The Politics of Opt-Out

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Andrew Sullivan thinks the “opt-out” public option is a piece of political genius.  Imagine, he says, what happens next if it passes:

Well, there has to be a debate in every state in which Republicans, where they hold a majority or the governorship, will presumably decide to deny their own voters the option to get a cheaper health insurance plan. When others in other states can get such a plan, will there not be pressure on the GOP to help their own base? Won’t Bill O’Reilly’s gaffe — when he said what he believed rather than what Roger Ailes wants him to say — be salient? Won’t many people — many Republican voters — actually ask: why can’t I have what they’re having?

….Imagine Republicans in state legislatures having to argue and posture against an affordable health insurance plan for the folks, as O’Reilly calls them, while evil liberals provide it elsewhere. Now, of course, if the public option is a disaster in some states, this argument could work in the long run. But in the short run? It’s political nightmare for the right as it is currently constituted. In fact, I can see a public option becoming the equivalent of Medicare in the public psyche if it works as it should. Try running against Medicare.

I was mulling over the exact same scenario last night and couldn’t quite make up my mind about how this would play out.  In the end, though, I think Andrew’s argument is pretty compelling.  As Rich Lowry complained over at The Corner, “Does a state get to opt-out of the taxes too?”  That’s technically a moot point if the public option is truly self-funding, but in the reality of the political world it’s powerful whether it makes sense or not.  It’s like Republican governors turning down stimulus money: it sounds good on the stump, but who’s going to do it in the real world?  It’s crazy if you’re paying for it anyway.

So yes, this could be a huge winner.  If it passes, then for the next four years Republican state legislators all over the country will be teaming up with the universally loathed insurance industry to try and deny their citizens access to a program that, to most of them, sounds like a pretty good deal.  I don’t know if Harry Reid was deviously thinking exactly that thought when he decided on this, but I’ll bet someone was.  It’s hard to think of something that could force the GOP to make itself even more unpopular than it already is, but this might be it.

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