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Kai Ryssdal: If you had to pick one part of the health-care debate that's gotten the most attention, aside from maybe death panels, the public option would be a pretty safe bet. The lines are pretty clearly drawn. Democrats on the left generally believe a government-run health insurance option is the only way to create competition and so force insurance companies to cut their prices. Republicans and some moderate Democrats think a public plan would just drive those private insurers out of business. The search for common ground continues, though. Hence the latest idea. Forget the federal government. What about state-run public health plans. From Washington, Tamara Keith helps us imagine how they might work.
TAMARA KEITH: So, you don't like the idea of a national public plan. What about 50 smaller public plans run by the states?
Senator Tom Carper, a Democrat from Delaware, is shopping that idea. Those aren't his words exactly. Here's how he put it in a video on his Web site:
TOM CARPER: Say to states if you don't have much competition, you don't have very good affordability. You can elect to establish your own option, your own state option.
What would it look like? Say you're shopping for health insurance in Maryland. You'd probably go on a Web site listing all the plans offered in your state. There would be plans from the private insurers we all know, and:
MEG MURRAY: One option would be the so-called Maryland Health Plan or the state-based public option.
Meg Murray is the CEO of the Association of Community Affiliated Plans. She says states have experience with this because they manage Medicaid -- the health program for the poor. And she likes the idea.
MURRAY: We believe all health care is local and so that the public plan should be established and organized and run on a local basis.
Washington State already has a public plan of sorts. Washington Basic Health covers 83,000 of the state's working poor. The state contracts with private insurers. Members choose a plan and pay a small premium. The state pays the rest. Dave Wasser is with the Washington State Health Care Authority.
DAVE WASSER: They pay us their monthly premium but otherwise it's more like they are a member of that health plan that they've selected.
Wasser says it's a popular program. But it's still far from clear whether this idea will make it into the health-care legislation.
In Washington, I'm Tamara Keith for Marketplace.