Right or wrong, it’s easy to understand why conservatives are so upset about Mitt Romney’s newly appointed transition leader, former Utah Gov. Michael Leavitt.
It’s become an article of faith for many on the right that the Affordable Care Act must be completely eliminated, either by the Supreme Court or wholesale legislative repeal. Non-absolutist conservatives will allow that some of its modest, popular provisions may stand — but only those.
Leavitt, by contrast, supports one of the law’s three key pillars — so-called “exchanges,” or the regulated, subsidized statewide marketplaces where uninsured individuals can go buy coverage. He turned heads last year when his eponymous firm began advising states — including Republican-led states — to stand up exchanges in compliance with the dread ‘Obamacare’. For a fee, Leavitt would lend his considerable expertise. That was when he was just a Romney surrogate. Now he’s poised to lead Romney’s transition, and from such an influential position could easily find himself appointed to a high-level policymaking role within a hypothetical Romney administration.
That’s why conservatives are so alarmed. And when you examine the guidance he’s provided to states — as a trusted policy hand and businessman — their alarm makes perfect sense.
Just one month ago, Leavitt Partners gamed out the future of health care reform for Mississippi health officials. No matter what the Supreme Court does, and no matter who wins the presidential and congressional elections in November, they concluded (PDF), “Exchanges are a public-policy mainstay; Premium subsidies will be altered in any scenario, but will remain; The popularity of Guaranteed Issue ensures survival, but may change depending on the scenario.”
In other words, even if the Supreme Court overturns the law, and Republicans sweep in 2012, big, big pieces of ‘Obamacare’ are here to stay.
To help befuddled state lawmakers and officials understand the complexities of the real ACA — not the conservative caricature — Leavitt Partners published answers to frequently asked questions (PDF) about the exchanges that portray the law as at least a worthwhile effort, if not a panacea for the country’s health care woes.
“The Patient Protection and Affordable Care Act (PPACA) was signed into law in March of 2010, setting into motion a number of groundbreaking provisions intended to transform and improve the current health care system,” the pamphlet reads. “Included in the act are measures that aim to expand insurance coverage, strengthen quality measurement, promote prevention, increase the primary and public health workforce, and develop models for payment and delivery system reform. To accomplish these provisions, the law outlines a series of processes, requirements and milestones to be met. One of those provisions requires state [sic] to establish a health benefits exchange.”
Neither the Romney campaign, nor a spokesperson for Leavitt Partners, could be reached for comment.
As a former governor and secretary of the U.S. Department of Health and Human Services, Leavitt’s experience in government is formidable. But for Romney, Leavitt’s long and complex history with the Affordable Care Act poses a real problem. It confirms fears among his conservative skeptics that Romney secretly likes ‘Obamacare’ — which was modeled on Romney’s own reform efforts while governor of Massachusetts — and that his pledge to fully repeal it is hollow.
To put Leavitt’s apostasy in context, flashback to 2008. Obama’s own transition co-chair John Podesta — founder of the liberal Center for American Progress — had no such history on the wrong side of an issue near and dear to the hearts of Democratic base voters and activists. He led a think tank that served as an intellectual nucleus for the Democratic Party, not a consultancy that saw opportunity where liberals saw heresy.
So it’s no surprise that conservatives view Leavitt’s history with Obamacare as a proxy for how Romney would actually govern.
Brian Beutler is TPM's senior congressional reporter. Since 2009, he's led coverage of health care reform, Wall Street reform, taxes, the GOP budget, the government shutdown fight, and the debt limit fight. He can be reached at firstname.lastname@example.org.