Pennsylvanian voters first elected Republican Rick Santorum to the House of Representatives in 1990. Four years later, in 1994, he was elected to the Senate, where he won his bid for re-election in 2000, but lost in 2006 to Democratic challenger Bob Casey, the Pennsylvania state treasurer. Santorum’s record is staunchly conservative, which made him a favorite among social conservatives, but which also made it difficult for him to connect with independent voters. Santorum won the Iowa primary, but came in fourth place in New Hampshire and in third place in South Carolina and Florida. He dropped his bid for the GOP presidential nomination in April 2012.
The Independent Payment and Advisory Board
Santorum and the Affordable Care Act (ACA)
Santorum, in his bid for the GOP presidential nomination, consistently denounced the Affordable Care Act (ACA) and criticized his opponents for their support of pieces of the legislation, proclaiming, “I never supported anything close to Obamacare. Sadly, that is not the case with the rest of the people in this field.” As a result, Santorum said that he was the only Republican candidate who can stand up to President Obama and repeal the ACA. In Florida, Santorum differentiated himself on the health care issue, arguing that Mitt Romney’s 2006 health care legislation in Massachusetts “does not provide the contrast we need with Barack Obama if we're going to take on that most important issue. We cannot give the issue of health care away in this election.”
The Individual Mandate
Santorum condemned opponents Romney and Newt Gingrich for their past support of the individual mandate (the ACA requirement that an individual must purchase health insurance starting in 2014), which Santorum does not and never has supported. Santorum repeatedly criticized Romney for his design and implementation of an individual mandate law in Massachusetts, which became the blueprint for President Obama’s Affordable Care Act (ACA)
In speech in Florida, Santorum criticized the ACA and told Florida's seniors that the new law would ration care by limiting access to doctors and increasing rates and wait times. He specifically denounced the law’s creation of the Independent Payment and Advisory Board (IPAB), which would be tasked with managing Medicare spending by controlling payments to providers. Santorum claimed that IPAB members, who would be appointed and not elected, would have too much power over seniors’ care. However, the ACA explicitly forbids it from rationing care, shifting costs to retirees, restricting benefits or raising the Medicare eligibility age, and the panel has yet to be set up.
Santorum claimed in the same Florida speech that, “The bottom line is more and more providers of health care are not taking Medicare because of the reimbursement rates.” However, it is unclear whether it is in fact true that more providers are opting out of Medicare. The Associated Press reported that, “A nonpartisan agency that advises Congress on Medicare policy reported that access for seniors generally remains good, despite localized problems and concerns about appointments for primary care.” Furthermore, the problem of declining reimbursement rates for doctors is not a result of the ACA but rather the consequence of the Sustainable Growth Rate (SGR) formula, which sets provider reimbursement rates and was designed as part of the Balanced Budget Act of 1997, passed under Gingrich’s leadership of the House of Representatives
Santorum and Medicare Reform
Santorum supports the Medicare changes advanced by House Budget Committee Chairman Paul Ryan (R-Wis.), which includes replacing the traditional fee-for-service (FFS) program with a premium support payment system that beneficiaries would use to purchase private insurance. Under Premium Support, Medicare beneficiaries would receive payments, or subsidies, to buy private insurance on a health care exchange, instead of participating in the traditional Medicare FFS model that is paid for almost entirely by the government. Ryan has been the main Republican proponent of this type of reform and included a detailed proposal in his Fiscal Year 2012 Budget Proposal, passed by the House of Representatives, but rejected in the Senate in April 2011. Santorum supports Ryan’s plan, and his website states that he would, “Implement Medicare reforms and innovation proposed by Congressman Paul Ryan and speed up their implementation.”
Role in Expanding Medicare Prescription Drug Plan (Part D) Benefits
Medicare Prescription Drug Plan (Part D), which was passed by Congress in 2003, is a federal program that subsidizes the costs of prescription drugs for Medicare beneficiaries. Its benefits are universal for all Medicare beneficiaries, so, as a result, it has significantly added to the federal budget deficit. Santorum supported the Medicare prescription drug program in 2003; however, he has since reversed his stance on it, calling it a “mistake,” because at the time only 15 percent of seniors were experiencing issues with prescription drug coverage, yet the reform extended coverage to all Medicare beneficiaries. Furthermore, when the program was created, Congress did not fund it, and as a result it has increased the budget deficit. Nevertheless, he still approves of and supports the private-sector market structure of the program.
What Is President Barack Obama's Position on Medicare Reform?
What Does U.S. Rep. Paul Ryan’s (R-Wis.) Propose for Medicare Reform in the House Budget Committee’s Fiscal Year 2012 Budget, “The Path to Prosperity?”
What Is the Premium Support Option, and How Is it Different From Current Medicare?
What Is the Independent Payment Advisory Board (IPAB)?