More Democrats are supporting public insurance programs

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