Check Up: Obamacare vs. Romneycare: Any real difference?

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Philadelphia Inquirer

viewed 9/1/12

by Robert I. Field, Ph.D., J.D., M.P.H.

Check Up: Obamacare vs. Romneycare: Any real difference?

...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....

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.

The Massachusetts version of Romneycare may be similar to Obamacare, but what lies ahead for the US, if Romney is elected, is by no means comparable to the reforms in Massachusetts:

  • Romney favors giving states the power to determine how to provide healthcare for its constituents over the feds.
  • Medicaid would come in the form of block grants under Romney, reducing funding and removing federal mandates on eligibility criteria. This could potentially leave some of our most vulnerable, indigent groups uninsured.
  • Not everyone would have the opportunity to be insured under Romneycare; people with pre-existing conditions could be denied coverage if they have not had continuous coverage.
  • He emphasizes allowing the free market and competition to reign, rather than allowing the federal government to implement cost-controlling measures.
  • He would give tax incentives to individuals to purchase insurance, which would likely mean less employers would offer it.

Health Care

Romney's healthcare plan may be more revolutionary than Obama's - Los Angeles Times

Romney-Ryan Medicaid plan would burden Massachusetts - Boston.com

Mitt Romney On Health Care - Kaiser Health News

Specializes in Geriatrics, Home Health.

Unfortunately, the Massachusetts Connector Authority doesn't apply to entities that self-insure, including the big hospitals and the colleges. If your company or college's insurance plan doesn't meet state regs, you have to find coverage through the Commonwealth Connector.

When I was in nursing school, and my employer's insurance premium went up 3 times in 1 year, I looked into the school plan. All students taking more than 9 credits are required to have some kind of coverage, and all Massachusetts community colleges offer the same bare-bones student health insurance plan. Among other things, it specifically excludes organ transplants and all gyn care except abortion and obstetrics services.

bardone

61 Posts

Am I the only one who thinks it's time to start referring to this as "health care reform" -- albeit two versions -- and ditch the monikers "Obamacare" and "Romneycare" once and for all?

ArrowRN, BSN, RN

4 Articles; 1,149 Posts

Specializes in Med Surg, PCU, Travel.

Sure its like looking like a green apples vs red apples...both are just about the same. Bottom line is everyone needs health care and costs in USA are too high and this needs to change. Getting everyone covered is a step in the right direction and would be positive for the health industry. People would start getting the care they need, all these new grad on allnurses.com would get jobs due to influx of new patients cause people will no longer avoid care due to fear of high bills,so unemployment goes done. Healthier people = Healthier economy.

hoosier guy

47 Posts

Like most things in politics the differences are subtile in theory and gulfs apart in practice. If you ever get a chance look at the party platforms, except for a couple things they are nearly identical.

Specializes in Trauma ICU, Peds ICU.

None of it is healthcare reform. It's all health insurance reform. As long as both sides are willing to sell out to big insurance by keeping them in the mix, things won't get better.

cally527, RN

217 Posts

Specializes in Med/Surg/Tele.
Unfortunately, the Massachusetts Connector Authority doesn't apply to entities that self-insure, including the big hospitals and the colleges. If your company or college's insurance plan doesn't meet state regs, you have to find coverage through the Commonwealth Connector.

When I was in nursing school, and my employer's insurance premium went up 3 times in 1 year, I looked into the school plan. All students taking more than 9 credits are required to have some kind of coverage, and all Massachusetts community colleges offer the same bare-bones student health insurance plan. Among other things, it specifically excludes organ transplants and all gyn care except abortion and obstetrics services.

When did you go to nursing school? The health plan offered by MA community colleges is VERY cheap compared to the cost of other plans and it complies with the MA Health Insurance requirements. $1050 for a full calendar year of health insurance is a pretty good deal. The plan I have does cover all routine ob/gyn care. I did not check to see if organ transplants are covered.....

Specializes in Geriatrics, Home Health.

I graduated in 2008. The MA Community college student health plan was still cheap then, but it covered very little.

Under the Affordable Healthcare Act, insurance company can not spend more than 20% for administrative expense, and must spend no less than 80% for patient care. To me that is not selling out to big insurance company at all.

Laura Z. Pam

16 Posts

Romney wants to end Medicare/medicaid as we know it, and change it to flat rate/voucher program, as well as cut benefits. Hm. How many of our paychecks are dependent, at least in part, on medicare/medicaid? Most. So, less health care for all, and less payment (with the same amount of work) for medical facilities. No Bueno.

Am I the only one who thinks it's time to start referring to this as "health care reform" -- albeit two versions -- and ditch the monikers "Obamacare" and "Romneycare" once and for all?

Ha. Agreed, but I think we're stuck with it. Obama's own campaign staff occasionally refer to it as "Obamacare". I just had to google the word moniker; it will be a nice addition to my limited vocabulary.

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