Former Massachusetts Governor Mitt Romney, who must be biting his lip to keep from announcing his bid for the White House, went on the record with Greta Van Sustren yesterday and doubled down on his support for Massachusetts health care reform and the individual mandate:

ROMNEY: [Reform in Massachusetts] is actually working pretty much as anticipated at the time it was passed….In my view, we could make the plan much more effective by doing something I proposed in the original legislation, which was to say that everybody had to pay something for their insurance, that there were no free rides, that people had to at least put some portion of the cost down for their premiums….

Actually, in our plan in Massachusetts, everybody is insured, so there’s no issue about preexisting conditions or changing jobs because you’re always able to have insurance. And the insurance companies don’t have a problem with that because we have everybody in the pool. They don’t have to worry about adverse selection where only the sick or only those with preexisting conditions go out and buy insurance. So because the entire state is insured, the system can work.

While Governor, Romney had advocated a “personal responsibility” policy that would have required individuals who failed to purchase coverage to spend up to $10,000 in the form of a bond that could be used to pay for hospital care. As my colleague Emma Sandoe explains, Romney’s plan ensured that the penalty funds were directed back into health care and provided a pretty powerful incentive to purchase coverage (rather than pay $10,000), but Democrats argued that charging everyone the same flat fee would disadvantage poorer families. To a family making $1 million a year, a $10,000 fee is only 1% of their income, while to a family making $30,000 a year, this fine is a third of their income. “The final version of the Massachusetts plan included a fee based on half of the cost of the lowest price plan either in their private insurance exchange system (Commonwealth Choice) or in their government subsidized program (Commonwealth Care) for lower income individuals.”

Romney may have some minor qualms with Massachusetts reform, but he supports its key pillars (although he disagreed with the employer requirement), which are also, as it turns out, part of the Senate health care proposal. It’s basically the Massachusetts plan with cost controls:

In recent media interviews promoting his new book, No Apology, Romney has tried to argue that the health care bill he signed differs from the Senate legislation because Massachusetts did not reduce Medicare spending. It’s a blatantly ridiculous argument, since states don’t have the ability to cut into the federally-funded Medicare program.

As Romney prepares for his second presidential campaign, he should take a page from his book and offer ‘no apology’ for supporting the kind of health care reform that Democrats are promoting. But if the previous campaign is any indication, to Romney, it’s probably still just a book title.

Last night, Sen. John McCain (R-AZ) introduced legislation preventing Democrats from using reconciliation to change Medicare spending. If adopted, the amendment would prohibit lawmakers from making changes to a program that makes up some 20% of the federal budget through the reconciliation process:

SA 3427. Mr. MCCAIN (for himself and Mr. GRAHAM) proposed an amendment to amendment SA 3336 proposed by Mr. BAUCUS to the bill H.R. 4213, to amend the Internal Revenue Code of 1986 to extend certain expiring provisions, and for other purposes; as follows:

At the appropriate place, insert the following: SEC. lll. PROTECTING MEDICARE. Section 310(g) of the Congressional Budget Act of 1974 (2 U.S.C. 641(g)) is amended by inserting before the period the following: ‘‘or to the medicare program established by title XVIII of such Act’’.

The problem isn’t just that McCain has voted for “nine out of 13 reconciliation bills that have been offered during his time in the Senate”; it’s that he has previously supported reducing Medicare spending using the reconciliation process — some of which cut Medicare by more than what the Senate health care bill is proposing:

- Balanced Budget Act of 1995: would have cut Medicare and Medicaid by a combined $452 billion over 7 years.

- Omnibus Budget Reconciliation Act of 1989: overhauled doctor payments for Medicare, included a number of other provisions designed to slow the growth in Medicare spending.

- Balanced Budget Act of 1997: cut Medicare by $115 billion over 5 years.

- Deficit Reduction Act of 2005: cut Medicare spending by $6.4 billion.

It’s difficult to see this as anything more than a message amendment designed to help McCain win a tough primary in Arizona. And it’s surprising that McCain chose to offer such a broad amendment, rather than drafting something that would have only protected the Medicare Advantage programs from reconciliation.

But, McCain can rejoice in the fact that Republicans who complain about out of control entitlement spending on one hand, but criticize Democrats for reducing wasteful Medicare spending on the other, are still taken seriously on the Sunday morning talk shows.

Several news reports are suggesting that Democrats have begun negotiating with Rep. Bart Stupak (D-MI) over his objections to the Senate’s abortion provisions (found on, as he likes to point out, on pages 2069-2078 of the Senate health care bill). To dissuade Stupak and his 10-12 anti-abortion colleagues from their paranoia about the government funding abortions, the House would have to pass a completely separate bill before accepting up the Senate legislation.

Negotiations would make sense if Stupak had some legitimate criticism about the Senate language or shared Democrats’ goal of maintaining current funding restrictions. But Stupak is not interested in protecting Hyde. Throughout the health care debate, he has relied on a fundamentally dishonest reading of the legislation because he has understood that health reform is his best opportunity to strip abortion coverage from private health insurance and now, he’s milking it for all it’s worth.

When NPR’s Michelle Block asked Stupak if he’s “really misreading what’s in the language in that Senate bill,” Stupak replied, “I don’t think I misread it” and explained that he understood the Senate abortion language because he was familiar with an earlier (and in some ways less restrictive) abortion amendment the Rep. Lois Capps (D-CA) introduced in the House:

STUPAK: Well, I don’t think I misread it. I sit on the Energy and Commerce Committee where Lois Capps injected the same language – the same language in the House bill. So, no, I sat through the committees. It’s very clear. The groups such as the Catholic Bishops, the Right to Life were all reading the language the same way. This is a drastic, radical departure from current federal law which says no public funding for abortion.

But Stupak really knows better. He understands that the Senate language is actually far more stringent than the Capps amendment. While Capps protected Hyde by specifying that subsidy dollars could only be used to abort pregnancies that threaten the life of mother or result from rape or incest, the Senate version explicitly instructs insurers to collect two separate checks from policy holders, sets standards for allocation accounts and authorizes state insurance commissioners to audit insurers’ compliance with the segregation requirements.

These details don’t matter to Stupak because he’s not interested in finding a way to keep public dollars from funding non-Hyde abortion. He wants to restrict abortion coverage in private insurance and his abortion amendment does just that. But fortunately, as Rep. Diana DeGette (D-CO) points out, “Ten or 11 votes is not going to kill the bill.” “Many of the 39 conservative Democrats who voted against the House bill could well find the moderate Senate version more to their liking.” Stupak is holding the health care bill hostage because he sees is it as an opportunity to insert his minority views into the legislation, but Democrats should call his bluff, keep the already-restrictive Senate abortion language and strip Stupak of his chairmanship.