Mitt Romney reiterated his support for Massachusetts’ 2006 health care reform and the individual requirement to purchase coverage during a town hall in Keene, New Hampshire today, stressing that people should be required to take responsibility for their own health care spending:

Q: Massachusetts health care, you haven’t said it was a mistake?

ROMNEY: I will repeal ObamaCare, but the Massachusetts plan was right for Massachusetts. Personal responsibility was the way to go. People in Massachusetts favor the plan 3 to 1. If they don’t like it they can get rid of it. I like what we did in our state. It won’t work in Mississippi. That’s what’s great about a state plan. Obama is trying to impose on nation. I like personal responsibility and I like freedom. I’m not going to back away from signing that bill.

Since announcing his candidacy for president, Romney has shied away from such direct endorsements of the mandate, a policy he has previously described as the “ultimate conservative idea” and “a Republican way.” “The Republican approach is to say, you know what? Everybody should have insurance. They should pay what they can afford to pay. If they need help, we will be there to help them, but no more free ride,” Romney told Fox News’ Neil Cavuto on April 12, 2006 during a national media tour promoting his groundbreaking 2006 health care reform law.

Following that accomplishment, Romney was asked many times if he thought his plan for expanding coverage by requiring Americans to purchase health insurance should apply to the nation. He repeatedly either hinted or directly stated that it could or should, without raising any constitutional concerns. It’s a position he first adopted in his challenge to Sen. Ted Kennedy in 1994. At that time, Romney said he would support a mandate on a national level if universal coverage could not be achieved through other means (such as providing tax incentives to purchase care) and would have voted for a Republican alternative to the Clinton plan offered by then Sen. Lincoln Chafee (R-RI), which included a national individual mandate. In fact, as recently as December 2007, Romney said if other states adopted the individual mandate, it would be “a terrific idea…we’ll end up with a nation that’s taken a mandate approach,” and endorsed the Wyden-Bennett health care proposal, which also included a national individual mandate.

Our guest blogger is Annabel Hogg, special assistant to the Domestic Policy team working with the Education, Health, and Women’s Rights departments.

In a 1994 Massachusetts Senate race debate, Mitt Romney revealed why he supported the option of safe and legal abortions for all women: when Romney was a teenager, a close family relative died as a result of an illegal abortion. The identity of this relative, however, was never revealed until now.

In 1963, Ann Keenan, the sister of Romney’s brother-in-law, died of an infection as a result of a back alley abortion. Keenan, 21 at the time of her death, was a former high school class president who had gone on to attend Michigan State University. Keenan’s devastated parents asked for memorial tributes to be made to the “Planned Parenthood Association.” It is the same organization Romney now vows to defund if he is elected president (even though Romney and his wife attended a Planned Parenthood fundraiser in 1994).

Keenan’s death occurred 10 years before Roe v. Wade was decided and came at a time when women who found themselves with an unintended pregnancy had few options.

Before Roe, as many as 5,000 women died per year as a result of illegal abortions. The legalization of abortion caused the number of pregnancy related-deaths and hospitalizations from unsafe abortions to plummet. The relationship between legal abortion and the protection of women’s health is undeniable.

Despite the existence of Roe, abortions rights are being curtailed at an alarming rate in various states throughout the country. There have been over 900 anti-abortion laws introduced since the 2010 midterm elections.

A majority of 2012 GOP presidential candidates have even signed a pledge by a right to life group that calls for the appointment of only pro-life judges, cabinet members, and agency secretaries with the intent of restricting the health rights of women in regard to abortion. (Romney refuses to sign the pledge, but Texas Gov. Rick Perry was the most recent candidate to endorse it.)

This extreme anti-abortion rights climate helps explain Romney’s about face on abortion from his 1994 stance, but it does not excuse it.

