Whether or not to provide Americans with the choice of a public health insurance plan has emerged as the line of demarcation in the federal health care reform debate. Proponents, rightfully, argue that the choice of a public plan would provide more affordable options for families and small businesses (particularly in rural America), create much needed competition within the health insurance industry, and serve as a guaranteed back-up for families who lose private coverage. Individuals and small businesses, in particular, would benefit from the cost-cutting bargaining power of a large group, just as large businesses and state governments pool their employees to negotiate better health care rates, and a public plan would not be driven by the profit-motive of private health insurers.
While the current debate in DC has focused on the choice of public health insurance plan, this Dispatch will outline how state legislators and health care advocates have already been advancing the priority of a public plan – helping to build grassroots support for creating the choice of a public health insurance plan as part of comprehensive health care reform. Notable state campaigns to extend public plans to more families include Healthy Wisconsin, a guaranteed health care program for all state residents, providing state employee-level benefits and ensuring consumers’ choice of providers, which passed the State Senate in 2007, and the Connecticut Healthcare Partnership, allowing small businesses and municipalities to buy coverage through the state employee health plan, which passed the legislature in 2008 but was vetoed by the Governor. This year, these initiatives have been reinvigorated by legislators and joined by other proposals that hinge on creating a public plan, like SustiNet, a comprehensive reform measure which creates a true public health insurance option in Connecticut, the nation’s insurance capitol.