Romney's idea was to permit Massachusetts insurers to sell catastrophic plans. As Avik Roy explained in Forbes, "Shorn of the costly mandates and restrictions originating in earlier state laws, these plans, called 'Commonwealth Care Basic,' could cost much less. Romney also proposed merging the non-group and small-group markets, so as to give individuals access to the more cost-effective plans available to small businesses." Romney's plan would also have involved a degree of cost sharing so that those receiving subsidies would have an incentive to minimize their consumption.
Romney agreed to the mandate, believing that Massachusetts citizens would get the opportunity to purchase inexpensive, catastrophic plans. But the legislature, together with Romney's successor as governor, Deval Patrick, changed the law to require insurers to offer three tiers of coverage -- all of them far beyond catastrophic care. Perhaps Romney ought to have foreseen what future legislatures and governors would do -- but that's a far cry from the accusation that Romneycare was indistinguishable from Obamacare.
Romney's proposed reforms included fraud prevention measures for Medicaid, requiring the income of both parents to be considered in children's Medicaid eligibility, medical malpractice tort reform, and giving individuals the same treatment as small businesses in the purchase of health plans. He envisioned a system of increased competition and choice.
The bill that passed the legislature contained a number of features Romney couldn't countenance. He opposed the mandate, preferring to permit individuals to post a $10,000 bond in lieu of insurance. The legislature overrode him. He vetoed the employer mandate, coverage for illegal aliens, the creation of a new bureaucracy to be called The Public Health Council, a provision limiting improvements to Medicaid, and one expanding Medicaid coverage to include dental care. His vetoes were overridden.
The health reform law Romney introduced -- as opposed to the one that was implemented by his successor -- stressed competition, reduced regulation and expanded choice for the consumer.
It was a mistake for Romney to sign the bill. As Avik Roy put it, "The individual mandate was a loaded gun that Romney handed to his opponents, who used it to force individuals to buy comprehensive insurance they didn't need." But Romney's bona fides as a free-market advocate and critic of Obamacare are not undermined by Romneycare. He can rightly claim that he foresaw, and attempted to prevent, the consequences of heavy-handed government control of the health care market.