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Romney and the individual mandate, again

at 10:00 AM ET, 03/22/2012
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When he got up and was questioned by Fred Thompson in the 2008 election, Governor Romney said, ‘Mandates, I love mandates, mandates work, this is what we need to do, we need to force people to buy insurance.’ And he defended his record in Massachusetts and, in fact, argued for exactly what President Obama put in place — was a government-mandated health care program at the federal level.” — Rick Santorum on ABC’s “This Week,” March 18, 2012

There’s been a considerable amount of discussion lately about whether Mitt Romney’s old campaign comments and op-eds provide proof that he actually supports a federal mandate, contrary to what he claims and what Fact Checker Glenn Kessler determined about the matter in a previous column. Still, critics such as Rick Santorum continue to pound home the notion that the former governor advocated a national insurance requirement.

Romney has stood firmly behind his Bay State mandate but swears that he doesn’t support such a policy at the federal level. He has said states should decide for themselves how to improve their health-care systems. Our previous column noted that he has shown consistency on this issue, despite a tendency to explain his stance in convoluted terms.

Let’s once again review key remarks that Romney opponents have highlighted to determine what the GOP delegate leader really said, as opposed to what people assume he meant.

The Facts

First, opposing the federal health-care law is perfectly compatible with expressing a love for insurance mandates and thinking they can work for states that want to adopt them, as Romney has done. It’s like saying “Cardinals are pretty, and I think every state should adopt that species as its state bird, but I would never force them to do that — I don’t have the right.”

What wouldn’t jibe with Romney’s position is if he said, “We need to force people to buy insurance,” as Santorum accused him of saying. This would suggest that the former governor thinks a national mandate is the only workable option for insuring Americans who don’t have coverage.

Romney’s critics often point to a 2008 debate in which Romney discussed his stance on health care with moderator Charlie Gibson and fellow candidate Fred Thompson. Let’s go to the transcript, which provides a classic example of Romney tripping over himself to explain his nuanced stance.

Gibson first mentions the Massachusetts health-care overhaul, which included a mandate similar to the federal one. He noted that Romney backed away from such a policy for the nation as a whole.

“No, no,” Romney said. “I like mandates. The mandates work.”

A baffled Thompson then jumped in, saying: “I beg your pardon? I didn’t know you were going to admit that. You like mandates?”

Romney doubled down. “Oh, absolutely,” he said. “Let me tell you what kind of mandates I like, Fred.”

At that point, Romney could have cut directly to his usual point about mandates being fine for states but unconstitutional at the federal level — in his opinion. Instead he led listeners into the weeds, talking about how his Massachusetts law promoted the “principle of personal responsibility” and helped his state tackle the problem of “free riders.”

Next he tangled with Thompson in an exchange about the details of his Massachusetts mandate: what level of income triggers the requirement and how many people qualify for it in his state.

Gibson kept the discussion from going farther down the wonkish path by asking Romney point-blank: “Yes or no. In your national plan, would you mandate people to get insurance?”

Romney answered indirectly, saying “I think my plan is a good plan that should be adopted by other states

Gibson cut him off, asking again whether the former governor would support a federal mandate. Romney responded, “I would not mandate at the federal level that every state do what we do.”

Two things are undeniable here. Romney said “I like mandates,” exactly as his critics point out. But he also said unequivocally that he would not support a national mandate.

Romney’s responses may very well represent an attempt to play both sides of the issue or to blur the lines between his stance on state versus national mandates, as New York magazine columnist Jonathan Chait suggested in a recent article.

But Gibson forced him to answer definitively whether he would support an insurance requirement at the federal level, and the answer was no.

There does not appear to be a single example of Romney saying “we need to force people to buy insurance” or anything along that line. In fact, he has said as far back as 2007 that states should decide for themselves what types of health-care policies to implement.

In describing his plan to the Florida Medical Association in 2007 — Romney’s most comprehensive remarks on health care in the 2008 campaign — he said: “We let states decide how they craft their own program. States are able to craft programs to match their unique needs, and, of course, we let states remain as the laboratories of innovation.” (The text of the entire speech is included in the previous column on this subject.)

In addition, a 2007 New York Times article explaining Romney’s health-care plan used the headline “Romney to Pitch a State-by-State Health Insurance Plan,” noting that his approach “departs significantly from the universal health care measure that he helped forge as governor of Massachusetts.” And his campaign literature from 2008 made clear that he wanted a “federalist” approach to universal health care.

One can reasonably argue that states will never achieve universal coverage without mandates or single-payer systems, but Romney has mentioned at least one alternative to achieving his goal: providing tax credits for people who purchase insurance.

It’s worth noting that Romney has said time and again that he plans to repeal the federal mandate if he becomes president. Whether or not he would applaud states for implementing mandates of their own is irrelevant. The fact remains that he has promised to let states decide for themselves.

Many of Romney’s critics suggest that a 2009 USA Today op-ed by the candidate helps prove that he supported a national mandate. Indeed, the former governor did brag in the article about his Massachusetts program and said the state’s insurance requirement discourages “free riders.” But in terms of its prescriptive aspects, the op-ed only recommends spending and cost reductions — rejecting the idea of broad-based government insurance — and bipartisan negotiations during the caustic health-care debates that took place that year.

In his summary paragraph, Romney wrote: “Republicans will join with the Democrats if the president abandons his government insurance plan, if he endeavors to craft a plan that does not burden the nation with greater debt, if he broadens his scope to reduce health costs for all Americans, and if he is willing to devote the rigorous effort, requisite time and bipartisan process that health care reform deserves.”

Nowhere in the op-ed did Romney propose a federal mandate.

The Pinocchio Test

In many ways, this is a silly debate, as opponents of Romney endeavor to put words in his mouth.

Romney certainly has struggled to explain his stance on mandates, especially when he talks about the nuances of his position and when he defends the Massachusetts law. But his message boils down to this: He likes state-level mandates because they encourage personal responsibility; he does not support a federal mandate and he would repeal the existing one as president; he wants every single state to come up with a plan for getting its residents insured; and he thinks the Massachusetts mandate has worked incredibly well for his state.

The former governor has walked a delicate line with some of his comments about the Massachusetts mandate and what it means for his national plan, but he has never expressly called for a federal insurance requirement. Some of his past remarks suggest he might have been open to the idea, but we deal with facts, not speculation. (Readers will notice that this column used this same standard in examining Republican claims that President Obama said he wanted higher gas prices).

In conclusion, Santorum deserves three Pinocchios for his comments about Romney and mandates. His opponent did indeed say he likes the requirements, but he never argued for “exactly what President Obama put in place” with the federal obligation, nor did he say “we need to force people to buy insurance.” (The Democratic National Committee received a higher count of Four Pinocchios for its ad because the editing of the TV clips was so manipulative.)

Three Pinocchios

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    About the Blogger

    Glenn Kessler has covered foreign policy, economic policy, the White House, Congress, politics, airline safety and Wall Street.

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