Romney Care, also known as the Massachusetts Health Care Insurance Reform Law, and Obama Care, also known as the Patient Protection and Affordable Care Act, have a number of differences which are unimportant or miniscule and not worth taking time to explain, explore or debate. Fortunately, they have some very important and significant differences the most glaring of which is Romney Care is Constitutional and Obama Care will hopefully be found to be as un-Constitutional as I believe it to be. The reasons behind this difference breaks down to one basic and significant fact, Romney Care is a statute only for the state of Massachusetts with no inferred or directed application outside the Massachusetts State borders. As a legally passed piece of legislation by the state of Massachusetts, Romney Care stands outside the purview of Constitutional review and thus can stand without posing any threat to the nation or the constitution which defines the divisions of power. States are allowed to do pretty much whatever they choose as long as it is not in direct contradiction of Federal Law or the Constitutional limitations placed on the individual states such as minting money or placing restrictive edicts, fines or taxes on interstate commerce. Obama Care may have overstepped the power of the Federal government and even stretched the already mightily expanded and mutilated Commerce Clause past its seemingly impossible breaking point; the Supreme Court should be giving us their binding opinion on that this summer. Simply put, requiring people to buy health insurance by an individual State is permissible, the Federal Government making the same demand, hopefully not so much.
There are some other differences worth noting as well. Romney Care is solely a health insurance mandate requiring every citizen in Massachusetts to purchase a minimal required amount of health care insurance or pay a fine in order to receive some minimal coverage through the State. Obama Care does the same basic thing except it also places the burden on employers who meet the minimal number of employees to either provide insurance coverage which meets the Federal guidelines or pay fines on a per employee basis. Those not covered by employer provided health insurance are required to purchase their own coverage which meets the Federal requirements or pay a fine in order to be granted minimal allowed amount of coverage by the Federal Government. One interesting item I found, providing I understand the mechanisms accurately, an employer actually faces a larger fine should they provide their employees insurance found not to meet the minimal Federal requirements than if they simply opted not to provide insurance and just paid the penalty up front. This would place employers in the position of possibly paying a higher penalty for attempting to provide insurance and being found not in compliance than if they simply refused to even try and comply. This sounds like a plan to force employers to simply choose the monetarily safer route and simply refuse from the start to even play the game. As the super-computer in War Games, the WOPR, stated at the end, “The only winning move is not to play.” Hopefully the Supreme Court is half as intelligent as the computer in an old sci-fi movie.
There is one more difference between the two systems. Where Romney Care stops at demanding everybody be covered by some form of health insurance even to the point of being state provided, it leaves the actual medical care in the hands of doctors and the market. Romney Care does not attempt to have the state of Massachusetts usurp and take complete control of the health care system within the state’s borders. Obama Care does go that extra mile, or maybe more like that additional light-year. Obama Care takes the huge leap of slowly but very assuredly forcing everybody eventually to come under direct government provided health care. One of the little tricks in the two-thousand-plus pages of legalese is a little trip lever that instructs that should your insurance coverage change in virtually any way, then you will be denied to continue to have that insurance for your coverage and you will be enrolled into the government controlled health care. This could be even if the government changed their requirements for health coverage to meet their strict definitions thus forcing your policy to change to include this new requirement and trip the switch forcing you into the government provided care. It does not take any great leaps of logic to see where such a system will eventually lead, and eventually would probably not take that long. This is a huge departure by Obama Care from Romney Care under the Obama system people can actually be placed under a health care system which is completely controlled and run by the government and will eventually lead to that socialist dream of a single payer health care system, the system which has generated such horror tales in every instance where it has been enacted. It may be a socialist dream, but it is freedom’s nightmare.
Beyond the Cusp