“One problem with the opt-out idea is that Republicans may seize on it in the future and turn it into a general opt-out for states to exempt themselves from the whole bill,” said Paul Starr, health care expert at Princeton University. “Remember there will be four years and two elections before the reforms go into effect. This would be the easiest step for Republicans take during that period to ensure that the whole thing would unravel. And it would unravel because states that adopted the reform would become magnets for migration by the sick from states that opted out.” – Opt-Out Public Option Gains Steam Among Dems, But Questions Remain
Sen. Tom Carper’s last minute idea may lack details when it comes to actual legislation, but it’s the buzz and holds promise of the magic 60 votes in the Senate, so some big progressives are signing on.
On the political side, it seems to offer Democrats cover who need it, while depriving Republicans of the hammer they so hope to have on “socialized medicine.” Yet Opt-Out also offers the naysayers something, a choice, even if we clearly won on policy. If it’s “Opt-Out,” who can complain? It could have been worse, Republicans can say.
In this new proposal, called the “Opt Out,” individual states would be able to choose whether they want to participate in the Public Option or not. The method of the “Opt Out” isn’t entirely clear but it could take many forms from executive order to state legislation to ballot measures.
… Progressives should see in the “Opt Out” an opportunity to win their policy proposal and create a political bulwark of public support behind the Public Option. Politically, Republicans should be quaking in their boots over the idea of an “Opt Out” or even an “Opt In.” State-by-state political and legislative fights to stay in the Public Option would give Democrats a rallying cry and mobilization tool. If these fights took the form of ballot measures there would even be Election Day opportunities for health care fights. Progressives would have a soft-money vehicle to mobilize voters most supportive of health care reform, namely progressive votes who make up the Democratic base. Republicans would be better off politically accepting a straight-up Public Option than having an “Opt Out.”
Earlier this week, Howard Dean weighed in first and affirmatively, via Sam Stein:
“If I were a member of the U.S Senate I wouldn’t vote for the [Senate Finance Committee] bill but I would vote for this,” Dean said, “not because it is necessarily the right thing to do but because it gets us to a better conversation about what we need to do.”
[...] “I would like to see that come out of the Senate because it is a real public plan,” he said of the opt-out compromise. “Then they can negotiate it [with the House] in conference committee… And if this passes I won’t say it is not reform because it is reform.”
“If this is what it takes to get 60 votes I say go for it,” said Dean
SEIU’s Andy Stern is in too:
“I’m in the fourth way option,” Stern said. “If Alabama doesn’t want a public option, they should consider that question. I don’t think the citizens of Alabama will want out. … I think we need a public option. I don’t think it needs to be triggered. The question is if there are certain state legislators who think it’s not appropriate for their state, they should have a right in some fashion to deal with it.”
So, progressives have convinced people that a public option should be included. But with so many in Congress wary, and the White House and Democrats committed to a 60-vote threshold in the Senate, Opt-Out is looking like a way through.
Now, it’s up to Speaker Pelosi to sell it. Question remains if the House Progressive Caucus will buy in.
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