America’s next big healthcare reform might already be underway

If you live in Colorado and buy your own health insurance , there’s a good chance you’re one of the 139,000 people enrolled in a public plan crafted by your state leaders.

You’re paying $0 for primary care visits and certain mental health visits, $0 for prenatal and postnatal care, and you don’t have to meet your deductible first.

On average, enrollees in these plans pay an estimated $14 to $33 less a month in premiums than people in comparable plans, and their annual out-of-pocket spending has fallen about 15 percent while holding steady for everyone else on the marketplace.

Colorado didn’t build a government insurance company, rather, it designed the plan itself, down to the copays, and then required private insurers to sell it alongside their own.

A public health insurance option was supposed to be part of the Affordable Care Act.

President Barack Obama supported the idea throughout his time in office, endorsing a government plan that could, in his words, “ keep insurance companies honest ” by giving them a government-backed competitor.

But the idea was stripped from the bill before passage, after it became clear Senate leaders couldn’t get garner enough votes.

Joe Biden campaigned for president on reviving a public option in 2020, but he never prioritized it once in office, and the progressive activists who championed it under Obama largely turned their sights to single-payer health care , which would cover all Americans.

Key takeaways Three states built a public option while Congress stalled.

In Colorado it’s now half the individual market.

It worked by forcing hospitals to charge less, not by the government selling insurance.

Whether it spreads depends on Medicaid cuts — states won’t pick two fights at once.

The problems a public option was intended to address — access, costs, reliability — have still not gone away and a growing number of policy wonks and elected officials have started to ask if the idea deserves a spot again on the national agenda.

Healthcare costs are soaring, and voters tell pollsters it’s among their top economic concerns.