How Does COVID-19 Crisis Affect Public Option Prospects?

by Leslie Small

To some policy experts, the COVID-19 pandemic offers a chance to rethink the national debate over universal health coverage — potentially bolstering the case for a Medicare for All system or a public option that provides government-sponsored, less expensive health plans alongside private offerings.

Meanwhile, two states aiming to implement their own public option programs have faced challenges due to the pandemic — but it's possible those setbacks may be only temporary.

Consider Washington state, which aims to have a public option on its Affordable Care Act exchange in 2021 in accordance with legislation passed in 2019. In a May 19 letter, Democratic Gov. Jay Inslee indicated that the program may be phased in slower than he initially planned, but it appears some health insurers are interested in helping the state administer its new initiative. A spokesperson from the state's exchange wrote in a June 4 email to AIS Health that five insurance carriers have now proposed public option products that would be available in 22 of the state’s 39 counties in 2021.

In Colorado, meanwhile, the picture is less encouraging, as the state has not yet passed legislation authorizing a public option program. Democrats in the state Senate said in May that they will abandon their effort to pass a public option bill this year due to the COVID-19 crisis, but they're aiming for a renewed push in 2021.

Chris Sloan, an associate principal at Avalere Health, says he doesn't expect any other public option initiatives to get off the ground when the next legislative sessions start in the fall. "It is difficult to get a major piece of health care reform through, even at state level, when all the oxygen is being taken up by other things," he tells AIS Health.

However, "I very much think that heading into 2021 — particularly in states that were already focused on this, or if Vice President [Joe] Biden wins the presidency — the fact that there are high levels of unemployment and higher levels of uninsured, more people on Medicaid [and] more people on exchanges will supercharge the focus on health care," Sloan says.

From Health Plan Weekly