By John Stang
A new phenomenon, out of the aligning of the stars I guess, is beginning to take hold, conservative commentators are supporting Romneycare. Romneycare is Mitt Romney’s Massachusetts healthcare plan that he supported while he was governor. That plan had the individual mandate, where people must purchase health insurance on the private market. It was also the model for Obamacare. Ann Coulter stated this about Romneycare:
In November 2004, for example, libertarian Ronald Bailey praised mandated private health insurance in Reason magazine, saying that it “could preserve and extend the advantages of a free market with a minimal amount of coercion.” A leading conservative think tank, The Heritage Foundation, helped design Romneycare, and its health care analyst, Bob Moffit, flew to Boston for the bill signing. Romneycare was also supported by Regina Herzlinger, Harvard Business School professor and health policy analyst for the conservative Manhattan Institute. Herzlinger praised Romneycare for making consumers, not business or government, the primary purchasers of health care. The bill passed by 154-2 in the Massachusetts House and unanimously, 37-0, in the Massachusetts Senate — including the vote of Sen. Scott Brown, who won Teddy Kennedy’s seat in the U.S. Senate in January 2010 by pledging to be the “41st vote against Obamacare.”
All those facts are right. Many Republicans were for the mandate before they were against it. Here is where Coulter makes a crucial distinction:
One difference between the health care bills is that Romneycare is constitutional and Obamacare is not. True, Obamacare’s unconstitutional provisions are the least of its horrors, but the Constitution still matters to some Americans. (Oh, to be there when someone at The Times discovers this document called “the Constitution”!)
The only reason the “individual mandate” has become a malediction is because the legal argument against Obamacare is that Congress has no constitutional authority to force citizens to buy a particular product.
Yuval Levin and Ramesh Ponnuru at National Review make a similar claim:
Governor Romney has at times attempted to argue that the chief problem with the federal law is that it imposes a sweeping one-size-fits-all model for the health-care system on the entire nation and prevents the type of state-by-state experimentation that could yield solutions that are better, and better fitted to local circumstances. This critique of Obamacare, though it contains a lot of truth, is both substantively and politically inadequate. The political inadequacy comes into relief when one looks at Obamacare’s least popular feature, its requirement that all Americans buy insurance policies that meet the federal government’s approval. Romney can rightly say that this requirement, when imposed at the federal level, raises constitutional issues that a state requirement does not. But much of the opposition to the mandate rests on hostility to being ordered around unnecessarily by any level of government, and Romney, alas, cannot align himself with that sentiment.
David Frum then offers this answer:
“The devil is always in the details. Yes, you adopted the basic design I pioneered in Massachusetts. You’re welcome. But then you added features that ruined a good basic concept. You finance your plan with the worst kind of tax increases: tax increases on work, saving, and investment. You expand coverage mostly by expanding our broken Medicaid system: more than half the people who will gain coverage under your plan gain coverage from Medicaid, not private insurance. You’re extending federal benefits by adding new costs onto state governments. Yes, you give the states a bit of money to help for a short period of time. Over the longer haul, your plan will force up state taxes as well as federal taxes.
state governments aren’t well positioned to control costs. Only the federal government can do that. Yet your plan’s cost controls are inadequate and worse.
In summation, the two arguments being offered here are that Romney’s healthcare plan is constitutional because it happens on the state level, while Obama’s individual mandate is unconstitutional because the federal government cannot mandate that citizens do something. The other answer, offered by Frum, is that states are better at controlling costs than the federal government is.
Why are conservatives cheer leading this plan now? First, Romney is going to be the nominee and this is a major weakness of his, so they might as well start coming up with a defense for their followers now. Second, is a way to change history, slightly. The truth is Bob Dole proposed a similar plan in the 1990s on the federal level and Romney has said he wanted his plan to go national. These columns and blog posts are a way to walk back conservative support for the individual mandate, without actually supporting the plan in its current form. Basically, we were young and stupid then, now we got a religion called the Tenth Amendment. Now, not all conservatives will buy this argument and the individual mandate will still be a big liability for Romney. So, since the commentators know their stuck with him they might as well find ways to defend his record.