HealthReformGPS is made possible through generous financial support from the RCHN Community Health Foundation. Visit them at

Romney and Obama present health reform visions in NEJM articles

Posted on September 27, 2012 | No Comments

PDF Version
Implementation Briefs
Editor's Comment

President Barack Obama and former Massachusetts Governor Mitt Romney released essays in the New England Journal Medicine (NEJM) presenting their visions for the future of health care reform. Obama calls for additional steps to fix the nation’s health care delivery system, including a “permanent fix to Medicare’s flawed payment formula that threatens physicians’ reimbursement.” President Obama also pledges his commitment to life sciences research, distancing himself from vice presidential candidate Paul Ryan’s proposal to slash medical research investments. Obama also touts various popular Affordable Care Act (ACA) provisions including the end of lifetime benefit caps, expanded preventive care services coverage, permitting young adults to remain on their parents insurance until age 26, rebates from insurance companies from the medical loss ratio (MLR) provision, and the efforts to reduce Medicare and Medicaid fraud. Romney touches on his premium support plan for Medicare, Medicaid block grants, and plan to prevent discrimination against patients with pre-existing conditions “who maintains continuous coverage.”

No Comments

Public comments are closed.

President Obama and Governor Romney offer different visions for the nation’s healthcare system. To inform public discussion about health care in the election and beyond, an analysis published by the Commonwealth Fund draws from microsimulation analysis to contrast the potential impact of implementing the Affordable Care Act (ACA) in full with Romney’s proposals to repeal the law, eliminate many of the new requirements for insurance markets, and make changes in Medicaid and Medicare. The report focuses on the following:
  • the number of Americans expected to gain health insurance;
  • changes in the affordability of insurance;
  • changes in consumer protections and consumer choice;
  • help for small businesses;
  • improvement in Medicare solvency;
  • improvement in health care quality; and
  • control of health spending growth.
The report's findings indicate that, in each area, implementation of the Affordable Care Act would likely outperform Romney’s proposals.
HealthReformGPS Editor, Sara Rosenbaum, and frequent guest contributor to HealthReformGPS, Timothy Jost, authored two Health Affairs pieces analyzing the Supreme Court's Thursday decision regarding the Affordable Care Act (ACA). Jost's post provides an overview of the Court's decision regarding the individual mandate while Rosenbaum's examines the Court's surprising Medicaid expansion ruling.
The New England Journal of Medicine's perspective piece "Consensus and Conflict in Health System Reform--The Republican Budget Plan and the ACA" by Timothy Stoltzfus Jost, J.D., compares and contrasts Representative Paul Ryan's (R-WI) "Roadmap for America's Future" with the Affordable Care Act (ACA). In terms of their similarities, both plans would create a health care system in which many Americans purchase private health insurance using partially means-tested public subsidies through an exchange-based, information-rich competitive market, which is (more or less) open to all regardless of health status. Those who choose to remain uninsured would incur a penalty (or forgo a benefit), and those who purchased insurance would be responsible for significant costs. Jost also details five key differences between Roadmap and the ACA in the piece.
The Congressional Budget Office (CBO), the legislative branch agency responsible for estimating the cost of legislation, issued two reports on July 24th related to the Affordable Care Act (ACA). The first report, revised cost and health insurance coverage estimates for the ACA in the wake of the Supreme Court ruling in NFIB v. Sebelius[1]. In that ruling, the Court concluded the individual requirement to purchase health insurance coverage, while not a reasonable exercise of congressional Commerce Clause authority, is constitutional as a tax under congressional Spending Clause authority. The Court also held that the ACA’s Medicaid expansion, requiring states to cover all non-elderly individuals with incomes below 133[2] percent of the federal poverty level was unconstitutional. However, rather than striking the requirement, the Court precluded the Secretary of the Department of Health and Human Services (HHS) from enforcing the mandate by withholding all Medicaid funds. As a result of the ruling, states now have the option of expanding coverage to 133 percent of the federal poverty level (FPL), and will receive enhanced federal matching funds as provided under the law, but are not required to expand coverage.[3]
The Supreme Court handed down its long-awaited ruling in the case of National Federation of Independent Businesses et al. v. Sebelius, Secretary of Health and Human Services, et al., upholding the individual requirement to maintain insurance coverage as a reasonable exercise of Congress’s taxing and spending authority and also upholding the constitutionality of the Medicaid coverage expansion. In a surprise coalition, Chief Justice Roberts was joined in his majority opinion by Justices Stephen Breyer, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan. The summary below describes the majority opinion, the concurring opinion (authored by Justice Ginsburg), and the dissenting opinion (written by Justice Scalia). Because the Court upheld the individual mandate, it never reached...
Below find a table summarizing the United States Supreme Court decision regarding the Affordable Care Act (ACA)...