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http://www.nytimes.com/2012/10/05/opinion/krugman-romneys-sick-joke.html?ref=paulkrugman
“No. 1,” declared Mitt Romney in Wednesday’s debate, “pre-existing conditions are covered under my plan.” No, they aren’t — as Mr. Romney’s own advisers have conceded in the past, and did again after the debate.
Was Mr. Romney lying? Well, either that or he was making what amounts to
a sick joke. Either way, his attempt to deceive voters on this issue
was the biggest of many misleading and/or dishonest claims he made over
the course of that hour and a half. Yes, President Obama did a notably
bad job of responding. But I’ll leave the theater criticism to others
and talk instead about the issue that should be at the heart of this
election.
So, about that sick joke: What Mr. Romney actually proposes is that
Americans with pre-existing conditions who already have health coverage
be allowed to keep that coverage even if they lose their job — as long
as they keep paying the premiums. As it happens, this is already the law
of the land. But it’s not what anyone in real life means by having a
health plan that covers pre-existing conditions, because it applies only
to those who manage to land a job with health insurance in the first
place (and are able to maintain their payments despite losing that job).
Did I mention that the number of jobs that come with health insurance
has been steadily declining over the past decade?
What Mr. Romney did in the debate, in other words, was, at best, to play
a word game with voters, pretending to offer something substantive for
the uninsured while actually offering nothing. For all practical
purposes, he simply lied about what his policy proposals would do.
How many Americans would be left out in the cold under Mr. Romney’s
plan? One answer is 89 million. According to the nonpartisan
Commonwealth Foundation, that’s the number of Americans who lack the
“continuous coverage” that would make them eligible for health insurance
under Mr. Romney’s empty promises. By the way, that’s more than a third
of the U.S. population under 65 years old.
Another answer is 45 million, the estimated number of people who would
have health insurance if Mr. Obama were re-elected, but would lose it if
Mr. Romney were to win.
That estimate reflects two factors. First, Mr. Romney proposes repealing
the Affordable Care Act, which means doing away with all the ways in
which that law would help tens of millions of Americans who either have
pre-existing conditions or can’t afford health insurance for other
reasons. Second, Mr. Romney is proposing drastic cuts in Medicaid —
basically to save money that he could use to cut taxes on the wealthy —
which would deny essential health care to millions more Americans. (And,
no, despite what he has said, you can’t get the care you need just by
going to the emergency room.)
Wait, it gets worse. The true number of victims from Mr. Romney’s health
proposals would be much larger than either of these numbers, for a
couple of reasons.
One is that Medicaid doesn’t just provide health care to Americans too
young for Medicare; it also pays for nursing care and other necessities
for many older Americans.
Also, many Americans have health insurance but live under the continual
threat of losing it. Obamacare would eliminate this threat, but Mr.
Romney would bring it back and make it worse. Safety nets don’t just
help people who actually fall, they make life more secure for everyone
who might fall. But Mr. Romney would take that security away, not just
on health care but across the board.
What about the claim made by a Romney adviser after the debate that
states could step in to guarantee coverage for pre-existing conditions?
That’s nonsense on many levels. For one thing, Mr. Romney wants to
eliminate restrictions on interstate insurance sales, depriving states
of regulatory power. Furthermore, if all you do is require that
insurance companies cover everyone, healthy people will wait until
they’re sick to sign up, leading to sky-high premiums. So you need to
couple regulations on insurers with a requirement that everyone have
insurance. And, to make that feasible, you have to offer insurance
subsidies to lower-income Americans, which have to be paid for at a
federal level.
And what you end up with is — precisely — the health reform President Obama signed into law.
One could wish that Mr. Obama had made this point effectively in the
debate. He had every right to jump up and say, “There you go again”: Not
only was Mr. Romney’s claim fundamentally dishonest, it has already
been extensively debunked, and the Romney campaign itself has admitted
that it’s false.
For whatever reason, the president didn’t do that, on health care or on
anything else. But, as I said, never mind the theater criticism. The
fact is that Mr. Romney tried to mislead the public, and he shouldn’t be
allowed to get away with it.
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