Romney preexisting conditions pledge leaves questions

(Bloomberg) — Republican presidential nominee Mitt Romney has vowed in recent weeks — most publicly during his first debate with President Barack Obama on Oct. 3 — that he will extend health insurance to people with preexisting medical conditions, yet has offered few details about how he’ll keep that promise.

While Romney says he would shield workers who have coverage from being dropped if they change jobs, his plan doesn’t explain what it would do for many others, such as those with ailments seeking coverage for the first time.

“It’s a complete mystery what he’s talking about,” says Joe Antos, a health care economist at the American Enterprise Institute, a Washington policy group. “He’s clearly asserting that he’s got a new policy but he hasn’t said what it is.”

Without specifics, he would leave it to the states to find solutions for everyone not covered under his proposal. Health-policy specialists say the plan echoes protections in a 1996 U.S. law and doesn’t show how it would help at least 36 million sick people at risk of being denied coverage.

As Massachusetts governor, Romney enacted a law in 2006 later cited as a blueprint for the Obama health care overhaul that bars discrimination while requiring residents to carry insurance. Though Romney says the state’s law has resulted in 98% coverage, he maintains that’s not his plan as a presidential candidate.

“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,” Romney said at the debate. Romney’s plan would void the administration’s law and instead bar insurers from denying coverage to those “who have maintained continuing coverage,” according to Lanhee Chen, policy director of the Romney campaign.

The Romney plan doesn’t spell out how it would help those who are unemployed, who don’t work in a field where employers provide coverage or have had gaps in coverage. About 89 million Americans, a little more than one-third of those under the age of 65, were uninsured for at least a month between 2004 and 2007, according to an August report by the Commonwealth Fund.

Coverage for preexisting conditions is among the more popular aspects of the Patient Protection and Affordable Care Act enacted in 2010 under Obama is a provision that bars insurance companies, beginning in 2014, from denying coverage or charging higher premiums to people with preexisting medical conditions.

Eighty-two percent favored that section of the health overhaul, according to an October 2009 Pew Research Center poll released before the law’s enactment. A poll released by the Washington-based center in June found that 43% of those surveyed approved of the law, compared with 48% who disapproved.

To keep the provision from bankrupting insurers, virtually all Americans are required to have insurance or face financial penalties. The so-called individual mandate was upheld by the U.S. Supreme Court in June.

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