(CNSNews.com) – Republican presidential candidate and former Massachusetts Gov. Mitt Romney has pledged multiple times that he would repeal and replace President Barack Obama’s signature health care reform law. However, his repeal proposals are light on specific details.
“If I were president, day one I will take action to repeal Obamacare. It's bad medicine. It's bad economy. I'll repeal it,” Romney said at the Jan. 26 GOP debate in Florida. “And I believe the people -- I believe the people of each state should be able to craft programs that they feel are best for their people.”
However, Romney’s plans for replacing Obamacare reveal few details.
The plan Romney lays out on his campaign Web site for replacing the law has five points – state leadership, tax reform, regulatory reform, malpractice reform, and market forces – and generally incorporates many long-time Republican policy ideas on health care reform.
However, none of those policies is fleshed out in specific detail, despite some of them having been put into detail in other proposals, such as Rep. Paul Ryan’s (R-Wisc.) entitlement reform plans.
Under the “state leadership” heading, Romney calls for block-granting of state Medicaid funds. Under such a policy, the federal government would simply give its half of Medicaid spending to a state as one lump sum with little or no strings attached.
“We can empower states to expand health care access to low-income Americans by block-granting funds for Medicaid and the uninsured,” Romney’s Web site says.
However, the site gives no more detail on exactly how Romney would set up this system.
In a May 12, 2011 speech at the University of Michigan, Romney said that in block-granting Medicaid funds, he would “limit the federal standards to those that are absolutely necessary.” However, that was the only policy-specific detail he offered.
Romney also cites other reform proposals, but again gives little detail.
“Mitt Romney’s reforms also offer the states resources to help the chronically ill, to improve their access to care, and to improve the functioning of insurance markets for others,” reads the Web site.
Under the “tax reform” heading, Romney’s single proposal is to extend to individuals the tax preferences employers receive for buying health insurance for their employees. Again, Romney does not offer specifics on the plan, such as how much it might cost or how much individuals might be able to deduct from their taxes.
“Mitt Romney will expand the tax deduction to also include those who buy their own health insurance,” the Romney campaign site says.
Under the “regulatory reform” headline, Romney broadly promises to “use limited federal regulation to correct common failures in insurance markets, while eliminating counterproductive federal rules,” but offers only two examples – the common GOP ideas of allowing interstate insurance purchases and the formation of private insurance pools.
Romney modifies the ObamaCare prohibition on insurance companies denying coverage based on a preexisting medical condition, saying that people who have been continuously covered for a certain period of time will not have their insurance canceled because of a preexisting condition. However, Romney does not say how long someone would have to be covered before they are protected against preexisting conditions.
“For example, individuals who are continuously covered for a specified period of time may not be denied access to insurance because of pre-existing conditions,” says the Romney Web site. “Mitt also believes that individuals should be allowed to purchase insurance across state lines, free from costly state benefit requirements. Finally, individuals and small businesses should be allowed to form purchasing pools to lower insurance costs and improve choice.”
On medical malpractice, Romney says he will “cap non-economic damages in medical malpractice litigation,” but does not say at what level he will cap them. Romney also says he “believes in providing innovation grants to states for additional medical liability reforms, such as alternative dispute resolution or health care courts,” but does not pledge to enact such a proposal and does not give any further details on how such reforms would work.
On unleashing market forces Romney pledges to “strengthen health savings accounts (HSAs),” but offers few details as to how he would do that. Romney does say he “believes that we should permit HSA funds to be used to pay for health insurance premiums,” but the details end there.
In his May 2011 speech, Romney mentioned promoting co-insurance plans that let people pay a percentage of their total health care bill out of pocket, much like traditional insurance co-pays. However, Romney did not elaborate on the details of that proposal in his speech and the co-insurance plan is not included on his Web site.
In that same speech, Romney mentioned an idea to have a rating of health insurance plans much like the product reviews published by Consumer Reports magazine, examining costs and benefits or different plans. He also said that he supports greater coordination of information technology among health care providers – but did not offer specifics on either proposal.
Romney also said he would promote alternatives to the fee-for-service payment model used by Medicare, suggesting that instead the government could use “capitated rates” and “bundled payments” instead. Capitated rates are fixed amounts paid to health care providers for a particular service. Bundled payments are single payments paid to several doctors who are treating a patient for related illnesses, such as those associated with diabetes.
Romney did not say which type of payment he favored or how either system would work.
Former Sen. Norm Coleman (R-Minn.), an adviser to the Romney campaign, in an interview on Jan. 22 said that if a Republican is elected to the presidency in November, ObamaCare will not be repealed, certainly not in its entirety.
“We’re not going to do repeal. You’re not going to repeal Obamacare,” said Coleman, who became a Romney adviser in September 2011. “It’s not a total repeal. … You will not repeal the act in its entirety, but you will see major changes, particularly if there is a Republican president. … You can’t whole-cloth throw it out. But you can substantially change what’s been done.
Romney’s campaign spokeswoman, Andrea Saul, rejected Colemean’s claims, telling The Hill, “With all due respect to Sen. Coleman, he’s wrong. Gov. Romney can and will repeal ObamaCare and is committed to doing so.”
CNSNews.com contacted the Romney campaign asking to discuss the candidate’s health care proposals in greater detail. Andrea Saul responded, stating in an e-mail that “Gov. Romney gave an entire speech on this in May.”
That speech, along with a PowerPoint presentation, posted on C-SPAN (scroll down at link) is not substantially different than the material posted on the campaign Web site.