Huntsman and Health Care: Underwhelming Reforms and the Shadow of the Individual Mandate

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As health care remains a top issue in the contest to win the 2012 GOP nomination for President, candidates are working hard to build their own narratives around the issue. Mitt Romney has decided not to back away from the universal health care reforms he championed in Massachusetts, but to emphasize the difference between a state-based overhaul and a federal one. Other candidates, like Michele Bachmann and Tim Pawlenty, say they wholly oppose ObamaCare and everything in it.

For Jon Huntsman, building a health care narrative is proving more difficult. His reform past is complicated, particularly when it comes to the most controversial piece of the Affordable Care Act – the individual mandate. The Huntsman campaign is taking pains to say that its candidate never sought to pass an individual mandate while he was governor of Utah, although the Huffington Post and the Salt Lake Tribune have turned up evidence to the contrary.

Both outlets report that Huntsman sought to implement a package of health reforms that would have included an individual mandate, but dropped the idea only because of opposition from conservatives in the state legislature. In other words, Huntsman was not philosophically opposed to the idea of requiring at least some individuals to purchase insurance; he just realized it was political untenable in Utah.

In this way, Huntsman lucked out. If he had dramatically reduced the ranks of uninsured Utahans via some kind of a mandate, subsidy program and expansion of public insurance programs, as one proposal called for, he’d be in the same boat as Romney. Instead, Huntsman can point to what did pass in Utah – a fairly ineffectual, but functioning, health insurance exchange based on free market principles.

Huntsman may not have major health care skeletons in his closet – at worst, he flirted with Romney-like reforms but never staked his tenure on them – but neither does the former governor have much to brag about.

The year Huntsman left the governor’s mansion, some 14% of the state’s population were uninsured, including 11% of children. The rate has not increased as the economy has tanked, which could be seen as a victory, but as the Tribune reports:

But it is health safety nets, not Utah’s market-based solutions, that are responsible for keeping the uninsured rate in check. Insurance premiums continue to soar and fewer employers — including small businesses — are offering health insurance.

So Utah looks basically like the rest of the country when it comes to health insurance. It’s hard to see how Huntsman will be able to point to his Utah health care record as a viable alternative to the Affordable Care Act in terms of containing costs or expanding coverage. His policies did neither. But thanks to the state conservatives who stood in his way, Huntsman can avoid most of the health reform fire; Romney will still take the bulk of that.