As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."
Tuesday, September 01, 2009
60 Again Shortly?
We're getting closer to Massachusetts being able to appoint an interim successor until the special election that will be held January 19 fills the slot once held by Ted Kennedy. I didn't think Massachusetts lawmakers would be constrained by appearances on this one. Plus, they are fulfilling the expressed desire of the electorate to have two Senators, including one who shares Ted Kennedy's beliefs and policy positions.
By the way, the whitewash of Kennedy from a liberal lion into the great conciliator and compromiser who would have bargained away the public option in a second is truly insidious. Jed Lewison, who was there during the Medicare Part D fight, has some good thoughts on this over at Daily Kos. In short, Kennedy opposed the Medicare deal because it became an industry trough-feed at the end. Despite this, conservatives keep parroting this "compromiser" spin, particularly with respect to that vote.
The reason for Fox's lie couldn't be more obvious: they desperately want Democrats to cave on the core elements of health care reform, and they think that creating a false narrative about Ted Kennedy will make their wish come true.
Ted Kennedy probably wouldn't want us to pass meaningful health care reform solely to honor his legacy. In fact, of all the reasons health reform needs to be passed, that's probably not even on the list.
But Ted Kennedy's passion for health care reform does inspire us to achieve the goal of universal, affordable coverage. And the record shows us that despite his best efforts, Republicans cannot be trusted to be fair partners in the process of getting there.
Yes, It's Hypocritical. Politicians Don't Always Care About That
The call to replace Sen. Kennedy with a temporary appointment is intensifying. Among the points I've heard bandied about by Democrats in the state is that Massachusetts cannot afford to be without representation for five months.
Um, pardon me, but wasn't Kennedy basically in a hospital bed for the past 18 months, off and on?
I don't think there's any way for Massachusetts Dems to justify changing a law they altered precisely to keep Mitt Romney from appointing a successor to John Kerry. So they... shouldn't justify it. We have an entire Internet meme called IOKIYAR - It's OK if you're a Republican - based on all of the hypocritical crap they've lodged at the country over the years. One for our side wouldn't really upset that balance.
What matters is getting the policy right. I believe Senate appointments that last for years, as we saw this year in New York and Illinois and Colorado and Delaware, are generally bad for democracy. I think a quick, or relatively quick, special election, within 4-5 months, while appointing a caretaker to represent the state in the interim, is probably a decent enough compromise. I wish all states would adopt such a measure.
What will be far more interesting is to see who runs for the seat. In addition to practically the entire Massachusetts delegation in the House (save Barney Frank, who probably has enough power where he sits already), you have former Rep. Joe Kennedy II, or even Kennedy's widow Vickie. Most of the members of Congress have been hoarding money while waiting for this opportunity, 25 years in the making, for a statewide Senate run. Marty Meehan, who left Congress last year to run Lowell University, has almost $5 million in his campaign account.
Even a "split-the-bill" strategy would require 60 votes for cloture on the more non-controversial items of health care reform. And as I noted, Republicans like Jon Kyl are objectively pro-discrimination against people with pre-existing conditions. Furthermore, expecting GOPers to go along with certain health insurance reform items after getting cut out of other elements of the bill is a fantasy. So those 60 votes will have to come from Democrats.
And all Democrats ought to stick with the wishes of their party rather than join a Republican filibuster. But there's one very sad detail - Ted Kennedy is fighting cancer. He's very sick. He didn't attend his sister's funeral. And while I believe he'd get wheeled in on a gurney if it meant the passage of his life's work, this letter shows that he's preparing for every eventuality. And here he runs up against Massachusetts state law.
A cancer-stricken Sen. Edward M. Kennedy has asked Massachusetts leaders to change state law to allow a speedy replacement of him in the Senate, fearing a months-long open seat will deny Democrats a crucial vote on President Barack Obama's health care overhaul.
In a note to Gov. Deval Patrick and other state leaders, Kennedy wrote "it is vital for this commonwealth to have two voices speaking for the needs of its citizens and two votes in the Senate during the approximately five months between a vacancy and an election." [...]
Kennedy's letter acknowledges the state changed its succession law in 2004 to require a special election within five months to fill any vacancy. At the time, legislative Democrats — with a wide majority in both chambers — were concerned because then-Republican Gov. Mitt Romney had the power to directly fill any vacancy created as Democratic Sen. John Kerry ran for president.
