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Does Obama’s New-Found Flexibility Open Door for State Single-Payer Systems?


Off-the-record conversation suggests yes.

While half the country is fighting to rescind President Barack Obama's signature health care overhaul, the president offered a "concession" Monday to let unhappy states design their own alternative plans under the scope of the ObamaCare law. This new flexibility may mark the "most significant change" since the law was enacted, but what might these changes mean in a practical sense?

According to Politico's Ben Smith, a source on a White House conference call with liberal allies Monday said the new flexibility would allow Democrats to offer more expansive health care plans than the one Congress passed:

Health care advisers Nancy-Ann DeParle and Stephanie Cutter stressed on the off-record call that the rule change would allow states to implement single-payer health care plans -- as Vermont seeks to -- and true government-run plans, like Connecticut's Sustinet.

The source on the call summarizes the officials' point -- which is not one the Administration has sought to make [publicly] -- as casting the new "flexibility" language as an opportunity to try more progressive, not less expansive, approaches on the state level.

"They are trying to split the baby here: on one hand tell supporters this is good for their pet issues, versus a message for the general public that the POTUS is responding to what he is hearing and that he is being sensible," the source emails.

Some states supporting the president's health care plan are looking to implement further health care regulations, including Vermont which is pursuing a single-payer system.

“Administration official discussed how this legislation would help give states the opportunity to innovate," one administration aide later tried to clarify.  "States have the flexibility to design plans in the way that works for them, so long as they meet the shared goals of reform. That could be any number of proposals from exchanges like the Utah model to other innovations that increase choice and competition.”

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