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How the Health Care Ruling Reshapes the Campaign How the Health Care Ruling Reshapes the Campaign

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How the Health Care Ruling Reshapes the Campaign

It's almost like a tale of two presidential campaigns, and two Mitt Romneys. In one campaign, most things are going well for Romney and badly for Barack Obama. Hardly noticed amid the drama of the  Supreme Court's decision to uphold the Affordable Care Act on Thursday was the news that the economy grew at a tepid 1.9 percent in the first quarter. Job growth is consequently slow as well. In fact, at 8.2 percent unemployment (still several points above what the rate was when Obama took office), it probably would mark a historic victory for any incumbent to win reelection in an economy beset by such grim numbers.  And there is little doubt that Romney gets economics, even if you dispute his solutions. At Bain Capital--whatever else you might think of that firm--Romney was a data and numbers whiz who took a tiny start-up and turned it into a $4 billion giant. So in this campaign Romney is looking pretty good, and he has open running room to go straight at the president's central weakness.

This is Compelling Romney.

But now there is another dimension to the presidential campaign, a reinvigorated one that is going to be mainly about repealing the ACA since the Supreme Court declined to overturn it. The initial reaction of many pundits is to say this gives Romney a fresh issue to rally his base. But these are no longer the primaries. His biggest problem is no longer his base; it is capturing the center. And in the general election it is on this issue that Romney looks weakest, indeed pretty silly. That is because, in effect, the Supreme Court has just handed Romney the greatest compliment, and the most dramatic vindication, of his political career: your successful health care law in Massachusetts is not only effective, it is constitutional. Beyond that, most polls show that while the ACA is not popular, many voters don't really understand it and remain undecided about it, and the Obama camp will now embark on a major selling job on which its numbers have nowhere to go but up. And yet Romney is being forced to run away from his own greatest achievement as if it were a terrifying ghost from his past, which, in the context of the Right's new Dogma, it is.

This is Absurd Romney.

As an example of the Orwellian doublethink in which presidential candidate Romney must now engage, he will be forced to repudiate, day after day on the trail, the uber-competent policy-maker he so proudly proclaimed himself to be only six years ago. And he must pretend, day after day, that he is really going to repeal "Obamacare" starting on day one of his presidency, or somehow issue "waivers" to all 50 states, when that will be close to practically impossible. How many voters will believe this pledge, except for the rabid Republican base? Probably not many.  How many voters will buy the sincerity of his opposition to the law? Probably not even the Republican base. 

Which brings us to Romney's central problem. He needs to persuade the rational middle of the country--where many voters are attracted to Compelling Romney but somewhat repelled by Absurd Romney -in order  to win the presidency. Yet now the Supreme Court has ensured that Obamacare won't go away as an issue for the rest of the general election, and he has committed himself uncompromisingly to battling it. Again on Thursday, looking very presidential with the Capitol dome behind him, Romney pledged to "act to repeal Obamacare" as "bad policy." But measured against his record as governor his words sounded like something out of 1984, as they did during the primaries. Obama, in his remarks at the White House on Thursday, indicated he would be refreshing voters' memories about the two Romneys regularly when he said that a requirement to purchase health care was supported "even by the current Republican nominee for president."

The difficulty of Absurd Romney's task is pointed up by Jonathan Gruber, an MIT economist who helped Romney design his 2006 health insurance program in Massachusetts. He says that the then-governor used reasoning and language very similar to that of Chief Justice John Roberts in arguing for the necessity of an individual mandate. While Roberts said that Congress did not have the right to mandate behavior, it did retain the right to "tax and spend," including penalizing people for not buying health care.

"It's a penalty for free riding on the system. That's the way Gov. Romney talked about it," says Gruber, who later became one of the key architects of President Obama's Affordable Care Act, which was modeled in part on the Romney law. "Justice Roberts used similar language today." Back in the 2000s, when Gruber demonstrated to Romney with computer models that, absent an individual mandate, one-third of Massachusetts' poorest and sickest would remain uninsured (and drive up costs for everyone), Romney jumped on the point, instantly converted, says Gruber. Romney went at the problem "like a management consultant or an engineer" with no ideological taint, even against the advice of his conservative political advisers, Gruber says. "They were concerned about the politics of universal health care. He argued them down."

Today, says Gruber, Romney is being "completely disingenuous" in arguing against a law whose principles he once embraced.  And somewhat absurd.  Gruber says Romney's suggestion that, as in Massachusetts when he was governor, states should be permitted to decide on their health care plans is also disingenuous. Massachusetts could devise its health care law only because it had access to a large amount of federal money, a $385 million Medicaid grant that it needed to use to extend care to the poor. "He says the states could do it but not the federal government. Well, actually the states can't do it" because they don't have the money, says Gruber. "What he should be saying is that he 'll give the states a trillion dollars to come up with their own plans, but he's not going to do that."

On the whole, Compelling Romney has a much better shot at taking the White House. But he now must contend with Absurd Romney through the rest of the election campaign.

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