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April 20, 2010

Romney On Health Care

First, let me follow up on my post yesterday on a blog report that Romney said he opposed repealing the individual mandate and the ban on pre-existing exclusions. Romney’s spokesman contacted Politico.com

“UPDATE: Fehrnstrom add that the mandate "should be repealed."

In a timely coincidence, Newsweek (via Hot Air’s Headlines) has an interview with Romney all about health care. I think it nicely encapsulates the challenges he will face on this issue in the Republican primary and should he be the nominee, the general election.

(Newsweek) So you would say the structure you put in place in Massachusetts—exchanges, subsidies, and an individual mandate—is essentially a conservative structure?

(Mitt Romney) What I'm saying is that the right place for health reform is at the state level. In a federalist system we don't need the federal government imposing its will on the individual states. The federalist, conservative approach is for states to solve their problems as they feel best. We solved it in a way that worked in our state on a bipartisan basis. Out of 200 legislators, only two voted no. And other states can solve it in the way that they feel best.

(NW)Would you have ever expected, when you were putting the bill together in Massachusetts, that five years down the line members of your own party would be comparing what you did to socialism? Does the reaction surprise you?

(MR)Well, the whole health-care debate has become highly politicized. During the 2008 election, [out of] the 14 debates, [in] 12 of them, health care was raised, and I described our Massachusetts plan and defended that plan. There was very little energy or passion around that issue. But because of Obamacare, it's been politicized.

(NW)How so?

(MR)I think that some Republicans believe that what we did in Massachusetts has to be decried in order to justify their criticism of Obamacare. But in my view, they're wrong. We're better off pointing out those things about Obamacare that we don't like instead.

(NW)What don't you like?

(MR)What we don't like is the intrusion of the federal government on the rights of states. We don't like raising taxes. We don't like the cuts in Medicare Advantage. And we don't like the price controls.

There’s quite a bit more and it’s well worth the time to read it all. Like him or not (and I tend to like Romeny more than some), he's going to be a factor in the 2012 Republican primary and this is going to be a major issue for him to deal with, it's worth reading his version of the story.

Federalism is a concept near and dear to my heart (and I imagine many of you as well). Problem is, it’s not exactly one most people are familiar with and it doesn't represent a ‘get out of jail free card’ for Romney on the matter. Yes, the states should be the laboratories of democracy but the success or failure of those experiments are going to be part of the judgment voters make about a governor when they run for President. To simply say, “hey, let’s not attack what I created in my state, let’s only talk about Obama’s plan” isn’t going to cut it. The media won't and his opponents sure as hell aren't going to give him a pass on it and focus only on Obama.

While I think (hope) ObamaCare is going to be a central issue in ’12, it won’t be the only one. A federalist defense of Massachusetts health care system and Romney’s central role in creating it, is one that is going to require a fair bit of nuanced thinking on the part of most voters. Presidential elections are often decided on the broad strokes and there simply isn’t a broad stroke differentiation to be made between the two plans. There may be some wonkish differences between Romney’s scheme of mandates, exchanges and subsidies when compared to Obama’s scheme of mandates, exchanges and subsidies but most people aren’t going to see them. When Romney says what he supported as Governor is different than what he’d support as President, he is asking voters to take a pretty big leap.

The very need for this type of interview, which Romney is going to have to give thousands of times in the next few years, illustrates his biggest problem…it’s almost impossible for him to talk about the faults of ObamaCare without first spending 20 minutes explaining and defending the Massachusetts plan. And then when he does get around to attacking ObamaCare he will be forced to go over it all again, point by point. Add to that something not covered in the interview…the Mass plan has been a disaster (Romney argues that the Democrats screwed it up by overriding his vetoes. More layers of nuance he has to defend on and voters have to buy into.) and you see what he is up against from a message standpoint.

The biggest hurdle for Romney is these aren’t factual questions (and getting people to believe those answers can be hard enough). Fairly or not, correctly or not, there are simply going to be a lot of people who will never accept his distinctions and explanations. People are going to make value judgments on Romney’s record on health care. Unfortunately for him, at the moment it seems people favor those who value repeal and who never bought into this type of scheme in the first place.


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posted by DrewM. at 11:42 AM

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