Defending Romney’s health plan, a Mass lawmaker makes the conservative case for the individual mandate

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HUDSON, N.H.—During a question-and-answer session this afternoon in a metal-fabrication shop, with the Republican minority leader of the Massachusetts House in attendance, Mitt Romney touted the health care plan he passed when he was governor.

"I want to get your rates down," Romney told a man who complained his rates had gone up ten-fold. "You know there's a lot about the Massachusetts health care plan. There are parts I like, and parts I don't like. One of the things I do like is that I understand for individuals, who wanted to buy insurance who were not part of a group, or a big corporation, the premiums for individuals dropped by 40 percent, when our plan came into place. Because again, there was competition by the various insurance companies ... I hope to be able to do that for you sir."

After the event, I asked Massachusetts House Minority Leader Bradley Jones why his state's plan—which closely resembles the national plan enacted under President Obama—isn't a good model for the nation, as Romney and others have argued.

"You know, Massachusetts' health care plan was an experiment," he said. "And for me, one of the fundamental misgivings about the whole Obama plan, aside from some of its underpinnings, is you didn't even let a state have an experiment to try out, to see does it validate certain assumptions, what are the things to take into account, how does it play out. I learned in school, when you do an experiment you got to let it run its course a little bit before you say 'hey, let's start the next experiment based on that.'"

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I wondered why Massachusetts, where the state plan has earned high approval ratings, shouldn't be considered the validating experiment for the national plan, as others who worked on the plan, like M.I.T.'s Jonathan Gruber, have argued.

Jones said the federal government needed to let Massachusetts' plan "play out."

"Because before we even embarked on it—this law was passed in 2006, and before we could even implement or have it really ramp in, they were doing things at the federal level with Obamacare. Because he was talking about it in 2009. Now as it's playing out, there are some things we could go back and change and certain assumptions we could maybe fix. You know, maybe we need to go back and look at what's comparable coverage, because there are some people who had coverage. Again, some of the assumptions that were put in place, haven't been carried out the way they were envisioned."

Jones said he didn't share the reflexive opposition to the individual mandate—the part of the law that would compel everyone to get insurance—which has become party orthodoxy in recent years, after conservatives flirted with the idea over the last two decades.

"What I would say to Republicans is, and I think Governor Romney has said this, I kind of view it as a conservative thing," he said. "Because we had a lot of free-riders."

He said that many of the "free-riders" were able-bodied young men who simply didn't think they would get hurt, but eventually ended up in hospitals, with the cost going to Massachusetts' taxpayers.

"This is a way of saying we're going to have personal responsibility, which is a conservative principle," he said.

But how could the federal government achieve a 40 percent reduction in premiums—like Romney had suggested—without the individual mandate?

"Well, I think there's going to be a component of tort reform, I think empowering people to have information about outcomes," Jones said.

Romney didn't wade quite that far into the discussion in his comments, saying only that he wanted to make it easier for health care companies to compete for individual subscribers, without having to be part of an employer plan.
"What I'm going to do is get the private insurance business to be more competitive," he said.
"You'll see companies competiting, like they do for car insurance. You watch that TV—that little, what is that little animal, that little gecko—you see these guys competing hard for your business."