Democrat’s hope fades for socialized medicine this year


While many Democrats campaigned in 2020 on creating a public option for the Obamacare exchanges, it appears increasingly unlikely that Congress will take up legislation to establish one this year.

A public option is a health insurance plan funded by taxpayers and enrollee premiums that consumers could purchase via the Obamacare exchanges.

There is not much room for it on President Joe Biden’s packed agenda.

“I think the chances are very slim we’ll see a public option because Democrats already have a very aggressive agenda with things like infrastructure and voting rights. The public option is going to get squeezed out,” said David Williams, president of the conservative Taxpayers Protection Alliance.

In 2020, Biden campaigned on giving people “the choice to purchase a public health insurance option like Medicare.” Thus far, none of his major legislative proposals, such as the American Rescue Plan or his recent fiscal year 2022 budget proposal, have included funding for a public option. However, Biden’s budget did say the president supported “creating a public option that would be available through the” Obamacare exchanges.


But expressing support isn’t a sign that it is a priority, suggested Alex Hendrie, director of tax policy at the conservative Americans for Tax Reform.

“The fact that he doesn’t provide any funding for it means he’s kinda just paying lip service to the idea,” Hendrie said. “It may be something he pushes in future years, but it doesn’t seem to be a priority for 2021.”

Congressional action on a public option will also be difficult as Democrats have only a seven-seat majority in the House, and the Senate is evenly split.

“I think the public option is great for the progressives in the party, but I think it is more problematic for some of the moderate Democrats,” said Williams. “It’s not something that moderate Democrats may want to vote on as it could hurt them in the 2022 election.”

The perceived need for a public option may have also been dealt a blow when the American Rescue Act included expanding premium tax credits for purchasing coverage on the Obamacare exchanges.

“It undermines the push for a public option because a majority of Democrats can say that we’ve already taken action on healthcare,” Hendrie said.

In February, Sens. Tim Kaine of Virginia and Michael Bennet of Colorado, both Democrats, introduced public option legislation they hoped to include in Biden’s American Rescue Act. But the policy did not make the cut.

“I don’t think this issue is serious for Democrat leaders,” Williams said. “[House Speaker] Nancy Pelosi and [Senate Majority Leader] Chuck Schumer really haven’t talked about the public option. Reading those tea leaves, it just doesn’t seem serious for them.”

Until about two weeks ago, Maura Calsyn, managing director of healthcare policy at the liberal Center for American Progress, would have agreed the chances were low because of little discussion in Congress about a public option. That changed in late May when Democrats Rep. Frank Pallone of New Jersey and Sen. Patty Murray of Washington released a letter asking for public feedback on a public option.

“I think that the chances for a public option are increasing because of that,” said Calsyn.

A spokesperson for the House Energy and Commerce Committee said Pallone “aims to introduce public option legislation by the end of the year.”

Calsyn also thought there was considerable support for a public option beyond just Pallone and Murray.

“I think there is widespread support among Democrats of expanding health coverage, and a public option is one of the clearest paths to improving affordability and getting more people covered,” said Calsyn. “Additionally, there is movement in Nevada and Colorado to create a public option, so I think support for it is growing.”


The Nevada Legislature passed a bill creating a public option on its exchange last week. Gov. Steve Sisolak, a Democrat, said he would sign the bill. However, the bill creating a public option in Colorado has faced a much more difficult road. It has gone from establishing a stand-alone public option to a more watered-down plan that would create a standard plan that all insurers would have to offer on the Colorado exchange. The bill has passed the Colorado state Senate and faces a final vote in the state House.

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