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.
I can not believe the ignorance of some of these posts. If these fine folks do not believe what Dr. Field lays before them so even they can understand it they should go out and do their own research. I did. Obamacare basically is Romneycare at the federal level. Obama found a program that worked and put it to good use. This story is about the ultimate flip-flop. When you really look at it all what other way can you do it? Insurance is the spreading out of risk and Medicare is top heavy because most of the insured are elderly and infirm. If you spread that pool to everyone over a certain age and just cover everyone under that age it would be a more reasonable way to render care and pay for it. Medicine has to stop being a business or it will never work for all of us and it will never work efficiently. Medicine should be like the police and firemen and the military. There for you when you need it, without it putting you out of business and on the street. What kind of free country it that? Romneycare/Obamacare is the first step toward Medicare for all. The right is doing what they always do, getting in the way of good ideas, even their own.— OldSouthPhilly- rationing is the next step when doctors refuse to accept the guidance of the central planners. the doctor/patient relationship will not survive.— jstash
- All these Constitutionalists that insist on the States taking the lead role and reducing the size of the Federal government keep ignoring the huge inequities in the State's budgets. There is no way that Mississippi can afford to cover all it's residents the same way a more prosperous or smaller state (like MA) can. It makes tremendous sense to have a uniform national health care coverage. Is the ACA the best plan? probably not, but there was zero sense of cooperation between the parties and so it fell to the Democrats to pass their bill.
...and Matt, just because you seeno value in higher education doesn't mean that Ph.D.'s are "a joke". I can assure you that getting one in my field (geoscience) requires a lot of hard work and time.— akh - One glaring difference you will never hear from a liberal: ROMNEYCARE - 70 pages vs. OBAMACARE - 2,074 pages. For more differences see link: http://mittromneyandhealthcare.blogspot.com/p/romneycare-vs-obamacare.html— El Luchador
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