WASHINGTON -- The 10th amendment is a cause celebre among the Tea Party. So Mitt Romney’s argument that uses state sovereignty to defend his health care mandate in Massachusetts should be taking off with conservatives, right?
The former governor of the Bay State hopes to move past RomneyCare by delivering a major speech Thursday that addresses about how he would change ObamaCare at the federal level. But many conservatives still don’t think he’s sufficiently dealt with questions about his own record.
“The poor guy got told that conservatives buy this,” said Grover Norquist, president of Americans for Tax Reform, in an interview. “Well, no, they don’t.”
Norquist was referring to research from the conservative Heritage Foundation that was used to bolster Romney’s 2006 signing of a universal health care bill -- a bill that is now, as Norquist put it, a “boat anchor” around Romney’s neck.
Many conservatives believe Romneycare is a fatal flaw that will destroy its namesake’s chances of winning the GOP presidential nomination next year. While Norquist did not go that far, he said that Romney’s approach, up to this point, has been inadequate.
“It’s a little uncomfortable when someone says, 'I am for freedom where you are but not where I lived,'” Norquist said.
Karl Rove, a former top White House adviser to President George W. Bush, agreed.
“Thus far, he’s sort of had the 10th Amendment answer, which is that states have the right to be the laboratories of democracy and test things, but the federal government doesn’t have a right to try and regulate all of us. I’m not certain that’s satisfactory,” Rove told conservative radio talk show host Hugh Hewitt on Tuesday.
The 10 amendment to the U.S. Constitution says: “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” It has become a rallying cry for many in the Tea Party, who have called for a shrinking of the federal government’s reach and power and a deference to states beyond Washington’s enumerated powers. This governing philosophy, often referred to as Federalism, has in fact been a bulwark of conservatism for decades.
Romney has appealed to the Federalist argument for years, seeking to neutralize concerns about the mandate in the Massachusetts law requiring individuals to have health insurance.
“I’m a Federalist. I don’t believe in applying what works in one state to all states if different states have different circumstances,” he said in December 2007 on NBC’s “Meet the Press.”
In a USA Today op-ed to be published Thursday morning, Romney wrote that if he were elected president, he would issue an executive order “paving the way for waivers from ObamaCare for all 50 states” and would call on Congress to repeal President Obama’s health care overhaul, which was passed a little more than a year ago.
Of his own health care law, Romney wrote in the op-ed: “Different states will experiment with and settle on the solutions that suit their residents best. Some states might pass a plan like the one we did in Massachusetts, while others will choose an altogether different route.”
But given the amount of time that Romney’s argument has been in the public square, its failure to take hold among grassroots conservatives suggests that it's not very persuasive.
“He can try the 10th Amendment gambit, but I believe it’s just that, a gambit,” Bob MacGuffie, a Tea Party activist in Connecticut, wrote in an email to HuffPost. “I think the grassroots perceive that Romney’s not reliable on the issues. He’s got very little, if any, grassroots support -– he’s just not genuinely passionate about our issues.”
James Capretta, a health care expert at the Ethics and Public Policy Center, made a similar point. “I really doubt he’s going to be able to win them over on that argument alone," he said. "On substance I think they’ll say, 'Even so, someone who would have done this thing as governor of a state, even though he might have the right to do it, doesn’t mean we want him to be president.'”
Yet there are some conservatives who say Romney could still make the argument that what happens in Massachusetts can stay in Massachusetts.
“The ObamaCare plan is different from Governor Romney's health plan because of the fundamental difference between state based reform versus a federal takeover of the health care sector of the economy,” said Brian Darling, director of Senate relations at the Heritage Foundation. “Romney could turn the health care issue into a good issue for him if he becomes the number one critic of ObamaCare.”
That appears to be the tactic Romney will try to take in his speech Thursday at the University of Michigan.
But thus far, Romney’s approach to his health care problem has differed sharply from the way that Minnesota Gov. Tim Pawlenty, another 2012 hopeful, has spoken about one of his controversial past positions.
During a debate last week in Greenville, S.C., Pawlenty addressed his past support of cap and trade legislation. “It was wrong, it was a mistake, and I’m sorry,” he said.
Pawlenty's camp, which believes it has neutralized the cap and trade issue, thinks Romney's response will only embed the health care thorn in his side more deeply.
There are rumors that some in Romney’s camp think the putative frontrunner should give a similar mea culpa. But if those rumors are true -– and Romney aides denied that they are -– that side has so far lost the internal debate.
UPDATE: 9:22 P.M. -- The Wall Street Journal delivered a nasty blow to Romney with an editorial released online eviscerating Romney's health law, his approach to it then and now, and laying out why they believe he is "compromised and not credible" on the "central question of 2012."
The only good news we can find is that the uninsured rate has dropped to 2% today from 6% in 2006. Yet four out of five of the newly insured receive low- or no-cost coverage from the government. The subsidies will cost at least $830 million in 2011 and are growing, conservatively measured, at 5.1% a year. Total state health-care spending as a share of the budget has grown from about 16% in the 1980s to 30% in 2006 to 40% today. The national state average is about 25%.
The safety-net fund that was supposed to be unwound, well, wasn't. Uncompensated hospital care rose 5% from 2008 to 2009, and 15% from 2009 to 2010, hitting $475 million (though the state only paid out $405 million). "Avoidable" use of emergency rooms—that is, for routine care like a sore throat—increased 9% between 2004 and 2008. Meanwhile, unsubsidized insurance premiums for individuals and small businesses have climbed to among the highest in the nation.
Like Mr. Obama's reform, RomneyCare was predicated on the illusion that insurance would be less expensive if everyone were covered. Even if this theory were plausible, it is not true in Massachusetts today. So as costs continue to climb, Mr. Romney's Democratic successor now wants to create a central board of political appointees to decide how much doctors and hospitals should be paid for thousands of services.
The Romney camp blames all this on a failure of execution, not of design. But by this cause-and-effect standard, Mr. Romney could push someone out of an airplane and blame the ground for killing him. Once government takes on the direct or implicit liability of paying for health care for everyone, the only way to afford it is through raw political control of all medical decisions.
Read the whole thing here.