In the first presidential debate on Oct. 3, Gov. Mitt Romney made a number of misleading, if not outright false claims with regard to the issue of healthcare. First, he believes that the Affordable Care Act is a federal takeover of health care. Second, cutting Medicaid growth by more than half would restrain federal spending. And third, giving each state the power to craft their own health care reform plans would fix a broken healthcare system.
Those questionable assumptions aside, it is clear that dismantling the social-safety net would have devastating consequences not only for 48 million uninsured Americans, but also a significant proportion of Asian Americans as well.
As Seattle City Councilmember Bruce Harrell notes: “Estimates suggest that 2.5 million Asian Americans would be uninsured in the absence of President Obama’s Affordable Care Act. Obamacare represents the opportunity to level the playing field in terms of protecting healthy communities.”
Gov. Romney has stated that he would issue an executive order to provide Obamacare waivers to all fifty states, work with Congress to repeal the full legislation of the ACA, and give each state the power to implement their own health care reform plans.
“What’s important to remember is that before the Act, states already were left to come up with their own health insurance reform plans—some did, but most did not,” said Pamela Clouser McCann, assistant professor at the University of Washington Evans School of Public Affairs.
Romney proposes to turn the Medicaid funding stream into block grants and limit federal standards and requirements on both private insurance and Medicaid coverage. How would that hurt minority communities? The answer again depends on how each state implements Medicaid, McCann explained.
“The racial distribution of Medicaid enrollees varies tremendously by state due to differences and populations and state politics. In some states, a block Medicaid grant could disproportionally harm minority communities, and since in all but six states children make up the majority of Medicaid enrollees, minority children might bear the brunt of this choice.”
Gunnar Almgren, UW associate professor of social work and social welfare, makes the same point. “Repeal of the Affordable Care Act would likely extend further the disparities in health care access for the poor and low-income populations in states that have historically been less able or willing to reduce their uninsured.” Block grants would also place a cap on the federal dollars that are available to provide health care for the low income. “The reduction in federal standards for Medicaid allows states to lower the quality of services for poor populations and communities,” he said.
Romney and Rep. Paul Ryan would have us believe that Medicaid spends more for medical care than is necessary. Harvard economist David Cutler takes issue with that conclusion. As Cutler writes in the current Journal of the American Medical Association, “A meat cleaver is rarely appropriate for open heart surgery. The cumulative reduction in Medicaid spending that Romney proposes is substantially greater than the savings that he said would ‘end Medicare as we know it.’” Scaling back on federal support for health care coverage assumes that states can pick up the slack, but ignores the reality that limiting federal standards would create additional pressures for minority communities.
“Advocates of low-income and poor populations worry that a retreat of federal authority in the regulation of health insurance benefits between states might allow large health insurance companies to choose to be licensed in the states with the most meager benefit requirements and consumer protections,” Almgren points out. “That in turn would allow them to market these policies in states with more stringent consumer protections and thus gradually induce a competitive ‘race to the bottom’ in the quality and equity of health insurance coverage.”
Seldom have Romney and Ryan addressed the unforeseen and damaging consequences that shredding the Affordable Care Act would have on American families.
“I have seen the detrimental impact of not having medical coverage in my own life through the eyes of family members, friends, and colleagues,” said Harrell. “Obamacare will ensure that they are no longer one major medical emergency away from health and financial disaster.”
Finally, in a clever bit of sophistry, Gov. Romney said that his Massachusetts health care law could be a model for the nation. “I think there are a number of features in the Massachusetts plan that could inform Washington on ways to improve health care for all Americans. The fact that we were able to get people insured without a government option is a model I think they can learn from.” As President Obama reminded him, Obamacare was modeled to a large extent on Romney’s original plan.
Despite the outright prevarication of Gov. Romney on applying the meat cleaver approach to solving the nation’s health care problems, the fact remains that reforming our present system is necessary to stave off disaster for our citizens. As Councilmember Harrell reminds us, President Obama’s leadership on health care has been consequential. “People can now seek solace knowing that their health is not tied to their employment status. This is absolutely critical in building a healthy Seattle.”
Let’s hope that in the remaining presidential debates, a clear-eyed assessment of what’s at stake for our community will prevail over Gov. Romney’s half-truths.