"The oddest thing is he doesn't want to do for America what he did for Massachusetts. He did mandate health care for Massachusetts, which is HillaryCare, and he doesn't want to do that for America."

Rudy Giuliani on Monday, November 26th, 2007 in a Washington Post interview.


Romney wants a different prescription for the nation

There are several pieces to this, so we'll take them one at a time.

First, Massachusetts: As governor, Mitt Romney oversaw a major rewrite of the state's health care program in 2006 that featured a mandate on individuals. Everyone in the state must enroll in a plan or face tax penalties. It's true that Romney vetoed the teeth behind part of the mandate — a charge to companies that didn't offer coverage to employees — which was later overridden by the state Legislature.

So, Giuliani is correct that Romney enacted a "mandate" plan, though Romney has sought to avoid that term. Giuliani also is correct that the program in Massachusetts shares some things with the health care proposal put forward by Sen. Hillary Clinton.

Both expand upon the current private-public system. Neither forces changes for those who like their current employer-provided insurance. Both aim to provide coverage for all, with subsidized private plans. And both mandate coverage by penalizing those who can afford to buy a plan but don't.

Now, does that mean the Massachusetts program is "HillaryCare"? We'll take a pass on judging that one.

Giuliani's other point is that Romney isn't proposing a national plan similar to what he did in Massachusetts. That's true, too. Romney has argued that population demographics vary so much by state that a universal plan can't be applied across the country.

Instead, he has proposed changing the way federal dollars are made available to states — which is what Massachusetts was able to do — so states are free to draw up plans that suit themselves.

Add it all up and Giuliani's got it right.



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