Mitt Romney, who was for health care reform before he was against it, now sounds like he's for it again. Or maybe not. The Republican presidential nominee said over the weekend that he would keep key provisions of the Affordable Care Act, the health care reform law he vows to repeal. Then a Romney aide said that wasn't exactly right. In any event, this clumsy pivot toward a general election campaign underscores the popularity of some portions of health care reform and the foolishness of Romney's unqualified pledge to kill it.
In an interview Sunday on NBC's Meet the Press, Romney said that he would keep some provisions of the Affordable Care Act after he persuades Congress to repeal President Barack Obama's signature legislative accomplishment.
"I'm not getting rid of all of health care reform," Romney said. "There are a number of things that I like in health care reform that I'm going to put in place. One is to make sure that those with pre-existing conditions can get coverage. Two is to assure that the marketplace allows for individuals to have policies that cover their family up to whatever age they might like. I also want individuals to be able to buy insurance, health insurance, on their own as opposed to only being able to get it on a tax-advantage basis through their company."
Funny, those concessions weren't mentioned during the Republican National Convention, where Obamacare was a dirty word.
The Affordable Care Act already bans insurers from refusing to cover children with pre-existing conditions, and that provision will extend to adults in 2014. The law also enables parents now to keep their children on their health care policies up to age 26. The Centers for Disease Control and Prevention reported Monday that the percentage of adults between 19 and 25 years old who were uninsured last year declined from more than 33 percent to 28 percent. That's the largest annual decline since the CDC began collecting the information 15 years ago. No wonder Romney has seen the light on at least this provision of health care reform.
He may have had an epiphany about banning insurers from rejecting patients with pre-existing conditions. An aide tried to clarify later that Romney only wants insurers to keep patients with pre-existing conditions who have continuous coverage. That means their policy would not get canceled, not that the uninsured could find coverage, and it doesn't paper over a moment of candor. And Romney's indication that he wants individuals to be able to more easily buy health insurance themselves rather than through their employers is exactly what the health care exchanges in the Affordable Care Act are designed to achieve.
Romney knows how health care reform works. As Massachusetts governor, he signed into law the 2006 reforms that require most state residents to have health coverage. Insurance is based on spreading the risk, and it's difficult to imagine requiring insurers to cover everyone with pre-existing conditions unless nearly everyone is required to have coverage. Yet as he seeks support from moderate and independent voters following the Republican National Convention, Romney says he would keep the most popular portions of health care reform while repealing the strong medicine that goes with them.
Those calculations don't work. But in the best light they may signal that Romney might be more pragmatic as president than he is as the Republican nominee hostage to the most conservative members of his party.