada, Illinois, Washington, Missouri, Virginia, Iowa, Minnesota, and Colorado and found that in these swing states the public option was more popular than other plans on the table, such as the Senate plan.
In 2010, 82% of Obama voters who voted for Brown in Massachusetts supported the public option.
A poll from November 10 and 11, 2010, by Angus Reid Public Opinion found that 52% of Americans supported a public plan. Their research had a 3.1% margin of error.
Between October 28 and November 13, 2009, Democratic Senator Dick Durbin's campaign organization polled Americans to rank their support for various forms of the "public option" then under consideration by Congress for inclusion in the final health care reform bill. The 83,954 respondents assigned rankings of 0 to 10. A full national option had the most support, with a 8.56 average, while no public option was least favored, with a 1.10 average.
I could go on. The point is that even with the grossly inaccurate propaganda spread about Obamacare when it was being voted on, the public option had majority support. The Obama administration now has a golden opportunity to offer a public option plan in all of the states where Republican governors are declining to design insurance exchanges, thereby controlling and improving the quality of health care, undercutting profit-hungry private insurance companies, and bringing prescription and hospital costs under control by creating entities with powerful motives to control health care costs.
So let's take them up on their offer!
One problem is that there is currently no funding mechanism for the HHS to create the insurance exchanges. However, public option models exist in some states that might be adapted relatively easily, and Secretary Sebelius can almost certainly free up enough staff for a task force to create a model that can be modified as needed state-by-state. Communities like this one can also serve as a source of ideas and connections to knowledge centers in individual states. More importantly, we can push the administration for the kind of public option that will provide quality universal coverage at the lowest cost. But we need to get cracking. The exchanges need to be open for enrollment by October, 2013, and the exchanges are set to start operating on January 1, 2014.