Stung by their man’s miserable performance in Wednesday’s debate, the Democrats have tried to change the subject by claiming that Mitt Romney “lied” repeatedly during the debate. But they have had a tough time coming up with any actual lies. The chronically truth-challenged Paul Krugman somewhat ironically stepped up to the plate in a New York Times column on Thursday that was titled “Romney’s Sick Joke.” You can always count on Krugman for understatement. This was Krugman’s contribution to the “Romney lied” theme:
“No. 1,” declared Mitt Romney in Wednesday’s debate, “pre-existing conditions are covered under my plan.” No, they aren’t — as Mr. Romney’s own advisers have conceded in the past, and did again after the debate.
Was Mr. Romney lying? Well, either that or he was making what amounts to a sick joke. Either way, his attempt to deceive voters on this issue was the biggest of many misleading and/or dishonest claims he made over the course of that hour and a half. Yes, President Obama did a notably bad job of responding. But I’ll leave the theater criticism to others and talk instead about the issue that should be at the heart of this election.
So, about that sick joke: What Mr. Romney actually proposes is that Americans with pre-existing conditions who already have health coverage be allowed to keep that coverage even if they lose their job — as long as they keep paying the premiums. As it happens, this is already the law of the land. But it’s not what anyone in real life means by having a health plan that covers pre-existing conditions, because it applies only to those who manage to land a job with health insurance in the first place (and are able to maintain their payments despite losing that job).
This is what Romney said during the debate:
MR. LEHRER: Let’s let the governor explain what you would do if “Obamacare” is repealed. How would you replace it? What do you have in mind?
MR. ROMNEY: Let — well, actually — actually it’s — it’s — it’s a lengthy description, but number one, pre-existing conditions are covered under my plan. Number two, young people are able to stay on their family plan. That’s already offered in the private marketplace; you don’t have — have the government mandate that for that to occur.
But let’s come back to something the president — I agree on, which is the — the key task we have in health care is to get the costs down so it’s more affordable for families, and — and then he has as a model for doing that a board of people at the government, an unelected board, appointed board, who are going to decide what kind of treatment you ought to have.
PRESIDENT OBAMA: No, it isn’t.
MR. ROMNEY: In my opinion, the government is not effective in — in bringing down the cost of almost anything. As a matter of fact, free people and free enterprises trying to find ways to do things better are able to be more effective in bringing down the costs than the government will ever be.
It continues from there. So, what does Romney’s health care proposal, which is basically a set of bullet points, say about pre-existing conditions?
Prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage.
So does that “cover” pre-existing conditions, or not? I think it would have been clear to most listeners that Romney meant his plan would address or deal with the issue of pre-existing conditions, not that the federal government would buy insurance to cover them. (Romney’s plan does not involve the federal government buying health insurance for anyone, beyond the existing Medicare and Medicaid programs.) And Romney’s plan does indeed address the issue of pre-existing conditions, by banning discrimination against those who have them and who maintain health insurance continuously. The continuous insurance requirement is necessary to prevent the obvious dodge (which Krugman specifically acknowledges) of waiting until you get sick and then buying insurance.
So what we have here is a policy disagreement, not a lie. Krugman tries to suggest that Romney’s approach to pre-existing conditions is meaningless because “this is already the law of the land.” But here Krugman is wrong, not Romney. Krugman is referring to the Health Insurance Portability and Accountability Act, which was adopted in 1996. HIPAA, as explained here, makes group health insurance portable because it “imposes limits on the extent to which some group health plans can exclude health insurance for pre-existing conditions.” But HIPAA “provides no protection if you switch from one individual health plan to another individual plan.” So Romney’s plan will indeed cover pre-existing conditions to a significantly greater degree than existing law. Moreover, Romney’s health care plan also proposes to “[e]nd tax discrimination against the individual purchase of insurance,” so the plan’s extension of portability to individual policies takes on added importance.
Health care policy can be debated endlessly, and Romney and Krugman obviously disagree. Krugman wants government-controlled medicine, and Romney wants to use the private sector and principles of competition to improve care and control costs. But for Krugman to say that Romney “lied” about his own health care proposal as it relates to pre-existing conditions is simply wrong.
Krugman trashes Obama’s debate performance in his column. In addition to the language quoted above, Krugman adds this at the end of the column:
One could wish that Mr. Obama had made this point effectively in the debate. He had every right to jump up and say, “There you go again”: Not only was Mr. Romney’s claim fundamentally dishonest, it has already been extensively debunked, and the Romney campaign itself has admitted that it’s false.
For whatever reason, the president didn’t do that, on health care or on anything else. But, as I said, never mind the theater criticism.
What is odd about this is that in the debate, rather than being unaccountably silent, Obama made precisely the point that Krugman did in his column. When Romney completed his answer, Obama said:
But let’s go back to what Governor Romney indicated, that under his plan he would be able to cover people with pre-existing conditions. Well, actually, Governor, that isn’t what your plan does. What your plan does is to duplicate what’s already the law, which says if you are out of health insurance for three months then you can end up getting continuous coverage and an insurance company can’t deny you if you’ve — if it’s been under 90 days.
But that’s already the law. And that doesn’t help the millions of people out there with pre-existing conditions. There’s a reason why Governor Romney set up the plan that he did in Massachusetts. It wasn’t a government takeover of health care. It was the largest expansion of private insurance. But what it does say is that insurers, you’ve got to take everybody.
So Obama misrepresented the extent to which Romney’s plan would change existing law, exactly as Krugman did. To which Romney responded:
And with regards to health care, you had remarkable details with regards to my pre-existing condition plan. You obviously studied up on — on my plan. In fact, I do have a plan that deals with people with pre-existing conditions. That’s part of my health care plan. And what we did in Massachusetts is a model for the nation, state by state. And I said that at that time. The federal government taking over health care for the entire nation and whisking aside the 10th Amendment, which gives states the rights for these kinds of things, is not the course for America to have a stronger, more vibrant economy.
So the very point that Krugman thought was missing from the debate was, in fact, thoroughly hashed out by the participants. Apparently Krugman was not paying close attention during the debate, and didn’t bother to check the transcript to make sure that the claim he made was correct. This is consistent with my impression that Krugman dashes off his Times columns in a half hour or less. Next time, he should exercise more care before declaring that those who disagree with him on issues of public policy are liars.