An energetic and well-prepared Mitt Romney went after President Barack Obama’s economic record and health care plan at the first of three presidential debates on Wednesday night at the University of Colorado in Denver, the only meeting between the two men slated to focus on domestic issues. Rather than debate the merits of preserving the Patient Protection and Affordable Care Act in its current form or repeal and replace the measure, as most Republicans favor, both Romney and Obama framed the debate of health care reform largely as an issue of cost.

 “I just don’t know how the president could have come into office, facing 23 million people out of work, rising unemployment [and] an economic crisis at the kitchen table, and spend his energy and passion for two years fighting for Obamacare instead of fighting for jobs for the American people,” Romney said, adding that as he’s crisscrossed the nation, he’s come across plenty of small businesses that fear the Patient Protection and Affordable Care Act will close them down. He cited a survey of employers in which three-quarters say PPACA “makes them less likely to hire people.”

Obama countered that in 2008, he was traveling around America “having those same conversations that Gov. Romney talks about” and that it wasn’t just businesses that were suffering under the yolk of health costs, “it was families who were worrying about going bankrupt if they got sick.

 “Millions of families all across the country, if they had a previous condition, they might not be able to get coverage at all,” the president said in defense of his signature domestic measure. “So, we did work on this, alongside working on jobs, because this is part of making sure that middle class families are secure in this country.

 “Insurance companies can’t jerk you around,” he continued. “They can’t impose arbitrary lifetime limits. They have to let you keep your kid on your insurance plan until [they] are 26 years old. And it says that you’re going to get rebates if insurance companies spend more on administrative costs than they do on actual care.”

Asked point-blank by Obama and moderator Jim Lehrer what he would replace the current health reform with, Romney said he would maintain PPACA provisions like prohibiting coverage denials because of pre-existing conditions and allowing young people to remain on their parents’ insurance plans, but added that “the right answer is not to have the federal government take over health care and start mandating to the providers across America, telling a patient and a doctor what kind of treatment they can have.”

However, Ron Pollack, executive director of health consumer organization Families USA, notes that Romney’s response regarding patients with pre-existing conditions didn’t apply universally. “[Romney] admitted — and his campaign spokesperson Eric Fehrnstrom confirmed — that people with pre-existing health conditions would only be protected from insurance company coverage denials if they had continuous health coverage in the past,” Pollack says. “As a result, the millions of people who were previously denied coverage due to pre-existing health conditions (such as asthma, diabetes, and cancer) would be left out in the cold.”

This omission is just one of a “number of health care assertions [by Romney] that were breathtakingly false and misleading,” according to Pollack. “Governor Romney said that 20 million people will lose health insurance under ObamaCare when it goes into effect. This assertion deserves its own special place in the Chuzpah Hall of Fame. As the Congressional Budget Office found, under Obamacare, health coverage would expand to over 30 million people who would otherwise be uninsured. In contrast, under Governor Romney's current proposals, the number of uninsured would increase to 78 million people within a decade — an increase of more than 60% from the latest Census Bureau report.”

Yet, “President Obama got it wrong in a couple of areas,” too, says Wayne Sakamoto, president of Health Insurance Interactive, Inc., in Naples, Fla., noting the president claimed assumed “that group health plans are cheaper than individual plans, which is not always the case. Then, Obama commented that Obamacare has the same three-month waiting period (like Romney’s healthcare proposal) for people with pre-existing conditions — but with the [Pre-existing Condition Insurance Plan], individuals need to be uninsured for six months before enrolling into the PCIP.”

By way of additional analysis, Sakamoto says, “I like that Romney is against having a federal board to review the cost of health care, allowing the private market (hospitals and providers and businesses) to be innovative and competitive to lower the cost of health care rather than having the federal government with its review board to regulate how the health care industry should lower [costs].”

Marli D. Riggs contributed additional reporting to this story.

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