Should Democrats press the public option?

health-careThere’s no question that the Affordable Care Act’s rollout has been “rocky,” to borrow the common parlance of the Beltway. The Web site troubles and shifting health coverage for some Americans, despite over-assurances from President Obama during the 2010 political debate, have naturally turned off some people. A much-ballyhooed poll from CNN yesterday shows that support for “Obamacare” has dropped to an all-time low.

But conservatives toasting the apparent turn in public opinion ought to look a little closer at the polling data. It’s true that only 35 percent of Americans favor the law, while 43 percent oppose it. But there’s a crucial third group: 15 percent oppose the ACA because it’s “not liberal enough.” That means that 50 percent of Americans either support the law or want policy changes that shift leftward.

Looking at the polls in that light suddenly shifts the political calculus. Republicans who want to repeal and “replace” the legislation — with measures that have never been entirely clear, especially when it comes to the most popular provisions of the ACA — are suddenly facing an uphill battle with the public.

This presents a pretty clear road map for Democrats worried that the biggest legislative achievement of the Obama era might turn against them. The CNN/ORC poll didn’t press people on what, exactly, “not liberal enough” meant, but it’s not hard to imagine what those people might want. Recall that while the legislation was being crafted, the public broadly supported a “public option” in the bill that would allow people purchasing insurance on the exchanges to select a federal health insurance plan.

So what if Democrats pushed for it? A public option would save $100 billion over 10 years, according to the Congressional Budget Office, and could offer respite from the plan cancellations and rate hikes that still persist with private insurers with the ACA in place.

There’s essentially no chance President Obama will take another bite at the health-care apple, especially with so many other priorities to tackle: his professed desire to combat climate change and income inequality before he leaves office, along with getting comprehensive immigration reform passed. But strategists on 2016 presidential campaigns ought to take heed.

Imagine a candidate who comes out early, and strong, for adding a public option to the ACA exchanges. It could become a signature issue with the liberal grass roots during the primaries, and it wouldn’t be a bad general election issue either — the polls in 2010 showed support for a public option among Republicans and independents as well as Democrats. As Ezra Klein has noted, the sudden disappearance of the public option from Democratic politics has been “a bit curious,” but perhaps its day is coming.

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