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Posted at 11:01 AM ET, 02/ 1/2011

Mitt Romney needs a better defense for RomneyCare

By Jennifer Rubin

Mitt Romney is struggling to find a defense for RomneyCare, the health care legislation passed when he was governor of Massachusetts. Romney's present argument is a legalistic and not very compelling one. On Good Morning America today, Romney said that despite the fact that the Massachusetts law contains the same individual mandate that a federal judge ruled was unconstitutional in ObamaCare, RomneyCare is different because it does not run afoul of the Commerce Clause, which is a limitation on the federal government. That's an accurate statement, but utterly beside the point.

Romney will be savaged because he adopted a plan that made ObamaCare and the notion of compulsory insurance (the individual mandate) popular.

For a preview of what is in store for Romney, it's worth looking back to the last presidential contest, when candidate Barack Obama opposed the individual mandate and Hillary Clinton supported it. Here's an excerpt from my 2007 interview with Cato's John Tanner:

Tanner notes that the [Clinton] plan is "a lot like Massachusetts" - referring to Romney's Commonwealth Care- which is not surprising since the same guru, MIT's Jonathan Gruber advised Clinton, Obama and Romney in developing health care plans that eschew a single payer system but regulate insurance and require government bureaucracy to enforce its edicts. Tanner notes that Clinton has tried to mask the degree of government control by repeatedly referring to "choice" and declaring that anyone can keep their current plan if they like. This, he says, is simply false. By requiring individuals to maintain their own insurance Hillary (like similar Democratic plans) must then set out "a minimum definition of what insurance is." Therefore, if your current plan doesn't measure up to Clinton's minimum guidelines "you do have to give it up."

What is wrong with requiring individuals to carry their own insurance? Tanner notes there is a certain appeal to individual responsibility in that "if you get hit by a bus we have to subsidize you" when you go into an emergency room. However, he notes that uncompensated costs are generally inflated by health care experts and represent only about 2 ½% of healthcare costs. Tanner contends that this problem hardly justifies the drawbacks of an individual mandated insurance system. . . .

Tanner is critical of Republicans like Romney in Massachusetts and Arnold Schwarzenegger who "conceded this argument that you must cover everyone" which inevitably led to individual mandate based plans. Tanner says that conservative should focus on bringing down costs and improving quality through market based reforms including which move away from employer based insurance coverage to individually purchased insurance.

This is not merely a think tank debate. Conservatives, from Tea Partyers to the speaker of the House, have argued not only about the constitutionality of ObamaCare, but about the infringement on personal freedom that it entails. That is applicable whether the state or the federal government is forcing you to buy insurance.

David Axelrod got this one correct when he talked to USA Today about potential 2012 matchups:

"We got some good ideas from him," said Axelrod in a clear effort to highlight Romney's involvement with implementing a law similar to that which is so disliked among Republicans nationwide.

This is true, since both relied on the same health-care guru.

Then there are the practical arguments against RomneyCare, many of which are identical to the points Rep. Paul Ryan (R-Wisc.) and others have raised in opposition to ObamaCare. Grace Marie-Turner argued in the Wall Street Journal last March:

While Massachusetts' uninsured rate has dropped to around 3%, 68% of the newly insured since 2006 receive coverage that is heavily or completely subsidized by taxpayers. While Mr. Romney insisted that everyone should pay something for coverage, that is not the way his plan has turned out. More than half of the 408,000 newly insured residents pay nothing, according to a February 2010 report by the Massachusetts Health Connector, the state's insurance exchange.

Another 140,000 remained uninsured in 2008 and were either assessed a penalty or exempted from the individual mandate because the state deemed they couldn't afford the premiums.

Mr. Romney's promise that getting everyone covered would force costs down also is far from being realized. One third of state residents polled by Harvard researchers in a study published in "Health Affairs" in 2008 said that their health costs had gone up as a result of the 2006 reforms. A typical family of four today faces total annual health costs of nearly $13,788, the highest in the country. Per capita spending is 27% higher than the national average.

