These [audience] expressions clearly reflect the straightforward policy implications of conservative principles. At the same time, I don’t think they ought to be taken purely at face value...Yes, conservatives have developed a series of policy stances — say, that subsidizing and regulating private health insurance is the greatest threat to freedom in American history. Rather than treat this as a principled view, Romney simply treats it as an atavistic expression of hostility toward Obama. He defends his Massachusetts plan by pointing out that it involves private insurance. That makes it exactly the same as Obama’s plan, but Romney probably figures most conservative voters don’t know that, and he’s probably right.That's exactly right (and, really, what some of us have been emphasizing for a long time). Conservatives simply don't have a lot of hostility to the program that Mitt Romney supported in Massachusetts; what they are hostile to is "Obamacare," which functions more or less on the same level as Barack Obama's (entirely fictional) apology tour foreign policy. That there is also an actual policy -- a law -- that corresponds to "Obamacare" is more or less coincidental.
Paul Waldman makes this point really well in a post today concentrating on Herman Cain's claim that he'd be dead if Obamacare had been enacted earlier (his emphasis):
I have no doubt that the typical Republican voter actually believes that when the Affordable Care Act is implemented, every time one of the nation’s nearly one million practicing physicians wants to perform a procedure or prescribe a medicine, they’ll have to literally place a call to Washington and get permission from some stingy bureaucrat...Why do they believe that? Because people like Herman Cain keep telling them so. I don’t know whether Cain is an ignoramus or a liar, but it has to be at least one, maybe both. He stood on a stage, looked into the camera, and told people that under the ACA, doctors will have to get permission from government bureaucrats for every procedure, and treatment of illnesses will proceed not according to the recommendations of medical professionals but on “the government’s timetable.”Exactly.
Now, the question I'm interested in is whether, in fact, most of the candidates on the stage last night, and most Republicans in the House and Senate, are actually on the "ignoramus" side of that. Not all -- Mitt Romney certainly knows very well what the ACA is -- but a lot of them. I'll say this: both I (in my Plum Line recap) and Andrew Sprung last night noticed that Romney had left open a huge hole in one of his health care answers, and no one up there on stage was able to take advantage of it. Of course, there are lots of reasons why that might be the case (not their strategy, didn't get called on, etc.), but it seems perfectly plausible to me that for at least some of them the problem is that they really do believe that "Obamacare" consists of some new huge government agency that is going to be making day-to-day decisions about whether people can get surgeries or not.
One more thing: I've watched seven Republican presidential debates so far, and I've yet to hear even a mild suggestion that the non-Romney candidates could describe what Obamacare actually will do.
Once again, the necessary disclaimer: I'm not saying that Romney will win the nomination; not every policy works this way for Republicans. And if GOP elites turn against him, they're apt to express it through health care. But I just don't think health care will cost him the nomination.