Presidential Debate Preview: What Obama and Romney Will Say About Obamacare

Obama talking pointsAs more than a year of furious campaigning draws closer to its frenzied conclusion, Wednesday's debate promises to be an epic clash of two political titans.

The Rumble in the Rockies between Mitt Romney and Barack Obama will pit the battle-scarred survivor of a cutthroat primary cage match against the grizzled veteran of four years of polarized partisan pummeling. Two candidates enter, one candidate leaves, and the, and the very fate of democracy hangs in the balance.

At least, that's the idea; the real thing will probably be a lot less exciting. Wednesday's debate, the first of three, will feature a moderate Democrat and a (sometimes) moderate Republican hashing through well-worn talking points. For the last few weeks, both Romney and Obama have spent hours in rehearsals, scripting out their responses to a slew of likely questions, honing witty zingers that they hope may earn them a few seconds of air time on news shows and a couple of clips that go viral on YouTube.

But if real drama actually occurs, one likely flashpoint will be health care reform. President Obama's signature legislation, which is expected to extend insurance coverage to 30 million Americans, has been attacked by Republicans on the basis of its cost, its new regulations, its potential effect on the health care industry, and a host of other points, both real and imaginary. Adding to the drama is the fact that Romney instituted an almost identical program when he was governor of Massachusetts. But in his quest for the Republican nomination, the GOP standard-bearer has joined the forces arrayed against Obamacare, tying himself in rhetorical knots to explain why he now opposes ideas he once championed.

Both men need to score points on the Patient Protection and Affordable Care Act Wednesday. The president needs to explain why it's vital to ensuring the health -- both physical and economic -- of the middle class. Romney has to explain how he plans to do away with it but still protect Americans' health. Here are some key points over which the candidates will probably clash.

How to Pay for It

One of Obamacare's biggest downsides is its cost. Modern health care isn't cheap, and Obama's plan will extend Medicaid and insurance subsidies to millions of new Americans. According to the Congressional Budget Office, the program will likely cost more than a trillion dollars between 2013 and 2022. On the other hand, the program's mix of taxes and cost-cutting moves would, according to the CBO, increase the deficit by a comparatively modest $109 billion over ten years.

• What Romney Might Say: Romney has made much of Obamacare's $1 trillion price tag, reducing the program's finances to a simple equation, wherein its costs are covered by "slashing" $500 billion from the Medicare budget and levying $500 billion in taxes "on everyone from middle-class families to innovative medical device makers." If Romney can make this charge stick, he'll score points against Obama.

• What Obama Might Say: The so-called $500 billion Medicare "cut" has been campaign fodder for months, and the Obama administration has emphasized that the Medicare savings won't come from cutting the program, but from slowing its rate of growth, as well as more aggressively prosecuting those committing Medicare fraud. Similarly, the much-discussed tax increases are largely focused on the medical establishment, although a few taxes, such as a small levy on the use of tanning beds, will impact some middle-class consumers.

• Potential Pitfalls: The trouble for Obama is that the debate's structure will make it hard for him to parry Romney's attack with an in-depth analysis of health care funding -- and any attempt to do so would likely bore his audience. If he hopes to refute the claim that his signature program will tank the economy, he'll have to explain its funding in a pithy, sharp way.

Who Is Responsible For It

In concept, it's hard to argue against making it easier for people to get health care: It's expensive, everyone needs it eventually, and too many people don't have access to it. The question, then, is not whether the government should be involved in health care, but where and at what level. And that is one area in which Romney and Obama notably clash.

• What Romney Might Say: For most of the election cycle, Romney has tried to distance himself from the Massachusetts health care program that was the template for Obamacare. However, in recent weeks, he has slightly changed his tune, taking more credit for his role in insuring millions of Bay Staters -- and arguing that giving everyone emergency room care qualifies as a health plan.

To differentiate himself from the president, Romney has focused on the question of who, exactly, is responsible for providing health coverage. Pledging to work with Congress to "replace" the Patient Protection and Affordable Care Act, he has promised to "issue Obamacare waivers to all 50 states."

Therein lies the heart of Romney's idea: He intends to replace the national health care plan with state-based ones, giving "each state the power to craft a health care reform plan that is best for its own citizens." Ultimately, however, he places responsibility firmly in the hands of individual consumers, stating that "I also want individuals to be able to buy insurance, health insurance, on their own."

