Friday, December 26, 2014

An inconvenient memory

Why Republicans are rejecting a health care concept originally conceived by Republicans

An inconvenient memory

 

 

Missouri has spoken. Or, to be more precise, Missouri's most ticked off voters have spoken. Last night, in the first-in-the-nation referendum on President Obama's health care law, they signaled a resounding thumbs down. Seventy one percent of voting Missourians supported Proposition C - which decreed that the feds have no business requiring citizens to buy health insurance, and that the state of Missouri should defy the new mandate.

The referendum win will bring forth much triumphant Republican spin - which is ironic, given the much-overlooked fact that the federal mandate concept was originally birthed by the GOP.

The Missouri verdict was fully expected. It was primary night in Missouri, and state Republicans were staging the more competitive contests - which meant that the primary electorate would skew heavily Republican. (Which indeed happened. The Senate Democratic primary drew 314,000 voters; the Senate GOP primary, 574,000 voters.) Overall turnout was light, but motivated August voters are typically angry voters, and Proposition C was intentionally crafted by its authors as a way for these folks to lash out at Obama, the Democratic Congress, and Washington in general.

Even though the referendum was basically symbolic - the real action on the insurance mandate issue will play out in the federal courts - last night's results will surely be framed by Republicans as a stunning blow for liberty, as proof that "the people" want the freedom to remain uninsured and thus drive up insurance costs for everybody else.

It's smart politics. Republicans will try to leverage the Missouri results to stoke more momentum for November, when the size of the conservative turnout may well determine whether the GOP retakes Congress. Priority one is to keep the party base ticked off and motivated. It's also no accident that Republican state lawmakers elsewhere - such as Indiana, Florida, Arizona, and Oklahoma - have been readying similiar ballot measures. All told, opposition to the health care reform law could prove to be a turnout motivator in 2010, just as Karl Rove's gay marriage referenda helped stoke conservative turnout for the 2004 Bush re-election bid.

But while it's smart politics, it's also slam-dunk hypocrisy.

What's fascinating about the Republican opposition to the health insurance mandate is the fact that the whole idea of a federal health coverage mandate was hatched by Republicans and conservative scholars. They're yelling at "socialist" Obama over a concept that they thought up in the first place, a fundamental truth that hasn't penetrated the tea-bag mindset. (And won't.)

The mandate idea - whereby citizens should be required to take responsibility for their health care, to spread the insurance risks so that premiums would be cheaper across the board - was prominently floated in 1989 and again in 1993 by the right-wing Heritage Foundation think tank. The Heritage proposal was even analyzed by the Congressional Budget Office, which described it this way: "(E)veryone would have to obtain insurance, either through a government program or from a private insurer, on their own, or through a family member. The states would be charged with enforcing the mandate..." Sound familiar?

But the idea predates Heritage. Republicans as far back as President Nixon, in the early '70s, talked up the basic concept. Bob Dole, a former Senate GOP leader, did it. So has another former Senate GOP leader, Dr. Bill Frist; appearing recently on the Fox Business Network, he endorsed the mandate concept and said it’s "about the only way" to achieve reform, that Americans "should be responsible to paying for it," and that they should face federal penalties if they don’t.

Senators Lamar Alexander and Lindsey Graham have talked it up, too. So has Senator Charles Grassley; in 2009, he told Fox News that there wasn’t "anything wrong" with the mandate concept. Just as motorists are required to carry auto insurance, he said, "the principle then ought to lie the same way for health insurance." Senator John Thune, a possible '12 presidential dark horse, has also spoken favorably of the concept, saying "there are good arguments on behalf of getting everybody into the pool."

And, of course, potential '12 frontrunner Mitt Romney made the mandate concept a key feature of his health insurance overhaul in Massachusetts back when he was governor - telling NPR in 2006 that citizens should be required to buy coverage, "otherwise, you're just passing your expenses on to someone else." Moreover, he assailed those who would refuse to buy coverage and defy the mandate law: "That's not Republican, that's not Democratic, that's not libertarian. That's just wrong."

Fortunately for the Republicans, their grassroots voters have no idea that the health coverage mandate was, and has long been, a Republican construct. The emotions of the moment leave no room for the complications of memory, and far be it for the GOP to dredge up recent history and enlighten its base. Adherence to principle means squat when there are elections to be won.
 

Dick Polman Inquirer National Political Columnist
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Dick Polman Inquirer National Political Columnist
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