Tom Carper’s hybrid state co-op/public option plan is gaining momentum in the Senate right now. If you want to know what to think about the plan look at who’s praising it.
A new proposal by Sen. Tom Carper would spell out how to boost competition in the private market by enacting government-run plans at the state level. States could act alone or in concert with others to gain more leverage in the marketplace, and would be bound by the same rules established for private companies using the national insurance exchange envisioned by the Senate Finance bill. Another option would entail states opening their workers’ employee-benefit plans to the general public.
The Delaware Democrat’s plan won praise from some in his party Tuesday as a way of bridging differences among them.
“Conceptually, having the states take responsibility makes a great deal of sense,” said Nebraska Sen. Ben Nelson, a key voice for moderate Democrats. “It is important that we really take a close look at this.” He noted that states are already in the health-insurance business because they administer Medicaid and other federal-state programs.
Mr. Nelson said state health plans could compete alongside the nonprofit cooperatives. Another Democratic centrist, Sen. Kent Conrad of North Dakota, said the Carper proposal was “very constructive.”
Ezra Klein, who has been a really good resource to understand the various proposals likes the plan.
[…]each state would have the option to:
1) Participate as grantees in the CO-OP program and apply for seed funding.
2) Open up that state’s employee benefits plan.
3) Create a state administered health insurance plan with the option of banding together with other states to create a regional insurance compact.
Each state would, in other words, be allowed to create a public option. And states could band together to give their public options more bargaining power and efficiencies of scale. This would do a couple of things. First, it would give residents access to a public competitor. Second, it would provide an acid test of whether a public competitor substantially changes an insurance market. Does it force private insurers to bring their prices down? Does it create more competition and transparency? Are consumers more satisfied? And if all that happens, will other states really resist adopting the public option?
To me it looks like the Co-op plan, and the main criticism of co-ops is that the co-ops are too small and too weak to effectively compete with the insurance giants. Regional co-ops are probably better than state to state options but are still small and relatively weak. I see this proposal as the public option in name only.
At this point I just want something to come out of the Senate with a public option. I think this may be the best we can hope for, and hope that the public option gets strengthened in the House-Senate conference. Once it gets out of conference, there are only 50 votes needed in the Senate (Biden breaks the tie).