• What Obama Might Say: If Obama engages Romney's argument, he might point out that states already have the ability to reject his Medicaid expansion. It's more likely, however, that he will focus on the plan's wide-ranging impact for millions of voters.

• Potential Pitfalls: Romney's tenure as Massachusetts governor makes him highly vulnerable on the subject of government-sponsored health insurance, and his recent defense of emergency room care is full of holes -- and contradicts his former statements. His argument that government at the state level is vastly different from government at the national level is abstruse, at best, and he faces an uphill battle trying to explain how Romneycare significantly differs from Obamacare.

Its Long-Term Consequences

Since many of Obamacare's reforms will slowly be phased in over the next few years, its ultimate effect has yet to be determined. For Obama and Romney, selling or torpedoing the plan will rely heavily on the ability to convincingly describe a world in which the Affordable Care Act is in full bloom.

• What Romney Might Say: In early September, Romney promised to "make sure that those with pre-existing conditions can get coverage," an apparent policy reversal that one of his aides quickly retracted. More generally, however, he has attacked the plan for its size and complexity, as well as for its policies, which he argues will "will make America a less attractive place to practice medicine, discourage innovators from investing in life-saving technology, and restrict consumer choice." In addition, he claims that it could cause "up to 20 million" Americans to "lose the insurance they currently have, the insurance they like and the insurance they want to keep." Independent fact checkers have determined that this last statement is demonstrably false.

• What Obama Might Say: While Romney will face a challenge in his attempt to paint a dire picture of Obamacare's effects when they haven't arrived yet, the president will also find it hard to demonstrate the benefits of a program that is still being slowly phased in. Some elements, like the creation of a high-risk pool for people with pre-existing conditions, and making it illegal for insurers to refuse coverage to people under the age of 19 based on pre-existing conditions, have already gone into effect, but their impact hasn't been widely studied or reported.

Similarly, while the percentage of people with health care coverage rose during the last year, the anemic growth rate of 0.6% was less than impressive. In light of this, Obama will likely focus on the more far-reaching aspects of the PPACA, many of which aren't scheduled to go into effect until January 2014.

• Potential Pitfalls: Because full implementation of the Affordable Care Act still to come, neither candidate will be able to stick strictly to provable facts to make their case. The key, then, will be for each man to explain his personal vision of how health care should be run in America -- and hope he can tell a compelling story that voters will want to endorse.

Bruce Watson is a senior features writer for DailyFinance. You can reach him by e-mail at, or follow him on Twitter at @bruce1971.

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This comment section isn't working properly. I've trid to do thumbs up/down and it doesn't register and when I try to respond to a comment it dosn't submit. what gives?

October 03 2012 at 5:48 AM Report abuse +1 rate up rate down Reply

Obamacare= healthcare rationing and death panels. Nothing else needs to be said.

October 03 2012 at 4:43 AM Report abuse +1 rate up rate down Reply
1 reply to lifehub's comment

Obamacare is modeled from Romneycare

October 03 2012 at 11:37 AM Report abuse -1 rate up rate down Reply

I might have figured out how our government is going to reduce the cost of Obama care. About 90% of health care expenses for an individual go towards end of life care. If this were omitted or drastically reduced such as to hold back an expensive medical procedure that would give you and extra year of life, this would give this bill some credibility for cost measures that they expect to keep under control. Think about it, one day you are going to be over the age 76 and wish you never heard of Obama care....................

October 03 2012 at 2:08 AM Report abuse +1 rate up rate down Reply

Obama is a clear and present danger to ALL Americans if he is re-elected! Why can't anyone see this? He is POWER-HUNGRY and really wants to be the leader of THE WORLD, and will do ANYTHING to get it. If he is re-elected, say goodbye to the America we know and love.

October 03 2012 at 1:07 AM Report abuse rate up rate down Reply
2 replies to Buckingham's's comment

Obama can't be leader of "THE WORLD" since I am not ready to relinquish that position yet......

October 03 2012 at 1:35 AM Report abuse rate up rate down Reply

Agree. Add to that libs believe they won't be affected in any way, simps that they are.

