As the concept of a public insurance option gains increasing visibility in the 2020 presidential race, the spotlight is also trained on Washington and Colorado — states that are at different stages of setting up their own versions of a public option yet are facing similar challenges.

While they can vary considerably, public option programs generally aim to offer individual market customers a more affordable choice for health coverage than existing commercial plans by means such as capping administrative expenses and provider reimbursement rates. A public option provision was infamously eliminated from the Affordable Care Act (ACA) during the push to get it through Congress.

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