Last Thursday the San Francisco Chronicle reported that under the current bills being considered in the House and Senate, 90% of Americans would not be able to pick a public health insurance option. The proposed rules would limit access to the Exchange, where the public option would be offered, to "individuals who cannot get insurance, or whose health care costs exceed 12.5 percent of their income."

Not only would that mean most Americans wouldn't have access to the public option - it also means that public option would be weaker. For the public option to bring down costs and provide quality care, it needs to have a large base of paying customers to be able to negotiate good rates. Further, it needs to be able to attract healthy young people. If it can't, then the public option may suffer what is known as "adverse selection" where only the sickest people get the public option. That would drive up the costs of the public option, and make it less effective.

In order to make the public option provide the most benefits for the most people, we need to open it up so that anyone who wants to buy into it may do so. Oregon Senator Ron Wyden is offering an amendment to allow anyone to access the Exchange, where the public option will be offered. Senator Barbara Boxer has already indicated her support for the Wyden Amendment. It's now up to Senator Dianne Feinstein to join Boxer, Wyden, and the American people in demanding everyone be allowed to choose the public option.

That's why we sent the following email to our members today, asking them to sign the letter to Senator Feinstein asking her to open the public option to everyone:

Dear friend,

Progressives like you have scored a major victory in the battle for health care reform, applying pressure that forced the House and the Senate to include a public option in each of the bills moving forward in Congress.

There's just one catch: These bills might not let you into the public option.

As the San Francisco Chronicle reported on Thursday, 90% of Americans won't be able to choose the public option once it is up and running. Instead you might be forced to stay with a private health insurer, even if they continued to deny your claims and refuse treatment you needed.

Fortunately, we still have an opportunity to throw the doors open and enable every American who wants a public option to choose it. Soon, the Senate will be considering an amendment by Oregon Senator Ron Wyden to enable anyone to buy into the public option.

Both of California's senators -- Sen. Barbara Boxer and Sen. Dianne Feinstein -- have expressed strong support for a public option but only Sen. Boxer has taken leadership on the Wyden Amendment. Now we need Sen. Dianne Feinstein to join Sen. Boxer in supporting it -- and open the public option to everyone.

If you want to be able to buy into the public option, Sen. Feinstein needs to hear from you now. Click here to sign the Courage Campaign's letter to Sen. Feinstein asking her to support a public option for everyone. DEADLINE: 5 p.m. Wednesday:

http://www.couragecampaign.org/LetUsIn

Your activism for the public option has already paid off. When it looked like Sen. Feinstein might not support a public option, 63,984 Courage Campaign members signed letters to her. Thanks to your activism and the work of our friends and allies, Sen. Feinstein released a statement saying she endorses a "strong public option":
"Private insurance companies must face more competition, and individuals should have more options. I believe that a public option, without pressure to make profits, will be able to offer Americans high quality coverage at a lower price. This is best accomplished with a strong, national public plan." --Senator Dianne Feinstein, October 23, 2009

If Sen. Feinstein supports a strong public option, she should have no hesitation in supporting the Wyden Amendment to enable anyone to join the public option. Click here to sign the Courage Campaign's letter and demand that she let you in. DEADLINE: 5 p.m. Wednesday:

http://www.couragecampaign.org/LetUsIn

Thanks for fighting to make sure everyone has access to health care -- before it's too late.

Robert Cruickshank
Public Policy Director, Courage Campaign