There’s been lots of political and economic discussion about exchanges and bending the cost curve and risk mitigation, but not a lot of real-world answers to some pretty basic questions about health care reform. Maybe you know these answers? Or maybe you’ll have a chance to ask a Congresscritter the answers?

1. We all know that Public Option will exclude people who have health care at work. Well, what happens when I get laid off or quit my job? Does COBRA constitute "health care at work?" Do I need to exhaust my 18 months of COBRA to be eligible for Public Option?

2. What happens when I go back to work after being on Public Option for six months? If my employer offers health insurance, but it’s pricey or suck-y, can I stay on Public Option, or does my new employer’s offered health care preclude my further participation?

3. What if I am transferred with my employer from one state to another that has opted-out of Public Option. and then I get laid off? Am I eligible for my previous state’s Public Option if I paid taxes there that calendar year? Or did being transferred to a non-Public Option state eliminate the possibility of enrolling anywhere after I’m laid off?

4. What if my laid-off spouse wants to join my employer-provided health care but would make my premiums a lot more expensive? Can I join Public Option when there’s a "family trigger event" like a layoff, a birth, or a marriage?

5. What if I’m laid off from my employer that covers my domestic partner too, but my state’s Public Option recognizes only relationships between one-man-and-one-woman? How does our family get health insurance coverage then?

6. What if I’m enrolled in my state’s Public Option when my state opts-out? How does my family get health insurance then?

7. What if my prescriptions hit my employer’s health insurance lifetime maximums? Can I enroll in Public Option when my employer’s plan stops paying for drugs to keep me alive?

8. What if my kid needs lifesaving treatment but it isn’t covered under my employer’s health care plan? Can I drop out and enroll in Public Option to get the help my child needs? Or does my employer’s health insurance on offer mean I’m ineligible despite its limitations?

9. If my spouse and I are both on Public Option in a family plan, and I get a job, do we need to take my employer’s family health care plan on offer? Or can I stay in Public Option as long as my spouse is enrolled?

10. What if my Public Option premiums go up so I join my employer’s plan after all, but the following year the premium expense flips? Can I re-join Public Option as a previous member, or must I stay in my employer’s plan?

11. Will employer health plans be available on Day One of employment, or will they still have waiting periods for enrollment? Can I stay on Public Option until my employer’s plan lets me in?

12. What if I’m being treated under Public Option and get a job? Will my employer’s health plan have to cover my treatment right away?

13. What if my employer drops domestic partner health insurance coverage as a cost-cutting measure? Is my partner then eligible for Public Option? Is our family eligible or must I stay in my employer’s plan?

14. What if I get promoted into a job that makes me no longer eligible for Medicaid but I can’t afford the employer health plan? Must I enroll in Public Option or can I stay in Medicaid that calendar year?

15. What if overtime pay makes me ineligible for Medicaid but I don’t drop out and take Public Option? Will I be penalized for staying in a program I’m ineligible for? What if my employer cuts my pay and I’m newly eligible for Medicaid? Will it still cover my kids’ current treatment being paid for under the employer plan?

I know that some of these questions will only be sorted out in the complex regulation-writing process at HHS and in the states after health care reform passes. But it would be nice, at least at a minimum, to see legislators recognize that the bill they pass needs to provide guidance in these areas. I haven’t "read the bill" so if some of my questions are answered there, please let me know.

With this summer’s foolishness over Death Panels and the current anti-abortion debate about the bill’s coverage of legal women’s health procedures, it seems to me a lot of real-world issues that affect a lot more people aren’t being talked about. If you have questions from your own real-world experience that you haven’t seen addressed as well, please leave them in the comments.