Mitt Romney, as my colleague Jonathan Chait keeps pointing out, has a big problem as he pursues the 2012 Republican presidential nomination: His signature achievement as governor of Massachusetts was creating a universal health coverage scheme that looks a lot like the Affordable Care Act.
In particular, the Massachusetts reforms include an individual mandate--a requirement that everybody get health insurance. The Affordable Care Act has one of those too. It's become the focus of the right's ire and is the element now under assault in the federal courts.
Romney shouldn't be ashamed of the Massachusetts reforms. As I noted yesterday, the system there is working rather well: More than 98 percent of residents, including nearly 100 percent of children, now have insurance, according to a new Urban Institute study. But Republican presidential aspirants can't make that argument, so Romney has been denouncing the federal law at every possible opportunity, calling it an "unconscionable federal power grab" and focusing on unpopular elements, like the cuts in Medicare spending, that aren't part of the Massachusetts law.
But yesterday's court decision and, more generally, all of the focus on the individual mandate puts Romney in real bind. There's no question that Romney thinks a mandate is ok in principle. He has said so repeatedly. In fact, he said it earlier this year, during an interview with Larry King. Via Wonk Room:
Because right now in this country, people that don’t have health insurance go to the hospital if they get a serious illness, and they get treated for free by government. My plan says no, they can’t do that. No more free riders. People have to take personal responsibility. I consider it a conservative plan.
So what did Romney have to say about Monday's decision by Judge Henry Hudson? He supports it, of course. Via the Atlantic and National Journal Daily:
"The court ruling supports Mitt Romney's view that 'Obamacare' is an unconstitutional power grab by Washington,'' said Romney spokesman Eric Fehrnstrom. "We should repeal the law and return to the states the power to determine their own health care solutions."
To be fair, Romney's statement is consistent with his previous defenses of the mandate in Massachusetts. After all, Hudson's decision says nothing about whether states have the discretion to impose mandates. It concerns itself only with federal power. In theory, Romney can support Hudson's ruling and still believe the mandate is ok, just so long as states rather than the federal government imposes it.
But the emphasis is on "in theory." In practice, it's not as if most of the people who oppose the individual mandate are trying to split hairs over issues of federalism. They think the requirement infringes upon personal liberty. Full stop.
Somehow I don't think they'll give Romney a pass just because he's willing to let state legislators, rather than federal ones, tell them they have to get health insurance.