Before the debt ceiling and deficit-reduction debates engulfed the national political dialogue, health care was shaping up to become a cornerstone of the debate leading up to the next presidential election.
Three of the GOP presidential candidates have already fought health care battles as governors. Former Massachusetts Gov. Mitt Romney and former Utah Gov. Jon Huntsman overhauled their states' health care system while in the governor's mansion, while Texas Gov. Rick Perry has overseen an array of women's health and family planning legislation during his 10-year tenure.
"Governors control a lot about what happens in the health care system in their state, although they are also in part stuck with the hand they're dealt," said Larry Levitt, senior vice president at the Kaiser Family Foundation. "Massachusetts and Texas are very good contrasts in both cases."
The health care legislation that Romney championed while governor has become a kicking post for his fellow presidential contenders because it so closely mirrors the Republican-hated Affordable Care Act that President Obama signed more than a year ago.
Former presidential candidate Tim Pawlenty, who dropped out of the race last weekend, even coined the term "Obamneycare" to tie the former Massachusetts governor to the health care law that the president looked to as a "blueprint for his plan."
The Massachusetts law requires all residents to purchase health insurance and all employers to pay for a portion of their employees' insurance. It also creates a state exchange that provides subsidized insurance to people who cannot afford it.
At a town hall meeting Monday, Obama said Romney's health legislation is "the exact same thing" as the law he enacted at the federal level.
"You've got a governor who's running for president right now who instituted the exact same thing in Massachusetts," Obama said on the first top of his Midwest bus tour. "It's like they got amnesia."
Jon Huntsman also looked to the Massachusetts plan when designing his health care law as governor of Utah in 2007, Politico reports. Huntsman's administration ultimately shied away from a personal mandate because it more than likely would not have passed the Republican-controlled state legislature.
"When you are deliberating something as important as health care reform you look and analyze every conceivable option," Huntsman told the Huffington Post in June. "You look at everything, you analyze every possible approach, you bring in the experts and then you make a decision. And our decision was to move forward with a market-based model. And I do believe that that's likely where this country is going longer term."
The Utah law created a private employer exchange for health insurance rather than the public pool created in Massachusetts. The former Utah governor has now become an outspoken opponent of requiring people to buy insurance.
"You can either look at the heavy-handed government-centric mandate enforcing people's behavior, which in cases like Massachusetts, we have seen premiums rise substantially ... or you can create a free market based exchange, which we chose in Utah," Huntsman said, according to the Boston Globe.
But Romney argued that he only supported the personal mandate because it was right for his state, not the entire country.