The Role of the Public Health Insurance Option in the Health Care Reform Debate of 2009-2010.
Kohnstamm, Paul W.
2011
- A successful legislative strategy for passing a comprehensive health care reform bill had eluded American presidents for generations. Each reform effort had its own unique challenges, and the conventional wisdom among observers is that the public option debate was yet another obstacle that President Barack Obama had to overcome in his quest for health care reform. The public option is a proposal ... read moreto create a government-run insurance plan to compete with private health insurers. While the public option did pose certain challenges to achieving health reform � such as creating an ideological gulf between liberals and conservatives and driving moderates away from the negotiating table � I argue that the policy had a net positive effect on the effort to pass the most comprehensive health care bill possible. The public option was able to be negotiated away for significant policy achievements that arguably impact more Americans than the public option that was ultimately debated by Congress. Further, the public option was used as a bargaining chip with stakeholders to negotiate for the financing of health reform and crucial political support for the bill. Lastly, the public option was a popular policy proposal that acted as a lightning rod in absorbing conservative attacks that would have otherwise been directed at less popular � yet more essential � provisions of the bill, such as the individual mandate. In this sense, the public option preserved comprehensive health care reform, and the basic structure of the Affordable Care Act.read less
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