In the fall debates, Romney's rivals couldn't or wouldn't do this. Pawlenty famously chickened out. Perry tried, but he was apparently too ignorant of the core elements of each plan to drive home the fundamental similarities. Santorum perhaps didn't have enough air time when there were eight on the stage and he was out on the wings
But since his strong showing in Iowa it's been different. On January 19 in South Carolina, he started in on Romney's insistence that while he created a free private insurance exchange in MA, the ACA imposes government-run healthcare -- never mind that the subsidized exchanges created by the ACA are essentially identical to the Massachusetts system. Santorum insisted on the equation:
92% of people in Massachusetts had health insurance, and Romneycare just expanded that to be full subsidized by the state of Massachusetts. Romneycare did not create a marketplace. It is a very prescriptive program. He is arguing for and defending a plan that is top down. It is prescriptive in government and was the basis of Obamacare.On January 26 in Florida, Santorum zeroed in on the individual mandate:
Governor Romney was the author of Romneycare, which is a top- down government-run health care system which, read an article today, has 15 different items directly in common with Obamacare, everything from the increase in the Medicaid program, not just that government is going to mandate you buy something that’s a condition of breathing, mandate that you buy an insurance policy, something that Governor Romney agreed to at the state level...Then, when Romney protested that his plan was popular in Massachusetts:
What Governor Romney just said is that government-run top-down medicine is working pretty well in Massachusetts and he supports it. Now, think about what that means...going up against Barack Obama, who you are going to claim, well, top-down government-run medicine on the federal level doesn’t work and we should repeal it. And he’s going to say, wait a minute, Governor. You just said that top-down government-run medicine in Massachusetts works well.When Romney insisted that his plan was about insuring the uninsured, while the ACA was about "taking over" healthcare for everyone, Santorum smart-bombed him on the mandate:
Folks, we can’t give this issue away in this election. It is about fundamental freedom. Whether the United States government or even a state government — you have Amendment 1 (ph) here offered by Scott Pleitgen (ph), who, by the way, endorsed me today, and it’s going to be on your ballot as to whether there should be a government mandate here in Florida.
According to Governor Romney, that’s OK. If the state does it, that’s OK. If the state wants to enforce it, that’s OK. Those are not the clear contrasts we need if we’re going to defeat Barack Obama...
Wolf, what Governor Romney said is just factually incorrect. Your mandate is no different than Barack Obama’s mandate. It is the same mandate. He takes over…
You take over 100 percent, just like he takes over 100 percent, requires the mandate. The same fines that you put in place in Massachusetts are fines that he puts in place in the federal level. Same programs.That left Romney with one shred of contrast. The ACA raises taxes on various parties and cuts Medicare spending to fund the exchanges; Romneycare raised no taxes and of course had nothing to do with Medicare (leaving the impression that it cost the state nothing). Santorum went after that piece last night in Mesa, AZ:
So, okay Governor, let's -- let's get this straight. First off number one, you funded Romney Care through federal tax dollars through Medicaid. I know it well, it's called disproportionate share provider tax. About $400 million that you got from the federal taxpayers to underwrite Romney Care to make sure you didn't have to raise taxes right away. But of course you had to. Ask your governor, of the $8 billion of tax increases he had to put in place.
Yes governor, you balanced the budget for four years. You have a constitutional requirement to balance the budget for four years. No great shakes. I'm all for -- I'd like to see it federally. But don't go around bragging about something you have to do. Michael Dukakis balanced the budget for 10 years, does that make him qualified to be president of the United States? I don't think so...
The bottom line is, what you did was you used federal dollars to fund the government takeover of health care in Massachusetts...
That's quite true. The Democrats raised new revenue and cut spending to pay for the ACA; Romney leveraged a federal government freebie, a $385 million use-it-or-lose it Medicaid grant to expand coverage.
So Santorum has exposed Romney's case for Romneycare/against the ACA as a fraud; like Jonathan Gruber, he's made it clear that they're "the same fucking bill." How much that has to do with his rise and Romney's faltering I won't speculate. But as the only GOP candidate willing and able to press this attack, he deserves his position as Romney's one remaining viable rival for the nomination.
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