It’s hard to be clear about what Governor Romney’s actual health plan is, beyond repealing Obamacare. The debate last week didn’t help in clarifying the confusion, with his staff walking back with Romney said in the debate as soon as it was over.
But let’s take him at his word on at least one issue: letting the states do health reform, rather than at the federal level. There’s a problem, in that between Medicare and Medicaid, a state really needs the federal government to be a partner in order to be successful. Massachusetts has been successful precisely because it was over half funded by the federal government. Ezra Klein and Jonathan Gruber explain in this video clip:
When California attempted a similar reform in 2007-08 under Governor Schwarzenegger, it has a more daunting task: Massachusetts started with a 10% uninsured rate. California’s uninsured rate is nearly 20%, so we had to raise a lot more money to make the math work–and that’s a big reason why it ultimately stalled: it was seen as too big a lift.
California has a proud history of state-based health reform efforts, from universal children’s coverage to employer mandates to single-payer to the reforms embodied in the Affordable Care Act. But Romney’s plans would make it harder to move forward with health reforms or expansions, even just here in California. It would be hard to make progress–or even maintain existing programs and services under Romney’s plan that would make cuts and shift more cost and burden on the states.