Romney's law is known for (1) its requirement that all individuals purchase health insurance and (2) the "Commonwealth Connector," a government bureaucracy much like that was championed by First Lady Hillary Clinton in 1993 and rejected by Congress in 1994.
Romney appears to have traded those big-government ideas in for full tax deductibility of out-of-pocket medical expenses and health premiums. Romney's tax reforms would not do as much to increase affordability or individual ownership as Rudy Giuliani's would. Nevertheless, they are a dramatic improvement over Romney's recent past.
Unfortunately, Romney still supports some reforms that would expand government.
Though he advocates block-granting Medicaid, he wants states to use the added flexibility to make more Americans dependent on government for their health care.
He wants to deregulate health insurance, but by having Congress strong-arm the states, rather than by letting Americans purchase health insurance from out-of-state. That's one free-market reform that neither Romney nor Giuliani have fully endorsed.
Nevertheless, Romney's abandonment of two major components of his Massachusetts law may signal the decline of big-government conservatism in health care.