There are important differences between what Mitt Romney did in Massachusetts and what Democrats passed last night, but the basic structure of the program designed to expand coverage, the minimum level of benefits, the individual mandates -- the nubs of the Obama-Democratic bill -- are based on the Massachusetts model (which itself was based on conservative models in the 1990s).
Romney and his supporters have to argue about the details: Romney was forced to accept changes to his bill in order to satisfy the Democratic legislature, that the bill didn't raise taxes (except fees on hospitals) and that, in any event, Massachusetts was a special case because of its relatively low percentage of uninsured folks; states should be left to experiment on their own, the bill didn't cut costs, etc. These aren't very compelling arguments politically, though I am sensitive to the substantive point. Sensitive, but not entirely convinced.
Whether RomneyCare worked is an open question: costs have risen (though the deep recession can be blamed here), forcing the state to beg the federal government for money, but it has achieved its coverage goal, and most people who are part of the insurance exchange are happy with it. One reason why the plan is fiscally tenuous now is because Romney and state Democrats left the heavy lifting -- the bending of the cost curve -- to their successors. Retrospective prediction: had the country not plunged into a recession, RomneyCare would be seen as a stunning and innovative success.
One thing Romney can say, and that Democrats can't, is that Romney's bill was bipartisan. He worked with his Democrats, with Sen. Ted Kennedy. This won't play well with a primary audience, however, especially if "Obamacare" remains as unpopular with Republicans as it is right now.
This article available online at: