“Romney’s Sick Joke”: An Attempt To Deceive Voters On His Healthcare Proposal
“No. 1,” declared Mitt Romney in Wednesday’s debate, “pre-existing conditions are covered under my plan.” No, they aren’t — as Mr. Romney’s own advisers have conceded in the past, and did again after the debate.
Was Mr. Romney lying? Well, either that or he was making what amounts to a sick joke. Either way, his attempt to deceive voters on this issue was the biggest of many misleading and/or dishonest claims he made over the course of that hour and a half. Yes, President Obama did a notably bad job of responding. But I’ll leave the theater criticism to others and talk instead about the issue that should be at the heart of this election.
So, about that sick joke: What Mr. Romney actually proposes is that Americans with pre-existing conditions who already have health coverage be allowed to keep that coverage even if they lose their job — as long as they keep paying the premiums. As it happens, this is already the law of the land. But it’s not what anyone in real life means by having a health plan that covers pre-existing conditions, because it applies only to those who manage to land a job with health insurance in the first place (and are able to maintain their payments despite losing that job). Did I mention that the number of jobs that come with health insurance has been steadily declining over the past decade?
What Mr. Romney did in the debate, in other words, was, at best, to play a word game with voters, pretending to offer something substantive for the uninsured while actually offering nothing. For all practical purposes, he simply lied about what his policy proposals would do.
How many Americans would be left out in the cold under Mr. Romney’s plan? One answer is 89 million. According to the nonpartisan Commonwealth Foundation, that’s the number of Americans who lack the “continuous coverage” that would make them eligible for health insurance under Mr. Romney’s empty promises. By the way, that’s more than a third of the U.S. population under 65 years old.
Another answer is 45 million, the estimated number of people who would have health insurance if Mr. Obama were re-elected, but would lose it if Mr. Romney were to win.
That estimate reflects two factors. First, Mr. Romney proposes repealing the Affordable Care Act, which means doing away with all the ways in which that law would help tens of millions of Americans who either have pre-existing conditions or can’t afford health insurance for other reasons. Second, Mr. Romney is proposing drastic cuts in Medicaid — basically to save money that he could use to cut taxes on the wealthy — which would deny essential health care to millions more Americans. (And, no, despite what he has said, you can’t get the care you need just by going to the emergency room.)
Wait, it gets worse. The true number of victims from Mr. Romney’s health proposals would be much larger than either of these numbers, for a couple of reasons.
One is that Medicaid doesn’t just provide health care to Americans too young for Medicare; it also pays for nursing care and other necessities for many older Americans.
Also, many Americans have health insurance but live under the continual threat of losing it. Obamacare would eliminate this threat, but Mr. Romney would bring it back and make it worse. Safety nets don’t just help people who actually fall, they make life more secure for everyone who might fall. But Mr. Romney would take that security away, not just on health care but across the board.
What about the claim made by a Romney adviser after the debate that states could step in to guarantee coverage for pre-existing conditions? That’s nonsense on many levels. For one thing, Mr. Romney wants to eliminate restrictions on interstate insurance sales, depriving states of regulatory power. Furthermore, if all you do is require that insurance companies cover everyone, healthy people will wait until they’re sick to sign up, leading to sky-high premiums. So you need to couple regulations on insurers with a requirement that everyone have insurance. And, to make that feasible, you have to offer insurance subsidies to lower-income Americans, which have to be paid for at a federal level.
And what you end up with is — precisely — the health reform President Obama signed into law.
One could wish that Mr. Obama had made this point effectively in the debate. He had every right to jump up and say, “There you go again”: Not only was Mr. Romney’s claim fundamentally dishonest, it has already been extensively debunked, and the Romney campaign itself has admitted that it’s false.
For whatever reason, the president didn’t do that, on health care or on anything else. But, as I said, never mind the theater criticism. The fact is that Mr. Romney tried to mislead the public, and he shouldn’t be allowed to get away with it.
By: Paul Krugman, Op-Ed Columnist, The New York Times, October 4, 2012
“New Wrapping, Same Contents”: Re-Packaging Mitt Romney As A Compassionate Conservative
“My heart aches for the people I’ve seen,” Mitt Romney said, on the second day of his Ohio bus tour. He’s now telling stories of economic hardship among the people he’s met.
Up until now, Romney’s stories on the campaign trail have been about business successes – people who started businesses in garages and grew their companies into global giants, entrepreneurs who succeeded because of grit and determination, millionaires who began poor. Horatio Alger updated.
