No Exit

One year ago, with the anti-“Obamacare” mantra of the midterm elections still reverberating, Mitt Romney’s health care record was widely predicted to be his downfall. He had spearheaded a plan as governor of Massachusetts that looked awfully like the Affordable Care Act; how could the Republican Party nominate someone so closely tied to its biggest public enemy? But Tim Pawlenty, then one of Romney’s rivals, choked after raising the “Obamneycare” line of attack, and none of the other contenders has been able to overpower Romney’s advertising. The absence of nationally televised debates in the last month gave the front-runner a break from talking about health care. “If the issue was going to kill him, it would have done so already,” says Romney adviser Vin Weber, a former House member.

That peaceful interval was the calm before the storm. Just as Romney is finally closing in on the nomination comes a spate of reasons to highlight these issues all over again. Friday is the second anniversary of President Obama’s health care overhaul; oral arguments begin on Monday in the Supreme Court case challenging its constitutionality; and Rick Santorum, drawn by the opportunity, is intensifying his health care barrage. At a time when Romney is supposed to be mopping up delegates, one of his biggest liabilities has taken center stage.

Romney’s team is putting a positive spin, naturally, on the conflation of events. “The more times he gets to talk about his position and his plan’s huge differences with Obamacare, the more it will register with voters that he wants to repeal it,” said Romney adviser Ron Kaufman. “Any day Obamacare is in the news is a good day for Romney.”

But the campaign’s effort to distinguish the Massachusetts reform from the national one suffered a major setback earlier this month when BuzzFeed uncovered a USA Today column from 2009 in which Romney cast his plan as a model. “The lessons we learned in Massachusetts could help Washington,” he wrote. Brace yourself for the mocking commentary from his GOP rivals and special-interest groups on all sides of the health care debate in the week leading up to pivotal primaries in Maryland, Wisconsin, and the District of Columbia.

The component (in both plans) that most vexes voters is the so-called individual mandate that requires people to buy health insurance. A compilation of polls by the conservative American Enterprise Institute found that, while Americans are divided over the legislation, they overwhelmingly oppose the mandate. That’s why freedom-loving tea party activists made it the target of their ire two years ago, and it’s what Santorum has zeroed in on. “Obamacare is, in fact, the death knell for freedom, and that’s why it must be repealed,” Santorum said in Alabama this month. After his Illinois defeat this week, the underdog Republican barked, “On health care—Obamacare, Romneycare, they’re interchangeable.”

Romney can’t run or hide from his association with his party’s biggest bugaboo, so he has decided to own it. On the eve of the Louisiana primary and the anniversary of the Affordable Care Act’s enactment, Romney’s schedule began with a “Repeal and Replace Obamacare Event” in Metairie. “He needs to be very aggressive on this issue,” Weber says. It’s a risky strategy, but the campaign has little choice: Obamacare is the issue that fueled the tea party and helped flip the House. (The approach mirrors one that President Obama unveiled this month. To deflect questions about gas prices, subsidies for troubled solar companies, and the Keystone XL pipeline, he has embarked on a national “energy tour.”)

The Republican National Committee may have hit on a message this week that allows the party to beat up on Obama’s health care law without unnecessarily implicating its likely presidential nominee. Instead of hammering away at the mandate, the RNC’s initial media blitz focuses narrowly on the law’s potential costs. A strategy memo and a television ad launched this week in six swing states—Florida, Nevada, New Mexico, Ohio, Pennsylvania, and Virginia—make no mention of the mandate. “Higher costs for patients. Higher costs for taxpayers. Another broken promise by Obama,” says the ad’s narrator.

Karlyn Bowman, AEI’s public-opinion expert who analyzed polling on the health law, says that with Romney waiting in the wings, it makes sense for the GOP to target costs. Still, she added, the individual mandate will continue to haunt the former Massachusetts governor. “It is a weakness for him in the Republican primary electorate, no question, and it’s going to be there as a burr under the saddle,” she said.

Romney will get through this tough week—after all, the other contenders still standing lack the resources and organization to unseat a president—but that won’t be the end. The modestly improving economy could push health care in front of jobs as the Republican Party’s most promising line of attack against the Democratic administration. This month’s firestorm is a reminder that the GOP’s probable nominee is the most awkward messenger possible for the “repeal and replace” battle cry. 

This article appears in the March 24, 2012, edition of National Journal.

Get the latest news and analysis delivered to your inbox. Sign up for National Journal's morning alert, Wake-Up Call, and afternoon newsletter, The Edge. Subscribe here.