Klein, however, is specifically reacting to video of an April 2010 Romney appearance that has recently resurfaced on YouTube. In the video Romney compares and contrasts the healthcare plan he signed into law as Governor of Massachusetts with the one President Barack Obama approved shortly before this appearance. He ends by saying that he wants “to eliminate some of the differences, repeal the bad, and keep the good” in ObamaCare.
What is perhaps most interesting about the video, says Klein, is that in it Romney “does something you'll never hear him do these days — note the similarities between” RomneyCare and ObamaCare.
First he points out that RomneyCare has “an incentive for people to become insured,” which he credits with getting 98 percent of Bay State residents insured. That “incentive,” of course, is the tax penalty individuals must pay for not having health insurance — in other words, the individual mandate. Given that the Romney of the video seems only to want to repeal those portions of ObamaCare that differ from his own program, it would appear that he would not repeal the individual mandate. In fact, when, around the same time as the video was taken, blogger Kavon Nikrad asked Romney point blank if he would repeal it, Romney flatly said, “No.” In addition, in a 2008 GOP presidential debate on ABC, Romney also made the case for the individual mandate, framing it as a matter of personal responsibility (as Newt Gingrich did repeatedly from 1993 until mid-2011). When Charles Gibson suggested that Romney had “backed away from mandates on a national basis,” the Governor replied, “No, no, I like mandates. The mandates work.”
Other similarities Romney mentions: the ban on denial of insurance to those with pre-existing conditions, the portability of insurance between jobs, and the inclusion of state insurance exchanges. Romney specifically states that “as a result” of the Massachusetts exchange, “the rates are much lower than they otherwise would be.” What he doesn’t mention is that “premium rates in Massachusetts are the highest in the nation and double the national average,” according to Ben Domenech, who adds: “They have increased dramatically since his plan passed — he really believes they would be even higher without it?” Moreover, Domenech says, Romney leaves out the fact that taxpayer subsidies, not the pooling of risk, are the reason so many Bay Staters have been able to obtain insurance on the exchange: “Of the 412,000 people added to the insurance rolls in Massachusetts since 2006, only 7,000 of them have coverage not subsidized in whole or in part by the taxpayers.”
Romney tries hard to contrast his healthcare plan with Obama’s, but most of his arguments are either weak or conflicting.
He gives a nod to “federalism,” correctly stating that under the Constitution the federal government has no business instituting a healthcare program while states have the freedom to do so. Shortly thereafter, however, he gripes that Obama’s plan, in contrast to his, will “cut Medicare,” yet Medicare is itself an unconstitutional federal healthcare program. Of course, since RomneyCare was instituted at the state level, there was no way it could have cut Medicare; but it does rely heavily on yet another federal healthcare program, Medicaid. Also, though he now claims that ObamaCare is a constitutional abomination, in 2007 he called RomneyCare a “model for the nation”; and, as mentioned above, he has defended the idea of a national individual mandate.
Klein, in another piece, suggests that Romney is using the federalism argument as a way to avoid the whole healthcare issue (and potentially other issues on which his policies as Governor conflict with Republican orthodoxy) and will have none of it:
Putting this aside, there’s no doubt that states should have flexibility over their own health care systems and that a state mandate does not raise the same constitutional questions as a federal one. Yet when governors run for office, we evaluate them based on the policies they enacted as state executives. If states are laboratories of democracy, governors should be judged by the experiments that they initiate. If Romney passed ambitious state tax or education reforms, he’d be running ads touting them. Similarly, he’ll no doubt be criticizing his primary opponents for their own governing records. If Romney were to get away with the federalism dodge in this instance, it would render the process of vetting presidential candidates who served as governors virtually meaningless, because they could respond to any unpopular aspect of their records simply by disavowing the same policies at the national level.
Romney claims that, unlike the federal healthcare law, the Massachusetts law “didn’t raise taxes.” But the “incentive” to purchase insurance of which Romney is so proud is a tax penalty (i.e., increase) levied on anyone who did not have health coverage during the previous year. Furthermore, while no other tax hikes may have been implemented at the time Romney signed the bill into law, the law has led “to massive cost overruns that ended up triggering future tax increases,” Klein reports.
Another difference between RomneyCare and ObamaCare is that ObamaCare contains “price controls” and RomneyCare does not, the Governor says in the video. Requiring insurers to cover those with pre-existing conditions at the same rates as healthy individuals — another feature of the Massachusetts law that Romney praises — surely qualifies as a price control. On top of that, the Bay State has since implemented more direct price controls, which, Domenech avers, are “an inevitable result of [Romney’s] law.”
At one time, then, Romney supported implementing his healthcare law at the national level. Today he says ObamaCare should be repealed in full. In between he merely called for repeal of the “worst aspects” of the law — or, as he says in the video, “repeal the bad, and keep the good.” But if “the bad” is simply those parts of ObamaCare that differ from RomneyCare, Romney would repeal very little of it.
“I don’t believe that Romney would outright veto an Obamacare repeal bill if it made it to his desk,” Klein writes. “But given the legislative obstacles involved, no bill would get that far in the first place without serious presidential leadership.” Such leadership, unfortunately, is not likely to occur in a Romney administration.