Katie Mahoney Katie Mahoney
Former Vice President, Health Policy, U.S. Chamber of Commerce


September 08, 2020


As a perilous test case for the nation, the state of Washington is unfortunately experiencing firsthand the harms of the public option. Despite the utopian promise envisioned by allowing consumers to choose a health insurance program run by the government rather than purchasing private insurance on their own or offered by their employer, premiums associated with this new option are even higher. This disappointing reality was recently highlighted in an article by Bloomberg, which exposed the fact that the state’s public option plan, “Cascade Care,” is a more costly health coverage option than what consumers were paying for their private coverage.

Employers of all sizes have raised ongoing concerns about the direct and substantial threats a public option would have on employer-sponsored insurance (ESI). To raise awareness of these threats, the U.S. Chamber launched Protecting Americans’ Coverage Together (PACT). The U.S. Chamber’s PACT is a partnership of business voices united to advocate for strengthening and building upon the current ESI system. It is highlighting the dangers of highly disruptive alternatives like a public option, which threaten to undermine the valued employer-sponsored system that provides health coverage for 180 million Americans.

According to a report released by PACT, by shifting employees prematurely into a public option for health coverage, millions of American workers and their families stand to lose the comprehensive coverage and quality care that they depend on and value. Worse, by introducing this option, the nation will see significant disruption in access across the health system and an increase in costs at a time when stability is critically important.

Unemployment rates have skyrocketed across the country due to the coronavirus pandemic and will likely take years to stabilize. COVID-19 has demonstrated the importance of private health coverage, which has the ability to respond to turbulent times with flexibility and certainty. For those Americans who have lost their jobs, and therefore their health coverage, Congress should recognize the significant upheaval Americans are experiencing and provide federal funding support and assistance so workers can maintain their health coverage through COBRA.

Sadly, Washington’s experience is not unique. More than 20 states have pursued the public option as a solution to the country’s cost challenges. However, despite assurances to the contrary, higher premiums are not the only repercussion. We can expect this latest dangerous experiment to drive up significant costs for families covered through other avenues in Washington state and, eventually, those across the country, as a result.

If Washington state’s 2021 public option premiums tell us anything, it’s that this new option is far from a silver bullet to reduce health costs and instead will likely make it harder for Americans to access health care services. Rather than focusing on failing proposals, it’s time for Congress to strengthen and enhance the current, reliable employer-sponsored insurance system that continues to be the driving force for health care innovation across the country.

About the authors

Katie Mahoney

Katie Mahoney

Katie W. Mahoney is the former vice president of health policy at the U.S. Chamber of Commerce.