I'm a bit all over the map on this. I actually think the Senate appointment process for vacancies is anti-democratic and wrong. But a five-month open seat does not serve the interests of Massachusetts residents either. Also, Kennedy, mindful of his cancer fight, could have resigned months ago. It's very sad that such choices have to be made given the process we have.
The real problem, of course, is that we have a system where everybody knows Ted Kennedy's position on health care - his committee staff helped write the Senate HELP bill - and he could easily indicate his position on elements of the bill from a hospital bed or through a staffer, but his specific presence on the Senate floor is required. The Senate is supposed to be about "relationships" and "comity" but the members cannot allow a colleague of 40-plus years the ability to make his preferences known given his medical condition. Ezra Klein adds:
That is to say, where Kennedy’s great friend Orrin Hatch would have voted to uphold a filibuster, now he will vote to shut it down, as that’s how the vote would have gone if Ted Kennedy were still alive, and it is neither decent nor small-d democratic to doom health care because the bill’s greatest advocate contracted incurable brain cancer.
Such a trade would not only be a grand show of respect for Kennedy’s life work, but it would uphold the outcome that Americans chose when they voted 60 Democrats into office in 2008. Conversely, if not one Republican can be found who feels enough loyalty to Kennedy to make sure that his death doesn’t kill the work of his life, then what are all those personal relationships and all that gentility really worth?
But Hatch was specifically asked this last night, and he ignored the question, saying that "The Democrats should be able to pass it. They have overwhelming majorities in the House, and they have 60 solid votes in the Senate." But they don't. Ted Kennedy is sick. He's barred from voting. And Orrin Hatch, supposedly this great friend of his, plays dumb about it. I guess blood - or the bloody shirt of partisanship - is thicker than water.
It shouldn't come to this at all - the filibuster was not designed to automatically require 60 votes on every piece of legislation, that's a recent development. But the next time you hear some member of the Senate club go on and on about "the great civility of this chamber" and "working with my esteemed colleagues on the other side," keep in mind that it's all a bunch of horseshit.
Everyone's freaking out about Kathleen Sebelius' statements about the public option on CNN over the weekend. I'm actually quite pleased that the conversation is moving back toward this, rather than the media obsessing over old conservatives shouting or people holding signs that confirm their ignorance. At least we're back to the policy. And talking about a health care reform with or without a public option in some way presumes a health care reform law. So maybe the teabagger protests have outlived their theatrical usefulness and everyone's ready to move on.
As to the specifics: Sebelius said that the public option was "not the essential element" in any reform. Which is of course true, based on the legislation they crafted. A bill where the public option would be an essential element would be a single payer bill. The bill that the White House and Congress put together relies far more on mandates and regulation, with a weak, walled-off public option that can only attract customers from the individual market and select small businesses thrown in to allow for "choice and competition," in their parlance. It's MassCare, which, depending on who you talk to, doesn't constrain costs enough or works pretty well. And MassCare does not have a public option. That part of reform was pretty much always designed as a bargaining chip, in the context of this legislation. And the White House has been bargaining with it consistently over a number of months.
As far as I can tell, there's been no change in the administration's position. It has always supported a public plan option. It has never claimed it essential, or the only path to competition in the insurance market. The one deviation came in July, when Obama said the words "must include" in a sentence that also had the words "public option." But it's not clear whether he was talking about the health insurance exchange or the public option. And that only happened, to my knowledge, once. That statement, not this one, was the deviation.
Try as we might to pin them down, the White House will never, ever, ever view a public insurance option as essential to passing a bill. Or anything else, for that matter, other than abstractions about "controlling costs" and "providing affordability." They want something to pass. Something they can call health care reform and tout as a victory after 40 years of defeats. If they think the best path to getting that through Congress is dropping the public option, they'll enthusiastically endorse such an approach. If they think it's not dispensable because 64 liberals in the House won't pass a bill without it, they'll have to keep it. The space in between, where the House doesn't compromise any further below a public option and the Senate doesn't allow anything beyond co-ops, is what Matt Yglesias describes as the legislative dead zone. This is basically the question House progressives must ask themselves:
If it comes right down to it and the senate is prepared to pass a bill that:
(a) subjects insurance companies to tough new restrictions, (b) taxes employers who don’t provide decent health insurance to their employees, (c) creates a new regulated marketplace in which individuals and small business employees can buy quality health insurance, (d) expands Medicaid eligibility, and (e) offers subsidies to ensure the affordability of insurance for middle class families
I have a hard time believing that House liberals will really kill the bill. But maybe they will.
