If this trade-off carries the day, the opt out public is gone.

In its place will be many of the alternatives we’ve been hearing about, including a Medicare expansion and a triggered, federally-based public option.

As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However if insurance companies don’t step up to the plate to offer such plans, that will trigger a national public option.

Beyond that, the group agreed—contingent upon CBO analysis—to a Medicare buy in.

That buy-in option would be available to uninsured people aged 55-64 in 2011—before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized (and so will likely be quite expensive). However, after the exchanges launch, the Medicare option would be on the exchanges, where people could pay into it with the exchanges.

continue reading… tpm - Democrats Agree Tentatively Trade Opt-Out For Trigger, Medicare Buy In, And More


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  1. brooklynmutt posted this