These state plans share the same objectives as Democratic proposals in Congress — to boost the number of people with health insurance or to make insurance more affordable to patients — but they differ in one important way: They don’t face the obstacle of a GOP-controlled Senate.
“Realistically, the gridlock in Congress is going to be there for the next two years, so to move the ball in a substantial way, states are going to have to take a strong leadership role,” said Tom Kise, spokesman for United States of Care, a nonpartisan research and advocacy organization.
At the top of the Democrats’ agenda is a state-run “public option.” Legislators in Illinois, Minnesota, Nevada, New Mexico, and Washington state are all pursuing forms of a state-operated insurance plan, which is meant to spur competition against private insurance to lower prices. The Obamacare legislation included a public option in its first draft, but the provision was removed before the law was passed.
The lessons that state lawmakers learn in the course of framing, passing, and implementing public option legislation could later prove valuable to legislators in other states or in Washington, D.C.