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ObamaCare vs. RomneyCare vs. RomneyCandidateCare


The number of uninsured would soar and the health-care safety net would unravel under Republican candidate Mitt Romney's  health proposals, according to a report by three economists.

In Florida, the number of uninsured would grow by 500,000 by the end of Romney's first term, instead of dropping by 2.5 million if President Barack Obama is re-elected and the Affordable Care Act takes full effect, they said.

The report was written by economists who helped design or implement the Massachusetts Health Insurance Law, signed by then-Gov. Romney in 2006. The economists compared Romney’s law – “RomneyCare” —to his current proposals on health insurance – “RomneyCandidateCare.”

“There’s a radical difference,” said MIT Professor Jonathan Gruber. The Massachusetts law has been an “enormous success,” he said, cutting the uninsured rate to 3 percent and gaining broad public support.

By contrast, he said, “Rather than fixing the problem (of the uninsured), RomneyCandidateCare would make it worse.”

Gruber co-authored the report, ObamaCare versus RomneyCare versus RomneyCandidateCare, with Brandeis Professor Stuart Altman and Harvard’s John McDonough. Gruber said the economists were called to Washington to advise Congress and the Obama Administration as the Affordable Care Act was being developed.

Huge Difference in Uninsured

Families USA, a consumer group that supports the Affordable Care Act, released the report on Thursday and set up the conference call between reporters and two of the economists.

As a non-profit, Families USA cannot back a particular candidate, said CEO Ron Pollock. But it can discuss public policy issues, including Romney’s stated desire to repeal ObamaCare, cut Medicaid funds to the states and change Medicare’s coverage to future beneficiaries.

The report forecasts the health-insurance landscape, depending on which candidate wins the election, by the end of the four-year term.

“There is a huge difference in how many people will wind up uninsured in 2016,” Pollock noted.

The economists calculated what would happen if RomneyCare – the Massachusetts law – were enacted in every state, and they compared the result to forecasts for ObamaCare. At the end of four years, they found, the number of uninsured who gained coverage was practically the same, and the cost to families who had to buy their own coverage was about the same.

The Massachusetts law served as a model for ObamaCare, Gruber said. The similarities between Romney's law and ObamaCare have placed the Republican candidate in an awkward spot.

On Wednesday in Ohio, for example, he bragged about the Massachusetts law, saying it was proof of his empathy. “(D)on’t forget—I got everybody in my state insured,” he said. 

But at a rally the same day, he attacked Obama’s health law as a threat to American freedom.  “He wants to put bureaucrats between you and your doctor,” Politico reported Romney as saying. “He believes that government should tell you what kind of insurance you have to have. He believes government should have a board of people who tell you what kind of care you can receive.”  

Higher Costs

In their report, the economists calculated that Romney’s current proposals would prove costly for middle-class families who aren’t covered under an employer plan and have to buy health insurance on their own. By 2016, premiums and out-of-pocket spending would total about $11,400 under Romney, compared to less than $6,000 under the current law.

Professor Altman said he helped design the bill that ultimately became RomneyCare and then ObamaCare while serving in the administration of Republican President Richard Nixon. Supported by both Nixon and top Senate Democrats, including Ted Kennedy, the law almost passed in 1974, he said.

Altman said that Romney and his running-mate, Rep. Paul Ryan, have proposed ideas that would significantly reduce funding to public programs, which would force cuts to health-care providers and shift more costs onto those who have private insurance.

He said the biggest hit would be to Medicaid, the joint federal-state program that covers low-income children, pregnant women, the elderly and disabled. 

Under ObamaCare, the federal government will temporarily underwrite the cost of expanding Medicaid to cover more low-income people. Just how many depends on which states decide to accept the expansion; Florida Gov. Rick Scott has rejected the offer, although the Legislature still hasn’t weighed in.

Romney and Ryan say they want to convert Medicaid to a block-grant program, removing the conditions attached to federal money so that states can experiment and use the funds more efficiently. But they would also cut the funding back by over $800 billion, Altman said. “There is no way the states can bring about enough efficiencies to make that up,” he said.

Altman also addressed the fears of Medicare beneficiaries that ObamaCare is taking money from them to pay for covering the uninsured. Altman said any reductions in future spending are more than offset by net gains for Medicare in other areas of the Affordable Care Act. 

In short, he said, campaign ads’ charge that ObamaCare is cutting Medicare benefits by $716 billion is “just not true.”

--Health News Florida is journalism for a healthy state. As a part of WUSF Public Media, it provides in-depth coverage of health issues and policy.  Question? Comment? Contact Carol Gentry, Editor, at   727-410-3266   or Carol.Gentry@HealthNewsFlorida.org.  

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