This is where Mr. Krugman comes in today, comparing the plan on offer to what is occurring in Switzerland, where everyone must buy insurance, lower-income residents get subsidies, and the insurance companies have very strict regulations by which they must abide.
So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.
If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.
But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.
(One thing nobody who endorses this type of plan talks about is the fact that we have no national regulatory framework for health insurance companies, and the regulatory vigor in the states, where they are now regulated, varies widely from one to the other, so the plan on offer would either have to create a large new bureaucracy to accompany that regulation of insurers, or rely on the balkanized state approach. Neither is ideal.)
The public option could be an element of a Swiss-style system, but not the essential one. In essence, there's very little daylight between what Krugman says and what Sebelius said yesterday. So, what is one to think?
Those trying to minimize the importance of a public option are only looking at the one currently up for discussion, which is not available to anyone who gets coverage through an employer. That's not really a big enough market to change insurance company behavior anyway, which is why I favor the kind of plan offered by Ron Wyden, where employees can opt out of their coverage and buy into the insurance exchange. In fact, we have historically seen a government program like the public option refined and tweaked once it came into existence, from Social Security to Medicare. So we should not view it as static.
Which is why it's important to include it now. Sure, the public option could be added in future years as a deficit reduction element, much as MassCare is considering going to fee-for-service medicine after getting their universal system in place. But we're having the conversation now, and including a government-managed element in isolation down the road would allow everyone to train their guns very directly. This will not be the last health care reform bill in the history of America, but it's certainly the one with the most potential to codify something like a public option into law. And all the action for doing that is in the Senate - the White House will go along with whatever can pass.
...also, too: this is bigger than health care reform, it's about the progressive wing of the party being credible on standing their ground. That has implications on a host of issues.
I think it's clear that this health care reform bill will not be the last one ever passed by the US Congress. Once certain mechanisms get set in place, they become hard to dislodge, and further actions will refine them and improve them. That's the feeling behind the progressive push for the public option. If that gains a toehold, in the future we can expand access or change the delivery system. I fear that a carefully circumscribed public option may never get off the ground, but I think that's the theory.
And that theory got more credence with an action by Massachusetts on Friday. They implemented their universal health care plan, not totally different than the Democratic plan in Congress, which expanded access but didn't have any cost controls. So the costs have continued to rise, forcing a choice from the state - scale back the program, or apply enough cost savings to keep it going. They opted for the latter, in an interesting way:
A high-level state commission recommended Thursday that Massachusetts seek to rein in health care costs by radically restructuring the way doctors and hospitals are paid.
The commission’s action kicks off the second phase of a health care overhaul that has succeeded in covering nearly every resident of the state but done little to slow the relentless growth of spending.
The recommendations, if approved by the legislature and Gov. Deval Patrick, would make Massachusetts the first state to end the practice of paying health care providers for each office visit, laboratory test or procedure.
Instead, primary care physicians, specialists and hospitals would group themselves into networks that would be responsible for a patient’s well-being and would be compensated with a flat monthly or annual fee known as a global payment.
That would be remarkable, to end fee-for-service medicine in the US. And because Massachusetts has expanded access, there may be enough patients to keep doctors in the state, instead of them all fleeing to where they can get paid per treatment. If this works in Massachusetts, then I would really be excited about getting any reform done and managing some of the details later. We need to look at this as the means to an eventual end of the US joining the community of industrialized nations providing decent care for their citizens at an affordable price.
The state of Massachusetts upped the ante in the fight over same-sex marriage by suing the federal government over its DOMA policy.
Massachusetts, the first state to legalize gay marriage, sued the U.S. government Wednesday over a federal law that defines marriage as a union between a man and a woman.
