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Mitt Romney’s health problems

The former Massachusetts governor attempts to distance himself from his health-care reforms. But wil

No, he's not the front-runner, but the former Massachusetts governor Mitt Romney is determined to snatch the Republican presidential nomination this time round. This week he managed to raise $1m for his campaign in a single, brief visit to New York, the former president George W Bush helping to pull those big-time Wall Street donors in.

Yesterday, he tried to overcome one of his biggest political obstacles in the GOP heartlands: his record on universal health care.

For though Romney is no liberal, the Massachusetts health-care bill that he helped to design and signed into law is widely credited with inspiring the current president's Obamacare plan.

Yes, that's right, the "socialised medicine" plan that Republicans are up in arms about – the plan that Romney himself described as "an unconscionable abuse of power", the plan that some states are at this very moment trying to prove is against the US constitution – was based on a Republican's idea.

Big Bad Gov

The main part that Republicans are challenging is the part that says citizens will be required by law to have health insurance. It's Big Government gone mad and an intrusion into private lives, say the conservatives. This is a sentiment shared by Romney – even though his Massachusetts law introduced America's first such requirement, making everyone get health coverage or pay a fine.

Yesterday, in a suitably businesslike PowerPoint demonstration in Ann Arbor, Michigan, Romney argued that he wants to "repeal and replace" Obamacare, in the hope that this will lay to rest any idea that he was the man behind the idea in the first place.

Not that he's apologising for the Massachusetts law, as conservative activists would no doubt prefer. An editorial in the Wall Street Journal did not pull any punches: "His failure to explain his own role, or admit any errors, suggests serious flaws both in his candidacy and as a potential president."

There was a sort of rowing back in March when he told supporters that "our experiment wasn't perfect – some things worked, some things didn't, and some things I'd change". Today he'll be tackling the issue head on, riskily choosing to lay out the detail of what he'd like to see instead of Obama's reforms.

And instead of dwelling on details of the past, Romney explained his alternative, claiming that Obamacare tramples all over the rights of states. He said he wants to give states block grants to provide their share of Medicaid and children's health schemes.

Abort, retry, fail

People would get a choice between tax credits to help fund insurance provided by their employer, as happens now, or a new type of tax deduction for those who decide to buy their own plan. He'll allow people to buy insurance across state lines. And he'll keep – but narrow – the rules that currently prevent insurers from refusing to cover people with pre-exisiting conditions. According to one of his advisers, Mike Leavitt: "Government's role is to organise an efficient market, not run the system."

But, for Romney's critics, the role of government is exactly what's at stake. They believe his record on health care means he's fundamentally adrift from the GOP's core principles, which are based on letting the market and competition have their way.

The Democrats, naturally, are making as much as they can out of Romney's dilemma, releasing clips from a 1994 campaign speech where he supported the idea of a federal mandate, saying: "I'm willing to vote for things that I'm not wild with." And they have released their own mock-PowerPoint slides with some of those "missing ideas".

Romney has reinvented himself many times before. When he ran for the nomination in 2008 he depicted his Massachusetts health-care policy as a market-friendly alternative to the failed Bill Clinton plan, which managed to win him the backing of conservative groups such as the Heritage Foundation. Plus there's that well-documented change of heart on abortion. In 2002, he ran as pro-choice. By 2007 he was declaring that his previous views had been wrong.

That led to something of a reputation for being a man who constantly changed his mind. Indeed, there are still websites dedicated to "Mitt Romney flip-flops". As one pundit wrote in the LA Times back in March: "If anything is transparently clear about American politics, it is that Mitt Romney will do or say anything to become president."

The former governor hopes that his detailed argument about the future of health care in the United States will succeed in changing that reputation. Good luck with that, Mitt. Sounds like you'll need it.

Felicity Spector is a deputy programme editor for Channel 4 News.