"You know, regardless of what they do, it's going to be up to the next president to either repeal and replace Obamacare or to replace Obamacare," Romney told a crowd in Orlando on Tuesday.
But it's Romney's unabashed public opposition to one of the law's most popular provisions - a ban on health insurance company discrimination against people with pre-existing conditions - that is once again stirring the political pot.
The former governor said this week, reiterating a position he's articulated in the past, that only Americans who have had constant, uninterrupted insurance coverage should be guaranteed access to a health plan, regardless of any pre-existing conditions.
Asked to clarify his position on Wednesday, Romney campaign spokeswoman Andrea Saul confirmed that the former governor does not support the across-the-board consumer protections for pre-existing conditions as written into Democrats' health care law.
"Governor Romney supports reforms to protect those with pre-existing conditions from being denied access to a health plan while they have continuous coverage," she said first in a statement to the Huffington Post later obtained by ABC News.
As for Americans with pre-existing conditions who may not have had continuous insurance coverage or spent a period of time without, Saul said Romney "supports reforms that empower states to make high risk pools more accessible by using cost reducing methods like risk adjustment and reinsurance," but suggested there would be no guarantees.
"Beginning on his first day in office, Governor Romney is committed to working with Congress to enact polices like these that protect Americans' access to the care they need," she added.
Democrats have seized on the position to cast the former Massachusetts governor, who authored a landmark state health law that mandated individual insurance coverage, as grossly out of touch. A New York Times/CBS News poll in March found that 85 percent of Americans support the law's pre-existing conditions protections.
"Mitt Romney just clarified the choice in this election - he'd put insurance companies back in charge," said deputy Obama campaign manager Stephanie Cutter. "People living with pre-existing conditions from asthma to breast cancer are on their own if Mitt Romney is elected president and millions more would lose their health insurance."
Romney's position - protecting people with pre-existing conditions so long as they've always had insurance - has been law since 1996, experts say. It does not immediately address people who have never had private health insurance, or who have had insurance but spent some time without, often because of financial circumstances and unemployment.
The governor believes in an incremental, market-based solution to boosting coverage and helping states develop ways to help those with difficulty obtaining insurance or care.
Romney's comments this week are not the first time he's publicly defended his approach. In March, the candidate had a lengthy exchange with "Tonight Show" host Jay Leno on the topic of pre-existing conditions.
LENO: "What about pre-existing conditions in children? That - I mean, I know people who could not get insurance up until this Obamacare and now they're covered. Their pre-existing condition is covered. …It seems like children and people with pre-existing conditions should be covered."
ROMNEY: "Yeah. Well, people who have been continuously insured, let's say someone's had a job for a while but insured, then they get real sick and they happen to lose a job, or change jobs, they find, gosh, I've got a pre-existing condition, I can't get insured. I'd say, no, no no. As long as you've been continuously insured, you ought to be able to get insurance going forward. See, you have to take that problem away. You have to make sure the legislation doesn't allow insurance companies to reject people."
LENO: "So you would make the law stand for children and people with pre-existing conditions?"
ROMNEY: "Well, people with pre-existing as long as they'd been insured before, they're going to be able to continue to have insurance."
LENO: "Well, suppose they were never insured before?"
ROMNEY: "Well, if they're 45 years old, and they show up and they say 'I want insurance because I've got a heart disease,' it's like, hey, guys, we can't play the game like that. You've got to get insurance when you are well. And so and then if you get ill, then you're going to be covered."
LENO: "Yeah, but there a lot people that - see I only mention it because I know guys that work in auto industry and they're just not covered because they work in brake dust and could get it - so they've just never been able to get insurance. And they get to be 30, 35, they were never able to get insurance before, now they have it. That seems like a good thing."
ROMNEY: "Well, we'll look at circumstance where someone was ill, and hasn't been insured so far. But people have had the chance to be insured. If you're working at an auto business, for instance."
LENO: "Right."
ROMNEY: "The companies carry insurance. They insure all their employees. You look at the circumstances that exist. But people who have done their best to get insured are going to be able to be covered. But you don't want everyone saying, 'I'm going to get back until I get sick,' and then go buy insurance."
LENO: "No, of course not. Of course. Of course."
ROMNEY: "That doesn't make sense. But you have to find rules that get people in that are playing by the rules."
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