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“He doesn’t get a chance in the debates to say too much,” she said. “I think he’s right on with what he says, for the most part. The law has worked well, and I think most of the charges against the law are not true. The right is so opposed to the national law, that they can’t even say anything positive about the Massachusetts law.”

Just four years ago, Mr. Romney’s health care law didn’t give him so much to worry about, with leading Republicans applauding it. Sen. Jim DeMint, South Carolina Republican, who endorsed Mr. Romney in the 2008 primaries, said he should pass a similar law for the whole country.

But when Republicans and Democrats began negotiating over health care reform in 2009, things changed, and provisions such as the individual mandate were no longer accepted in Mr. Romney’s party, said John McDonough, director of the Center for Public Health Leadership at Harvard University

“It was the summer of 2009 as the debate heated up that the ground shifted significantly,” Mr. McDonough said. “Romney was unable to do that because his signature was on the left. So I think to some extent, he’s done the best he could in attempting to be consistent in an environment where everyone around him was running for cover.”