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What's a Public Option Insurance Plan? An example from Washington State

In a new VSSL Issue Brief, VSSL members Anna Morenz and Joshua Liao describe key elements of "public option" health plans in Cascade Care.


Passed via WA SB 5526 in May 2019, Cascade Care includes the creation of public option insurance plans that provide a way to stabilize the individual insurance market and offer additional choice and competition in so-called “bare counties” with only one health plan on Healthplanfinder, the state’s Health Benefit Exchange (HBE). These public option plans will be offered exclusively as individual market coverage on Healthplanfinder. In addition, Cascade Care reflects a set of changes that affect other, non-public option plans offered on the HBE.

Cascade Care is noteworthy because it is considered the nation’s first attempt at providing a public option for health insurance. Attention to the public option plans in Cascade care reflects continued interest in public option plans since the idea was considered but ultimately excluded from the Patient Protection and Affordable Care Act of 2010. In 2019, four different bills involving a federal public October 2020 option plan were introduced by members of Congress. As of May 2020, at least 18 states have considered legislation to create public option plans or expand Medicaid eligibility in order to allow individuals to purchase coverage under plans with publicly determined payment rates.

Given this momentum, Drs. Morenz and Liao wrote the issue brief to outline key elements of the public option plans within Cascade Care for the coverage period beginning January 1, 2021.


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