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Go Home Holtz-Eakin: Romneycare Is Waaay Different From Obamacare

TIMOTHY NOAH FEBRUARY 29, 2012

Holtz-Eakin: Romneycare Is Waaay Different From Obamacare

Another conservative has gamely stepped up to the challenge of arguing that Romneycare is to Obamacare as day is to night, up is to down, virtue is to vice, liquid is to solid, etc., etc. I suppose someone had to try again after Ann Coulter failed so miserably. It's not an enviable assignment, and I hope National Review paid Douglas Holtz-Eakin, a former director of the Congressional Budget Office who is now president of the American Action Forum (a think tank chaired by Republican hack Fred Malek), twice its usual word rate to make his case. This is hardship duty.

"Yes," Holtz-Eakin writes, "Massachusetts re-directed existing health spending to expand coverage. The resemblance ends there." He then lists various features of Obamacare that cannot be found in Romneycare:

$500 billion in new taxes on investment income, medical devices, health insurance companies, and “Cadillac” health-insurance policies. Massachusetts did not have a dangerous Independent Payment Advisory Board, misguided Patient-Centered Outcomes Research Institute, futile Center for Medicare & Medicaid Innovation, and myriad other agencies, boards and bureaucracies. Massachusetts did not rely on budget gimmicks like the CLASS Act, student loan “savings,” and mythical Medicare cuts to squeeze past the finish line.

Mitt Romney loves to talk about how Romneycare didn't raise taxes, as if increasing tax liability while sucking on the federal teat constituted thrift. As of fiscal year 2010 Romneycare had increased Massachusetts health care spending by about $700 million, with roughly half paid by the federal government through the Medicaid program and about half paid by the state. (For what it's worth, Michael Cannon of the Cato Institute says this calculation lowballs the actual cost by a factor of 19. Incidentally, no "budget gimmick" in Obamacare can compete with Romneycare's getting the feds to pick up half the tab.) After Eakin gets done complaining about all the awful revenue-raising and "dangerous" cost-cutting features of Obamacare that are absent from the Massachusetts law, he then complains ... that health care spending under Romneycare is out of control. Which is a bit like the old joke where one person says "The food in this restaurant is terrible" and another, agreeing, says, "And such small portions!"

I could list many other differences between Obamacare and Romneycare. Obamacare begins with an "O," for instance, and Romneycare begins with an "R."

What Holtz-Eakin omits is that both programs are structurally quite similar, with the government creating state health-insurance exchanges (in Massachusetts they call it the Connector—hey, another difference!) through which private companies sell insurance policies that must conform to certain government-imposed standards. In both Romneycare and Obamacare there are government subsidies to lower out-of-pocket insurance premiums paid by lower-income people. And in both Romeycare and Obamacare insurers are required to take all comers in exchange for an individual mandate requiring everyone to buy health insurance. This last is the single feature of Obamacare that conservatives most deplore (even though it was originally their idea.)

Ezra Klein, who is nominally the target of Holtz-Eakin's salvo, replies at length in his blog. (Among other things, Klein says Holtz-Eakin miscalculates the health care cost increase in Massachusetts.) But if you're a Republican, you don't care what Klein, a card-carrying member of the lamestream media, thinks. You care what conservatives think! Alas, as with Coulter, the right doesn't appear to be buying it, if this American Spectator blog post by W. James Antle III is any indication. The inescapable paradox remains that the Obama policy most loathed by Republicans was invented by the person most likely to be the Republican presidential nominee.

It's Stee-rike One for Coulter and now Stee-rike Two for Holtz-Eakin. Who wants to bat next?

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33 comments

Why don't they just come out and say they are against it because a Democrat did it? It would make things simpler.

- ironyroad

February 29, 2012 at 5:33pm

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Is it not enough that the label on Obamacare says, "made in Massachusetts?"

- Nusholtz

February 29, 2012 at 7:10pm

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Next up might be my former friend, Michelle Malkin.

- liberalref

February 29, 2012 at 7:14pm

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"Making distinctions without differences" could be the motto for Repub disinformation campaign with respect to Obamacare vs Romneycare.

- Haole45

March 1, 2012 at 12:04pm

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No mention anywhere of Brieitbart dying?

- basman

March 1, 2012 at 12:34pm

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There definitely is a mention of Andrew Breitbart's passing at The Dish this morning.