Potential vice president running mate Sen. Marco Rubio (R-FL) dismissed the importance of programs like Medicare and Social Security during a speech at the Reagan Presidential Library this afternoon, arguing that the initiatives “weakened us as people”:

These programs actually weakened us as a people. You see, almost forever, it was institutions in society that assumed the role of taking care of one another. If someone was sick in your family, you took care of them. If a neighbor met misfortune, you took care of them. You saved for your retirement and your future because you had to. We took these things upon ourselves in our communities, our families, and our homes, and our churches and our synagogues. But all that changed when the government began to assume those responsibilities. All of a sudden, for an increasing number of people in our nation, it was no longer necessary to worry about saving for security because that was the government’s job.

Watch it:

Americans may have certainly taken care of each other in the absence of formalized access to affordable health care, but that support did little to drastically ameliorate the fears and anxieties of seniors. As Ted Marmor explains in The Politics of Medicare, “The biggest fears included not being able to pay for care and risking turning to children or siblings for help, or it meant relying on the charitable attitude of the doctor or hospital. Most profoundly, it was the sense that illness or injury — bad enough themselves — could be disastrous for family finances unless you were lucky enough to have retiree coverage from a union or government plan.”

Indeed, prior to Medicare’s enactment in 1965, “about one-half of America’s seniors did not have hospital insurance,” “more than one in four elderly were estimated to go without medical care due to cost concerns,” and one in three seniors were living in poverty. Today, nearly all seniors have access to affordable health care and only about 14 percent of seniors are below the poverty line.

Texas Gov. Rick Perry (R) has just signed the controversial Susan B. Anthony anti-abortion pledge, vowing to nominate strict constructionist judges, “select only pro-life appointees for relevant Cabinet and Executive Branch positions,” push for defunding Planned Parenthood and other taxpayer-supported abortion providers, and to sign a Pain-Capable Unborn Child Protection Act.

The document would severely hamper the appointment process — excluding more moderate politicians like Rudy Giuliani from prominent posts — but its embrace of the Pain-Capable Unborn Child Protection Act is even more bothersome and yet another example of the party’s anti-science agenda. The act, which Nebraska, Idaho, Kansas, Oklahoma, and Alabama have signed into law, limits abortions after 22 weeks based on disputed research that fetuses can feel pain at that point of development. Though debate exists, a thorough review of the medical evidence in the Journal of the American Medical Association determined that “pain perception probably does not function before the third trimester.” Before then, “the fetus’s higher pain pathways are not yet fully developed and functional.”

But why worry about “untruths” when right-wing lawmakers can use “false research” to challenge Roe v. Wade? The bill purposely undermines the ruling’s viability standard — “the point at which the fetus can live outside the womb” — as the point when states can ban abortions and aims to submit fetal pain as “a new dividing line at which abortions could be banned.”

While most other GOP presidential candidates have agreed to the pledge, Mitt Romney refused to sign it, saying it was “overly broad and would have unintended consequences.”

In a sure sign that the federal government doesn’t have the funds necessary to implement exchanges on behalf of states that opt out of building their own, the Department of Health and Human Services is actively lobbying reluctant governors and legislators to accept a “second chance” for avoiding federal intervention:

U.S. Department of Health and Human Services officials told Montana legislators Tuesday that the agency is working on a new partnership model to let state agencies help run the exchange — perhaps without the need for legislative authorization.

Marguerite Salazar, a regional director of the Department of Health and Human Services, said the proposal for the partnership is new within the past two months. State agencies are being invited to Washington D.C. next month to discuss it. “I think it is going to be the option for states that are nervous about a full-fledged exchange,” she said in an interview.

Montana is one of many states that have so far refused to pass a law authorizing a state-level insurance exchange, paid for by the federal government. Like some other states, Montana’s legislature does not likely meet again soon enough to authorize an exchange prior to the January 2014 implementation.

