Think tank's book says Romney not to blame for Obama health law

It's unfair to call Mitt Romney the architect of President Obama's healthcare law because of how thoroughly the Republican presidential candidate's reforms were altered under his Democratic successor, a new book argues.

The Great Experiment, a free-market analysis of the 2006 Massachusetts healthcare law, makes the case for giving states more freedom to develop and test their own healthcare solutions.

One of the book's co-authors, on Capitol Hill Tuesday to tout the book, faulted Massachusetts insurance exchange regulators and Democratic Gov. Deval Patrick for fundamentally changing the goals of Romney's reforms, for example by requiring that everyone have high-value, comprehensive coverage.

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"Six months after the law was signed, there was an election and the Democrats took the corner office and as a result their political appointees were placed on the connector board and made a number of decisions that have differed from what the original vision for the reform was — or even what the debate was in the legislature," said Josh Archambault, director of healthcare policy for the nonprofit Pioneer Institute, which published the book.

Romney has come under increasing criticism from primary rivals Rick Santorum and Newt Gingrich for allegedly inspiring President Obama's national healthcare reform law, particularly its mandate that everyone have health insurance. Democrats and their allies have been more than eager to add to Romney's grief by saying his reforms inspired them every chance they get.

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The new book however argues Romney's successor transformed the Massachusetts law in five fundamental ways by:

• requiring far more expensive minimal coverage than the catastrophic insurance Romney had advocated for;

• increasing requirements on small businesses by requiring them to provide higher quality coverage to more workers to avoid penalties; 

• undercutting individual responsibility by offering free insurance to everyone under 150 percent of the federal poverty level;

• failing to transform the insurance marketplace for small business by limiting employee choices; and 

• failing to keep the cost of uncompensated care under control.

The Patrick administration for its part highlights the law's positives: Massachusetts has a far lower uninsurance rate than the national average (5.6 percent vs. 16.3 percent in 2010); a falling number of safety-net users (315,000 in 2010, down from 445,000 in 2006); and relatively stable premiums ($437 per month in the individual market in both 2006 and 2010) compared to the rest of the country.

The book goes on to argue that the federal government should empower states to experiment with reforms by reforming the tax treatment of insurance, creating state-administered high-risk pools and reforming Medicaid to give states more flexibility.


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