Outside the Beltway

Mitt Romney Tries To Thread The ObamaCare/RomneyCare Needle

Mitt Romney began his effort to confront what is likely to be his biggest political liability in the 2012 campaign.

Doug Mataconis · Friday, May 13, 2011 · 7 comments

Mitt Romney tried to confront what is likely to be his biggest political liability in the race for the 2012 GOP nomination, the health care plan that he signed into law as Governor of Massachusetts:

ANN ARBOR, Mich. — Former Gov. Mitt Romney of Massachusetts came here on Thursday to address the biggest threat to his nascent presidential campaign, defending core elements of the health care law enacted in his home state five years ago even as he tried to reassure conservatives that he would work to roll back the similar national overhaul President Obama signed into law last year.

It was the start of a treacherous balancing act for Mr. Romney, one that forced him to confront not just the complexities and passions surrounding health policy but also questions about his willingness to stick to his principles under political pressure.

Speaking before a group of doctors, health policy experts and local officials at the University of Michigan medical complex, he embraced the aspect of the Massachusetts law most criticized among Republicans, the mandate that individuals buy insurance. He said it was necessary, given the needs of his state at the time.

But Mr. Romney said that if he were president he would seek to repeal the new national health care law with its similar mandate, arguing that it was inappropriate for the federal government to prescribe such a sweeping measure for states.

“Our plan was a state solution to a state problem,” he said while walking his audience through a corporate-style slide presentation, “and his was a power grab by the federal government to put in place a one-size-fits-all plan across the nation.”

Mr. Romney is in an especially tough political box. To fully repudiate the Massachusetts bill he signed into law might give fuel to those who have already accused him of being an ideological flip-flopper, given that he has changed his stances on abortion and immigration to more conservative positions. To defend the health plan too energetically might further alienate a huge group of Republican voters.

He sought to defuse the problem to some degree by addressing it frankly and acknowledging the difficult politics of the situation for him. Addressing calls from conservatives to apologize for the law, Mr. Romney said he was aware that some believe “that would be good for me politically.” But, he said, “There’s only one problem with that: it wouldn’t be honest.”

For a politician who is still dealing with the charge from the 2008 campaign that he’s a flip-flopper who changes positions based on the political winds, there is, I suppose, some value in sticking by your previous actions even when in the face of overwhelming opposition. Even before yesterday’s speech, Romney was under fire for being out of touch with what The Wall Street Journal called the real issues at stake in the health care debate:

Like Mr. Obama’s reform, RomneyCare was predicated on the illusion that insurance would be less expensive if everyone were covered. Even if this theory were plausible, it is not true in Massachusetts today. So as costs continue to climb, Mr. Romney’s Democratic successor now wants to create a central board of political appointees to decide how much doctors and hospitals should be paid for thousands of services.

The Romney camp blames all this on a failure of execution, not of design. But by this cause-and-effect standard, Mr. Romney could push someone out of an airplane and blame the ground for killing him. Once government takes on the direct or implicit liability of paying for health care for everyone, the only way to afford it is through raw political control of all medical decisions.

Mr. Romney’s refusal to appreciate this, then and now, reveals a troubling failure of political understanding and principle. The raucous national debate over health care isn’t about this or that technocratic detail, but about basic differences over the role of government. In the current debate over Medicare, Paul Ryan wants to reduce costs by encouraging private competition while Mr. Obama wants the cost-cutting done by a body of unelected experts like the one emerging in Massachusetts.

Mr. Romney’s fundamental error was assuming that such differences could be parsed by his own group of experts, as if government can be run by management consultants. He still seems to believe he somehow squared the views of Jonathan Gruber, the MIT evange

list for ObamaCare, with those of the Heritage Foundation.

It’s a vast change for Romney who, after it became clear that John McCain was the 2008 frontrunner, quickly became the candidate that most mainstream conservatives rallied around even as they ignored many of his changes in position on hot button issues like abortion. This time around, though, the passion with which the right has taken up the opposition to the Affordable Care Act makes Romney anathema to the hard-core right. Judging from the initial reaction to his speech, it doesn’t seems like he’s done much to solve that problem.

Following  up on its pre-speech editorial, The Wall Street Journal wasn’t impressed at all:

F. Scott Fitzgerald famously wrote that “The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function.” If we may judge by his health-care speech at the University of Michigan yesterday, Mitt Romney is a very smart man.

