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Triggers are Nothing but a Plan to Kill the Public Option

As debate on health care moves forward in the Senate, it seems like a good time for a reminder: There is no such thing as a good trigger for the public health insurance option. In fact, triggers are nothing but a plan to kill the public option.


1. The status quo is unacceptable

The logic at the heart of a trigger is that the status quo is ok, as long as it doesn’t get worse.

A trigger says that some condition must be met in the future for a public health insurance option to be created in a state. That condition could be levels of competition or affordability, but whatever it is, the situation on the ground in a state must measurably worsen before the trigger is pulled and a public option created. That’s unacceptable.

People are going bankrupt and dying every day because they are uninsured or underinsured. The House and Senate bills don’t go into effect until 2013 or 2014, and triggers ask people in states to wait even longer to get relief from insurance company abuses.

As Senator Chuck Schumer said, “Any reasonable criteria for triggering a public plan has already been met.”

And that’s assuming a trigger is written in such a way that it could actually be triggered.

2. The trigger is a catch-22, designed never to be triggered

We’ve tried triggers before in this country. Medicare Part D has a trigger written into the bill that will allow the government to start negotiating for better drug prices if they start increasing by huge margins. Even though drug prices under the program have skyrocketed, with Medicare Part D paying on average 30% more for drugs than regular Medicaid and costing taxpayers over $60 billion extra over 10 years, the trigger has never been triggered.

That’s what happens when triggers are written by Republicans and their lobbyist friends. Indeed, the trigger proposed by Senator Olympia Snowe, who voted against even debating health care on Saturday, was a catch-22 designed never to trigger.

As I’ve explained:

The trigger amendment isn’t a fig leaf. It isn’t even a co-op. It’s a plan to kill the public health insurance option outright, and give taxpayer money straight to private insurance companies.


The overwhelming majority of Americans support a real public health insurance option. Poll after poll confirms this. And the public option is even popular in places like Arkansas, Louisiana, and Nebraska [pdf]. Nearly all Democrats in the Senate support it. And it’s the right thing to do.

Triggers are not an acceptable substitute no matter how they are written.

(also posted at the NOW! blog)

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Jason Rosenbaum

Jason Rosenbaum

Writer, musician, activist. Currently consulting for Bill Halter for U.S. Senate and a fellow at the New Organizing Institute.