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What Is the Public Plan Option, and How Does It Affect Health Reform?

From Kelly Montgomery, for About.com

Updated: June 30, 2009

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Question: What Is the Public Plan Option, and How Does It Affect Health Reform?
Answer:

If you have been following healthcare reform efforts, you may have heard about a public plan option that promises to improve access to health coverage. This option has been rather controversial, and is quickly becoming a key issue in the reform debate. But what exactly is the public plan option, and what would it mean for consumers, as well as the insurance industry?

The public plan option would provide health coverage that is similar to individual coverage available through private health plans, except that the federal government would administer the plan by designing the plan's coverage, collecting premiums, and paying providers.

Proponents of the public plan are careful to point out that public plans would not be designed to replace coverage that is offered by private insurers. Instead, they would be available as another coverage option for Americans seeking health insurance. Because there are some states where one particular insurer dominates the individual market, the public plan would provide some much needed competition and help keep premiums and out-of-pocket costs low.

Opponents of the public plan believe that it is a precursor to a government-controlled single-payer health system. They believe that because the public plan does not have to turn a profit, it will drive private insurers out of business, leaving the government as the only available insurer. For those who believe that having a single-payer system is a good thing, this might not sound so terrible, but opponents believe that government-controlled single-payer healthcare will limit consumer choices and possibly lead to the long waits and lower quality of care experienced by patients in some other countries.

This public plan option is quickly becoming a polarizing issue in the health reform debate. Lawmakers on both sides of the debate are drawing their lines in the sand -- proponents declaring that they will not accept any reform bill that does not include a public plan option, opponents firmly refusing to sign off on any bill that does include one. Proponents seem to have strength in numbers in their favor, but if they do succeed they may not be able to achieve the bipartisan support they were hoping for.

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