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Question: Will there eventually be a public option?

Answer: The Patient Protection and Affordable Care Act, signed by President Obama on March 23, 2010, is a huge step forward for health care consumers. It will bring quality, affordable coverage to all Americans through the creation of health insurance exchanges (marketplaces where people can shop for coverage with user-friendly information about quality and costs, like what members of Congress and Federal employees use); income-based tax credits to help people afford coverage; and the expansion of Medicaid, the federal-state partnership program that provides health coverage to low-income Americans. However, much to the dismay of many health care advocates and consumers, the Act did not include a publically run health care option.

All is not lost, however, when it comes to the public option. Nothing in the Affordable Care Act prevents states from setting up their own public options, as long as they comply with the standards that health plans must meet under the law. The Affordable Care Act sets a floor of health care improvements that all states must meet, but it also allows states to go above and beyond the law to make health coverage even better for their residents. So, states can—and some likely will—look into creating their own public options as a way for their residents to get coverage.

Whether the future will bring a national public option is an open question. The creation of a federal public option would require action from Congress, and right now this would be a heavy lift to achieve. However, what’s important to understand about achieving change in the health care system is that it is an ongoing process. We celebrated a great victory with the passage of the Affordable Care Act this year. Now, we must continue our fight, both to make the implementation of the law work well for consumers, and for future victories—including a public option—in the years to come.

Claire McAndrew is a Health Policy Analyst at Families USA, a nonprofit, nonpartisan organization striving to achieve quality, affordable health coverage for all Americans. For more information, visit

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