| Uninsured Texans desperate for health insurance reform may be shut out from participation if the public plan becomes an "option" decided on at the state level. This means that Republicans at the state level might be able to block certain aspects of Federal health insurance reform.
Some Senate Democrats representing Red States (so designated by Presidential preference) are reticent to support a robust public option, the likes of which would let uninsured folks buy in to a government-run insurance plan if faced with a lack of coverage. Meanwhile, Senate Republicans are united in their opposition to a strong public program to give all Americans access to health care. Per TPM, the latest "compromise" to pass any sort of public option might allow individual states to "opt out" of the national plan:
Both conservative and liberal Democrats seem to be open to a new public option proposal floated by Sens. Chuck Schumer (D-NY) and Tom Carper (D-DE) to allow states not to participate in the plan if they decide they don't want to.
Now, most importantly, Red States can't opt out of reforms to the insurance industry, thus making President Obama's overall goals for reform--an end to recission, no denials for pre-existing conditions, caps on out-of-pocket expenditures and premiums--the keys that will force real reform on the corporate insurance providers. These are all really important strides forward for a state that has watched insurance premiums rise 91.6% under Governor Perry. However, this compromise would hurt folks in opted-out states who lack any other choice except for a government-provided plan. The mandate to carry insurance would still exist for Texans, who thus would be forced to buy into a corporate plan.
Admittedly, I have a hard time envisioning a scenario in which the Lone Star State doesn't opt out of the public option. Texas has a preponderance of elected Republicans who simply don't want the people of Texas to have access to health care. Governor Rick Perry openly advocates for leaving the nation. Why should we expect him to opt in to a public option? Whether via the Republican Governor, Republican-majority State House and Senate, or Republican-majority Congressional/Senatorial delegation, I fail to see how Texas--home to the highest rate of uninsured residents of any state in the country--manages to stay opted in. Granted, this proposal is far from being complete or specific. But unless there is a component that strongly compels every state to participate, this latest compromise could end up hurting the Texans who need this reform the most. As a Red State resident, I strongly urge Congress not to let some of the neediest states escape without the reform we need.
People in Red States basically rely on Federal policies to mitigate the harm perpetrated on us by our own elected officials. Because we live in Texas, because we've been gerrymandered into a scenario where both houses of our legislature and Congressional delegations are majority-troglodyte, we might not end up with the same right to access care as folks in states with sane representation at any level. And while this is a pretty strong argument as to why we need to elect more Democrats in Texas at the state and local level, it's not OK for more of our people to suffer needlessly while we work towards doing it.
The graphic to the right shows the rates of uninsured by state. We're the worst. Texas is the worst. The people of Texas need help. We've already been abandoned by our own state officials. We can't let the folks in the Federal level do the same. The people of Texas deserve the same access to health care as any other state in the nation.
Here's what you can do: call your Representative NOW. Urge them to pass real health care reform, that not only includes strong consumer protections and industry regulation, but also doesn't allow individual states to opt out of the public option.
I'm ultimately a pragmatist, a utilitarian. I understand that no public option is far worse for our nation as a whole than a public option for just some of us. I'm just tired of public policy that gives benefits to some, not all. Here in the Red States, things are already pretty bad. Here in Republican-led Texas we're doing pretty terribly on just about every major issue: energy, the environment, education, criminal justice; heck, even the food stamps system is utterly broken. We need to get health care reform right, and especially in the Red States, we need to make sure it's inclusive to all Americans who need it.
But hey, at least schadenfreude-loving UT football fans can take heart: if the opt-out passes, I'm betting Oklahoma doesn't get the public option, either.