Obamacare vs. Romneycare: Is there a difference?
Mitt Romney says his Massachusetts health reform plan is much better than Obama's. He claims it's different in important ways. Here's a more careful look.
Obamacare vs. Romneycare: Is there a difference?
by Robert I. Field, Ph.D., J.D., M.P.H.
Mitt Romney says his Massachusetts health reform plan is much better than Obama’s. He claims it’s different in important ways.
If there are big differences, it’s difficult to find them.
In an interview last week with a Denver TV station, Romney cited the key features that differentiate his reform approach from Obama’s.
He declared, “My health care plan I put in place in my state has everyone insured, but we didn’t go out and raise taxes on people and have a unelected board tell people what kind of health care they can have.”
Let’s do some quick fact checking.
Does Romneycare have everyone insured? Close, but not fully there. The plan cut the state’s rate of uninsurance by almost half. As of 2010, the rate was just over 6% for the nonelderly population, the lowest of any state. That’s a huge accomplishment, but there is still a ways to go before everyone has coverage.
Did Romneycare raise taxes? No, but the state didn’t need to. It covered the cost of reform with larger payments that it negotiated from the federal government for its Medicaid program.
Does Romneycare have an unelected board that tells people what kinds of health care they can have? It does. The Massachusetts Connector Authority serves as the state’s insurance exchange. It sets standards for the types of plans that may be sold, thereby determining the kind of access residents will have to health care services.
Is Obamacare any different? Not really.
It will extend coverage to 30 million more people, which will reduce the country’s rate of uninsurance by about half to roughly 8 percent. Not too different from Romneycare.
It does raise taxes in a number of ways, including new levies on tanning salons, medical devices, and high-end insurance policies. But, unlike Massachusetts, it doesn’t have a higher level of government to turn to for help, so it needs a new source of revenue to cover the cost.
It does let unelected officials determine what kind of insurance people can receive by setting standards for coverage under the state exchanges that will sell it. Just like Romneycare.
Romney’s comment about an unelected board was probably also a reference to a new board that Obamacare created called the Independent Payment Advisory Board (IPAB). It recommends cost-cutting measures under Medicare. Romney, along with several fellow Republicans, has complained about the scope of its power. But Romneycare is a state-based program while Medicare is purely federal. It couldn’t have included an IPAB or any other measure concerning Medicare, even if Romney had wanted it to.
After all is said and done, these aspects of the plans are relatively minor, anyway. In their underlying structure, Obamacare and Romneycare are almost identical.
Both expand coverage in the same three ways. They reform the market for individual insurance by creating exchanges to sell it, subsidizing those with low incomes, and mandating that everyone maintain coverage in some form. They expand Medicaid to cover more people. And they penalize employers who don’t offer coverage to their workers.
Romney and his fellow Republicans should be proud that Obama copied their health reform approach. Instead of drawing false distinctions between the two plans, they should boast of leading on health reform and leaving Obama and Democrats to follow.
Imitation is the sincerest form of flattery.
For a PHD you certainly miss a major point. Obamacare will fine companies if they don't offer healthcare. But the amount of the fine is substantially less than most companies contribute right now. So why would the companies not just pay the fine and allow the government to pick up the healthcare?— bigeee1- when you say "allow the government to pick up healthcare"..you do realize that means me and you? It sounds like that fine needs to be hiked up a bit.
Its like the Koch Brothers paying $400M in pollution fines. To them, its just a cost of doing business. Some companies will never be responsible "citizens". Others will get the message.— Donald Segretti - For a PHD you certainly miss a major point. Obamacare will fine companies if they don't offer healthcare. But the amount of the fine is substantially less than most companies contribute right now. So why would the companies not just pay the fine and allow the government to pick up the healthcare?— bigeee1
- Inquirer daily news ; both rags good for nothing more than wrapping fish.DNC nothing more than platform for nation of Islam .— winter
- Ya'know I was REALLY following you, until you said the "Islam" thing.
It makes me think you have deeper motives.— Cuddles - I appreciate the analysis. I think this is a goods summary; however, the author missed one major point.. Obamacare is a Federal program, while Romneycare is a state program. That is a major difference.
Our country was founded by STATES...that agreed to unite under a Federal authority. Generally, States are responsible for its own citizens, while the Federal government protects and regulates the national interests. . We should not be growing ANY federal government now.— Live - grow the federal or grow the state either way you will pay the same in taxes.
when they cut federal programs cities and states pick up the cost and raise taxes.
— the lopez! - It appears that the main issue that Republicans have with the Affordable Care Act is the method of paying for the expansion of care. They don't like the individual mangate and the penalty. What is the Republican proposal for paying for it? They have none. Why don't they have one? Because they really just want to kill the bill. The Ryan budget would dramatically increase the number of people who are uninsured. All to fund additional tax cuts for the wealthy.— MikeP
- Now the Philly.com "Health" section has become a left wing propaganda tool...how about some plain old good journalism without an obvious agenda?— dogman5
- This is not propaganda, these are facts. Mitt Romney is the godfather of health care reform in this country, something he should be proud of. Instead he runs from his single greatest achievement like the plague. If you can't see this, you are really a moron.— N&M
- Biggee1:
Good point re: fine vs coverage. My company has already told us they're suspending their health care contributions and paying the fines. Of course, they tell us it will be cheaper in the long run for the employees as we can get our insurance on the "competitive exchanges"...Yeah, right— Polecat_39 - a PHD is like being a Chiropractor. What a joke.— Matt from Iowa
- You sir are the joke. http://publichealth.drexel.edu/Faculty/Faculty-Member/5034/facultyid--82/ — ephraim
- Matt is having a brain subluxation. Quick, somebody, get him to a chiropractor, so he can have an adjustment. Oh, wait, maybe he is high on ethanol from the fumes of all that Iowa corn processing for gasohol. Or maybe chiropractors in the Iowa legislature have legislated creationism to replace science, so he doesn't know what Ph.D. means. — Jinchesco
- People still want to defend the deadbeats that can afford health insurance, but stiff the system.— chasing history
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