In Our View: ‘Public-Option’ Health Care

Gov. Jay Inslee’s proposal for a “public-option” health care plan in Washington is interesting but will require extensive vetting. As with any grandiose idea, the devil is in the details, and there is much we don’t know about Inslee’s effort to shore up health care coverage throughout the state.

In the meantime, the proposal from Inslee and Democratic lawmakers reflects the inevitable reaction to Republican efforts to undermine the Affordable Care Act, colloquially known as Obamacare. Rather than repealing and replacing Obamacare — as Republicans in Washington, D.C., long promised — the party spent the past two years working to destroy the law from within. That strategy could backfire, as Democratic-led states are inching closer and closer to single-payer health insurance.

“We are proposing to the state Legislature that we have a public option that is available throughout the state of Washington so that we can increase the ability to move forward on the road to universal health care,” Inslee said Tuesday. Also this week, New York City Mayor Bill de Blasio proposed a $100 million-a-year plan to expand health care coverage for those who lack it, and new California Gov. Gavin Newsom proposed reinstating a requirement that individuals have health insurance or pay a tax, with plans to expand that state’s health care. In both cases, coverage would extend to undocumented immigrants.

There is no telling whether these proposals will gain traction in the requisite state houses and city council. But they are indicative of the continuing debate over health care and are representative of the need for Congress and the Trump administration to demonstrate leadership on the issue.

Rep. Jaime Herrera Beutler, R-Battle Ground, took a step this week by introducing a bill to protect coverage for those with pre-existing conditions, but such leadership was nonexistent during the two years Republicans had control of the House, Senate and White House. Despite spending the previous six years decrying Obamacare, Republicans failed to devise an alternative and were unable to fulfill vows to overturn the law; instead, the administration worked to destabilize it.

As part of the tax bill passed in late 2017, Republicans removed the individual mandate; they slashed marketing budgets for promoting Obamacare; they narrowed the window for sign-ups; and they allowed for coverage plans that provide scant coverage and previously were impermissible. Last month, a federal judge in Texas ruled that removal of the individual mandate rendered the entire law unconstitutional, a ruling that has been stayed pending appeal.

That strategy has, indeed, undermined Obamacare. With uncertainty over the law contributing to insurers pulling out of the market, residents in 14 Washington counties have only one coverage plan available this year on the market’s exchange. State Rep. Eileen Cody, D-Seattle, said in support of Inslee’s plan, “This is the step that we can take to make sure we are offering our citizens a plan that looks like Medicare.”

It will be up to lawmakers to determine whether that would be beneficial to Washingtonians. In truth, the proposal is unlikely to gain much traction this year in the Legislature; big ideas often require years to gain momentum.

But the proposal itself signals a coming clash over health care. Still holding control of the Senate and the White House, Republicans in Washington, D.C., must lead the way in devising realistic changes to Obamacare; they might not like the alternatives.