The current round – getting much closer to the end game – on congressional health care action, puts this as a final package headed toward Senate vote: Inclusion of a public health insurance options, with “opt out,” meaning the included ability of individual states to decide not to participate.

While the talk swirls about the “opt-out” option, which has been notable in discussion for some weeks but now seems a solid part of the Senate package, the question for this space becomes: What of the Northwest states? What will Washington, Oregon and Idaho choose to do?

In the case of Washington and Oregon, the answer seems obvious. Since no further action would be needed (if the current package becomes law) to participate in a public option, and since both states are run by people who as a whole likely back the public option, that would seem to be that. These two will be “public option states.”

The question mark will be Idaho. Many of Idaho’s top elected officials are highly skeptical, to put it minimally, of the public option. Of the 50 states, Idaho probably would be among the half-dozen or so where opposition or criticism of the option would be greatest. A conservative Republican Idaho elected official (as most of them are) ordinarily would have to reverse stance heavily to go along with the public option.

And yet, what if they did not? If the program for whatever reason crashes and burns nationally, that would be one thing – it might be withdrawn or scaled back in the larger picture on its own. But suppose it functions somewhere close to as-intended? Imagine the scene of Idaho elected officials defending their refusal to allow Idaho citizens to obtain affordable health insurance, when they (and the businesses they run or are employed by) could do that by moving across the border? The “opt-in” option could put them in quite a bind, unless they went along with the thing described in so many conservative circles as a chamber of horrors.

It may even be so intended.