Why Romney Should Take Credit for Obamacare

Jon Gruber is not the kind of guy who votes Republican for president. He is, after all, a liberal professor from Massachusetts. But at one point he was ready to make an exception for Mitt Romney. Back in 2004, Romney, then governor of the Bay State, summoned Gruber from MIT to his office on Beacon Hill. A leading health-care economist, Gruber had spent the previous few years modeling an insurance system that was neither liberal (like single-payer) nor conservative (like total deregulation), but somewhere in between. Romney, craving a signature policy achievement, was eager to hear more.

Gruber described the details: a marketplace where Massachusettans could shop for private coverage; subsidies to help poorer residents purchase insurance; a requirement that everyone contribute as much as they could afford. Best of all, he explained, there was no need to raise taxes or reduce services; just stop wasting $400 million a year on expensive ER visits for the uninsured and the reforms would pretty much pay for themselves. Romney was sold. "As a management consultant, his eyes lit up," recalls Gruber. "He just said, 'It's the right thing to do.' "

Thinking back, Gruber can't help but gush. "I'm a Dem through and through, but Romney really knocked my socks off," he says. "I thought, here's a guy who knows how to get things done."

Now, six years later, Romney and Gruber no longer see eye to eye. With Republicans whipping themselves into an apocalyptic frenzy over President Obama's newly minted health overhaul —which happens to be a close replica of the Massachusetts model—Romney has morphed into the law's harshest critic, calling Obamacare "an unconscionable abuse of power" and vowing to lead a nationwide campaign to repeal it. Gruber, for his part, will never again consider voting for Romney. "He's the one person who deserves the most credit for the national plan we ended up with," says the economist, who has also advised Obama on health care. "And yet he's railing against it. Does the guy believe in anything?" The media, meanwhile, are gleefully writing Romney's political obituary, claiming that the similarities between Obamacare and Romneycare will alienate Republican primary voters —and that Romney's convoluted efforts to pretend the plans don't share some DNA will alienate everyone else.

But should Romneycare really be the end of Romney? It's true that the governor has an irritating tendency to rebrand himself for each new campaign. But on health care, he was an innovator when it mattered most, shepherding a plan with clear conservative roots through a liberal legislature and showing the rest of the nation how to fix its broken insurance system in the process. Our political culture may be too polarized to see Romney's résumé in anything but electoral terms, and Romney himself may be too much a part of that culture. But this doesn't change the fundamental fact that Romneycare was a groundbreaking accomplishment. Unless we value gridlock, solving big problems is something that should qualify people for the presidency, not disqualify them.

In fact, Romneycare is exactly the kind of plan a GOP candidate should be able to run on in 2012: a center-right idea that is proven to work. Consider the policy's intellectual history. Today, Republicans claim that individual mandates are unconstitutional. But the first president to embrace the concept was a Republican: Richard Nixon. By the late 1980s, a pair of conservative health-care economists, Mark Pauly and Stuart Butler, were pushing GOP leaders to combat the Democratic Party's single-payer proposals with a package of market reforms centered on insurance exchanges, mandates, and subsidies. In 1989 their work inspired President George H.W. Bush to assemble a plan that would require individuals to buy insurance. Unfortunately, Bush's brain trust decided his program was too conservative to survive a Democratic Congress. In 1993, however, Senate Minority Leader Bob Dole based the GOP's official policy response to Hillarycare on one of Butler's Heritage Foundation proposals, and 10 years later, Romney relied on the same model to create what he calls "the ultimate conservative plan" in Massachusetts—the plan that would, in turn, go on to serve as the basis for Obamacare.

None of which would matter if Romneycare weren't effective. But it is. Conservatives complain that coverage in Massachusetts is still relatively expensive and that early costs were higher than expected. They're right—largely because Romneycare was implemented immediately, without cost controls in place. As a result, the program experienced an initial budget shortfall and premiums remained steep. But now, as the legislature tackles expenses, the net cost of the plan has stabilized at a little more than 1 percent of the state's budget. And while some rates are still rising, others—like nongroup individual premiums—have declined by as much as 40 percent. Best of all, only 160,000 Massachusettans are uninsured today, down from 600,000 in 2006.

The problem for Romney, of course, is that his reforms so closely resemble Obama's that whenever he promotes the former, it sounds as if he's praising the latter—a bind that clearly frustrates the former governor. "Some Republicans seem to believe that our Massachusetts program has to be decried in order to justify their criticism of Obamacare," he tells NEWSWEEK. "But in my view, they're wrong." To differentiate his plan, Romney has taken to attacking Obamacare's cost-control measures and claiming that only the states should implement reforms. But neither argument seems likely to quiet critics. Republicans won't suddenly decide that something they believe to be socialist tyranny is OK as long as it's imposed on a state-by-state basis, and most voters want more cost control, not less. By splitting hairs, Romney is only reinforcing the perception that he's willing to say anything to get elected—and he's risking both Democratic and Republican support in the process. A more consistent message than "replace and repeal" might go something like this: "Reform was a Republican idea, and the Democrats are messing it up. Who better than me to fix it?"

Ultimately, conservatives who treat Romneycare like an albatross rather than an achievement are discouraging local Republican leaders from pursuing reasonable center-right solutions. In the 1980s and 1990s the most innovative welfare, education, job-training, and economic-development programs emerged from state capitals controlled by Republicans. Tommy Thompson spearheaded the national push for welfare reform from Wisconsin; in Michigan, John Engler proved that high standards, rigorous assessments, and strong public charter schools could boost student achievement. When these policies went mainstream, the GOP didn't disown them—it applauded. But now the party seems to be too obsessed with oppositionism to contribute constructively to the national conversation. During a speech in Baltimore on Feb. 2, 2007, Romney outlined his ambitions for the Massachusetts plan. "I'm proud of what we've done," he said. "If Massachusetts succeeds in implementing it, then that will be a model for the nation." Last month Romney's dream came true. If Republicans knew what was good for them, they would stop treating it as a nightmare.