Obamacare Isn't Romneycare, and the GOP Didn't Invent It


The proponents of the Affordable Care Act (ACA) have a number of talking points, the favorite of which seems to be that Obamacare is really a Republican idea. The purpose of this talking point is to create the illusion of bipartisanship and promote the idea that the GOP only wants to argue about its name.

The argument that follows the talking point is that the ACA is based on the GOP's Romneycare. Let's forget that Romney vetoed many parts of the legislation. Let's forget that the legislation was broadly expanded by Romney's Democratic successor. Let's forget that Romney distanced himself from his own plan during the Republican primaries largely because the idea was unpopular with actual Republicans. Finally, let's forget the struggles Romney had to get the nomination, introducing the question of whether he is truly reflective of the party.

Even if Romney were a bedrock Republican endorsed by all 50 states, the ACA is vastly different from what Romney actually proposed. The ACA is comprehensive coverage rather than catastrophic coverage. Romney opposed the employer-based insurance concept, whereas the ACA heavily encourages it with tax subsidies and penalizes those who do not comply. The penalties in the ACA are as much as 10 times as much as those in Romneycare. So the talking point that the ACA draws on Romneycare is very loosely defined.

The talking point is correct that the GOP has considered these ideas previously. It is virtually impossible to produce 2,000 pages of healthcare reform without touching something that has been considered by someone else. The individual mandate has roots within the Heritage Foundation and Milton Friedman. Similarly, McCain argued for a tax on healthcare plans. It is, however, a bit of a stretch to say that the ACA is a Republican idea because a specific concept out of 2,000 pages derives from a GOP platform.

It is beyond that stretch, though, to attribute a concept to Republicans when the concept is applied in the exact opposite of the intended use. Milton Friedman, a Libertarian icon, argue for an individual mandate when he worked for the Hoover Institute. In his article, Friedman argued that employer-provided healthcare benefits are a significant component in the rise of cost of healthcare. Yes, Milton Friedman envisioned an individual mandate, but it was in response to the problems caused by the employer-provided insurance market which is so strongly encouraged by the ACA.

The individual mandate for health insurance makes sense within the context of a plan that protects society. The government requires the owner of a car to own auto insurance to protect society for the negligent use of the car. Today, the government requires hospitals to treat patients regardless of ability to pay. Hence the government can justify an individual mandate for health insurance so that society can protect itself from having to pay for the "Free Riders." This is what Romney meant when he said that "A free ride on the government is not libertarian."

The ACA is 2,000 pages of law with many moving parts. Some of these parts have been talked about in the past by Republicans. That doesn't mean that the Republican Party was the genesis of the ACA. What parts derive from Republican leanings frequently promote the problems that the GOP sought to solve.