Former Gov. Mitt Romney says other states can replicate Massachusetts' program of universal health care if the federal government creates an environment in which private health insurance can expand.
In a speech being delivered Friday to the Florida Medical Association, the Republican presidential contender is to declare he wants the government to help states lower premiums by deregulating their insurance industries.
Romney says Washington also should make tax changes so all people can use pretax dollars to buy coverage - as workers do who get coverage through their employers.
And he says the Medicaid program for people with low incomes should be overhauled. The goal should be to provide states with block grants so they can create insurance programs - freed from federal mandates - that are tailored to their individual needs.
Copying the Bay State
In Massachusetts, a federal block grant was used to subsidize low-income insurance coverage, which, in turn, is being used to encourage residents to engage in more preventive and less emergency care. Similar grants were used nationally in 1996 so states had the freedom to restructure their welfare programs.
Romney's plan would help people buy private health insurance "in a way that builds on the experience in Massachusetts but doesn't force a one-size-fits-all approach on other states," said Sally Canfield, a Romney policy adviser who previewed the speech for reporters.
Health care has typically been an issue emphasized by Democratic candidates. The former Massachusetts governor has battled to claim it for the GOP by citing the 2006 measure he signed into law to help bring coverage to people who lack insurance.
On Thursday, Democratic front-runner Hillary Rodham Clinton outlined her own vision for covering the 45 million nationally who lack insurance, although Romney has preferred to deride as "Hillarycare" the universal health program she tried unsuccessfully to implement in 1993 while serving as first lady.
Modification
The overarching principle in Romney's national plan stems from the line in the Hippocratic oath: "Do no harm." The candidate says Americans like their existing system of employer-provided coverage, and he believes it needs only modifications to expand to the uninsured.
One slide in the presentation he plans to deliver states: "No Europe-like rationing."
While the presentation highlights features of the Massachusetts plan, Romney also distances himself from the government bureaucracy it created and its requirement that all state residents get coverage by July 1. He says states will be free to craft the specifics of their own programs.
Social and fiscal conservatives such as those Romney is courting generally favor fiscal discipline, loathe government bureaucracy and oppose federal mandates.
"We're not saying every state has to have a mandate," said Canfield, the Romney policy adviser. "Their uninsured may be a different slice than it was in Massachusetts."