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BY UPHOLDING the constitutionality of the historic national health care reform law last week, the Supreme Court sets up a fierce ideological battle.

It's between Mitt Romney and Mitt Romney.

If elected president, Romney promises to repeal Obamacare. He says it is bad law and bad policy, and unfairly raises taxes on the American people.

His problem is that as governor, he imposed the same law, policy, and taxes on Massachusetts citizens.

The tax increase Romney now rages against is the result of the "individual mandate," which requires Americans to buy health insurance and penalizes them if they don't.

Five Supreme Court justices agreed that the penalty is a tax that Congress has the power to levy. It's exactly the same penalty Romney imposed in Massachusetts.

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The Massachusetts health care reform law, which Romney pushed and promulgated, requires all Bay State citizens to buy health insurance and penalizes them if they don't.

Romney began his effort with a November 2004 op-ed in The Boston Globe entitled, "My plan for Massachusetts health insurance reform." He called for a bipartisan commitment to pass a "comprehensive, market-based reform program," that would restrain the growth in health care costs without raising new taxes; change how health care is provided; and lead to "every citizen in Massachusetts having health coverage."

Remember, no one forced the individual mandate on Romney. It was his baby, introduced in a speech he gave at the John F. Kennedy Library in June 2005.

When the governor unveiled his proposal, a Globe headline proclaimed, "Romney eyes penalties for those lacking insurance." When reporters pressed him about it, the governor said: "No more 'free riding,' if you will, where an individual says: 'I'm not going to pay, even though I can afford it. I'm not going to get insurance, even though I can afford it.' "

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Building on his rationale for the mandate, Romney added, "It's the ultimate conservative idea, which is that people have responsibility for their own care, and they don't look to government to take care of them if they can afford to take care of themselves."

When he signed the sweeping new health care bill into law in April 2006 at a joyous Faneuil Hall ceremony, it was gleefully hailed as a symbol of historic bipartisan achievement. A photograph of a beaming Romney, surrounded by US Senator Edward M. Kennedy and the Democratic leaders of the Legislature, captured the giddy promise of the moment.

Yet, even in the midst of celebration, some Democrats and health care advocates expressed concern about the cost. After the signing ceremony, Romney did the one thing he does with consistency: duck. "I think what we know is how much it's going to cost over the next three years. We've done the best human beings can do to carry out the full analysis and review," he said.

In Massachusetts today, health care reform is seen as a positive political achievement, even as the business community, health care providers, insurers, and advocates work together to come up with a plan to lower costs. Meanwhile, on the national front, the politics of health care reform have taken a turn for the perverse.

Romney, the governor who championed the individual mandate, is now the presidential candidate who opposes it. And Barack Obama, who opposed the individual mandate as a presidential candidate, is now the president who modeled his health care plan after Romney's.

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What Obama is saying about health care reform sounds remarkably similar to what Romney once said in Massachusetts: It's good for everyone, including the mandate that requires people who can afford health insurance to buy it.

"That's why, even though I knew it wouldn't be politically popular, and resisted the idea when I ran for this office, we ultimately included a provision in the Affordable Care Act that people who can afford to buy health insurance should take the responsibility to do so," said Obama after the Supreme Court ruling.

"No more 'free riding' " is how Romney once put it.

Somehow, Romney now expects what happened in Massachusetts to stay in Massachusetts. But, the Supreme Court just made it harder for him to walk away from it.


Joan Vennochi can be reached at vennochi@globe.com. Follow her on Twitter@Joan_Vennochi.