Judd Gregg admits that the failure of the Affordable Care Act’s long-term health care program CLASS won’t unravel the entire health care law in this morning’s interview with the Washington Post’s Sarah Kliff, but the former Republican senator offers some rather surprising explanations of why he included an amendment in the law that requires the program to remain solvent for 75 years. Last week, HHS Secretary Kathleen Sebelius cited Gregg’s provision as a reason for why the government has stopped implementing CLASS. From the interview:

SK: Tell me more about why you decided to offer that amendment.

JG: I knew we weren’t going to kill the CLASS Act because it was Sen. Ted Kennedy’s proposal, and he was very sick, and most of us were very sensitive to the fact he was sick. This was his last hurrah, legislatively. I knew we were going to implement it, although I didn’t think the concept was sound. Conceptually, it makes sense to prefund long-term care insurance…. but what this bill did was just the opposite. It was totally unsound. [...]

SK: Does the end of the CLASS Act say anything about the rest of the health law? Or is this an isolated incident?

JG: This was a sidecar. This was not a core element of the overall bill. It was put in as a courtesy to Sen. Kennedy. I do happen to think the overall bill is going to massively fail on the fiscal side and probably fail on the substantive side too. But you can separate off the CLASS act as not having an effect on the underlying bill, even though the underlying bill will also fail.

This won’t read well to the people who had worked by Kennedy’s side for years trying to build a program that would provide some very basic health care services to people who need help taking care of themselves. Nor should it. Gregg knows full well that the program could work if one were to include a mandate or tinker with the eligibility and premiums to ensure that it attracts enough healthy enrollees to keep it sustainable over the long term. To say that CLASS is a pipe dream included in the law to appease a dying senator is not only offensive but also very untrue.

David Corn points to this video of Mitt Romney effusively praising the late Sen. Ted Kennedy for helping secure federal funding for Massachusetts’ health care reform law at its signing ceremony in 2006, even going so far as to call him a “parent” of reform. It’s “probably not what Romney wants GOP primary voters to have in mind when they enter a polling place or caucus meeting,” but it is a video Democrats will likely point to if Romney is the eventual nominee:

Also recall that Kennedy initially opposed the law’s central tenet — a requirement that everyone purchase health insurance. The mandate originated as a Republican idea and was heavily promoted by Romney as a “conservative solution” that would force people to take “personal responsibility” for the cost of coverage. As Kennedy explained in December 2005, “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. I can buy into that.”

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.