The public option –long debated and absent from President Barack Obama’s health reform plan – appears to no longer be an option.

Sandy Praeger

The plan, authorizing the federal government to oversee insurance products to compete with private insurers, is “off the table,” according to Kansas Insurance Commissioner Sandy Praeger.

Praeger, speaking as part of a health care reform panel for the National Association of Insurance Commissioners today (Feb. 26), said that “there doesn’t appear to be support” for the initiative included in the U.S. House of Representatives’ health reform bill.

What is closer to reality, she said, is the Senate’s version, calling for health insurance exchanges to promote competition among private insurers for affordable products meeting consumer needs.

What discussion there was about covering the uninsured during the President’s Health Summit Feb. 25 focused on the exchanges, not a public option.

The absence of the public option, Praeger noted, also preserves existing rules for state regulators to be there for consumers and continue to monitor their own marketplaces.

“I think we may have some standards that Congress, through [the U.S. Department of Health and Human Services] will want us to adopt, but I think the regulations at the state-based level will continue to let us assure our markets are functioning at the state level,” Praeger said.

Kim Holland, Oklahoma’s insurance commissioner, added that the public option “highlights one of the challenges in health care reform.

“There are vast differences in the diversity of our nation and respective jurisdictions,” she said. “Like Kansas, Oklahoma has a very, very competitive insurance market, a lot of companies competing for business, but that is not the case in every state. The public option, from our [the NAIC’s] perspective….some supported it and some didn’t, depending on the needs in their marketplace.”

Recently, Sen. Michael Bennet (R-Colo.) started a petition to get the public option included in a final health care bill, using under budget reconciliation rules, requiring only 51 votes in the U.S. Senate to pass reform measure, rather than 60 votes to pass a health reform bill as is.