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.
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- 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 - rationing is the next step when doctors refuse to accept the guidance of the central planners. the doctor/patient relationship will not survive.— jstash
- 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
- Any article that examines facts and exposes distortion will be called a rag or supporting a socialist agenda. These people are morons who can't even bear to hear their arguments and candidates picked apart.— phil80
- @bannedrepublican--If the bill was "corrupt" shouldn't the Supreme Court have found it unconstitutional? Exactly what does "rammed through" mean? Was a vote conducted? Were the votes counted? Are you saying that bills passed in a Democratic Congress are "corrupt" and "rammed through" and but bills in a Republican Congress have integrity? Are there different voting procedures under a Democratic Congress and a different standard of Constitutionality used by a Supreme Court evaluating a bill passed by a Democratic Congress?— mick-of-the-moment
- Sarah Palin said the author is in no position to make any commentary, he just has a big fat resume and can not quote the cliff notes of any Ayn Rand book.— mick-of-the-moment
- @bannedrepublican--Did the House and Senate vote on it, or did Obama's Kenyan death squads mandate it?— mick-of-the-moment
- It was a corrupt bill rammed through by democrats.....the people were not represented.
- One big difference....People in MA wanted it....the American people didn't.
- @Live--You are TOTALLY incorrect. This country was not founded by the states. The United States begins with the ratification of the Constitution. The first words are: "We the people." This is an important distinction. Many of the delegates at the Constitutional Convention did want to make the document something created by the states, with wording to that effect, but this was rejected in favor of a strong federal government. Under the Articles of Confederation it was a "We the States" kind of government, the Confederacy did the same thing. How did those governments work out long term? I know that to understand this requires reading and study and not just listening to Rush and Hannity so I am sure you will reject it.— mick-of-the-moment
- Grover Norquist, the GOP's wonderboy is married to a muslim, and is a secret member of the Muslim Brotherhood.— gordon7
- The biggest difference is 30 million who won't be covered if Republicans can undo the ACA. And there are additional millions who would lose their "donut hole" coverage. Only a single-payer health care system will end the ripoff of for-profit health insurance. 15-25% of health care dollars go to admin costs, compared to about 2% of VA costs. Paul Krugman has nailed it: http://www.nytimes.com/2012/08/31/opinion/Krugman.html?_r=1&hp— Jinchesco
- To date, the best comment I have ever heard, about Obama care was, "Obama care will burden the health system with to many people",my thought is, if you need health care you ain't waitin for Obama care you will burden the system whether you are covered or not.— Thelonius Monk
- Insure them all and let God sort them out.— Thelonius Monk
- i just went my doctors for a checkup we began to talk about the healthcare ( mind you he voted for the President in 08) The healthcare is costing him & the doctors money. He stated to me that he will not be fool again. He will vote for Romney— bigguy1
- The big difference is a move towards centralized planning, something our founding fathers deplored - as should we, because for every new entitlement and regulation, we incrementally forfeit freedom and liberty. Romney wins and the emperor occupying 1600 Pennsylvania Ave packs.— KeepRight
- liberal rag— psualum
- All these stories by the liberal press are so slanted towards the left, to make socialist Obama look good.— dan39564
- People still want to defend the deadbeats that can afford health insurance, but stiff the system.— chasing history
- a PHD is like being a Chiropractor. What a joke.— Matt from Iowa
- 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
- You sir are the joke. http://publichealth.drexel.edu/Faculty/Faculty-Member/5034/facultyid--82/ — ephraim
- 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 - 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
- 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
- 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
- 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! - 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 - 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
- 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
- Abington Memorial Hospital
- Agency for Healthcare Research and Quality
- American Medical Association
- Aria Health
- Centers for Disease Control and Prevention
- Centers for Medicare & Medicaid Services
- Consumer Medication Safety site from ISMP
- Cooper University Hospital
- Crozer-Keystone Health System
- ECRI Institute
- Inquirer Health & Science
- Institute for Safe Medication Practices
- Jefferson Health System
- Kaiser Health News
- Kennedy Health System
- Lourdes Health System
- Medical Society of New Jersey
- Mercy Health System
- New Jersey Department of Health and Senior Services
- New Jersey Hospital Association
- NPR.org Shots
- NYTimes.com: Well
- Penn Medicine
- Pennsylvania Department of Health
- Pennsylvania Health Care Cost Containment Council
- Pennsylvania Medical Society
- Pennsylvania Patient Safety Authority
- St. Mary Medical Center
- Temple University Health System
- Tenet Healthcare
- The ACP Advocate Blog by Bob Doherty
- The Chester County Hospital
- The Hospital & Healthsystem Association of Pennsylvania
- U.S. Department of Health and Human Services
- U.S. Food and Drug Administration
- Virtua
- WSJ.com Health
