Two issues are now front and center. The first is Obama’s Affordable Care Act, passed against Republican opposition in 2010. The biggest applause line at any Republican rally this year has been the pledge to repeal “Obamacare.” The law has come to symbolize all that conservative Republicans believe is wrong with Obama’s presidency, including the cost of the legislation and the government’s role in the health-care market. Obama has stressed the law’s consumer protections to win greater support for it, but he has made little progress. The measure stirs passions among Republicans who hate it; Democrats who like it feel far less passionate about it.
The other issue is Medicare. It flared up in August after Romney chose House Budget Committee Chairman Paul Ryan as his running mate. Ryan’s federal budget blueprint calls for the government to eventually provide fixed payments for Medicare beneficiaries, who could then buy insurance on the private market.
Romney’s team jumped on Medicare immediately after Ryan’s selection, trying to put Obama on the defensive by charging that it was he who would undermine the program.
Romney said Obama had cut $716 billion from Medicare to help pay for his health-care overhaul. The reductions come from payments to hospitals and other providers, not from benefits to seniors. And the Ryan budget includes the same reductions.
— Dan Balz
Here are Obama and Romney’s positions on health care, broken down by subject:
AFFORDABLE CARE ACT
Although Obama has said he would be open to making small changes in the 2010 health-care law, he would vigorously defend its main planks and press for its implementation in a second term.
One of his biggest challenges: trying to increase cooperation from the states, several of which adamantly oppose the law. The legislation calls on states to expand their Medicaid programs, but the Supreme Court ruled in June that the federal government can’t penalize states for refusing to do so. Nearly a dozen governors say they are considering not expanding their programs, and some might seek greater flexibility in return for participating.
Obama has been silent on how much leeway he might provide to entice reluctant governors. His aides predict that almost all the states will ultimately go along with the Medicaid expansion, because the federal government will pay most of the costs.
Obama also will prod states to create insurance exchanges. Under the law, federal authorities will have to set up and run an exchange if a state declines to do so.
The president has expressed some support for changing the medical malpractice system. Although he opposes limits on jury awards, he is pressing ahead with pilot programs to test whether alternative systems for resolving malpractice claims can cut down on lawsuits.