October 03 2012 at 4:44 AM Report abuse +1 rate up rate down Reply

ObamaCare is a mess and will end up costing triple what Obama led us to believe. He said it wouldn't raise taxes, or diminish Medicare. Two lies in a row. Also, his plan doesn't address the major problem of hospital and medical costs, which are over-inflated. Typical Obama to want to start a Socialized program without figuring out who is going to pay for it, except to stick it to the taxpayers once again. Romney needs to stick it to him on ObamaCare. It is not the answer to the problem.

October 03 2012 at 12:42 AM Report abuse -1 rate up rate down Reply

I might have figured out how our government is going to reduce the cost of Obama care. About 90% of health care expenses for an individual go towards end of life care. If this were omitted or drastically reduced such as to hold back an expensive medical procedure that would give you and extra year of life, this would give this bill some credibility for cost measures that they expect to keep under control. Think about it, one day you are going to be over the age 76 and wish you never heard of Obama care....................

October 03 2012 at 12:22 AM Report abuse +1 rate up rate down Reply

This outlet already knows what is going to be said about Obamacare? They must be mediums here. Desperate for their idol, Obama to win, eh?

October 02 2012 at 11:54 PM Report abuse rate up rate down Reply
Cheryl Moeller-Linim

So many subject to choose from on the Republican side, all of which have no bearing on the best interests of the country. Abortion, contraception, monitoring a woman's menstrual cycles, redefining "rape", allowing molesters such as cops (Arizona) off without penalty for sexual assault while downgrading the victim, discussing that when REAL rape occurs, the body has a way of "shutting down that whole pregnancy thing", preventing "so-called voter fraud" that doesn't exist, RELIGION, the fact that Rush Limbaugh thinks our whole country's woes began when they gave WOMEN THE RIGHT TO VOTE, promoting division and violence in our country and taking away a woman's right to report her spouse beating her with no remedy unless the officer actually WITNESSES the beating. The list goes on. They will blame the Bush economic disaster all on the President although they voted down every jobs bill and every single thing proposed by Democrats to move the country forward. It's so predictable. I wonder if Romney will send Annie out there to tell everyone to "JUST STOP IT. THIS IS HARD. YOU SHOULD TRY IT.".

October 02 2012 at 10:34 PM Report abuse -2 rate up rate down Reply
1 reply to Cheryl Moeller-Linim's comment

Ahhh Cheryl. NOBODY is trying to prevent you from having, or using contraception. The Republican's simply don't support religious bodies having to provide that for you, and I've never even heard it alleged that ANYBODY wants to monitor your menstral cycle (EEEEK!). Todd Akin is an idiot who happens to be a Republican. I do believe that the Romney camp asked him to withdraw from the race??? I find it very disappointing that some Republican conservatives have chosen to endorse his campaign, but I don't believe anyone is advocating for "redifining rape". If you know of such a thing, please forward the link. Rush Limbaugh is a COMMENTATOR, not a candidate. He makes money by saying the most outrageous things he can think of. His comments fall along the lines of some you've just made-broad generalizaions that have litte to no root in reality. Just because he's loud doesn't mean he's right. And, last I checked, he didn't set policy for anyone. Please forward the link where the Republican party advocates allowing a man to abuse his spouse, unless it's witnessed by the police. As to the Republicans "voting down" bills, you are aware that Democrats had control of Congress for the first two years (the majority) of his presidency, right? The Republican might have voted against Obama's policies, but since Democrats held the majority, the Republicans couldn't vote his policies down along, now could they? While I'll agree that things fell off sharply at the end of the Bush administration, you should also be aware that Democrats had control of Congress during that time AND that the deficit has increased by 6 TRILLION dollars under Obama's watch. But I'm sure that's Romney's fault, too.

October 03 2012 at 1:05 PM Report abuse rate up rate down Reply
1 reply to start913's comment

...couldn't vote down his policies ALONE..... not along. Sorry - typo.

October 03 2012 at 1:36 PM Report abuse rate up rate down

Well, Bruce Watson, nice story telling us what they "might" say. Should we all just not watch the debate now that you seam to have all the answers.??? I think I'll watch and make up my own mind.!!!!!!!!!!!

October 02 2012 at 10:06 PM Report abuse +5 rate up rate down Reply

Obamacare is costing me an extra $2,000 a year on my medical premiums. There isn't a doubt who I'll vote for in this election.

October 02 2012 at 9:59 PM Report abuse +2 rate up rate down Reply
3 replies to John's comment