Republican Mitt Romney adamantly denies the health care reforms that he implemented as governor of Massachusetts are similar to the health reforms that President Obama later implemented and Romney has vowed to repeal.
But the top executives who helped Romney implement his health care reforms are now using the expertise they gained working for him to help more than a dozen states comply with very similar requirements under Obama's new health care law.
Like Romney's program, Obama's health care initiative requires everyone to have health insurance. To ensure people can meet that requirement, Obama ordered states to follow Massachusetts' lead and set up by 2014 health care exchanges that make private insurance available to anyone who needs it.
"Everyone is very interested in the way Massachusetts did it," said Patrick Holland, one of the founders of the Massachusetts exchange, known as the Health Connector.
Holland and Jon Kingsdale, whom Romney appointed to run the Massachusetts exchange, left the Health Connector in 2010 and became Boston-based advisers to other states, including Maryland, that are preparing to implement requirements of the new federal health care law. Three other former Health Connector employees are working with them, Holland said. Kingsdale could not be reached for comment.
"We've all been pretty busy," Holland told The Washington Examiner. "The  deadline can feel far away, but it's actually a year from now when you really need the [exchange] to be up and running."
In addition to Maryland, the former Romney aides are working with Connecticut, Vermont, Rhode Island, Oregon, Washington and California.
The similarities between Obama's health care reforms and Romney's have been hotly contested in the campaign. Obama claims he based his reforms on Romney's, but the Republican challenger insists the federal program is fundamentally different. Romney has joined in Republican criticisms of Obama's plan as virtually socialist and vowed to repeal it if elected president.
"The [health care] reforms I propose for the country could not be more different from Barack Obama's," Romney wrote in USA Today. "Abolishing it and putting sensible changes in its place will be one of my highest priorities as president."
But Romney's former aides are finding that the Obama program is similar enough to Romney's that states are willing to pay them to explain how Massachusetts did what they now need to do.
"There are a lot of practical challenges that Massachusetts faced in setting up its Health Connector that states are now facing with the Affordable Care Act," Joshua Sharfstein, Maryland's secretary of Health and Mental Hygiene.
Besides helping set up an insurance exchange, Romney's former aides are helping Maryland deal with the so-called individual mandate -- the most controversial element of the Obama plan -- that requires everyone to buy health insurance or pay a penalty. The mandate is widely denounced as government overreach by Republicans, but Romney's plan had a similar requirement.
"Frankly, they helped with the implementation of the individual mandate," Sharfstein said. "These are not ideological issues, these are practical issues."
The political irony of Holland's job is not lost on him. Romney is pledging to overturn the law that created consulting jobs for Holland and his former colleagues from Massachusetts.
"For us, we try to approach the work as politically agnostic," Holland said. "But politics do become an issue."