Indeed, some states may be receptive to the “partnership.” Inside Health Policy (subscription only) reports that the National Conference of State Legislatures has adopted a policy that pushes the idea that “a state should be able to choose which exchange functions can be turned over to the federal government to carry out and pay for.” HHS should “work with states to determine which exchange functions might most appropriately be developed and, at a state’s request, administered by the federal government rather than by the 50 individual states and territories,” their policy says. Consumer advocates, however, have expressed some concern about the model, arguing that the relationship could allow states to opt out of establishing critical regulations and leave the federal government in charge of governing essential elements of the new marketplace.

HHS has already gone out of its way to maximize flexibility, allowing for conditional approval of a state’s exchange if there is evidence it will be operational by the beginning of 2014.

The Congressional Budget Office has released a new report pinning this year’s deficit at $1.3 trillion – the third-largest in the last 65 years — and predicting that real GDP will rise 2.3 percent this year and 2.7 percent next year. Federal spending on health care will continue to increase faster than GDP, but CBO notes that some of the cost will be contained by the cost-saving mechanisms in the Affordable Care Act:

“CBO estimates that outlays for Medicare (excluding receipts from premiums) will total $555 billion (3.5 percent of GDP) in 2012, about the same, in nominal terms, that it estimates for 2011. Between 2013 and 2021, outlays are projected to grow at an average annual rate of 6.3 percent, reaching $966 billion (4.1 percent of GDP) in 2021. Spending will be pushed up over the decade by increases in the number of beneficiaries and in health care costs per beneficiary (in nominal terms). At the same time, growth in spending will be restrained by reductions in updates to payment rates that were included in the 2010 health care legislation and by the program’s sustainable growth rate mechanism, which, under current law, is projected to reduce payments to physicians by about 30 percent in 2012 and by additional amounts thereafter.

In other words, beginning in 2014, as 32 million individuals begin receiving health care coverage and visiting doctors, health care expenditures will naturally increase. Costs will continue to grow higher than current law until around 2015, at which point the Medicare savings (payment changes), the excise tax on so-called Cadillac health plans, and the Medicare payment board will cause costs “to be restrained.”

ThinkProgress filed this report from a town hall in Cincinnati, OH.

During a town hall meeting in Cincinnati, Ohio yesterday, Rep. Steve Chabot (R-OH) faced stiff resistance from constituents over his opposition to federal funding for Planned Parenthood.

After a citizen asked the congressman why he stood “against funding Planned Parenthood when public funds are not used for abortion,” Chabot argued that the money was fungible so he opposed funding because “they are the largest abortion provider in the United States.” This response brought loud jeers and shouts of “no!” from the audience. When Chabot later accused Planned Parenthood of using federal funds for abortion, one constituent asked, “Do you have any proof of that happening?” Chabot declined to respond.

MODERATOR: Why do you stand against funding Planned Parenthood when public funds are not used for abortion and Planned Parenthood is so important to poor women’s health care?

CHABOT: Relative to Planned Parenthood, they are the largest abortion provider in the United States.

AUDIENCE: No! No! No!

CHABOT: Well, they are. [...] But the folks in Congress, like myself, who happen to be pro-life, aren’t satisfied because we know money is fungible and you can take out of one pot and use it, you don’t have to provide the same costs out of that particular pot.

CONSTITUENT: Do you have any proof of that happening?

CHABOT: [Silence] Next question.

Watch it:

By Chabot’s logic, Congress ought to strip federal funding for any religious organizations that receive federal funds to finance their charitable and social work because “money is fungible.” Yet it’s difficult to imagine Republicans will use the same standard to target groups like the United States Conference of Catholic Bishops any time soon.

Still, the questioner makes an important point that ought not be missed in the discussion: Planned Parenthood is vitally important to women’s health care, especially poor women. Despite Sen. Jon Kyl’s (R-AZ) assertion that abortion is “well over 90 percent of what Planned Parenthood does,” in fact, it accounts for just 3 percent of their services. The other 97 percent includes such procedures as breast cancer exams, STI testing, and cervical cancer screening.

Yet if Chabot and Republicans in Congress had their way, Planned Parenthood would lose $330 million in federal funding that would otherwise be used to provide critical medical services to women across the country.