Has Mitt Romney figured out a position on health-care reform?

at 04:22 PM ET, 03/23/2011

“If I were president, on Day One I would issue an executive order paving the way for Obamacare waivers to all 50 states,” writes Mitt Romney. “The executive order would direct the Secretary of Health and Human Services and all relevant federal officials to return the maximum possible authority to the states to innovate and design health-care solutions that work best for them.”

I’m not exactly sure what Romney means by this. An executive order can’t overturn the requirements in the Affordable Care Act. It can’t free Michigan from having to comply with federal law. So is he simply endorsing Wyden-Brown? Stating a philosophical principle? Promising to err on the side of federalism when such questions come before his administration?

Still, for all its vagueness, it’s very different than “If I were president, on Day One I would issue an executive order directing every member of my administration to do everything possible to slow or block the implementation of health-care reform.” Presumably, Romney will eventually say that, too, but he seems to be trying out a federalism line first.

And I hope he sticks with it. After all, it’s edging mighty close to the health-care policy I recommended Romney adopt:

Over the years, various politicians have proposed federalist pathways to universal care. The federal government would set out some basic conditions — X percentage of residents covered with insurance that’s at least up to X standard — and provide some funding, and states could go their own way. Ron Wyden and Scott Brown, in fact, have a proposal to turn the Affordable Care Act into that bill, at least for the states that want to take advantage of it.

With the Republican argument against the Affordable Care Act trending in a federalist direction, you could imagine some conservative politician who actually wanted to solve the coverage problem embracing something like this. Romney hasn’t been known for his courage as a campaigner, but if he wanted to go on offense, he could develop a proposal along these lines and use it to both frame his effort in Massachusetts as a good thing — after all, he did bring near-universal coverage to his state — and create a policy platform that allows him to offer actual solutions to the nation’s problems (an important part of any general election campaign) while maintaining a harsh critique of Washington.

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