The federal Defense of Marriage Act interferes with the right of Massachusetts to define and regulate marriage as it sees fit, Massachusetts Attorney General Martha Coakley said. The 1996 law denies federal recognition of gay marriage and gives states the right to refuse to recognize same-sex marriages performed in other states.
Massachusetts is the first state to challenge the federal law. Its lawsuit, filed in federal court in Boston, argues the act "constitutes an overreaching and discriminatory federal law." It says the approximately 16,000 same-sex couples who have married in Massachusetts since the state began performing gay marriages in 2004 are being unfairly denied federal benefits given to heterosexual couples.
True, Massachusetts is the first state to challenge DOMA, but several individuals have chosen to do so. And the Obama Justice Department's brief in that case was basically the touchstone to seething in the gay community over the White House disrespecting their civil rights. Just yesterday AIDS activists shut down the Capitol Dome over a broken promise from Obama on needle-exchange programs.
It appears that Obama will have an opportunity, at some point, to submit a new brief and right this wrong. I hope he takes it.
This has been a very interesting week in the fight for health care reform. Let's take a look at some of the major developments.
• Single-payer: Sen. Bernie Sanders introduced S.703, a single-payer health care bill (called the American Health Security Act of 2009), in the Senate. While this would be a companion bill to HR676 on the House side, it's the first time I can remember, and apparently the first time since the death of Paul Wellstone, that anyone in the Senate has carried a single-payer bill. Sanders in the release calls the bill "the most fiscally conservative option for reform" because private insurance overhead would be eliminated, saving over $400 billion dollars annually. Now that such a bill has been introduced in both Houses, there should be a demand from single-payer advocates to get the CBO to score the bill. Without numbers that Washington trusts, and sadly the CBO is the only number-crunching body with that authority, single payer will not be taken seriously. But a true accounting of the cost savings could spur reform. You can find the bill here.
• The Public Option: Howard Dean has jumped squarely into the health care debate from his perch at DFA, advocating strongly for a public insurance option to compete with the private market. Dean has gone so far as to say that without a public option, health care reform essentially doesn't exist.
Obviously, the insurance industry wants no part of a public option, that would force them to compete on price and quality of coverage, instead of the current system of competing to deny care to their customers to maximize profits. They say such a system would put them out of business. To which I say, YAY! What's important to understand is that there are public options and there are public options. Ezra Klein explains the structure of the three most common proposals:
• Single-Payer Lite. This was the rationale you heard during the primary campaign. A public insurance plan able to use Medicare's bargaining power to secure deep discounts for its customers and ensure the maximum possible network would be cheaper and more efficient than private insurers. Over time, this increased efficiency would make the plan more attractive because it could offer more coverage for less money. As consumers recognized this fact, they would increasingly migrate towards the plan, and the public insurer would become, if not a de facto single payer system, something close to it. The public insurer, in this scenario, is a game changer. But it's a game-changer because it's a form of single payer using a mild version of monopsony buying power.
• The Level Playing Field Plan. Insurers, predictably, howled that a public insurer with access to Medicare's market power would put them out of business. (Generally speaking, liberals agreed with that.) The messaging they settled on was conceptually odd but has proven pretty effective. A public insurer, they argued, would not be competing on a "level playing field." This might have caused someone to wonder when, exactly, the market had ever cared about "fair." But instead, this frame has been widely adopted, with Obama telling Chuck Grassley, "I recognize that there's that concern. I think it's a serious one and a real one. And we'll make sure that it gets addressed." In answer to this, Len Nichols proposed a public insurance plan that doesn't have access to Medicare's bargaining power, and this is the policy that CAP's paper advocates. This is not single-payer lite. It's just an insurer without shareholders or highly-paid executives. (I should note that some, like Harold Pollack, believe you could begin with this plan and end with the single-payer lite plan. I'm not convinced, but its possible.)
• The Catch-All. I've heard that the insurance industry and some advocates are interested in a compromise that looks a lot like Medicaid choice. Here, you'd have a public insurance option, but only for people making under a certain income level. It's a way of folding Medicaid into the new system.
