Romney to Replace Obamacare with...Essentially Nothing

Tommy Christopher (via @rcooley123) at Mediaite has a good catch on Mitt Romney's health care proposals, from an interview Romney gave to Mark Halperin of Time magazine. Asked what would happen to people with pre-existing conditions after he were to repeal Obamacare, Romney said:

If people have been continuously insured, and then they decide to change jobs or change locations, they should not be denied coverage if they go to a new place or have to get a new policy. So people continuously insured should be able to get new insurance.

As Christopher points out, people who have been continuously insured already have this right, and have since 1996, under Title 1 of HIPAA. As he puts it, Romney "is selling you something you already owned." And lest you think maybe Romney just misspoke, you can see the very same words in his platform: "Prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage." So, on the critical question of pre-existing conditions, Romney is offering precisely nothing.

That is hardly the end of Romney's useless ideas on health care. His platform says we should return control over health insurance to the states. In principle, this could be workable; after all, in Canada each province has its own health insurance plan. States are big enough entities to do this: if Prince Edward Island can have its own plan, so could Rhode Island. And there is diversity in the provincial plans: Quebec's covers prescription medicine, while Ontario's does not. But this only works because the federal government has strong conditions on what level of coverage the provinces can provide. Romney, on the other hand, says we should "Limit federal standards and requirements on both private insurance and Medicaid coverage." This is a sure recipe for bad health insurance regulation at the state level.

Another plank in his health care platform is to "Empower individuals and small businesses to form purchasing pools." This will not enable individuals or small businesses to have anywhere near as much bargaining power as the state insurance exchanges in the Affordable Care Act.

Romney also says we should turn Medicaid into a block grant, giving states more flexibility. As Aaron Carroll points out, states acquired a great deal of flexibility with Medicaid during the GW Bush Administration, but have not introduced any great innovations. Why Romney thinks that would change is anyone's guess.

And of course, what would a Republican health care proposal be without the usual references to tort reform, "innovation grants to explore non-litigation alternatives to dispute resolution" (tort reform again), allowing insurance to be sold against state lines (which would weaken state's ability to regulate; isn't that where Romney said authority should be?) and getting rid of the tax deduction for employer-provided health care?

So, instead of the Affordable Care Act, Romney promises to give us what we already have on pre-existing conditions, plus junk to give insurance companies even more control over the health care market than ever.