Mitt's New Health Care Story

At the tail end of an excellent Wall Street Journal article about Mitt Romney's Presidential fundraising operation, we are told that Romney has a defense prepared for the inevitable campaign-trail questions about the Massachusetts health care law he signed in 2006. That is, another defense.

The former governor told donors that the plan he signed in Massachusetts was the best for the state at the time, but that no one plan should be imposed on the nation.

A Romney fund-raiser said the former governor also would argue that the Massachusetts law was necessary to stave off the imminent bankruptcy of the state's Medicaid program. The law's requirement that most in the state buy insurance coverage had been hatched by the conservative Heritage Foundation and was used by Mr. Romney to thwart state Democrats from winning a government-run insurance option, he will argue.

There is a kernel of truth in that last line: a major impetus that drove the stakeholders to collective action was the very real threat of a universal-coverage ballot initiative passing.

Nevertheless, I foresee a potential problem if Romney in fact makes the above argument: several hundred thousand copies of No Apology, in which he tells a completely different story. (Actually, as I previously reported, two somewhat contradictory stories in the hardcover and paperback.)

The truth is, the chapter of No Apology titled "Healing Health Care" (especially the original hardcover version) is one of the better discussions of the issue you're likely to come across, certainly in a mass-market political book. I would take issue with parts of it, and some important things have been left out, but overall it's a pretty reasonable overview of the issues at stake, the difficulties in solving those issues, the way Massachusetts went about it, and what that all translates into at a national level.

It even includes a line that, however trite, is the truth about the Massachusetts law, and applies equally to "ObamaCare": "All of us knew the bill wasn't perfect; nothing that groundbreaking could be."

Here's what the chapter does not say: anything about the need to "stave off the imminent bankruptcy of the state's Medicaid program," or "thwart state Democrats from winning a government-run insurance option."

Not one word about either of those things forcing him, reluctantly, to the health care reform table. Quite the opposite. He writes in the book that he did it to help people.

He writes that he made the decision shortly after the election that made him governor in 2002. He recognized the large number of people facing health and financial distress because they were unable to obtain health insurance, he writes (even briefly describing some specific sad stories). "And as governor, I was in a position to do something about it."

Romney goes on, in the book, to describe the long, mostly out-of-the-limelight process of gathering and examining information with a group of advisors; of arriving at a plan; and of then taking the proposal -- still not public -- to Senator Ted Kennedy in Winter 2004, who would need to help gain federal approval for some of it, and whose support could make or break the bill's chances in the state legislature. "He quickly grasped the structure of our program, and following a few meetings, he agreed to support our approach," Romney writes.

Next up, Senate President Robert Travaglini, who "liked our plan," and "agreed to support it with a few modifications, none of which I seriously objected to." The House side, however, took a year to produce a bill that "retained the original vision, plus added features," which Romney signed (vetoing some provisions, which the legislature overrode) in April 2006.

This blog is read by more than a few people who were involved with, or were very close to, this process, and I'd certainly appreciate their input about how closely that tale does or doesn't match what really happened. From my perch at the time, I'd say it's fairly accurate, albeit skimming over or completely omitting some important steps and contributors.

But, accurate or not, the point is that just very recently, in committing to print his personal version of those events, Romney clearly claimed that it was all his idea (including, although he doesn't say so in the book, the individual mandate, which was part of the proposal by the time it reached the Kennedy stage). He clearly claimed that he was the driving factor, and that his sole motivation was the desire to extend health care coverage to all the residents of the Commonwealth.

So now, for him to claim on the campaign trail -- if the Post story is correct -- that he did it as some sort of defensive measure, his hand forced by imminent Medicaid bankruptcy and a far worse Democratic bill barrelling down the statehouse halls, looks patently like a complete retelling of his tale, even from just a few months ago.

And why, oh why, would the guy with the inauthenticity and flip-flopping image problem do that?

I think I have an idea about that -- or at the least, about why he pushed for the health care reform law in the first place, starting all this trouble.

Romney, in my opinion, believes that to further your career you're supposed to rack up accomplishments. Things that get bullet-pointed on a resume, or CV, or campaign brochure. Not end-result accomplishments, necessarily, but 'look at what I did' accomplishments.

He genuinely tried to do that as governor. In fact -- and I'd have to go back and dig this up -- I believe it was in 2004, maybe '05, that Romney's political office printed up this really snazzy full-color supplement-style piece, the back page of which had a great big chart showing all his campaign promises with checkmarks showing whether they had been accomplished, nearly accomplished, or in the works. (He had it inserted in copies of the Boston Globe, and also mailed to Republican activists in South Carolina.)

Romney made a genuine effort to not just bring back the death penalty to Massachusetts, but to create a first-of-its-kind, cutting-edge error-proof death penalty system. He put together a really impressive commission on it, which produced a real, groundbreaking plan that he submitted as a bill. It went nowhere, because the only way his experts could find to square that "error-proof" circle was flagrantly useless, impractacle, expensive, and unconstitutional. But he tried.

He also pushed for tangible, brochure-ready actions on education -- particularly relating to the racial achievement gap -- that, while in my opinion of dubious effect on actual education, were actual things that the government didn't do before he was governor, and began doing because he was governor.

There are other examples as well, but you get my point -- and of course health care was the biggest bullet-point of them all.

All of this turned out to be, politically, a drastic miscalculation. It's debatable how much those sorts of accomplishments ever matter in a Presidential nominating process, but I think it's inarguable that they are outright liabilities among contemporary Republican primary voters. They don't want people in government to do anything; they want them to stop Democrats from doing things, or undo things Democrats have done.

I've read Tim Pawlenty's book, watched quite a few of his recent speeches, and perused much of his campaign materials, and with very few exceptions the only actions he wants voters to think he took as governor are cutting taxes, cutting budgets, and vetoing things. Haley Barbour's not much different. And that's before you even get to the Bachmanns and Gingriches

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