For Romney, focus is always ‘Obamacare,’ never ‘Romneycare’

The Supreme Court’s decision to uphold the individual mandate central to President Obama’s healthcare law carried immediate benefits for Mitt Romney, namely a newly energized Republican electorate and the ability to keep hammering his promise to repeal the law on “Day One.”

“This is the time of choice for the American people,” the presumptive nominee said during an appearance in Washington on Thursday. “If you don’t want the course that President Obama has put us on, if you want instead a course that the Founders envisioned, then join me in this effort. Help us. Help us defeat Obamacare.”

But the Supreme Court’s decision also was a reminder of what Romney’s campaign would like Republican voters to forget — that he too embraced an individual mandate in his efforts to win universal healthcare for his state as governor of Massachusetts. The law that was once considered Romney’s signature achievement is one that he now rarely mentions.

Romney’s healthcare law, which required most state residents to purchase health insurance or pay a fine, engendered distrust among millions of Republican primary voters who viewed the law as the precursor to Obama’s healthcare plan. And Romney’s rejection of the president’s federal effort opened him to charges of flip-flopping from opponents on both sides.

On the eve of Thursday’s decision, the Democratic outside group American Bridge 21st Century dredged up video of Romney from a 2006 press conference speaking favorably of a healthcare mandate.

“With regards to the mandate, the individual responsibility program which I proposed, I was very pleased to see that the compromise from the two houses includes the personal responsibility principle,” Romney said in the 2006 video released by American Bridge. “That is essential for bringing healthcare costs down for everyone and getting everybody the health insurance they deserve and need. So I was very, very pleased with that development.”

On the campaign trail over the last few years, Romney’s emphasis has been dramatically different. He has insisted, as he did Thursday, that Obama’s healthcare law was an overreach of federal power. And he has argued that while states may have the power under their constitutions to care for the uninsured (as his state did), “the federal government should not take over that power,” he has said.

When pressed in interviews, the former Massachusetts governor has also rejected the notion that his law inspired Obama’s federal law. “People asked me, would you use your RomneyCare and have a federal program just like it? And I said, ‘Absolutely not,’” Romney told CNN host Piers Morgan last year, “It would violate the Constitution, and states have differences that you have to accommodate.”

At the same time, Romney has refused to disavow the Massachusetts law, noting that it is popular within his state and has helped to insure millions of children.

But those are fine distinctions to make in the heat of a presidential campaign. For that reason, when Romney has talked about healthcare on the campaign trail, his focus is squarely on his criticisms of Obama’s plan, which he described this week as a massive “power grab by federal government.”

Romney’s vow to repeal and replace Obama’s healthcare plan as one of his first acts in office has become one of his most reliable applause lines. But he has offered few details about how he would “replace” that plan as president, though his aides promise that there is still plenty of time to reveal those details in the remaining four months of the race.

Among the few hints about his plans: He has said he would task states with caring for the uninsured and the poor, rather than having the federal government impose “a one-size-fits-all Obamacare-type plan.” But he has offered only the vaguest details about how that would work, stating, for example, that he would distribute the money that “the government normally sends” to states as block grants.

The former Massachusetts governor has come under fire from Democrats for failing to embrace one of the most popular provisions of the president’s plan, which prohibits insurance companies from discriminating against people with pre-existing conditions.

During a question-and-answer session with voters in Ohio in late February, Romney said that he would support a federal law that would prevent insurance companies from dropping patients who become sick, but then offered a different definition of “pre-existing conditions coverage.”

“I want to make sure that at the federal level we have a law that says the insurance company can’t drop you from coverage if someone gets sick in your family or if you get sick,” he told the audience in Ohio. “I also want to make sure that someone who’s been continuously insured and becomes ill, if they change jobs or lose a job can’t be denied coverage. That’s the so-called preexisting coverage provision.”

On Thursday, he did not mention the “continuously insured” requirement of his plan when announcing that as president he would make sure “that those people who have pre-existing conditions know that they will be able to be insured and they will not lose their insurance.” The Romney campaign said there had been no shift in his policies.

As usual, there was no mention of Romney’s own plan in Massachusetts, much less the lessons that he learned from that experience.

maeve.reston@latimes.com

Twitter: @maevereston