Health Reform Counterfactuals

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"Health Reform Counterfactuals"

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I agree with almost everything in this Ezra Klein post, including his first two points and even most of point three, but I think this is a bad example:

Third is that voters don’t approach elections with strong views on policy issues. Instead, they look to the political leaders they already trust to tell them what their views should be. If President Romney had proposed ObamaCare before a mostly Republican Congress, it would’ve gotten an easy majority of Republicans — both in Congress and in the country — and almost zero Democrats. Party affiliation drives policy opinions, and not the other way around.

The thing is that we actually do have an example of Mitt Romney working on a similar bill in Massachusetts and what happened is that it passed with overwhelming bipartisan support:

House Speaker Sal DiMasi compares the new health law to the Mayflower Compact that the pilgrims wrote after they landed on Plymouth Rock in 1620.

“It was supposed to be a community of people where laws were made for the common wealth. That’s why we became a commonwealth,” he said. [...]

Gov. Romney, a Republican and a former businessman, bases his support on economics. When Romney became governor three years ago, a business colleague urged him to do something about the 500,000 or more Massachusetts residents without health insurance. Nearly nine out of ten are in working families. [...]

Ed Haislmaier, of the The Heritage Foundation, a conservative Washington think tank, which helped frame the legislation — agrees with Romney.

The point I would make is simply that Republican politicians haven’t historically been universally averse to the mandate/regulate/subsidize framework. Had they chosen to negotiate in good faith within the mandate/regulate/subsidize framework, it’s likely that a bill similar to the Affordable Care Act would have passed, but with many Republican votes. What’s more, given the opportunity to dissent from the left without spiking the bill, a bunch of progressive Democrats would have done so. And had that happened, the resulting legislation would be substantially more popular with Republicans and Independents than the current legislation is. And the change in public opinion would have been driven by the change in elite signaling rather than by the change in the content of the legislation.

But I don’t think it’s a given that the opposition party’s leaders will reject the president’s proposals out of hand. It really depends on what they’re more interested in doing. The Democratic Party showed in the 2005 Social Security debate that it’s possible for a Republican President to formulate a proposal that meets with a response of massive resistance, but on most issues—taxes, Medicare, immigration, K-12 education, invading Iraq—there were always Democrats who were eager to cut deals with the Bush administration.

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