The private nonpartisan Commonwealth Fund released its analysis of the impact of the Affordable Care Act, Romney’s proposals and what would happen if nothing were done at all.
They are “distinctly different approaches” under Romney and Obama, Commonwealth President Karen Davis said.
The group, which advocates for better health care, particularly for the poor, said the current health reform will reduce the number of uninsured in 2022 by 32.9 million, leaving 27.1 million still without insurance. That number would be 60 million if nothing were done but would increase to 72 million under Romney’s proposals, the group said, primarily because of Romney’s idea to shift federal Medicaid funding into a block grant to states.
In Commonwealth’s analysis, nearly 2.3 million Georgians – 25 percent – would be uninsured if nothing is done, versus 930,000 under the Affordable Care Act and more than 2.5 million under Romney’s proposals. In South Carolina, 1.1 million – 27.7 percent – would be uninsured if the status quo continued, while 420,000 would be uninsured if the Affordable Care Act continues and 1.27 million would be uninsured under the Romney plan.
Commonwealth made a number of assumptions in its analysis in part because the Romney campaign has not specified exactly what it would do in many health care issues, including the conversion of Medicaid to block grants to the states. The analysis assumed that would result in an overall reduction in federal funding that states would respond to equally by cutting costs such as provider reimbursement and reducing eligibility.
“If they could find more ways of cutting that cost and less eligibility cuts, then the uninsured numbers that we have would likely be lower,” said Sara Collins, Commonwealth’s vice president of affordable health insurance. In most states, however, Medicaid costs and payments are already low, so further reductions there might be difficult to pull off, she said.
“We felt this was a reasonable set of assumptions about how states would respond to the block grants,” Collins said.
Romney has proposed capping non-economic damages in malpractice cases and innovation grants for nonlitigation alternatives to lawsuits, something the health care overhaul didn’t address, Davis said.
“Most experts really think it was an omission (from the health care law) not to address the issue of medical liability, particularly in the context of efforts to improve patient safety,” she said.
Other Romney proposals appear to have a mixed benefit in the analysis.
He proposes ending tax discrimination against people who buy individual health care policies compared with those who get them through an employer, and he wants to allow insurance companies to sell across state lines.
Romney would also urge small businesses to band together through trade groups and other associations to purchase insurance as a group, but he has not spelled out specifically how he would do it, according to the analysis. That would be helpful to businesses with younger, healthier workers but might be present problems for those with older workers, according to the analysis.