Over at the Washington Monthly, Ryan Cooper makes a compelling case for why Herman Cain’s opposition to health care reform — from President Clinton’s efforts to Obama’s law — hasn’t done any favors for the small business community he claims to represent:

By staving off any efforts at cost control, Cain and his allies left small businesses in an increasingly untenable position. Health care price increases disproportionately affect small businesses, mostly due to their lack of bargaining power—large companies, with their bigger pools of employees, can negotiate better prices. This is a major drag on the sector, not only making it more expensive for a small business to do the same work as a large one but also impinging their ability to attract talented employees, as large companies can offer better benefits. As Cain and others are fond of pointing out, restaurants are mostly small— according to the NRA, 91 percent of restaurants have fewer than 50 employees, so they are part of this broader trend. Survey data bear this out: a 2008 survey, ironically from the NFIB, concluded: “The ‘Cost of Health Insurance’ continues its reign as the number one small business problem, a position it has held for over 20 years.”

During an interview in 1999, Cain himself “cited health-care insurance as one barrier foodservice operators face in trying to recruit and retain employees” and then “faulted Congress and the Clinton administration for not coming up with affordable health insurance for everyone.”

But despite his opposition — and that of many business owners who see reform in terms of short term cost increases rather than longer-term savings — the Affordable Care Act provides tax credits for small businesses that purchase health insurance for their employees and will offer employers greater choices and purchasing leverage through state-based insurance exchanges in 2014.

This morning, the Obama administration released new regulations that could yield significant efficiencies and savings for the American health care system. Under the new rules — the result of the Affordable Care Act — providers will be encouraged to form Accountable Care Organizations (ACOs) that will accept a “a flat fee for all care related to a particular patient or condition.” “If they could deliver high-quality care in a cost-effective way, they could keep the money they saved,” the Washington Post’s Sarah Kliff explains. “The hope is to do nothing less than change the basic business model of American medicine from making money by getting patients to spend more money to making money by saving patients money.”

ACOs have been supported by both Democrats and Republicans, but providers balked at the administration’s draft proposal earlier this year, calling the rules unworkable and overly stringent. Hospitals and doctors complained that they would need to invest “many millions of dollars” to meet proposed criteria but would see little chance of return under rules for bonus payouts. As a result, today’s final rules “make it easier for doctors and hospitals to participate by cutting in half the number of performance measurements, removing the electronic health records requirement and eliminating financial risks for some groups.” The administration essentially deregulated its draft regulations, making “significant concessions” to providers in order to coax “doctors and hospitals to come on board” with the new payment structures. It estimates that ACOs “could save the government up to $940 million from 2012 through 2015,” and could start to shift the nation away from the unsustainable fee-for-service health care system.

But Republicans — who had initially criticized the administration for proposing overly stringent regulations — responded to the new rules with mockery. The Senate Republican Policy Committee’s analyst Chris Jacobs, published a post titled “Improving Quality — Through Regulations???” in which he poked fun at the page length of the new rules:

It’s precisely this kind of “analysis” that discredits Republicans as credible partners or critics of health care reform and suggests that they will stick to their “overegulation” rhetoric even when the administration deregulates its own rules.

At a campaign event in Iowa today, GOP presidential contender Mitt Romney was confronted by a woman in the audience about his support for so-called “personhood” laws that would define life as beginning at conception, effectively outlawing common forms of birth control. “98% of American women, including me, use birth control,” she said, “so could you help me understand why you oppose the use of birth control?”

Romney answered simply, “I don’t” — a surprising departure from the rest of the field’s radicalized anti-contraception views. Romney explained that his support of birth control is not inconsistent with his anti-abortion stance because, “I believe life begins at conception and birth control prevents conception.” Watch it:

As the woman pointed out, however, Romney studiously avoided commenting on the stickier side of this issue — whether he supports hormonal contraception (like birth control pills) that can also prevent eggs from being implanted, which many conservatives think is tantamount to abortion.

Romney was also less-than-straight about his pro-states’ rights approach to abortion. Although he claimed, “I would like to see the Supreme Court return this right to the states,” he has recently pledged to push for federal abortion restrictions.

Romney has a mixed record when it comes to supporting women’s access to safe, effective contraception. In an effort to pander to social conservatives powerful in the Republican base, Romney said he would expand a Bush-era rule that allows doctors to deny women access to contraceptives.

While numerous states have enacted legislation that limits women’s access to abortions through 24-hour waiting periods, reduced Medicaid funding, and compulsory ultrasounds, the most effective measures for undermining women’s choice may be a new crop of supply-side laws that focus on lowering the number of providers of abortion services, Theodore Joyce argues in the New England Journal of Medicine. Kansas and Virginia, for instance are leading the way in regulating providers out of existence through new licensing requirements for room sizes, staffing, and other physical specifics and may soon serve as a template for red governors hoping to effectively ban abortions in their states.

Joyce studied the impact of a 2004 Texas law which instituted a 24-hour waiting period for all abortions and required “abortions at or after 16 weeks of gestation be performed in a hospital or an ambulatory surgical center.” He found that while the supply-side restriction had “dramatic effects,” the demand-side 24-hour waiting period “had none“:

The number of abortions performed in Texas at or after 16 weeks of gestation dropped by 88%, from 3642 in 2003 to 446 in 2004, while the number of residents who left the state for a late abortion almost quadrupled, from 187 in 2003 to 736 in 2004. Despite this large outflow, there were 2460 fewer abortions at 16 weeks or later in Texas residents 1 year after the law took effect, a 68% decline. By 2006, Austin, Dallas, Houston, and San Antonio had ambulatory surgical centers in which abortions were performed at or after 16 weeks of gestation, but the number of such abortions remained well below the 2003 level. Over the same period there was no meaningful change in the number of abortions before 16 weeks of gestation. The demand-side policies had no measurable impact.

Supply-side laws significantly impact access for lower-income women who lack the means to travel to states with less restrictive policies. “Thus, if a ‘blue state–red state’ distribution of abortion services evolves,” Joyce warns, “the pre-Roe racial and socioeconomic patterns will probably reemerge. Women with resources will travel substantial distances for an abortion, whereas less-advantaged women will travel less.”