Jay Inslee, the governor of Washington state, just signed into law the first-ever statewide experiment with a "public option" in heath insurance. This is a momentous event, but so far it hasn't been getting that much attention in the media. Inslee is also a 2020 Democratic presidential candidate, so it will now be incumbent upon him to become the champion spokesman for instituting a public option nationwide.

Enacting a public option is a big deal, for a number of reasons. Many Democrats (myself included) still have strong feelings against those Democrats in Congress who directly fought against including a public option in the Patient Protection and Affordable Care Act (otherwise known as Obamacare). Two senators in particular -- Max Baucus of Montana and Joe Lieberman of Connecticut -- successfully stripped the public option from what was being considered when the Obamacare bill was being written. Since that time, the issue has faded into the background of the healthcare debate, but it is now experiencing a renaissance of sorts.

As opposed to "Medicare For All" (more on that in a moment), the public option has now been rebranded as "Medicare For All Who Want It" or, sometimes, "Medicare X." Rather than moving the entire U.S. healthcare system over to single-payer all in one fell swoop, Medicare For All Who Want It would leave this choice up to the individual. Like your health insurance and want to keep it? Fine. No problem. But if you don't like your current insurance, if you are shopping around for insurance, or if you don't have health insurance at all, then you would have the option to join Medicare on the public exchanges, right next to all the private insurance plans. So if you, as a consumer, wanted to choose this public option, then you would have the chance to do so. That's a pretty easy concept, and politically it might be a lot easier sell than destroying the private health insurance market entirely, by fiat. The choice of joining Medicare would not be imposed on everyone, it would instead be up to each and every one of us. The costs and benefits of doing so would be competing with the best the private health insurance market could offer. May the best plan win.

This is precisely what Inslee just signed into law in Washington state. Well, not precisely -- the public option wouldn't be labeled "Medicare," but it would have a transparent list of its benefits and costs for everyone to compare to what else was on offer. No family would have to spend more than 10 percent of their income on health insurance. The public option would be available in every county in the state, whereas currently there are over a dozen counties where only one private plan is available on the exchange (meaning people in those counties have no other choices). But, unfortunately for Inslee, this all won't happen until 2021 -- after the presidential election, in other words. So he won't have solid results to point to and people in Washington won't have experienced the new system yet.

The fear that all the private insurers have is that they simply won't be able to compete against the public option. They know how much overhead they spend, and they know that Medicare has far less of an overhead -- a competitive difference that will allow the public option to be offered cheaper than they can manage. So they see their own business model as dooming them in competition with a single-payer model.

They might be right, and then again they might not. That remains to be seen. The big question is how many people will migrate to the new public option and leave the private health insurance market. Nobody really knows the answer to that, because no state has instituted such a system before. Washington will be the test case, in other words, and the data will be examined microscopically to see the effects on the marketplace of having a public option to choose. There are multiple ways the new system could fail -- it could fail to garner much interest from the public, it could wind up costing too much, it could fail to bring down prices, etc. But it could also succeed, of course, and become a model for other states to institute for their citizens. But we won't even begin to know this until roughly 2022, when the first year's data becomes complete.

But at least we will have such data to examine. This is why the new Washington law is so ground-breaking. To date, the advocates of a true single-payer Medicare For All plan have never chalked up such a state-level victory. This hasn't been from lack of trying -- they got very close to enacting single-payer in Vermont, and made strides towards doing so in California, but both of these legislative efforts failed. In Vermont, they simply could not make the numbers work -- it was going to be too expensive for such a small state to institute. In California, the bill that passed one legislative chamber didn't even really address the cost side of the equation at all. This should be a cautionary note to anyone -- like presidential candidate Bernie Sanders -- who insists that only a pure single-payer system is the answer to all our health insurance ills. If such a plan can't pass legislative (or economic) muster in these two very blue states, then it is going to be a monumental job to get Congress to approve such a thing at the national level. It may be a great idea in theory, but implementing it is going to be a nightmare no matter how it happens, in other words.

