ANN ARBOR, Mich. — Republican Mitt Romney outlined a national health care plan Thursday that would empower states to decide coverage rules, spelling out differences with President Barack Obama's overhaul but refusing to renounce his own Massachusetts law that was a precursor to Obama's.
The all-but-declared 2012 presidential candidate said that backing away from the plan he signed as Massachusetts governor or changing his overall health care vision would be politically expedient given that health care has become a liability rather than an asset for him among conservative critics in the past two years.
But he declared, "I am not adjusting the plan to reflect the political sentiment."
The former Massachusetts governor tried to address a huge vulnerability in an appearance in Michigan, as well as counter the notion that he bends his positions to suit the current political environment. He was lambasted during his first White House run for reversing his positions on abortion and gay rights for what critics called political reasons. The health plan he described Thursday was the same one he proposed during his presidential run
Romney used a 29-minute appearance in this early primary voting state where he has family roots to lay out differences between the Massachusetts and federal plans. Instead of speaking from prepared remarks at a GOP-sponsored event at the University of Michigan hospital, he talked from notes and used a slide presentation to deliver what at times felt like a college lecture on health care.
Comparing his state version with Obama's, he said, "Our plan was a state solution to a state problem. And his is a power grab by the federal government to put in place a one-size-fits plan across the nation." He added that his state's plan was "a more modest approach."
His pitch is unlikely to appease critics who want him to make a clean break from the Massachusetts law's requirement that all residents obtain health insurance. That mandate is a cornerstone of the Obama-backed plan passed by Congress last year and despised by conservatives who have much power in determining the Republican presidential nominee.
Much of what he said Thursday, he's said before.
Romney again said the law he backed as governor was right for Massachusetts but Obama's, which requires federally mandated health care coverage for all U.S. residents, is a bad idea and should be repealed. He said that many pundits argue that he should stand up and say his own state law was a mistake, "that it was just a bone-headed idea and I should just admit it."
"There's only one problem with that," Romney said. "It wouldn't be honest. I, in fact, did what I believe was right for the people of my state."
"Governor Romney is spot on," Utah Gov. Gary Herbert said after the speech. "This has been Utah's message to the Feds all along—give states control of block funding, let states be the incubators of innovation, limit federal intrusion, maximize state flexibility, promote portability and enhance customer choice. It's like he took a page out of Utah's playbook."
"You can only tell with the passage of time if this approach is going to work," said Quin Monson, associate director of Brigham Young University's Center for the Study of Elections and Democracy. "This is going to be a majority issue for Mitt Romney. Anything he can do to diffuse it and handle it early on is a good idea."
Kirk Jowers, head of the University of Utah's Hinckley Institute of Politics and a Romney supporter said the speech was a good starting point.
"It is a question among voters, about how 'Romneycare' and 'Obamacare' compare and what his vision for the future is. … It's a great first step of settling the issue. Romney has been very consistent on saying health care should be left to the states," Jowers said.
Romney devoted one of his first major policy presentations of an expected 2012 presidential bid to the issue that many conservatives believe could keep him from the nomination. He sharply criticized Democrats' health policies and outlined an alternative.
He said the Democrats' law, which is being phased in over several years, amounts to a takeover of the health care system that raises taxes and cuts services to seniors. Romney said his 2006 version expanded coverage through private insurance plans without adding taxes in Massachusetts and, if elected president, he would let states come up with their own plans.
Numerous analysts say Romney's Massachusetts law raised taxes indirectly, by redirecting Medicaid funds to pay for the expanded coverage.
"The states would be responsive to the people closest to them and the solutions could be tailored," Romney said. "My experience is that health care delivery in Massachusetts is different than Montana."
Romney previously has had to explain reversals in his stands on abortion and gay rights. Critics say the changes were a politically expedient way to transfer a Massachusetts moderate-liberal into a staunch conservative who could win GOP presidential primaries.
This time, the health care issue is one of Romney's biggest hurdles.
Like the federal law, the Massachusetts plan requires individuals to buy health insurance and imposes tax penalties on those who don't. Both plans penalize small businesses above a certain size that don't provide coverage to their employees. Both rely on new taxes for some of the financing.
Since Congress approved the national health overhaul a year ago, Romney has struggled to answer criticism of his role in the Massachusetts plan.
Thursday's speech — in both the timing and the content — is an indication of just how much Romney's second bid is informed by his missteps four years ago.
Last time, he spent months dogged by questions about his Mormon faith. Aides now acknowledge he never fully answered voter concerns in the yearlong run-up to the Iowa caucuses. Just weeks before them, he delivered what aides now call "the Mormon Speech." But after much buildup, the speech failed to undo months of a whisper campaign that suggested Mormons are not Christian.
This time, Romney's advisers suggested that he deliver a health care policy speech early and get past it, even before he launches a full-fledged campaign and weeks before he participates in his first presidential debate.
Romney finds himself in a position that's somewhat similar to the one Hillary Rodham Clinton found herself in during the Democratic presidential primary in 2008 over her vote to authorize the war in Iraq. Liberals dogged her with questions about that 2002 vote; she refused to apologize, though she made several attempts to explain her thinking. Still, Clinton was never able to convince liberals that her position was not disqualifying.
Romney will spend the next months trying to convince conservatives of the same.