Romney Shakes Etch-A-Sketch on Repealing Entire ACA

September 9th, 2012

I have heard a number of murmurs from the Romney campaign over the last few months regarding a decision not to scrap the entire ACA root and branch. Today, Romney said as much on Meet The Press.

When the show’s host, David Gregory, asked Mr. Romney what elements of Mr. Obama’s health care program he would maintain, Mr. Romney said he would still require that insurance companies cover those with pre-existing conditions, just as the president’s law has.

“I’m not getting rid of all of health care reform,” Mr. Romney said, while emphasizing that he planned to replace the president’s plan with his own. “There are a number of things that I like in health care reform that I’m going to put in place. One is to make sure that those with pre-existing conditions can get coverage.”

I wonder, just wonder, if instead of passing the massive Affordable Care Act, Obama had tried to pass a more limited act that took on pressing problems, like pre-existing conditions, and the like (this was his strategy during the campaign). Would the opposition have been as strong? Would the President have taken such a big hit to his mandate (no pun intended)? Would John Roberts have not lost so much sleep? Well, for sure, I wouldn’t have gotten a book deal. So I guess that is one plus.

Also Romney had this to say about the Supreme Court and the Constitution:

Pressed on his social views, Mr. Romney reiterated that he did not think that taxpayers should have to pay for abortions and that he wanted Supreme Court to overturn Roe v. Wade.

Reminded that he had once called himself a “severe” conservative, Mr. Romney seemed to play down that description. “I am as conservative as the Constitution,” he said.

Judge Posner is working on a piece in The New Republic about the Constitution of Mitt Romney as we speak.

Update: It seems Romney was for keeping parts of the ACA before he was against it:

In an interview Sunday on Meet the Press, Mitt Romney said we would keep parts of health care reform. The statement from Romney reflects an earlier position he held, just after health care reform was passed and before the Republican primary in which he said he “like some of the similarities” in ObamaCare to RomneyCare. Romney said he would “repeal the bad and keep the good” while mentioning the coverage for preexisting conditions, as well as the individual mandate were good aspects of ObamaCare like he mentioned today.

I really don’t think he still feels that the individual mandate is a good aspect. If you watch this video, there are only a few differences he does not like. The first is that the ACA is a federal plan while RomneyCare is a state plan. The former is bad, the latter is good. Romney says he is a “federalist” and some junk about the 10th Amendment. Second, he complains that the ACA raises taxes (paging John Roberts). So how do we keep a mandate that is a tax but is not a tax? Third, he complains that the ACA cuts medicare. Fourth, he opposes the ACA’s price controls.

So, what would that mean? If you repeal the bad about the fact that it is a federal mandate rather than a state mandate, the entire thing disappears. If you repeal the tax than the mandate is gone, though Romney likes the idea o fa mandate. So just restore funding to medicaid? The one thing the Court actually found unconstitutional is the thing Romney would get rid of. That makes some sense, I suppose.

Update: From National Review, this non-response from the Romney campaign:

Eliana, I reached out to the Romney campaign for clarification about Mitt Romney’s remarks this morning about liking some parts of Obamacare. An aide pointed out that Romney first said on Meet the Press that “I say we are going to replace Obamacare. And I am replacing it with my own plan.”

In reference to how Romney would deal with those with preexisting conditions and young adults who want to remain on their parents’ plans, a Romney aide responded that there had been no change in Romney’s position and that “in a competitive environment, the marketplace will make available plans that include coverage for what there is demand for. He was not proposing a federal mandate to require insurance plans to offer those particular features.”

Update: I always laugh when older people refer to sandals as thongs. I prefer flip flops. Speaking of which, it seems the etch-a-sketch keeps shaking:

After Mitt Romney said on NBC’s “Meet the Press” Sunday that there were certain parts of Obamacare that he liked, a campaign aide confirmed to BuzzFeed that one of the elements that a Romney health care overhaul would be a guarantee that people with pre-existing conditions can’t get kicked off their health insurance plans.

“Gov. Romney will ensure that discrimination against individuals with pre-existing conditions who maintain continuous coverage is prohibited,” the aide said.

The statement stands in contrast to a report in National Review Online earlier Sunday, which quoted an anonymous aide saying Romney would allow “the martketplace” to sort out coverage for such people.

The aide pointed to an occasion earlier this summer when Romney firmly staked out support for insuring people with pre-existing conditions.

However, without an individual mandate — which Romney has repeatedly opposed — it’s unclear how he would ensure such coverage.

Neera Tandon, Byron York, and Jonathan Chait are currently arguing on Twitter. I’ll update later.

Update: More explications from Ezra Klein how Romney would ensure deal with pre-existing conditions without a mandate:

This isn’t the first time that Romney has endorsed that position: Back when the Supreme Court was about to issue its decision on Obamacare, his spokeswoman Andrea Saul laid out a few more of the policy points.

Andrea Saul confirmed that the former governor does not support the across-the-board consumer protections for pre-existing conditions as written into Democrats’ health care law.

“Governor Romney supports reforms to protect those with pre-existing conditions from being denied access to a health plan while they have continuous coverage,” she said first in a statement to the Huffington Post later obtained by ABC News.

It makes sense, politically, to support the end of pre-existing conditions: It regularly polls as one of the health-care law’s most popular provisions.

Policy-wise, however, there’s a significant amount of space between “ending pre-existing conditions” and “ending pre-existing conditions [with continuous coverage].” Under the former scheme, insurers cannot deny coverage to an individual — no matter what. Under the latter, insurers can, in certain situations, refuse to cover some individuals.

The idea of “continuous coverage” is pretty much what it sounds like: Under the scheme Saul laid out earlier, an individual who kept buying insurance month after month could not be turned away by an insurance company. The goal is to create an incentive for healthy people, who don’t think they really need coverage, to keep paying monthly premiums — ensuring that they would have access to health insurance if their health should take a turn for the worse.

And this from National Affairs on how to cover pre-existing conditions through high-risk pools.

This approach to covering pre-existing conditions would not be inexpensive, of course. But its price tag would be tiny compared to the recent health-care bill’s. And using high-risk pools to cover people who are uninsured because of pre-existing medical conditions would not cede all power over our health-care system to bureaucrats in Washington. Nor would it disrupt insurance arrangements that are working well for the vast majority of Americans. It would leave in place the many protections already available to people in the much larger employer-based insurance market. Indeed, it would likely ease cost pressures on many Americans who are currently insured — by properly funding high-risk individuals who are now pushing insurance premiums up for everyone.

The many advantages of high-risk pools create an opening for opponents of Obama’s approach. Critics should seize the chance to present a coherent case to the public for replacing the deeply flawed new law — advancing in its place a series of targeted, incremental solutions to the specific problems plaguing our health-care system.