Public option escape hatch?
State public option opt-out proceeds in U.S. SenateThe health insurance reform debate could very well move to the Arkansas Capitol if the U.S. Senate's new version of the health reform bill becomes law. Senate Majority Leader Harry Reid announced that the new provision will allow states to opt out and reject participation in any policy that includes a national public option.
The chart to the right shows the states with the highest and lowest rate of uninsured residents (Arkansas ranks 40th). Here are some early specifics about how the opt-out would work, should it make the final bill signed into law. In his press conference, Reid said that states could not opt out before 2014.
2011-2012: National insurance exchange is phased in; consumer reforms begin taking effect.
2013: Public Option goes into effect. Americans are mandated to have insurance coverage.
2014: States can opt out with the exact process to be determined. Apparently, the opt-out will require a 2/3 vote of the state legislature, with the governor able to veto an opt-out. I don't have a link to this timeline -- it's simply what I'm being fed from people in the know.
Under this scenario, Arkansas residents would participate in the public option (if they qualify) in 2013. The legislature would then have to vote to opt out of the plan the next year. What is also apparent is that regardless of the opt-out provision, states CANNOT opt out of any reforms that prevent rescission or the denial of coverage for a pre-existing condition pursuant to the legislation.
One interesting aspect of this scenario if it happens -- we'll be able to see tangible results as to whether a public option works between the states who opt-out vs. the states who remain in the system. Will physicians flock to the states who opt-out to avoid a potential decline in reimbursement rates? Will insurance premiums be more competitive in the states who remain in the system? How will the quality of health care vary between these states? Do the states who opt-out still share in the burden of funding a national public option? Can state legislatures preempt such legislation by enacting pro-active legislation before 2014?
The chart to the right shows the states with the highest and lowest rate of uninsured residents (Arkansas ranks 40th). Here are some early specifics about how the opt-out would work, should it make the final bill signed into law. In his press conference, Reid said that states could not opt out before 2014.
2011-2012: National insurance exchange is phased in; consumer reforms begin taking effect.
2013: Public Option goes into effect. Americans are mandated to have insurance coverage.
2014: States can opt out with the exact process to be determined. Apparently, the opt-out will require a 2/3 vote of the state legislature, with the governor able to veto an opt-out. I don't have a link to this timeline -- it's simply what I'm being fed from people in the know.
Under this scenario, Arkansas residents would participate in the public option (if they qualify) in 2013. The legislature would then have to vote to opt out of the plan the next year. What is also apparent is that regardless of the opt-out provision, states CANNOT opt out of any reforms that prevent rescission or the denial of coverage for a pre-existing condition pursuant to the legislation.
One interesting aspect of this scenario if it happens -- we'll be able to see tangible results as to whether a public option works between the states who opt-out vs. the states who remain in the system. Will physicians flock to the states who opt-out to avoid a potential decline in reimbursement rates? Will insurance premiums be more competitive in the states who remain in the system? How will the quality of health care vary between these states? Do the states who opt-out still share in the burden of funding a national public option? Can state legislatures preempt such legislation by enacting pro-active legislation before 2014?
posted by Steve Harrelson @ 10/27/2009 06:27:00 AM | Permalink |
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