The Real Difference Between RomneyCare And The Affordable Care Act Is That The ACA Is Paid For

Today’s Mitt Romney speech on health care contained a lot of nonsense, but this slide is accurate and important:

I really wish more discussions of why the Affordable Care Act is so controversial would start with this. The Affordable Care Act gives health insurance to millions of people who previously lacked it. That costs money. Money that the Affordable Care Act obtains through higher taxes (largely on the rich) and through reductions in spending (mostly subsidies to private insurance company Medicare subcontractors). That’s some controversial stuff with a lot of money at stake. People don’t like it.

And while Mitt Romney’s universal health care bill in Massachusetts is very structurally similar to the ACA, it’s not really paid for. The financing was a mix of Medicaid waivers, deficit-financed federal grant money, and hand-waving. I was fine with that stuff. I’m not really a “deficit hawk” guy. But there’s something a little bit bizarre about claiming this as the distinctive virtue of the Commonwealth Care approach.