IMO the biggest mistake made by the Obama Administration regarding the Affordable Care Act was not failing to include a public option. It was the fact that the Administration didn’t saturate the nation’s media with public service ads explaining clearly how it would work when it all went into effect. And because most of the big stuff in the law wont go into effect until 2014, the Right has had plenty of time to lie and frighten people into thinking “Obamacare” will kill Grandma.
Polls continue to show that more people than not don’t like the ACA (although one suspects many of the “don’t likes” are liberals who want single payer). So the Right has been vowing to “repeal and replace” the ACA. However, they flounder a bit on the subject of what “replace” will mean.
Now we’re beginning to get some idea of what Mittens would do as president, and it’s not pretty. He’s essentially warming up John McCain’s ideas from the 2008 campaign. For those of you who don’t remember, McCain’s basic idea was to eliminate the tax exclusion for employers who provide health insurance benefits, thereby phasing out such benefits and dumping everyone into the private market. Then, the miracle of “free market competition” would cause insurance costs to go down and provide people with better options. That’s the theory, anyway.
But Mittens also has to steer away from anything resembling his Massachusetts plan, because it’s too much like “Obamacare.” So, says Brian Beutler,
… neither Romney nor McCainâ€™s plans allow individuals to pool risk in insurance exchanges, require insurers to sell insurance to all comers without price-discriminating against sick people or fight the adverse selection problem by requiring both sick and healthy people to enter the pool. Romney isnâ€™t calling for those reforms â€” because though they would solve the problems with his outline, they would also add up to â€œObamacare.â€
In short … this would be a nightmare. It would be all the bad things about the long-standing status quo, but on steroids.
On top of that, Romney has embraced some version of Paul Ryan’s Medicare plan, privatizing Medicare and providing seniors with subsidies to buy insurance on the private market. And he wants to eliminate Medicaid and just give block grants to the states to come up with their own programs to provide health care for the poor. In many states, that’s pretty much guaranteeing that the poor will be left to heal themselves.
See also Jon Healey, “Mitt Romney vs. employer-provided healthcare insurance.”