Public Option with "Trigger"

The last few weeks the media and the politicians have all been focusing on the public option in a health care plan. Steve Benen notes that a "public option would improve the system by lowering costs, expanding access, and using competition to improve efficiency."

The President likes the idea of a public option. Obama has even stated that, "I am pleased by the progress we're making on health care reform and still believe, as I've said before, that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest. I look forward to a final product that achieves these very important goals."

For those who are not fans of the public option there has been talk of a "trigger." Olympia Snowe, the Senator from Maine, wants to prolong the public option with a "trigger mechanism."

According to the Associated Press, Sen. Olympia Snowe (R-ME)--a potentially key moderate on the Senate Finance Committee--hasn't forsworn signing on to a health reform bill that includes a public option. But she's holding out to see it affixed to a "trigger mechanism," which would, in theory, give insurance companies a years-long window to lower costs on their own and only "trigger" the public option if they failed to do so.

"If you establish a public option at the forefront that goes head-to-head and competes with the private health insurance market ... the public option will have significant price advantages," Snowe said. But this was her argument against making the public option available as soon as the bill becomes law.

So why would anyone want to wait longer to see if insurance companies can bring down health care costs when the system being used hasn't worked?

Here's why:

Those who like the idea of a "trigger" argue that if we pass a reform package and private insurers can lower costs, expand access, and improve efficiency on their own, we wouldn't need a public option. It's better, they say, to wait for the system to get really awful before utilizing a public option to make things better.

The problem should be obvious: if proponents of such an idea realize that a public option would necessarily improve the overall system -- and they must, otherwise there would be no need for the trigger to kick in when things got even worse -- then why deliberately delay implementation of the part of the policy that lawmakers already realize would help?

Or, put another way, if Snowe knows a public option is a good idea, there's no reason to push it off to some arbitrary date in the future, as the system deteriorates in the interim.

Why is Rahm Emanuel now raising the idea of the "trigger"?

White House Chief of Staff Rahm Emanuel irked quite a few members of his own party yesterday when he told the Wall Street Journal how flexible the administration is on health care reform. To hear Emanuel tell it, the White House would accept a "triggers" provision favored by some centrist Republicans, and isn't wedded to a public option.

As luck would have it, Emanuel also headed to Capitol Hill yesterday afternoon for a meeting with some of the same lawmakers he'd just annoyed with his comments. Roll Call reported that the president's chief of staff got an earful, but "reassured" Democrats that the White House still wants a public option in the reform package.

Progressive Caucus Co-Chairwoman Lynn Woolsey (D-Calif.) warned Emanuel that he would lose the caucus' votes if the White House compromised on the issue and included a "trigger" that could delay a public insurance plan indefinitely. The trigger idea is backed by conservative Democrats but is anathema to liberals.

"We have compromised enough, and we are not going to compromise on any kind of trigger game," Woolsey said she told Emanuel. "People clapped all over the place. We mean it, and not just progressives."

Emanuel wants to negotiate? Who is he negotiating with...the Republicans who don't want to change the for-profit system of health care..or the insurance companies who don't want to change the for-proft system of health care? There seems to be no wiggle room!