It is imperative to place the importance of the public option in perspective. The public option represents only a tiny fraction of what will be accomplished by health care reform.
According to the Congressional Budget Office only about 2 percent of Americans would have enrolled in the public option and premiums for the public option would have been somewhat higher than the cost of private health insurance.
In its report of October 29, 2009, under the legislation enacted by the House only one-fifth of persons purchasing insurance through the Exchange - about 6 million persons - would have purchased insurance under the public option. (Page 6, CBO report of October 29) And according to its report of November 18, 2009, scoring the Senate bill as introduced by Senator Reid, even fewer people - only 3 to 4 million Americans - would have utilized the public option instead of purchasing private insurance. (Page 9, CBO report of November 18)
Furthermore, the public option would not have been free - it would not have been an entitlement. People would have to pay a premium to acquire insurance under the public option, just as they would for private health insurance. And in both reports the CBO predicted that the cost of health insurance under the public option would have been slightly higher than the cost of private insurance. (Page 6 October 29 report, Page 9 November 18 report)
The great significance of the health care reform legislation is that it extends health insurance to more than 30 million Americans who are currently uninsured and it improves the coverage of tens of millions more who are underinsured. Furthermore, the legislation will require a massive redistribution of wealth towards low income persons. Under either the House or the Senate bill the cost of expanding Medicaid plus subsidizing low income families to purchase health insurance will on the average exceed $100 billion annually - as compared to savings of about $2.5 billion annually if a public option had been included in the plan.
This health care reform legislation will confer a massive benefit on America's poor, with or without a public option.