Key Differences Between RomneyCare and ObamaCare

*Got questions about RomneyCare and ObamaCare? Visit our newly updated page on RomneyCare – The Truth about Massachusetts Health Care to find articles like this and other questions you may be wondering.

It is often asserted that RomneyCare is the same thing as ObamaCare, but this is simply not true. It is important to note that Massachusetts, the state where Romneycare was founded, opposed Obamacare. In fact, Massachusetts opposed Obamacare so much that they elected Senator Scott Brown (R) in 2010 to be the deciding vote against Obamacare after Senator Ted Kennedy’s death. Why would the state where Romneycare was founded be opposed to Obamacare if the two laws were really the same? The answer is, of course, that they are not the same. While there are similarities between the two laws, there are also key differences. Below is a table of differences between the Romney plan and the Obama plan.

Overall Size and Scope
Whole bill was 70 pages
Romney vetoed significant sections of the bill including the employer penalty for not providing health insurance
Romney favored an “opt out” provision from the mandate
Romney favored no mandated benefits for health care coverage, catastrophic only
No federal gov. insurance option
Intended as a market driven solution to healthcare
Whole bill was 2,074 pages
Very broad regulation of the insurance industry including an employer penalty for not providing health insurance and no “opt out” provision
Establishes a 15 member board of unelected bureaucrats with great control over health care benefits and risks rationing health care
Leaves open the option of creating single-payer gov. insurance in the future
Intended as a step toward gov. run insurance
No new taxes!
Romney balanced the state’s budget first, then passed healthcare law
No cuts to Medicare benefits
Modest cost to state (only added 1% to state budget)
Increased taxes by $500 billion and taxes people who don’t buy insurance
Despite massive federal gov. debt, Obama still passed Obamacare
Cuts Medicare by $500 billion
Overall costs unknown!
Very strong bipartisan support
Strong special interest support
Very popular among the public in Massachusetts
Strong consensus of approval was built in the state to support the law
Consensus was built to support an individual mandate
Absolutely no bipartisan support
Very controversial and divided special interest groups
Unpopular in nation overall
No consensus was built to support a mandate
Does Constitution Define it as a “Tax” or “Penalty/Fee”?
Supreme Court Chief Justice Roberts ruled state mandates are “penalties” because states have different authority and powers than the fed. gov.
Mass. constitution never considered this a tax
Supreme Court ruled that federal gov. only has the authority to enact this law by its ability “tax,” and does not meet the required standards to be considered a “penalty.”
This tax breaks Obama’s promise that he would not raise taxes on the middle class
A state solution to a state problem
Through collaboration and discussion, Massachusetts created a consensus among stake holders to support the new law
Federal gov. “one-size-fits-all” plan
Doesn’t take into account that each state is unique in important ways such as:
1)Vastly different debt levels between states (some states can’t afford new spending on health care)
2)Some states have three times the percentage of uninsured citizens (Much greater costs will be imposed on states with a larger percentage of uninusured citizens)
3)Conservative states will reject implementation of federal gov. plan.

As the above table illustrates, the plan Romney proposed was a much more conservative, business friendly law than what the Democrats passed under President Obama.

The Boston Globe editorial board recently published an article defending RomneyCare on conservative grounds. The editorial board states “the role Romney played on the state level was skillful, creative, and business friendly. Romney was a governor sensitive to business concerns and worried about the state’s business climate.”

A crucial difference between RomneyCare and ObamaCare is that the two healthcare plans, while similar in some ways, present vast differences in the essential origins and motives that separate Barack Obama and Mitt Romney. One author summarized it this way:

We know what Romney’s goal was when he passed his health care plan. His goal was to involve the private sector of Massachusetts in insuring a small percentage of the Massachusetts’ residents [who didn’t have health insurance and who were receiving free health care from the government.]

Obama’s goal prior to signing Obamacare into law was much, much bigger.
In 2003, he said, “I happen to be a proponent of a single-payer universal health care plan.”

The fact is, Obamacare was originally going to be single payer. It was going to be European — as close to it as Congress would allow. But that was curbed. What they got, instead — what we got, instead — was the first step. Obamacare. The first step toward single-payer, universal healthcare coverage.

And that is the crucial difference. Romney never said, never touted, never promised that “we may not get [single-payer] immediately” or even a little later than immediately. Romneycare is not Obamacare because Obamacare is just getting started. One was an end in and of itself. The other is (still) a means to an end.

In 2006 when RomneyCare was passed, most conservatives praised Romney’s plan. The Bush administration sent a letter praising the passage of the new law. An often overlooked fact is that without the support of the Bush administration, Romney’s health care law never would have become a reality.

One of Romney’s main goals in passing healthcare legislation was to counter many much more liberal attempts within Massachusetts to take over the healthcare system. The Boston Globe newspaper discusses in detail one plan that Romney feared would become law if action was not taken. That plan was the imposition of a payroll tax of up to $1,700 per employee on all businesses that did not offer health insurance to their employees. It was a serious threat. The plan had been voted on in the year 2000 and the law barely failed by 3%. In 2006 the employer mandate coupled with a heavy payroll tax was to be voted on again.

In regard to ObamaCare, Romney firmly believes that each state should have the right to craft its own health care program. Health care has traditionally been a state issue, not a federal issue, and Romney wants to keep it that way. In his book, No Apology, Romney states:

“My own preference is to let each state fashion its own program to meet the distinct needs of its citizens. States could follow the Massachusetts model if they choose, or they could develop plans of their own. These plans, tested in the state ‘laboratories of democracy,’ could be evaluated, compared, improved upon, and adopted by others.”

