ROBINSON: Romney's mixed message on health care

In an interview broadcast Sunday on “Meet the Press,” I thought I heard Romney say he liked some aspects of President Barack Obama’s Affordable Care Act and would keep those provisions in place. Impossible, right? Romney’s position all year has been that if he’s elected, he’ll begin repealing Obamacare on Day One. My ears must have deceived me.

But when I checked the transcript, here’s what I found:

“MR. ROMNEY: Well, I’m not getting rid of all of health care reform. Of course, there are a number of things that I like in health care reform that I’m going to put in place. One is to make sure that those with pre-existing conditions can get coverage. Two is to assure that the marketplace allows for individuals to have policies that cover their — their family up to whatever age they might like. I also want individuals to be able to buy insurance, health insurance, on their own as opposed to only being able to get it on a tax advantage basis through their company.”

So Romney wants to repeal Obamacare and replace it with Obamacare, or at least the consumer-friendly parts of Obamacare that Romney knows are popular. What he would leave out is the part he knows is unpopular: the individual mandate compelling some Americans to obtain health insurance or pay a fine.

But as Romney knows, it’s the individual mandate that makes the other benefits possible by preventing young, healthy people from gaming the system. They would just wait until they got sick to purchase insurance, knowing they couldn’t be turned down because of the “pre-existing conditions” measure.

Romney is familiar with the problem of these so-called free-riders because he solved it when he was governor of Massachusetts. With an individual mandate.

To review, Romney was for Obamacare before he was against it before he was for it again, except the keystone element that makes the rest of Obamacare work, which he developed and implemented but steadfastly opposes.

Hold it, breaking news, this just in: After the “Meet the Press” appearance, a Romney aide clarified that Romney didn’t actually intend to guarantee that people with pre-existing conditions could get insurance. Rather, he would somehow encourage the free market to provide such coverage — even though, as anyone with diabetes or kidney disease can attest, the free market does no such thing.

My advice is that before making a serious attempt to understand what Romney might actually do, make sure your health insurance policy covers whiplash.

We know more about how Romney would handle Medicare. Beginning in 2023, the program would no longer be a promise to provide health care to seniors. It would be a promise to give seniors a voucher that is unlikely to cover the full cost of buying private health insurance.

We also know what Romney and running mate Paul Ryan plan to do about Medicaid, the health care program for the poor. Ryan’s proposed budget, which Romney has endorsed, would give block grants to the states and let them run the program. This would mean inadequate funding, which would mean merciless cuts. Among those whose well-being is most threatened by the Romney-Ryan plan are seniors who have exhausted their savings and whose nursing home care is paid not by Medicare but by Medicaid.

Don’t worry, Romney says, he’ll make sure all Americans have the health care they need and deserve.

Someday. Somehow.

On one level, the confusion Romney generated Sunday about his views simply reflects his willingness to say whatever he thinks people want to hear. “Romney panders” is such a familiar story by now that it hardly qualifies as news.

But health care is no ordinary issue. Bringing universal health insurance coverage to the citizens of Massachusetts — via the individual mandate — was Romney’s greatest accomplishment as governor. This is subject matter he truly understands.

He knows full well that if he fulfills his promises, or threats, regarding Obamacare, there won’t be any affordable coverage for people with pre-existing conditions. He knows that if he follows through on Medicare and Medicaid, seniors will have to pay more for their care and many poor Americans won’t receive adequate care at all.

No wonder Romney has so much trouble sticking to a consistent story.

Eugene Robinson is a columnist for the Washington Post.