WASHINGTON – The projected cost of private, non-group health insurance would be twice as high for American families in 2016 if the Affordable Care Act is repealed and replaced with Republican proposals, according to an analysis by three prominent health care economists.
Families would pay $11,481 per year for private, non–group health insurance under the policies advocated by Republican presidential candidate Mitt Romney, compared with $5,985 a year under the Affordable Care Act.
The advocacy group Families USA issued the analysis at a Sept. 27 briefing as both candidates were heating up their campaign rhetoric.
The analysis was conducted with the help of three health policy experts, all of whom advised then-Gov. Romney as he developed the Massachusetts health insurance law. The Massachusetts law, enacted in 2006, is widely considered a model for the ACA.
Alicia Ault/IMNG Medical Media
Jonathan Gruber, PhD
"There is no doubt, it was the model for the [ACA]," Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology, Cambridge, said at the briefing. He helped with the Families USA analysis and was a principal adviser to Mr. Romney, as well as to the Obama Administration on the ACA.
While the Massachusetts health law, dubbed "RomneyCare" by the Families USA report, is very similar to the ACA, "RomneyCandidateCare" – what the report terms policies espoused by the Romney campaign – is not the same, said Ron Pollack, executive director of Families USA. They are "as different as day and night."
Under "ObamaCare" (the report’s term for the ACA), depending on income, families would receive tax credits to help pay for premiums and in some cases, for other out-of-pocket costs. Under "RomneyCandidateCare," families would receive tax deductions.
Mr. Gruber and two other analysts – Stuart Altman of Brandeis University, Waltham, Mass., and John McDonough of Harvard School of Public Health, Boston – determined that the average size of the credit under the ACA would be $4,231 in 2016, while the Romney tax deduction would be around $2,490.
Some 20.3 million people would receive subsidies under the ACA, while only 10.1 million people would under Mr. Romney’s plan.
The year 2016 was selected because it is the end of the next presidential term.
The economists also projected a huge increase in the number of uninsured under a Romney administration. Using Census Department and Congressional Budget Office estimates, they project that without any health reform at all, the number of uninsured Americans would hit 56 million in 2016.
As enacted, the ACA is slated to reduce the number of uninsured to 25.3 million at that time. Conversely, the Romney plan would increase the number of uninsured to 67.2 million, the analysis found.
When looking at the three plans, the economists made certain assumptions regarding how "RomneyCandidateCare" would be implemented, should Mr. Romney be elected:
• The ACA would be repealed.
• Medicaid would be funded through block grants to the states.
• End tax discrimination against the individual purchase of insurance (per the Romney campaign website).
• Protections would be included for those with preexisting conditions.
The report homed in on potential effects of a Romney presidency on Medicare. The aim was in part to dispute the Romney campaign’s allegation that the ACA will cut Medicare benefits by $716 billion.
Alicia Ault/IMNG Medical Media
Stuart Altman, PhD
"Nothing could be further from the truth," said Mr. Altman, who added that the reduction came from a rejiggering of Medicare payments to private insurance plans for beneficiaries enrolled in Medicare Advantage.
Further, should the ACA be repealed, Medicare would no longer provide many free preventive care services and efforts to reduce beneficiaries out-of-pocket costs under Part D would be rolled back.
Finally, the report noted that the ACA would extend the life of the Medicare Trust Fund, in part by requiring higher income workers to pay in slightly more, and by reducing the Medicare Advantage payments. "RomneyCandidateCare" would not do so, and would also threaten Medicare by converting it to a voucher program, according to the analysis.
That’s because over time, the program would reduce the value of the Medicare subsidy, while costs would continue to rise. "By the time people born in 1983 reach Medicare eligibility age, their coverage would be worth 42% less than it would be under ObamaCare," the report said.