Liberals See Open Door for Public Option, Single-Payer Healthcare

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Liberals say President Obama’s support for accelerating state waivers for the healthcare reform law creates new opportunity for the federal government to back more liberal healthcare policies rejected during past debate over the reform law.

Obama on Monday endorsed a Senate bill that allows states to seek earlier exemptions from the reform law in order to build their own healthcare systems that meet the law’s coverage and affordability goals. The federal law currently provides the waiver option in 2017, but Obama is backing a bill from Sens. Ron Wyden (D-Ore.), Scott Brown (R-Mass.) and Mary Landrieu (D-La.) that would move the date up to 2014.

The original healthcare reform bill included a public-option insurance plan to compete with the private market, but it was dropped months before the final law passed. Consumer Watchdog said the accelerated waiver program gives liberal states the leeway to implement more progressive reforms.

“State waivers give progressive reformers in California and elsewhere the ability to move forward on ambitious reform plans that can pass at the ballot box in 24 states but would never get the time of day in Washington,” Consumer Watchdog President Jamie Court said in a statement.

Rep. Peter Welch (D-Vt.), who is sponsoring similar legislation in the House, told The Hill that Obama is acknowledging that a “one-size-fits-all” plan is not necessarily the way to go.

“If a state wanted to pursue a public option or private market approach, they’d be free to do it,” said Welch, whose governor is pushing for a single-payer healthcare system.
Vermont Sens. Patrick Leahy (D) and Bernie Sanders (I) said last month that the waiver bill would give their state the flexibility needed for a single-payer system.

“This state waiver bill will give Vermont and other states the choice to go above and beyond what the federal health care law does by devising their own reforms,” Leahy said in a statement last month.

Other liberal groups were putting a positive spin on the White House announcement Monday.

“The law has always recognized that the best way to expand and improve coverage is for states to implement reform in ways that are smart, efficient and work best for them without falling short of the healthcare law’s important quality and coverage benchmarks,” said Ethan Rome, executive director of Health Care for America Now.

The pro-reform Families USA group stressed that Obama’s announcement does not alter the healthcare law's goals, but it urged caution in setting waiver benchmarks for comparability.

“It will be critically important that regulations defining allowable State Innovation Waivers require premiums, benefits, cost-sharing for services, deductibles, and out-of-pocket costs to be at least as protective for families at each income level as provided in Medicaid and exchanges under the Affordable Care Act,” said Families USA Director Ron Pollack. 

The administration said on Monday it would propose waiver regulations in the spring.

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