By Glen Johnson
As Mitt Romney prepares for a major address on health care here this afternoon, the likely presidential contender is still expected to continue defending what has become a third rail in Republican politics: a requirement from government that people purchase health insurance.
The so-called individual mandate was a core component of the signature health care plan Romney signed into law while governor of Massachusetts, and he has stuck by that decision -- even as he has decried it as part of the federal plan signed into law last year by President Obama.
During a question-and-answer period last month in Las Vegas, for instance, Romney used an example of someone without insurance getting in a car wreck and going to the hospital.
"We don't let them die in the streets," Romney said. "They go to the hospital and are treated. And guess who pays for that? You. Government. You all are paying for that."
He said the example underscored his reasoning behind signing the Massachusetts law, which required Massachusetts residents to obtain health insurance or face tax penalties.
"We're going to insist on personal responsibly," he said. "We're going to say that people who have the ability to pay should pay for themselves. And that concept led to us coming up with an experiment."
He also made clear, however, that he did not support the federal law, saying it was an overreach into a policy that should be decided by states.
"I would never do what President Obama did, which is usurp the power of the states and replace it with an overreaching federal government hand," Romney said. "That's the wrong way."
Whether Romney is able to effectively draw the distinction between his support for a state-imposed individual mandate -- and his opposition to a federally-imposed one -- may be crucial to his ability to explain a health care position that has caused some Republicans to doubt his presidential chances.
Romney is not expected to denounce the Massachusetts plan today, as some Republicans have wanted him to, and instead is planning to focus far more on his vision for dismantling President Obama's overhaul and creating a new national model. In an op-ed Romney writes in today's USA Today, for example, he mentions the word "ObamaCare" eight times, but only mentions Massachusetts once.
His five-point proposal -- to be outlined today in a PowerPoint presentation -- has an over-arching goal of giving states more power in the health coverage arena. He would give states block grants for Medicaid, for example, and allow them to craft their own coverage plans.
Romney also proposes offering a tax deduction to those who buy their own health insurance on the open market, just as those who buy it through their employers can now have their health costs taken out before taxes. His plan would also allow individuals to purchase insurance across state lines, according to his op-ed. A Romney adviser said the plan would not add to the deficit or raise taxes, but Romney has not yet detailed how much the tax deduction would cost and how that would be offset.
Romney's plan also includes malpractice reform, capping damages in lawsuits and giving grants to states to come up with alternate ways to resolve legal disputes.
His plan would still ensure that people with preexisting conditions aren't refused access to coverage, one of the most popular aspects of the Obama plan.
Romney, in a policy address for a campaign in which he has still not publicly described himself as a candidate, will become the first in the GOP race to outline a health care proposal. It is a bold move as he seeks to turn one of his biggest perceived negatives into a positive.
But as an indication of some of the challenges ahead, his apparent reluctance to address Massachusetts health care head-on is already drawing criticism in some conservative circles.
"Mr. Romney now claims ObamaCare should be repealed, but his failure to explain his own role or admit any errors suggests serious flaws both in his candidacy and as a potential President," the Wall Street Journal writes this morning in a harsh editorial.
Democrats are also planning to go all out in trying to rebut Romney today, in a way that they have not done for any of the other Republican hopefuls.
Michigan Democrats are planning to criticize Romney before his speech here, and Massachusetts Democrats are planning a conference call following the speech. National Democrats this morning are releasing a mock presentation of the "missing slides from Romney's Powerpoint."
Democrats have also been pointing to comments Romney once made in which he supported a plan that included a federal individual mandate.
During his 1994 US Senate campaign against the late Edward M. Kennedy, Romney said he would have backed a health care bill that had been crafted by then-Senator John Chafee, a Rhode Island Republican. That plan included a federal mandate.
"I'm willing to vote for things that I am not wild with," Romney told the New Republic of the plan. That comment was resurrected yesterday by the Massachusetts-based liberal blog Blue Mass Group.
When asked about the past comments, a Romney spokeswoman stressed that he does not now support a federal mandate.
"Governor Romney has made it very clear over the last many years, including during the 2008 presidential cycle, that he opposes a federally imposed individual mandate," spokeswoman Andrea Saul said in a statement.