Health Reform 101: The Public Option in Plain English

There are more than 400,000 words in the Senate healthcare bill, but to most folks two of them matter most: public option. Yet with progressives and conservatives at war over this issue, it's hard to separate fact from fiction. Here, we break it down for you without the spin, talking heads or industry jargon.

Question: What is the "public option"?

Answer: The government would offer people a health-insurance plan like Medicare, but you wouldn't have to be a senior citizen or disabled to join it. This "public option" would compete with plans offered by insurance companies, forcing prices down and giving consumers more choices.

Q: Why is there so much hype, uproar and confusion about it?

A: People disagree—often, but not always, along party lines—about how involved the government should be in our health-care system. Generally, Democrats think that healthcare is a right not a privilege, that government should help make healthcare affordable for everyone, and that big businesses need to be regulated sometimes. Republicans typically believe that involving the government in healthcare interferes with business's freedom to make money and sets the stage for a government-run healthcare system, as exists in many socialist countries.

Q: Who is the public option for?

A: Supporters see the public option as a way to make insurance coverage more affordable, especially for 44 million people who don't have any insurance or the additional 25 million who don't have enough insurance.

Q: I hear that the government may tax me if I don’t have insurance? How will it affect the uninsured?

A: The plan would require every American to have insurance and make employers contribute money toward the cost of their workers’ insurance coverage. When they file their federal tax return, people would have to prove that they had health insurance. Those without coverage would be penalized.

Q: What if I don’t have enough insurance? Will the public option help me get better coverage?

A: People who currently do not have any or enough health insurance could buy coverage cheaper through the public option than through the private plans currently available. (Go here to learn more about the implications for the underinsured. To learn about the impact upon people without any insurance, go here.)

Q: How will it affect people on Medicaid?

A: Nothing changes if you are already on here to learn more about the implications for people on Medicaid.)

Q: I keep hearing about the House version and the Senate version. It's very confusing. How do they differ?

A: The primary difference lies in how the public option will be paid for, not in its coverage and benefits. The House wants to tax employers who fail to provide coverage for their employees; the Senate proposes taxing healthcare and pharmaceutical companies and people earning over $200,000 per year, especially those with top-of-the-line health-care coverage provided by their employer whose premiums often cost over $8,000 per year.

Q: Where along that timeline are we? And what steps are still involved to get health reform passed?

A: The House has already passed its version of health reform. The Senate is trying to pass its version before Christmas. At that point House and Senate leaders will work out the differences to create one bill that the entire Congress can vote on.