If the Supreme Court Kills ObamaCare, Should We Thank Mitt Romney?

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.

Comments (5)

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  1. Ken says:

    Interesting twist on this issue.

  2. Aurelius says:

    That first paragraph made me depressed.

    I guess Repeal is a pipe dream.

  3. Brian says:

    Good post, but I would disagree with Graham a little – one, I don’t think all liberals were against the individual mandate. Certainly, diehard-leftists want the employer to provide insurance, but they wouldn’t be opposed to the individual mandate if part of the deal involved the poor and at least most of the working class being given free healthcare through Medicaid.

    Also, at the end of the day, I think this bill is about control – that is, controlling an entire industry and making sure that almost everyone participates in paying into it. The individual mandate strikes me as a “Centrist” idea, if it had to be labeled as anything.

    I really do believe that, in our country, somewhere in the realm of centrism there is a road to authoritarianism. I hope we never find that road.

  4. Arnie Ree says:

    Well, that would be going around your elbow to get to your thumb, but I’ll take whatever works to kill the ACA.

  5. Linda Gorman says:

    Interesting but another hypothesis covers more of the available facts. A variety of state reforms have been funded by a few foundations dedicated to ending private medicine since the failure of ClintonCare and the founding of the Robert Wood Johnson state experiments in the early 1990s. They included Kentucky Kare, TennCare, and the insurance “reforms” that destroyed health insurance markets in New York, New Jersey, and Massachusetts.

    What all of the foundation experiments had in common was a steady increase in centralized control over individual health care choice, a fondness for HMO structures, and the expansion of third party payment.

    With the collapse of TennCare, it was evident that enrolling the uninsured in Medicaid would not work. The experience in New Jersey showed that guaranteed issue with community rating simply produced astronomical premiums. It was clear that the grand design would be a failure without a way to force the relatively healthy to subsidized people who were poor risks. This produced the incessant babble about needing a large risk pool to lower costs.

    Massachusetts as the test bed for the individual mandate was simply the next step in this process. If Romney hadn’t gone for it another governor would probably have been convinced to cover himself in glory by “solving” the health care crisis by talking about individual responsibility as he cynically committed to using the people of his state as guinea pigs.