Public Option Lite:
The average health-insurance policy to be purchased through the health-insurance exchange is estimated to cost about $6,500, of which the income group affected by Cantwell's amendment could expect to pay somewhere between $300 and $2,000. Bypassing the health-insurance exchange could lower this group's costs, a finance committee aide told me, to somewhere between $250 and $800. (The estimate is based on the experience of Washington state's Basic Health plan, on which the Cantwell plan is closely modeled.) Under the Cantwell proposal, states could band together to negotiate with health insurers. The more states banded together, the larger the pool they'd be bargaining for. The larger the pool they bargained for, the larger the discount they could extract from private insurers—and the more this scheme would start to resemble a bona fide public option.
The only major shortcoming I see is that the Cantwell option demonstrates a little too starkly how superior a government-directed solution is to a market-based solution in expanding coverage while controlling costs. Why create a health insurance exchange at all? Single-payer, anyone?