METAIRIE, La. — Mitt Romney on Friday looked to pre-empt Supreme Court arguments that will shine a spotlight on a key vulnerability for him in the Republican primary – health care reform.
Romney called Democratic President Barack Obama's signature overhaul "an unfolding disaster for the American economy, a budget-busting entitlement and a dramatic new federal intrusion into our lives."
Romney was marking the second anniversary of the signing of the health care law, which requires all Americans to pay insurance or face a tax penalty. That mandate to buy insurance has become a focal point for conservative anger, and critics say it represents unwanted or even unconstitutional government intrusion.
Romney, though, signed a health reform law as governor of Massachusetts that required everyone in the state to buy insurance, legislation that became the model for the national overhaul. Romney's support of the Massachusetts law has fueled conservative criticism against him. Skepticism about his health care record, combined with moderate positions he's taken on other issues in the past, is part of what's contributing to Romney's struggle to wrap up the GOP nomination.
The White House on Friday released a report highlighting the benefits of the overhaul, including a provision that makes it illegal for insurance companies to refuse to cover people who have pre-existing medical conditions.
In a written statement, Obama said the law "has made a difference for millions of Americans, and over time, it will help give even more working- and middle-class families the security they deserve."
The health care law is unpopular with voters. An AP-GfK poll conducted in February found that overall, 35 percent of Americans say they support the health care reforms Congress passed two years ago, while 47 percent oppose it.
Coming up next week are three days of arguments in the Supreme Court over whether the overhaul, particularly the requirement to buy insurance, is constitutional. Among other options, the justices could uphold the law, strike it down completely or get rid of some provisions.
The arguments are likely to shine a spotlight on Romney's own health care record in Massachusetts.
As governor, Romney signed a health care law that requires everyone in Massachusetts to buy insurance or pay a penalty. The law ended up covering most of the uninsured in the state, but health care costs have risen in the years since it was passed. Critics have dubbed it "RomneyCare," and the plan inspired the national law.
In addition to a mandate to buy insurance, both Romney's law and the national plan include special marketplaces to buy insurance, as well as a series of requirements that health plans have to meet in order to sell plans there.
Romney has refused to disavow the Massachusetts legislation, instead saying that it was the right plan for his state. He says he has never believed it should have become a national model and insists states should be allowed to come up with their own solutions to health care problems.
"Different states have created different approaches, and I will return to states the responsibility for caring for their own uninsured," Romney said Friday as he campaigned in Louisiana.
Still, Democrats were quick to point out that Romney has previously suggested his Massachusetts law could become the basis for a national plan. "Lessons we learned in Massachusetts could help Washington...find a better way," Romney in 2009 wrote an opinion piece in USA Today. Obama campaign strategist David Axelrod has pointed out that the White House used Romney's plan as a model for the national legislation.
"Gov. Romney was an early supporter of the individual mandate, and as governor put a mandate in place to ensure all Massachusetts residents were taking responsibility for their own health care and everyone could get covered at a lower cost," Obama campaign spokesman Ben LaBolt said in a statement. "He called his health care reform plan a national model."
Romney says that his plan was right for his state, but insists it shouldn't have become the basis for a national plan.
If Obama intended to use the Massachusetts law as a model, "Why didn't he call me?" Romney routinely says when he's asked about the issue at campaign stops.
The individual mandate was originally proposed by a conservative think tank as an alternative to the national health plan that then-First Lady Hillary Clinton was proposing in the mid-1990s. Republican presidential candidate Newt Gingrich, then the Speaker of the House, backed the idea at the time.
Now, the public remains broadly opposed to an individual mandate. Six in 10 say they oppose a law that would require every American to have health insurance or pay a penalty if they don't. Just 34 percent support a mandate for individuals to have health insurance.
There are other provisions that are more popular. The health law also made it illegal for insurance companies to deny health coverage to people because of pre-existing medical conditions.
Still, that requirement is part of why the mandate is also included in the law – it makes sure that young, healthy people are buying insurance even if they don't need very much medical care. That brings down insurance costs for everyone. A mandate also keeps people from using emergency room care when they don't have insurance.
Romney recognized those realities at the state level. "Getting every citizen insured doesn't have to break the bank," he wrote in the 2009 opinion piece. "Using tax penalties, as we did, or tax credits, as others have proposed, encourages `free riders' to take responsibility for themselves rather than pass their medical costs on to others."