Nearly 29 million people in the US lacked health insurance before the COVID-19 pandemic began. Disproportionately, they had lower incomes and were racial/ethnic minority members, socioeconomically disadvantaged, and less healthy than people with insurance. 1 Between February and May 2020, 5.4 million more became uninsured because of job losses, the greatest increase in the uninsured rate on record. Creating a public option-a Medicare-like insurance plan that people can choose alongside other

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... ns-was a centerpiece of President Biden's campaign platform. 2 Compared with Medicare for All, a public option would represent an incremental coverage expansion but has maintained broader public support. During the 2020 campaign, 67% of voters favored a public option, compared with 57% for Medicare for All. 3, 4 A public option has also been endorsed by the American College of Physicians. 5 Despite its popularity, key elements of the public option remain to be defined. Who is eligible, what it covers, and how it pays physicians and hospitals are critical policy choices that will shape its identity and effects on patients and the health care system.