The New Republic

It's one of those days when the news cycle is moving faster than I can write about it. As of Wednesday afternoon, the chatter online is all about the Romney campaign's unexpected decision to cite his Massachusetts health reforms as proof that he cares about average Americans facing financial hardship.

The decision is unexpected because Romney has spent the past two years vowing to repeal the Affordable Care Act, whose scheme for expanding insurance coverage is basically a national version of what Romney did in Massachusetts. Romney's rhetoric on Wednesday has reinforced the doubts of conservatives who think Romney doesn't genuinely share their views, on health care or government activism generally. If you want to catch up on this saga and what it means for the campaign, Philip Klein, Greg Sargent, and Benjy Sarlin have the goods. Or just move up one item on the Plank and see what Noam has to say.

For now, though, let's return to the controversial ad that started this whole discussion, because it happens to frame the policy choices in this election almost perfectly—even if it does so in a less-than-perfect way.

The ad comes from Priorities USA, the pro-Obama organization. Its on-camera narrator is Joe Soptic, who lost his job in 2002 after Bain Capital, which had acquired his steel plant during the 1990s, shut it down. “When Mitt Romney and Bain closed the plant,” Soptic explains, “I lost my healthcare, and my family lost their healthcare.” Later, Soptic tells us, his wife became sick but did not seek medical attention. When she finally did, doctors discovered an advanced cancer that they could not treat. She died a few weeks later. “I do not think Mitt Romney realizes what he’s done to anyone,” Soptic says, “and furthermore I do not think Mitt Romney is concerned.”

On MSNBC’s "Morning Joe," Mark Halperin said “this is about as low as either side has gone” while host Joe Scarborough called it “outrageous.” Even the Huffington Post’s Sam Stein, hardly a Romney apologist, thought the ad went over the line. Based on the available information—sorry, I haven't had time to do independent reporting—Priorities USA deserves at least a little grief. 

Stories of personal hardship are never as simple as they sound at first blush and this particular tale appears to be no exception. According to an account in Reuters and, subsequently, a story on CNN, Soptic’s wife actually had health insurance when he lost his job. She only lost it two years later, when, because of an injury, she too became unemployed. It was not until two years after that that doctors discovered the cancer that, shortly thereafter, took her life. The ad implies that, if not for Bain’s shuttering of the plant, Soptic’s wife might still be alive. That allegation makes the ad more dramatic. It's also impossible to substantiate without more information, like what kind of cancer she had and when her symptoms began to appear. Journalists have a higher standard of proof than this. Politicians should, too. (Yes, Senator Reid, I'm looking at you.)

But I also think the reaction of Halpern and Scarborough goes way too far. An unproven allegation is not the same as a disproven allegation. And stories like this really do happen. When older workers lose their jobs, they frequently end up in jobs with lower salary and benefits, leading to a downward financial spiral that can last for years. When people have no health insurance, they frequently react by delaying medical care. The Institute of Medicine famously concluded that 18,000 people a year die prematurely because they didn't have health insurance. That estimate may be too high, but there's plenty of evidence some lower number is accurate—and that many, many more suffer financially, physically, or both.

These facts matter, perhaps more than the specifics of Soptic's story, because the fate of the under- and uninsured is a central issue in this campaign. President Obama’s position is that the federal government has an obligation to make sure every American has health insurance, regardless of age, pre-existing condition, or employment status. That’s why he signed the Affordable Care Act, which puts in place a coverage system that will go a long way towards accomplishing that goal. Romney, of course, wants to repeal the Affordable Care Act. He also wants to change Medicare and Medicaid so that they provide less financial protection, while introducing tax changes that would likely weaken employer-sponsored insurance.

Does this mean Romney "doesn't care," as Soptic suggests? His campaign platform alone doesn't tell us that. There are honest, truly compassionate conservatives out there who take similar positions, not out of indifference but out of considered policy judgment. But those conservatives are the ones who offer detailed alternatives that might—according to credible, non-partisan health care experts—meaningfully increase health care access. They are also the ones who indicate, via policy substance and rhetoric, that improving access to health care should be a governing priority. Romney has done none of these things. In fact, his unexpected comments on Wednesday, made in response to the Priorities USA ad, is one of the very few times he's spoken about this subject at all. (And even that wasn't very detailed.)

The specifics of Soptic's story remain ambiguous. The consequences of Romney's policy choices do not. Does talking about those consequences make some people uncomfortable? I can only hope so.

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