Mitt Romney Takes the Bait on Health Care

On Sunday, Mitt Romney tried to move to the ... "center" ... on health care reform by claiming that he would preserve certain parts of the Affordable Care Act, or Obamacare. Namely, Romney claimed that he would keep the requirement that insurance companies accept all applicants regardless of a pre-existing condition. He also said he would let stand the provision of Obamacare that lets parents keep their young adult children on their health care plan.

Then, in typical Romney fashion, he immediately backtracked on pre-existing conditions and said that he would only allow that for people who have had continued insurance coverage. Because there is no history in the United States of people being dropped by their insurance companies when one gets sick, or one losing their job when they get sick (and thus coverage) and not being able to afford coverage, thus creating a gap. You know. Not in Mitt Romney's country club.

The early reaction of pundits to this sudden (and simultaneously not-so-sudden) shift in Mitt Romney's stand has been that now that the RNC is behind him, Romney is trying to move to the center to reach key swing voters who may not like the Republican-concocted fantom version of "Obamacare" but sure as hell like the above-mentioned parts. You don't win votes by telling parents that you will take health care coverage away from their kids.

Certainly, that is also Mitt Romney's goal. Basically, he wants to muddy the water on health reform and fool people into thinking, "Oh, hey, Romney will keep the good parts of Obamacare, too." But this is exactly where Mitt steps into it. He takes the bait laid out by President Obama. And he immediately transforms the conversation about health care into the progressive frame rather than the GOP frame. How so?

First, simply by discussing "good parts" of Obamacare, Mitt Romney concedes that Obamacare has good parts! OMG, it's not the Devil's spawn! It pours cold water all over the right wing's fervent belief that health reform is a socialist communist freedom-killing poisonous wreck. It will not only turn the conversation but also dispirit Mitt Romney's base (just have a look at the comments section when Drudge broke this story), who have never wanted to hear about "replacing" Obamacare, but only about repealing it. And that stance is not new - the Republican party concentrated all of their efforts on killing health reform during its legislative process, not on tweaking it. Anything short of that would be giving Obama credit for being a president who was trying to do what is right for the American people rather being the Kenyan anti-colonialist usurper they believe him to be. The fervent right's belief that Obama is destroying America cannot be sustained by anything short of a full-throated defense of the idea that he can do no right.

But even worse than dispiriting his base and screwing with his own party's anti-Obama frame, by merely bringing up 'parts' of Obamacare that he would keep, Romney takes the debate over health care reform where the Obama team wanted it to be all along: the details. If Mitt Romney will keep a couple of popular parts of health reform in place, the natural question is, which of the other popular parts of health reform will he also keep, which of those popular reforms will he tear down, and why? Let's list them:

  • Community rating (your insurance company cannot gouge you) and guaranteed issue (pre-existing conditions).
  • Requiring that insurance companies provide preventive care without a copay or deductible.
  • Outlawing lifetime - and eventually annual - limits on coverage.
  • Requiring insurance companies to spend 80-85% of premium revenue on actually providing health care.
  • Closing the Medicare prescription drug coverage gap (the "donut hole").
  • Giving small businesses 35% tax credits for providing insurance to their employees.
  • Requiring insurance companies to cover a basic set of essential benefits (no more junk insurance).
  • Create marketplaces (exchanges) where individuals and small businesses can shop for insurance.
  • Providing subsidies for people to be able to afford insurance through the exchanges.
  • Expanding Medicaid to all low-income Americans (below 133% of poverty) and fully funding the expansion at the federal level for 3 years and at 90% thereafter.
  • More than doubling the capacity of community health centers.
I could go on, but you get the point. We want to talk about the details. And we know that when it's broken down to parts, the lion's share of health care reform is hugely popular with the American people. So, Mr. Romney, which of these popular reforms will you keep, and which ones will you repeal?

In addition, it is the context of a detailed policy discussion that the individual mandate can be explained better. Simply put, the individual mandate - a requirement that those who can afford it must buy insurance - is there to sustain the insurance company mandates laid out above. You cannot have community rating and guaranteed issue without exploding premiums if you do not have a mechanism of ensuring that healthy people carry insurance. That's what the individual mandate does. You cannot have the big Medicare drug discounts that are included in health reform if drug companies don't have the incentive that more people who have insurance will be able to pay for their medication.

Why did Mitt Romney do it? Why did he just get himself dragged into exactly where the Obama team wanted him on health care? There are a million reasons, but none more prominent than the Democrats' well-done convention last week. Democrats at the convention took pride in our president's accomplishment, ensuring that once and for all, affordable health care became a right rather than a privilege for those who can afford it. Democrats at the convention took pride in the sacrifices they made to ensure that families would no longer have to live one medical emergency away from bankruptcy. President Obama took pride in doing what was needed to be done, damn the political consequences.

Democrats at the convention broke with the conventional wisdom that President Obama and Democrats will dare not run on health care reform, the President's crowning achievement. They turned the table. They challenged the Republican agenda of returning us to the days when children born with a medical condition could not get coverage, when the cancer treatment for a little girl had to be cut short because her insurance plan reached her lifetime cap, when seniors had to choose between buying their medicine and buying groceries.

That rattled Mitt Romney's cage, and he wanted to quickly get the attention of voters before they made up their minds for Obama. With polls coming out of the conventions showing a significant bounce for Obama and no more than a blip (that is the most generous description) for Romney, Romney got desperate and stepped right into it. Dare I say it was orchestrated this way by the Obama team? Probably not, but for the longest time, Democrats have been waiting for the Republicans to get into the details of health reform. Their nominee just stepped in it.