Health Care Reform in the U.S. Presidential Election

The Patient Protection and Affordable Care Act, which President Obama signed in March 2010, is considered by supporters as one of the president’s culminating achievements to date. The Act has stimulated considerable controversy, garnering extensive criticism from conservatives and suffering in opinion polls. As a result, health care reform has taken a central position in the 2012 presidential campaign. This brief highlights the candidates’ positions on health care reform and the Patient Protection and Affordable Care Act.

Barack Obama

Main Themes

Consumer protection and cost control

Policy Proposals

President Obama has refused to consider a repeal or partial repeal of the law. For Obama, the Affordable Care Act is the answer to problems in cost control and inequality in the American health care system and must be implemented in full.

Mitt Romney

Main Themes

Federal overreach and fair market competition

Policy Proposals

In general, Mitt Romney proposes to create a fair marketplace for health insurance through deregulation and competition.

• Repeal the Affordable Care Act
• Limit federal requirements on Medicaid spending
• Promote accessibility options, including exchanges, subsidies, and public-private partnerships
• Encourage purchasing pools, reinsurance, and risk adjustment
• Promote the direct purchase of insurance through reformed tax law
• Allow Health Savings Accounts to be used for insurance funds
• Enact medical malpractice reform
• Increase states’ flexibility through block grants for Medicaid
• Reform Medicare into a “premium support system,” a federal subsidy that recipients could use to purchase health insurance from the private market

Rick Santorum

Main Themes

Freedom of choice and deregulation

Policy Proposals

In general, Rick Santorum supports a more privatized health care system, with reforms focused on “reducing mandates and onerous regulation.”

• Repeal the Affordable Care Act
• Allow patients to buy health insurance across state lines.
• Expand Health Savings Accounts to better reach underinsured and uninsured consumers.
• Promote personal insurance purchasing in order to improve portability from the current employer-based model.
• Reform medical liability law to discourage lawsuits.
• Federal funds for state high-risk pools
• Increase states’ flexibility through block grants for Medicaid
• Reform Medicare into a “premium support system”

Newt Gingrich

Main Themes

Deregulation

Policy Proposals

In general, Newt Gingrich supports privatization as a means of cost reduction and improved options for purchasers of insurance.

• Create a tax credit or deduction for the purchase of health insurance
• Allow the purchase of health insurance across state lines
• Increase states’ flexibility through block grants for Medicaid
• Use federal funds for state high-risk pools
• Expand Health Savings Accounts
• Enact medical malpractice reform
• Promote research through subsidization and other incentives