If the single-payer lite plan is jettisoned, with the "level playing field" plan offered, such a public option would not achieve the kind of bargaining power to make it cost-effective. You reduce a bit of overhead and eliminate the profit motive to a certain extent, but you will not have done much to force private industry to heel. So if Dr. Dean wants to advocate for a public option, it had better be the right kind. For his part, Max Baucus, who has as much power over health care reform as anyone in Congress, characterized the public option as more of a bargaining chip than an actual policy point:
"Essentially, it's to keep it on the table to encourage the private health insurance industry to move in the direction it knows it should move toward—namely, health insurance reform, which means eliminating pre-existing conditions, guaranteed issue, modified community ratings. [TRANSLATION: Measures that would force the insurers to cover the sick as well as the healthy, at a cost that everyone could afford.] It's all those actions that insurance companies must take in order to provide affordable coverage. And the public option helps encourage the private companies to move in that direction, because they're worried. We might have to modify the public option to get enough votes. I hear some concerns among Republicans about the public option. The main purpose is to keep the health insurance feet to the fire."
Which leads us to...
• Industry Concessions: The insurance industry has offered what I imagine they consider their grand bargain: they will agree to both guaranteed issue (no more denial for pre-existing conditions) AND community rating (charging a flat rate for a community regardless of medical history) in exchange for an individual mandate that forces everyone to buy health care. This would be significant, but the devil is in the details:
The companies left themselves several outs, however. The letter said they would still charge different premiums based on such factors as age, place of residence, family size and benefits package.
"If the goal is to make health care affordable, this concession does not go far enough," said Richard Kirsch, campaign manager for Health Care for America Now. "It still allows insurers to charge much more if you are old." His group, backed by unions and liberals, is trying to build support for sweeping health care changes.
Importantly, insurers did not extend to small businesses their offer to stop charging the sick higher premiums. Small employers who offer coverage can see their premiums zoom up from one year to the next, even if just one worker or family member gets seriously ill.
Ignagni said the industry is working on separate proposals for that problem.
"We are in the process of talking with small-business folks across the country," she said. "We are well on the way to proposing a series of strategies that could be implemented for them."
Lots of outs for themselves, particularly age, which is intimately tied to increased need for care. It's good in the abstract because the industry clearly feels the need to move in the direction of reform. But they sang a lot of this tune in 1993 as well. Kevin Drum has more.
• Massachusetts Debate. One of the more interesting arguments among health care reformers concerns Massachusetts' "universal health care" policy adopted in 2006. It included an individual mandate and shared responsibility for stakeholders to provide subsidies to ensure everyone signed up for insurance. Monica Sanchez took a look at the MassCare plan relative to Barack Obama's principles for health care reform and found it lacking. A sample:
1. Does it protect families' financial health?
NO - Of those surveyed in a fall 2008 survey of Massachusetts residents on healthcare conducted by the Boston Globe and the Blue Cross Blue Shield of Massachusetts Foundation: in a recent survey 13% of insured said they were unable to pay for a health service; 13% said they were unable to afford to fill a prescription; and 33% ranked the cost of care their biggest health concern.
2. Does it make health coverage affordable?
NO - not for the middle class and not even for some people with low incomes. According to the report released last month, "Massachusetts' Plan: A Failed Model for Health Care Reform," by Drs. Nardin, Himmelstein, and Woolhandler, in fiscal year 2009, to bring cost increases down from more than 15.4% to 9.4% for CommCare, the state cut benefits and increased copays.
Read the whole thing. Jon Gruber argues that cost control was not entirely a part of the Massachusetts reform, as it focused more on universality. Thus it created what amounts to an entitlement in the hopes that the political dynamic could be changed to focus on bringing down costs once the plan was in place. In other words, there is, as Ezra Klein put it, an embedded political logic to doing coverage first.
States don't really have the bargaining power to bring down costs, nor can they deficit spend, so I don't know how building the political advantage for cost control really helps them, actually. And while this would possibly make sense on the national level, the Obama plan seeks to do everything at once, so it's not really germane.
• Budget Reconciliation. Harry Reid says he is completely open to using the budget process for health care reform, meaning that such legislation would only need 50 votes. Others violently disagree, not just Republicans but people like Budget Committee Chair Kent Conrad and Ben Nelson. In steps Steny Hoyer, of all people, as a mediator.
As House Speaker Nancy Pelosi (D-Calif.) did earlier Thursday, Hoyer defended the House’s decision to include budget reconciliation in its budget.
