IF YOU DOUBT HOW IMPORTANT Chapter 58 is to Romney, all you have to do is glance at his portrait hanging in the Massachusetts State House. At his request, the artist depicted a copy of the signed law on the desk. The only other item there (besides a lamp) is a portrait of Romney’s wife, Ann.
But Romney had not come to office promising to tackle health care, and didn’t take much interest in the issue until a longtime friend and business associate suggested it—appealing to Romney’s analytical side, as a former investment banker, by pointing out that the cost of treating uninsured patients in emergency rooms was likely raising costs for everybody else. “That began to grind in my mind,” Romney told me in an interview after the anniversary event, “and I began to wonder what in the world can we do.”
Even that might not have turned health care into Romney’s legacy if not for another circumstance. Massachusetts was on the verge of losing hundreds of millions of dollars a year in extra hospital funding, which it had been receiving through a special program that the administration in Washington—George W. Bush’s—didn’t want to renew. The only way to keep the money was to use it differently, to pay for insurance rather than continue subsidizing hospitals directly.3
This was the point when Romney forged a partnership with Ted Kennedy, the iconic liberal Democratic senator from Massachusetts. It would be difficult to exaggerate how unlikely a pair they made, characterologically as well as ideologically, and that’s not to mention the fact that the two had faced off in a bitter, frequently nasty Senate race when Romney tried to unseat Kennedy in 1994.
But “we were friendly on a personal basis,” Romney told me, “we just had different ideas on how to get things done and what was the best thing to do for people.” And the situation with federal funding meant both men could get a win. Romney would get a chance to keep state finances whole, without having to raise taxes or cut spending elsewhere. Kennedy would get a chance to see Massachusetts get close to universal coverage, as he’d long wanted.
The two ended up visiting the then-outgoing secretary of health and human services on his last day before stepping down, then headed next door for a reception where—by some accounts, though Romney told me he doesn’t remember—the two entertained a crowd by telling jokes about each other. But the Bush administration’s agreement was only the beginning of the process. Massachusetts still had to come up with a new health insurance system, which meant Romney had to work with the overwhelmingly Democratic state legislature.