President Obama signed the Affordable Care Act (ACA, more often referred to as Obamacare) into law in March, 2010. It is intended to make health care more affordable for families and small business, to bring greater transparency to the insurance industry and to increase coverage of pre-existing conditions and ban lifetime limits. Estimates are that 34 million more US citizens will be covered and that this Act will help keep insurance premiums down. Once the law is fully implemented, an estimated 95% of Americans under the age of 65 will have healthcare insurance (www.barackobama.com).
The US Supreme Court in March, 2012 began its review of the constitutionality of the ACA. The key question centers around whether Congress exceeded its authority with the inclusion of the "individual mandate", which requires that almost all adult Americans purchase health insurance or risk financial penalty. The individual mandate is set to take effect in January, 2014. The outcome of the Supreme Court decision, which is expected in June 2012, will determine whether the law stands as is or if certain or all provisions of the law are determined to be unconstitutional, including the tax provisions.
In March, 2012 the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) estimated that the insurance coverage provisions of this legislation would cost $1.252 trillion from 2012-2022. The CBO and JCT have not estimated the budgetary effects in 2022 of the other provisions of the ACA, however over the 2012-2021 period, those other provisions (taxes, fees and penalties) were previously estimated to reduce budget deficits (cbo.gov/publication/43080). Budget accounting rules however require the CBO to double count Medicare reductions, which would otherwise reveal that there will in fact be an increase in budget deficits, not a decrease (see Medicare issue), if Medicare savings and revenues are applied to the Medicare Hospital Insurance Trust Fund.
On his first day in office Mr. Romney would issue an executive order to facilitate the federal government issuing Obamacare waivers to all 50 states. He would then work with Congress in an effort to repeal the Affordable Care Act (ACA). He claims it will add $1 trillion in health care spending and to pay for it, the ACA raises $500 billion in taxes on everyone from middle-class families to innovative medical device makers and then slashes $500 billion from Medicare.
Mr. Romney would pursue policies that give each state the power to craft their own healthcare reform plan. He would 1) block grant Medicaid and other payments to states, 2) limit federal standards and requirements on private insurance and Medicaid coverage, 3) ensure flexibility to help the uninsured, including public-private partnerships, exchanges, and subsidies, 4) ensure flexibility to help the chronically ill, including high-risk pools, reinsurance, and risk adjustment, and 5) offer innovative grants to explore non-litigation alternatives to dispute resolution (www.mittromney.com).
As Governor of Massachusetts, Romney passed a universal health plan. It included private, employer-sponsored insurance in which all, but the smallest employers had to provide insurance to their workers or pay a penalty, utilized Medicare to insure the elderly, and an expanded Medicaid-like program to insure the poor. It also provided subsidies to low-income individuals and small employers and it created state-based private insurance exchanges to make insurance more accessible and affordable to individuals and small employers. It also included almost all residents to maintain insurance or pay a penalty like the individual mandate (www.cnn.com/2011/10/25/opinion/altman-romney-obama-health-care/index.html).