Color of Change has released a petition that they’re sending to the Democratic leadership opposing the opt-out clause for the public option. Here is part of their reasoning.

If the fight around stimulus dollars is any lesson, we might see right-wing governors or legislatures — many of them from states with large poor and Black populations — refuse to participate, just to score political points.

But that’s not what happened. Right-wing Governors and legislatures pretended to refuse to participate, but eventually fell in line. That includes Rick Perry and Mark Sanford and all the rest. I think 99% of all stimulus dollars offered to the states, if not all of it, was accepted, at least to this point. Color of Change shouldn’t be spreading misinformation like that.

In fact, what the opt out provision could wind up like is the Medicaid program, which also has an opt out clause in it, but which has seen 100% compliance in the states since 1982:

In fact, after complaining that Medicare/Medicaid would lead to socialism in America during the 1960s, all 50 states have chosen to participate in the Medicaid program — a jointly funded venture between the states and the federal government, which gives states the option to opt out. “Every state has been in Medicaid since 1982. None have ever dropped out,” Turtle Bay writes on Daily Kos. “True, Arizona wasn’t in until 1982, but that’s partly because for a state to get in, they had to actually set up a program.” The stimulus is another example:

And the stimulus — probably the best example of all, even though it isn’t clear that the states had any actual authority to opt-out. We saw the usual gang of idiots saying they were going to reject the stimulus, or in one case, actually attempt to do so over the objections of his state legislature. And what happened? We’ve got Bobby Jindal carting around oversized stealth stimulus checks to promote himself…

Now, Color of Change could be right or Turtle Bay could be right. Certainly the conservative movement is far more radical than it was in the 1960s and 1970s, and willing to deny help to their poorest constituents; but still and all, none of them have dropped out of Medicaid or denied their states stimulus money, leading one to believe that it’s all rhetoric. What would illuminate this question, and offer a better guess as to which way things will go, is some actual DETAILS about the opt out. And I’m credibly told that they don’t exist.

This opt out formulation didn’t exist until three weeks ago, and the mechanism for opting out is completely unclear. We don’t know if it’ll take a state legislative action, gubernatorial decree or a ballot initiative to opt out. We also don’t know if states will have to have the public option available for some time until the opt out decision can be made. Reid said in his press conference states will have “until 2014″ to opt out, but with most of the benefits of the health care bill not coming on line until 2013, does this mean that states will have to offer it for a year, or not? It’s unclear. And it’s unclear because there isn’t full language yet.

We do seem to know that the underlying public option is the one that came from the HELP Committee, which is similar to Chuck Schumer’s “level playing field” approach, but which is administered by the HHS Secretary and will only pay provider rates within the average range of what private insurance companies pay. There’s also this nugget buried in a Politico post, which suggests that Reid’s team is devising ways to ensure that states will have a hard time opting out.

Under Reid’s proposal, nonprofit insurance cooperatives, which were included the Senate Finance bill, would also be offered in a new insurance marketplace known as an exchange. But if a state chose to opt out of the public option, they could not offer a co-op to replace it, according to Reid’s office.

I don’t know if this is the best idea. But lots of seed money and a fair amount of administrative jobs would come into a state with a co-op, and so this reflects tying the public option to additional tangible items to make it difficult for a state to say no. And in the case of both Medicaid and the stimulus, practically none of them did.