Romney to detail his healthcare Rx

Mitt Romney, expected to roll out his healthcare plan in Florida today, will call for a combination of federal tax breaks and incentives to states to help the uninsured afford coverage, while offering strategies to rein in health costs, such as capping punitive damages in malpractice cases.

Drawing on some aspects of the Massachusetts health coverage law he helped enact as governor, Romney will urge states to redirect federal money that is now spent on expensive emergency room care for people without insurance, putting it instead toward helping low-income people pay for health insurance.

Sally Canfield, policy director for the campaign, said the plan would not require any new money. It relies entirely on reallocating existing federal spending on healthcare and creating a more vigorous market to drive down premium prices, she said.

"What we're trying to do is build on the Massachusetts example, and what worked here, and provide a way for states to have access to the same types of choices we have in Massachusetts," she said.

Romney's proposal also looks to make insurance premiums more affordable for individuals by deeming health costs tax deductible once they enroll in a plan. The Massachusetts law created the Commonwealth Health Insurance Connector partly to give individuals access to the same tax deductions available to businesses and other groups.

But unlike the Massachusetts law, Romney's proposal would not penalize anyone for failing to buy insurance, nor would it sanction businesses that do not provide it for their employees. Individual states could set such rules, but the federal government would stay out of such requirements.

In hopes of lowering healthcare costs, Romney would also provide federal incentives for states to deregulate their insurance markets -- encouraging them, for example, to get rid of laws that require insurers to pay for certain medical services, such as in vitro fertilization.

He would also give states more flexibility in how they use federal Medicaid dollars, making it easier for states to develop innovative programs -- such as one in Utah that helps people manage chronic illnesses, keeping them healthier and reducing costs, the Romney campaign said.

The plan also includes a raft of proposals to help drive down health costs, including changes in medical liability requirements. And the plan would provide more information to consumers so they could shop for the best quality and prices.

Romney's address today to the Florida Medical Association is designed to go beyond his standard stump speech on his healthcare policy in which he lauds the Massachusetts plan as a way to lower premiums and extend coverage to more people without too much government involvement. Critics have said he has glossed over less appealing details of the Massachusetts law.

Meanwhile, in New Hampshire yesterday, Senator Hillary Clinton called for continuing education for doctors, training more nurses, and giving more information to patients about physicians and hospitals as ways to improve healthcare.

The seven-point plan also suggests spending $125 million to create a public-private group that would oversee healthcare quality; finding ways to reduce racial, ethnic, and socioeconomic disparities in care; providing higher payments to healthcare providers that offer coordinated care; and extending to the federal employee healthcare plan the Bush administration's recent decision to refuse Medicare payments for preventable injuries and infections during hospital stays.

Clinton's speech in Lebanon, N.H., was the second in a series of three to lay out her healthcare proposals. In May, she introduced another seven-point plan that she said would lower national healthcare spending by at least $120 million a year. Next month, she plans to unveil proposals to ensure universal healthcare coverage. In her husband's first term as president, she spearheaded the failed attempt in 1993 to overhaul the nation's healthcare system.

Healthcare has emerged as a major issue in the presidential race, as candidates offer prescriptions for extending coverage to the estimated 47 million Americans without it.

Lisa Wangsness can be reached at lwangsness@globe.com.