July 10, 2013

Miller’s first law of political rhetoric holds that when one party in a Washington debate resorts to certifiably Orwellian language, they’re desperate, doomed or both.

Yet there’s no other way to view the latest Republican assault on Obamacare. The GOP sees blood in the water because the White House (sensibly) put off the employer mandate for a year. The truth is there shouldn’t have been an employer mandate at all — a point to which we’ll return in a future column — but Republicans have seized on the hook of this supposed “snafu” to hang their latest faux outrage.

“Is it fair for the president of the United States to give American businesses an exemption from his health-care law’s mandates, without giving the same exemption to the rest of America? Hell no, it’s not fair,” House Speaker John Boehner told his caucus Tuesday.

“I never thought I’d see the day when the White House, this president, came down on the side of big business, but left the American people out in the cold as far as this health-care mandate is concerned,” said a mock-shocked Eric Cantor.

“We agree with you that the burden was overwhelming for employers,” Republican leaders wrote to the president Tuesday, “but we also believe American families need the same relief.”

The same relief? How dumb do they think Americans are? “Relief” from the certainty that they’ll have access to group health coverage no matter their health status? “Relief” from income-based subsidies if they need help to buy a private health plan? “Relief” from finally knowing that they can never go broke from serious illness in one of the richest countries on earth? “Relief” from the job lock that binds countless Americans to large employers when they’d rather start a business or work on their own, but fear that if their family has any health issues they’d be left to fend for themselves? “Relief” from at last joining the community of advanced nations that view health coverage for all as an essential feature of a decent society, a view embraced decades ago even by conservative icons such as Margaret Thatcher?

War is peace. Freedom is slavery. Barack Obama is a tool of big business and an enemy of the people.

To listen to Boehner and Cantor, you’d have no idea that Obamacare’s design has a thoroughly conservative pedigree. The line clearly goes from the Heritage Foundation to that group’s collaborations with the Democratic Leadership Council to Romneycare to Obamacare. Republicans may be tired of hearing this truth, but if it isn’t repeated at moments like this, the extent of the GOP’s doublespeak will go unpoliced.

Hell (to borrow a phrase from the speaker), a dozen years ago I wrote an Atlantic Monthly piece that showed how single-payer Democrat Jim McDermott and ultra-conservative Ways and Means Committee leader Jim McCrery could agree on this model of subsidized private coverage with community rating and access to group rates as a path to universal coverage that honored both parties’ values. In Massachusetts, Mitt Romney and Ted Kennedy then showed this deal could be struck in the real world. It’s all there in black and white. You can’t shove this down the memory hole, Mr. Boehner.

As conservatives have long taught us, the only way to move toward universal coverage via private insurers is to require that everyone has coverage (and to subsidize lower-income folks who need help buying it). Otherwise, healthy folks opt out, and the insurance pool is destabilized. What’s more, if the GOP really cares about “relief,” there’s already relief written into health reform that exempts people from the mandate to carry coverage if they have to spend more than 8 percent of their income to do it.

A responsible, problem-solving opposition party seeking relief might say “we think that percentage of income exemption should be lower.” Or: “We’d be better off starting with catastrophic coverage for every American to limit federal costs.” But Republicans are not acting like a responsible, problem-solving opposition party. The party’s current national leadership has never offered a plan to cover more than 3 million of today’s 50 million uninsured.

Why not? Because, as Daniel Patrick Moynihan told me not long before he died, “those folks don’t vote Republican.”

As I’ve long argued, I’d be happy to repeal Obamacare on one condition:The GOP offers a plan that the Congressional Budget Office certifies will cover today’s 50 million uninsured. Basic catastrophic coverage with special funding for preventive care and wellness would be fine by me for starters. If Messrs. Boehner and Cantor would offer up such a plan and fund it honestly, I’d take that deal tomorrow.

It ain’t happening — and honest observers of all stripes should ask why.

The answer — the heart of darkness on health care, so to speak — goes back to Bill Kristol’s argument in 1993-94. If Democrats are allowed to show that government can help assure basic health security, Kristol preached, it will boost the party’s political fortunes for decades. Republicans have felt bound ever since to kill the thing in its cradle before Americans come to appreciate how vital such protections are in an insecure era.

Immigration is not the only issue on which Republicans find themselves on the wrong side of history and common sense nowadays.

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