Any list of Republicans responsible for Obamacare has to start with Mitt Romney. As governor of Massachusetts, Romney worked with future Obamacare architect Jonathan Gruber, the late liberal icon Ted Kennedy, and a Democratic legislature to push a universal coverage plan in the state. The law expanded Medicaid, mandated that individuals purchase a specific type of insurance, and set up an exchange on which individuals used government subsidies to purchase government-designed insurance. Sound familiar? Under Romneycare and before the adoption of Obamacare, Massachusetts had the highest insurance premiums in the nation, by far — more than double the neighboring state of Connecticut — which was a sign of things to come nationwide once Obamacare was adopted. Romneycare was used as the model for Obamacare, and his support and subsequent rise in GOP politics, allowed Democrats to sell their proposals as being less radical than they actually were.

In his two campaigns for the Republican nomination, Romney twisted himself into a pretzel trying to defend his plan, and eventually struggled to draw distinctions between the structurally similar plan that was his signature legislative accomplishment as governor and Obamacare, which he claimed to passionately oppose. His defense of his version of the individual mandate was full of deception. His nomination in 2012 ensured that Republicans would never be able to run a credible campaign against Obamacare in the final election year before the law was to be implemented. There are some “Never Trump” Republicans who may look back with fondness on Romney as representative of a more civil politics and as somebody who correctly identified Russia as America’s top “geopolitical foe.” But among those who care about limiting the size and scope of government, he should never be forgiven for his role as one of the founding fathers of Obamacare.