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The Public Option “Alternatives” Are Proving to be Mostly Worthless

When Democrats killed the public option several attempts were made to create face saving “alternatives.” Two alternatives actually made it into the Affordable Care Act, the CO-OP provision and “multi-state plans” overseen by the Office of Personal Management. As the law is set to be implemented it is growing abundantly clear neither will provide much benefit.

The CBO has long ago concluded the CO-OP program would have little impact and its funding has been repeatedly slashed in budget deals.

It now also looks like the much touted “multi-state plans” will provide no real advantage over what is currently offered. From Politico:

The Affordable Care Act calls for the federal government to contract with two multistate plans — and one has to be a nonprofit. They have to be available in at least 31 states next year, although they don’t necessarily have to be available in every community in a state at the outset. Within four years, they have to be available nationwide. Having failed to get a government-run public option, backers wanted at least one nationwide, nonprofit alternative to compete with the standard commercial plans.

So far, only Blue Cross Blue Shield has publicly declared that it will offer multistate plans. But the Blues already provide coverage in all 50 states, and the early indications are that their multistate plans will basically be clones of the standard plans they’ll be selling anyway in any given state. That means consumers won’t really be getting anything new.

These public option alternatives are an abject failure or smashing success depending on your perspective. If you were hoping they would provide many of the same benefits as a public option you will be extremely disappointed.

On the other hand if the real goal was to protect the insurance industry from a public option by creating a mostly worthless fig leaf, then they served that role wonderfully.

Photo by hitthatswitch released under Creative Commons License

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Jon Walker

Jon Walker

Jonathan Walker grew up in New Jersey. He graduated from Wesleyan University in 2006. He is an expert on politics, health care and drug policy. He is also the author of After Legalization and Cobalt Slave, and a Futurist writer at