It's almost as if they want to give the GOP an excuse to make the election even more about health care than it's already going to be... maybe they really do believe that the bill is going to be a net positive in the eyes of voters.

There was no other provision during the legislative debate that was nearly as divisive, or as enraging to the grassroots, as the government-run "option". Even the Blue Dogs balked at the idea of this one (which uses Medicare rates "plus a little"). We know that a plan like this would make everyone else's health care more expensive, and thus end up being the only plan as people were forced to migrate into it... and once it is the only plan, time for all the problems you see in countries with single-payer (have your pick: waiting lines, government rationing, shortages, etc.).

We have been through all the rotten things about this proposal over and over on this blog. See here, or here, or here. It would be a deficit nightmare, as it becomes a gigantic Medicare program covering all Americans (even if forcing doctors to accept artificially low payments is a good way to game a CBO score).Perhaps this proposal is an attempt to rally the despondent base, but it seems more like a political gaffe. Remember the Kaiser polls that repeatedly showed that when you surround this issue with lovey-dovey rhetoric, people are neutral, but as soon as you mention possible consequences of a government-run health plan, people become vastly opposed?

I think the "Repeal and Replace" caucus is going to owe the Progressive Caucus a nice thank-you note for this one.

It took less than four months for the liberal wing of the Democratic party to introduce an amendment to the Affordable Care Act. Rep Lynne Woolsey (D-CA) introduced the Public Option Act along with 128 co-signers on July 21. The CBO claims that the new public option would reduce the deficit by $53 billion between 2014 and 2019.

The only way the deficit can be reduced is, if starting in 2014, premiums in the government insurance plan are priced below what private insurers can offer in the exchanges, care is rationed or denied, and providers receive lower reimbursements. Private insurers will ultimately be crowded out ot the market if this amendment is passed and the United States will be on its way to a single-payer, government-run insurance plan--Medicare for All. I have been warning of this outcome since President Obama said during the campaign that his number one domestic policy agenda item would be health care reform. As a Canadian who grew up under a single-payer system, it is inevitable that Americans will face the same issues as Canadians--denied care, long waiting lists, and lack of access to the latest technology for treatments and procedures if the public option becomes a reality.

The only cost control device advocates of a public plan have ever proposed is racheting down the fees paid to providers. In this case, they apparently intend to pay Medicare plus 5%, and since Medicare rates are going to plummet under the recently passed legislation, we are talking about fees way below what the private sector will pay.

Two problems: (1) Squeezing the providers does not control costs, it shifts costs from patients and taxpayers to doctors, nurses, physicians assistants, etc. But why should the people who provide our health care be singled out for assesment? Isn't the goal of universal health care a social goal that everyone should contribute to? (2) It will lead to a widening gap between the fees paid by Medicare, Medicaid and the new public plan and the rates paid by everyone else. This will lead to a two tiered health care system in which the sickest and poorest patients will be pushed to the end of the rationing lines.

The Democrats’ new public option proposal underscores the point I made recently that the “health reform wars have only just begun.” Issues like the public option; who will ultimately run the exchanges; and how we will actually control health spending all remain in play and will have to be resolved. The public option would “resolve” the spending problem by simply forcing down payments and prices until spending declines. In an accounting sense that will work, as CBO shows, but only by hollowing out health benefits as doctors leave, quality suffers and waiting lists increase.

Will it pass? No time soon. But the real story is that public option proponents have likely already achieved their objective through the “OPM alternative” included in the enacted legislation. Far from being an alternative, it is the fast road to a public plan – as I warned before the legislation passed. Why? Because the “alternative” gives the Office of Personnel Management the power to establish national plans. These are to be private – but in name only. OPM already has enormous reserve powers to establish and regulate private national plans for federal workers. The Administration can use these powers to set up a national public option network in which merely the bill-paying function is privately managed, just as in much of Medicare. For the “alternative,” the legislation adds sweeping new OPM powers to negotiate medical-loss ratios, minimum benefits, premiums, profit margins, and “such other terms and conditions as are in the interests of enrollees in such plans.” Sounds like a much tougher public option than last week’s proposal.

The new Democratic bill will catch all the passion and anger. But it will be a phony war and a smokescreen. If the OPM alternative remains in law the advocates of the public option have already achieved their goal.

Health reform is a historic step that will expand health coverage to 94% of all Americans. But, health reform isn't a one time job. We must continue to build on it. That's why 128 of us in the House have joined together to reintroduce legislation creating a public health insurance option.

A public option plan would be focused on delivering quality, efficient health care across our country -- not shareholder returns or market share. Because of this key difference with private health insurance plans, it would introduce competition into a market that is is often described as "highly concentrated." This new competition would bring down costs for consumers. The Congressional Budget Office estimates that a public option's premiums would be five to seven percent cheaper than private plans. It would also expand choice and put pressure on insurance companies to lower their premiums and better serve their enrollees.

CBO tells us that the public option will save $68 billion by bringing down health care costs in the exchanges. Anyone who is serious about reducing the deficit, or committing to pay for government spending must seriously consider this proposal. My colleague on the Fiscal Commission, Jan Schakowsky, has already presented this idea and is pushing for a public option to be a recommendation of the Commission.