The big news yesterday on the health care policy front is that the 11th Circuit case against the individual mandate is headed to the Supreme Court before the 2012 election, not after. This means a decision about the constitutionality of the individual mandate is likely to come in mid-2012, after the Republicans have chosen a nominee but well before the election ramp up. This is good political news for nearly everyone in the race on the Republican side, with one obvious exception: Mitt Romney.
Let’s back up a moment to explain why. There’s one line that Romney used in Florida during the most recent debate which is still sticking in my craw today, and I’m having a hard time shaking it. Excerpt – in response to a question from Chris Wallace about Perry referring to Romney’s Massachusetts’ reforms as “socialized medicine”:
“I don’t think [Perry] knows what he was talking about in that — in that regard. Let me tell you this about our system in Massachusetts: 92 percent of our people were insured before we put our plan in place. Nothing’s changed for them. The system is the same. They have private market-based insurance. We had 8 percent of our people that weren’t insured. And so what we did is we said let’s find a way to get them insurance, again, market-based private insurance. We didn’t come up with some new government insurance plan.”
Now, there’s a factual criticism here regarding the latter part of his comments, and the way people get that insurance under Romney’s plan – namely, the overwhelming number of those newly covered are subsidized by other taxpayers, and are on Medicaid, not private market-based insurance. This is directly the opposite of Romney’s case for his plan in 2007 and 2008, where he explicitly framed the matter not as a Massachusetts-specific solution, but as he said on the day he signed the bill into law, the “Republican way of solving a problem which we face as a nation.” He’s continued to maintain his approach is a “Republican way to reform the marketplace” which ensured personal responsibility, as opposed to “expecting someone else to pay” for your own care.
This is ironic, given that the effect of his plan has been to shift health care costs for the newly covered (reducing the number of uninsured from a little over 9% to 4.4%) to the taxpayers. Of the 412,000 people added to the insurance rolls in Massachusetts since 2006, 47% are on Medicaid, and only 7,000 of them have coverage not subsidized by other taxpayers.
