These states tried an Obamacare public option. It hasn’t worked as planned.

In Nevada, officials face an uphill battle implementing a policy the state’s incoming Republican governor called “bullshit” — and the state is already proposing easing targets for insurers to account for higher-than-expected medical inflation.

And in Washington state, which was the first to pass a public option in 2019, enrollment remains paltry, and while the cost of the health insurance plans has decreased, state health officials said the policies available are still too expensive.

“It’s still got a ways to go,” said Washington state Rep. Eileen Cody (D), who sponsored the state’s public option bill. “It’s not exactly what I had envisioned — I’ll put it that way.”

With Republicans set to take control of the House in January, progressive plans to build on Obamacare at the federal level are going nowhere, leaving it to state lawmakers to inch toward Democrats’ goal of universal health coverage. The rocky implementation of the public option plans in these three western states illustrates the challenges the left faces in doing so as blue state ambitions run up against a powerful health care industry accustomed to getting its way.

“The unfortunate reality is that there’s really big forces and really powerful forces that want to see the status quo continue to exist, and the status quo doesn’t allow for some of these more innovative changes that take out profit and take out some of the high reimbursement rates that we’ve been seeing,” said Liz Hagan, director of policy solutions at the progressive group United States of Care, which advocates for states passing public option policies. “A lot of the arguments and pushback have led to some of these public options being more of a public-private partnership, or public option-style plans.”

Insurance companies, which have long viewed the public option as an existential threat, and private market advocates continue to argue that the policy isn’t living up to its goals and, instead, will damage the nation’s health insurance landscape — and, with it, people’s ability to access affordable health care and a robust network of providers.

“They’re price controls. That’s what they are. And they’ll have the same effect that we’ve had in price controls for centuries, which is a reduced availability of the controlled commodities, whether they’re medical services or wheat or anything else,” said Robert Moffit, a senior research fellow in the Center for Health and Welfare Policy at the conservative Heritage Foundation. “I think the likelihood of them being successful, making a price control system work, is nil.”

The public option envisioned by liberals during the Obamacare debate was a government-run insurance plan that would compete in the private market. That’s not what Colorado, Nevada and Washington are doing. Instead, they are using their regulatory authority to…