Mitt Romney wants everyone to know just how much he hates ObamaCare: At a major speech on health care policy in Michigan this afternoon, the former Massachusetts governor told the crowd that the Obama administration is so anti-federalist that it "fundamentally doesn't believe in the American experiment." According to Romney, the Obama White House exhibits a pervasive "distrust" of states and state governments, "the most egregious example" of which so far is its health care overhaul: ObamaCare. Romney argues that the president's overhaul constitutes a "a power grab by the federal government" designed to put in place a one-size-fits-all solution that he firmly believes is a "government takeover of health care."
But you know what Mitt Romney loves? RomneyCare—the suspiciously-similar-to-ObamaCare health care overhaul he signed into law as governor of Massachusetts—and, in particular, its individual mandate to purchase health insurance. No, he said, it's not a perfect system, but compared to ObamaCare's "government takeover," RomneyCare is a "more modest proposal," and he remains proud of it: "I in fact did what I thought was right for the people of my state," he said.
Here's the problem: ObamaCare, which includes a health insurance mandate, is a near carbon copy of RomneyCare: a hefty Medicaid expansion coupled to equally large middle-class insurance subsidies, new regulations that all but turn health insurance into a public utility, and an individual mandate to buy a private insurance plan. Indeed, the same Obama administration that Romney accused of being fundamentally anti-American has on multiple occasions explicitly cited the plan that Romney signed into law as the direct model for their plan.
Romney's only real contrast between his plan and the president's plan boiled down to a single, simple distinction: Obama's overhaul was a federal overhaul; Romney's was state-based. Romney would have us believe that the same system of mandates and regulations that constitutes an unconscionable imposition on individual liberty at the federal level is somehow a natural and great part of the American way of life at the state level. As for the mandate, well, it was a sensible way to enforce encourage "personal responsibility," a conservative policy solution designed to fend off the "big-government approach" of making taxpayers cough up for uncompensated care while letting hospital emergency rooms crowd with uninsured.
Never mind the absurdity of the idea that complying with the government's orders is somehow taking "personal responsibility." The claim about uncompensated care is yet another way in which Romney effectively sides with the Obama administration, which these days is busy making the same point in favor of its health insurance mandate. It might be a more convincing argument if the mandate were successful in solving those problems: As The Wall Street Journal pointed out this morning:
Uncompensated hospital care [in Massachusetts] rose 5% from 2008 to 2009, and 15% from 2009 to 2010, hitting $475 million (though the state only paid out $405 million). "Avoidable" use of emergency rooms—that is, for routine care like a sore throat—increased 9% between 2004 and 2008.
Romney also decried ObamaCare for failing to lower health costs. He's right. But the overbudget RomneyCare doesn't either: Indeed, its designers have explicitly admitted that the state's plan was to increase coverage first and hope to figure out how to control spending sometime later.
That Romney would rely on the same mistaken defenses of the mandate as Obama may seem surprising, but in the context of this deeply confused speech, it's really not: Romney may want us to believe that he hates ObamaCare, but his speech resembled nothing so much as a defense of it. If anything, he made the case better than Obama did. And that's why, in the end, the same criticisms Romney lobbed at ObamaCare apply to his own plan. If there's a difference, it's that Romney doesn't distrust states. Instead, he distrusts individuals. It's a distinction, to be sure, but not one that makes RomneyCare any more appealing.