On a purely political level, this issue could pay dividends for Democrats for years to come. Democrats running for office in public option states would have a reliable, winning issue in every election ("the Republicans want to take away your health insurance"). And in opt-out states, Democrats would also have a strong message ("I will give you the same options that everyone else in the country has already"). That's an issue that could breath new life into the Democratic party in red states.And Andrew Sullivan wound up coming to the same conclusion.
Ezra Klein sees it a differently:
I don't think there will be any real fight over the public option, and I think that virtually no states will opt-out...I'm going to split the difference. First of all, I think Ezra is exactly correct about the debate. No one really cares very much about the substance of the public option; everyone cares a lot about it's symbolic value. So there's a good chance that once it passes, no one will care to revive the debate.
My prediction is that the public option, if it passes, will be much like that. States wouldn't be able to opt out till 2014. By 2014, we'll be arguing over all manner of things, but a public insurance option for the small sliver of the population with access to the health insurance exchanges will be one of those things. In that scenario, where there's very little controversy over the public option, I don't believe that state legislatures and governors are going to go to the trouble of rejecting it, and I don't believe that anyone will manage to reinvigorate the controversy around it. The controversy around the public option is an expression of the controversy around Barack Obama's presidency in general, and health-care reform in particular. Once those issues are essentially settled, the underlying policy isn't going to hold people's attention (emphasis added).
...or at least they wouldn't, if everyone was (1) behaving rationally, and (2) seeking to maximize votes. The problem for the Republicans is that neither of these conditions can be assumed to hold. In particular, it seems highly unlikely that "the controversy around Barack Obama's presidency in general" will be "essentially settled" among conservatives in 2014, particularly if Obama wins a second term. In fact, should Obama win a second term but have the Democrats lose the House somewhere along the way, there's a very good chance that Obama will be facing impeachment in 2014 or 2015 (not conviction, but impeachment) -- that is, unless the core of the Republican party changes dramatically.
Does that mean that states with Republican legislatures and/or governors will definitely go after the public option? No; Ezra may be right that health care won't be a major issue at that point, and it isn't really possible to predict which phantoms the Becks and Rushes of the world will be conjuring up in five years. So, as I said, I'll take the middle course: if Republicans remember to oppose the public option once they can do so, then the logic kicks in that Democrats stand to benefit from the inevitable GOP charge to self-destruction on the issue. I'd say it's impossible to predict, however, whether or not Republicans will remember this one -- there's nothing inherent in the issue that would force it onto the 2014 GOP agenda.