A public option is a health plan anyone can choose – a reliable, not-for-profit alternative that competes directly with for profit insurance companies. By finally introducing real competition, it pushes prices down, expands choices, and gives families and small businesses an affordable, patientfirst option. And if you like your current plan, you can keep it.
Most importantly, it puts patients ahead of profits. No more care denied because an insurance company decided it wasn’t profitable enough.
Today, families are being crushed by rising premiums and out of pocket costs. A public option tackles both by offering a lowercost plan that forces insurers to compete. It cuts unnecessary overhead, negotiates fair drug prices, and expands access to affordable care – so people pay less and get the care they need.
Full Policy Details
How the Public Option Works
- Available to all individuals and small businesses through the ACA marketplaces
- Federally administered with state flexibility for implementation
- Standardized benefits for clear, apples-to-apples comparison
- Offered alongside private plans to ensure real competition – not replacement
Payment Model & Provider Participation
- Providers reimbursed at Medicare-based rates to control costs while maintaining broad participation
- Hospitals and physicians participate voluntarily, supported by predictable patient volume
- Encourages value-based care models that reward outcomes over volume
- Ensures robust provider networks, with targeted support in underserved areas
Rural Hospital Protection & Essential Services
- Enhanced reimbursement for rural hospitals based on low patient volume, geographic isolation, and community need
- Stability payments (monthly or global budgets) for critical access and sole-community hospitals
- Protects essential services such as emergency care, obstetrics, and inpatient capacity
- Builds on existing Medicare rural designations while strengthening longterm financial stability
- Ensures no community loses access to hospital care due to low population density
Lowering Costs SystemWide
- Negotiates prescription drug prices using federal purchasing power
- Operates with significantly lower administrative overhead than private insurers
- Creates a benchmark plan that pressures private insurers to lower premiums
- Reduces uncompensated care by expanding consistent coverage
Financing & Affordability
- Expanded subsidies ensure affordability for low and middle income households
- Premiums designed to be self-sustaining, supported by enrollees and existing ACA subsidies
- Risk adjustment mechanisms prevent adverse selection and stabilize premiums
- Savings from lower drug prices and reduced overhead flow directly to consumers
Protecting Choice and Stability
- No one is required to switch plans – employer sponsored coverage remains intact
- Guarantees an affordable option in areas with limited insurer competition
- Ensures continuity of coverage during job changes or life transitions
- Strengthens, not disrupts, the current system
Incentives for Better Outcomes
- Preventive care participation can reduce premiums or provide rebates
- Chronic disease management improves outcomes and lowers longterm costs
- Consumers who choose high value, lower cost care options can share in savings
- Rewards smart choices, never penalizes illness
Implementation Approach
- Phased rollout beginning with ACA marketplaces
- State option pathways for expanded integration (e.g., Medicaid alignment
5 Responses
Wouldn’t it be better to roll out universal healthcare where our tax dollars go into funding the healthcare system? Below is how you fund it.
Additionally cutting military spending in half, cutting DoD contractors by at least 30%, eliminating ICE, defunding the DEA. The only reason the DEA was started was an excuse to jail more black people.
The DEA is getting in the way of trained doctors being able to properly treat chronic pain patients, patients with like myself with chronic pain due to rare chronic diseases plus dealing with raging ADHD. Also fentanyl is coming in from China and other parts of Asia, not South America. We have white rich people including those in the White House who use coke like they’re on ski slopes. Use the Norway model regarding drugs (which other EU countries use), and you not only significantly reduce ODs by upwards of 95%, you have the potential to generate billions of dollars in tax revenue which can go towards universal healthcare.
Cutting off ALL FUNDING TO ISRAEL (it’s time to tell Netanyahu to get fucked, and it’s our responsibility is to save the Palestinian people). Also we make genocidal sociopath pay the U.S. government 75% of what we paid them.
We go back to FDR style taxing where the wealthiest pay 90% in taxes (they’ll still be rich). We quit giving major corporations like Google, Amazon, Meta, Apple, Blackrock, GE, P&G, FedEx, UPS, ex tax breaks so ridiculous that someone making less that $50K pays more in taxes than these booger sugar loving, Eyes Wide Shut sex cult sociopaths.
Tax the shit out of these corporations, and create laws which put a cap on C-Suite salaries including bonuses and stock options. It’s not hard. When they inevitably complain and threaten to move HQ to Mexico (they won’t), you tell them to suck your balls.
Also tax the shit out of private equity and hedge funds at a minimum 40% because they’re responsible for our housing and rental costs going so high it’s significantly raising the rate of people who are unhoused. Additionally you limit the amount of single family homes they’re allowed to own no more than 5 single family homes and 5 apartment buildings per geographic location, ie Cincinnati metro area including Warren, Butler, Clermont, and Clinton counties. Again, they don’t like it? Tell them to eat your ass if they’re not happy.
