Health Insurance Navigator

By Lisa Zamosky

Last night’s debates confirmed that when it comes to the future of health care, President Obama and Governor Mitt Romney have very different views about the right path forward. Here are some highlights from last night.

Obamacare vs. Romneycare

Romney vowed once again to repeal Obamacare on day one of his presidency. But he also said he’d keep certain parts of the law that make sense, although he was vague last night, as he has been in recent weeks about just what that means.

The President reminded voters that the federal law is a near identical version of the law Romney put in place in Massachusetts when he was governor of the Commonwealth.

“The irony is we’ve seen this model work really well in Massachusetts,” Obama said of Romney’s desire to do away with health reform.

But Romney was eager to draw differences between the law he passed and Obamacare. “We didn’t raise taxes. You raised them by $1trillion,” he told the President. “We didn’t put in place a board to tell people what treatments they can receive,” Romney said, referencing the law’s establishment of an Independent Payment Advisory Board (IPAB), which I explained in detail in this earlier post.

Medicaid

Currently, about 51 million people have health insurance through Medicaid, the state-federal health insurance plan for people with low incomes. Under President Obama’s health reform law, an additional 16 million are expected to gain coverage when eligibility requirements expand in 2014.

But the Supreme Court’s decision this summer to allow states to choose whether or not they wish to expand their Medicaid program is likely to limit how many more people will ultimately be covered. Still, expanding Medicaid is a central part of the President’s health reform law.

Romney reiterated last night that he takes a very different view. States, he said, should have the ultimate authority over how their Medicaid program is run, with no federal involvement. Romney would give states block grants, or lump sums of money, to manage the plan as they saw fit. Each year states would receive an increase to match inflation, plus a 1% increase.

Medicare

Romney told viewers last night that the health reform law takes $716 billion out of the Medicare program, and he suggests that those cuts affect seniors with Medicare today.

Obamacare does, in fact, cut the program by that amount, but mostly by reducing payments to insurance companies and health care providers. Romney said those payment cuts will hurt seniors because health care providers will stop accepting new Medicare patients, which remains to be seen. However, so far under the law, seniors have gained benefits and saved money on prescription drugs through discounts available once beneficiaries reach the Medicare “donut hole.”

Romney’s plan for Medicare involves changing the program’s current structure. Instead of a defined benefit, seniors would get financial support (also called a voucher) to go out and purchase their own coverage. Options would include either traditional Medicare or a private plan. The Medicare eligibility age also rises from 65 to 67 in Romney’s plan. People currently 55 and older would not be impacted.

But Obama countered that the plan will leave seniors on the hook for more of their medical costs, which independent studies have found to be true. “The problem is the voucher may not keep up with inflation, costing seniors more than $6,000 a year,” the President said.

Common Ground

In the end, both candidates agree that the cost of health care is a huge problem for this country, and one that needs to be addressed. Obama sees his health reform law working as well for the country as Romney’s did in Massachusetts, while Romney says state control and a greater emphasis on free markets will be more effective.

“Republicans and Democrats both love America,” Romney said. “We need to have leadership in Washington that will actually bring people together.”

Who’s the right man for that job? You’ll have your chance to decide next month.

Did you watch last night’s debates? Share your thoughts here about what you heard.