Romney got on board with Romneycare once he realized that it would push bottom rung coverage of the uninsured off to the general insurance pool including Employer Head Count taxes, rather than the 1% income tax pool and the Uncollectable Debt books of hospitals and clinics. Like BC MSP Group Premiums and Ontario OHIP Taxes Romneycare has fees based on the number of employees.
https://en.wikipedia.org/wiki/Massachusetts_health_care_reform#Employer_taxes

"As a result of the 1986 EMTALA legislation, hospitals across the country faced unpaid bills and mounting expenses to care for the uninsured."

"According to a 2016 study in the American Economic Journal, the reform "reduced the amount of debt that was past due, improved credit scores, reduced personal bankruptcies and reduced third-party collections."[61] The authors note that the "results show that health care reform has implications that extend well beyond the health of those who gain insurance coverage."[61]"