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To secure the Republican nomination for president, Gov. Mitt Romney ran away from his signature Massachusetts health care law he once touted as a model for the nation. Ran away, that is, until his general election prospects started to dim. Facing a persistently large gender gap in the polls, in August Romney boasted of his Obamacare look-alike plan, "I'm the guy who was able to get healthcare for all the women and men in my state." Now confronting an even larger empathy gap in the wake of his jaw-dropping 47 percent remarks, Mitt this week protested that nothing "shows more empathy and care about the people of this country" than "I got everybody in my state insured."

Unfortunately, what Gov. Romney giveth, President Romney will taketh away. In March, Mitt Romney declared, "If I'm the godfather of this thing, then it gives me the right to kill it." But the former Massachusetts governor isn't merely promising to "kill it dead" at the national level. As it turns out, Romney's plan for draconian cuts to Medicaid would strangle the popular and successful program he put in place in Massachusetts and force tens of thousands back to the ranks of the uninsured in his home state.

By most measures, Gov. Romney's signature 2006 health care law has been a tremendous success. Enjoying the consistent support of Bay State residents by a 2 to 1 margin, the bill Gov. Mitt Romney signed into law lowered the uninsured rate from 12.5 percent to a national low of two percent. In March, a study by the National Bureau of Economic Research (NBER) showed that universal coverage in Massachusetts is indeed making people there healthier. Meanwhile, the rate of growth for business and individual insurance premiums has slowed dramatically, a trend state regulators earlier this year announced will result in only a 1.2 percent increase.

But as the Boston Globe reported May, President Romney "would probably cripple the Massachusetts health care law":

"It would have been impossible for Massachusetts to do what it did without increased federal Medicaid support," said John McDonough, a major architect of the state's health care overhaul law and now director of Harvard University's Center for Public Health Leadership. "What he's proposing is in direct opposition to what he did as governor,'' said Amy Whitcomb Slemmer, executive director of Health Care for All in Massachusetts, citing the Bay State's 98 percent coverage rate, the highest in the nation. "That kind of expansion would not have been possible under a block grant program," as Romney has proposed. Block grants give states more flexibility in spending federal money, but restrict funding increases.
Like his running mate Paul Ryan, Mitt Romney has called for the repeal of the Affordable Care Act. But not content to stop there, Romney, like Ryan, has proposed steep cuts to Medicaid spending and pledged to hand over the shrunken pool of funds as block grants to the states, draconian reductions which go to help pay for yet another massive tax cut windfall for the wealthy. And it is precisely that formula that would smother his once-beloved Romneycare in its cradle.

As Think Progress explained, Romney in the past had been very up front about the crucial role federal funding—and flexibility—played in making his signature achievement possible. Mitt made that point to Bill O'Reilly in 2010:

"[F]rom the beginning the plan was a 50/50 deal between the federal government and the state government. The Feds fund half of it, they have from the very beginning." The Boston Globe notes that "approximately 56 percent of the gain in coverage was related to increased federal Medicaid support" in Massachusetts, and of the newly insured, "18 percent gained coverage through Medicaid, and another 38 percent gained coverage through Commonwealth Care, a program that federal Medicaid dollars pay half of."
(Continue reading below the fold.)

But like the new insurance coverage for 30 million Americans nationwide under the Affordable Care Act, the gains in Massachusetts would be a thing of the past under a Romney administration in Washington. Projections from the Congressional Budget Office suggest that 48 million more people would be uninsured under Paul Ryan's House GOP budget, a scheme similar to Romney's. That figure would include hundreds of thousands in the state Romney once governed.

Despite his subsequent denials, Romneycare is virtually identical to the Affordable Care Act. As the NBER pointed out in a recent study, "the general strategies for obtaining nearly universal coverage in both the Massachusetts and federal laws involved the same three-pronged approach of non-group insurance market reforms, subsidies, and mandates, suggesting that the health effects should be broadly similar." Last year, MIT professor and Obamacare/Romneycare designer Jonathan Gruber explained the difference between Romney's own Boston bill and what Mitt calls Obamacare:

"Zero difference," he said. "This is, to my mind, the most blatantly obvious case of politics trumping policy I've ever seen in my life...Because they're the same f--king bill. He just can't have his cake and eat it too. Basically, you know, it's the same bill. He can try to draw distinctions and stuff, but he's just lying. The only big difference is he didn't have to pay for his. Because the federal government paid for it. Where at the federal level, we have to pay for it, so we have to raise taxes."
Nevertheless, Mitt Romney on Wednesday suggested he was indeed a caring man, one Americans could trust when it came to their health care—and everything else:
"I think throughout this campaign as well, we talked about my record in Massachusetts, don't forget -- I got everybody in my state insured. One hundred percent of the kids in our state had health insurance. I don't think there's anything that shows more empathy and care about the people of this country than that kind of record."
Well, there is thing President Romney could do that would show more empathy. That is, by not betraying the promise Gov. Romney made to thousands of men, women and children in Massachusetts and taking away their health insurance.

Originally posted to Jon Perr on Fri Sep 28, 2012 at 07:37 AM PDT.

Also republished by Daily Kos.

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