Matt Miller - The Archives

GOP to the uninsured: Drop dead
The Washington Post, July 10, 2012

The House is voting (again) to repeal the Affordable Care Act on Wednesday.

Meanwhile, six Republican governors (so far) say they won't go along with the law's planned Medicaid expansion for 4 million uninsured people in their states, even though the feds would pick up nearly all the tab.

See the pattern here?

The Republican message to uninsured Americans in the wake of the Supreme Court's recent ruling couldn't be clearer: You're on your own.

The party may not have officially adopted the "let 'em die" policy of right-wing hecklers at that CNN primary debate, when Ron Paul was asked what should be done when uninsured folks show up at the hospital. But as a practical matter, Republicans are in pretty unsavory territory. What other conclusion can we draw when Rick Perry, who presides over a state where fully one in four people lack health coverage, makes swaggering indifference to these Texans' plight a point of sovereign pride?

Fifty million uninsured Americans would be the immediate casualties of the GOP's "let them eat the emergency room" mentality. But all of us would be at risk. In America—alone among wealthy nations—everyone is a pink slip or job change or new illness away from finding they've lost coverage or are uninsurable.

This is the shameful reality behind the GOP's rhetoric on health care. Republicans don't want to spend a penny to insure the uninsured.

We know this because back during the original debate over Obamacare, the "boldest" GOP alternative would have extended coverage to 3 million of the 50 million uninsured, versus Obama's 30 million (which still leaves us 20 million short of behaving like every other civilized nation, mind you).

It was not always thus. It's striking to recall that back in 1992, George H.W. Bush put out a serious plan to cover 30 million of the then 35 million uninsured. (Democrats at the time rejected it, figuring they'd do the job on their own terms once Bill Clinton won. We know how that turned out.) So the erosion of Republican seriousness over two decades can be tracked with unusual precision. As the ranks of the uninsured have soared, the size of Republican compassion has shriveled.


Daniel Patrick Moynihan gave me the most convincing explanation not long before he died in 2003. "Those folks never vote for us," he told me, summing up the Republican mind on the issue, "and we have our priorities for the money."

Like trillions more in tax cuts for the best-off Americans over the next decade.

You may have noticed that Republicans have been struggling to come up with a credible alternative to the Affordable Care Act once they repeal it. Why is it so hard? Because Obamacare WAS the Republican alternative. It was the conservative-designed mandate and subsidy approach. Republicans are in such an intellectual cul-de-sac on this issue that Paul Ryan actually blasted Obamacare for being a sop to the president's "cronies" in the insurance industry. Oy!

I feel like a broken record but some truths bear repeating. Only in America could a Democratic president pass Mitt Romney's health plan and fund it partly through John McCain's best idea from the last campaign (taxing some employer provided plans) and be branded a "socialist."

In every other advanced nation, the idea that government has a central role in assuring basic health security was settled decades ago—a consensus conservatives abroad embrace. Always remember: conservative icon Margaret Thatcher would have been chased from office if she had proposed anything as radically conservative as Obamacare—which relies on private docs to deliver the medicine, after all, and still leaves 20 million people uncovered.

Here's what you should do, Mr. President. In the debates this fall, pull out a small laminated card you've had made as a prop for this purpose. Then remind Mitt Romney that the ranks of the uninsured today are equal to the combined populations of Oklahoma, Connecticut, Iowa, Mississippi, Kansas, Kentucky, Arkansas, Utah, Oregon, Nevada, New Mexico, West Virginia, Nebraska, Idaho, Maine, New Hampshire, Hawaii, Rhode Island, Montana, Delaware, North Dakota, South Dakota, Alaska, Vermont and Wyoming.

Read that list slowly, Mr. President. Then ask your opponent: Would America turn its back on the citizens of these 25 states if everyone there lacked basic health coverage? That's what we've been doing for decades. You knew it was right to act when you were governor of Massachusetts, Mitt. How can you pretend we don't need to solve this for the nation? And how can you object with a straight face when your own pioneering plan was my model?

The president should also say he'd be happy to talk reform once Republicans offer a rival plan that the CBO certifies will cover 30 million people, as the Affordable Care Act does.

Today's Republican party won't do it. They want the money for tax cuts for the top. They don't care.