It’s not exactly Sophie’s choice, but you have to admit there’s something a little poignant about Mitt Romney’s dilemma. To win the GOP nomination for president, he’s being forced by Tea Party types to distance himself from his greatest public achievement – making Massachusetts the first state in the union to achieve universal health care.
To mask this abject act of self-repudiation, Romney is attacking Obamacare with unwonted ideological zeal. “Obamacare is bad law constitutionally, bad policy and it is bad for America’s families,” he assured a group of New Hampshire Republicans over the weekend. Ladling on the conservative boilerplate, he added, “The federal government isn’t the answer for running health care any more than it’s the answer for running Amtrak or the Post Office.”
The problem for Romney – as his presidential rivals gleefully keep reminding conservatives — is that Romneycare is the policy template for Obamacare. It has the same basic architecture: a menu of competing private health care options (“exchanges” in the federal law, the “Connector” in Massachusetts), public subsidies for those who need them, and an individual mandate requiring all adults to buy medical coverage. The biggest difference between the two approaches, ironically, is that Obamacare is a lot tougher on containing health care costs than the Massachusetts law.
Nationally, about 15 percent of Americans (roughly 45 million) lack basic health care coverage. Thanks to Romneycare, it’s less than three percent in Massachusetts. Romney says he’s proud of that accomplishment, but Massachusetts may have to file a paternity suit to get him to own up to the individual mandate.
Romney’s disingenuous attempts to disavow the obvious similarities between his approach and the President’s aren’t doing much for his reputation for intellectual honesty. Given conservatives’ fanatical loathing for the President’s bill – “Repealing Obamacare is the driving motivation of my life,” avers Minnesota Republican and Tea Party pin-up Rep. Michele Bachmann – Romney evidently feels the bill he hammered out with Massachusetts Democrats poses an existential threat to his candidacy.
So the GOP front-runner is seeking refuge in federalism: “One thing I would never do is to usurp the constitutional power of states with a one-size-fits-all federal takeover,” he said in New Hampshire. Let me get this straight: it’s OK for states to adopt a “socialist” approach to universal coverage, including the heartily despised individual mandate, as long as it’s not foisted on them by Washington?
Maybe Romney will find a way to persuade conservatives to forgive him for governing effectively in a deep-died blue state. But at what cost? Let’s face it, Romney is basically a pragmatic problem-solver, not a right-wing ideologue. Pretending to be otherwise will cast further doubt on his authenticity as a candidate, even if it’s the only way to run in today’s radicalized Republican Party.