The ban on medical underwriting and exclusion of pre-existing conditions?
The elimination of lifetime maximums?
The penalty for those who choose not to sign up for insurance?
The expansion of Medicaid to cover those with incomes up to 133% of the federal poverty level?
Requirement that Medicare control its costs or be subjected to stricter controls on useless or dangerous procedures and treatments?
The tax credit for small employers obtaining health insurance?
The requirement that preventive care is covered – at no cost to subscribers?
Tight restrictions on insurers seeking to cancel coverage when subscribers get sick?
It wouldn’t be good policy to eliminate many of these provisions, and, more to the point, it isn’t possible.
First, the policy problem facing Mr Romney. Let’s take just one example; he’s said he
b) ensuring anyone with pre-existing conditions can get coverage
I don’t see how that works. In fact, Romney’s “assurances” about coverage for pre-ex are no more than what exists today; as long as you move directly from one insurance plan to another your pre-ex conditions are covered. For those Americans who haven’t had coverage for a few months, you’re out of luck – insurers won’t have to offer coverage.
Oh, and there are no price limits on what insurers can charge you, so even though Romney says your pre-ex conditions will be covered, it may cost you two, three, even five times more than the list price for that policy. Which means – really – Romney doesn’t guarantee pre-ex will be covered.
That’s just one provision that’s problematic for Mr Romney. The reality is there’s a lot to like about Obamacare, as Romney has found – otherwise he wouldn’t be backpedaling on his earlier promise to kill the whole thing. Sure, most folks are only really interested in the one or two provisions that directly affect them – perhaps coverage of kids till they’re 26, or expanded coverage of Medicare drugs. But he can’t – the practical reality is that unless he gets 60 senators to agree with him, he can’t overturn PPACA or significantly change any of its provisions.
So, the lack of any substantive discussion of health reform in the last debate was appropriate; it’s the law of the land and won’t/can’t be changed despite Romney’s occasional statements to the contrary.