The New York Times Defends RomneyCare

Proving once again that Mitt Romney's biggest (only?) fans are the same folks who continue to support ObamaCare (a slowly dwindling crowd), the editorial board at The New York Times steps up to defend RomneyCare:

Since reform was enacted, the state has achieved its goal of providing near-universal coverage: 98 percent of all residents were insured last year. That has come with minimal fiscal strain. The Massachusetts Taxpayers Foundation, a nonpartisan fiscal monitoring group, estimated that the reforms cost the state $350 million in fiscal year 2010, a little more than 1 percent of the state budget.

If RomneyCare's cost isn't a budget problem, then how come the state began yet another round of discussions last week about how to control rising health care costs?

Oh right: Because the RAND corporation now says that the state's health costs are rising 8 percent faster than its GDP, because the program is projected to cost about $2 billion more than initially estimated over the next decade, and because state health insurance commissioners have warned that the cost problem is so great that the program's very existence is at stake. No worries, though, an anonymous writer at the New York Times editorial board says it's not a problem!

But what about health insurance premiums? Aren't they lower?

The average premiums paid by individuals who purchase unsubsidized insurance have dropped substantially, 20 percent to 40 percent by some estimates, mostly because reform has brought in younger and healthier people to offset the cost of covering the older and sicker.

This is true, but it conveniently omits two important factors. The first, as I've noted before, is that prior to RomneyCare, Massachusett's individual insurance premiums, were the highest in the nation, in large part because of strict community rating and guaranteed issue regulations that aren't in force in most states. Enforcing a mandate on a community-rated, must-issue health insurance pool—i.e. one in which insurers are required to sell policies to all comers and aren't allowed to price differently based on health history—is likely to bring down prices somewhat. But those effects aren't likely to be felt in the majority of states that hadn't implemented such regulations.

Meanwhile, adding individuals to the pool to the mandate merely managed to bring the state's individual health insurance premiums down from the most expensive in the country to the second-most expensive in the country. Following the passage of RomneyCare, family plan premiums were reported to be the highest in the nation, with double digit rises expected to continue. RomneyCare's role in pushing up premium prices? Economists at Stanford and Columbia University recently found that "health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent in aggregate, and by about 7 percent for firms with fewer than 50 employees." If cheap premiums are what you're looking for, RomneyCare doesn't seem to be the answer.

The Times editorial board doesn't even tell the whole truth when it eventually admits the law's cost control flaws:

What reform has not done is slow the rise in health care costs. Massachusetts put off addressing that until it had achieved universal coverage.

Now, it's true that the plan's wonky designers eventually decided that, in order to bring all the necessary constituencies on board, cost control would have to wait. As The New York Times reported in 2009, "the lawmakers and strategists behind the Massachusetts plan strongly defend their incremental approach. Only by deferring the big decisions on cost containment, they said in recent interviews, was it possible to build a consensus among doctors, hospitals, insurers, consumers, employers and workers for the requirement that all residents have health insurance."

But that's not what the state's political class promised up front while pushing the plan on the public. In early 2006, Mitt Romney himself declared that under his plan, "the costs of health care will be reduced." So RomneyCare was initially sold to voters as cost-control, only to later be revealed as a plan that intentionally deferred significant—and necessarily difficult—cost containment decisions. Saying now that cost-control was never a goal is an attempt to selectively rewrite history. Anyone want to take bets on how long it takes before a similar rewriting effort gets underway when ObamaCare results in similar, and similarly predictable, failures?