1. There are two reasons why the success of Romneycare is disputed. First, it's Romney's fault: he and the legislature decided to punt on the stronger cost-controlling measures at the time of the bill's implementation. Second, the economy collapsed, leaving the state scrambling for the funds it assumed it would have. But on the deliverables: getting coverage to more people, increasing choice and competition, and keeping up a level of care: the Massachusetts system is doing pretty well. If Obamacare remains unpopular, and the economic recovery helps Massachusetts fix its budget issues, Romneycare might stand out as an undeniable success: a state chose the route that best fit its profile and it worked. It's harder for Romney to create a contrast today because the basic outlines of Obamacare look just like the basic outline of Romneycare, and partisan allegiances are distorting public perception.
2. It's ungrounded to assume that health care will be the Big Issue among Republican primary voters two years from now. If it's not the biggest issue, or the second biggest issue, then it's not really Romney's problem. It's true that the war in Iraq influenced the way the Democratic primary began, but any number of factors having nothing to do with the war influenced how it ended.
3. It's probably true that Republican candidates will stumble over themselves trying to tout their economic libertarian credentials on the assumption that the Tea Party movement represents or is of one mind with the Republican primary electorate. We don't have enough data to know whether the movement represents a re-engagement of dormant but pre-existing conservative voters, or whether their adherents are additive elements to the GOP. We have no way of knowing how the Ron Paul wing of the right (the broad right) will interact with the older Tea Partiers, with whom they share economic but not necessarily cultural values. The Democratic Party's primary system has been amended over the years to allow insurgents to do well; the GOP 's primaries remain hierarchical and controlled by long-standing and entrenched interests. If Romney's the candidate of the hierarchy, then he'll get the better of the systemic advantages. Tea partiers haven't had much success, as of yet, in winning elections and building sustaining institutions. Don't assume they'll control the Republican nominating process, even if it seems as if they'll dominate the tone today.
4. Romney is a serious, sober guy. Just read his book. It's half a cliche campaign book, and half a really learned and well-thought-out disquisition on the problems facing American today. If the fundamental divide in the party is between the lambs being led to slaughter wing -- the bleating, noisy wing -- and the wing that seeks a solutions-oriented leader, Romney has a case to make.
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