What RomneyCare Means Now

Today we’ve got a genuine must-read from Jonathan Cohn at The New Republic: a comprehensive analysis of Mitt Romney’s proposals for federal health care policy.

Taking these proposals seriously is especially important because thanks to conservative criticism, we’ve all gotten used to the idea of associating Romney’s thinking on health care with so-called “RomneyCare,” the Massachusetts health reform plan that was a model for the Patient Protection and Affordable Care Act of 2010.

Even if you think Romney’s lying when he promises to repeal “ObamaCare” in its entirety and gradually replace it with an assortment of right-wing “market-oriented” initiatives largely aimed at restricting insurance coverage, it is abundantly clear that this is one topic on which he will be cut zero slack by his conservative guardians. Besides, the overall agenda Romney would be forced to embrace as Job One (or Job One-and-a-Half after the repeal of ObamaCare) the moment he is inaugurated, implementation of the Ryan budget, constitutes a definitive reversal of everything ObamaCare is intended to accomplish–a true 180 degree turn on health care policy aimed at bringing back the good ol’ days before health care was considered a “right.”

Here’s the lede for Cohn’s assessment of Romney’s proposals:

The gist: Repeal the Affordable Care Act; end Medicare and Medicaid as we know it, by turning the former into a voucher program and the latter into a block grant scheme; unravel private insurance, by changing the tax treatment of benefits and undermining state regulation.

The good. Not much. Once in a while he talks up worthwhile reforms designed to improve the quality of care. He also endorses malpractice reform, which is a worthy idea, although his approach would do in a way that reduced damage awards without improving compensation for actual medical errors.

The bad: Changing the tax treatment of health insurance makes sense if you do it alongside other reforms. But if you do it without those reforms, it undermines employer-sponsored coverage without providing adequate alternatives.

The ugly: Up to 58 million more people could end up without health insurance, relative to what will happen if current law stays in place, according to one credible estimate drawn from the things he’s said so far

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Please read the whole thing when you get a chance, and share it with someone who is thinking of voting for Romney as some corporate technocrat who will “fix” the economy and make government a tad more efficient.

Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.