Romney Critic Crafted Giuliani Health Plan

If Giuliani begins to articulate some of the arguments that Pipes has already formulated about Romney, the former New York mayor might appeal to some of the free-market conservatives who play an influential role in the GOP's presidential nominating process.

Gingrich Weighs In

Former House Speaker Newt Gingrich does not fault Romney for enacting an individual mandate but pointed to estimates showing the plan's cost rising as a cause for concern.

Speaking of Romney in February, Gingrich told ABC News, "He's had a little bit of a rough patch with the cost of the health plan in Massachusetts."

To allay conservative concerns, Romney is quick to say that his focus in Massachusetts was on expanding "private, market-based" health insurance rather than on expanding public health insurance programs. His campaign is also quick to stress that the emphasis of his federal plan would be on flexibility.

The "best approach," said Madden, is to give states "flexibility" to "leverage their federal dollars so that more people can be covered with private-market based insurance."

If early-state victories catapult Romney ahead of Giuliani in the race to become the GOP's standard bearer, his health care plan is likely to play a key role in his effort to present himself as a competent CEO who can work across the aisle to solve problems that have befuddled Washington.

Romney's Health Plan Challenges Democratic Hopefuls

Democratic strategists view Romney's record of extending health coverage to nearly 125,000 previously uninsured individuals as presenting a stiff 2008 matchup.

Speaking about Romney's health care record during a 2006 political conference sponsored by the Hotline and the University of Virginia, Steve Murphy, a Democratic strategist advising New Mexico Gov. Bill Richardson's presidential campaign, said, "A nominee who has passed universal health insurance is a formidable animal in the general election."

After avoiding all references to his health care record while delivering a major speech to the Conservative Political Action Conference in March, Romney is beginning to frame the health care issue in a way that might resonate in a general election.

When asked by CNN's Wolf Blitzer to address conservatives who might object to the individual mandate contained in his health care plan, Romney said, "I want to talk to the people, not just to those conservatives who are critical, and the people of this country recognize that they got some real concerns in health care. … This is a big issue for this country. … We have to stand up and not just talk about it."

ABC News' Leigh Hartman contributed to this report.

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