CBO’s analysis took into account the probability that some states would opt not to allow the public plan to be offered to their residents. Rather than trying to judge which states might opt out, CBO applied a probability recognizing that public opinion is divided regarding the desirability of a public plan and that some states might have difficulty enacting legislation to opt out. Overall, CBO’s assessment was that about two-thirds of the population would be expected to have a public plan available in their state.
This estimates sounds a bit low to be honest. There are currently eleven state governments completely controlled by Republicans. (AZ, FL, GA, ID, NE, ND, SC, SD, TX, UT, VA) Roughly 79 million people (26% of Americans) live in these states, and I would not be surprised if everyone of them opt-out of the public option right away, or at least sometime before 2014. In addition to these eleven, there are easily another dozen conservative states where I suspect the Republican party can gain complete control of the state government for at least some period of time in the next 4 years. Add to that that not all Democrats fully support the public option, and I estimate it is more likely that over 40% of the country will be opted out of the public option before it is ever made available.
It's great to see that the Democrats have put the health care of the people of Texas at the tender mercy of Rick Perry. I guess the new motto is: Universal affordable quality health insurance for everyone lucky enough not to live a red state.