To many, health care is more important this election cycle than ever. It’s considered to be the second most important issue in the presidential election, topped only by the economy. In fact, it’s the most interest the issue has received since 1992, according to a recent study published in the New England Journal of Medicine.
"The economy dominates most voters’ thinking in terms of their priorities for choosing a candidate,” says study co-author Robert Blendon, a professor of health policy and political analysis at Harvard School of Public Health. “But in a close election, the two candidates’ stands on health care issues could help swing the balance among some voters.”
It’s not much of a surprise: The implementation of the Patient Protection and Affordable Care Act has in part defined President Obama’s presidency, but it’s also confused and divided a nation. And along with it, issues like Medicare and women’s reproductive rights have also taken the spotlight.
See how President Obama and Republican challenger Mitt Romney compare on some health care issues.
Also read about how the PPACA has polarized brokers this election year
Issue: Abortion and birth control
Obama: The president supports women’s rights in regards to abortion and birth control. His Patient Protection and Affordable Care Act requires that contraceptives be made available for free for women enrolled in workplace health plans, including the morning-after pill. It’s been a controversial issue, especially for religious conservatives, who have rejected the contraception mandate. Many Catholic institutions—including Notre Dame University—have sued the feds over it, saying the government values cannot be imposed on institutions that conflict with their religious teachings.
He is a strong supporter of Planned Parenthood.
Romney: Gov. Romney said in mid-October that he wouldn’t pursue any abortion-related legislation if elected president. In an interview with CBS Evening News in August, Romney said it was a non-issue in regards to the election. “Recognize this is the decision that will be made by the Supreme Court. Democrats try and make this a political issue every four years, but this is a matter in the courts. It’s been settled for some time in the courts.” As governor of Massachusetts, he supported a woman’s right to choose. Later, he said he opposed abortions with the exceptions of rape and incest, and the health and life of the mother, but would not change any previous legislation. He also said he would end federal aid to Planned Parenthood.
photo credit: BrandonSigma
Issue: Nationwide reform
Obama: This one’s simple. It’s full-steam ahead for the Patient Protection and Affordable Care Act under President Obama. The law has already gone through a lot in just a couple years. After being signed into law in 2010, the law has undergone numerous threats of repeals from Republicans and survived a Supreme Court case this past June. Many of the law’s provisions have gone into effect already, but most of the heavy hitters wait until the start of 2014, including the individual mandate and the implementation of state exchanges.
Poll after poll confirm Americans are still torn on how they feel about the health reform law, but with time, more seem to be getting used to the idea. The PPACA was touted as a way to expand health coverage and contain costs. Its main provisions include: the requirement that all Americans obtain health coverage, a marked expansion of the Medicaid program, the creation of health insurance exchanges, and many consumer protections, including the ban of pre-existing conditions exclusions from insurance companies.
Romney: Romney has been adamant about saying he’ll work to repeal the PPACA on his first day in office, though many say that’s a hard task to do. Instead of national reform, Romney instead believes states should come up with alternatives that meet their own needs. But still Romney favors some of PPACA’s popular provisions. He said in September that “there are a number of things that I like in health care reform that I’m going to put in place.” Those include two popular PPACA provisions: allowing young adults under 26 to keep their coverage under their parents’ health-insurance, and making sure that those with pre-existing conditions can get coverage.
He has cited his popular Massachusetts health care overhaul as an example of what states can do. His 2006 health care law requires almost all residents to have coverage or pay a tax penalty, and mandates that most employers offer insurance to their workers. It also established a health insurance exchange. The Kaiser Family Foundation found that his legislation cut the number of uninsured in Massachusetts in half.
Obama: The president’s health reform law includes the expansion of Medicaid, but the Supreme Court ruled in June that the federal government can’t penalize states for refusing to do so. Nearly a dozen governors say they are considering not expanding their programs, and some might seek greater flexibility in return for participating.
Romney: Romney wants to replace the current Medicaid funding system, which gives the Centers for Medicare & Medicaid Services a considerable amount of control over states’ Medicaid programs, with a block grant program. The program would provide each state with an amount equal to what the state received from the federal government last year, plus an inflation adjustment, plus an additional 1 percent increase, he said.
“Don’t have the federal government tell everybody what kind of training programs they have to have and what kind of Medicaid they have to have,” Romney said in the first of the three 2012 presidential debates Oct. 3. “Let states do this. And, if a state gets in trouble, we can step in and see if we can find a way to help them.”
Photo: AP Photo/Lynne Sladky
Obama: The president rejects Republican proposals that would turn the government program into a voucher system. He says that the PPACA will rein in Medicare spending. The law is expected to reduce Medicare spending by $716 billion over 10 years by cutting back on payments to providers and Medicare Advantage plans. Most recent polling shows Obama and the Democrats have the edge on the Medicare debate.
Romney: He supports turning the program into a “premium support” program that would give seniors a fixed payment to buy private insurance or a government plan similar to what currently exists.
Photo: Seniors enrolled in seven of the 10 most popular Medicare prescription drug plans will be hit with double-digit premium hikes next year if they don't shop for a better deal, according to Avalere Health. AP Photo:Danny Johnston, File.