A new study released by the private foundation, The Commonwealth Fund, has revealed that 72 million Americans would be uninsured by 2022 if Republican presidential nominee Mitt Romney wins the election and has his health care plan enacted. That compares to 27 million uninsured by the same time if President Barack Obama's Affordable Health Care Act (ACA) was kept in place with his reelection.
"There are stark differences between what each candidate has proposed for our health care system, and this report shines a light on how Americans might be affected, based on their age, their income, and where they live," the report's lead author Sara Collins, vice president for affordable health insurance at the Commonwealth Fund said to CNN. "The report finds that repealing the ACA would significantly increase the number of Americans without health insurance, limiting their ability to get the health care they need and exposing them to burdensome medical bills and debt."
The analysis was conducted by economist Jonathan Gruber, who advised the policymakers who wrote the ACA.
Currently, the government says there are more than 48 million Americans -- about 16 percent of the population -- without health insurance.
While some of President Barack Obama's ACA has already been implemented -- such as, allowing children 26 and younger to be covered by their parent's plans and not allowing insurance companies to deny people with pre-existing conditions -- many of the proposed changes will not be enforced until 2014. These include implementing near-universal health care coverage, with steps like expanding Medicaid health insurance plans to cover more low income people and organizing state-regulated plans that people can choose from.
State plans would all have to fit regulations set by the federal government, which has also set goals of including free annual wellness exams and getting rid of the prescription drug benefit's "donut hole" -- or gap between the initial coverage limit and the upper limit set by the federal government. In general, they are high-deductible insurance plans, which means low premiums but higher deductibles in case of an accident.
The Commonwealth Fund, which has supported the ACA, said that if all the intended changes were made, 23 million more Americans would get insurance.
However, in comparison, The Commonwealth Fund's analysis showed that 12 million fewer Americans would receive health insurance under Romney's plan compared with current rates. Romney has pledged to repeal the ACA and implement his own changes, which he believes will encourage more private insurance incentives (instead of state-decided plans) and give the individual more say in choosing a plan that is right for them. For example, those who wouldn't seek preventive women's health care wouldn't pay for those services under his plan.
The study also found that Romney's plan would cost Americans more money. People who choose to buy health insurance on their own would pay 14 percent of their income, compared to only 9 percent under the ACA, The Commonwealth Fund stated. The Congressional Budget Office and the Joint Committee on Taxation added that repealing the ACA would cost a federal budget deficit of $109 billion between 2013 and 2022.
The Romney campaign argued the fund's study results were false.
"The Commonwealth study sadly contributes little to the health reform conversation that this country deserves," Romney spokeswoman Andrea Saul told TPM. "It badly mistakes Governor Romney's proposals. Worse, it assumes a fantasy world where Obamacare has been a success. Instead, Americans have seen their insurance premiums increase, small businesses are facing massive tax increases, and seniors will have reduced access to Medicare services. The simple truth is this: The American people do not want this law, we cannot afford this law, and when Mitt Romney is President he will repeal it and replace it with common-sense, patient-centered reforms that strengthen our health care system."
Though Romney hasn't provided exact details, he has laid out a broad framework for his health care proposal. Instead of opting for state-selected plans, the consumer would choose which private company they wanted to be insured by based on their needs. He or she would pay for that plan from funds from a personal health savings account (HSA) and be aided by tax breaks. Employers would deposit money into the HSAs, and the employee would choose the health care company.
Proponents of the HSA plan argue it will give Americans more choice.
"Health savings accounts empower the consumer in all aspects of health care decision making," Alabama Governor Robert Bentley said in a statement to the Associated Press explaining why he rejected the "essential health benefits" plan under the ACA on Oct. 1.
Bentley, a physician, added that having the federal government mandate what states should provide restricts people to picking plans that may not fit their needs.
"The Affordable Care Act includes many provisions, all supposedly geared toward making health insurance affordable, yet it does not include any significant mention of health savings accounts. I contend that the law does not make health insurance affordable and negatively affects consumer choice," he added.
Romney's plans would still allow for ACA provisions such free annual wellness exams and getting rid of the prescription drug benefit's donut hole and, theoretically, would push people towards high-deductible insurance plans. However, instead of being mandated by the federal government to include these benefits, consumers can choose to go with a company that includes these provisions. That way people will only pay for what they want coverage for.
"Healthcare is the only service in the United States that you buy and use without knowing what the price is," Dr. Scott Atlas, a Romney adviser with Stanford University's Hoover Institution, told Reuters. "If you're paying out of a health savings account, you actually see the bill. It really does reduce prices."
Critics, however, argue that those plans would not help people who have prolonged illnesses because they would spend their allotted health care funds faster and be forced to pay for care out of pocket.
Medicaid block grants would allow states to dole out the funds to the groups who they think need it the most, rather than try to add coverage for a federally-set amount of people.
Romney has argued that the ACA will increase costs for consumers, who already pay an average of $15,734 per hospital stay and spend 17.4 percent of the GDP on health care costs, NBCNews.com pointed out. For comparison, Romney's old health care plan he enacted in Massachusetts, the basis for the ACA, did increase costs while making sure that 98 percent of the population was insured. But, Romney has since claimed that while the plan worked for Massachusetts, it shouldn't become a federal mandate, and states and individuals should have more choice in choosing their health care.
The Commonwealth Fund isn't the first group to criticize Romney's plan. Families USA released a report stating that Romney's plan would cost families 92 percent more than the ACA by 2016.