A state opt-out PO sounds too good to be true. What am I missing?

[Kurt_and_Hunter]

I am in favor of a state opt-out PO as I understand it (which is probably very limited understanding since it's a lot of vague stuff in news reports) because it seems to have no practical downside. And would be a potential political disaster for pugs.

What I cannot understand is how it could appeal to anyone other than a liberal Democrat as a compromise. As described, it seems win-win for Dems and Americans and a stone loser for pugs because I don't think a single state would actually opt out. (If there would be fiscal burdens on states of which I am unaware that would make opt-out more likely.)

Assume a good national public option. It is one option of several in a state-level insurance exchange. Also assume that the federal public option is an attractive option—cheaper and/or better.

There is no way that even the wingiest of wing-nut states would act to remove the federal PO as an option, at least not without speedy repercussions.

Wing-nuts are candy-ass. Chicken hawks. Chronic whiners. (One of Timothy McVeigh's cited reasons for hating the government is that he felt his subsidy for not planting crops was too low!)

If a federal PO is a subsidized welfare scam (the wing-nut view) that doesn't mean RWers are too proud to line up at the trough. In fact, they'd be fools not to. If they believe a federal PO is a give-away funded out of general revenue (inaccurate, but their view) they have a citizen's right to get some of their tax money back.

Now if any of the wing-nut governors had actually failed to get every possible nickel out of the stimulus plan, had cash-for-clunkers been a failure in red America, and if red states were not a perpetual drain receiving more from the federal government than they contribute... then maybe I could imagine a state actually de-listing a federal PO from an insurance exchange.

Medicaid specifically benefits poor people and costs states money (unlike a federal PO), yet they don't opt out of it. Hard to see anyone opting out of an option that helps folks further up the income ladder.

And the threat to the insurance companies is not diminished. Surely nobody thinks NY and CA, NJ, IL and Mass. are going to opt out. That's probably about half the total insurance market right there. (I don' think even Alabama would opt out. Just making a point.)

And how does such a thing address any Blue-Dog concerns? I cannot imagine that anyone's big objection to a national PO is that it would be available in their state.


I just can't see how this would appeal to any pug or right-leaning Dem. Seems like a guarantee of more political trouble down the road for them.


So flesh out my understanding of this thing. What downsides am I missing?