Curiously absent from these narratives have been the stories of ordinary Americans caught in an economy over which they have no control. That is, most of us.
At least until now.
“I was yesterday with a woman who was emotional,” Romney recounts, “and she said, ‘Look, I’ve been out of work since May.’ She was in her 50s. She said, ‘I don’t see any prospects. Can you help me?’”
Could it be Romney is finally getting the message that many Americans need help through no fault of their own?
“There are so many people in our country that are hurting right now,” Romney says. “I want to help them.”
Later in the day, Romney told NBC that because of his efforts as governor of Massachusetts, “one hundred percent of the kids in our state had health insurance. I don’t think there’s anything that shows more empathy and care about the people of this country than that kind of record.”
But the repackaging of Mitt as a compassionate conservative won’t work. The good citizens of Ohio — as elsewhere — have reason to be skeptical.
This is, after all, the same Mitt Romney who told his backers in Boca Raton that 47 percent of Americans are dependent on government and unwilling to take care of themselves.
It’s the same Romney who was against bailing out GM and Chrysler. One in eight jobs in Ohio is dependent on the automobile industry. Had GM and Chrysler gone under, unemployment in Ohio would be closer to the national average of 8.1 percent than the 7.2 percent it is today.
This is the same Romney who has been against extending unemployment benefits. Or providing food stamps or housing benefits for families that have fallen into poverty. Or medical benefits. To the contrary, Romney wants to repeal Obamacare, turn Medicare into vouchers, and turn Medicaid over to cash-starved states.
This is the same Mitt Romney who doesn’t worry that Wall Street financiers — including his own Bain Capital — have put so much pressure on companies for short-term profits that they’re still laying off workers and reluctant to take on any more.
And the same Mitt who doesn’t want government to spend money repairing our crumbling infrastructure, rebuilding our schools, or rehiring police and firefighters and teachers.
Romney says he feels their pain but his policy prescriptions would create more pain.
Mitt Romney’s real compassion is for people like himself, whom he believes are America’s “job creators.” He aims to cut taxes on the rich, in the belief that the rich create jobs — and the benefits of such a tax cut trickle down to everyone else.
Trickle-down economics is the core of Romney’s economics, and it’s bunk. George W. Bush cut taxes — mostly for the wealthy — and we ended up with fewer jobs, lower wages, and an economy that fell off a cliff in 2008.
In Ohio Romney is repeating his claim that, under his tax proposal, the rich would end up paying as much as before even at a lower tax rate because he’d limit their ability to manipulate the tax code. “Don’t be expecting a huge cut in taxes because I’m also going to be closing loopholes and deductions,” he promises.
But Romney still refuses to say which loopholes and deductions he’ll close. He doesn’t even mention the “carried interest” loophole that has allowed him and other private-equity managers to treat their incomes as capital gains, taxed at 15 percent.
What we’re seeing in Ohio isn’t a new Mitt Romney. It’s a newly-packaged Mitt Romney. The real Mitt Romney is the one we saw on the videotape last week. And no amount of re-taping can disguise the package’s true contents.
By: Robert Reich, Robert Reich Blog, September 26, 2012
“The Red Flags Are Flying”: Senate Candidate Tommie Thompson Wants To “Do Away With Medicare And Medicaid”
Paul Ryan admits that he’s an “end Medicare as we know it” candidate.
But, somehow, we are not supposed to think that he would actually end the popular and successful healthcare program for the elderly, as well as related Medicaid programs for the poor and people with disabilities.
The “as we know it” part provides a sort of cover, at least in the eyes of a media that is more inclined toward stenography than journalism.
Never mind that Ryan, a rabid reader of government-can-do-no-good fanatic Ayn Rand, goes positively wide-eyed when he starts talking about how desperately he wants to downsize government—and shift control of healthcare and retirement programs to the insurance and Wall Street interests that so generously fund his campaigns. We’re not supposed to talk about the long-term crony-capitalist scheme of certain Republicans to do away with government programs that work so that private sector profiteers can come in and create programs that don’t work—except for private sector profiteers.
Never mind that the Republican nominee for vice president has a long history of decrying Social Security, Medicare and Medicaid in Randian terms such as “collectivist” and “socialistic.”
Never mind that Ryan has griped that “Social Security right now is a collectivist system. It’s a welfare transfer system.”
