Could a President Hillary Clinton enact a public option?

Probably not.

While a public option could have financial benefits for consumers seeking coverage, the prospect of Congressional approval does not appear favorable even if Hillary Clinton is elected this fall. Unless Democrats regain comfortable majorities in both the Senate and the House, they are unlikely to marshal sufficient votes for a public option in the insurance exchanges or a Medicare buy-in option for 55- to 64-year-old adults.

A more likely opportunity would be for an individual state, such as California or Vermont, to propose its own public option and seek federal approval to implement it in its state-based exchange. Thus, the best prospect for a public option may reside with state proposals to a receptive executive branch to test this approach.

I thank John Ayanian for sharing the piece, which he co-authored with Richard Hirth.


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