- liberalref

March 1, 2012 at 1:00pm

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Romneycare uses arial typeface, but Obamacare uses sans serif. Ariel is a mermaid beloved by young girls everywhere, but "serif" sounds like "Caliph", which is Muslim.

- GeoffG

March 1, 2012 at 1:42pm

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Excellent take-down, Timothy; way to cut through the FUD.

Regarding barf bag, couldn't have happened to a more deserving person. He won't be missed.

- GSpinks

March 1, 2012 at 1:46pm

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Gspinks a little dercheretz for the dead. I was wondering who the first ghoul/fool would be.

- basman

March 1, 2012 at 2:47pm

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Really, GS? That is your level of humanity?

- liberalref

March 1, 2012 at 4:14pm

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I spare no humanity for the inhumane, or tolerance for the intolerant.

- GSpinks

March 1, 2012 at 6:47pm

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That is an elevated position to take. And even at that, I suspect you mean only the right-wing intolerants, not left-wing ones.

- liberalref

March 1, 2012 at 7:10pm

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Gspinks, the guy died at age 43 leaving a wife and 4 kids. Don't be such a sanctimonious putz.

- basman

March 1, 2012 at 8:43pm

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This took 20 seconds --- Noah, can you use Google? The really big difference is that ObamaCare will be declared unconstitutional soo. *** Nine Differences Between ObamaCare and RomneyCare *** 1) The bill called "ObamaCare" is 2700 pages long, and RomneyCare was only 70 pages in 2006. So there are 2,630 more pages of differences between ObamaCare and RomneyCare. 2) RomneyCare was uniquely designed for Massachusetts, but ObamaCare is a one-size-fits-all mandate imposed upon all states, regardless of each state's needs and economic conditions. 3) ObamaCare expands the size and power of federal government beyond the "few and defined" powers delegated by the Constitution, thus diminishing State powers; in comparison, RomneyCare invokes "numerous and indefinite" powers to mandate that citizens be insured, thus preventing some from "gaming the system" — where free-riders were formerly getting government to pay for medical bills when they could afford to buy insurance in the first place. 4) One Trillion dollars is needed to fund ObamaCare — 500 Billion in higher taxes & 500 Billion borrowed from Medicare. In contrast, taxes were not increased to fund RomneyCare, nor were funds borrowed from Medicare. 5) RomneyCare was enacted only after Mitt Romney balanced the state budget; whereas, ObamaCare was enacted during a time when Barack Obama and a Democrat-dominant Congress didn't even try to balance a budget and didn't even propose a budget, but engaged in massive federal spending, unprecedented in the history of the United States. 6) RomneyCare is constitutional by virtue of the "numerous and indefinite" powers reserved to the States via the 10th Amendment to the Constitution; ObamaCare is unconstitutional because it overreaches the limited federal powers enumerated in Article 1 Section 8 of the Constitution. 7) In a June 2011 GOP Presidential Debate sponsored by CNN, Mitt Romney said that "if people don't like it in our state, they can change it." In contrast, Barack Obama has consistently resisted the repeal of his healthcare bill, even when the majority of Americans want to repeal ObamaCare. 8) Mitt Romney passed Massachusetts Healthcare with bipartisan input and support; in comparison, Barack Obama imposed ObamaCare upon Fifty States using a partisan approach that largely excluded input from Republican Senators and Congressmen — and continues to exclude input from "We the People." 9) While the majority of Americans don't want Obama-Care, the majority of citizens in Massachusetts support RomneyCare. According to a 2011 survey by Harvard School of Public Health and The Boston Globe, 63% of Massachusetts residents support the 2006 health law, while 21% say they oppose it. The Massachusetts Health Care Plan is in place because the citizens of Massachusetts wanted it in 2006, and still want it in 2011. Mitt Romney applied business solutions to make it happen without raising taxes. While a clear majority like the law, nevertheless, any citizen of Massachusetts who doesn't like RomneyCare has 49 other options to break free of the Massachusetts healthcare mandate.

- mr_rationale

March 2, 2012 at 1:41am

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Is the Heritage nebbish now on the Romney payroll?

- liberalref

March 2, 2012 at 9:09am

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libref, when will you learn?

basman, how is that my fault? I didn't tell him to start a large family, then live like a fat hog so that he could die of a treatable, preventable condition in the middle of his life and career. I hope he at least had the decency to take out enough life insurance that they won't be cast into destitution without their primary breadwinner. Then again he probably made enough money that they'll be fine even without it.

