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Repeal ObamaCare? Grrrrrrr…

Posted by John McDonough  January 4, 2012 11:45 PM

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I confess, every time I hear Mitt Romney say that his first act as President will be to "repeal ObamaCare" (aka: the Affordable Care Act), I grit my teeth and go grrrrrr.

It's this: as I discussed in an earlier post, while a large proportion of Americans say they don't like the ACA, they also say they like many of the law's provisions. But Mitt and his competitors for the Republican presidential nomination never get asked about those individual provisions the public likes. And the press corps has been thoroughly complicit in letting them get away with this.

As a public service, I am listing 50 provisions I ask the media to ask Romney et al if they are committed to repealing as President. (Click on the ACA link above if you would like to read the actual language in the ACA text.)

Here we go: "Governor Romney, if you are elected President, are you committed to repealing the section of the Affordable Care Act (section # in parenthesis) that:

1. Prohibits health insurance companies from imposing lifetime or annual benefit caps on health insurance policies and consumers? (1001)

2. Prohibits health insurance companies from rescinding an individual's insurance coverage because of an error or misstatement on a coverage application not connected to fraud? (1001)

3. Requires health insurances to cover proven clinical preventive services without co-pays or deductibles? (1001)

4. Permits parents to keep their adult children up to age 26 on their health insurance policies? (1001)

5. Requires health insurers to provide enrollees with a clear summary of benefits and coverage not to exceed four pages? (1001)

6. Requires health insurers to spend no more than 15 or 20 cents of every premium dollar on profit, marketing, administrative costs as opposed to medical expenses? (1001)

7. Sets national standards for administrative simplification to reduce the paperwork burden on patients, providers and insurers? (1104)

8. Prohibits health insurers from refusing to cover individuals based on pre-existing medical conditions? (1201)

9. Requires the establishment of health insurance exchanges in each state to provide an easy, online way for consumers to compare and buy health insurance? (1311)

10. Provides tax credits to income eligible individuals to be able to afford to purchase health insurance? (1401)

11. Protects income eligible individuals from excessive cost sharing? (1402)

12. Establishes a new tax credit for eligible small businesses to provide health insurance for their workers? (1402)

13. Allows all low income persons without health insurance to enroll in their state Medicaid program? (2001)

14. Establishes a Community First Choice Option so that disabled Medicaid beneficiaries can obtain community based attendant services so they don?t have to enter a nursing home? (2401)

15. Allows state Medicaid programs to enroll Medicaid clients with chronic conditions in a "health home" to provide coordinated care? (2706)

16. Financially penalize hospitals with excessively high rates of hospital-acquired infections? (3008)

17. Directs the Secretary of Heath and Human Services to establish and update annually a national strategy to improve the delivery of health care services, patient outcomes, and population health? (3011)

18. Creates a new Innovation Center within the Centers for Medicare & Medicaid Services (CMS) to research, develop, test, and expand innovative programs that improve quality and reduce the cost of care? (3021)

19. Sets up a program that allows CMS to share savings with doctors and hospitals who take responsibility to improve the quality and cost of care to Medicare enrollees. (3022)

20. Financially penalizes hospitals with excessively high rates of preventable readmissions? (3025)

21. Reforms the Medicare Advantage program to stop overpayments to private health insurance plans saving more than $135 billion over ten years? (3201)

22. Shrinks and eliminates the Medicare drug plan coverage gap -- called the "doughnut hole"  -- within ten years? (3301)

23. Establishes a "Prevention and Public Health Investment Fund" to invest in prevention and public health to improve health and restrain the growth in health care costs? (4002)

24. Sets up a new federal council to set national health prevention and promotion priorities and strategies? (4003)

25. Directs Medicare to cover, without cost sharing, annual wellness visits and prevention services for all enrollees, and waiving co-insurance for most preventive services? (4103/4)

26. Directs state Medicaid programs to cover counseling and pharamacotherapy for pregnant women enrollees for tobacco cessation? (4106)

27. Establishes a new grant program to support school based health clinics to provide preventive and primary care services to medically underserved children and families? (4108)

28. Requires all chain restaurants with at least 20 locations to disclose the calories of each item on menus and menu boards? (4205)

29. Directs the U.S. Access Board to set standards for the accessibility of medical diagnostic equipment for individuals with disabilities? (4203)

30. Requires all employers with 50 or more employees to provide break time and a place for breast-feeding mothers to express milk? (4207)

31. Establishes a national childhood obesity demonstration program? (4306)

32. Creates a National Health Care Workforce Commission to review projected workforce needs, and to provide information and recommendations to Congress and the Administration? (5101)

33. Provides a 10 percent payment bonus for five years for primary care and general surgeon physicians participating in Medicare who practice in a health professional shortage area? (5101)

34. Creates a national fund to expand the number of community health centers and to increase funding for existing centers? (10503)

35. More than doubles funding for the National Health Service Corps which pays medical education debt for new physicians who practice in underserved areas for at least two years? (10503)

36. Sets up a new program to increase graduate nurse education training? (5509)

37. Requires drug, device, biological, and medical supply manufacturers to report gifts and other transfers of value to physicians, group practices, and teaching hospitals, to be made public on a federal website? (6002)

38. Requires nursing homes and other nursing facilities to implement compliance and ethics programs, and to provide clear information on facility ownership? (6101/2)

39. Establishes a national independent monitoring program to oversee interstate and large instrastate nursing home chains? (6112)

40. Sets new powers and authority for the Department of Justice, CMS, and State Medicaid agencies to identify, prosecute and prevent fraud and abuse? (6401-16)

41. Creates a national initiative to prevent and eliminate elder abuse, neglect, and exploitation? (6703)

42. Establishes a process under which the U.S. Food and Drug Administration may license a biological product shown to be bio-similar or interchangeable with a licensed biological product? (title VII)

43. Requires health insurance plans to cover the costs for individuals participating in approved clinical trials? (10103)

44. Directs the establishment of at least two new multistate insurance plans to be made available in each state health insurance exchange? (10104)

45. Reauthorizes the Indian Health Care Improvement Act for the first time since 1992 to expand the Indian Health Service workforce, create new delivery models, improve behavioral health, construct facilities, enhance health promotion and prevention, and create a youth suicide prevention program? (10221)

46. Establishes the Office of Minority Health within the Department of Health & Human Services? (10334)

47. Establishes new centers of excellence for the treatment of depressive disorders? (10410)

48. Creates a national education campaign for young women and health professional about breast cancer and its risk factors? (10413)

49. Sets up a national diabetes prevention program at the Centers for Disease Control and Prevention (CDC)? (10501)

50. Provides grants to states to test alternatives to civil tort litigation to emphasize patient safety, disclosure of medical errors, and early resolution of disputes? (10607)

Clearly, there are ACA provisions opponents could pick out to create an alternative list for elimination. (There are many more than 50 provisions I could have included in this list.) Doesn't matter. The Romney-Republican call-to-arms is to "repeal ObamaCare" entirely. Everything, without exception. The only reason they can get away with this is because the journalistic community is letting them do so.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

John E. McDonough is a professor of practice at the Harvard School of Public Health. He is the author of the book “Inside National Health Reform”, published in 2011 by More »


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