Never mind that, as recently as 2010, Ryan dismissed Medicare and Medicaid as part of a “socialist based system” that needs to be replaced.
The red flags are not supposed to go up until someone actually says they want to, you know, “do away with Medicaid and Medicare.”
Never mind that, even now, Ryan complains about how America is being overwhelmed by “takers” (citizens who claim benefits to which they are entitled) and the “welfare state” (Social Security, Medicare and Medicaid).
Only when a candidate starts talking about ending entitlement programs—as in “doing away” with them—can we be serious about the immediate threat those programs actually face.
Meet Tommy Thompson, former Republican governor of Wisconsin, former Bush-Cheney administration secretary of health and human services, former candidate for the Republican nomination for president and mentor to Paul Ryan.
Speaking to a Tea Party group while campaigning for Wisconsin’s open US Senate seat, Thompson recounted how he “reformed” welfare in Wisconsin.
Back in the 1990s, Thompson said he wanted to “end welfare as we know it.” In fact, he replaced the program with a classic combination of high-government spending, lots of patronage appointments and rising poverty.
Now, Thompson has dropped the “end welfare as we know it” pretense. He brags that he finished off “one of the entitlement program.”
And he’s gunning for a couple of other entitlement programs.
Which ones?
You guessed it: Medicaid and Medicare.
Declaring that he wants to “change Medicare and Medicaid like I did welfare,” Thompson asked a May gathering of the Lake Country Area Defenders Of Liberty in Oconomowoc, Wisconsin: “Who better to and who better than me, who’s already finished one of the entitlement programs, to come up with programs to do away with Medicaid and Medicare?”
The video has only now surfaced and its a blockbuster—especially in the aftermath of the release last week of a similar video that saw Republican presidential nominee Mitt Romney dismissing 47 percent of Americans as a “dependent” class unworthy of Republican consideration.
Just to repeat: a top Republican Senate candidate has been caught on video talking about how he would “DO AWAY WITH MEDICAID, AND MEDICARE.”
Just to repeat: “DO AWAY WITH MEDICAID, AND MEDICARE.”
It should be understood that Thompson is no fringe-dwelling Todd Akin. As the longtime Republican governor of a swing state, he’s worked with every GOP president since Ronald Reagan, and he oversaw social programs for the Bush-Cheney administration. This year, he’s one of his party’s premier recruits in the fight to retake the Senate. Indeed, the race between Thompson and Democratic Congresswoman Tammy Baldwin could decide which party controls the chamber.
Thompson is, as well, closely aligned with Paul Ryan. The Senate candidate’s ties to Ryan’s politically connected family go back to when the Republican vice presidential nominee was a child. Thompson has been a Ryan booster from the very beginning of the younger Wisconsinite’s career in electoral politics—when Thompson was the powerful governor of the state and Ryan was organizing his first Congressional bid.
When Thompson joined the Bush-Cheney Cabinet, he and Ryan kept regular company in Washington. They look forward to working together when Thompson becomes the point man on entitlement debates in a Republican-controlled Senate and Ryan is the Romney White House’s chief liaison to Capitol Hill.
The voters will have something to say about that, however.
If they want to preserve Medicaid and Medicare, they will remember that, while Ryan may add the “as we know it” spin, Thompson gets to the heart of the matter when he says it is the intention of these “reformers” to “do away with Medicaid and Medicare.”
By: John Nichols, The Nation, September 24, 2012
“The Grandfather Of Obamacare”: How Mitt Romney Paid For Romneycare With Federal Help
Republican presidential candidate Mitt Romney told Univison in an interview Wednesday that he did not mind when President Obama called him the “grandfather” of Obamacare when referring to the program Romney instituted when he was governor of Massachusetts. Quite the opposite. Romney thought other states might take a page from the Massachusetts playbook.
We didn’t have to cut Medicare by $716 billion. We didn’t raise taxes on health companies by $500 billion, as the president did. We crafted a program that worked for our state. I believe the right course for health care reform is to say for each state we’re going to give you the Medicaid dollars you’ve had in the past, plus grow them by 1 percent. And you, as the states, are now going to be given targets to move people to insurance, and you craft programs that are right for your state. Some will copy what we did; others will find better ideas.
Romney is right: The state of Massachusetts did not cut Medicare to finance health care (nor could it have, as states don’t have a say in the federally financed entitlement budget). Whereas the Affordable Care Act levies a tax on insurance companies and makers of medical devices, the Massachusetts law has no similar provision.