- GSpinks

March 2, 2012 at 10:58am

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When will I learn what? To be trashy like you? Nevah.

- liberalref

March 2, 2012 at 3:41pm

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To keep your mouth shut when you don't know what you're talking about. I've been posting on these boards since 2008; and I'm not one to keep my mouth shut. You are more than welcome to go back and find where I lauded Bill C. for being a philandering slut, or Mother Jones' for hyperpartisan screeds that have maybe the slightest attachment to reality. Until such time as you have evidence to support your hypothesis, the only trash around here is you.

- GSpinks

March 2, 2012 at 4:22pm

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You are taking the same tack as Karl Roid, telling me to leave. KR is my new name for roid, because he reminds me a a great deal of Karl Rove, who is pugnacious, an ideologue, and a master of projection (as are you; you practice schadenfreude and then call others "trashy.") You handle dissent about as well as our KR does. Your reference to me and reality is funny. I am the reality check around here, the person who calls down those fatuous enough to think that they could do a better job as president than does Barack Obama, and who think that the presidency is a giant bully pulpit. But I know what you mean. My comments bear a tenuous relation to reality in your mind because I don't adhere to your nutty ideology and your left-aping of the Breitbarts of the world.

- liberalref

March 2, 2012 at 4:43pm

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Gspinks I learned over the last day or so that when Ted Kennedy died Breitbart said things about him worse than what is being said about Breitbart coming from the left. That set me back for a minute before I thought about it a little. The answer to that is that of course it was wrong for Breitbart so to trash Kennedy just as it is wrong to do the equivalent of cartwheels over his dying. It's a measure of the yawning, irreconcilable ideological divide in America that that celebration over the "enemy's" death is for some a virtual reflex. To the right, well nigh universally, and to many on the left, see Ariana Huffington's tribute to him, Breitbart was either loved or liked for qualities ranging from his force nature, manic energy, fearlessness in fighting for what he stood for as evident in his take no prisoners approach, catholicity in his friendships spanning the political spectrum, generosity, modesty, loyalty, being entirely engaging, incredibly gregarious, or as one guy put it in frenzy of adverbs: ...garrulous, cheerful, raging, enthusiastic, hysterical, joyful, frenetic, passionate, untamed, smart, personally modest, technologically ambitious, weirdly visionary, compulsively pugnacious, monomaniacal—hard to take at times, and impossible not to love at all times... Breitbart could apparently argue with you in the most passionate and intense way, love the experience and then want to have a drinik with you and see you again. He was committed essentialy, it seems, to the truth as he saw it. So while there are the truly malign, murderous and destructive whose death we might well welcome, your comment: .. I didn't tell him to start a large family, then live like a fat hog so that he could die of a treatable, preventable condition in the middle of his life and career.. is so incredibly hateful, mean spirited, inhumane and out of proportion to what Breitbart did politically at his worst--and coming from someone, you, whose comments here I think I've found generally reasonable, disagree with you or or not--that it reflects much more on you than on him.

- basman

March 2, 2012 at 4:51pm

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"is so incredibly hateful, mean spirited, inhumane and out of proportion to what Breitbart did politically at his worst"

And this is where the disagreement arises, because I think it's exactly in line with what Brietbart did at his worst. And don't get any ideas, I lost most all respect for Teddy when I heard about his political theory of mistating his opponents positions; being honest enough to admit such a thing openly does, oddly, restore some modicum of respect for me. But the saddest part of his passing was Scott Brown getting his seat, as far as I'm concerned. Are you telling me his best quality was that he could have a difference of opinion with you and still want to have a drink with you? That should be par for the course in America, not a reason to lament his passing.

