Thursday, October 11th, 2012
Republican presidential candidate Mitt Romney promises to repeal the Affordable Care Act, or “Obamacare,” as soon as he is inaugurated. But how would he replace it? Mr. Romney is not big on details, unfortunately. And whether they are healthy or have a life-threatening disease such as mesothelioma, Americans deserve to know details before they vote in November.
In the first debate with President Obama, Mr. Romney was asked how he would replace Obamacare. He began his response this way:
“Well, actually it’s — it’s — it’s a lengthy description. But, number one, preexisting conditions are covered under my plan. Number two, young people are able to stay on their family plan. That’s already offered in the private marketplace. You don’t have to have the government mandate that for that to occur.”
According to Mr. Romney’s campaign website, however, his plan would “Prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage.”
In other words, if you buy insurance while you are healthy and don’t let it lapse, you can change policies even after you have developed a medical problem. But once you are uninsured for any reason, you have no protection from being denied coverage.
On the other hand, if the Affordabe Care Act is not repealed, beginning in 2014 insurance companies may not deny coverage to any person with a pre-existing condition, period. The ACA also provides that nearly everyone obtain insurance or pay a penalty. This is to prevent people from waiting until they are sick to buy insurance, which would be ruinous to the insurance industry.
To be fair, Mr. Romney’s plan does provide an incentive to buy and keep insurance also — if you develop a health problem while you are uninsured you may be unable to obtain insurance for the rest of your life. In other words, things wouldn’t change much from the way they’ve been for several years.
Obamacare includes several programs to make affordable group insurance plans available to people who don’t get health insurance through their jobs. Mr. Romney has hinted that he might create similar programs. His website says he would “Ensure flexibility to help the uninsured, including public-private partnerships, exchanges, and subsidies.” But that’s all it says; he provides no further details.
This week in Ohio, Mr. Romney met with the editorial board of the Columbus Dispatch. He told the editors that people without insurance would have a chance to make a “choice” to be covered. Exactly what he meant by that, he did not say.
However, he also minimized the problems people have with no insurance. “We don’t have a setting across this country where if you don’t have insurance, we just say to you, ‘Tough luck, you’re going to die when you have your heart attack,’ ” he told the editors. “No, you go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital. We don’t have people that become ill, who die in their apartment because they don’t have insurance.”
But the “free” treatment the poor get in emergency rooms drives up everyone else’s bills. And a Harvard study found that about 45,000 Americans die every year because they don’t have insurance.
As to the second point — today parents may keep children on their health plans until the age of 26. That was not true until the government made it the law. Mr. Romney says “You don’t have to have the government mandate that for that to occur.” But, in fact, it didn’t occur until there was a government mandate.