Via Politico Pulse, CNN’s Sanjay Gupta ran a telling segment comparing Romneycare to Obamacare last night, in which he asked the former Massachusetts governor how he would encourage healthier people to purchase insurance without a mandate:
GUPTA: Mandate is a seven-letter word, but many people regard it as a four-letter word. Should mandates be a part of reforming health care?
ROMNEY: We’ll you’re not going to put people in jail for not having insurance, of course that’s…
GUPTA: But you could penalize them…
ROMNEY … None is talking about that, but there are various ways to encourage people to get insurance. One is to give everybody a credit — a tax credit that you only get to use if you have insurance.
Romney — who championed the individual requirement in Massachusetts as a way to lower the state’s spending on uncompensated care — didn’t support repealing the ACA’s mandate until the middle of last year and so he appreciates the importance of bringing everyone into the health care system. That’s why what he’s really proposing is a mandate in disguise: using economic incentives to encourage healthier and younger people to purchase insurance before they become sick and shift the costs of their care throughout the health care system. Only under his plan, people who forgo coverage would essentially be penalized by not receiving a tax credit.
It’s the same concept as the Affordable Care Act, only worse. The Congressional Budget Office (CBO) estimates that eliminating the current mandate structure — which asses a direct penalty on those who don’t purchase insurance — would reduce coverage by 16 million people and even generous tax credits –- which likely go beyond what’s included in the Romney’s plan — would cover only 40 to 50 percent of the uninsured. They would also fail to grow with rising costs and wouldn’t be accompanies by the regulatory protections of the ACA, which allow the millions of Americans with pre-existing conditions to find affordable coverage. But this at least demonstrates that Romney appreciates the importance of a mandate-type approach, no matter how much he’d like to deny it.