What You Should Know

For decades, progressive policy leaders have pushed to create a national public option for health coverage, which would allow all Americans to buy health insurance through a government program. So far, they have failed to enact such a policy, but the idea continues to show up in bills at the federal and state levels. 

Supporters argue that the public option is necessary to increase the number of Americans with health coverage, particularly in areas where the health insurance market is not competitive. Indeed, many Americans who buy health insurance through the exchanges created by the Affordable Care Act (or ObamaCare) have only one “choice” of insurer. The portion of enrollees in this predicament peaked in 2018 at 26 percent. 

Policymakers should work to make health insurance more affordable and competitive, but adding a public option won’t achieve this. Any new government-run health plan is likely to face the problems already present in Medicare and Medicaid (programs for seniors and low-income people, respectively), namely: unsustainable budgets, less access to health care (in spite of health insurance coverage) and worse health outcomes.

Perhaps of greatest concern, a public option would speed the U.S. along a path to completely government-run health care. When the public option becomes the only option, the government becomes the only payer, or single payer, for health care. We should avoid this path, which will result in fewer options, not more, for patients, as well as a decrease in the overall quality of health care available and a less healthy society.