State Public Health Insurance Option: Advancing Equitable, Affordable, and Dependable Coverage

Access to health care continues to cost people too much. Increased costs force many families to choose between affording health care and other basic necessities to make ends meet. States have the opportunity to meaningfully address coverage, equity, and affordability issues now through implementing state-based coverage options, such as a public health insurance option.

The cost of health care is the most prominent concern across all of USofCare’s listening activities.  Public options save money for all by containing health care costs, increasing competition, and investing in payment reforms, while freeing up family budgets for gas and groceries. Affordability and access to care are core to good health and more important than ever. In the past few years, millions of people have either lost their health care coverage (due to job loss) – or face challenges even affording their current coverage. The erosion of insurance coverage is not entirely new but a continuation of a trend that predated the pandemic, which has resulted in significant job loss and disruptions in insurance coverage. Also problematic is that the burden does not fall equally across populations; Black, Hispanic, American Indian/Alaskan Native, Native Hawaiian, and other Pacific Islander people are uninsured at higher rates than whites.

In response to this urgent need for change, leaders in several states have been actively exploring new ways to expand and leverage public coverage sources as a way to create additional choices for their residents. A public health insurance option, or “public option,” is a government-regulated insurance plan that is often privately-run and made available to individuals, small businesses, and nonprofit organizations. They provide an alternative (typically at a lower cost) to a traditional private insurance plan. Public option plans improve the health care system by adding lowering costs, increasing dependability, and making quality health care more accessible.

In the wake of the pandemic, public options are one solution that can bring people together across party lines and demographics. In the process of creating a public option, state policymakers arm themselves with new tools and intentional planning to address systemic health inequities in their state. All while adding a new, more affordable coverage choice to address the soaring health care costs that negatively impact far too many lives.