RomneyCare vs. ObamaCare

Can you tell the difference?

Mitt Romney has gone to great lengths to distance his Massachusetts health plan from the ObamaCare Act, without specifically or even generally, providing any insight whatsoever into what he perceives to be the  differences, so I guess it is up to us to try and do that. The facts appear to be that there are an awful lot of similarities between the plan he signed in Massachusetts in 2006, and the one that President Barack Obama signed in 2010.

Key among them: Both leave in place the major insurance systems; employer-provided insurance, Medicare for seniors and Medicaid for the poor. They both seek to reduce the number of uninsured by expanding Medicaid, and by offering tax breaks to help moderate income people buy insurance. In both cases, people are required to buy insurance or pay a penalty, via  a mechanism called the “individual mandate” in ObamaCare, and “individual responsibility” in RomneyCare.  My editorial assistant would argue Romney’s camp had the better messaging. And finally, companies that don’t offer insurance to employees have to pay fines, with exceptions for very small business (10 employees or less) and a few other weird cases.

Smarter Than A Fifth Grader?

Let’s see if you have survived the media onslaught and can tell the difference between ObamaCare and RomneyCare. Here are 12 descriptions of the plans that I got from digging through the legislation that created the two plans, official summaries, private reports and recorded interviews with experts. See if you can tell whether each description is for ObamaCare or RomneyCare.

1. “Individuals who are deemed able to afford health insurance but fail to comply, are subject to penalties for each month of non-compliance in the tax year … . The penalties, which will be imposed through the individual’s personal income tax return, shall not exceed 50% of the minimum monthly insurance premium.”

2. Employers “who employ 11 or more full-time equivalent employees” and do not make a “fair and reasonable contribution” to their employees’ health insurance (whatever that means) are required to pay a fine.

3. “Tax credits to make it easier for the middle class to afford insurance will become available for people with income between 100 percent and 400 percent of the poverty line who are not eligible for other affordable coverage.” Yeah – read that 3 times real fast.

4. Children and adolescents up to age 18 “whose financial eligibility as determined by the division exceeds 133 per cent but is not more than 300 per cent of the federal poverty level” will be eligible for Medicaid. This makes my head spin like the Aflac duck.

5. “Americans who earn less than 133 percent of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid.”

6. A recent poll asked people whether they had a generally favorable or unfavorable view of the health plan. Responses split 41 percent and 41 percent between favoring and not favoring. Another 18 percent said they were undecided.

7. Small businesses qualify for tax credits if they pay for at least half of the workers’ health insurance. A small business is defined as having fewer than 25 full-time workers paid average annual wages below $50,000. Not only a small business, but a cheap small business.

8. Experience shows the plan is not significantly going to lower costs. Supporters of the law are actively considering new legislation aimed at cost containment.

9. The plan creates a Patient-Centered Outcomes Research Institute “to conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions.”

10. For individuals who make more than $200,000 or couples that make more than $250,000, the plan increases Medicare taxes on wages in 2013 by 0.9 percent and imposes a 3.8 percent tax on investment income.

11. This plan is completely unconcerned about cost control, with no incentives by insurance companies, employers or employees to keep costs down.

12. This plan is 100% subsidized by another and entirely separate government agency. If the plan loses money, the other government agency picks up the difference.

So, are you smarter than a fifth grader? 

All 12: You’re completely nuts! You qualify to be an analyst on either Fox News or The Last Word with Lawrence O’Donnell.

8-11:  You spend way too much time watching MSNBC and listening to NPR! You should go walk your dogs.

6-7: You have been reading arcane government documents only available on-line.  You can probably get a researcher job on Melissa Harris-Perry‘s Saturday morning show.

5-6: Wonky Honorable Mention. Maybe a guest shot on Bill O’Reilly.

3-4: Dumber than a fifth-grader.  You really haven’t been paying attention, have you?

0-2: Never watch or listen Club. You would rather watch a baseball game or Law & Order re-runs or maybe listen to 70s and 80s top forty, wouldn’t you?

ANSWERS:

1. RomneyCare

Source: Massachusetts Department of Revenue, TIR 09-25: Individual Mandate Penalties for Tax Year 2010
Note: Both plans have individual mandates. The federal penalties start small, but eventually ramp up to $695 per year or 2.5 percent of income, whichever is higher. Eventually, federal penalties will tend to be higher than the Massachusetts plan.

2. RomneyCare

Source: Massachusetts Department of Revenue, Health Care Information for Employers
Note: Federal law exempts employers with fewer than 50 workers. Additionally, under the federal plan, employers pay fines only if their workers qualify for tax credits to buy insurance.

3. ObamaCare

Source: HealthCare.gov, Provisions of the Affordable Care Act, By Year
Note: The Massachusetts law also provides subsidized health insurance, but the income cut-off is 300 percent of the federal poverty level.

4. RomneyCare

Source: Massachusetts health care law
Note: The Massachusetts law expanded Medicaid for children. The federal law expands Medicaid to adults, but sets the cut-off at 133 percent of the federal poverty level.

5. ObamaCare

Source: HealthCare.gov, Provisions of the Affordable Care Act, By Year
Note: The Massachusetts law expanded Medicaid for children. The federal law expands Medicaid to adults, but sets the cut-off at 133 percent of the federal poverty level.

6. ObamaCare

Source: The Kaiser Family Foundation, Kaiser Health Tracking Poll, April 2011
Note: Polls show the federal law has split public opinion. Polls in Massachusetts show the program is significantly more popular.

