States try out Obama-inspired public health plans during Trump admin

Source: Raw Story · Bias: Far Left

Summary

Nearly two decades ago, progressives fought to include a so-called public option — a government-run health plan — in the broad health care overhaul known as Obamacare. That effort failed, defeated by heavy lobbying from the insurance industry and opponents who decried it as a government takeover of health care.But the final Affordable Care Act, which President Barack Obama signed in 2010, didn’t bar states from adding a public option plan to their state-run insurance marketplaces. In recent years, several states have done so — and others might follow as rising health care costs, the expiration of federal subsidies and Medicaid cuts make coverage less affordable and available for millions of Americans.This year Nevada became the third state, after Colorado in 2023 and Washington in 2021, to add a public option plan to its marketplace. So far, 10,762 people have signed up, according to figures provided by the Nevada Health Authority.The goal of such efforts, said Christine Monahan, an assistant research professor at the McCourt School of Public Policy at Georgetown University, is to provide an alternative to profit-driven private insurance companies, “and to give people an option that doesn’t have that kind of capitalistic incentive in place.”The results so far have been mixed, however. It’s still too early to say whether the states’ public option plans, which are public-private partnerships rather than purely government-run, will significantly lower costs for consumers or pay enough to providers to ensure their continued participation.Meanwhile, other states’ efforts to create public options have stalled. In 2024, Minnesota delayed the creation of a public option amid concerns about the lack of a dedicated funding source. Efforts in Maine and New Mexico also have faltered.“It’s really too early to see what the right combination of design of a public option is,” said Andrew Shermeyer, a doctoral candidate in health policy at the University of Minnesota and the author of a study on the Colorado plan. “We don’t know what works and what doesn’t. So that’s a real challenge for policy makers.”Different approachesAs public-private partnerships, the public option plans in Washington, Colorado and Nevada rely on the participation of private insurers as well as health care providers. And they have to compete for customers with the purely private plans offered on the exchanges.“We all know health insurance is extremely, extremely unaffordable and expensive. So the challenge behind it is you have to find something that’s attractive to consumers,” Shermeyer said. “You have to find something that insurers will comply with, and you have to find something that providers will feel adequately compensated for.”States have used a combination of carrots and sticks to make sure those things happen.In Washington state, private insurers that sell plans on the state marketplace can choose to offer the public option plan, which is called Cascade Select, but they don’t have to. To keep costs down and premiums low, the state mandates that participating insurers pay providers within a certain range.In the first two years that Cascade Select plans were available, many providers were unwilling to participate. So in 2023, Washington began requiring that hospitals contract with at least one public option plan. The change has expanded the availability of Cascade Select plans — as of last year, they were available in every county — and boosted enrollment: Last year, about 30% of Washingtonians who purchased coverage on the marketplace enrolled in a Cascade Select plan, up from 1% in 2021.We don't know what works and what doesn't. So that's a real challenge for policy makers.– Andrew Shermeyer, researcher at University of Minnesota Laura Kate Zaichkin, director of market competition and affordability at the Washington Health Benefit Exchange, said that figure is up to 40% this year. In 2021, Zaichkin said, Cascade Select premiums were a bit higher than for many other plans on the exchange. This year, they are about $100 per month cheaper, she said.Zaichkin said the public option is more important than ever, because of the recent expiration of federal tax credits that had dramatically lowered the costs of purchasing marketplace coverage, as well as looming Medicaid cuts.“I would say that it is a really important lever,” she said. “It always has been, and it is even more so right now, when individual market coverage is under threat and when customers cannot afford their premiums.”Unlike in Washington, every private insurer that participates in Colorado’s marketplace must offer versions of the state’s public option plan, which is called the Colorado Option, in every county where it sells its own plans.

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States try out Obama-inspired public health plans during Trump admin
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States try out Obama-inspired public health plans during Trump admin

Far Left

Nearly two decades ago, progressives fought to include a so-called public option — a government-run health plan — in the broad health care overhaul known as Obamacare. That effort failed, defeated by heavy lobbying from the insurance industry and opponents who decried it as a government takeover of health care.But the final Affordable Care Act, which President Barack Obama signed in 2010, didn’t bar states from adding a public option plan to their state-run insurance marketplaces. In recent years, several states have done so — and others might follow as rising health care costs, the expiration of federal subsidies and Medicaid cuts make coverage less affordable and available for millions of Americans.This year Nevada became the third state, after Colorado in 2023 and Washington in 2021, to add a public option plan to its marketplace. So far, 10,762 people have signed up, according to figures provided by the Nevada Health Authority.The goal of such efforts, said Christine Monahan, an assistant research professor at the McCourt School of Public Policy at Georgetown University, is to provide an alternative to profit-driven private insurance companies, “and to give people an option that doesn’t have that kind of capitalistic incentive in place.”The results so far have been mixed, however. It’s still too early to say whether the states’ public option plans, which are public-private partnerships rather than purely government-run, will significantly lower costs for consumers or pay enough to providers to ensure their continued participation.Meanwhile, other states’ efforts to create public options have stalled. In 2024, Minnesota delayed the creation of a public option amid concerns about the lack of a dedicated funding source. Efforts in Maine and New Mexico also have faltered.“It’s really too early to see what the right combination of design of a public option is,” said Andrew Shermeyer, a doctoral candidate in health policy at the University of Minnesota and the author of a study on the Colorado plan. “We don’t know what works and what doesn’t. So that’s a real challenge for policy makers.”Different approachesAs public-private partnerships, the public option plans in Washington, Colorado and Nevada rely on the participation of private insurers as well as health care providers. And they have to compete for customers with the purely private plans offered on the exchanges.“We all know health insurance is extremely, extremely unaffordable and expensive. So the challenge behind it is you have to find something that’s attractive to consumers,” Shermeyer said. “You have to find something that insurers will comply with, and you have to find something that providers will feel adequately compensated for.”States have used a combination of carrots and sticks to make sure those things happen.In Washington state, private insurers that sell plans on the state marketplace can choose to offer the public option plan, which is called Cascade Select, but they don’t have to. To keep costs down and premiums low, the state mandates that participating insurers pay providers within a certain range.In the first two years that Cascade Select plans were available, many providers were unwilling to participate. So in 2023, Washington began requiring that hospitals contract with at least one public option plan. The change has expanded the availability of Cascade Select plans — as of last year, they were available in every county — and boosted enrollment: Last year, about 30% of Washingtonians who purchased coverage on the marketplace enrolled in a Cascade Select plan, up from 1% in 2021.We don't know what works and what doesn't. So that's a real challenge for policy makers.– Andrew Shermeyer, researcher at University of Minnesota Laura Kate Zaichkin, director of market competition and affordability at the Washington Health Benefit Exchange, said that figure is up to 40% this year. In 2021, Zaichkin said, Cascade Select premiums were a bit higher than for many other plans on the exchange. This year, they are about $100 per month cheaper, she said.Zaichkin said the public option is more important than ever, because of the recent expiration of federal tax credits that had dramatically lowered the costs of purchasing marketplace coverage, as well as looming Medicaid cuts.“I would say that it is a really important lever,” she said. “It always has been, and it is even more so right now, when individual market coverage is under threat and when customers cannot afford their premiums.”Unlike in Washington, every private insurer that participates in Colorado’s marketplace must offer versions of the state’s public option plan, which is called the Colorado Option, in every county where it sells its own plans.

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