Truth Emerges about the Public Option

Who really will be allowed to join?

Sunday on This Week with George Stephanopoulos, George and his guests suddenly realized that the public option, whatever shape it takes, will be very limited. While it’s good to see the MSM finally get real about the public option, Campaign Desk has been making this point for some time. In fact, we did a search of media coverage of the public option and discovered that the press pretty much avoided telling the public that the public plan would not be for most of them. Between August 15 and September 15, a Factiva search turned up 2335 stories in newspapers, business publications, and general interest publications mentioning a public plan. But when it came to telling readers who could actually join, only seventy-six outlets gave the full story.

Currently, lawmakers would restrict the public option to small businesses buying coverage for their workers and people seeking policies in the individual market. The plan would be off-limits to the millions of Americans who get their insurance from employers. The limitation, of course, is meant to prevent “crowd out”—that’s jargon for taking too much business away from private insurers. With so few people using the plan, though, it’s hard to see how it will lower health care costs or compete against the likes of insurance giant WellPoint, which is aggressively marketing very cheap and very limited insurance products to individuals.

Sunday, Stephanopoulos drilled his guest, Missouri Sen. Claire McCaskill, about the public option. She said there was “some kind of opportunity to go to a public not-for-profit option among many private options” that people without insurance now could use. Then she conflated the public option with the insurance exchange, the government brokerage service called for by the draft bill. McCaskill pointed out that “not everybody can even go to this exchange and buy insurance with any kind of subsidy,” and that a “fairly limited number of people—twenty-five to thirty million—would even be on this insurance exchange.”

Stephanopoulos then turned to his panelists, where Atlanta Journal-Constitution political columnist Cynthia Tucker further narrowed the scope of the public plan. Stephanopoulos asked if people actually realized how limited the public plan would be, noting that the Congressional Budget Office estimated that only about twelve million people would be able to use such a plan; if states opted out, the number would be even smaller.

Tucker came back with a figure of “ten to twelve million people within a decade,” pointing out that Obama himself has said a public option is only a sliver of health care reform. The public plan for which liberals and progressives are fighting so hard, she said, is neither a panacea nor an evil government takeover. All of which makes the larger point—there are more important aspects of reform to talk about.

Last week on MSNBC’s Countdown, Keith Olbermann also discovered the limitations of the public plan. Olbermann quoted Oregon Sen. Ron Wyden, who said that more than 200 million Americans would not qualify for such a plan. Olbermann noted that only very small companies and those people who cannot afford to get private insurance would be able to use it. In other words, said Olbermann, the public plan would be for “everyone who could not get it (insurance) otherwise.”

Reporters and editors take note: If you want to keep making the public option the continual political story du jour, please tell your audiences that most of them won’t even be able to use the plan. But we suggest that time and space might be better used discussing the individual mandate, and how much money people will have to find in their budgets to pay for the coverage they will be required to buy. It’s the affordability issue, really.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.