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The public health insurance optionalso known as the public insurance option or the public optionis a proposal to create a government-run health insurance agency that would compete with other private health insurance companies within the United States. The public option is not the same as publicly funded health carebut was proposed as an alternative health insurance plan offered by the government. The public option was initially proposed for the Patient Protection and Affordable Care Actbut was removed after Sen.
Joe Lieberman I-CT threatened a filibuster. The public option was featured in three bills considered by the United States House of Representatives in In the first two bills, the public option took the form of a Qualified Health Benefit Plan competing with similar private insurance plans in an internet-based exchange or marketplace, enabling citizens and small businesses to purchase health insurance meeting a minimum federal standard.
The Public Option Act, in contrast, would have allowed all citizens and permanent residents to buy into a public option by participating in the public Medicare program. Individuals covered by other employer plans or by state insurance plans such as Medicare would have not been eligible to obtain coverage from the exchange.
The federal government's health insurance plan would have been financed entirely by premiums without subsidy from the Federal government,  although some plans called for government seed money to get the programs started. President Barack Obama promoted the idea of the public option while running for election in Ultimately, the public option was removed from the final bill.
While the United States House of Representatives passed a public option in their version of the bill, the public option was voted down in the Senate Finance Committee  and the public option was never included in the final Senate bill, instead opting for state-directed health insurance exchanges.
House of Representatives Democrats introduced H. In the run-up to the Democratic National Conventionthe Democratic Platform Committee approved a plank supporting the addition of a public option onto the Affordable Care Act. The Clinton campaign stated shortly before the plank was added that as president Clinton would "pursue efforts to give Americans in every state in the country the choice of a public-option insurance plan", while Bernie Sanders applauded the decision to "see that all Americans have the right to choose a public option in their health care exchange, which will lower the cost of healthcare".
The purpose behind the public option was to make more affordable health insurance for uninsured citizens who are either unable to afford the rates of or are rejected by private health insurers. Supporters argued that a government insurance company could successfully lower its rates by using greater leverage than private industry when negotiating with hospitals and doctors,  as well as paying the employees of the public option insurance company salaries as opposed to paying based on individual medical procedures.
Supporters of a public plan, such as Washington Post columnist E. Dionneargue that many places in the United States have monopolies in which one company, or a small set of companies, control the local market for health insurance. Economist and New York Times columnist Paul Krugman also wrote that local insurance monopolies exist in many of the smaller states, accusing those who oppose the idea of a public insurance plan as defenders of local monopolies. He also argued that traditional ideas of beneficial market competition do not apply to the insurance industry given that insurers mainly compete by risk selection, claiming that "[t]he most successful companies are those that do the best job of denying coverage to those who need it most.
Economist and former US Secretary of Labor Robert Reich argued that only a "big, national, public option" can force insurance companies to cooperate, share information, and reduce costs while accusing insurance and pharmaceutical companies of leading the campaign against the public option. Many Democratic politicians were publicly in favor of the public option for a variety of reasons.
President Obama continued campaigning for the public option during the debate. In a public rally in Cincinnati on September 7,President Obama said: The final bill, the Patient Protection and Affordable Care Actincluded provisions to open health insurance exchanges in each state by October 1, As the Act requires Americans to purchase health insurance, the federal government will offer subsidies to Americans with income levels up to four times the federal poverty level.
An alternative proposal is to subsidize private, non-profit health insurance cooperatives to get them to become large and established enough to possibly provide cost savings   Democratic politicians such as Howard Dean were critical of abandoning a public option in favor of co-ops, raising questions about the ability of the cooperatives to compete with existing private insurers. While politically difficult, some politicians and observers have argued for a single-payer system.
A number of alternatives to the public option were proposed in the Senate. Instead of creating a network of statewide public plans, Senator Olympia Snowe proposed a "trigger" in which a plan would be put into place at some point in the future in states that do not have more than a certain number of private insurance competitors.
Senator Tom Carper has proposed an "opt-in" system in which state governments choose for themselves whether or not to institute a public plan. Senator Chuck Schumer has proposed an "opt-out" system in which state governments would initially be part of the network but could choose to avoid offering a public plan. In mid-November, it was reported that 40 House Democrats would not support a final bill containing the Amendment's provisions.
Republican House Minority Whip Eric Cantor has argued that a public plan would compete unfairly with private insurers and drive many of them out of business. Cannona senior fellow of the libertarian CATO Institutehas argued that the federal government can hide inefficiencies in its administration and draw away consumers from private insurance even if the government offers an inferior product.
A study by the Congressional Budget Office found that profits accounted for only about 4 or 5 percent of private health insurance premiums, and Cannon argued that the lack of a profit motive reduces incentives to eliminate wasteful administrative costs. Moffit of the Heritage Foundation has argued that a public plan in competition in private plans would likely be used as a "dumping ground" for families and individuals with higher than average health risks.
This, in his view, would lead to costs that business should pay being passed onto the taxpayer. Marcia AngellM. The chief executive of AetnaRon Williamsargued against the public option based on issues of fairness. On the News Hour with Jim LehrerWilliams noted that a public option creates a situation where "you have in essence a player in the industry who is a participant in the market, but also is a regulator and a referee in the game". He said, "we think that those two roles really don't work well.
Public polling consistently showed majority support for a public option. Between October 28 and November 13,Democratic Senator Dick Durbin 's campaign organization polled Americans to rank their support for various forms of the "public option" currently under consideration by Congress for inclusion in the final health care reform bill.
The 83, respondents assigned rankings of 0 to A full national option had the most support, with an 8. A survey designed and conducted by Drs. From Wikipedia, the free encyclopedia. Health care reform debate in the United States. Public opinion on health care reform in the United States. Halpin, Peter Harbage June Retrieved September 21, But successful models still rare nationwide".
Senate panel votes down public option for health care bill. Key details of health reform bills. The New York Times. Archived from the original on Public option should be part of reform". Jackson Lee predicts "vigorous public option" on health care. The marketing of Obamacare exchanges begins. Retrieved October 10, Questions and answers"Washington PostNovember 14, Cannon August 6, News Hour with Jim Lehrer.
Retrieved September 4, Retrieved August 28, Plurality opposes public option". Archived from the original on August 21, Retrieved August 27, Retrieved October 9, Public option gains support. Voters back, but also fear, health reform". Retrieved from " https: Healthcare reform in the United States.
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