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A public health insurance plan

Posted by: Julia Eisman on Apr 24, 2009

Should health reform give people the option to buy a public health insurance plan? 

Our answer is "Yes."

That question - and answer - have generated a lot of discussion on the Hill and a fair amount of ink in the media.

 A public plan would be valuable for many reasons:

- It would create healthy competition and encourage the private sector to play fair;

- It would offer consumers more good choice about which plan best suits their needs.

Not everyone agrees with us, including the private insurance industry. They fear that competition with a public plan will drive them out of business.

E.J. Dionne outlines some of the political and ideological tug-of-war in a column in yesterday's Washington Post:

What if including a robust public plan has the effect of dooming a bill that gets affordable health insurance to everyone? Should public-plan advocates block any bill that doesn't contain their idea, as originally conceived? Of course not.

Dionne recognizes we have a window of opportunity to make real reform and points out some groups are placing an "emphasis on creative compromise in place of creative obstruction."

Dionne cites an example of a partnership between Families USA and PhRMA advocating that health reform include an expansion of Medicaid, a limit to out-of-pocket costs, and significant subsidies to help middle-income people purchase insurance. While not perfect, Medicaid is uniquely suited to serving the needs of low-income and vulnerable Americans. We must improve and expand Medicaid as a starting point for expanding coverage. It is extremely helpful to have PhRMA send this message loud and clear to Members of Congress.

Dionne makes an important point about creative compromises and his column is a valuable one. One clarifying note:  Dionne appears to suggest that expanding Medicaid is a substitute for a public health insurance plan option. That is not Families USA's position. Expansion and improvements to Medicaid are a foundation for expanding health insurance coverage. On top of that expansion, we support subsidies to moderate income families to purchase coverage-with the choice of a public health insurance plan.