NCPA - National Center for Policy Analysis


November 24, 2009

According to a report by The Hill, at least 11 states plan to use bills or ballot questions to block aspects of pending health reform legislation, providing crucial hints about which states will try to opt out of a proposed public health insurance plan option as well.

Early this summer, states began introducing measures to exempt themselves from individual and employer mandates, as well as other aspects of current health reform proposals, according to the National Council of State Legislatures:

  • The Congressional Budget Office (CBO) has estimated that one-third of states would opt out of the Senate's public plan.
  • This will limit the public option pool to three to four million U.S. residents -- about one million less than the House version.
  • The CBO did not estimate how states that opt out would affect premiums under a public plan.
  • However, many analysts have said that premiums would be higher if many states do not participate because the plan's ability to reduce costs is contingent upon large numbers of participants.

The Hill identified Virginia and New Jersey as states that could possibly opt out, after Govs.-elect Bob McDonnell (R) and Chris Christie (R) each denounced health reform plans during their campaigns.  Other states that could choose to opt out of a public plan include the 13 states that have both Republican governors and Republican-controlled legislatures or the 10 states under split-party control, say Observers.

Source: Ryan Holeywell, "Some states already poised to opt out of government-run public health plan," The Hill, November 23, 2009.

For text: 


Browse more articles on Health Issues