She also was farsighted in identifying a further problem for Romney:

One of the challengers Mr. Romney could face in 2012 is Gov. Mitch Daniels of Indiana. Mr. Daniels went in a very different direction in tackling the problem of the uninsured. He created a program targeted to lower-income uninsured people who weren't eligible for Medicaid or employer insurance. Mr. Daniels's Healthy Indiana program has a fixed budget and relies on shared responsibility between the newly insured and the government in managing health spending.

Romney has many assets as a candidate, but he needs to come up with a better response to critics who will drill down on his greatest liability. I have thought what that might be. I've asked those supportive of his candidacy: What's the defense for RomneyCare? I've yet to hear a satisfying answer. But it is early. Perhaps Romney and his team will come up with something. But first they need to drop their legalistic argument.

By Jennifer Rubin  | February 1, 2011; 11:01 AM ET
Categories:  2012 campaign, Mitt Romney  
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Repent, Romney, repent! It's your only hope.

Posted by: WashingtonDame | February 1, 2011 11:23 AM | Report abuse

How about . . .
We tried it. It didn't work.

Posted by: ProfessorHardy | February 1, 2011 11:35 AM | Report abuse

Romney is a brilliant, extremely accomplished man, but RomneyCare is a deal-breaker.

Posted by: eoniii | February 1, 2011 11:55 AM | Report abuse

The flip flop issue is a real problem for Romney. He was burned on it respecting abortion last time around and his hesitation in repudiating RomneyCaare may result in part from his desire to avoid it this time. Even if he were to do so at this point, however, he flip flop would be even more pronounced and exacerbate that problem.

My greater concern with Romney, however, is and has been since his first candidacy, his initial implementation of RomneyCare. As Jen suggests at a minimum this signified an acceptance of the left wing imperative for "mandatory universal coverage". He could say, ostensibly that he opposes Obamacare not only because its UC but also because of the abject failure of his similar program in Massachussetts. Yetthe critique of OC, RC is not new. It was mooted at the time RomneyCare was implemented and the current results of the latter were anticipated. That he went along with it anyway suggests very poor policy judgement and creates real doubt about his fortitude and commitment to actual repeal if elected. Even a Republican President with a Republican Senate majority will need to demonstrate such fortitude, commitment and supplement it with considerable rhetorical skill to get a full repeal. These considerations make Romney's candidacy problematic in the extreme.

Further, conservatives have some reason to doubt Romney on a number of fronts and his opposition to the recent tax deal is another such reason. Its not that there was not an entirely plausible - though for me ultimately unconvincing under the extant circumstance - argument against the deal but that it is inconceivable that someone who so recently supported a RomneyCare would oppose such a deal. It seems to have been a particularly egregious pander.

A couple of days ago Jen wrote about the the importance of principled, coherent and determined opposition to Obamanomics for the Republican nominee and its difficult to see how Romney will be able to present himself as an effective exponent of such opposition.

Posted by: cavalier4 | February 1, 2011 11:59 AM | Report abuse

I agree with WashingtonDame and think that Romney's only shot is to repent - which of course opens him up to the flipflop charge that cavalier mentions. The health care issue is looking to be one of the biggest issues in 2012. If not THE biggest. Romney can't hope to defend RomneyCare as he has and expect to get out of the Republican field. In my opinion, he has too much baggage to emerge as the Republican nominee.

Posted by: RitchieEmmons | February 1, 2011 12:22 PM | Report abuse

Romney-care will turn off the Tea-party anti-government rightwingers who only like no taxes, no government types. His religion will turn off the southern evangelicals who only get excited when a candidate talks out loud about their own peculiar brand of religious fantasy. The middle of the road Republicans don't like his record as Governor of Massachusetts and object to his random pandering to the extremists on the right.

He does have good hair. that's got to count for something.

Posted by: thebobbob | February 1, 2011 1:27 PM | Report abuse

I don't know how many times I am going to have to post this, but here it is again...