But could a state with a capped Medicaid budget, as Romney has proposed, copy what Romney did in Massachusetts and end up with universal coverage? Romney’s own experience suggests probably not: His state a special pot of federal money, alongside a preexisting assessment on hospitals and insurers, to expand insurance coverage to 98 percent of its population.
Way back in 1985, under then-Gov. Michael Dukakis, Massachusetts set up a program called the Uncompensated Care Pool. Much like the name suggests, the pool is used to finance health care for those without insurance. Massachusetts financed the plan largely through assessments on hospitals and insurers. Under Romney’s administration In 2004, each industry paid in about $157 million to keep the pool running. That plan still operates today — under the name Health Safety Net – and covers health care needs that Massachusetts residents cannot afford.
Since the late 1990s, Massachusetts has also received additional Medicaid funds to enroll populations that other states traditionally do not cover. In 2005, when Romney was governor, the federal aid amounted to $550 million. As former Romney adviser John McDonough explains in his book “Inside Health Policy,” the funds were crucial to laying the foundation for universal health coverage. He takes us back to 2005, when the George W. Bush administration was getting ready to end that special funding arrangement:
“In Masachusetts, $350 million is a lot of money, and the news set off alarm bells. Governor Romney reached out and formed a partnership with Senator Kennedy to scheme how to keep the extra federal dollars coming. At that moment, the state’s mundane desire to retain federal dollars merged with the policy goal of universal coverage to create a new policy imperative. Romney and Kennedy proposed that Massachusetts keep receiving the extra payments and in return the state would shift the use of those dollars [to] subsidies to help lower-income individuals purchase health insurance coverage.”
Ryan Lizza recounts a similar version of events in his New Yorker article on Romneycare. That state ultimately secured three years of additional Medicaid funding, $1.05 billion, which largely financed the Massachusetts expansion. Both accounts suggest that it was a special commitment from the federal government, rather than a capped budget, that spurred Massachusetts’ success.
Since then, employers and individuals have chipped in to keep the universal coverage program afloat. The Blue Cross Blue Shield Foundation of Massachusetts saw spending by both of those groups increase in the year after Romneycare became law, which they attribute to rising medical costs and the insurance expansion.
Five years later, it’s largely federal funding that keeps Massachusetts’ universal coverage afloat. Since 2005, the state has twice renewed that federal waiver — the one Lizza and McDonough wrote about — to provide additional Medicaid dollars to the state.
The most recent renewal was last December 2011, when the state secured $26.75 billion in federal funds over the course of three years. It will, among other programs, continue to finance the universal coverage program.
“The milestone agreement also ensures the ongoing success of Massachusetts’ historic health care reform initiative, through which more than 98 percent of the Commonwealth’s residents, and 99.8 percent of children, have health insurance,” Massachusetts Health and Human Services Secretary JudyAnn Bixby wrote at the time. “The waiver fully funds our ongoing health care reform implementation.”
So Massachusetts used not just federal Medicaid money but federal dollars above and beyond that Medicaid money to finance their health reforms. It is difficult to see how Romney’s proposal to cut Medicaid spending and hand that reduced share over to the states would allow other states to follow Massachusetts’ example. It might not even permit Massachusetts to continue following Massachusetts’ example.
By: Sarah Kliff, The Washington Post, September 21, 2012
“Trust Me, I’ll Figure It Out”: Mitt Romney Re-Explains Why He Can’t Be Trusted On Health Care
Over the weekend, Mitt Romney muddied the waters about where he stands on health-care reform with a series of vague statements from himself and his campaign about health insurance for people with pre-existing conditions.
His floundering is a subset of a larger problem: He has committed himself to a set of positions that won’t allow for a replacement of Obamacare with something that actually fixes the problem of tens of millions of Americans without health insurance, including those with pre-existing conditions.
Sarah Kliff of the Washington Post describes Romney’s progression on pre-existing conditions:
It started with the Republican presidential candidate saying during an appearance on “Meet the Press” that he liked the Affordable Care Act’s provision that requires insurers to cover preexisting conditions, and would support something similar. Hours later, his campaign clarified he did not, however, support a federal ban against denying coverage for preexisting conditions. Around 10 p.m., the Romney camp had circled back to the same position it held back in March: that the governor supports coverage for preexisting conditions for people who have had continuous coverage.
