With Mitt Romney set to announce his candidacy later this week, the Boston Globe’s Brian C. Mooney is publishing a series about Massachusetts’ groundbreaking health care reform law. This first piece explains how the idea was hatched — Romney was inspired by Staples founder Thomas G. Stemberg — made its way through the Democratically controlled legislature, was embraced by business groups, and eventually signed into law by Romney on April 12, 2006.
Mooney reports that Romney’s political advisers weren’t too keen on Romney — who was even then expected to just serve one term as governor before making a run for the presidency — embracing a traditionally liberal issue, but ultimately settled on what they and Romney saw as a fairly conservative approach: encouraging individuals to take personal responsibility for their health care costs by buying insurance coverage through exchanges:
The first step was finding a way to make the 37 percent who could afford insurance but didn’t have it buy in. Romney’s answer came in part from an administration consultant, Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology and a leading adviser, usually to Democrats, on health care reform issues….“What my numbers showed is that it made enormous sense to have the individual mandate,’’ Gruber recalled. Without it, the money available for new insurance subsidies would cover half as many people.
“Romney was intrigued with it because of the personal responsibility aspects,’’ said Gruber, recalling his one meeting with the governor. And if younger, healthier people were coaxed into the system, the cost of premiums would moderate for a larger population.
“There was the moral ‘free rider’ argument, but the numbers said it was financially feasible, too,’’ Gruber said.
There were other new elements. Murphy had a “eureka moment’’ after a meeting with officials of the conservative Heritage Foundation. He was raving about their concept of an “exchange’’ to provide one-stop shopping for small businesses and individuals seeking health coverage from commercial insurers. This would also prove a forerunner to Obama’s national plan.
Today, conservatives see these ideas as unconstitutional conspiracies to usurp individual freedoms, but back in 2005, America’s greatest liberal Senator needed some convincing. In fact, up to that point, the late Ted Kennedy had opposed the mandate and only came to support the provision as part of a larger reform package. “I’ve never been one for individual mandates in the past, but I do think that the way this has been proposed, in that everybody will do their part, that’s a compromise,’’ Kennedy said in December 2005. “I can buy into that.” (Incidentally, current Massachusetts Governor Deval Patrick experienced a similar conversion).
Kennedy bought it and so did Romney, who came to see the mandate as the “ultimate conservative” solution. “It’s the ultimate conservative idea, which is that people have responsibility for their own care, and they don’t look to government to take of them if they can afford to take care of themselves,” he told the Boston Globe in June 2005. “I think it appeals to people on both sides of the aisle: insurance for everyone without a tax increase.” He even went so far as to suggest that it can be applied to the nation as a whole — although he quickly walked back these statements and proposed an altogether different health care proposal during his 2008 presidential campaign.
Mooney’s whole piece is worth reading, if only to remember just how distorted the political health care rhetoric has become.