Right off the top, Romney delivered one of the tightest lines of his campaign: “What the court did not do on its last day in session, I will do on my first day if elected president of the United States. And that is, I will act to repeal Obamacare.”
It went downhill from there. Careful to repeat the word “Obamacare” some 18 times throughout his brief remarks, Romney was careless with the facts in his rebuttal.
Maybe it is the inherent awkwardness of the fact that Romney’s major governmental accomplishment is an individual mandate-driven health-care plan, but his response was fear- rather than fact-based. This is consistent with the “attack and distract” strategy he has deployed when it comes to policy during his general-election campaign.
At least three claims Romney made in his speech deserve particular scrutiny:
First, Medi-scare: “Obamacare cuts Medicare—cuts Medicare by approximately $500 billion.” Medi-scare is a classic fear-mongering technique usually deployed by Democrats against Republicans, most vividly by the television ad depicting Paul Ryan pushing grandma off a cliff. The Affordable Care Act does try to rein in Medicare costs by slowing the rate of growth and ending the Medicare Advantage program, but that should be consistent with Republican values of increasing efficiency and reducing waste, fraud, and abuse. Moreover, the Ryan plan, which Romney endorses, would cut at least that amount but redirect the savings to reducing the deficit. Playing the Medi-scare card is low and discredited, but hearing it from a Republican nominee is more than a bit surreal.
If you’re actually interested in governing as well as in winning, the impulse to scream “repeal” has to be followed by a plan to “replace.”
Second, the deficit-bomb card: “Obamacare adds trillions to our deficits and to our national debt.” Deficit and debt make up one of the Obama administration’s greatest weaknesses among independents. It is ultimately a form of generational theft. But the nonpartisan Congressional Budget Office scored the ACA and determined that it actually would reduce the deficit by more than $100 billion in the next 10 years. I agree that government estimates almost always lowball the eventual costs, especially in the realm of entitlements, but the CBO scoring can’t just be ignored in favor of a partisan narrative. And of course, one of the arguments for health-care reform in general is that it will reduce costs in the long run with our aging population and improve American industry competitiveness.
Third, “Obamacare puts the federal government between you and your doctor.” This is always the emotional kicker, directly connected to the oft-repeated talking point that the ACA is a “government takeover of health care.” That would be scary indeed, but keep in mind the liberal critique of the Obama health-care reform is that it is too insurance-industry-friendly. After all, there was never even a public option, let alone the single-payer fantasy. The current system is far from perfect and far from free market. I happen to believe that third-party-payer problem is a big part of what drives up costs. But the Big Brother dystopian fantasy captured by this instant classic in the paranoid style typed by Ben Shapiro—“This is the greatest destruction of individual liberty since Dred Scott. This is the end of America as we know it. No exaggeration.”—is just that. A paranoid exaggeration.
Other specters offered up by Romney include the estimate that an unspecified 20 million Americans will lose health insurance under the ACA and that the law represents a $500 million tax increase. (Keep in mind that the penalty/tax would only be paid by people who refuse to buy health insurance and therefore continue to freeload off the rest of us when they go to the emergency room for urgent care.)
Of course, this law will not solve all the problems in American medicine, and it almost certainly will create some new ones. But aspects of the bill—like coverage of children up to age 26 and stopping insurance companies from denying people insurance due to preexisting conditions—are justly popular and improvements over the status quo.
Republicans beyond Romney were also quick to hoist the “repeal” banner—calling a vote in the House on July 9. They believe this ruling could be a political benefit in terms of getting out the vote in November. The Romney campaign claimed that they raised more than a million dollars online in the hours after the decision. This could be the boost the Romney camp needs for the Tea Party to overlook the ironic inconsistency of the GOP nominee on this core issue. Republicans may very well get a base boost from this decision, reflected in both dollars and votes.
But if you’re actually interested in governing as well as in winning, the impulse to scream “repeal” has to be followed by a plan to “replace.” There are plenty of good Republican policy proposals on how to reduce costs and increase individual choice in health care, but Mitt Romney still needs to decide which specific policy plan he would enact. Unclaimed ideas range from medical-malpractice reform to expanding health savings accounts to allowing insurance purchases across state lines to generic-drug importation. There might even be some degree of bipartisan support for a few these reforms. Then again, the individual mandate once had bipartisan support as well.
Bottom line: simply making up stats for the sake of soundbites is beneath a serious nominee. There is an obligation to propose as well as oppose if you are running for president.