The article:

RomneyCare & ObamaCare: Can you tell the difference?

By Angie Drobnic Holan
Published on Tuesday, March 20th, 2012 at 4:58 p.m.

To help you get ready for next week's arguments on the health care law before the U.S. Supreme Court, we will be publishing some helpful guides and summaries. For our first installment, we're re-publishing our fiendishly difficult quiz to see if you know the difference between RomneyCare and ObamaCare.

Mitt Romney has gone to great lengths to distance his Massachusetts health plan from the federal law, even giving a PowerPoint presentation to emphasize the differences. But the truth is that there are an awful lot of similarities between the plan he signed in Massachusetts in 2006, often called "RomneyCare," and the one that President Barack Obama signed in 2010, dubbed "ObamaCare."

Both leave in place the major insurance systems: employer-provided insurance, Medicare for seniors and Medicaid for the poor. They seek to reduce the number of uninsured by expanding Medicaid and by offering tax breaks to help moderate income people buy insurance. People are required to buy insurance or pay a penalty, a mechanism called the "individual mandate." And companies that don't offer insurance have to pay fines, with exceptions for small business and a few other cases.

Take the quiz

Are you smart enough to tell the difference between ObamaCare and RomneyCare? Here are 10 descriptions of the plans that we got from the legislation that created the two plans, official summaries, private reports and interviews with experts. See if you know whether each description is for ObamaCare or RomneyCare.

1. "Individuals who are deemed able to afford health insurance but fail to comply are subject to penalties for each month of non-compliance in the tax year ... . The penalties, which will be imposed through the individual’s personal income tax return, shall not exceed 50% of the minimum monthly insurance premium." 

2. Employers "who employ 11 or more full-time equivalent employees" and do not make a "fair and reasonable contribution" to their employees' health insurance are required to pay a fine. 

3. "Tax credits to make it easier for the middle class to afford insurance will become available for people with income between 100 percent and 400 percent of the poverty line who are not eligible for other affordable coverage."

4. Children and adolescents up to age 18 "whose financial eligibility as determined by the division exceeds 133 per cent but is not more than 300 per cent of the federal poverty level" will be eligible for Medicaid.

5. "Americans who earn less than 133 percent of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid."

6. A recent poll asked people whether they had a generally favorable or unfavorable view of the health plan. Responses split 41 percent and 41 percent between favoring and not favoring. Another 18 percent said they were undecided.

7. Small businesses qualify for tax credits if they pay for at least half of the workers' health insurance. A small business is defined as having fewer than 25 full-time workers paid average annual wages below $50,000.

8. Experience shows the plan is not significantly going to lower costs. Supporters of the law are actively considering new legislation aimed at cost containment.

9. The plan creates a Patient-Centered Outcomes Research Institute "to conduct research to provide information about the best available evidence to help patients and their health care providers make more informed decisions."

10. For individuals who make more than $200,000 or couples that make more than $250,000, the plan increases Medicare taxes on wages in 2013 by 0.9 percent and imposes a 3.8 percent tax on investment income.

So how many did you get right? (Answers below)

All 10: You're CBO Gold! You qualify to be an analyst at the Congressional Budget Office! 

8-9:  Lobbyist Silver! You're good enough to be a health care lobbyist! Watch out, Billy Tauzin!

6-7: Bronze Policy Wonk Circle! You can be a researcher at the Kaiser Family Foundation -- or Ezra Klein!

5-6: Talking Head Honorable Mention. You're good enough for shouting matches on cable news channels!

3-4: Pollster's "don't knows." It's hard to have an opinion when you don't know what's in the plan!

0-2: Chain E-Mail Level. You forward chain e-mails that say the federal health care law puts a tax on real estate. (Pants on Fire, by the way.)


1. RomneyCare

Source: Massachusetts Department of Revenue, TIR 09-25: Individual Mandate Penalties for Tax Year 2010
Note: Both plans have individual mandates. The federal penalties start small, but eventually ramp up to $695 per year or 2.5 percent of income, whichever is higher. Eventually, federal penalties will tend to be higher than the Massachusetts plan.

2. RomneyCare

Source: Massachusetts Department of Revenue, Health Care Information for Employers
Note: Federal law exempts employers with fewer than 50 workers. Additionally, under the federal plan, employers pay fines only if their workers qualify for tax credits to buy insurance. 

3. ObamaCare

Source:, Provisions of the Affordable Care Act, By Year
Note: The Massachusetts law also provides subsidized health insurance, but the income cut-off is 300 percent of the federal poverty level.

4. RomneyCare

Source: Massachusetts health care law
Note: The Massachusetts law expanded Medicaid for children. The federal law expands Medicaid to adults, but sets the cut-off at 133 percent of the federal poverty level. 

5. ObamaCare

Source:, Provisions of the Affordable Care Act, By Year
Note: The Massachusetts law expanded Medicaid for children. The federal law expands Medicaid to adults, but sets the cut-off at 133 percent of the federal poverty level. 

6. ObamaCare

Source: The Kaiser Family Foundation, Kaiser Health Tracking Poll, April 2011
Note: Polls show the federal law has split public opinion. Polls in Massachusetts show the program is significantly more popular. 

7. ObamaCare

Source: Internal Revenue Service, Small Business Health Care Tax Credit for Small Employers
Note: Tax credits start at 35 percent of the employer's health premium costs and increase to 50 percent in 2014.

8. RomneyCare

Source: Gov. Deval Patrick, Patrick-Murphy administration proposes comprehensive health care cost containment legislation, Feb. 17, 2011; AP, Lawmakers hear bill to rein in Mass. health costs, May 16, 2011

9. ObamaCare

Source: U.S. Government Accountability Office, Patient-Centered Outcomes Research Institute (PCORI) Governing Board; Patient-Centered Outcomes Research Institute (PCORI), About Us

10. ObamaCare

Source: Kaiser Family Foundation, summary of new health reform law

About this article:


Additional sources listed with answer key.

PolitiFact, Krugman calls Senate health care bill similar to law in Massachusetts, Feb. 4, 2010

PolitiFact Texas, Howard Dean says the health care bill that President Barack Obama signed is like the one Mitt Romney signed as the governor of Massachusetts, Dec. 5, 2010

Kaiser Family Foundation, summary of new health reform law, accessed May 28, 2011

Kaiser Family Foundation, summary of Massachusetts health reform law, September 2009

The Boston Globe, Countdown to coverage, June 18, 2007

E-mail interview with Dr. Jonathan Gruber of MIT

Researchers: Angie Drobnic Holan

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