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Lawmakers Push for Public Option on Health Insurance Exchanges

As a way to strengthen the Affordable Care Act, progressive lawmakers are supporting the public healthcare coverage option to be sold on the health insurance exchanges.

By Vera Gruessner

A total of five senators and multiple organizations are looking to create a public option for healthcare coverage to be available among all Americans purchasing insurance through the Affordable Care Act’s health insurance exchanges. Senators Jeff Merkley (D-Ore.), Bernie Sanders (I-Vt.), Dick Durbin (D-Ill.), Chuck Schumer (D-N.Y.) and Patty Murray (D-Wash.) will be leading a campaign fighting for the right to have a public option alongside private payers on the health insurance exchanges, according to the nonprofit news agency Common Dreams.

Affordable Care Act

“The Affordable Care Act has made great progress in helping millions of people get access to health insurance. But at a time when 29 million people are still uninsured, and 31 million are underinsured, we must continue to make needed health care reforms so that the American people can have health care as a right, not a privilege. Insurance companies have shown they are more concerned with serving their shareholders than their customers. Every American deserves the choice of a public option in health insurance,” stated Senator Bernie Sanders (I-VT).

Much like the first support for the Affordable Care Act, there is widespread support among progressive lawmakers in favor of creating a public healthcare option, Stephanie Taylor, co-founder of the Progressive Change Campaign Committee (PCCC), told the news source. With the health insurance exchanges facing problems due to three major national payers reducing their participation in the marketplace, a public healthcare coverage option may be vital for increasing competition among payers.

“We see this as the most significant health care push by Democrats since the passage of Obamacare. This resolution supporting a public option for every American represents a Democratic Party increasingly unified behind a strategy of playing offense on big progressive ideas,” Taylor told the source.

“Aetna’s failed extortion attempt and decision to pull out of 11 states has created new urgency in this moment for making a public option available to every American,” continued Taylor. “With Hillary Clinton actively campaigning on big ideas like a public option, debt-free college, and expanding Social Security benefits, Democrats will earn a mandate in 2016 to govern boldly and progressively in 2017. Bernie Sanders’ partnership with Senate leaders and grassroots groups on this push shows increasing Democratic unity around big progressive ideas.”

READ MORE: 7% of Counties Retain One Payer on Health Insurance Exchanges

Under the Progressive Change Campaign Committee, the work will involve bringing this proposal in front of other senators and the Democratic presidential nominee Hillary Clinton. Some of the organizations that are part of the Progressive Change Campaign Committee include, UltraViolet, Working Families Party,, Democracy for America, Daily Kos, and the AFL-CIO.

The lawmakers are bringing forward a resolution that outlines the challenges faced in the healthcare industry and how a public option could remove these barriers. Some of these challenges include health disparities as well as the fact that 31 million Americans remain underinsured even with the Affordable Care Act. The proposal also cites the strength of public options like the Medicare program.

The general support from the American public of a Medicare-for-All program is also vital to note. The Progressive Change Institute released a survey in 2015 of more than 1,500 voters that shows 71 percent support a Medicare Buy-In for All program.

Before the Affordable Care Act was passed into law, it was proposed to create a public option but this was blocked in Congress. President Barack Obama has come out in favor of the Medicare-for-All option this past summer. Democratic presidential nominee Hillary Clinton has also supported a public healthcare coverage plan in an economic speech on August 11, reports the news publication Common Dreams.

The campaign for a public option also gears itself toward criticizing health insurance companies like Aetna, which has dropped out of the health insurance exchanges. With UnitedHealthcare and Aetna declining participation in the public marketplace, the competition within the state exchanges declines and some payers hold a greater monopoly on healthcare coverage.

READ MORE: Affordable Care Act Replacement Seeks Automatic Enrollment

The lack of competition in the public marketplace “has created new urgency in this moment for making a public option available to every American,” said Taylor.

“Rather than refighting old political battles and trying to put insurance companies back in charge, Republicans should join Democrats in expanding choice for consumers by supporting a public health insurance option. We need more competition in the insurance markets, not less, and a public option would help reduce costs and provide consumers with more affordable options when it comes to their health insurance,” Senator Chuck Schumer (D-NY) said in a public statement.

If the public option improves competition within the health insurance exchanges, payers may come back and participate in the ACA marketplace. In fact, one of the key things that could strengthen the Affordable Care Act may be a Medicare-for-All option, according to Jacob Hacker, the Stanley Resor Professor of Political Science and the Director of the Institution for Social and Policy Studies at Yale University. An extra option like this would increase market competition, which would be necessary in certain counties that face only one or two health payers.

In an editorial for the Journal of the American Medical Association, President Barack Obama came out in favor of a public health insurance option as a way to strengthen the Affordable Care Act. Obama explained that the public payer would compete alongside private payers on the exchanges and offer more affordable health plans to consumers.

On the other side of this debate, FreedomWorks CEO Adam Brandon stated: “A government-run health insurance program could only hurt the free market and is just another example of the government’s desire to grow and control even more aspects of people’s lives. Furthermore, a public option is hardly an option – millions of Americans would be compelled to join an insurance plan that they may not want.”

READ MORE: Affordable Care Act Marketplace Consumers Face Fewer Choices

“An insurance program run by the government, and unaccountable to free market forces is a 1930s solution to a 21st Century problem. The crux of the issue is that when we speak about health, we’re talking about people’s lives. The artificially low premiums, government inefficiency, and stagnation that come attached with a public option will only unnecessarily hurt people and cost lives.”

Whether or not a public healthcare option will be available in the coming years rests solely with which political party overtakes the Senate and the House in the coming presidential election. There will need to be more progressive lawmakers available in Congress to pass this type of legislation.


This article was updated with a comment from FreedomWorks CEO Adam Brandon.


Dig Deeper:

How Payers Could Succeed in ACA Health Insurance Exchanges

How the Affordable Care Act Changed the Face of Health Insurance


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