Jan 9, 2019 - Health

More Democrats are supporting public insurance programs

New York Mayor Bill de Blasio in a rain jacket

New York City Mayor Bill de Blasio. Photo: John Lamparski/Getty Images

State and local Democrats are embracing a bigger role for public insurance programs — or at least, they want to be seen as embracing a bigger role for public insurance programs.

Driving the news: New York City Mayor Bill de Blasio put together an extensive media rollout yesterday for what he billed as a revolutionary plan to “guarantee health care for every New Yorker,” through a locally run public option.

  • Washington state Gov. Jay Inslee also announced his own plan for a statewide public option.
  • A day earlier, California Gov. Gavin Newsom called for expanding the Affordable Care Act’s premium subsidies in his state.
  • Democrats in Colorado’s legislature are also eyeing a public insurance option.
  • A handful of other states — most notably New Mexico — are also expected to look seriously at Medicaid buy-in proposals this year.

Yes, but: Some of these plans aren’t as Earth-shattering as they may seem.

  • De Blasio’s pitch, for example, largely seems to either extend or simply reiterate the availability of existing programs.
  • Details about Inslee’s proposed public option are also patchy.

The big picture: The political calculus here is a lot more clear than the policy. If you’re a Democrat, especially a progressive Democrat, especially a progressive Democrat with at least some national profile or ambition, you want to be on the side of expanding access to public insurance programs.

  • This is an echo of “Medicare for All” — a popular political alignment with a whole lot of policy debates and decisions still to come.
  • But having some work left to do on policy isn’t the end of the world.
  • States’ efforts to set up new programs, or to expand access to Medicaid, will help inform a lot of future decisions about what’s most effective and most politically feasible.
  • That will shape other states’ efforts, as well as the 2020 campaign.

Go deeper: Newsom wants to expand ACA subsidies in California

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