The Opt-Out as a Trap in the Making

If the stimulus proved one thing, it’s that Republicans can’t really walk the walk on fiscal conservatism: they’ll vote against increased government spending, and promptly pocket the cash (e.g., Phil Gingrey, R-GA). The opt-out public option risks creating the same atmosphere: conservatives will stand against it on principle, but be punished at the polls for denying their lower-income constituents a shot at affordable, quality healthcare. And, should the public option compete favorably against private plans, resulting in lower prices, the difference in red states will be palpable, with all of the electoral consequences that implies.

If we believe in the public option, this is an experiment progressives should readily embrace, as a chance to prove, once and for all, that government programs can create a happier, healthier citizenry (as if, say, the highway system wasn’t proof enough). Admittedly, results come at the expense of the citizens of those states that do opt out, but it won’t be Democrats making those calls.  The Republican desire to avoid the opt-out experiment — thus ducking the “difficult” choice between helping one’s constituents and “standing on principle” — speaks volumes.

[I]t is one of the happy incidents of the federal system that a single courageous State may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country. — Supreme Court Justice Louis Brandeis.



  1. If it’s important enough for the Federal government to take it up, shouldn’t that preclude the idea of states as laboratories? If waiting for other states to try the Massachusetts experiment is not acceptable, then why give so many the choice to opt out and not try the experiment?

  2. I really suspect that no state is going to actually opt-out. In most states, even the blue ones, some legislator looking to make a name for themselves is going to float a bill. In some of the more conservative states, the bill might even get to the floor. But show me a politican who turns down free money (which to the states this is) and I’ll show you the bridge I have for sale.

  3. Well, there might be a couple extremely backwards states (Louisiana, South Carolina, I would predict) that actually make a show of denying it. But again, that’s the genius here. I saw this floated as an idea long before it was really rolling around in Washington, a “blue state public option,” but in this case, it will really be an “all but the wingnuttiest states” public option, and even a few of those will keep it. Tennessee certainly will, and so will most of the Southern states.

    That’s why this is kind of geeeenius.

  4. i live in massachusetts and i am a participant in the state run healthcare option and i couldn’t be more satisfied. i’m self employed and also work per diem (read no benefits) and therefore am on my own for health insurance. if the state option weren’t available, i would have no insurance whatsoever.

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