Blocks with health care symbolsWashington's set of tiered public plans will cover “standardservices” while offering coverage at a cost up to 10 percent lessthan comparable private insurance. (Photo: ShutterstocK)

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The debate in Washington about how to fix the health care systemcontinues to rage on, with various options proposed and debated.Across the country, the state of Washington is taking actions,implementing the first public option for its residents.

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According to the Associated Press, the new option will be universallyavailable to residents regardless of income by 2021. The set oftiered public plans will cover “standard services” while offeringcoverage at a cost up to 10 percent less than comparable privateinsurance. That lower cost is due in part to the fact thatproviders are subject to a cap on rates they can charge tocustomers.

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The plan has already been approved by the state legislature,with Governor Jay Inslee expected to sign it into law.

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Related: 4 approaches to expanding health care (and only oneis Medicare for All)

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Washington isn't the only state venturing a toe into the publicoption pool, with arguments set to erupt in the Connecticut statelegislature over proposed legislation to create a public optionthat supporters say will help small businesses provide coverage toworkers. The Connecticut Mirror reports that battle is aboutto be joined, however, with big insurers in the state arrayed onone side together with the Connecticut Business and IndustryAssociation against state Comptroller Kevin Lembo, theDemocrat-controlled General Assembly and patient advocates.

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While Washington is offering a hybrid system that retainsprivate insurers to manage the new public option plans,Connecticut's public option would be administered by the state—andinsurers, which make up a powerful lobby in the state, are fiercelyopposed, claiming that “a public option would harm the state'sinsurance industry, potentially leading to job losses. They alsocontend it would disturb insurance markets by raising costs foreveryone else, prove unaffordable for businesses it aims to helpand add to the state's indebtedness.”

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“It will be disruptive to the marketplace and not do anything,”CBIA CEO Joe Brennan told the Mirror, adding, “This product, as faras we can tell, does nothing to address the cost of care.”

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Insurers and the CBIA are lobbying fiercely against theproposal, although backers counter that the “legislation wouldprovide small businesses with a desperately needed alternative toincreasingly unaffordable commercial plans, while injecting greatercompetition to force down prices.”

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“It's a full court press to prevent this from happening,” saidstate Rep. Sean Scanlon, co-chairman of the legislature's Insuranceand Real Estate Committee and a strong supporter of the publicoption. “That's something you can see on a daily basis at the stateCapitol.”

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The proposal has already made it past procedural obstacles,although it's not certain that the governor will sign it should itpass. It would create a public option for businesses with 50 orfewer employees, with the comptroller's office, which already runsthe state's health plans, handling administration.

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Lembo did say that he would contract with insurers to run theplan, thus avoiding potential job losses; in addition, he said inthe report that by making it easier for small businesses to offerinsurance to employees, it would stimulate job creation throughmaking it easier to launch a business.

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Marlene Satter

Marlene Y. Satter has worked in and written about the financial industry for decades.