I lived in Massachusetts in 2002, and Mitt Romney is the only Republican I’ve ever voted for.
Mostly, I don’t even regret it; he was a good governor and his opponent was lousy. But since winning that election, he’s become known primarily for two things—flip-flopping, and his state-level universal health-care program. It’s a program that sets up a system that’s quite similar to what’s envisioned by the Patient Protection and Affordable Care Act signed into law Tuesday by President Barack Obama. And that means that the two pillars of Romney’s political career—the health-care plan and his unswerving determination to pander to the conservative base—have come into sharp, almost embarrassing, tension.
Thus, Monday morning he penned a blistering item for National Review Online condemning Obama as having “betrayed his oath to the nation.” The three paragraphs are full of blistering insults about “raw partisanship"; “the lowest denominator of incumbent power,” “historic usurpation of the legislative process,” and “fraudulent accounting.”
The core of Obama’s plan is exactly the same as the core of Romney’s plan. In an ideal world, Romney would just come out and say that.
“The act should be repealed,” he writes, “that campaign begins today.”
• Tunku Varadarajan: The Conservative the Right Loves to Hate But what did Obama actually do that Romney finds so horrible? What did Obama do that Romney hasn’t already done? Well, according to Romney, the evil of Obamacare is that it raises taxes, cuts Medicare, installs price controls, and puts a new federal bureaucracy in charge of health care. Romney’s Commonwealth Care, of course, put a new state bureaucracy in charge of things, so that’s a real difference. It also raised taxes (to be fair, over Romney’s objection) but mostly was financed out of federal grant money designed to reimburse hospitals for unpaid-for care. This revenue source hasn’t really proven adequate, and the state’s been having some trouble dealing with that since Romney left. When Obama takes a version of Romneycare nationwide, however, their problem will largely be solved and Romney’s legacy intact.
It would be intact, that is, if Romney wasn’t committed to the proposition that the bill is horrible and in need of repeal.
To be clear, the two plans are essentially the same. Both start from the premise that reasonably prosperous individuals should be able to take their own money and use it to buy health-insurance coverage without depending on an employer to do it for them. That means creating a regulated individual insurance market that works. To do that, you need to eliminate insurance companies’ power to discriminate against people with pre-existing medical conditions. Then to ensure that the risk is spread fairly, you need to make sure that everyone signs up for insurance coverage. Last, to ensure that everyone can sign up for insurance coverage, you need to provide subsidies so that people can afford the premiums.
There’s a lot more in Obama’s bill, from efforts to boost public health with menu labels and promotion of active lifestyles, and plenty for people with all different kinds of ideologies to quibble over. But that’s the core of Obama’s plan, and it’s exactly the same as the core of Romney’s plan.
In an ideal world, Romney would just come out and say that, and advocate that conservatives should shift around the edges to make the plan more to their liking—laxer regulations on what constitutes insurance, a tax burden that falls less heavily on the rich, etc.
After all, Texas GOP Sen. John Cornyn is already admitting that he doesn’t actually want to repeal all of Obamacare, noting that “there is non-controversial stuff here like the pre-existing conditions and exclusion and those sorts of things.” The problem is that once you admit that this is a good idea, you commit yourself to the whole package. National Review’s Ramesh Ponnuru dubbed Cornyn’s good sense ”Cornyn’s Folly” and then explained that unless the pre-existing condition element is “modified substantially, the individual mandate has to stay, too—and therefore so do the subsidies and the minimum-benefits regs. Without perhaps realizing it, Cornyn has come out for tinkering at the edges of Obamacare.” Cornyn has, in other words, inadvertently made the argument for Romneycare. It’s a position that makes sense on the merits, and makes sense politically for a GOP that surely doesn’t want to charge against what Cornyn dubs the “non-controversial stuff.”
But to get out of the current repealer cul-de-sac, Republicans need a leader who’s capable of framing the Obama’s core ideas as basically sensible. In a decent world, that leader would be Romney. Instead, he’s busy embarrassing himself and running away from his legacy.
Matthew Yglesias is a fellow at the Center for American Progress Action Fund. He is the author of Heads in the Sand: How the Republicans Screw Up Foreign Policy and Foreign Policy Screws Up the Democrats.