Tuesday, December 27, 2011

Flip flopping on RomneyCare

Although both Newt Gingrich and Mitt Romney seem to be doing a flip flop on RomneyCare, significant changes to the Massachusetts law have taken place since the initiating bill passed in 2006. As a Massachusetts state legislator, I have seen many bills working their way through the committee process that seek to add procedures/equipment/illnesses to what we call the “minimum creditable coverage” (MCC) standard—the definition of what a policy must cover in order to be deemed “legal” (that is, not subject to penalty for the policy owner via his/her personal income tax return).

The continuing ratcheting up of the MCC has produced health insurance policies that average well over $14,000 per year for a small group family plan, the highest premium cost in the country (a statistic from the Internal Revenue Service). At the same time, RomneyCare did not carry with it any provisions to reduce the cost of health care delivery; just the theory that universal coverage would temper fast rising premiums as well as emergency room visits for people without health insurance. The theory proved not to be correct, but the blame for this can be pinned on the state legislature’s actions since the enactment of RomneyCare as much, or more so, than the 2006 legislation.

It is not at all surprising that both Gingrich and Romney have reformulated their opinions on RomneyCare as it pertains to ObamaCare. No one questions that the Affordable Care Act (ACA) was premised on the Massachusetts concept, but one only has to look at the results of this incubator experiment in Massachusetts to see that, perhaps, this solution should not be ported to the nation as a whole.

For those who do support the ACA, there may be some level of comfort in noting that, in spite of Massachusetts leading the way in high health insurance premiums both before and after RomneyCare, the rate of increase since passing RomneyCare is tracking below the national average. Cost savings measures, such as uniform electronic medical records and accountable care organizations are being discussed at the Statehouse as ways to make our health care delivery system more efficient and less subject to fee-for-service arrangements.

In my opinion, expressing disappointment with a system that was so promising five years ago (before it was implemented) is not at all hypocritical, but reflective on outcomes to-date. The more important policy issue for these candidates is not the repeal of ObamaCare, but what avenue will yield the best, most affordable health care delivery system for the United States.

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