Although he claims to have had nothing to do with it, Jonathan Cohn’s excellent defense of Massachusetts’ health reform law has seemingly compelled Mitt Romney to deliver a major policy address on health care later this week, during which the former governor will undoubtedly distance himself from his Massachusetts reforms and “lay out plan to repeal and replace Obamacare.”
Expect Romney to call for the repeal of the Affordable Care Act, amplify the failures of Massachusetts reform, argue that one state’s experiences shouldn’t be transferred to the nation. He will likely put forth a proposal that deregulates insurance markets, allows insurers to circumvent consumer protection laws by selling policies across state lines and offers individuals a tax credit to purchase insurance on the open market. It will likely hedge very closely to what Romney offered in 2008:
Deregulate State Markets. Encourage states to eliminate the cumbersome insurance regulations that drive costs up and providers out of the market.
Fix The Tax Code. Level the playing field by making all health care expenses tax deductible, eliminating the special treatment afforded employer-provided health plans.
Stop The Free-Riders. Use some of the money currently spent on providing expensive “free care” for the uninsured at emergency rooms to instead help the truly needy buy private insurance.
Reform The Medical Liability System. Institute federal caps on non-economic and punitive damage awards to eliminate frivolous lawsuits and bring an end to the practice of defensive medicine.
Promote Innovation In Medicaid. Give states flexibility to spend their Medicaid dollars in whatever way they find most efficient and effective.
Bring Health Care Into The 21st Century. Improve quality and enhance transparency by introducing the same competitive forces that drive innovation in other sectors of the economy.
Note the lack of any serious solution for expanding access to the 32 million Americans who will lose health insurance coverage if Romney successfully repeals health reform. The GOP has offered to expand the state-based network of high-risk insurance pools to cover individuals who would be denied coverage in the individual market because of chronic conditions and Romney may very well back a similar solution in his new plan. But creating large risk pools of sick people does not a sustainable health solution make, as the government will have to spend billions of dollars to insure the costly sick patients who private insurers view as unprofitable,
What would work of course, is the kind of moderate approach that Romney championed as Governor of Massachusetts (and Obama adopted nationally) — establishing regulated exchanges, offering comprehensive benefits, and an individual mandate to ensure that there aren’t any “free riders” in the health care system. Unlike the theoretical plan that Romney will likely offer, that kind of solution has proven successful. It has extended coverage to almost everyone in the state, increased the percent of private companies offering health insurance to their employees and lowered the amount of money spent on uncompensated care. In fact, here is a video of Romney making his case for it.