WASHINGTON -- One of the few individuals who worked on health care reform under both Mitt Romney and President Barack Obama said on Friday that the controversial individual mandate provision was virtually identical in the bills signed into law by each of them.
"They are very similar," said Jonathan Gruber, a professor of Economics at the Massachusetts Institute of Technology, in an interview with The Huffington Post. "They aren't the same exact mandate, but they have the same basic structure."
Gruber was a key architect of the sweeping health insurance reform legislation that Romney passed as governor of Massachusetts. In addition, he advised Democrats and the Obama administration on how to build the Affordable Care Act. As that 18-month process unfolded, Gruber famously unloaded on Romney for his attacks on Obamacare, arguing that the two were the "same fucking bill."
Those similarities, he said on Friday, extend to the individual mandate.
"Basically the way it would function is you have a form 1099-HC, which is like a health care form you get from your insurer every year, and you would attach it to your taxes," he said, describing how the mandate would work nationally. "That form would show you have health insurance and you're fine. If you don't have health insurance, you fill out a form on your taxes ... which computes whether you're exempt from the penalty, [which would be the case] if your income is too low or insurance costs too much. Finally, if you don't have the form and you're not exempt, there will be a penalty on your taxes."
In Massachusetts, the Department of Revenue is in charge of enforcing the penalty. For the Affordable Care Act, the responsibility would rest with the IRS.
"The size of the penalty in Massachusetts is an amount that depends on your income," Gruber said. According to the Associated Press, in 2012, "those making more than three times the poverty level –- $32,676 for an individual –- pay the highest penalty of $105 per month, or $1,260 per year."
Nationally, added Gruber, "they do a similar thing. It would be whatever is bigger: $695 or 2.5 percent of your income."
As governor, Romney initially opposed including an individual mandate as part of health care reform. Under pressure from legislators, he ended up signing one into law. Since then, Gruber relayed, the policy has worked well. In the first year alone, 98 percent of tax filers "got it right." A total of 44,000 residents in a state of 6 million paid a penalty.
"I will say that the fines have gone down," current Massachusetts Gov. Deval Patrick (D) said Friday morning on MSNBC, "because more and more people, as the statistics you cited indicate, have taken up insurance."
As recently as 2008, Romney was comfortable with the idea that such a penalty constituted a tax. But the contours of the debate have changed dramatically since then. And in the wake of the Supreme Court's decision to uphold the constitutionality of the Affordable Care Act's individual mandate under Congress' taxing authority, the presumptive Republican nominee has begun denouncing the mandate as a major tax hike in the strongest possible terms.
"But the people of America, I think, recognize that this legislation is not right for America. It will cost $500 billion in taxes," Romney said at a fundraiser on Friday morning.
In a conference call organized by the Obama campaign, Patrick insisted that the mandate did not constitute a tax. "This is a penalty," he said.
A top Obama administration official, meanwhile, said that if Romney were to argue that Obamacare included a massive tax hike, the president was prepared to respond that, by logical extension, Romney raised taxes in Massachusetts.
A request for comment from the Romney campaign was not immediately returned.
UPDATE: Romney spokesperson Andrea Saul responded in an email, which noted (accurately) that Obama insisted the mandate wasn't a tax while crafting reform. But Saul did not account for how that makes it any different from what Romney passed as governor.
Governor Romney disagreed with the court’s ruling and its findings. What's troubling is the President told the American people the mandate was not a tax, and then sent his lawyer to the Supreme Court to argue it was a tax. So he said one thing to get it passed, and then contradicted himself to get it past the court. This court's decision raises the stakes for the election in November. While Governor Romney is disappointed with the court's ruling, ultimately it is the people who will have the final word.
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