The inclusion of the “Community Health Insurance Option” is a good slap to Senate republicans and others who voted against public option provisions in committee on the Baucus bill. But the legislation still has a worrisome 'opt-out' provision which would allow these 'red state' legislators to vote down the public option in their states before the provision even takes effect.
Firedoglake has a good post on this:
http://fdlaction.firedoglake.com/2009/11/18/senate-public-option-opt-out-is-bad-unlimited-pre-reform-opt-out/Senate Public Option Opt-Out Is Bad, Unlimited, Pre-Reform Opt-OutBy: Jon Walker Wednesday November 18, 2009 5:44 pm
The public option in the merged Senate bill is called the “Community Health Insurance Option.” Harry Reid attached an opt-out provision to the public option. Any state can choose to not allow the public option to be offered their state.
To opt-out, a state must pass a law to stop the public option from being offered in the state. States can opt back in by repealing the opt-out law they previously passed:
(3)STATE OPT OUT.—
(A) IN GENERAL.—A State may elect to prohibit Exchanges in such State from offering a community health insurance option if such State enacts a law to provide for such prohibition.
(B) TERMINATION OF OPT OUT.—A Statemay repeal a law described in subparagraph (A) and provide for the offering of such an option through the Exchange.
Unfortunately, the opt-out provision is an unlimited, pre-reform opt-out. This is one of the worst ways to design the opt-out. There is no restriction placed on when states can start opting out, and, presumably, this will allow states to start opting out right away. That means there will be a three four year window after the bill is passed and before the public option is first made available. That is a huge window in which Republicans and health insurance lobbyists can work to opt a state out of the public option.
The opt-out will quickly become a partisan football at the state level after reform is passed. Expect many red states to start passing laws to opt-out their states right away. I would not be surprised if a dozen red states quickly opted out in 2010. The simple conclusion: If you live in Texas, you are out of luck.
and, this from Open Left: http://www.openleft.com/diary/16100/senate-optout-public-option-wont-start-until-2014-wont-cover-abortion-proceduresSenate opt-out public option won't start until 2014, and won't cover abortion procedures by: Chris Bowers Wed Nov 18, 2009 at 20:19
The Senate health care bill is now online. It is a lot to wade through, but I can tell you a few things right off the bat: 1. The opt-out public option in the bill will not begin until 2014. This is one year later than even the 2013 date included in earlier versions of the bill. 2. The opt-out mechanism is simply when states pass a law. So, that means both state legislatures (except in Nebraska), plus a Governor's signature. Now, even if the opt-out public option passes into law, conservatives have an extra year to try and organize against it. 3. The penalty for individuals not purchasing health insurance will be $95, and also will not start until 2014. 4. Also, while the Senate bill does not include Stupak language in the House bill, the public option will not cover abortion procedures. Obviously, in a bill this large, these bullet points just scratch the surface. Consider them appetizers.
pdf of Senate bill:
http://democrats.senate.gov/reform/patient-protection-affordable-care-act.pdf
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