Mitt Romney may have have had a tight rope to walk when it came to his support for the individual health insurance mandate, but he pulled no punches with his 2010 campaign health care plan. The proposal is almost identical to the initiative he had offered just two years earlier — it’s boilerplate of GOP health policy.
And like most Republican schemes — which seek to lower health care costs by deregulating the insurance market and opening it up to greater competition — Romney’s plan wouldn’t provide adequate coverage to people with pre-existing conditions or anyone else with a chronic disease who would likely be denied insurance in a true free market structure. He addresses that concern by establishing state-based high risk pools that would provide coverage for anyone denied insurance in the individual market and takes some very small steps to prohibit companies from discriminating against people with pre-existing conditions. Romney would repeal the broad prohibition against denying coverage to individuals with pre-existing conditions that’s already in law (thanks to the Affordable Care Act) and replace it with a limited protection that would not, as Romney put it, necessarily cover an uninsured American who just had a heart attack:
ROMNEY: Couple of common failures I’d go after. Ensure that individuals with pre-existing conditions who are continuously covered for some specified period may not be denied coverage. So you’re not going to say to somebody if you’ve never had insurance and you’re age 55 and you suddenly had a heart attack and now you want to buy insurance, you don’t say to them ‘oh fine you get it.’ That doesn’t work very well. You say instead ‘if you’ve been insured for 10 years and you have a heart attack and you’ve changed jobs because of that continuous period of insurance of course you will continue to be covered.
As Romney himself recognized in Massachusetts, insurance reforms don’t work very well unless you can encourage everyone to participate in the health insurance market and eliminate “free riders” who would only purchase coverage when they need it. Insurance protections and the individual mandate go hand-in-hand, as establishing one without the other leads to a very substantial spike in premiums. Romney tries to prevent that from happening by setting “some specified period” during which individuals “may not be denied coverage.” But a better way ensure that people have access to insurance before that “sudden heart attack” (and maybe even to prevent it) is to do what Romney has already done in Massachusetts — pair a pre-existing conditions exclusion with an individual mandate.