In it, but not of it. TPM DC
The new message reflects a Republican Party consensus against using government power to help insure the tens of millions of Americans who lack coverage -- the Affordable Care Act's key accomplishment. In 2008, President George W. Bush created an election year controversy when he boasted, "[P]eople have access to health care in America. After all, you just go to an emergency room." But for Romney, it's the culmination of a years' long conservative pressure campaign, which has forced him to abandon the premise of his 2006 Massachusetts health care law.
To fully appreciate the enormity of Romney's shift, you need go no further than Romney's own book or a series of public statements he made, some as recently as 2010.
"After about a year of looking at data -- and not making much progress -- we had a collective epiphany of sorts, an obvious one, as important observations often are: the people in Massachusetts who didn't have health insurance were, in fact, already receiving health care," Romney wrote in No Apology.
Under federal law, hospitals had to stabilize and treat people who arrived at their emergency rooms with acute conditions. And our state's hospitals were offering even more assistance than the federal government required. That meant that someone was already paying for the cost of treating people who didn't have health insurance. If we could get our hands on that money, and therefore redirect it to help the uninsured buy insurance instead and obtain treatment in the way that the vast majority of individuals did -- before acute conditions developed -- the cost of insuring everyone in the state might not be as expensive as I had feared.
"The whole idea of Romneycare was to avoid this kind of free riding," Gruber told TPM.
The Republican nominee made the same point while running for president in 2008. In March 2010, the year 'Obamacare' was enacted, he was still arguing that the guarantee of emergency room coverage ought to be supplemented by bringing Americans into the insurance system.
"It doesn't make a lot of sense for us to have millions and millions of people who have no health insurance, and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they're people who have sufficient means to pay their own way," Romney said at the time on MSNBC's "Morning Joe." "And so we said, look, we've got an idea. Let's take all the money we've been spending to give out free care -- paying hospitals who give out free care -- and help people who can't afford it buy insurance."
Watch Romney's position evolve over the years: