Okay, here's something everyone should consider.

Yes, this plan is brilliantly devious. Yes, it's Machiavellan. Yes, it has the potential to make a strong public option available to a large majority of Americans. And, yes, down the line it can reap big electoral dividends by making an incredibly sharp electoral issue for state-level Democrats.

But it's still very disturbing. The precedent that comes to mind is FDR's compromise with racist Southern Senators in the 30s to pass Social Security. Yes, they would vote for it, but in exchange the bill would have to be modified to purposefully exclude blacks.

When you're pushing this compromise, what you're essentially voting to do is give cheap affordable health insurance to everyone except poor Southern blacks and Hispanics, for the reason that certain Senators just don't want those dark-skinned types to have health insurance.

Whatever happened to solidarity with even the least of us?

Wait a imnite - Yesterday it was a "robust public option with opt out" now it's some kind of public option? This is nothing but the classic bait and switch.

It was a trial balloon floated that people decided they could live with, not they're walking it back and watering it down.

Forget this.

This is a classicly rotten Democratic compromise that gives to the Republicans and the insurance interests yet another chance to strangle the baby in the crib. What would it take to "opt out"? A legislative majority in a state? If so, everyone living where a state legislature is controlled by Republicans gets screwed. Would it require a super majority in a legislature to opt out? At least that way Democrats would have to acquiesce, but think about how much less it costs to buy state Reps and Senators than it does on the Federal level? Insurance companies would have a ball and people would suffer because of it. The states that need a public option the most are those in the south and they are all controlled by Republicans. Are we to abandon the poor and middle class in that section of the country? I think not.

I'd love to see a good public options with opt out. It would let the GOP controlled states prove to the country just how well their market forces approach would work. <&/snark;>

I'd like to see the public option that goes along with this.

Make the madate opt out as well. If a state opts out of the public option, they should opt out of the mandate as well.

I do not understand the people who are portraying this as a betrayal of the sane people in the states that might opt out. This outrage seems to rest on the assumption that once they opt out, there is no going back.

This is not the case unless the bill is specifically written that way--which it is not, and which it will not be. Such a provision would be politically impossible.

So what would happen if states did opt out?

First, it's necessary to understand the importance of this being "opt out" rather than "opt in". An opt-in program starts with the default position of nobody participating--placing the burden of action on those who want to be a part of it to take action. An opt-out program is just the opposite: the default at the beginning is everyone participating, and that places the burden of action on those who reject it--forcing them, not us, to take a politically risky stand.

But let's assume a few states do opt out. What happens then?

One of two things: the public option is successful, or it is not.

If it is not, then there is something wrong with it and it's right and proper that it be fixed before expecting reluctant states to come on board. If the PO, as first implemented, is a failure, then you're not missing out on anything by not having it as an option.

But if the PO is, as it is expected to be, overwhelmingly successful, then any politician who voted to opt their state out of it will be lucky to keep their jobs. Once the savings and benefits of the PO become too great to ignore, voting against the PO will be as nearly impossible as voting against the fire department. Social Security was a third rail of politics for decades for a very good reason: everyone except the most extreme anti-government jihadis love it.

And what you'll end up with in the end is not only a national public option, but a number of red states which are quite a bit bluer now that the pitchfork-wielding mobs have voted the crazies out of office.

I don't see a downside to this, as long as it's written properly and with a robust, comprehensive public option. It is absolutely brilliant politics that provides cover for the Blue Dogs and moderate Republicans while putting all of the pressure and political risk on those opposed to reform.

Win.

My god. For us progressives here in the deep south who are fighting tooth and nail to elect Democrats to replace these Demopubs. We NEED to be able to show how Obama has helped us with Healthcare at the very least. IF it happens that we are shut out of it... That will be a disaster in many ways. I am wondering if Obabma could ever get re-elected as it is now - the way he's let the Bush cronies STAY in the justice dept. Let them Politically railroad our last Democratic Gov, protected Bush's and Rove's emails and torchure activities, and now even my 17 year old son is hating on him for wanting to cut out some of his (getting shorter every year) summer vacation days. In my state we have NO competition in the health insurance field right now. If Obama allows this to happen, I'm going to work hard to replace him - and I was a huge supporter and gave a lot of money (for what I earn) to help him get elected.

I think because insurance is regulated on a state-by-state basis, the Republicans and any corporate-compliant politician thinks expanding coverage can be fought more successfully at the local level than the national. I think this Schumer-Carper idea stinks to high heaven.

An Opt-Out Trigger!

The counter proposal to the State Opt-Out plan is to combine it with a reverse version of Olympia Snowes trigger.

By combining the Opt-Out concept that allows states to opt out of a public Option, with a reverse Olympia Snowe trigger, AND a very strong public option, I think we can come up with a politically acceptable proposal that would provide the type of coverage we all want, and would make it politically insane to oppose.

1. We need a strong public option, we still need to keep a very close eye on this as it works it's way through the process. It must start from Day 1.

2. The Snowe trigger. Take Olympia's snow proposal, and her numbers EXACTLY, EXACTLY, EXACTLY, notice the importance I put on her numbers, and make it a reverse trigger. If the insurance companies don't perform as she defined, THAN AND ONLY THAN, individual states may choose to Opt-Out of the public option.

These are the conditions, that Olympia Snowe herself along with the support of Blue Dog Dems, that define non acceptable performance of the Insurance Companies. With the Opt-Out trigger, her definition would stand, and any opposition after previous support would be so blatantly dishonest that even the general public would see it.

Checkmate!

Political "incrementalism" at it's finest.

This opt-out scheme may just weed out some state-level obstructionists in the process, but it still represents our lawmakers falling way behind the public will.

We, the People, think and act by leaps and bounds, as our lawmakers work with incremental changes.

Maybe Jefferson and some of the founders wanted it that way, but if they saw how stretched out that slinky gets, with the lawmakers at the tail and the public at the head, they might have been more deliberate and included some sort of public referendum in the voting process, to which the lawmakers' antics could be compared and their real representation measured.

We have the tools to do it, but taking that power away from big money is like pulling a grizzly cub away from it's momma.

We are seeing these greedy HMOers getting slowly, inexorably backed against the wall, and we all need to remember how desperate a cornered beast can be. They have committed to an all-out, all-or-nothing fight against healthcare reform, almost to the point it seems like they know their end is near.

So all I can say, again, "beware the cornered beast."

They are their most dangerous when realize they are mortally wounded, (the election of 2008) and facing annihilation (public opinion swiftly gaining for a public option, which might just open the floodgates to single-payer.)

Expect much worse from them before this is over.

I really don't care one way of another on this, but is sounds like capitulation to the Tenthers who've been saying that public health insurance violates the Tenth Amendment. Our Governor, Timmy Palenty (Minnesota) has made noises about it and was supposedly looking a passing a law to prevent Federal intervention in our state. Like I said, it sounds like a capitulation to these crazies.

The comparison with FDR getting social security passed by reluctantly going along with racist southern State senators to effectively exclude poor Black people is compelling, especially to me since I live in South Carolina, a state that could easily opt out. Nevertheless, politics ain't pretty. If you aren't willing to get your hands dirty, you will never be effective in government. The bottom line is that poor minorities in the South and everywhere else DO now have social security. None of us would have this excellent government program if FDR hadn't made this unsavory deal. In the 30s I would have held my nose and voted for FDR's social security bill (though Elanor Roosevelt would have screamed at me), and I would today hold my nose and vote for the current bill with a strong public option, but a provision that allows states to opt out. Hopefully, the opt-out provision could be repealed in the future. It looks like the alternative would be a terrible bill or no bill at all. I do have my limits. I would vote no if the bill ended up with no public option or a weak public option. It could be many years before we have another chance at this.

I don't quite understand the proposal.
A state Legislature can vote to let citizens die in the gutter without health care, but what is the upside for opting-out states? Would they be paying less?

A couple of observations:

- in Texas, most if the districts are fixed, there will be no change.
Remember Perry called THREE special sessions to fix the boundaries

- I assume most employees (like myself) would prefer to continue my
probably superior insurance, rather than drop to the PO

- the poor will need the PO, but they cannot dislodge the entrenched
republicans

- meanwhile, people will continue dying without insurance

So we will end up paying taxes to cover people in other states; I bet
that will be Perry's next move: to somehow challenge that.

I think this is absolutely heinous! The longer this goes on the bigger the capitulation is to the party of NO, and the weaker the reform gets every time. And for WHAT?

Schumer's version of the public option in the Senate Finance Committee had more support amongst this conservative group because it made the option a LESS powerful competitor against private insurers; and now he wants to further diminish the effects of an option by severely reducing the potential risk pool and thereby damaging its viability too? What of the disenfranchised citizens who want this choice in the states that opt-out? I'm pretty sure the parameters of an 'opt-out' will be harsh too. I'm cringing just thinking about a state's inability to enter the option (for so many years, etc...) after it has opted out; how permanent will THAT be?

I'd say this capitulation only amounts to another victory for private insurers, who will maintain their tyranny in states that opt-out. I say no, or rather, HELL NO!

The opt-out is electoral poison for the current iteration of the GOP. Those rural counties aren't going to stay Republican strongholds for long once they see what their representatives are voting away from them.