Commenting on Paul Krugman's blog, Alice Olson demonstrates her ignorance.
“ I, for one, am glad the Voting Rights Act, Medicare and Medicaid didn't have opt-out options.”
— Alice Olson
Opt-out public option
State participation in Medicaid is voluntary; however, all states have participated since 1982 when Arizona formed its Arizona Health Care Cost Containment System (AHCCCS) program.
Medicaid does not have an opt out option, because medicaid requires states to opt-in *and* design a medicaid program. Medicaid is like the original Carper let states do it on their own compromise. A public option with an state opt-out option will make the public option available to more people than the Carper medicaid like compromise as the default option is key when it is easier to obstruct a bill than to pass one.