The Patient Protection and Affordable Care Act, which President Obama signed in March 2010, is considered by supporters as one of the president’s culminating achievements to date. The Act has stimulated considerable controversy, garnering extensive criticism from conservatives and suffering in opinion polls. As a result, health care reform has taken a central position in the 2012 presidential campaign. This brief highlights the candidates’ positions on health care reform and the Patient Protection and Affordable Care Act.

Barack Obama

Main Themes

Consumer protection and cost control

Policy Proposals

President Obama has refused to consider a repeal or partial repeal of the law. For Obama, the Affordable Care Act is the answer to problems in cost control and inequality in the American health care system and must be implemented in full.

Mitt Romney

Main Themes

Federal overreach and fair market competition

Policy Proposals

In general, Mitt Romney proposes to create a fair marketplace for health insurance through deregulation and competition.

• Repeal the Affordable Care Act
• Limit federal requirements on Medicaid spending
• Promote accessibility options, including exchanges, subsidies, and public-private partnerships
• Encourage purchasing pools, reinsurance, and risk adjustment
• Promote the direct purchase of insurance through reformed tax law
• Allow Health Savings Accounts to be used for insurance funds
• Enact medical malpractice reform
• Increase states’ flexibility through block grants for Medicaid
• Reform Medicare into a “premium support system,” a federal subsidy that recipients could use to purchase health insurance from the private market

Rick Santorum

Main Themes

Freedom of choice and deregulation