In short:
Taxing the wealthy making more than $1B at 90%. Taxing those making $500k-$999k at 60%. Tax capital gains at 40% the same bonuses are taxed.
End all tax breaks and incentives for fortunate 500, and 100 companies making more than $1B/yr, and implement a 80% tax rate. If they offshore their money, it gets taxed at 90% plus interest for every year it sit offshore. Put caps on C-Suite salaries including bonuses, bonuses, and stock options.
Companies making $100M-$999M get taxed at 70% and same rules apply to offshoring of money and C-Suite.
Companies earning between $10M-$99M/yr get taxed at 60%. C-Suite and offshoring stays the same. Companies making between $1-$10M get taxed at 40% .
Companies making $500k-$1M get taxed at 25%.
Startup companies and small businesses get a 5yr tax abatement to incentive growth.
Equally small businesses get a $50K GRANT to help get their business started and off the ground. NOT A TAX BREAK!!! AN ACTUAL GRANT!! Tax breaks assume people have $50K to start a business. I promise you, speaking as someone who wants to open a small business, we don’t. An actual grant. If they hire employees at living wages, they get an additional $20K for 3 years to help with payroll. This will help create new businesses, new jobs and jumpstart the economy.
HOUSES AND LUXURY THINGS
Houses over $2M get an additional 3% property tax increase to their current property tax. The 3% is federal.
PRIMARY HOUSES $3-$10M, where the people live primarily (at least 7 months of the year) get a 6% federal property tax added to their municipal property taxes. Houses $11-$16M get a 8% federal property tax. Houses $17-$25M get a 10% federal property tax. Houses
$25+M get a 13% federal property tax.
Second houses, and vacation rental properties over $350 get a 5% non-use tax. Second homes and vacation rentals over $1M get a 10% non-use, vacation rental tax. Second houses over $2M, the government is going spank you for taxes. Own a yacht? Taxing it! Own a personal plane (8 seater or bigger)? Taxing it. Have a luxury car collection? TAXING IT!! BILLIONAIRES SHOULD HAVE NEVER EXISTED!!!
CHURCHES……Tax the shit out all of them based on their income.
This is how you fund universal healthcare where doctors and nurses get paid good wages for all the schooling they endured, and you also create safe staff to patient ratios. You get the meds directly from overseas to save money. No more of this pre-auth bullshit either.
Wouldn’t it be better to roll out universal healthcare where our tax dollars go into funding the healthcare system? Below is how you fund it.
Additionally cutting military spending in half, cutting DoD contractors by at least 30%, eliminating ICE, defunding the DEA. The only reason the DEA was started was an excuse to jail more black people.
The DEA is getting in the way of trained doctors being able to properly treat chronic pain patients, patients with like myself with chronic pain due to rare chronic diseases plus dealing with raging ADHD. Also fentanyl is coming in from China and other parts of Asia, not South America. We have white rich people including those in the White House who use coke like they’re on ski slopes. Use the Norway model regarding drugs (which other EU countries use), and you not only significantly reduce ODs by upwards of 95%, you have the potential to generate billions of dollars in tax revenue which can go towards universal healthcare.
Cutting off ALL FUNDING TO ISRAEL (it’s time to tell Netanyahu to get fucked, and it’s our responsibility is to save the Palestinian people). Also we make genocidal sociopath pay the U.S. government 75% of what we paid them.
We go back to FDR style taxing where the wealthiest pay 90% in taxes (they’ll still be rich). We quit giving major corporations like Google, Amazon, Meta, Apple, Blackrock, GE, P&G, FedEx, UPS, ex tax breaks so ridiculous that someone making less that $50K pays more in taxes than these booger sugar loving, Eyes Wide Shut sex cult sociopaths.
Tax the shit out of these corporations, and create laws which put a cap on C-Suite salaries including bonuses and stock options. It’s not hard. When they inevitably complain and threaten to move HQ to Mexico (they won’t), you tell them to suck your balls.
Also tax the shit out of private equity and hedge funds at a minimum 40% because they’re responsible for our housing and rental costs going so high it’s significantly raising the rate of people who are unhoused. Additionally you limit the amount of single family homes they’re allowed to own no more than 5 single family homes and 5 apartment buildings per geographic location, ie Cincinnati metro area including Warren, Butler, Clermont, and Clinton counties. Again, they don’t like it? Tell them to eat your ass if they’re not happy.
In short:
Taxing the wealthy making more than $1B at 90%. Taxing those making $500k-$999k at 60%. Tax capital gains at 40% the same bonuses are taxed.
End all tax breaks and incentives for fortunate 500, and 100 companies making more than $1B/yr, and implement a 80% tax rate. If they offshore their money, it gets taxed at 90% plus interest for every year it sit offshore. Put caps on C-Suite salaries including bonuses, bonuses, and stock options.
