NYT's Bruce Bartlett: The Health Mandate Romney Still Supports
http://economix.blogs.nytimes.com/2012/10/23/the-health-mandate-romney-still-supports/
Republicans have a dilemma on health policy. They are adamantly opposed to government paying for health care or a mandate requiring people to buy health insurance. At the same time, they recognize that they cannot say to the world that if a dying person shows up at an emergency room without insurance, that person will be left to die in the street. Thus they support a little-known mandate requiring hospitals to treat the uninsured, the Emergency Medical Treatment and Active Labor Act.
...
In fact, the Emergency Medical Treatment and Active Labor Act isn’t even remotely a substitute for health insurance or something that obviates the purpose of health reform. It does not demand that all hospitals care for whoever walks in, only those who require urgent care to avoid serious injury or life-threatening consequences. Only hospitals that both participate in Medicare and have emergency rooms are covered by the law
...
Therefore, even if we accept the Republican contention that Emtala is sufficient to deal with the problem of the uninsured without mandating that people obtain health insurance, all that is happening is a shifting of the cost of caring for such people. To a large extent, they end up being paid by the insured through higher medical bills and insurance premiums. In New York, for example, a 9 percent surcharge on all hospital bills covers the cost of caring for indigents, though complaints abound of hospitals failing to comply with the law.
The purely partisan hatred by Republicans for the individual mandate – which used to be the foundation of their health policy – has ironically led them to embrace another mandate on hospitals. But it is a very inadequate and inefficient substitute for health insurance – something Mr. Romney used to acknowledge – and every bit as much a violation of Republican principles, which oppose unfunded mandates, as the individual mandate that they abhor.