Proposing the Public Option

Idea

Recognizing that any move toward introducing universal health coverage required bridging exceedingly difficult political and administrative gaps, Jacob Hacker developed the so-called "public option" while an inaugural New America fellow in 2001. His idea of a public insurance pool based on the Medicare model gave political candidates a proposal that brought America a crucial step closer to achieving universal coverage.

Incubation

Hacker released his idea in a 2001 paper and continued to develop and distribute it. He was aided by Roger Hickey of the Campaign for America's Future, who, along with Hacker, introduced the idea to leading presidential candidates. By 2008, it was part of all three major Democratic candidates' platforms and was a component of then-President Barack Obama's original health care reform legislation.

Impact

The public option didn’t survive 2008, but it remains a key component of continued efforts to update the Affordable Care Act. It can also be credited with making universal health care more popular among voters, as it polled better than other proposals in advance of the 2008 presidential election