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Trying (and failing) to Etch A Sketch on health care

Since the very first day of his presidential campaign, Mitt Romney has promised voters he'll repeal the Affordable Care Act.

Since the very first day of his presidential campaign, Mitt Romney has promised voters he'll repeal the Affordable Care Act. How much of the law would he destroy? As of earlier this year, all of it -- Romney endorsed what he described as "complete repeal."

Yesterday, kicking off a near-comical display of ineptitude, Romney tried to adopt a new position on health care.

"I'm not getting rid of all of health care reform," Romney told David Gregory. "Of course, there are a number of things that I like in healthcare reform that I'm going to put in place. One is to make sure that those with pre-existing conditions can get coverage."

Soon after, the Romney campaign changed its mind, quietly letting National Review know that Romney doesn't actually intend to extend coverage to those with pre-existing conditions; he actually expects the free market to work its magic.

And soon after that, the Romney campaign changed its mind again, telling BuzzFeed that Romney "will ensure that discrimination against individuals with pre-existing conditions who maintain continuous coverage is prohibited."

So, for those keeping score at home, over the course of one day, Romney went from supporting full repeal to partial repeal, while taking four different positions on protections with those with pre-existing conditions.

As a political matter, this kind of incompetence can kill a campaign. There's a presidential election in 57 days and at this point, no one, including the candidate, seems to have the foggiest idea what Mitt Romney intends to do on health care policy -- an area that used to be his signature issue. How is it possible that eight weeks before Election Day, Team Romney is still figuring out its position on Obamacare?

And as a substantive matter, it's important Americans understand what Romney's plan actually entails.

At least for now -- it's possible Team Romney will adopt an entirely new position, or even more than one, before the end of the day -- Romney believes an employee who has a pre-existing condition should be able to keep his or her coverage if they change jobs. There's no reason to give him credit for taking this bold stand -- since 1996, federal law has already protected these folks, and Romney is simply endorsing the longstanding status quo.

But what about everyone else who has a pre-existing condition, including children? As Sam Stein reported a while back, they're out of luck.

For starters, there is the question of what happens to individuals with pre-existing conditions who lose their jobs rather than move to a new one? Often, COBRA coverage doesn't fully cover treatment costs or last long enough. Another, perhaps more pertinent question is what happens to people who enter the insurance market already suffering from a pre-existing condition? [...][A statement from the Romney campaign] confirms that under a Romney presidency, there would be no federal prohibition barring health insurers from discriminating against pre-existing conditions. Instead, his administration would push reforms that help eat away at the problem.

Those "reforms" -- including turning responsibilities to states -- have been largely ineffective.

An ABC report added that Romney's policy "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."

So, what's the bottom line? First, Americans with pre-existing conditions would be in pretty big trouble if Romney's elected. Second, the fact that Team Romney keeps contradicting themselves about their own position on health care points to a campaign in surprising disarray.

As a rule, when the right hand doesn't know what the further-right hand is doing, there's cause for concern about the competence of the campaign.