The first-of-its-kind health-care plan passed by the Massachusetts Legislature provides Gov. Mitt Romney valuable political capital, but it's also fraught with potential perils as he aims to make the top tier of Republican presidential contenders.
Romney is facing criticism from some conservatives that the bill he helped engineer would expand government and impose a new financial burden on businesses. The plan has already come under attack from the libertarian Cato Institute in Washington D.C., the op-ed columns of the Wall Street Journal, antitax activists such as Grover Norquist, and MSNBC pundit Tucker Carlson.
Romney, as he has sought to raise his national profile, has chided GOP leaders in Washington for veering from the bedrock party principle of limited government. Critics say Romney's signature contribution to the health-care plan — a provision requiring all residents to carry health insurance or face financial penalties from the state — will only cast him as one of those big-government Republicans.
"I think that this bill pretty well locks Romney, no matter what else he does, into that realm," said Michael Tanner, director of health and welfare studies at the Cato Institute. "I do see him being attacked from people who see this as being government paternalism, or big government."
Romney, who considers the health-care initiative one of his major accomplishments as governor, is sensitive to such critiques and has been careful to couch the bill in Republican-friendly terms. He made sure at a Monday press conference to say the plan was "market-based" and endorsed "personal responsibility."
Romney has seized on the issue to tout his ability to work with Democrats on a solution that has eluded Washington politicians — notably potential 2008 rival Hillary Clinton, the Democratic senator from New York. (The governor often refers derisively to Clinton's failed bid for universal coverage in the 1990s as "Hillarycare," but Clinton praised Romney's efforts Wednesday, telling the Associated Press, "To come up with a bipartisan plan in this polarized environment is commendable.")
Julie Teer, political director for Romney's political action committee, said in an e-mail: "The governor took a Democrat ideal — getting everyone health insurance — and applied conservative Republican free-market principles to achieving it."
The state's health-care plan — and his role in crafting it — were featured prominently on the national airwaves Wednesday, and the issue was the top story in Wednesday's Wall Street Journal, Washington Post and New York Times. It was also the first question reporters asked of White House press secretary Scott McClellan aboard Air Force One Wednesday morning.
"I think it's another example of how the states are really the laboratories of democracy in our federalist system," McClellan responded.
Some observers expect Romney to be able to showcase the health-care plan as an example of why governors make better presidential contenders than senators.
"I think that there's a lot more upside in the bill than there is downside for him," said Tom Rath, a Republican National Committee member from New Hampshire.
"Certainly someone could play it as, this is another big-government Massachusetts plan," added Dante Scala, associate professor of politics at Saint Anselm College in Manchester, N.H. "But depending on how well Romney can defend the plan, I think it could have a good effect."
But as the governor looks to sign the health-care bill next week and begin celebrating it on the campaign trail, he will have to answer to conservative critics on a several points, including a component of the plan that calls for a new state entity to regulate healthcare, said Regina Herzlinger, a Harvard Business School professor and senior fellow at the conservative Manhattan Institute.
"Sooner or later that's going to come out, and those red-blooded free-market people are going to say, 'Who appointed you king of the world?"' said Herzlinger, who said she applauds Romney for his efforts.
Herzlinger said Romney will also have difficulty defending the requirement that individuals have health insurance, and a proposed $295-per-employee charge on businesses that don't provide health insurance to employees.
Romney said this week he didn't see the charge as a tax. Others do. Norquist and Massachusetts antitax crusader Barbara Anderson have both criticized the plan. Romney has the power to veto or suggest changes to any portion of the bill, and he met with business leaders Wednesday to hear their views on the legislation. A spokesman said the governor was likely to seek modifications on the business assessment.
Norquist said Wednesday he could accept the new $295 assessment if the state repealed an existing $62-per-employee fee that companies that offer insurance pay into the state's pool for the uninsured.
Other conservative groups and commentators have come out in support of the plan. The Heritage Foundation in Washington D.C. helped write part of the bill, and syndicated radio talk show host Hugh Hewitt, who is close to Romney, gushed on his website Wednesday: "The Romney campaign just took a big jump forward."