What If Romney Had Won in 2008?

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His health-care reform plan probably wouldn't be called "Obamacare." Photo: Darren McCollester/Getty Images

Kevin Williamson, making a pro-Mitt Romney argument in National Review, makes a passing point about the Affordable Care Act: "Obamacare," he writes, "is precisely the same sort of program that a Pres. Al Gore or a Pres. John Kerry might have signed into law."

Right, it’s also the sort of program a Mitt Romney might have signed into law.

After all, Obamacare was designed by the same economist who designed Romneycare. When Romney ran for president in 2007, he was the right-winger of the field, earning a National Review endorsement, which regarded his health care achievement as mostly positive (“His conservative accomplishments as governor showed that he can work with, and resist, a Demo­crat­ic legislature. He knows that not every feature of the health-care plan he enacted in Massachusetts should be replicated nationally, but he can also speak with more authority than any of the other Republican candidates about this pressing issue.”)

If Romney had won his last presidential campaign, he probably would have implemented something like the Affordable Care Act. He would have sold his party on its more conservative character by pointing out that, unlike Masscare, this one includes Medicare cuts and a wide array of reforms to limit Medicare waste in the future. (In other words, just what Obama did.)

Now, within the conservative movement, Williamson is making the “moderate” argument. He’s insisting that Obamacare is merely a liberal bureaucratic disaster rather than a radical plot to sap our precious bodily fluids. But the less extreme analysis of health care is still far more extreme than even the conservative view of it a few years ago. It took Obama’s embrace of Romneycare for conservatives to desert it en masse.

Williamson is arguing that conservatives should abandon their obsession with the repeal crusade, and allow Romney to build a consensus for radical changes to the Affordable Care Act:

This will be especially important when it comes to repealing Obamacare, the first step of which is: Do not announce that you are repealing Obamacare. The smart way to repeal Obamacare is to revisit the legislation and to amend it in ways that remove the worst of its statist overreach and replace it with the best available free-market alternatives. The Wyden-Ryan approach is one possible model for amending Obamacare, but it is not the only one, and it is not sufficient by itself. In any case, it will be more effective to amend the legislation in such a way that it is effectively repealed and replaced than to have an emotionally satisfying but probably unwinnable fight over repeal per se.

First of all, in the Wyden-Ryan approach, subsidized private insurance through exchanges, is not a reform of Obamacare. It is Obamacare. And this fact illustrates the broader problem with Williamson's argument. He wants conservatives to stop demanding that Romney commit to a full and total effort to repeal every single part of the Affordable Care Act, and instead let him muck around in the legislation so that it conforms with conservative principles. But the reason conservatives are so insistent on pinning Romney down is that, if he were allowed to muck around in the legislation, he'd wind up with something very similar.

What conservatives want is for Romney to ignore his technocratic impulses. They have good reason to want that.