Here’s what we’ve learned about Mitt Romney this week: As governor of Massachusetts, he not only signed into law a health care overhaul that served as the model for ObamaCare, he and his staff actively insisted upon the clear inclusion of its most controversial feature, an individual mandate to purchase health insurance. And even though the former governor now claims to oppose the president’s federal version of the Massachusetts overhaul, Romney has named an ObamaCare profiteer who’s been urging state officials to comply with a key feature of the federal health law to run a major part of his political operation.
Given that Mitt Romney continues to defend the Massachusetts health care overhaul he signed into law while serving as the state’s governor, it is not very surprising to find that he and his statehouse advisers were heavily involved in negotiating the details of the plan, promoting its alleged virtues, and even in promoting the individual mandate. But it's still revealing to understand how concerned he and his staff were that the law include a strong mandate.
Through a public records request, The Wall Street Journal has unearthed a trove of emails between Romney and his top staffers regarding the Bay State health care law. The finds include a top health policy aide insisting, “We must have an individual mandate for any plan to work,” and complaining that a rival Democratic proposal was insufficiently clear about the provision. Other emails show Romney advisers contemplating a state-run campaign to publicly shame employers for not offering health insurance.
The article also notes an early draft of an op-ed that Romney personally drafted defending the law and the mandate:
According to the emails, Mr. Romney personally drafted an op-ed article published in The Wall Street Journal the day before he signed the legislation. The draft, written on a Saturday, also defended the individual mandate, in different language from the final version of the piece as published.Using an argument deployed today by the Obama administration, Mr. Romney defended the mandate by noting that taxpayers generally foot the bill when the uninsured seek health care."Either the individual pays or the taxpayers pay. A free ride on government is not libertarian," the published op-ed stated. In a line that didn't make the edited version, Mr. Romney added: "An uninsured libertarian might counter that he could refuse the free care, but under law, that is impossible—and inhumane."
Romney, whose supported continued federal stimulus even after President Obama took office and whose state-based health care plan provided the model and much of the inspiration for the president's 2010 federal health care overhaul, is probably not the most definitive authority on what does or does not qualify as libertarian. But the existence of the deleted passage does suggest that Romney knew early on that libertarians would be among the least receptive to the idea of a mandate, and felt that libertarian criticisms needed to be addressed directly.
I’m not sure if Romney’s decision to appoint Michael Leavitt to prepare the GOP campaign for a potential White House transition process is more surprising, but it is certainly telling: Leavitt has spent the last two years running a consulting firm that encourages states to set up health insurance exchanges as called for by ObamaCare. And his firm has profited handsomely from it, doubling in size to handle all the consulting requests.
Like Romney, Leavitt has called for repeal of the federal health law. But through his consulting firm, he and his staffers have also repeatedly counseled that state officials should erect ObamaCare's government-run health insurance exchanges, which are the primary vehicle for the law’s combination of subsidies and new insurance regulations. As Politico reported last year:
Leavitt has said some relatively positive things about certain elements of Obama’s health reform law, suggesting earlier this year that “Obamacare” empowers the HHS secretary “to do certain things that are clearly aimed at trying to move us in the right direction.”
McKeown, who still works with Leavitt at his Utah-based health care consultancy, acknowledged that the former governor does not want to undo one key part of the controversial legislation.
“We believe that the exchanges are the solution to small business insurance market and that’s gotten us sideways with some conservatives,” he said.
The exchanges are not only a matter of principle for Leavitt — they’re also a cash cow.
As Ben Domenech notes, Leavitt’s firm explicitly opposes the position of every major libertarian and conservative think tank: that states should refuse to set up ObamaCare’s exchanges. Leavitt claims to support exchange creation out of pragmatic principle, which may explain why he’s sometimes failed to note his personal financial stake in seeing states move forward with exchange-creation.
Both bits of news underline the weakness of Romney's oppositon to ObamaCare. The GOP candidate's promises to do away with the president’s health law have never been terribly convincing: His plan to offer states waivers to avoid the law probably won’t work. His promises to push for repeal have always come across as hollow when paired with his defense of his own law.
That’s even more true now. Not only did Romney accept the mandate in Massachusetts, he forcefully defended it while his staff insisted on its inclusion. And despite widespread distrust of Romney’s commitment to unwinding the federal health care overhaul, Romney decided to appoint as a senior adviser someone who profits from ObamaCare and professionally urges conservative legislators to fall in line with one its key directives despite contrary advice from every major policy shop that opposes the health law.
Does this sound like someone whose commitment to opposing ObamaCare and its mandate is in any way reliable? It’s almost as if Romney doesn’t really find ObamaCare or its underlying structure particularly objectionable, and is merely pretending to vehemently oppose the law because he believes that’s what the voters his campaign is targeting want to hear.