So did Mitt Romney ever suggest that Romneycare could serve as a model for health reform on a national level?
Yesterday I made the case here that he did maintain this — which, if true, would severely undercut Romney’s primary argument right now, which is that the individual mandate on the state level is acceptable, while on the federal level it amounts to something akin to tyranny. But I’d like to reconsider the case a bit, because it’s more nuanced than I first thought — Romney may have never said his plan should be a model for federal reform.
A Romney adviser points me to a speech Romney made in 2007, in which he clearly spelled out the case for a federalist approach in terms that are very consistent with what he’s saying now:
“A one-size-fits-all national healthcare system is bound to fail. It ignores the very dramatic differences between states and it relies on a Washington bureaucracy to manage. You think about this, I do not want the guys that ran the Katrina clean up running our healthcare system. So in my view, healthcare reform has to take a federalist approach ... 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. And by the way, I like the plan we came up with in Massachusetts. I wouldn’t be surprised if other states say, `I like that way, I’m going to copy it.’ And I’d be proud if they did. Some states will find they’ve got better answers than what we came up with, and if they do, hats off to them.”
Yesterday, in making the case that Romney suggested that Romneycare could be a model for federal reform, I pointed to a 2009 CNN quote in which he said:
“I think there are a number of features in the Massachusetts plan that could inform Washington on ways to improve health care for all Americans. The fact that we were able to get people insured without a government option is a model I think they can learn from.”
Viewed in the larger context of Romney’s record on health care, it’s plausible to see this as consistent with the state-based approach he’s long advocated. He could have merely meant that Washington policymakers should see his state-based approach — in which states are free to emulated each other or to go off in their own direction as they see fit — as the right one, and that Washington should play a role in encouraging it. Read this way, Romney has been basically consistent in making the distinction between the mandate being valid on the state level but dangerous on the Federal level.
Of course, this doesn’t solve Romney’s primary political problem, which is that conservatives don’t care about this distinction. Now that Obama has employed the individual mandate as a pillar of Obamacare, conservatives hate it whether it’s employed on the state or federal level, and it only annoys them further when Romney insists that the distinction is ah important one. It’s unclear whether Romney will ever be able to talk conservatives out of their apoplexy on this topic, but he certainly seems committed to giving it one hell of a try.