As Mitt Romney tries to distance himself from Obamacare, he ran into some trouble last night when he got stumped by comedian Jay Leno. Leno asked Romney what he would do to help people with preexisting medical conditions, who are often denied coverage today by insurance companies worried about increased costs.
Romney’s answer was essentially nothing. Someone who has forgone insurance doesn’t deserve to get medical coverage, Romney suggested, because, “we can’t play the game like that.” Asked what he would do to help people with pre-existing conditions, Romney replied:
ROMNEY: People with pre-existing conditions, as long as they have been insured before, they are going to be able to continue to have insurance.
LENO: Suppose they haven’t been insured before?
ROMNEY: Well, if they are 45 years old and they show up and say I want insurance because I have heart disease, it’s like, ‘Hey guys. We can’t play the game like that. You’ve got to get insurance when you are well and then if you get ill, you are going to be covered. […]
We’ll look at a circumstance where someone is ill and hasn’t been insured so far, but people who have the chance to be insured –- if you are working in the auto business for instance, the companies carry insurance, they insure their employees, you look at the circumstances that exist –- but people who have done their best to get insured are going to be able to be covered. But you don’t want everyone saying, ‘I am going to sit back until I get sick and then go buy insurance.’ That doesn’t make sense. But you get defined rules and get people in who are playing by the rules.
Watch it (beginning 2:15):
Barring insurance companies from denying coverage to people with pre-existing conditions is one of the Affordable Care Act’s most popular and important provisions. The problem, for Romney, is that this can only function when coupled with an individual mandate (as he well knows), the constitutionality of which the Supreme Court considered yesterday.
Without the mandate, healthy people could forego buying insurance until they became sick, thus driving up costs for everyone and potentially collapsing the system as there may not be enough people paying into the system to cover the costs of all the sick people. Moreover, there are people who, from a young age or even birth, have pre-existing conditions due to congenital diseases.
Under Romney’s current plan, since they have no existing history of coverage, it’s conceivable people born with pre-existing conditions would be completely unable to ever get insurance. Insurance companies have already said that without the mandate, they’d go back to denying coverage to people with pre-existing conditions.
Romney himself seems to understand this, telling Leno, “you have to find rules that get people in” to the insurance market so they don’t freeride. A former governor of Massachusetts named Romney came up with just a such a rule — it’s called the individual mandate. But now that Romney is running for president for Pete’s sake, he hates mandates, and so he has literally nothing to offer people with pre-existing conditions expect for a scolding about how they should have purchased insurance earlier.