Blocks with health care symbols Washington's set of tiered public plans will cover “standard services” while offering coverage at a cost up to 10 percent less than comparable private insurance. (Photo: ShutterstocK)

The debate in Washington about how to fix the health care system continues to rage on, with various options proposed and debated. Across the country, the state of Washington is taking actions, implementing the first public option for its residents.

According to the Associated Press, the new option will be universally available to residents regardless of income by 2021. The set of tiered public plans will cover “standard services” while offering coverage at a cost up to 10 percent less than comparable private insurance. That lower cost is due in part to the fact that providers are subject to a cap on rates they can charge to customers.

The plan has already been approved by the state legislature, with Governor Jay Inslee expected to sign it into law.

Washington isn't the only state venturing a toe into the public option pool, with arguments set to erupt in the Connecticut state legislature over proposed legislation to create a public option that supporters say will help small businesses provide coverage to workers. The Connecticut Mirror reports that battle is about to be joined, however, with big insurers in the state arrayed on one side together with the Connecticut Business and Industry Association against state Comptroller Kevin Lembo, the Democrat-controlled General Assembly and patient advocates.

While Washington is offering a hybrid system that retains private insurers to manage the new public option plans, Connecticut's public option would be administered by the state—and insurers, which make up a powerful lobby in the state, are fiercely opposed, claiming that “a public option would harm the state's insurance industry, potentially leading to job losses. They also contend it would disturb insurance markets by raising costs for everyone else, prove unaffordable for businesses it aims to help and add to the state's indebtedness.”

“It will be disruptive to the marketplace and not do anything,” CBIA CEO Joe Brennan told the Mirror, adding, “This product, as far as we can tell, does nothing to address the cost of care.”

Insurers and the CBIA are lobbying fiercely against the proposal, although backers counter that the “legislation would provide small businesses with a desperately needed alternative to increasingly unaffordable commercial plans, while injecting greater competition to force down prices.”

“It's a full court press to prevent this from happening,” said state Rep. Sean Scanlon, co-chairman of the legislature's Insurance and Real Estate Committee and a strong supporter of the public option. “That's something you can see on a daily basis at the state Capitol.”

The proposal has already made it past procedural obstacles, although it's not certain that the governor will sign it should it pass. It would create a public option for businesses with 50 or fewer employees, with the comptroller's office, which already runs the state's health plans, handling administration.

Lembo did say that he would contract with insurers to run the plan, thus avoiding potential job losses; in addition, he said in the report that by making it easier for small businesses to offer insurance to employees, it would stimulate job creation through making it easier to launch a business.

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Marlene Satter

Marlene Y. Satter has worked in and written about the financial industry for decades.