The “continuous coverage” distinction is key: In order to retain the right to insurance that covers your pre-existing condition, you need to make sure to pay health insurance premiums every month. But often, the reason people lose health insurance because they have lost their job. Telling the recently unemployed to pay out of pocket for continuous coverage, typically at a cost of several hundred dollars a month for an individual or more than $1,000 for a family, is often not viable.
It’s worth noting that the purpose of the continuous coverage requirement is similar to the purpose of the individual mandate: It provides an incentive for healthy people to stay in insurance pools, avoiding a “death spiral” in which only sick people buy insurance.
Unaffordability is not a fatal problem for Romney’s continuous coverage proposal. It could be fixed with a range of subsidies that make it affordable for people to maintain continuous health coverage. Essentially, that’s what Obamacare does, and what Romney’s health plan in Massachusetts did.
For a conservative approach to fix at least part of the affordability problem, see this article from National Affairs by James Capretta and Tom Miller. Capretta and Miller propose to combine a Romney-style proposal on pre-existing conditions with significantly expanded funding for high-risk insurance pools, in hopes of covering up to 4 million uninsured Americans with pre-existing conditions.
But Capretta and Miller estimate that their plan would cost somewhere on the order of $200 billion over 10 years. Where is the indication that Romney plans to make such a significant financial commitment, let alone get one out of a Republican Congress? Romney’s platform is full of expensive promises — restore $700 billion in Medicare cuts, grow defense spending to 4 percent of GDP, cut tax rates. It funds these promises in part by drastically cutting spending on health care for the non-elderly. Implementing something like the Capretta-Miller proposal would be a significant reversal of course.
And what about the tens of millions of Americans who are uninsured not because they have pre-existing conditions but simply because they cannot afford insurance coverage? Romney says he wants to replace Obamacare, but his plans do not signal much help for them.
Romney has talked about leveling the playing field for individual purchasers of insurance, so they would get the same favorable tax treatment as businesses buying insurance for their employees. This would make it easier for individuals to buy their own health plans, but it’s not a substitute for Obamacare-style subsidies. Any way you structure a tax incentive, it’s likely to over-subsidize the wealthy and under-subsidize the poor, leaving huge swaths of America still unable to afford insurance.
Romney hasn’t said exactly how his tax incentive would work. But it would probably be a tax credit (whose value is static across incomes) or a tax deduction (whose value rises with income). In 2008, John McCain proposed a $5,000 per family tax credit for health insurance. Scaled up for health-care inflation, that would likely be closer to $6,000 today.
The average health plan premium for a family is now $15,745. Some middle- and upper-middle-income families can be expected to cover a gap of about $9,000. But poorer people need a larger subsidy if we hope to get them covered.
(It is also worth noting that if Romney plans to convert the existing tax exclusion for employer-provided health care into some other health-care subsidy, he cannot also use it as an area for tax-base broadening to pay for his cuts in tax rates, and he needs a lot of base-broadening to make his tax-cut math work.)
The key to the subsidy structure in both Romney’s Massachusetts plan and Obamacare is that the subsidies decline in value as people’s incomes rise. Under Obamacare, people with incomes up to 133 percent of the poverty line get Medicaid, which has very little cost to the beneficiary. Above that, they get sliding-scale subsidies for private insurance; the poorest beneficiaries pay just 2 percent of their incomes. Middle-income people get smaller subsidies, and wealthy people have to pay their own way.
Republican rejection of the Medicaid expansion is especially problematic, because Medicaid is cheaper than private insurance, and people earning less than 133 percent of the poverty line have almost no money of their own to contribute toward premiums.
Telling these people the federal government will pay 40 percent of their health insurance premiums will not get them insured. The options aside from Medicaid are to provide them private insurance at significantly higher taxpayer cost than in Obamacare, or leave them uninsured. It is easy to guess which option Republicans in Congress would prefer.
Romney doesn’t want to get into these details about who will get what subsidies. But the details are important. They are the difference between expanding health insurance coverage to the vast majority of Americans, and leaving tens of millions of Americans without access to the health care they need. And they are the difference between actually making it possible for people with pre-existing conditions to get the coverage they need, and not making it possible.
As on so many issues, Romney’s line on health reform is essentially, “Trust me, I’ll figure it out.” But uninsured Americans stand to gain a lot from the implementation of Obamacare. They have no particular reason to believe that Romney’s vague alternative would bring them similar benefits.
By: Josh Barro, Bloomberg, September 13, 2012
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