In keeping with the belief that states should be able to craft their own programs, Romney has said that on his first day as president, he would issue a waiver to all 50 states allowing them to opt out of ObamaCare. This waiver would allow states to postpone the implementation of ObamaCare while Romney works with congress to formally repeal the bill.

In conclusion, a recent article in The New Yorker magazine states that “Romney had accomplished a longstanding Democratic goal – universal health insurance – by combining three conservative policies.” In other words, Romney had beaten Democrats at their own goal of providing universal health insurance – but Romney’s novel approach accomplished this goal not with a government takeover, but with conservative principles. The success of Romney’s healthcare law led many Democrats to consider adopting a similar approach to achieving universal health insurance. However, the end result from the Democrats under President Obama was a plan with a much larger government, much greater spending, increased taxes, and less power to the states and individuals to determine their own health care goals.

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13 Responses to Key Differences Between RomneyCare and ObamaCare

  1. Tracey says:

    Great job on this. I hope those who criticize Mass Care will take some time to get educated on the differences between Obama Care and Mass Care.

  2. AfricansforRomney says:

    Wait, wait you missed one more thing. Obamacare was passed, signed without anyone knowning what is in it.One of the dumbest thing in Obamacare is no one knows what’s behind it.
    It is like Obama the “cons. law teacher” were giving grades without reading. Scary!

  3. Shane Ownbey says:

    RomneyCare VS ObamaCare

    RC – Applies to only 8% off MA workers that were not insured.
    OC – Applies to 100% of Americans

    RC – Bill is 70 pages long
    OC – Bill is 2000-3000 pages long (28X greater)

    RC – Romney VETOED 8 parts of the Bill before it was passed
    OC – Obama VETOED 0 parts of the Bill & has not read the entire bill

    RC – Written by Office of Govenor MITT ROMNNEY
    OC – Witten by . . . . ?

    RC – Funded by existing revenues
    OC – Paid for by borrowing money

    RC – Did not raise taxes
    OC – Raises taxes

    RC – Inforced by Massachutes Health (MassHealth)
    OC – Inforced by the IRS

    RC – Adopted by 67% majority vote in MA (2/3rd)
    OC – Forced thru Congress and has no Bi-partisan support (Obama Democrats only) Backroom deals

    RC – Leaves 0.02% of children un-insured
    OC – Leaves 11% of children un-insured

    RC – Doesn’t affect / cut Medicare
    OC – Reduces Medicare Benefits

    RC – Ruled as Constitutional
    OC – Ruled as Unconstitutional twice (so far)

    RC – Does not Regualte Health Care Industry – works with Healthcare Providers and Private insurance companies
    Oc – Regulates 100% of the Health Care Industry – Forces Healtcare Providers and Private insurance to comply.

    RC –
    OC – caused the loss of many democratic seats in Novemeber of 2011

    RC – Still in effect in MA
    OC – Budget concerns, Constitutionality of mandate in question.

    RC – Don’t like it – Try another approach
    OC – Don’t like it – Tough!

    RC – Stayed on Budget Projections
    OC – Went over budget by 100% (can Obama add)

  4. Henry says:

    More differences:

    – Did NOT have to bribes senators to vote for RomneyCare. (LA Purchase, Cornhusker Kickback)
    -The Democrats did NOT place themselves under Obamacare
    – Romney did NOT have to lie to a Representative about the Abortion coverage, like Obama did to Stupek (spelling?).
    – Did not mislead about the cost, paid for 10 years, only get full coverage for 6, evaluate cost after 10.
    – Did not cut back room deals with big Pharm to run ads supporting it, to give them sweetheart deals.
    – The people of his state wanted it! Six years later, still in place.

  5. Tom says:

    I think these are good as a starting point. It is critically important based upon my conversations with everyday people that the more granular differences receive explanation for the public. Saying that Obamacare has all these new taxes doesn’t have the impact of the medical devise manufacturer saying he’s laying off workers in anticipation of the tax on his products. The IPAB doesn’t exist under Mass. healthcare, and is very frightening to the average peon, as long as it is repeatedly explained to them. I hope you win and I suggest you get more detailed and use more concrete examples.

  6. Tawn Kent says:

    Kuddos to Ben Collins for taking the time to clearly and succinctly differentiate between RomneyCare and ObamaCare. I needed a very short but concise treatment on the differences that distinguish both plans. If we make the mistake of believing the mainstream media we are left with the false conclusion that they are one and the same. With Ben’s outstanding analysis I can clearly make heads from tales between the two and express myself to others in a more accurate and confident manner. I hope to read more of Ben’s cogent writing here at MRC.

  7. Ben Collins says:

    Very nice points everyone. Thanks for the feedback.

  8. sherms says:

    Posting well done.. Thanx a lot…

  9. manfromthemountain says:


  10. Pingback: What is the difference between RomneyCare and ObamaCare? « Battleground Watch

  11. Victor Lundquist says:

    Dr. Collins: THANK YOU! This is OUTSTANDING!

    Shane, Henry, and other above. Thank you for great observations and additions to truthletting.

  12. Pingback: Yes, Virginia, There IS A Difference Between ObamaCare and RomneyCare « Virginia Virtucon

  13. Linda says:

    The above is excellent. My question is why doesn’t Romney and his surrogates talk about the differences? I am afraid if he does not get more assertive and quit being Mr Nice Guy, we will have 4 more years of obama. Where is the fire in the belly? We need to see that.