On Twitter, Politico's Ben Smith asks,
"At this
point, how is current proposal substantially different from
Romneycare?"
The answer is, it ain't.
Here's how Mitt Romney
explained the differences between the health care bill he
signed in Massachusetts in 2006, and Obamacare, in a CNN
interview earlier this month:
(T)here's an important difference between what we did and what
President Barack Obama is proposing. Number one, we solved our
problem at the state level. Let states deal with the problem of
uninsured individuals.
And, number two, we have no public option. There's no
government option. And what's primarily wrong with the
president's plan is that he wants to get the federal government
into the health insurance business. It's going to require
massive subsidies, a trillion dollars of costs down the road.
Though we haven't seen the current bill yet, if reports are
accurate, it does not contain a public option or Medicare
expansion. What remains is a Medicaid expansion, a mandate
forcing individuals to purchase insurance or pay a tax, and
sliding scale subsidies for individuals to purchase
government-designed insurance policies on new government-run
exchanges -- and those elements formed the core of Romneycare.
So now, if Obamacare passes, Romney will be left telling angry
primary voters that the only real difference between the two
plans is that he implemented his policies at the state level,
while Obama did it through the federal government. Sure, it's
clearly worse if the federal government is implementing bad
policies, but it's hard to see how such an argument would pass
muster with anybody but those who are already ardent Romney
supporters. It's sort of like saying, "As governor, I raised
state income taxes, but the thought of raising federal income
taxes -- that's an outrage!"
UPDATE: Romney spokesman Eric Fehrnstrom
emails Ben Smith:
There are some similarities. For instance, the concept of the
"exchange" where people can shop for affordable health plans
was pioneered in Massachachusetts. But Mitt's Romney's health
care reforms are different in several important respects.
First, the bill signed by Governor Romney did not raise taxes.
Second, its focus was on strengthening the private insurance
market, and I don't think anyone believes that Democrats have
given up on their dream of a public option. And finally,
Governor Romney believes states should be free to come up with
their own approach instead of having Washington create a
"one-size-fits-all" solution for the entire country.
This answer is problematic on several levels. For one thing,
while the Romney camp would like to argue that the bill he signed
did not raise taxes, in actuality, it did include a mandate that
individuals purchase insurance or pay a penalty. In arguing
against Obamacare, conservatives have described the mandate as a
middle class tax hike. Republican candidates will spend all of
2010 describing it as such, and if anybody else were running
against Obama in 2012, it would be used to argue that he violated
his pledge to not raise the taxes of those making under $250,000.
If Romney wants to spend the Republican presidential primary
siding with Democrats and the Obama administration in arguing
that the individual mandate isn't a tax, I'm sure his opponents
will be thrilled. Furthermore, this doesn't even take into
account the subsequent tax hikes signed by Romney's successor to
help pay for the ongoing costs of the health care bill, such as
last year's cigarette tax increase.
Fehrnstrom argues that the Romney plan was about strengthening
private insurance, and yet, just as the government dictates the
design of private health care policies offered on the exchanges
created by the Senate bill, so too, does Romneycare. In
Massachusetts, the Commonwealth Health Insurance Connector's
Board approves plans offered in the exchange, and determines what
counts as "Minimum
Creditable Coverage" needed to comply with the insurance
mandate.
I responded to the whole attempt to differentiate between federal
and state policy above, but as Smith
notes, "in the end, Romney does seem to have helped set the
model for the national plan."
