Scoring Last Week’s RomneyCare Debate

Rick Santorum went for the jugular in Thursday night’s Republican presidential debate, exposing Mitt Romney’s weak and contradictory defense of his Massachusetts health-reform law.

Mr. Santorum attacked Mr. Romney’s claim that the individual mandate affects only “the 8% of people who didn’t have insurance.” Mr. Romney insisted that “92% of the people in my state had insurance before our plan went in place. And nothing changes for them.”

Mr. Santorum blasted back that “what Governor Romney said is just factually incorrect,” because the mandate affects 100% of the residents who are forced to buy health insurance “as a condition of breathing in Massachusetts.”

In an earlier debate, Newt Gingrich underscored the point when he described a Massachusetts couple fined $3,000 by the state. They had health insurance, but it didn’t meet the state’s specifications. Lauren and Nick Destito had owned a tree and landscaping business for 25 years before the economy collapsed in 2008. They were forced to declare bankruptcy but still tried to abide by the state’s health-insurance mandate, purchasing a policy that cost them $750 a month.

No dice—according to a government official, the amount of health insurance they can afford is determined “not, unfortunately, from your perspective but from the state agency’s view.” After garnering national attention for their plight, the couple won on appeal.

Mr. Romney’s attempt to contrast his plan with ObamaCare wasn’t convincing. “I don’t like the Obama plan,” he said in Thursday’s debate. “His plan cuts Medicare by $500 billion. We didn’t, of course, touch anything like that. He raises taxes by $500 billion. We didn’t do that.”

These are bogus boasts: States have no authority over cuts in the federal Medicare program, so cutting Medicare never was an option with RomneyCare. Massachusetts didn’t raise taxes to finance its plan because it relied on previously enacted health-insurance taxes and an infusion of federal Medicaid money to finance its coverage expansion. The state simply passed a big share of its costs to federal taxpayers.

Mr. Santorum challenged Mr. Romney on his claim that RomneyCare is “very different than ObamaCare,” citing a new study that lists key features the two plans have in common, including the Medicaid expansion, an employer mandate and the individual mandate.

The study is from the liberal Families USA, which credits John McDonough and explains he “was deeply involved” in developing both RomneyCare and ObamaCare. Among the key checkpoints showing the similarities between the two plans: “RomneyCare authorizes ‘tiers’ of insurance coverage, which are called Gold, Silver, Bronze, and Young Adult . . . ObamaCare sets the following tiers for policies: Platinum, Gold, Silver, Bronze, and Young Adult.” And government will specify which benefits must be included in health plans under both reform laws. Mr. McDonough earlier said the federal law is “Massachusetts with three more zeros.”

Mr. Romney repeatedly says he believes in state-level solutions. But when he says he wants to give states more discretion in implementing ObamaCare, there is very little daylight between his position and President Obama’s. The president has said Congress should pass legislation to accelerate the provision in the law that would allow states more flexibility in implementing the health law starting in 2014.

Mr. Santorum was passionate in insisting that Mr. Romney’s defense will collapse in a debate with President Obama, and the candidate would be wide open to attack. “Folks, we can’t give this issue away in this election. It is about fundamental freedom,” he said.

Mr. Romney has indeed backed himself into a corner by insisting on defending his health plan while attacking ObamaCare. In the Oct. 11 debate at Dartmouth College, Mr. Romney said: “[W]e all agree about repeal and replace. And I’m proud of the fact that I put together a plan that says what I’m going to replace it with.”

Does he really mean that he wants to use Massachusetts as a model for his “replacement” plan? No wonder voters are worried.

Unless Mr. Romney takes steps to conform his position with reality, he will have trouble convincing voters he is serious about repeal and will have an even harder time mapping a clear plan on health reform should he be elected president.

Published in The Wall Street Journal, January 30, 2012. 

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