Mitt Romney's health care reform law in Massachusetts has gone down a path that should concern supporters of Obamacare. (David Goldman / AP)
Weeks after the botched rollout of Obamacare’s exchanges, Democrats are desperately trying to reassure Americans that a not-ready-for-primetime website is unrelated to the benefits customers will experience when they can finally enroll.
“Despite this initial bump in the road, we must remember the Affordable Care Act is more than a website,” wrote Congressman John Dingell, D-Dearborn, in a constituent email over the weekend. “It’s affordable, quality health insurance made available to everyone.”
But that reassurance is no more credible than the fib that website crashes were due to high traffic volumes. Yes, Obamacare is more than a website — it is more premium hikes, more government deficits, more waiting to get care. How do we know?
Because Obamacare is modeled after Massachusetts’ 2006 health care law. Indeed, President Obama will be in Boston Wednesday singing its praises. But for the last seven years, Romneycare has failed in its promise of lower costs, better care access and universal coverage.
Passed by Republican Gov. Mitt Romney and a Democratic legislature, Romneycare pioneered Obamacare’s now familiar individual mandate, government-built health exchanges, and Medicaid expansion. Defensive about his signature gubernatorial achievement being the model for his presidential rival’s unpopular reform, Romney in 2012 said that reform should be state-based and not centrally-planned from Washington, D.C.
Romneycare was actually tailored for the known demographics of its state’s uninsured population, unlike its wide-open federal counterpart. As a result, Romneycare’s smooth rollout was a contrast to Obamacare’s chaos.
But, ominously, the wheels started to come off as Romneycare’s features kicked in. Within two years of its launch, the program’s costs were exploding.
“Coverage for the uninsured in the state exchange was more expensive than estimated,” says Josh Archambault, director of Health Care Policy at Massachusetts’ Pioneer Institute, of 20 percent cost over-runs that necessitated tax hikes. To control costs, he adds, Massachusetts also doubled down on exchange regulation, reducing customers’ choices.
What’s more, Romneycare inflated state health premiums that were already among the nation’s highest. Which is to say, while Romneycare has failed to reduce costs, its residents were already paying for a heavily regulated system. Not so for the rest of America, which is now witnessing sticker shock as Washington imposes Massachusetts-sized costs on everyone. Michigan premiums for an average family will grow 12 percent, according to exchange data compiled by the Heritage Foundation. Indiana’s premiums rise 26 percent; Florida’s 25 percent.
Massachusetts’ health entitlement spending ballooned to 40 percent of its budget (and you thought Michigan’s 25 percent was out of control). But didn’t all this spending lead to universal health coverage in Massachusetts? No. The state already had an unusually low 6 percent of its population uninsured. Romneycare has cut that number in half, mostly with hundreds of millions in government subsides. But coverage is still not universal.
Meanwhile, access to health care has declined.
If Romneycare predicted Obamacare’s high costs, it warns of worse: growing physician shortages as regulations drive caregivers from the market. A 2011 survey “by the Massachusetts Medical Society reveals that fewer than half of the state’s primary care practices are accepting new patients, down from 70 percent in 2007,” reports Anne-Marie Turner, president of the Galen Institute. “The average wait time for a routine checkup with an internist is 48 days. It takes 41 days to see an OB/GYN, up from 34” in one year.
This doctor shortage, driven by poor government reimbursement for health services, also has increased hospital emergency room visits, contradicting Obama’s — and Michigan Gov. Rick Snyder’s — claim that Medicaid expansion will reduce uncompensated care. Just 53 percent of internists and 62 percent of family physicians, for example, will see Massachusetts Medicaid patients.
“Insurance rates have continued to increase with more mandates like fertility coverage,” says Paul Bachman, director of research for Boston’s Beacon Hill Institute. “So now the governor has approved price controls that dictate that health costs can’t increase more than inflation.” That means more doctor shortages.
As Romneycare shows, the future does not fulfill John Dingell’s promise. The Affordable Care Act is unaffordable.
Henry Payne’s column runs every Tuesday online. Payne is a Detroit News editorial writer and editorial cartoonist. He also is editor of The Detroit News Politics forum. Email him at: email@example.com.