The likely Republican Presidential candidate fulfilled the White House’s fondest wishes, defending the mandate-subsidize-overregulate program he enacted as Massachusetts Governor in 2006 even as he denounced President Obama’s national reprise. He then proposed his own U.S. reform that is sensible and might do so some actual good, but which also runs against the other two plans. These are unbridgeable policy and philosophical differences, though Mr. Romney is nonetheless trying to leap over them like Evel Knievel heading for the Snake River Canyon.

(…)

The political tragedy is that Mr. Romney could have emerged as one of ObamaCare’s most potent critics had he made different choices two years ago amid one of the country’s most consequential debates in generations. He might have said that as Governor he made a good-faith effort to resolve some of health care’s long-running dysfunctions, but that it hadn’t worked out and that’s why state experiments are valuable.

Reason’s Peter Suderman notes that most of Romney’s defense of the Massachusetts plan could also be used to defend the Affordable Care Act:

ObamaCare, which includes a health insurance mandate, is a near carbon copy of RomneyCare: a hefty Medicaid expansion coupled to equally large middle-class insurance subsidies, new regulations that all but turn health insurance into a public utility, and an individual mandate to buy a private insurance plan. Indeed, the same Obama administration that Romney accused of being fundamentally anti-American has on multiple occasions explicitly cited the plan that Romney signed into law as the direct model for their plan.

(…)

That Romney would rely on the same mistaken defenses of the mandate as Obama may seem surprising, but in the context of this deeply confused speech, it’s really not: Romney may want us to believe that he hates ObamaCare, but his speech resembled nothing so much as a defense of it. If anything, he made the case better than Obama did. And that’s why, in the end, the same criticisms Romney lobbed at ObamaCare apply to his own plan. If there’s a difference, it’s that Romney doesn’t distrust states. Instead, he distrusts individuals. It’s a distinction, to be sure, but not one that makes RomneyCare any more appealing.

National Review’s Stanley Kurtz doesn’t see how Romney can survive this:

Let’s say Romney’s candidacy survives for now. The idea that the RomneyCare issue fades away with time seems totally implausible. Every debate from here on out is bound to feature all the candidates taking pot shots at RomneyCare. Far from fading away, RomneyCare is going to become the central issue of the nomination campaign-the surest way to take down a major rival and establish a challenger’s conservative credentials to boot. How is Romney going to overcome that? And even if he does, how is he going to unite the party?

Maybe if he handles himself well, serving as the butt of every other candidate’s attack will actually elevate Romney. That might work with an issue on which conservatives are genuinely split. But RomneyCare? As we saw today, a courageous defense of RomneyCare only gives ammunition to Obama and the Democrats. How can Romney survive that? It’s tough to see how. Am I missing something?

Of course as Allahpundit points out, there really isn’t much else that Romney could have said that would’ve come across as believable:

No one would have believed him had he apologized so there was no sense in doing it. On the contrary, if I were advising him, I’d tell him to go on the attack and make his opponents be as specific as possible in what they’d do differently. The more he can discredit their plans as unworkable, the more he can reframe RomneyCare as the best choice from a very bad set of health-care policy options. In fact, if he’s feeling extra cheeky, he could use the public’s ruinous love affair with Medicare to his advantage. Under RomneyCare, the state forces you to buy a product from a third party; under Medicare, the state forces you to buy the same product from the state. It simply calls it a tax instead of a mandate, and instead of granting you coverage immediately, it shafts you until you’re 65. Do Pawlenty, Gingrich, et al. also oppose the “mandated” premiums known as FICA? I’m not sure Romney wants to go the Mediscare route since it’ll make fiscal cons even angrier at him than they are now, but if he gets desperate enough, look out.

Despite all of this, of course, Romney remains at or near the top of all of the polls of the 2008 GOP field, and there are increasing signs that the three people bunched with him at the top of those polls — Mike Huckabee, Sarah Palin, and Donald Trump — aren’t going to run after all. If that happens, then it will be Romney at the top with candidates like Tim Pawlenty and (possibly) Mitch Daniels trying to get there, and then a field of gadflies and candidates who simply have no chance of winning, led by Ron Paul. Considering that he is one of the few candidates performing well against the President in a head-to-head poll, Romney would have a fairly good argument to make to GOP primary voters.

Romney’s real problem are the activists in the GOP base. Thanks to RomneyCare, they’ve pretty much soured on him at this point and every other candidate in the race is likely to be attacking him because of it. Can he survive? You can never say never in politics, especially with a candidate with an essentially unlimited purse, but it’s going to be incredibly difficult in the current political environment. More importantly, if this speech marks the tone that Romney will take on the campaign trail when the RomneyCare question comes up, I don’t think its going to be good enough.