The campaign desperately needs clarity on this issue. It needs also to shake that worrying tentativeness on Romneycare -- a timidity that suggests to voters that Romney has something to hide.
The answer to the question: "Wasn't Romneycare exactly the same thing as Obamacare?" is, to quote Nancy Pelosi, "Are you serious?" The Massachusetts law contained an individual mandate, which states -- unlike the federal government -- are allowed to impose. But it did not consist of 2,700 pages of new regulations; 159 new boards and commissions; and more than $500 billion in new taxes (and counting); the Independent Payment Advisory Board, a rationing board whose decisions are unreviewable by the courts and practically untouchable by Congress itself; restrictions on religious liberty; Medicare cuts; affirmative action mandates for medical and dental schools; huge new authority over one-seventh of the U.S. economy for the Secretary of Health and Human Services; and open-ended regulations of the way doctors and others perform their jobs.
Beyond that, a glance at the history of Romneycare in Massachusetts shows that Romney's instincts and initiatives were for free-market reforms. An 85 percent Democratic legislature thwarted his best efforts, and a Democratic successor as governor twisted the law's trajectory dramatically.
Before Romney's time, Massachusetts had enacted a number of laws that made its health care system needlessly expensive. All policies offered in the state were required to cover expensive treatments such as substance abuse counseling and infertility. In 1996, the state passed a law requiring "guaranteed issue" and "community rating" -- meaning people could wait until they got sick to purchase health insurance. Naturally, rates skyrocketed. In addition, a 1986 federal law required hospital emergency rooms to treat all patients, regardless of ability to pay.