The EFM Feature

It’s amazing how many people are writing Mitt Romney’s political post-mortem since the passage of Obamacare. The analysis goes something like this: RomneyCare has a statewide individual mandate; ObamaCare has a national individual mandate; consequently, there’s very little difference in the two programs.

In the short term, there is something to this analysis as a matter of politics, but it fails on the merits. Because it fails on the merits, I think it will ultimately fail as a matter of politics.
Why does it fail? Off the top of my head I can think of four hugely important distinctions between RomneyCare and ObamaCare. They are, in no particular order:

  1. RomneyCare was uniquely designed for Massachusetts; ObamaCare is a one-size-fits-all imposition on all states, regardless of their economic condition. Massachusetts is the third-wealthiest state in the United States. Moreover, even before state-level health care reform, 89% of its residents were insured. Do you think it’s possible that a wealthy state with a low percentage of uninsured might have greater means to offer universal coverage? Consider this chart. Some much poorer states have up to 25 to 26% of their population uninsured. How much more will it cost to offer universal coverage in those states? Shouldn’t they be free to work out solutions that fit with their economic reality?
  2. RomneyCare was enacted only after Mitt balanced the state budget. If you don’t think this an important distinction, then you haven’t been paying attention. Mitt enacted health care reform in a wealthy state, that he first rendered fiscally sound, to cover a modest amount of uninsured. Obama enacted his reform in a nation that is shattering deficit records to insure millions upon millions of uninsured with no money in the bank. How much conservative anger about ObamaCare is driven by fiscal concern? I know much of mine is. How can we possibly pay for this? Who could rationally think we can afford this reform in an era of record deficits?
  3. Mitt created bipartisan consensus while Obama rammed his reform down our throats and against the majority opinion of the American people. Had the President attempted a truly bipartisan reform, we likely would have had a bill, but it would have been far more modest, far less controversial, and it would not have broken the bank. There’s a difference between leadership — which Mitt showed in Massachusetts — and the raw exercise of power, which Obama, Reid, and Pelosi demonstrated in Washington. How much conservative rage stems from the fact that we (and the rest of America) were essentially steamrolled?
  4. RomneyCare is constitutional; ObamaCare may very well prove to be an unconstitutional abuse of federal power. I know quite a few people are sneering at the multiple lawsuits challenging the federal individual mandate, but — like it or not — the states and the federal governments have different constitutional powers. States have a general “police power,” which allows them to pass laws to advance the health, safety, and (traditionally) morals of the community. The federal government is limited to its enumerated powers. Constitutional critics of Obamacare ask a common-sense question: Where in the enumerated powers of the Constitution is the federal government empowered to require citizens to purchase a product from a private entity? I’m generally persuaded that the national individual mandate should not be constitutional, but I’m not necessarily persuaded that the Supreme Court will have the guts to invalidate the central provision of the largest social reform legislation of the last fifty years. At any rate, those who don’t mind wonky legal discussions of the issue should read this.

Look, I know that there are some conservatives who believe that an individual mandate — in any context — is fundamentally wrong. I don’t think a national individual mandate is right, but I do think it can work for some states. To say, however, that because Mitt Romney created state-level, bipartisan, popular plan in a state with a budget he balanced, he’s somehow disqualified from the Republican nomination because Obama bastardized his ideas and rammed them down all our throats . . . well, I just don’t buy that.

And neither should you.

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