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A Curious Answer

Mitt Romney on Obamacare

8:09 AM, Sep 7, 2011 • By JEFFREY H. ANDERSON
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On Labor Day, during the GOP presidential forum in South Carolina, Mitt Romney had the following exchange with the host, Sen. Jim DeMint (R., S.C.).  DeMint asked, “As you know, if you’re the nominee, the president is going to say that you implemented Obamacare in Massachusetts. How would you describe what Massachusetts did, the mandate to buy health insurance at the state or federal level?”

Romney-01

Perhaps somewhat surprisingly, Romney replied, “That will be one of my best assets if I’m able to debate President Obama, as I hope to be able to do, by saying, Mr. President, you give me credit for what you’ve tried to copy in some ways.” 

Romney immediately continued:  “Our bill dealt with 8 percent of the population, the people who aren’t insured and said to them, if you can pay, don’t count on the government.  Take personal responsibility.  We didn’t raise taxes, Mr. President.  You raise them $500 billion.  We didn’t cut Medicare.  One president in modern history cut Medicare, this president, and I’ll say to him, why don’t you give me a call and I’ll [tell] you what to do right and what not to do.  And the critical thing is this:  He dealt with — we dealt with 8 percent; he dealt with 100 percent of the American people.” 

Romney curiously concluded, “It [ObamaCare] has got to be stopped, and I know it better than most.”

It’s true that Romney didn’t cut Medicare.  (Nor, as a governor, could he.)  Romney’s health-care law, however, applies to all Massachusetts residents, not just 8 percent of them — even if only 8 percent were originally out of compliance with it.  Like ObamaCare, Romney’s health-care law requires 100 percent of residents, with perhaps very few exceptions, to buy (often heavily taxpayer-subsidized) government-approved health insurance.  True, the vast majority of Massachusetts residents already had insurance when the law was passed, but that’s the case nationally as well. 

And Romney did raise taxes on those who violated this newly imposed insurance mandate. 

In his book, Romney quotes Atul Gawande, a Harvard-affiliated doctor, who offers a generally favorable description of RomneyCare but notes that “those who had no coverage had to enroll in a plan or incur a tax penalty.”  Gawande subsequently says that RomneyCare contains a “requirement that individuals buy insurance.”  Romney doesn’t dispute Gawande’s description.

The website Mass.gov says, “The individual mandate is a requirement that all Massachusetts residents over the age of 18, for whom available health insurance is affordable, obtain and maintain health insurance that meets minimum coverage requirements beginning July 1, 2007.

“Individuals who cannot show proof of health insurance coverage by Dec. 31, 2007, will lose their personal income tax exemption when filing their 2007 income taxes….

“Failure to meet the requirement in 2008 will result in a fine for each month the individual does not have coverage. The fine will equal 50 percent of the least costly, available insurance premium that meets the standard for creditable coverage.”

Of course, the individual mandate is hardly the only problem with RomneyCare (or, even more so, ObamaCare).  Shawn Tully, senior editor at Fortune magazine, has written that RomneyCare’s taxpayer-funded insurance “subsidies are enormous”; they are “90% for families earning $44,000.”  Gawande (again, as quoted in Romney’s book) gleefully says, “For the past year, I haven’t had a single Massachusetts patient who has had to ask how much the necessary tests will cost.”  Not surprising (but without any hint of making the connection), Gawande notes that “The Massachusetts plan didn’t do anything about medical costs,” and Romney concurs:  “That is the task that remains.” 

Another Harvard-affiliated doctor, a friend of mine, writes that “Romney's biggest selling point for the Massachusetts mandate was the ‘free rider’ emergency room problem.  Five years later, there is no decrease in ER utilization.”  My friend notes that — as would also be true under ObamaCare — much of the decrease in the number of uninsured has been through Medicaid, which doesn’t pay doctors well at all; thus, “primary care docs…will be supplanted by nurse practitioners and other care extenders who will become the new primary care providers.  Instead of following, say, 2000 patients, a primary care MD will now be responsible for 8000 patients and supervise three to four NPs who will be the first responders available in emergencies.  This process is taking place in academic centers as I write, and community care centers will follow suit.  The vast majority of patients in Massachusetts have no idea that this shift is taking place and may not be amused as it happens to them, courtesy of Mitt and his mandate.”

During the South Carolina forum, Romney also reiterated his oft-repeated pledge that, on day-1 of his administration, he would issue a “waiver from ObamaCare to all 50 states” (a proposal that is also highlighted in his newly released economic plan).  But Kathleen Sebelius, President Obama’s Secretary of Health and Human Services, has already been issuing more than enough ObamaCare waivers — including waivers to two entire states that also happen to be swing-states in the upcoming election:  New Hampshire and Nevada. 

There are at least three serious problems with Romney’s waiver pledge.  One, waivers can’t wipe ObamaCare off the books.  (That’s why the Obama administration has been so willing to issue them.)  Two, while leaving ObamaCare legally intact, issuing waivers somewhat undermines the immediate sense of urgently for repeal (again, hence the Obama administration willingness...).  Three, even if Romney were to issue waivers to all 50 state governments, thereby freeing them from their burdensome obligations under ObamaCare, such waivers wouldn’t provide relief to the 300-or-so million American citizens, each of whom would continue to be bound by ObamaCare’s unconscionably statist decrees.

On day-1 of any new administration (whoever is at the helm), we don’t need more waivers.  We need repeal.

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