The document discusses the similarities and differences between the Massachusetts health reform law known as "Romneycare" and the federal Patient Protection and Affordable Care Act known as "Obamacare". Both laws require individuals to have health insurance, create state-based health insurance exchanges, and provide subsidies for lower-income households. However, the ACA covers more people nationwide and optionally expands Medicaid eligibility, while Romneycare only expanded coverage for certain groups in Massachusetts. The document also outlines some perceived pros and cons of the ACA.

1. BCC111Orientation to United States Health Care
Practices
By
Dixie Beougher
1-5-15

2. ObamaCare is the
unofficial name for The
Patient Protection and
Affordable Care Act
which was signed into
law on March 23, 2010.
Based on “RomneyCare”
introduced in 1997
which passed into law in
the state of
Massachusettes in 2006.
Photo credits: whitehouse.gov

3. SIMILARITIES:
 State-based exchanges
Both laws create exchange authorities
charged with operating health insurance
marketplaces.
 Subsidies for lower-income households
While the amount of individual subsides
vary, and the income levels for eligibility
differ, both laws provide financial
assistance to lower-income households so
that health insurance is affordable
 The individual and business mandates
Both laws require that individuals who can
afford insurance to purchase insurance or
face a financial penalty.
DIFFERENCES:
 Size and scope
The Massachusetts law applies to the 6.5
million residents of the commonwealth.
The ACA covers more than 300 million
people spread across 50 diverse states.
 Cost sharing for preventative services
The ACA requires insurance policies
cover preventative services, such as
cancer screenings, with no co-pays or
deductibles
 Medicaid expansion
In Massachusetts, Medicaid was
expanded for children, parents, pregnant
women and the long-term unemployed.
Under the ACA, states have the option of
expanding the Medicaid program to all
families and Individuals with incomes up
to 138 percent* of the FPL(federal poverty
level).
Photo credit: John Moore/Getty images

4.  The ACA was amended
by enactment of the
Health Care and
Education Reconciliation
Act of 2010. Together
these acts are known as
the Affordable Care
act(ACA). These laws
include a number of
provisions designed to
increase access to
healthcare, improve the
quality of healthcare, and
explore new models of
delivering and paying for
healthcare.
 Despite it’s length and
complexity, most of the
important reforms are
contained within the first
140 pages of the law.
 2 major sections titled
individual mandate and
employer mandate.

5.  Myth, Obamacare Means
Higher Taxes.
 Fact, Many Americans will
save on medical costs and taxes
because of ObamaCare, many
more won’t pay a dime more
than they do now as far is taxes
go.
 Myth, Comfort Care, since
2011 a “brain surgeon” called
up the Mark Levin show to let
him know that patients over 70
years old could be given
“comfort care” instead of brain
surgery depending on the
decision of a panel.
 Fact, The AANS
(American Association of
Neurological Surgeons)
stated that the man was
most likely not a
neurosurgeon and was
rather pretending to be.
 Myth. Cheapest
ObamaCare Plan Will Be
$20,000 per Family.
 Fact, This ObamaCare
myth is a misleading
quote from an IRS report
on what Americans will
pay for a Bronze plan in
2016.

6. PROS CONS
 ObamaCare helps to curb
the growth in healthcare
spending.
 Medicare is improved for
Seniors including
eliminating the donut hole,
keeping rates down and
expanding free preventive
services.
 Medicaid is expanded up to
15.9 million men, women
and children below 138% of
the poverty level.
 ObamaCare focuses more on
making sure people are
covered than it does on
addressing the cost of care in
the first place.
 Medicare payments to
doctors and hospitals have
been limited. (Medicare pays
doctors more than any other
type of coverage and the rates
have led to complex problems
that are driving the costs of
health care up for everyone).
 Medicaid is expanded using
Federal and State funding.
Not all State’s have to expand
Medicaid leaving 5.7 million
of our nations poorest
without coverage options.

7.  The individual mandate
originally purposed by the
Heritage Foundation in
1989, requires all Americans
to have basic health
coverage or be penalized.
The individual mandate is
officially part of the Shared
Responsibly Provision and
is called an Individual
Shared Responsibility
Payment.
 The fee works like this: if
you don’t have insurance in
2015 or obtain an
exemption, you get charged
a fee for every month you
don’t have insurance on
your year-end taxable
income. If you have
coverage for at least one
day within the taxable year,
then you won’t owe the
payment for that month.
The IRS routinely works with taxpayers who owe amounts they cannot
afford to pay. The law prohibits the IRS from using liens or levies to
collect any individual shared responsibility payment. However, if you
owe a shared responsibility payment, the IRS may offset that liability
against any tax refund that may be due to you.

9. The bottom line is that
ObamaCare doesn’t ration
health care, it helps protect
consumers against the
health care rationing
insurance companies have
been doing for years.

10. Burdett, G. , Romneycare Vs. Obamacare: Key Similarities
& Differences, 2013
Retrieved from:
http://boston.cbslocal.com/2013/11/13/romneycare-vs-
obamacare-key-similarities-differences/
http://www.kff.org
http://www.irs.gov/Affordable-Care-Act/Individuals-and-
Families/Questions-and-Answers-on-the-Individual-
Shared-Responsibility-Provision
http://www.whitehouse.gov/blog/2014/12/03/historically-
slow-growth-health-spending-continued-2013-and-data-
show-underlying-slo