For all the controversy over a government-run insurance option, the program outlined in health overhaul legislation likely would play a minuscule role in efforts to expand health care coverage, according to many health care experts and lawmakers.

Of the 30 million Americans likely to purchase insurance through exchanges created by the legislation, only 6 million -- or one fifth -- would enroll in a public insurance plan, according to a Congressional Budget Office (CBO) analysis of the House bill. Viewing it another way, the 6 million using the public option would amount to only 2 percent of the 282 million Americans under the age of 65 who are projected to have health insurance by 2019, when the legislation is fully implemented.

And that number could shrink because states may decide to opt out of a public insurance plan, an escape clause that's likely to be included in the Senate plan.

. . . Senate Majority Leader Harry Reid (D-Nev.), has said the Senate overhaul bill would allow states to opt out of the public plan -- a step political experts say at least some would likely take. . . . No matter what the states do, the government-run plan is not likely to attract a large membership, at least according to the CBO. The CBO reasoned that the plan may not be able to offer a price advantage -- in part because the House bill requires a government-backed insurer to negotiate payment rates rather than dictate them to hospitals and doctors.

If the number of people in the public plan turns out to be 6 million in 2019, that would work out to an average of 120,000 per state. But that number probably would be smaller in the smallest states, perhaps totaling just tens of thousands.

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