Hillary Clinton re-embraces the public option for health care.
When the Democrats spar over health care, former Secretary of State Hillary Clinton likes to remind the audience that after the Obama administration’s health care reforms, “we are at 90% coverage. We have to get the remaining 10.” The question is how to do it, and Clinton doesn’t have a simple or comprehensive answer like her rival, Bernie Sanders, who has vowed to make single-payer health care a reality. One answer for Clinton is a public health insurance option: a popular progressive solution to drive down health care costs that Clinton enthusiastically supported while running for president in 2008. It was not included in her health care policy roll-out—at least at first. After Quartz asked last week why the idea didn’t merit a mention by Clinton’s campaign website, it was updated to reference the public option. “We regularly update our website with additional details on Hillary Clinton’s policy positions,” a spokesperson said. During a January debate, Clinton said that “even when the Democrats were in charge of the Congress, we couldn’t get the votes for [the public option].” And previously, her aides have been diffident, with national spokesperson Brian Fallon brushing aside a query about the public option on MSNBC—”Sure. Public option, sure.”—to explain that Clinton and Sanders agree about the need to cover everyone. But, just as Sanders must field awkward questions about whether his plan can even be implemented, Clinton must answer how she will cover everyone under the patchwork Affordable Care Act, which has dramatically increased health insurance coverage without fully extending universal coverage. The good news? A lot of the uninsured, almost half, are eligible for government aid already: That means part of the problem is still about public awareness—making sure people are aware of the help they are entitled to, and encouraging them to enroll. The bad news? Subsidies probably aren’t high enough. Data from Kaiser Health News suggests that most uninsured people don’t get coverage because they can’t afford it, even with government support. Sanders’ plan to simply guarantee health care for everyone would help eliminate the hurdles caused by fears of ineligibility. It would also eliminate the 15% of uninsured Americans who are ineligible for subsidies because they declined an insurance offer from their employers, and the 9% who would qualify for Medicaid if their states agreed to join the federal government in expanding its reach. During the Obamacare debate, some saw a public insurance option as a good halfway point to maximize the efficiency of single-payer without driving insurance companies out of business. The idea’s eventual failure was celebrated by some health care wonks who saw it as a distraction from the more important parts of health insurance reform.