During last night’s debate, Mitt Romney made an attempt to distinguish his own Massachusetts health care plan with President Obama’s national health care law, but in doing so, he only reinforced the similarity of the two plans. What follows is a point-by-point refutation of Romney’s answer, based on the official transcript, and citations from the actual text of the Massachusetts health care law.
ROMNEY: Let me tell you this about our system in Massachusetts: 92 percent of our people were insured before we put our plan in place. Nothing's changed for them. The system is the same. They have private market-based insurance.
If you recognize this argument, that’s because it’s a formulation of Obama’s, “if you like your plan you can keep it” argument. In fact, Obama himself put things almost identically in his Sept. 2009 health care speech to a joint session of Congress: “First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.”
Neither bill literally says that people have to drop their coverage, but both Obamacare (officially the PATIENT PROTECTION AND AFFORDABLE CARE ACT) and Romneycare (officially AN ACT PROVIDING ACCESS TO AFFORDABLE, QUALITY, ACCOUNTABLE HEALTH CARE) effectively make people lose their current coverage. For one thing, both mandate that individuals purchase insurance, and once the government does that, it has to define what qualifies as “insurance.” Obamacare employs the phrase “minimum essential coverage,” where as in Romneycare, it’s called “minimum creditable coverage” (see Chapter 111M, section 1). In both cases, anybody who does not have a qualified insurance policy, therefore, has to obtain one that meets the government-imposed standards, or pay a fine.
Furthermore, both plans create incentives for businesses to drop employer-based private insurance and dump workers on the government exchanges. We’ve seen rumblings of this as Obamacare moves closer to implementation, and last year theBoston Globe reported the following news: “The relentlessly rising cost of health insurance is prompting some small Massachusetts companies to drop coverage for their workers and encourage them to sign up for state-subsidized care instead, a trend that, some analysts say, could eventually weigh heavily on the state’s already-stressed budget.”
So, Romney’s claim in last night’s debate is just as dishonest as when Obama made the same claim to the American people two years ago.
But there’s more.
ROMNEY: We had 8 percent of our people that weren't insured. And so what we did is we said let's find a way to get them insurance, again, market-based private insurance. We didn't come up with some new government insurance plan.
Again, if this strikes you as familiar, it’s because Obama also used similar language in his health care speech: “Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices…We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices.”
It’s not clear if by “new government insurance plan,” Romney meant a “public option,” but either way, that’s moot, because the idea wasn’t a part of the final version of the national health care bill that Obama signed, either. Yet what both plans do have in common is a government-run health care exchange, in which individuals use government subsidies to purchase health insurance that meets requirements set by government-appointed officials.
If you want the more technical language, here’s Chapter 118H, section 2, of the Massachusetts legislation:
For the purpose of reducing uninsurance in the commonwealth, there shall be a commonwealth care health insurance program within the commonwealth health insurance connector, established by chapter 176Q. The program shall be administered by the board of the connector, in consultation with the office of Medicaid and the health safety net office. The program shall provide subsidies to assist eligible individuals in purchasing health insurance, provided that subsidies shall only be paid on behalf of an eligible individual who is enrolled in a health plan that has been procured by the commonwealth health insurance connector under said chapter 176Q, and shall be made under a sliding-scale premium contribution payment schedule for enrollees, as determined by the board of the connector.
You can view the Commonwealth Care website here, run by an nominally “independent” but nonetheless public agency known as the Connector, with its board appointed by state officials, including the governor. (For more on the board, see Chapter 176Q, section 2, part b.)
Nonetheless, Romney dug in last night.
ROMNEY: Our plan in Massachusetts has some good parts, some bad parts, some things I'd change, some things I like about it. It's different than Obamacare.
As he has before, Romney says there are some “bad parts,” but won’t specify what they are. He says it’s “different from Obamacare,” but his statements only reinforce how similar his plan really is.
In the past, Romney’s tried to tout the fact that he vetoed some of the benefit mandates but was overridden by the legislature. That’s a disingenuous argument, because he spent years crafting the bill, signed it with a smiling Ted Kennedy at his side, touted it publicly, and issued symbolic vetoes knowing that they would be overridden, just to give him some conservative cover. This argument would be the equivalent of a Republican Senator having worked with Democrats for a year to pass Obamacare, voting it out of committee, giving it the 60 vote threshold it needed to break a filibuster, and then voting against final passage and trying to use that final meaningless vote to make a case to primary voters.
On the merits, Romney’s attempt to differentiate his plan from Obama’s doesn’t hold up to scrutiny. He is consistently making a series of blatant lies. Will any of his opponents hold him accountable?
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