“Reconciliation on healthcare is a fallback position. It is not the preferred option. The preferred option is creating a bipartisan consensus,” Hoyer said [...]
Republicans argue that Democrats, by having reconciliation in their hip pocket, can pull out of any negotiations, whenever they want, making those talks potentially pointless for the GOP.
Hoyer said that if Democrats acted in that way, the Republicans would have a right to complain.
“If they are negotiating in good faith and then we pull the rug out from under them, I think that would be harmful to our objective of passage with a degree of bipartisan support and therefore credibility in the public,” he said.
Without reconciliation as a fallback, Republicans wouldn't even come to the table. So I do think it's a vital tool and shouldn't be set aside just yet. Hoyer had some interesting things to say about single payer and the public option, as well.
In other news, MSNBC is calling Massachusetts for Clinton, which means she overcame the combined force of John Kerry, Teddy Kennedy, Deval Patrick, their attendant political machines, the media coverage generated by their endorsements of Obama, and Barack Obama's charisma. That seems pretty impressive to me.
I thought Massachusetts would flip, but it looks like Connecticut might, instead. Both campaigns are going to be able to call this a winning night, with all-important California lurking in the distance. And the delegates, why won't the news nets tell us about the delegates? Because it requires math?
Massachusetts Candidate who wins popular vote could lose the delegate split (93 delegates total)
Tennessee Clinton 38 Obama 30
Oklahoma Clinton 23 Obama 15
That appears to favor Obama.
UPDATE: Obama looking good in Colorado, North Dakota, Minnesota and Idaho in early returns.
...CNN calls North Dakota for Obama. But Missouri looks good for Clinton, and her leads in Massachusetts and New Jersey are very healthy (New Jersey, with all those suburbs, is kind of a can't-miss Clinton state, I'm surprised I was duped into thinking it was a bellweather). Clinton's having a good night.
...Fox News apparently just called Connecticut for Obama. But that state is so close that the delegate count will be a tie. Significant in the spin game, however.
...Utah goes to Romney and Obama. But I thought only black people vote for Obama? I guess the Utah Jazz came out in FORCE!
Romney is having a TERRIBLE night, only winning his home states and losing significantly in the South as Huckabee overperforms to a significant degree. We knew McCain would win big tonight, but I thought Mittens would at least put up a fight. He's banking everything on California and I don't think he'll be able to make it.
...State updates:
Hillary Clinton: New York Tennessee Oklahoma New Jersey Massachusetts Arkansas
Markos sez Survey USA is doing well, which means Clinton is poised for a 10-point victory in California. Of course, he's basing that off of current numbers, and in a lot of states, the urban districts report late. Not sure if that's the case in NJ and MA, but if that's the final spread, why did it take so long to call the states?
If the MA and NJ numbers hold, Clinton has something to crow about. But with 9 victories already, so does Obama.
All candidates try to put their best foot forward and take credit for things done by others. But Mitt Romney is doing this to the extreme when talking about the Massachusetts health care reform:
(Romney) decries "socialized medicine" and says the Massachusetts plan is "all a private initiative, a private-based, market-based healthcare" -- omitting the fact that the state and federal governments subsidize much of the overall cost and that a public board negotiated the benefits and prices that private insurers now offer.
He wows audiences by telling them that premiums for individuals dropped from $350 a month to $175 a month, without clarifying that those figures are for the lowest-cost plan available for 37-year-olds and without mentioning that for many people, especially the elderly, premiums can be several hundred dollars more.
And he sometimes downplays the role that Democrats on Beacon Hill had in putting together the final plan.
This is my favorite part:
Romney has also implied that the new insurance law banned insurers from rejecting anyone based on a preexisting condition.
Dick Powers, a spokesman for the Commonwealth Connector, said, however, that the state's prohibition on rejecting applicants became law in the 1990s, before Romney was governor.
Mitt Romney: proudly leading the way on things that were already in place before he got there! Did you know that Romney ended the Civil War? OK, not really, but did the Civil War re-start while he was in office in Massachusetts? No! So, there you have it.
The Massaschusetts health care plan was written by Democrats, and when Romney vetoed certain parts of it, the Legislature overrode his veto. As the Speaker of the Massachusetts House said, "our bill ... became law despite Mitt Romney, not because of him."
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