The Health Care Public Option: An Idea Whose Time Had Come

Sometimes a policy idea has the power to shape history. While the “public option” did not make it into the final health care reform bill, the idea of providing a choice of regulated private insurance or a public insurance plan was crucial to building the movement to enact the Affordable Care Act.

Without the public option, progressive groups would have remained torn between reform plans that offered either exclusively private or public insurance. The public option provided a point of unity that became a foundation for the coalition and grassroots campaign to enact health reform law.

As with many ideas, timing was everything. As I recount in "Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States," the public option had been included in legislation introduced in 1994 by Rep. Pete Stark, then chairman of the Health Subcommittee of the House Ways and Means Committee, a position he also held in the last Congress. But it had been forgotten by both me and Yale Professor Jacob Hacker when we each separately came up with the proposal several years later.

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