The subsidies weren't large enough, making the public option not affordable for many.

And, if mandates are included, insurance companies may prey upon these people with plans that have overly high deductibles or the barest of coverage.

In reference to the public option the Democrats must be able to answer these three question for the average American:

When does it start?
How much does it cover?
How much will cost?

And if the answers to these three questions are:

Not soon enough.
Not everything.
Too much.

It is maddening to watch.

From PNHP:

The public option refers to a new public plan that would compete with private health insurers in an effort "to keep them honest". It is a concept trumpeted by Jacob Hacker, now a professor of political science at the University of California Berkeley. His original idea, as first envisioned in the 1990s, was that a large public program, operated along the lines of Medicare, could cover as much as one-half of the non-elderly population by shifting all or most of the uninsured, as well as all Medicaid and SCHIP enrollees, into the plan from the start.  Because of its size and efficiency, such a large plan would be able to keep its premiums much lower than private plans, thereby increasing its attractiveness to enrollees. In addition, all non-elderly Americans, whether privately insured or not, would be eligible to participate. Government subsidies would be extended to those unable to afford the plan. Private insurers would be required to offer the same minimum benefits as the public plan.

So the initial idea was premised on the idea that a public plan could bring needed competition into the financing of health care. Forget that dream.  Although the current House and Senate bills both include a "public option", it is in name only. What might have roared like a lion is becoming, at most, a mouse that barely squeaks. The details change every day, but already these kinds of changes from Hacker's original concept make it a policy non-starter:

•  Many people with private insurance who want to change will not be able to select the public option

•  The public plan may not kick in until 2013 or until such time as private plans have been demonstrated not to save money (a so-called "trigger")

•  Whatever new regulations that are imposed by the reform bill will only apply to new private plans; existing plans will be grandfathered in as is

•  Private insurers worry that a public plan would crowd them out by undercutting their premium levels, so they lobby to keep the public program small

•  The current proposals in Congress do not impose caps on private insurance premiums; nor do they allow the public option to significantly lower its premium rates below private plans

•  The public plan will not be "pre-populated" with all Medicaid and SCHIP enrollees from the start, thereby keeping the plan small

•  Instead of initial coverage estimates in the range of 120 million enrollees by public plan advocates, the Congressional Budget Office (CBO) estimates that only 10 million would be enrolled because of the fine-print restrictions now being placed on the plan within Congressional committees. These restrictions are being heavily lobbied by the private insurance industry to ensure that they won't have any real competition.

If all people do is listen to what is being said about Congress' plan, by members of the committees, as well as the president, it's very hard to get a clear understanding of what this plan is all about.  As the committees have been tinkering with things, their messaging has not changed much - unless you are paying attention to the details so you know when you are being bamboozled - so people are still thinking "public option" is the same public option from the beginning of this process when it was termed "robust."

It's getting weaker by the day, and moving farther away from helping people who need care.

If you go to Congressman Waxman's site and click Health Care Reform and then America's Affordable Health Choice Act of 2009, District by District Impact, you can see how few people will have their taxes increased to pay for the public option part of the bill.

In my district, it's only 1% so that 67,000 people can have health insurance. 14,100 small businesses can receive a 50% credit on health insurance. From what I've read about the cost, I don't think many uninsured can afford it anyway after the three year wait. But it's better than what they are going to settle for now. I'm thoroughly disgusted about this. Obama should be fighting hard for this. I hope every Democrat who refused the public option loses their next election.

I'll do the short link in case anyone wants to look at their district. 13% of my district are uninsured but we can't make 1% help pay. And, why do Republicans and Blue Dogs hate small business? They stand to get the greatest benefit of all.

Congress is not giving us the option for a ROBUST public option. What Congress is offering is an extremely weak, watered down, severely restricted public option that was designed by Congress so that it can in no way compete with the insurance companies or change their behavior. To quote Ian Welsh:

I'll settle for a good public option, or even a non-sucky one. But I'm becoming convinced that any public option will either be too compromised, or non existent, and at that point, all that happens is you have slashes to Medicare and Medicaid, forced purchase of bad insurance, and through those purchases more money being pumped into the system. link

Dear Friend,

If you're like most Americans, there's nothing more important to you about health care than peace of mind.

Given the status quo, that's understandable. The current system often denies insurance due to pre-existing conditions, charges steep out-of-pocket fees - and sometimes isn't there at all if you become seriously ill.

It's time to fix our unsustainable insurance system and create a new foundation for health care security. That means guaranteeing your health care security and stability with eight basic consumer protections:
No discrimination for pre-existing conditions
No exorbitant out-of-pocket expenses, deductibles or co-pays
No cost-sharing for preventive care
No dropping of coverage if you become seriously ill
No gender discrimination
No annual or lifetime caps on coverage
Extended coverage for young adults
Guaranteed insurance renewal so long as premiums are paid

it goes on to ask me to pass this along to my 'social network'...

Does not look much like what BTD (and I) would call a good bill. Now, if consumer protection regulations were all I had ever hoped to achieve with a Dem president and Congress, maybe I would be happy with this. Likewise if he had been honest a few months ago and said he did not think he could get real reform done this year, but here's what he could do, and would tackle universal coverage next year after he had paved the way, and gotten troops out of Iraq so we could pay for it easier. (Yes, I am fantasizing here)

It is entirely possible that he had to promise the insurance companies he would not fight for real reform in order to get them to not fight these consumer protections.

I think the whole thing was bungled from the start, when he handed it over to the least trusted institutions in America (Congress and insurance companies) to come up with the plan.

the more inclusive approach appears just as effective.