The Medicare For All Who Want It idea is a lot more incremental and organic. By offering a public option next to all the private insurance plans, marketplace forces will determine who wins this ideological battle. If the public option proves to be popular, because it is seen as being better -- by being cheaper, being less of a hassle, being more comprehensive, or for whatever other reason -- then the consumers will flock to it. Eventually even businesses will choose to enroll their employees in the public option rather than paying more for private insurance plans. This will cause a migration of people from the private market to the public market. If this migration becomes overwhelming, then the private plans are going to eventually wither on the vine -- they'll have such small pools of people participating that they'll become unprofitable to the insurance companies, who will eventually stop offering the plans. But this may not kill off the private insurance companies, since under the new Washington system all the public option plans will actually be administered by private insurance companies (some European countries run their entire insurance market in similar ways, without sacrificing universal coverage). What will die will be the private health insurance companies own for-profit plans, not the companies themselves.

If the spiral of people shifting from private plans to the public option continues, though, then eventually Washington may wind up with almost everyone choosing the public option and virtually no one left on the private insurance plans. This is just one scenario, mind you, as there are no guarantees this spiral will even materialize. But it shows how Democrats who are convinced that a public option will be superior to private insurance might be proven right in the end -- and without forcing anyone off their current insurance by government edict. A single-payer advocate with the strength of his or her convictions shouldn't be afraid of testing the theory in the marketplace rather than disrupting the entire market by force, in other words.

Once again, though, we won't even begin to know any of how it turns out until 2022, at the earliest. In other words, there won't be any data to analyze before the 2020 election. So in political terms it will have a limited impact on the race (especially the Democratic nominating race). But maybe Jay Inslee will be able to use it nonetheless, because without actual data to point to nobody can criticize the new plan as a failure yet. Inslee can tout the plan as being the most wonderful answer to the problem, and there will be no contradictory data to refute any claims he now makes.

There will be a fierce debate between the single-payer purists on health insurance and those who advocate a public option as an interim step. The Democratic candidates are all currently staking out their positions, and the sparks are going to fly at some point. The purists insist that incrementalism isn't good enough and the only way to get costs down and improve coverage for everyone is to tear down the existing system and rebuild it from the ground up. Nothing less will do, because the current system is so inherently flawed. The public option advocates will point to the public's fear of that much disruption in the health insurance system, and now they will also be able to point to Washington state as an example of how instituting a public option is a lot more realistic politically than changing an entire state to single-payer all in one fell swoop -- which hasn't be successfully done in any state yet.

In other words, this debate is going to shift as a result of what Jay Inslee just signed in Washington. It may not shift all that much in the 2020 race, though. Inslee is a complete longshot at this point with very little actual public support at all among Democratic voters, so no matter what he does as governor is going to have a rather limited impact on the general debate. But it may indeed have a large impact on Democratic politics in the coming years, as actual data become available and the experiment is either seen as a sweeping success or a failure (or, more likely, somewhere in between). Even if a Democrat is elected president in 2020, and even if a big enough blue wave develops to give him or her a Democratic House and Senate, it's still going to be very hard to pass any comprehensive health insurance reform bill. It may not happen by 2022, in other words, and it may not have happened by 2024. There will still be enough Republicans in the Senate to block any such legislation, so in the end the Washington experiment may prove to be instrumental in whatever Democrats ultimately decide to do. It may even become a much larger issue in the 2024 election than launching Inslee to the nomination this time around. Nevertheless, he still will deserve the credit for such a pioneering step, because Washington's new public option is the first concrete step any state has taken towards a large-scale reimagining of the health insurance system. As Joe Biden might say, this is a big effin' deal, and Inslee deserves the credit for taking such a monumental step, no matter how it turns out in the end.

-- Chris Weigant

Follow Chris on Twitter: @ChrisWeigant