This article is one of 12 that examine where President Barack Obama and former Massachusetts Gov. Mitt Romney stand on some of the issues that are important to voters.
Obama in March 2010 signed into law his landmark legislation, the Patient Protection and Affordable Care Act. It was upheld by the Supreme Court 5-4 on June 28.
The act requires that U.S. citizens obtain health insurance coverage or pay a penalty to the federal government. The flat-dollar penalty amounts for people 18 or older would be $95 in 2014, $325 in 2015 and $695 in 2016, according to ABC News.
Most reforms brought about by the act, including the requirement to buy health care insurance, are scheduled to be implemented in 2014. Some reforms have already begun, such as the provision that allows children to stay on their parents’ insurance plans until they are 26.
In the Supreme Court’s opinion, Chief Justice John Roberts wrote: “The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”
The court did not hold up a provision requiring that states expand their Medicaid roles, saying they should be free not to do so if they’re willing to give up federal funding promised under the act.
Romney would act to repeal and replace the Patient Protection and Affordable Care Act. In a speech given after the Supreme Court upheld the constitutionality of the act, Romney said it puts the federal government between an American and his or her doctor, in addition to adding trillions to the national debt and killing jobs.
Under Romney, the federal government would instead help create a “level playing field” for competition among the states, according to his campaign website. His plan would give states the power to come up with their own health care reform plans.
Romney believes consumers should have the power to make their own health care choices. He said he would keep certain parts of the Patient Protection and Affordable Care Act, including the provision that allows children to stay on their parents’ insurance plans until they’re 26.
MU political science professor Lael Keiser, who specializes in policy implementation, said Obama’s plan is geared more toward expanding health coverage, while Romney’s is geared toward reducing costs.
“Romney’s plan would only require insurance companies cover people with pre-existing conditions who have had continuous coverage in the past, while with Obama’s health care plan, people cannot be denied coverage based on pre-existing conditions,” she said.
“Without the individual mandate, the overall cost of the act would be much higher," she said. "Romney’s plan gets rid of the individual mandate. You would have fewer people covered under Romney’s plan, but Obama’s plan might increase costs because it expands coverage. Some argue, however, that increasing access reduces costs in the long run.”
Kosali Simon, a professor of health economics at Indiana University, said Romney’s health care plan in Massachusetts is similar to the Affordable Care Act. He has since distanced himself from the Massachusetts plan, saying he would do things differently on a federal level.
“The problem with comparing Obama and Romney’s health care plan is that we are at a different point right now,” Simon said. “With Obama’s plan, we have an enacted law with several pieces implemented already. It’s very concrete.”
When you consider what Romney is putting forward, it’s still only a set of ideals, she said. “What we know of his plan is still in terms of principles, although we do know that the Romney plan would be different from the Obama plan on a number of fronts, such as less federal regulation.”