Note To Romney: Health Reform Won’t Dramatically Expand Government Health Care

Mitt Romney reiterated his critique of Obamacare during a “victory” address celebrating his primary night wins in Connecticut, Delaware, Rhode Island, Pennsylvania and New York, last night. The speech sounded like a recitation of his usual misrepresentations, but included one particularly surprising nugget:

ROMNEY: With Obamacare fully installed, government will come to control half the economy, and we will have effectively ceased to be a free enterprise society. This President is putting us on a path where our lives will be ruled by bureaucrats and boards, commissions and czars. He’s asking us to accept that Washington knows best — and can provide all.

The charge is particularly disingenuous because Romney almost certainly knows that government is already heavily invested in health care and that the Affordable Care Act — much like his own reforms in Massachusetts — doesn’t dramatically expand its reach. Instead, it builds on the existing public/private partnership, in which public health already comprises more than 40 percent of the nation’s health care spending:

As the Congressional Budget Office (CBO) concluded, after the law’s initial boost of coverage expansion in the first decade (as the uninsured enter the health care system), “the increases and decreases in the federal budgetary commitment to health care stemming from this legislation would roughly balance out, so that there would be no significant change in that commitment.” By 2014, private sector growth is projected to accelerate — thanks to health care reform — but even then, “private health insurance is anticipated to account for roughly 31 percent of national health spending, or about the same share as was expected without enactment of the Affordable Care Act,” actuaries at the Center for Medicare and Medicaid estimate. “For 2011–13, government outlays (averaging 5.2 percent growth) are projected to roughly maintain a 45-percent share of total health spending.” The public/private balance, in other words, remains the same.


Remember that Romney sold his 2006 Massachusetts reforms by arguing that the state could take the the tax dollars it’s already spending on uncompensated care and — together with additional federal funding approved by the Bush administration — expand and subsidize private coverage for the uninsured. The Affordable Care Act does something very similar, while also raising additional revenue to pay for the law and reduce the federal deficit. So if using tax-payer dollars to provide care to the uninsured constitutes “government control,” then Romney himself could be considered a fan of the so-called nanny state.


As a general point, Romney’s claim that the government will control “half the economy” through health care spending is particularly inaccurate. National health spending is projected to continue to grow faster than growth in the economy, increasing from 17.7 percent of GDP to 19.8 percent of GDP in 2020 — nowhere near Romney’s 50 percent mark.