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A Public Plan Alternative?

This article is more than 10 years old.

As the debate on Capitol Hill about whether to let uninsured Americans buy into a government run health plan, like Medicare, becomes more polarized, some stakeholders are floating what they say could be middle ground options. A few days ago, Senator Max Baucus said his health care reform bill (due out this week), might establish an insurance cooperative instead of a public plan based on Medicare. An insurance co-op is run by it's members. Trade and professional associations have used this model to increase the buying power of individuals. But these groups don't always have the money or clout to bargain for lower insurance premiums.

House leaders say they are not interested in creating insurance cooperatives.

Another "compromise" option that is getting some attention would let uninsured residents buy into their state employee plan. In Massachusetts that would be the Group Insurance Commission where workers chose from several different private insurance programs. The GIC typically holds premium increases to half or less of the going rates for private health insurance.

In doing so, the GIC does keep pressure on major health insurers to find savings. But I doubt that the GIC, or other state employee plans, would satisfy those who want a new government run insurance program that could pave the way for national health insurance.

Some state employee plan directors say the mechanics of this option are tricky. How would they collect premiums outside the state payroll system? How would adding a new population of members who may be behind on caring for their health affect the costs of coverage for existing members? These and other questions are part of a fluid, dynamic conversation in what President Obama calls the make or break period for national health reform in Washington, DC.

Martha Bebinger

This program aired on June 14, 2009. The audio for this program is not available.

Martha Bebinger Twitter Reporter
Martha Bebinger covers health care and other general assignments for WBUR.

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