- GSpinks

March 2, 2012 at 5:27pm

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But is what Breitbart did at his worse inform what you should publicly do or how you should publicly react to his death? You are misframing my argument. I have laid out some of the praise for Breitbart as a way of suggesting to you that he is light years away from the category of the earth's worst whose death we may well welcome. My argument was not that you should lament his death, though that would be entirely appropriate in the sense that we would lament or at least be saddened by someone's premature death and his leaving behind in this order: a wife and 4 little kids, other members of his family, and a wide swathe of people of all political dimensions who loved or liked him and/or respected him. My argument *is* that his death ought not be a time for a triumphant yelp excoriating him and clicking one's heels in joy at his premature dying. I think too you read down the nature of the accolades bestowed on him. They range far beyond his merely befriending those he disagreed with: but regardless I repeat the issue is not the lamenting of his death or a defence of him as such but rather the public evincing of spiteful joy at his dying. Finally, here's a little though experiment for you. It's likely that Ted Kennedy at Chappaquidick (sp?) did far worse than anyything Breitbart did--what T. Kennedy did was felonious. And it's arguable that even Bobby did far worse politically than anything Breitbart did in being counsel to the committee headed by Joe McCarthy in perhaps the blackest and besmirching excercise of political persecution in American history. On the basis of your argument as I understand it one woulld have been thrilled by, and publicly said so, the premature death of either of them before such redemption or political evolution/transformation as they managed. So there's that too to consider in yipping it up at a guy's way premature death.

- basman

March 2, 2012 at 6:04pm

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libref, I'm glad you're full of yourself. Now, are you going to go back through the several years of my blathering on these boards in order to justify your pet theory, or will you continue to ride your high-horse up and down these boards, patting yourself on the back and lamenting how people persecute you by asking you to defend your theories with measurable, quantifiable facts? Yes, that's a rhetorical question, because I've seen more than enough of your arguments to know how this is going to play out.

Oh, and basman, don't get me wrong, I'm not celebrating his death to any extent. As a (non-practicing) Catholic I know for a fact (I said "fact", heh) he has had to undergo final judgement; and I only hope he was good enough a person to not be automatically sent to hell to suffer for all eternity. (I'm not betting my donuts, though). But mourn? Hell no. Just a little relieved that that's over with.

- GSpinks

March 2, 2012 at 6:10pm

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There we'll leave it.

- basman

March 2, 2012 at 6:28pm

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Basman wins in a KO. And notice that GS is backing down somewhat after the incredibly nasty "barf" bag comment of yesterday. GS doesn't even have the courage of his nasty convictions. Don't get me wrong. I didn't like Andrew Breitbart one little bit. He was shrill and disingenuous and angry. But it is no accomplishment to try to be just like him. Only schoolboys would think it an accomplishment.

- liberalref

March 2, 2012 at 6:36pm

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I did not see your further rejoinder before my last posting, but I dare say it still applies. You have some excellent points. All I can say is my comments are public, and certainly convey the spite I feel for what he represented, but I can't copp to this "joy" thing. I'd like to feel sad that he didn't have time to redeem himself; but we were promised that we would never know the hour or the day and so we needed to do our best in each moment, in case it was our last. How's that for shit out of luck? If I'm glad about anything, it's that he isn't being judged on what I think of him.

- GSpinks

March 2, 2012 at 6:53pm

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Wow, didn't see that one coming. I didn't know you could be different kinds of stupid, libref. You continue to amaze me.

- GSpinks

March 2, 2012 at 7:21pm

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What do you see coming, the sunrise, or maybe the sunset? You are so ferociously eloquent: where do you get it from?

- liberalref

March 2, 2012 at 10:25pm

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What do I see coming now? More inane comments, responses that don't approach the subject and no cohesive train of thought. What was I expecting? You to finally stop flapping your fingers on the keyboard like a petulant child; which you inevitably do once you're too tired to concentrate (or perhaps get distracted).

- GSpinks

March 3, 2012 at 3:29pm

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The adolescent calls the grown-up a child. Classic.

