Wednesday, April 25, 2012

Mitt Romney has radical health plan to undo his original reform

Romneycare Romney celebrating passage of Romneycare. That's history. Mitt Romney is not one to put a lot of specific plans on paper. His radical budget, for example, has the numbers he's set as goals: $500 billion in cuts in 2016, but $100 billion in additional defense spending. How he would get there would be so hugely unpopular and unsustainable that he won't actually provide any details.

His new health plan, the one that would replace Romneycare Obamacare, is largely the same. The Los Angeles Times' Noah Levey worked to piece together the outlines of his emerging health plan, noting that "Romney has only sketched the outlines of a plan, and aides have declined to answer questions about the details." But what Levey has compiled shows a plan as radical as Romney's budget would be.

The centerpiece of Romney's plan would overhaul the way most Americans get their health coverage: at work. He would do so by giving Americans a tax break to buy their own health plans. That would give consumers more choices, but also more risk.

Critics and independent analysts say the impact would probably leave a larger number of Americans without insurance. [...]

While offering consumers more choices, Romney's plan would give companies strong incentives to stop providing insurance to workers. It also would overhaul the 46-year-old Medicare and Medicaid programs for the elderly, poor and disabled.

The plan could swell the federal deficit; a similar plan backed by Sen. John McCain (R-Ariz.) during the 2008 presidential campaign would have cost more than $1 trillion over 10 years, on par with the price tag for the Obama healthcare law.

Decoupling insurance from employment has been a goal for progressive reformers, too, but in a very different way. Where most independent health experts and progressive policy-makers would offer a Medicare-like alternative'state-sponsored rather than employer-sponsored insurance'Romney would throw everyone into the largely unregulated individual insurance pool, without the bargaining power of a large employer group behind them.

With Obamacare repealed, with it would likely go the reforms, meaning that once again insurers could deny people coverage based on their pre-existing medical conditions. They could kick out people who get sick, and they could go back to arbitrary and unfair premium setting, making women or older people or people in certain geographic areas pay much higher premiums. Of course this would lead to more people being uninsured. It would be the pre-Obamacare status quo, without employment-based insurance plans acting as a backstop.

Romney would also voucherize Medicare, using the Paul Ryan formula, giving seniors a subsidy to shop in the private market, a plan that the CBO and other analysis say would force seniors to pay thousands more out of pocket. Finally, he would turn Medicaid into block grants, like Ryan's budget would, cutting millions of low-income Americans out of the health care system entirely. That's what Republicans like to call forcing everyone to "have skin in the game," forcing people to reduce their health care consumption and thereby reduce costs.

Don't worry, though, competition will finally work this time, they say. Once you get the barrier of tax-subsidized employer-based insurance out of the mix, it'll be a free market health care nirvana.


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