If Gov. Mitt Romney were elected president and moves ahead with his proposal to replace the Affordable Care Act with tax incentives to buy insurance and Medicaid block grants, 12 million Americans would lose their health insurance coverage, bringing the total number of uninsured to 72 million by 2022, according to an analysis from the Commonwealth Fund.
Conversely, if President Obama were reelected and the ACA remains intact, the number of uninsured would drop by 33 million, leaving 27 million Americans uninsured, according to the report.
The reason for the projected jump in the number of uninsured under Gov. Romney is due mainly to his pledge to repeal the ACA, which would greatly expand insurance coverage. The other factor driving up the number of uninsured is his proposal to provide states with block grants to fund the Medicaid program, said Sara R. Collins, vice president at the Commonwealth Fund.
The researchers assumed that the Medicaid block grants would grow at the rate of population growth plus 1% and that states would have to cut their own costs to account for this lower rate of spending growth. They estimated that about half the cuts would be in provider payments and reduced benefits; the other half of the cuts would come in the form of reduced eligibility for the program, which would lead to more people joining the ranks of the uninsured.
The report is based on modeling conducted by Jonathan Gruber, Ph.D., a professor of economics at Massachusetts Institute of Technology in Boston. He estimated what insurance coverage would be if the ACA had not been implemented, what it would be like if the law were fully implemented with all states participating in the Medicaid expansion, and how coverage would be affected if Gov. Romney moved forward with his Medicaid block grants and proposals to provide tax incentives for individuals purchasing health insurance on their own.
Dr. Gruber advised Gov. Romney on the development of the 2006 Massachusetts health insurance law and the Obama Administration on the ACA. He also contributed to a recent analysis by the consumer advocacy group Families USA, which found that health insurance would be more expensive under a Romney presidency.