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Is the public option dead? Not quite.

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John Moore GETTY IMAGES

Jonathan Bernstein wonders whether, post-health reform, liberals have forgotten about the public option. Politically, he finds, there’s decent support for saying they have:

It’s still very early, but the first hints are a lot less promising than I would have expected for public option supporters. I checked the web sites of non-incumbent Democrats running for the Senate with decent chances of winning this year: those running in open seats and weak Republican seats in Nevada and Massachusetts. Of the seven candidates in six states that I looked at who had issue positions listed (a few still have only placeholder or minimal sites so far), none of them mentioned a public option. None. Two mentioned drug reimportation; two didn’t mention health care at all.

But in terms of policy, it’s a bit of a different story: A handful of states are using the health reform law to test out various government-run health plans.

NPR’s Sarah Varney reports on the Alameda Alliance for Health, a nonprofit health plan run by a county in Northern California that plans to compete against private insurance companies when the state’s health insurance exchange launches in 2014:

In 2014, under the federal health overhaul law, millions of Americans will be able to buy coverage through state-based insurance exchanges. In California, government-run public plans, like the Alameda Alliance for Health, will go head-to-head with private insurance companies to compete for all those new customers, and those who run the county plans believe they can offer a robust network of doctors and hospitals to bargain shoppers looking for low-cost coverage.
“I think when some people get to make a choice,” says [Alameda Alliance for Health CEO Ingrid] Lamirault, “having local offices they can walk into and get help with things and get their questions answered, and when they call customer service they get their calls answered in under two minutes. Those kinds of things are important to them.”

Other states, too, are taking some steps toward similar approaches. Montana is exploring how to open up its Medicaid program to public employees and, eventually, to any citizens in the state, although it’s unclear whether the state will receive waiver authority to do so. Oregon is toying with a similar approach just as Vermont moves forward on its plan to go single-payer. The public option may not have much political traction, but in terms of state policy it isn’t dead either.

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