Perry’s critique of Romney health law has practical focus

Analysts think Governor Rick Perry of Texas, signing his book for a supporter in Denver earlier this summer, is unlikely to hammer his GOP rival Mitt Romney on the health care issue. Analysts think Governor Rick Perry of Texas, signing his book for a supporter in Denver earlier this summer, is unlikely to hammer his GOP rival Mitt Romney on the health care issue. (Ed Andrieski/Associated Press)
By Matt Viser
Globe Staff / August 26, 2011

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WASHINGTON - Governor Rick Perry of Texas tepidly criticized Mitt Romney’s Massachusetts health care plan yesterday, but the two GOP rivals remain in general agreement over the Bay State’s right to develop its signature health care law.

“Massachusetts is free to experiment with state-run health care,’’ Perry wrote last year in his book “Fed Up.’’ “If federalism is respected, the people of Massachusetts are free to try it while the rest of the nation sits back and watches to see if they have any success, and whether any success they do have is worth the price of liberty to get it.’’

The argument largely mirrors the one Romney laid out in a high-profile speech three months ago in Michigan, and it differs from those of others in the field - including Representative Michele Bachmann - who question the constitutionality of the individual mandate at the heart of Romney’s Massachusetts plan.

Perry’s nuanced stance - criticizing the Massachusetts plan while praising the state’s right to pursue one - illustrates how health care is unlikely to be the primary thrust of his argument against Romney. As Perry has surged to the top of the polls less than two weeks after announcing his candidacy, he has placed far more emphasis on jobs and the economy, areas in which Romney is seen as holding his own, than on health care, long seen as Romney’s Achilles heel in GOP circles.

“The perils of health care may have been overstated for Romney,’’ said Steve Lombardo, a Washington-based Republican consultant who advised Romney’s 2008 campaign but so far is not working for any candidate this year.

Health care had long been seen as the chief impediment to Romney, because the version he shepherded through in 2006 as governor of Massachusetts served as a template for President Obama’s national plan last year. Romney felt so vulnerable on the issue that he devoted an early policy speech to defending his decision in Massachusetts, at the same time trying to make clear that he opposed the federal plan and would work to repeal it.

Conservative editorial pages have taken him to task for the Bay State’s health care overhaul, and voters have asked him on the stump about it, but few of his opponents so far have tried to capitalize on the issue directly.

The GOP candidate who most prominently tried - and failed - to bring the issue up has dropped out of the race. Former Minnesota governor Tim Pawlenty began attacking Romney’s plan two months ago by calling it “Obamneycare’’ but backed off in a New Hampshire debate.

Perry’s comments so far have focused on more practical terms, such as waiting times for doctor appointments, than on the broad critique of a state’s right to pursue an individual mandate. He hints at that feature of the Massachusetts plan with a reference in his book to the “price of liberty’’ that the plan requires.

“Massachusetts provides a great example of laboratories of democracy in action,’’ Perry wrote, going on to criticize the plan even as he defends the state’s right to pass it.

“Massachusetts enacted universal health care on a statewide basis in 2006, including an individual mandate and an expansion of the Medicaid rolls,’’ he wrote. “Since then, the waiting times to see a doctor in Massachusetts have nearly doubled.’’

An annual Massachusetts Medical Society survey found that the average wait time for new, nonemergency patient appointments with an internist went up from 33 days in 2006, the year the health care law was enacted, to 53 days in 2010. This year, the figure went down to 48 days.

One of the primary problems conservatives have with Romney’s health care plan in Massachusetts is the mandate that residents obtain health insurance or face tax penalties. But Perry may have a hard time criticizing Romney on signing a law that included a mandate.

Perry signed an executive order mandating that all teenage girls in Texas receive the human papillomavirus vaccine to guard against the sexually transmitted infection. The Texas Legislature later overruled that decision, and Perry said this month that he was wrong to have pursued the policy.

Perry yesterday began to criticize Romney over health care.

“I think Mitt is finally recognizing that the Massachusetts health care plan that he passed is a huge problem for him,’’ Perry told conservative commentator Laura Ingraham on her nationally syndicated radio show. “And yeah, it was not almost perfect. I truly believe that you have to have the free market in play with our health care. I think Obamacare, which was modeled after the Massachusetts plan, is an absolute debacle.’’

But in the next breath, he said the state had a right to pursue the plan.

“I’m a big believer that the answer to our health care issues in this country can be found in the states - allowing them to come up with the ways to deliver health care, come up with the innovative approaches,’’ Perry said. He ran through a list of current Republican governors, saying they “will come up with ways to deliver health care in their states.’’

Perry’s position means that at this point he and Romney disagree only on whether the Massachusetts plan was a success. They both oppose Obama’s national health care plan and say they would repeal it.

“That’s exactly how Romney has defined it - that it was good for Massachusetts but not necessarily for a national policy,’’ said Linda L. Fowler, a professor of government at Dartmouth College. “The candidates must have decided maybe that’s a plausible explanation.’’

Aides have said that Bachmann, a Minnesota Republican, plans to soon unveil her plan for a health care overhaul.

She has been one of the brashest critics of Obama’s health care law, and she has also said any plan that includes an individual mandate, such as the one passed in Massachusetts, is unconstitutional.

“I think that the government is without authority to compel a citizen to purchase a product or a service against their will,’’ Bachmann said earlier this month at a GOP debate in Iowa.

“If a state can force their citizens to purchase health insurance, there is nothing that the state cannot do. This is clearly an unconstitutional action, whether it’s done at the federal level or whether it’s at the state level,’’ she added.

Mark Miner, a campaign spokesman for Perry, reiterated Perry’s position, saying, “Of course Massachusetts should be free to choose Romneycare or any other system - but then we are free to criticize it, learn from it, and gain understanding about those who chose to implement it.’’

In his book, Perry also criticizes the Bay State in other ways.

“I would no more consider living in Massachusetts than I suspect a great number of folks from Massachusetts would like to live in Texas,’’ he writes. “We just don’t agree on a number of things.

“They passed state-run health care, they have sanctioned gay marriage, and they elected Ted Kennedy, John Kerry, and Barney Frank repeatedly - even after actually knowing about them and what they believe!’’

In the interview with Ingraham yesterday, he also had a slight for a certain island off Cape Cod.

She asked him to pledge not to vacation on Martha’s Vineyard, as Obama has for the past three summers. He replied: “I’m not even sure I know where it is.’’

Matt Viser can be reached at