Companies making $100M-$999M get taxed at 70% and same rules apply to offshoring of money and C-Suite.
Companies earning between $10M-$99M/yr get taxed at 60%. C-Suite and offshoring stays the same. Companies making between $1-$10M get taxed at 40% .
Companies making $500k-$1M get taxed at 25%.
Startup companies and small businesses get a 5yr tax abatement to incentive growth.
Equally small businesses get a $50K GRANT to help get their business started and off the ground. NOT A TAX BREAK!!! AN ACTUAL GRANT!! Tax breaks assume people have $50K to start a business. I promise you, speaking as someone who wants to open a small business, we don’t. An actual grant. If they hire employees at living wages, they get an additional $20K for 3 years to help with payroll. This will help create new businesses, new jobs and jumpstart the economy.
HOUSES AND LUXURY THINGS
Houses over $2M get an additional 3% property tax increase to their current property tax. The 3% is federal.
PRIMARY HOUSES $3-$10M, where the people live primarily (at least 7 months of the year) get a 6% federal property tax added to their municipal property taxes. Houses $11-$16M get a 8% federal property tax. Houses $17-$25M get a 10% federal property tax. Houses
$25+M get a 13% federal property tax.
Second houses, and vacation rental properties over $350 get a 5% non-use tax. Second homes and vacation rentals over $1M get a 10% non-use, vacation rental tax. Second houses over $2M, the government is going spank you for taxes. Own a yacht? Taxing it! Own a personal plane (8 seater or bigger)? Taxing it. Have a luxury car collection? TAXING IT!! BILLIONAIRES SHOULD HAVE NEVER EXISTED!!!
CHURCHES……Tax the shit out all of them based on their income.
This is how you fund universal healthcare where doctors and nurses get paid good wages for all the schooling they endured, and you also create safe staff to patient ratios. You get the meds directly from overseas to save money. No more of this pre-auth bullshit either.
Two reasons. First, the private insurance industry is a major job provider. Almost all of those jobs are filled by working class Americans. Second, having people have a financial stake and benefit in their health insurance plans encourages healthier behavior. We will set premiums at an affordable level but we can differentiate premiums based on whether you are a smoker. This has been shown to help reduce cigarette smoking. The public option also establishes that health care is a right for all.
Yes, universal healthcare will consolidate that labor pool and a vacated market is going to cost job loss, but that’s why you have to think bigger, universal healthcare is one puzzle piece in an entirely overhauled economy that prioritizes the labor that produces wealth, rather than a corrupt cabal of pedophiles and sociopaths who happen to own everything and can’t help but own more and more by their insatiable greed. It requires vision, thinking beyond the job loss of one specific industry sundowning. A public option is better than nothing, sure, but why go to the negotiations table with what you’re willing to settle for, rather than what you hope to strive for? Closing down the health insurance industry will displace workers, yes, but we could replace those lost jobs with more meaningful, well paid, and socially needed jobs by investing in the government and civil service jobs we need (increasing government jobs through infrastructure and social services investments have ALWAYS resulted in more private sector jobs)… give those who lost their jobs the training and economic support they need to transition into those new jobs. A universal basic income is pretty much mandatory at this point if we ever want to at least put a leash on the excesses of capital and bring it to heel for the good of the people. We need an FDR level New Deal legislation that radically re-centers power to the People. Racism aside, the economy Americans are nostalgic for was built on government intervention and investment. Had FDR lived to finish his 4th term, he was planning a new constitutional set of amendments for a worker’s bill of rights. For the past 50 years the owner class distracted us with culture wars to divide us, while they’ve chipped away at everything we worked so hard to get, but there’s nothing left to chip away, and Democratic Party’s approach for incremental change is crawling back to where we already were and still losing ground. It’s only a New Deal & LBJ’s Great Society level of boldness that will save America. Everything less is putting a bandaid on a sinking ship. American capitalism as we know it is collapsing… what we put in it’s place determines our future. We live in an abundant world, if we take care of it and each other.
And to your other point about having personal stakes in how paying for your healthcare inspires healthier living, now that I think about it… 1) WTF does that even mean? 2) Your premiums are paid for by your taxes in a universal healthcare system, why can’t you add a smokers tax (if you’re going that draconian with it)? 3) There may be some studies that show premium hikes effect a decline in unhealthy habits like smoking, but there are also studies that show economic stability also reduces the usage of addictive and health risk substances, and by greater margins, precisely because of the reduction in stress that economic stability brings. One of these approaches attacks our economic freedom and mobility by adding a monetary penalty to untreated addiction, and the other alleviates having the need for a vice in this economy in the first place, which makes it easier to effectively treat.