"Thank you Glenn Beck for not researching your comments on the Massachusetts Health Care system before you opened your mouth." The truth is that Mitt Romney, then Governor of Massachusetts, line-item vetoed...EVERY...SINGLE...THING that we all hate about the system up there. It was the democrat controlled state house and state senate that overroad those vetos to put back the things we all hate.

Thus, the democrats' in Washington...who know that Romney is the only republican that can beat Obama, and know that the health care legislation that they put forth and Obama not what the people want...are using this to hit Romney over the head so that they can run against Palin or some other republican that is much easier to beat.

However, what the Democrats should be saying is, "We followed OUR OWN PARTY'S PLAN in Massachusetts...(Remember that it was the democrats' in Massachusetts that overroad Romney's Vetos)...when we came up with the plan for the entire nation...called Obamacare.

Mitt must work to overcome the problem with this plan...but he shouldn't have had to in the first place.

I don't care what party your from...or how you believe politically (conservative or liberal)...but just do all the research first...(hear me Glenn Beck)...before you open your mouth.

If you all don't believe me...look up the bill that Romney signed...and see that there are lines through the things we hate (those are called "line-item vetos), and then look at the bill after the Democrats in the State House and Senate overroad those vetos. If your unwilling to look it up and do your own research...then either your a bigot, because you hate Mormons and your looking for an excuse to keep Romney from winning, or your unwilling to listen to the facts. Which is it?

Posted by: haubrick4 | February 1, 2011 1:35 PM | Report abuse

As a lifelong resident of Massachusetts, I have had a bird's eye view of both Mitt Romney and Romneycare. The cost curve pushed upward in both insurance premiums and demand for higher state subsidies. The emphasis on coverage has caused longer waits for primary care physicians and appointments.

Romney had a 90/10 Democrat to Republican legislature. If he had a concern about cost curves he should have veto'd the bill, had it subsequently overturned, then had a face saving signing ceremony with Ted Kennedy and the state Democratic Grand Poubas. He did not. He was even more enthusiastic than the Democrats themselves, and believed he would translate Romneycare on becoming a great Presidential issue. On that point he could not have made a greater miscalculation.

Posted by: TheStatistQuo | February 1, 2011 1:46 PM | Report abuse


I think it is so need and I agree with the topics. Romney will be savaged because he adopted a plan that made ObamaCare and the notion of compulsory insurance popular.

Click the link and see exclusive video footage.

Posted by: webcontent2011 | February 1, 2011 3:11 PM | Report abuse

I am agree with this topics. It's a good idea for health like guru.

Click the link and see exclusive video footage.

Posted by: webcontent2011 | February 1, 2011 3:21 PM | Report abuse

Just an excuse... basically he is un-electable because of his magic underwear.

Posted by: WmLaney | February 1, 2011 4:55 PM | Report abuse

I'm saddened to say that I agree with you, Ms. Rubin. Mr. Romney is in many ways the best candidate to turn around this failing enterprise which is our government. I do not believe that he would try to defend or rescue Obamacare, but as long as he defends the Massachusetts plan, he'll be unable to win conservative support.

Are we back to blackballing citizens from office for their religion, Mr. Laney? I call that bigotry.

Posted by: athorpe | February 1, 2011 11:32 PM | Report abuse

Romney has missed the last train out of Dodge on this one. As others have rightly pointed out, the plan known as Romneycare was going to be shoved through by the Democrat controlled legislature; Mitt should have long since claimed he knew it was a bad plan, but it was the best he could get from that lot, he tried to do everything he could to ameliorate the damage and it still stinks. Which is why he knows now better than to let Liberals write bills. But he needed to be making that argument in 2007, not 2011.

Posted by: RES_ | February 1, 2011 11:49 PM | Report abuse


Well, Romney would be a quite dramatic improvement on Obama and would is numerous way an extremely impressive man and political figure. RC notwithstanding, I'm quite sure he'd go full speed with repeal if he won with 55% and had 60 Republican Senators. Whether he could or would do it with a 51% win and 52 Republicans in the Senate is another matter all together.


He's still not doing it.

Posted by: cavalier4 | February 2, 2011 12:30 AM | Report abuse

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