Seven months out from the first voting, the first big Republican presidential debate Tuesday revealed the most disconnected lineup of candidates of modern times. Maybe it will change.

There was an odd illogic to the whole gaudy two-hour CNN show. All the candidates condemned the economic record of their own party—joblessness and mammoth budget deficits—although, except for Rep. Ron Paul, they pretended that it was the work of President Obama. Their remedies were even more of what got us the big deficits and unemployment: cut or eliminate taxes paid by the rich and corporations and then rid the banks, investment companies, manufacturers and energy companies of all government restrictions on their conduct. Except for Rick Santorum, they pretty much repudiated the foreign policies of the two George Bushes and John McCain—military intervention in Muslim lands—though not by name.


But the real whimsy involved the party’s acknowledged front-runner, Mitt Romney, whom the rest of the field treated deferentially. The leader of the pack is the man who perhaps more even than Barack Obama is responsible for the health-insurance reform law, the Affordable Care Act, which Republicans everywhere are supposed to loathe as the toil of Satan. Former Minnesota Gov. Tim Pawlenty had referred to it Sunday as “Obamneycare,” but when CNN interlocutor John King asked him about it Pawlenty almost apologized. He did not mean anything by it but was just pointing out that Obama had bragged that it was patterned after Romney’s great work in Massachusetts.

Although they all condemned “Obamacare” and promised to repeal it (presidents don’t have that power) if they are elected, none of the others touched on Romney’s role although it was the mid-sized elephant in the room. They must all have hoped that Romney will founder on his own without their making so transparent the party’s big dilemma, that its likeliest leader is father of the nation’s first universal health insurance law.


Romney had tried to stand behind his proudest achievement but somehow distinguish it from Obama’s. It may work—he is even with Obama in the polls—but it is hard to see how his so-far nonsensical explanation can carry the day. His plan, he says, was right for Massachusetts but maybe not for the whole country. But, as a sympathetic New Yorker article about his fight to achieve universal health insurance in Massachusetts pointed out last week, he hoped it would be the template for a national law for which he would lead the fight.

If Romney wins the nomination or is closing in on it as the battle in the federal courts to toss universal coverage because of the insurance mandate climaxes, can the Republican-dominated appellate courts fail to take notice of the glaring paradox? It would be undoing universal insurance—a reform long demanded by the public—because it included a bit of Republican orthodoxy.


The private insurance mandate actually did not originate with Romney. President Richard Nixon delivered the plan to Congress on Feb. 6, 1974. Everyone in America would be insured through either Medicare, Medicaid or a mandate for every business in the country, large or small, to offer private health insurance to its employees and pay 75 percent of the premiums with some government subsidy for a few years. Nixon fled the office soon afterward and President Gerald Ford futilely pled with Democrats to pass the bill.

The mandate to buy private insurance, though this time it was on individuals, not companies, was the centerpiece of Republican policy in the 1990s. The party’s main think tank, the Heritage Foundation, outlined it in 1990. It was the only way to hold people responsible for paying for their own care. Sen. John Chafee was the lead sponsor of the Republican plan, which mandated private coverage, in 1993, but President Clinton refused to compromise and the whole enterprise failed.

Then came Romney, who thought the health-care crisis was Massachusetts’ No. 1 problem. He enlisted Sen. Edward M. Kennedy, the Democratic lion who had fought for universal coverage for 35 years. Kennedy held out for a single-payer plan all those years but finally acknowledged that it was hopeless and that Nixon had fathered the only plan that ever had a chance of passage. He joined with Romney, who was persuaded by research that showed that without a mandate a third of the uninsured, mostly younger, would never be covered.

Romney and Kennedy went to Washington Jan. 14, 2005, to persuade the Bush administration, which needed to provide a waiver for the Medicaid aspect of the plan (the same as Obama’s). They got it. Bush would continue federal funds flowing to subsidize people buying insurance.


Barack Obama needed more persuasion. He opposed the mandate during the 2008 presidential campaign.

Kennedy hired Romney’s health expert to lead the Senate toward a Romney-style health law. In the late spring of 2009, as the Senate and House plugged along in writing an insurance law, they finally persuaded Obama that the Republicans were right all along and that without Romney’s or Nixon’s mandate on either individuals or businesses the country could never achieve anything close to universal coverage.