Romneycare as the model for ACA

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While not identical, The ACA was built on the same principles of Romneycare introduced a decade ago in Massachusetts, and this was built on the principles developed by the Heritage foundation, a (very) conservative think tank. 

It is curious that people predicting disaster for the ACA didn't bother to look how Romneycare actually fared, which is pretty well:

Despite some early glitches—some uninsured had to wait months before enrolling, because of administrative backlogs—the program has allowed the vast majority of residents to get health insurance. Today, about 96 percent of the people in Massachusetts have health insurance, the highest, by far, of any state. (Some estimates suggest the proportion is even higher.) Studies have shown that access to health care has improved, and financial hardship has diminished, even at a time when other economic pressures are growing stronger. Both insurance premiums and health care costs are increasing in Massachusetts, as they have been across the country, but not at a faster rate—and, just now, the state has started to introduce the kind of cost control measures that Obamacare already has. A key ingredient in the Massachusetts success was the strong support it got from the state’s business and political establishments—from the Republican governor who signed it (Mitt Romney) to the beloved baseball team that championed it (the Red Sox).

Obamacare Exchanges Start Tuesday, Oct. 1. Here's Why They're Worth It | New Republic

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A notable exception to this monkish silence is Stuart Butler of the Brookings Institution in Washington. Butler, 67, is the Zelig of modern health-care reform, present at every critical stage. In 1993, as a scholar at the conservative Heritage Foundation, he designed a health-care plan around an individual mandate that became the main alternative to the Clinton administration’s plan. A decade later, when he soured on the mandate, many conservatives followed suit. President Obama’s decision to make the mandate a pillar of the ACA ignited broad conservative antipathy to the idea, which left Butler, its progenitor, awkwardly situated when Heritage became the locus of opposition. His decision last July to leave Heritage after 35 years and move to Brookings is a gauge of how far Republican health-care policy has moved to the right since the Clinton era.

The Return of the Death of Obamacare - Bloomberg Politics

By the way, the individual mandate is simply a necessity if you want to end discrimination on the basis of pre-existing conditions (see here)

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Speaking about Heritage:

The Mystery of Moore

Jonathan Chait seems boggled at an op-ed from Stephen Moore, the chief economist at the Heritage Foundation, attacking Obamacare: Not one alleged fact cited in the piece is right. And we’re not talking about matters of interpretation. CBO has not changed its view that the ACA will reduce the deficit; health costs have not increased faster than before; premiums are not skyrocketing.

Chait treats this as a story about the way the right is handling Obamacare’s success. Conservatives made a number of very specific predictions about what would happen when the ACA went into effect: health spending would soar, deficits would balloon, premiums would shoot up, more people would lose insurance than gain it. When none of these things happened, when the law’s first year of full operation went better than even supporters had expected, the reaction was, I believe, something new in American politics: right-wingers simply acted as if their predictions had come true, as if all the imagined disasters were actual truths on the ground.

That is indeed part of the story about that Moore op-ed. But there’s another aspect of the story, which is Moore himself: this is a guy who has a troubled relationship with facts. I don’t mean that he’s a slick dissembler; I mean that he seems more or less unable to publish an article without filling it with howlers — true, all erring in the direction he wants — in a way that ends up doing his cause a disservice. For example, his attempt to refute something I wrote about Kansas ended up being mainly a story about why Stephen can’t count, which presumably wasn’t his intention.

But here’s the mystery: evidently Moore has had a successful career. Why?

Think about Heritage: It’s immensely wealthy, and could surely afford to hire a technically competent right-wing hack. The Wall Street Journal, similarly, could have attracted someone much less likely to trip over his own intellectual shoelaces. Again, the problem isn’t even that Moore got the macroeconomics of recent years all wrong, although he did; it’s the inability to write without making embarrassing mistakes.

So why is he there (and he’s not alone — there are some other incompetent hacks at Heritage)?

I suspect that the incompetence is actually desirable at some level — a smart hack might turn honest, or something, But it’s remarkable.