- liberalref

March 3, 2012 at 7:34pm

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Mickey Kaus on Breitbart, for example: ...Andrew Breitbart R.I.P.: One day in the summer of 2010 I woke up to a commotion outside my door. It took me a while to figure out what was going on, but it turned out that my neighbor, Jodie Evans, was having a fundraiser for her friend Jerry Brown, then running (successfully) for Governor. But there were protesters. Specifically, Andrew Breitbart, who was gliding around on rollerskates with a video camera, trying to catch Brown in the act of attending the party. I thought it was a little risky of Brown to go to Evans’ house–her Code Pink organization does some wild things. But what struck me most was the mood–the way the lefties in the party and Brietbart waved to each other. It turns out they knew him. He’d gone to the Brentwood School with some of them. “Everybody tells me he’s a good guy,” one of the aggrieved Brown funders later conceded. David Frum could not have known Breitbart. At least that’s the most charitable reason I can think of for why he picked the occasion of Breitbart’s sudden death to promote the cheap, bogus meme that Andrew had a “giddy disdain for truth and fairness” as long as a story helped his side.  ”Just as all is fair in a shooting war, so manipulation and deception are legitimate tools in a culture war,” writes Frum. I’ve known right-wingers who were like that (‘See, we attack Kerry with this, and by the time he answers we’ve moved on to the next charge!’) Breitbart wasn’t one of them. Yes, he had a jaundiced view of the left, and a pugilistic–I might say, Frum-esque–view of the Middle East. But he said what he though was true, even when that hurt his side or put his own career at risk. Exhibit A: At the height of “Weinergate,” the moment of Breitbart’s greatest triumph, he began to have doubts about the key source, one “Dan Wolfe,” who had caught Rep. Anthony Weiner’s off-color tweet.  Instead of burying these doubts, Breitbart went public with them, something that threatened to badly complicate his side’s narrative. (“Is there a real ‘Dan Wolfe’ … or has someone for months elaborately pretended to be?”) He got a lot of grief from some conservatives for this.** Exhibit B: Breitbart was a powerful speaker, and in the early days of the Tea Party he opened for Glenn Beck at rallies. But in his view the Tea Party was a success because it was a big tent focusing on cutting the size of government, not on social issues (where Breitbart, as pretty much of a ‘South Park Republican,’ often agreed with the left). Beck’s turn to vague religiosity annoyed him, and he said it. He knew this wasn’t going to get him in good with Beck, and it didn’t. I would go so far as to say that Breitbart had an instinctive honesty–pretty much the opposite of what Frum charges. I don’t know the ins and outs of the Shirley Sherrod mess, in which Breitbart posted a video the end of which had been lopped off before he saw it. But I guarantee you  Breitbart posted it because he felt it truthfully made a legit point (and he wasn’t aware what the rest of it would show).  I also know that there were plenty of stories presented by the “cohort of young conservative journalists” that he refused to publish because he wasn’t certain they’d hold up. He didn’t pretend to have the institutional standards of, say, CBS and Dan Rather. But he had a commitment to truth, independent of ideology, that (as Frum notes) many on left and right lack. P.S.: I first met Breitbart when he showed up at a panel I was on at UCLA. He told me he was the guy who posted items for Matt Drudge, and I immediately realized he was the most powerful person in the room. Nobody could understand why I was sucking up to the crazed hippie kid in shorts. Later, during the Gray Davis recall campaign, I published a suggestive item from a reader who said he had a Oui magazine article describing a gang bang Arnold Schwarzenegger said he’d once participated in. Breitbart immediately tipped off Smoking Gun, which sent a reporter to get the Oui issue and had the article up on the web in a matter or hours. It was later pointed out to Andrew that he could have gotten all the credit if he’d waited to get the Oui issue himself. But he didn’t want to get credit so much as to get the story and get it out quickly. (He did go out of his way to give me credit, though.) It wasn’t a pro-GOP story, of course. P.P.S.: It hasn’t sunk in yet, only in part because I’ve been too annoyed at Frum to let it.  I still mentally expect to see Andrew again. He’s always around. Nobody was too unimportant for him to argue with for hours. At the height of some controversy, in which he’d be betting his entire operation on the basis of his gut, I’d be stuck in a jam on the San Diego freeway and there he’d be in his Volvo SUV, stuck too, honking and waving while taking one of his four kids home from school.  He was one of those people who had so much energy he seemed ubiquitous. Maybe there was more than one! I thought we’d all wind up working for him. I didn’t realize until today how unhappy I’d be not to. _____ **–Wolfe has yet to appear, as far I know....

- basman

March 4, 2012 at 2:20pm

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Thank you very much for posting Mickey Kaus' comments, basman.

- liberalref

March 4, 2012 at 5:49pm

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Libref, there's nothing grown up, let alone mature, about you. If you were, you would have apologized by now for your accusations that I only hate people on the right, when I've spent 4 years on these boards heaping disdain indiscriminately. A "grown-up" would have done it by now, and you have not.

basman, thanks for the article! It gives me hope that maybe he wasn't the boogie man I thought him to be; honest mistakes are acceptable.

- GSpinks

March 5, 2012 at 3:45pm

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