There is no doubt that the campaign to “repeal and replace” ObamaCare will have its weakest standard bearer if Mitt Romney becomes the Republican candidate for President. His embrace of an “individual mandate” to buy health insurance or pay a penalty, as legislated in his 2006 Massachusetts health reform, is anathema to those faithful to the ideal of limited government. When Mr. Romney declares that he will issue a universal waiver from ObamaCare’s regulations as his first executive order, the people who should be voting for him fear that such action would be a substitute for repeal, instead of a preparation for it. (Do these folks really think a clean repeal bill, like the one passed by the House of Representatives in January 2010, will be on the president’s desk on inauguration day?)
But maybe we should look at it another way: If Mitt Romney had never signed his 2006 law (which was motivated, as the president’s men are so fond of telling us, but an idea generated at The Heritage Foundation), those of us committed to defeating ObamaCare would never be in the fortunate position we are today – the whole, ungodly mess hanging by a thin thread after a brutal hazing in the Supreme Court last week.
Without Massachusetts’ 2006 law, there is almost no likelihood that the Democrats would have written an individual mandate into the bill. Instead, they would have just hiked taxes. The only reason they painted a thin varnish of so-called “individual responsibility” onto the bill was so that they could pin some of the blame on Mitt Romney and certain conservatives who had embraced it. As noted by Avik Roy, the individual mandate was traditionally anathema to liberals, who prefer straight-forward tax hikes.
The individual mandate is a small part of ObamaCare’s financing. According to the Congressional Budget Office’s original score, it was scheduled to raise $65 billion over ten years (2010 through 2019), only 5 percent of ObamaCare’s $1.2 trillion dollar haul, of which 62 percent was supposed to come from revenue and 38 percent from “savings” (i.e. throwing granny under a bus by cutting Medicare). The biggest share of revenue, $210 billion, was to have come from increasing the Medicare payroll tax. There were provider taxes of $109 billion; and assorted other taxes (including limiting the deductibility of medical expenses) of $102 billion.
The Democrats never shirked at labeling those taxes accurately. So why not just frame the penalty for disobeying the individual mandate as a tax on the rich? The same cash flows could have easily been labeled taxes as penalties. Indeed, it would have been easier to write into the bill and far more appealing to the president’s political base. Most importantly, it never would have raised the slightest constitutional objection.
The only reason to take this run at the Constitution was to wield the individual mandate against conservatives in the next political campaign. As we can see from Mr. Romney’s struggle, it was a reasonable choice. But they didn’t count on the Supreme Court. If the Supremes do strike down ObamaCare, Mr. Romney might well deserve some of the credit – although he’d be loath to do so with this argument.
John R. Graham is Director of Health Care Studies at the Pacific Research Institute, & Senior Fellow at the National Center for Policy Analysis. This post first appeared at John Goodman’s National Center for Policy Analysis health blog.