January 24, 2016


 'Hillarycare' Did, and Didn't, Lead to Obamacare : The real precursor was Mitt Romney's plan, say people who wrote the president's health care law. (Sahil Kapur, January 22, 2016, Bloomberg)

[O]bama's plan more closely resembles the Massachusetts overhaul signed into law in 2006 by the state's then-governor, Mitt Romney, Obama's Republican opponent in 2012. But people who helped write the 
Affordable Care Act give Clinton credit for laying the political groundwork that helped Obama succeed where her husband, former President Bill Clinton, failed.

"The Affordable Care Act was modeled after Romney's Massachusetts plan, not the 1993 Bill Clinton plan," said Timothy Jost, an expert on health care law. "The 1993 plan and the ACA are very different proposals." 

Obama's plan is a federal version of Romney's in its basic structure: A regulated marketplace that prohibits insurers from refusing coverage for sick people, or charging them higher prices; requires most people to buy coverage; and provides subsidies to low-income people to help them afford coverage. The goal of both plans was to preserve most existing coverage while extending it to the uninsured.

Clinton's plan, by contrast, was more ambitious in its scope and would have been more disruptive for the vast majority of Americans who receive insurance coverage through an employer or through Medicare or Medicaid, the government programs for the elderly and disabled and for the poor. The sprawling proposal sought to achieve universal health coverage by offering all Americans a standard minimum-benefits package and imposing limits on out-of-pocket expenses, along with a broad requirement that employers provide insurance.

"It did try to impose a fundamentally new system," Jost said, arguing that many people would have seen their coverage--or the source of it--change.

"For all the criticism that the ACA has caused disruption, it's remarkably incremental compared to what the Clinton administration proposed back in the 1990s," said Larry Levitt, a health policy expert with the Kaiser Family Foundation who worked in the Clinton administration and helped develop the proposal. "The ACA leaves the current private insurance system largely unchanged for the majority of people who get coverage through their employers. The Clinton Health Security Act would have required most people to switch their health insurance coverage to new health insurance alliances, and it imposed caps on how fast premiums could rise."

Too bad Mitt didn't have sense enough on being better at administering it than the UR.
Posted by at January 24, 2016 7:43 AM