Too bad for Mitt Romney and the political cage he inhabits.
Romney's response to the landmark decision by the U.S. Supreme Court to uphold President Barack Obama's health care reform law was to shake his fist, promising to get rid of it "on my first day as president of the United States." Never mind that he would have no power to do so, unless he's running for king.
If Romney hadn't decided that he wants the presidency more than personal integrity, he might have savored the victory for a program modeled after the one he helped establish in Massachusetts as governor — with an individual mandate. It is now pretty popular. Even political independents in the Bay State have grown to embrace the overall program at upwards of 70 percent approval, with 58 percent endorsing the individual mandate. It has cut the number of uninsured residents in the state to less than 2 percent. Compare that to a state like Florida where nearly 4 million people are uninsured, or about 21 percent.
In Massachusetts, it must be tremendously comforting to know that regardless of a job loss or any pre-existing conditions, you and your family will always have access to affordable health insurance. The rest of America won't have too much longer to wait for similar health care security in 2014, as long as the Affordable Care Act remains on the books. Thank you for that, Chief Justice John Roberts!
As to the individual mandate, the requirement that everyone maintain health coverage or pay a penalty, Romney was for it before he was against it. In 2009, Romney said, "Using tax penalties, as we did … encourages free riders to take responsibility for themselves rather than pass on their medical costs to others."
Before Romney followed the right turn of his party, he understood that the individual mandate was the conservative approach to universal coverage and cost containment. It kept private insurers in the game as opposed to Medicare-for-all, an approach I favor but that sends conservatives running for their hammer-and-sickle banners.
As governor, Romney was so enamored with the individual mandate that he vetoed the employer mandate part of the Romneycare program (a veto overridden by that state's Democratic Legislature.) He wanted individuals alone, and not their employers, to shoulder the health insurance requirement. At the time, Romney had no liberty concerns that government was forcing its citizens to buy a product they didn't want. He was more interested in those "free riders."
But now that the U.S. Supreme Court has upheld the individual mandate in the ACA under Congress' taxing power, Romney and his allies are spitting mad, promising repeal.
They should be careful what they wish for, because the rest of Roberts' ruling constrains Congress' power to creatively address serious national problems. Conservatives may approve of limiting Congress' Commerce Clause powers and ability to condition federal funds for joint federal-state spending programs, such as Medicaid, on serving more people, but this boxing in of Congress will inevitably lead to a bigger federal government.
No matter how much tea-partiers stomp their feet, America is not going to go back to a time when government consisted of a post office and traveling circuit judge (and, of course, their sacrosanct Medicare, Social Security and veterans' benefits). Inevitably the United States will move toward a more progressive society, haltingly maybe, but universal health care is in this nation's future.
As Justice Ruth Bader Ginsburg points out in her partial dissent, Congress could have established "a tax-and-spend" single-payer program, but instead chose "a solution that retains a robust role for private insurers and state governments."
If the ACA is repealed, as Romney promises, a progressive Congress down the road may reject an approach that invites states and private insurers to participate, seeing it as risky in light of the court's precedent. That's the warning I have for all those who would see the death of Obama/Romneycare. Get ready for Medicare-for-all.