Despite vows to repeal the health reform law on his first day of office, Republican presidential candidate Mitt Romney isn't likely to entirely repeal the Affordable Care Act, attorney experts wrote in a Journal of the American Medical Association.
With a social platform based on "repeal and replace," according to the candidate's website, the former Massachusetts governor will likely target the individual mandate, federal Medicaid payments to states and the controversial Independent Payment Advisory Board, according to John Kraemer at the Georgetown University School of Nursing and Health Studies and Lawrence Gostin at Georgetown University Law Center.
"'Repealing and replacing' the ACA is unlikely, requiring Obama to lose the presidency and Republicans to hold the House and 60 Senate seats to prevent a filibuster," they wrote.
The Constitution requires the president execute on laws regardless of whether he disagrees with them, unless Congress grants discretion. The ACA does not provide a blanket waiver that allows states to disregard the ACA's key provisions, as they would likely violate the "take-care" clause, the authors noted.
However, the ACA does allow waivers for certain provisions that can better fulfill the act. Nevertheless, states must specifically request waivers, which would not become available until 2017. Obama has sought an amendment to make innovation waivers available by 2014.
Romney, although unclear on how it would be carried out, says, he "will issue an executive order that paves the way for the federal government to issue Obamacare waivers to all fifty states," suggesting states could waive all or parts of the ACA.
According to a Kaiser Family Foundation poll, Romney is gaining ground on voter support for healthcare issues. For instance, Obama and Romney are neck and neck on which candidate would do better for Medicare, with 46 percent support, compared to 41 percent, respectively, according to Kaiser Health News.
For more information:
- read the JAMA article
- see the Romney website details on healthcare
- here's the Kaiser Health News article and Foundation poll
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