7. ObamaCare

Source: Internal Revenue Service, Small Business Health Care Tax Credit for Small Employers
Note: Tax credits start at 35 percent of the employer’s health premium costs and increase to 50 percent in 2014.

8. RomneyCare

Source: Gov. Deval Patrick, Patrick-Murphy administration proposes comprehensive health care cost containment legislation, Feb. 17, 2011; AP, Lawmakers hear bill to rein in Mass. health costs, May 16, 2011

9. ObamaCare

Source: U.S. Government Accountability Office, Patient-Centered Outcomes Research Institute (PCORI) Governing Board; Patient-Centered Outcomes Research Institute (PCORI), About Us

10. ObamaCare

Source: Kaiser Family Foundation, summary of new health reform law

11. RomneyCare

Neener-Neener. See number 12.

Source: Ezra Klein in the Drudge Report http://www.drudge.com/news/154957/klein-ryancare-obamacare-similar

12. RomneyCare

That other agency would be the Federal Government. Seriously. No wonder it works.

Source: The American Spectator http://spectator.org/archives/2012/02/15/obamacare-vs-romneycare-a-cruc

Amazing Poll Results. And, Obamacare.

 

The amazing thing about the Health Care Plan, or as I guess now everybody calls it, Obamacare (even President Obama), is that when you poll Americans on whether they approve of Obamacare, an overwhelming majority (72%) say they are against it, but when you ask the very same people whether they like the pre-existing condition part or the children remaining on their parent’s plan part, they overwhelmingly support it (78%)!

Our Supreme Court is concerned largely with the individual mandate component of the law.  Overall, when asked if “the federal government should or should not be able to require all Americans to obtain health insurance or else pay a fine,” just 28 percent of those surveyed said they supported the mandate, while 66 percent opposed it. Republicans polled 15-1 against, while Democrats polled 46-43% against as well. When polled separately, and asked whether they would support Obamacare without the mandate, 68% said they would. Yet, these same respondents said that if leaving the mandate in was the only way that the law would remain in place, 73% said they would support that. The SAME respondents.

How can this be? Are Americans stupid? Well, maybe. Define stupid. The better answer is that if you throw serious amounts of money at the media, behind a well-engineered campaign, you will produce whatever result you desire. The Republicans and their Super-PACs have done a great job of maligning Obamacare to the extent that I believe 8 year-old boys and girls wake up screaming in the middle of the night, convinced that Obamacare is hiding in their closet, just waiting for the right moment to fly out and pounce on them. Probably with some cadaver it just grabbed from an Obamacare death panel.

So, the conclusion is that while we all hate Obamacare (like good little Germans), we all want our kids to remain on our health care plans until they get out of grad school, and we don’t want  those evil insurance companies to be able to turn Aunt Ethel away just because she discovered a lump, or charge her more money to treat other pre-existing conditions. We can’t stand the individual mandate (we don’t believe it’s constitutional, but the only amendments we can name are the first and second, depending upon what part of the country we live in), yet when faced with a world without Obamacare, we’ll go with the individual mandate. After all, we reason, we HAVE to have Social Security cards, and IDs and Auto Insurance (if we choose to drive, and really, who chooses to walk?). We HAVE to go through TSA screening at the airport if we want to fly. There are after all, Justice Scalia, many things our government requires of us, even today, though you’re right, not cell phones … yet.

A Silver Lining For Progressives? 

So, I guess the big spend against Obamacare got its objective done, but even if the Supremos knock it down on constitutionality, some political analysts believe it would make it easier for Obama to cast Republicans in Washington — including conservatives in the Supreme Court — as obstructionists who have worked against the interests of middle- and low-income Americans. So, maybe the big spend to tell the big lie might backfire on the boys in red.

Democratic political consultant James Carville said that if the court were to strike down the law, “the Republican Party will own the healthcare system for the foreseeable future.””Go see (conservative Supreme Court Justice Antonin) Scalia when you want healthcare,” he told CNN.

A ruling against “Obamacare”, as opponents have dubbed the law, could also take much of the steam out of an issue that has been a rallying cry for Republicans seeking to take over the White House and Senate, and keep control of the House of Representatives, in the November 6 elections. Republicans’ portrayals of the 2010 healthcare law as a step toward socialism and a dangerous intrusion by the government into Americans’ daily lives have helped inspire conservatives, including those in the small-government Tea Party movement.

Without “Obamacare” to rally them into action, it is unclear whether some conservatives would remain as passionate about the 2012 elections, analysts say.

“If this whole thing gets overturned, they could certainly lose some momentum,” said Republican strategist Ford O’Connell, adding that Republicans would need to come up with an alternative, free-market healthcare plan to avoid losing the interest of some Tea Party conservatives. “If it gets overturned, (Republicans) are in for a knock-down, drag-out fight” in the November elections, “because … it is going to fire up progressives,” O’Connell said.

More Interesting Poll Results.

In a measure of how difficult it is to generate support for big change in almost any direction on health care, the Medicare restructuring at the center of the House GOP’s long-term budget plan fared as badly in the survey as Obama’s individual mandate. Asked what Medicare should look like in the future, just 26 percent said it “should be changed to a system where the government provides seniors with a fixed sum of money they could use either to purchase private health insurance or to pay the cost of remaining in the current Medicare program.” Fully 64 percent said “Medicare should continue as it is today, with the government … paying doctors and hospitals directly for the services they provide to seniors.”

Even a solid 56 percent to 30 percent majority of Republicans preferred the current system. How’s that grab you?