On Monday, the NAHU Board of Trustees voted to adopt a position paper outlining our opposition to a public health insurance plan, also known as a “public option.” Policymakers are currently considering proposals to implement public plans that would provide coverage to Americans through state or federal marketplaces that would compete alongside private insurance plans. NAHU has been a leading opponent of the public option since 2008, is deeply concerned about the damaging impact that a public option could have on private-market coverage, and will continue to strongly oppose any efforts to implement a national public health insurance plan.
Ongoing market challenges, including low insurer competition, carriers leaving the marketplaces and high prices for private-market coverage, are increasing the pressure on many to implement a public option. NAHU contends that a public plan would never compete fairly with the private market, could exacerbate the worst elements of existing public health programs, including inefficiencies, high costs and bureaucracy, would be financially infeasible in the long run, and could potentially devastate existing private market coverage. While there is low political and practical viability for future legislation to pass given the current political control of Congress, as a public option was not viable even with Democratic supermajorities in both chambers, in addition to the failures of the Co-Op program, we remain concerned about any efforts to implement a public plan.
Given the ongoing market challenges, NAHU has advocated that establishing a government run plan is not a short-term option for these immediate problems. Instead, we have long advocated that the most immediate solution would be to allow carriers in the individual market outside of the exchange to be used for premium tax credits. Since credits are already paid directly to carriers, there is no reason why this very simple option would not be the very first choice if there were no longer carriers offering coverage inside of the exchange.
The release of this paper comes as support for a public option continues to grow among Democrats. This week, nearly three-fourths of Senate Democrats signed onto a non-binding resolution offered by Senator Jeff Merkley (D-OR) to implement a public option. The signers included all of the Senate Democratic leadership, but noticeably absent was Senator Tim Kaine (D-VA) as well as several moderate senators who are expected to face difficult re-election contests in 2018. Besides the Senate Democrats calling for a public option, Hillary Clinton has indicated her support of the plan, which was included in the non-binding Democratic Party platform approved at this year’s convention. Additionally, President Obama wrote an article published in the Journal of American Medical Association (JAMA) in July calling for the implementation of a public plan “where competition is limited.”
With the latest calls for a public option, NAHU strongly opposes any federal or state legislative proposal to create a public option to compete with private insurers. Please be assured that we will push back very hard against any efforts toward a new public health insurance plan.