On June 29th the Supreme Court upheld the individual mandate portion of the Affordable Care act, referred to as ObamaCare by most, including president Obama. The Individual mandate has become the most contentious portion of national health care reform law.
The Individual mandate states beginning in 2014, there will be a mandate for most individuals to have health insurance or potentially pay a penalty for noncompliance. Individuals will be required to maintain minimum essential coverage for themselves and their dependents. Some individuals will be exempt from the mandate or the penalty, while others may be given financial assistance to help them pay for the cost of health insurance.
We as citizen continue to go back and forth on the effects of the Supreme Court upholding the Affordable Care Act. As I take time to research and write about Health Care Reform changes in the US, I must take a step back and look at the closest examples of health care reform legislation that includes an individual mandate. I inevitable must take a look at Massachusetts Health care law.
Six years ago then Governor Romney help passed comprehensive health care reform in Massachusetts, and the results have led to 98% of Massachusetts residents being covered
According to CSB News. While two percent of Massachusetts’s residents are still not covered, that compares favorably to the national average of 16 percent uninsured.
The Obama administration cited Massachusetts as a model for the 2010 Affordable Care Act, which had an individual mandate at the heart of its Supreme Court review.
Though Romney opposes the Obama health reform, Romney defended the mandate as a personal responsibility during his first campaign for the Republican presidential nomination.
“We said, look, if people can afford to buy it, either buy the insurance or pay your own way. Don’t be free riders and pass on the cost of your health care to everybody else,” Romney said in a televised debate before the 2008 New Hampshire primary.
MIT economist Jonathan Gruber, who advised both Romney and Obama on their plans, says insurance companies supported the reforms in both instances, because they were guaranteed more customers, particularly young and healthy people who were among the most likely to be uninsured.
So if the Obama plan was based off the Romney plan what are the differences?
Ways that RomneyCare (RC) is better than ObamaCare (OC):
1. RomneyCare provides deeper premium support and cost sharing subsidies to make health insurance more affordable to those receiving public subsidies.
2. ROMNEYCARE established an insurance exchange (Connector) with a directive to be an advocate to keep consumers’ health insurance premiums more affordable.
Ways that ObamaCare is better than RomneyCare:
1. ObamaCare premium support and cost sharing subsidies help families with incomes up to 400% of the federal poverty line, vs. 300% FPL under ROMNEYCARE.
2. ObamaCare bans lifetime and annual benefit caps and ROMNEYCARE does not.
3. ObamaCare eliminates medical underwriting and pre-existing condition exclusions for all health insurance policies. Massachusetts did this in the 1990s and so there was no need for this to be addressed in ROMNEYCARE.
4. ObamaCare requires health insurance companies to spend at least 80-85 cents of every premium dollar on medical costs as opposed to profits, marketing and overhead. ROMNEYCARE includes no such provisions.
5. ObamaCare allows young adults to stay on their parents‘ health insurance policies until they reach age 26. ROMNEYCARE allows young adults to stay on their parents’ plan for up to two years after they are no longer dependent, and no older than age 25.
6. ObamaCare requires that all health insurance policies cover preventive care services (ie: contraception) with no co-pays or other cost sharing. ROMNEYCARE has no such protections.
7. ObamaCare requires that all Members of Congress and their staffs can receive federal health insurance coverage via the new state health insurance exchanges. ROMNEYCARE did not make any similar requirement on Massachusetts state legislators.
8. ObamaCare improves Medicare for its beneficiaries by: closing the prescription drug “donut hole;” providing an annual wellness checkup with no cost sharing; lowering beneficiary premiums; and extending the life of the Hospital Insurance/Part A Trust Fund by about 8 years. ROMNEYCARE does not address or improve Medicare at all.
9. ObamaCare instigates a significant effort to lower the health care system’s administrative costs. ROMNEYCARE has no such provisions at all.
10. ObamaCare instigates a series of reforms in the delivery of medical care services, including the establishment of accountable care organizations, medical homes, value-based insurance designs, penalties for excessive rates of hospital acquired infections and readmissions, and more. ROMNEYCARE does not address delivery system improvements at all.
11. ObamaCare establishes a series of programs and initiatives to improve public health, prevention and wellness, including the creation of the first-ever national prevention strategy. ROMNEYCARE provides funding for some existing public health programs, though no new public health or prevention initiatives.
12. ObamaCare requires every chain restaurant with at least 20 outlets to post on menus and menu boards the calories of every item on its menu. ROMNEYCARE has no such public information requirement.
13. ObamaCare includes major new funding for community health centers and the National Health Service Corps to improve the nation’s supply of primary care services. ROMNEYCARE has no such provisions.
14. ObamaCare requires the establishment of a National Health Workforce Commission — appointed, though blocked from convening by House Republicans. RomneyCare does not address health care workforce needs at all.
15. ObamaCare establishes major new provisions to combat health care fraud and abuse in Medicare, Medicaid, and private insurance. RomneyCare includes no provisions addressing fraud and abuse in any sector.
16. ObamaCare establishes new standards and a national framework to combat elder abuse, including violence, neglect, and financial exploitation. RomneyCare includes no such provisions.
17. ObamaCare requires that drug, medical device, and medical supply companies publicly report all gifts, honoraria, and other gratuities to physicians and other licensed medical professionals. RomneyCare includes no such provisions.
18. ObamaCare directs the Food & Drug Administration to create a pathway for the approval of so-called “bio-similars” or generic-like versions of biopharmaceutical drugs, provisions strongly supported by the pharmaceutical and biotechnology industries. RomneyCare has no such provisions.
19. ObamaCare includes provisions to ensure that nursing patients and their families are able to obtain transparent information about the ownership and corporate responsibility of nursing homes. RomneyCare includes no such protections.
20. ObamaCare establishes a new 10% tax on indoor tanning services, which have been linked to the explosion in serious skin cancers, especially melanomas, among young women ages 15-35. RomneyCare does not address this epidemic.
In the last couple of months, I’ve gotten the sense that Health Care Reform is viewed differently based on your political view, what the media has chosen to focus on, and a lot of other factors that are not always based on facts. In my field I’ve chosen to look at the pros, and cons from different perspectives, and try to be objective as possible.
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