I voted for Mitt Romney in 2002, thinking a competent, business-oriented, moderate Republican technocrat would be good for Massachusetts. And it was! Romney plus large Democratic majorities in the legislature even brought about a solid universal health care program. So in the wake of Mitt Romney’s ferocious and dishonest broadside against the Affordable Care Act, I have a piece at The Daily Beast lamenting Romney’s flip-flopping disavowal of his own legacy:
To be clear, the two plans are essentially the same. Both start from the premise that reasonably prosperous individuals should be able to take their own money and use it to buy health-insurance coverage without depending on an employer to do it for them. That means creating a regulated individual insurance market that works. To do that, you need to eliminate insurance companies’ power to discriminate against people with pre-existing medical conditions. Then to ensure that the risk is spread fairly, you need to make sure that everyone signs up for insurance coverage. Last, to ensure that everyone can sign up for insurance coverage, you need to provide subsidies so that people can afford the premiums. […]
After all, Texas GOP Sen. John Cornyn is already admitting that he doesn’t actually want to repeal all of Obamacare, noting that “there is non-controversial stuff here like the pre-existing conditions and exclusion and those sorts of things.” The problem is that once you admit that this is a good idea, you commit yourself to the whole package. National Review’s Ramesh Ponnuru dubbed Cornyn’s good sense ”Cornyn’s Folly” and then explained that unless the pre-existing condition element is “modified substantially, the individual mandate has to stay, too—and therefore so do the subsidies and the minimum-benefits regs. Without perhaps realizing it, Cornyn has come out for tinkering at the edges of Obamacare.” Cornyn has, in other words, inadvertently made the argument for Romneycare. It’s a position that makes sense on the merits, and makes sense politically for a GOP that surely doesn’t want to charge against what Cornyn dubs the “non-controversial stuff.”
But to get out of the current repealer cul-de-sac, Republicans need a leader who’s capable of framing the Obama’s core ideas as basically sensible. In a decent world, that leader would be Romney. Instead, he’s busy embarrassing himself and running away from his legacy.
John Dorscher makes a similar point in a good piece for McClatchy. I do think, however, that it’s going to far to say that regulate/mandate/subsidize is a “Republican idea.” What it is is a technocratically sound idea for combining universal coverage with the continued existence of private insurance companies. People from a lot of different perspectives can converge on that idea. You might be a libertarian who thinks this is the best way to head-off political momentum for single-payer. Or you might be a progressive who thinks it’s the most politically feasible way of extending coverage and reducing income inequality in the short run.
In other words, it’s a genuine compromise idea, reconciling liberal desire to guarantee coverage to everyone with various ideological and interest group concerns that militate against just signing everyone up for a government program.