When the Supreme Court recently upheld President Obama's Affordable Care Act, Mitt Romney repeated his pledge that, if elected president, he will "repeal and replace Obamacare."
The candidate's campaign website has put forward a Romney health care plan. But if you lay Romneycare on the table and examine its vital parts, the diagnosis is unavoidable: Romneycare is brain dead on arrival.
In truth, Romneycare is nothing more than a motley collection of Republican talking points.
Take, for example, Romney's assertion that he wants to "restore state leadership and flexibility" and return "states to their proper place in charge of regulating local insurance markets." Yet, a few lines later, Romney proposes to "allow consumers to purchase insurance across state lines."
This is no mere flip-flop in words. It exposes the mendacity that lies at the lifeless heart of Romneycare.
Some states have insurance commissioners who are dedicated to protecting their citizens; others exercise little or no oversight over the insurance industry. Louisiana provides a case in point. In 2007, the state's Insurance Rating Commission was abolished, leaving health insurance companies free to jack up rates as they saw fit. Enacting Romneycare would spark a race to the bottom that would incentivize health insurers to base their operations in states that extend little or no protection to purchasers nationwide.
Bobby Jindal, the Republican governor of Louisiana, appears to like such arrangements. Following the Supreme Court's decision, Jindal said:
As we get farther away from the ruling, reality will dawn on people, and we will be right back to where we were. The American people did not want or approve of Obamacare then, and they do not now. Americans oppose it because it will decrease the quality of health care in America, raise taxes, cut Medicare, and break the bank. ...
I have vowed not to implement Obamacare in Louisiana, because this November we're going to elect a new president and a new Congress who will repeal and replace the terrible law.
- 55,799 Medicare recipients received a $250 rebate in 2010 to help cover prescription drug costs
- 487,292 Medicare recipients last year received free preventive services, such as mammograms, colonoscopies and annual wellness exams
- Insurance companies that violated the ACA's requirement that 80 percent of insurance premiums be spent on health care will provide more than $4 million in rebates to 43,700 Louisiana families this year
Of course, neither Romney nor Jindal ever speak about what the ACA is already doing to help individuals in Louisiana and elsewhere. They continue to serve up fact-free talking points about the manifold blessings that will flow once health insurance is again turned over to the states.
- Blue Cross Blue Shield of Texas refusing to cover surgery for a newborn with a heart defect
- Blue Cross of California and Health Net of California rewarding employees based on their success rescinding the insurance of policyholders with an illness or injury requiring costly treatment
- Assurant Inc., UnitedHealth Group, and WellPoint Inc. dropping the coverage of tens of thousands of policyholders to avoid paying hundreds of millions of dollars in hospital and doctor bills
Why such inhumane behavior? Follow the money. In testimony before the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations in 2009, Karen Pollitz, Research Professor at Georgetown University Health Policy Institute, explained:
Representatives of the insurance industry have testified that rescission is rare and occurs in less than one percent of policies. Even if this estimate is accurate, it is not necessarily comforting. One percent of the population accounts for one-quarter of all medical bills. The sickest individuals may be small in number, but they are the most vulnerable and most in need of coverage.
In addition to a lack of official data on rescissions, there also are not good data on the number of new policyholders who become subject to post-claims investigations or on the other possible outcomes of those investigations, including policy termination, policy "reformation," or imposition of a pre-existing condition exclusion.
We don't have this information because health insurance industry medical underwriting standards and practices are proprietary. Insurers compete intensely on their ability to avoid risk. Yet, the stakes for people could not be higher. Access to timely and quality health care is directly related to access to health insurance. It is troubling to not know how frequently the problem of health insurance rescission applies, or who is harmed.
Without the humane restrictions established by the Affordable Care Act, insurers would be free to become snipers once again -- picking off the most vulnerable one by one. Romneycare boldly declares that it will: "Limit federal standards and requirements on both private insurance and Medicaid coverage." But it is precisely "federal standards" in the Affordable Care Act that now restrain private insurers from singling out the most vulnerable and killing their access to health care when they most need it.
Yet, Romneycare also claims another of its goals is to: "Prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage."
That sounds good until you reach those last two weasel words: "continuous coverage."
As Romney must surely know, individuals who had been denied coverage in the past would once again be at the mercy of insurance snipers if the Affordable Care Act were repealed.
Does Romney genuinely care about the millions of Americans who would suffer as a result? One finds little evidence of such care in Romneycare.