Romney told Jay Leno on Tuesday that uninsured Americans who are sick should not be able to obtain coverage.
"If they are 45 years old and they show up and say, 'I want insurance because I have heart disease,' it's like, 'Hey guys. We can't play the game like that,'" Romney said. "You've got to get insurance when you are well and then if you get ill, you are going to be covered."
Romney opposes a federal health insurance mandate, which would require people who are "well" to obtain coverage, thereby preventing health care costs from being borne by taxpayers and the medical system when the uninsured get sick. He supported a mandate as governor of Massachusetts.
He has also called for a full repeal of the Affordable Care Act, which provides financial subsidies aimed at expanding coverage to millions more Americans who are currently uninsured.
"Only in Mitt Romney's world of tax cuts for billionaires and elevators for his cars would denying health care coverage to Americans with pre-existing conditions make sense," said Obama campaign spokeswoman Lis Smith.
"But to most Americans, ensuring insurance companies don't discriminate against people with pre-existing conditions means the difference between solvency and bankruptcy and life and death," she said. "With every day of this campaign, Mitt Romney shows why Americans can't afford his out-of-touch and extreme policies."
Romney told Leno he does support carry-over coverage for people with pre-existing conditions who switch jobs, so long as they have always been insured.
"People who have been continuously insured, let's say someone's had a job for a while and been insured, then they get real sick and they happen to lose a job, or change jobs, they find, 'Gosh, I got a pre-existing condition I can't get insured,' I'd say no, no, no. As long as you have been continuously insured, you ought to be able to get insurance going forward," Romney said."
"People with pre-existing conditions, as long as they have been insured before, they are going to be able to continue to have insurance," he said.
Romney campaign spokeswoman Amanda Henneberg explained that the former governor believes states should be given "the flexibility, resources and incentives to care for their own residents."
"Unlike President Obama, the American people are not looking for a single Washington solution to every problem," she said in an email.
This post has been updated.