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Can We Please Stop Pretending Republicans Have Ever Had A Health Care Plan?

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Now, I know what Steven Brill is doing in his Fresh Air interview is more to say that the level opposition to the ACA is irrational, rather than that the ACA is horrible (although there are some elements of both.) But this argument remains utter bullshit:

And, you know, let’s step back and sort of look at the big picture. What I think most Americans don’t understand about Obamacare is Obamacare is a Republican policy position. Obamacare is slightly more conservative than a plan that Richard Nixon proposed in the ’70s to head-off a Ted Kennedy plan that was much more liberal. Obamacare is more conservative than Romneycare.

So imagine the Democrats’ surprise when they sort of finally relent through Senator Baucus in the Senate and write a bill that basically, you know, kind of throws in the towel on decades of Republican opposition to more liberal plans and throws in the towel, and says, all right we’re going to go along with the Republican plan.

Brill, at least, doesn’t pretend that the Heritage Foundation was the source of the ACA, but a lot of the same fallacies are present in his own misleading claims.

Whether the Nixon plan was more liberal than the ACA is debatable. But Brill himself explains why the question is beside the point. You might, at this point, be wondering why if everyone favored health care plans more liberal than the ACA no actual health care reform of any kind passed. One crucial reason is that Nixon’s plan wasn’t a “Republican proposal” in any meaningful sense. It was a proposal a Republican pretended to support when it appeared that Congress might pass something better. Hopefully you’re all aware by now of the Heritage Uncertainty Principle, the fact that federal Republican health care plans only exist if there is no chance of them being implemented. Nixon’s proposal was entirely within this tradition:

At first, Kennedy rejected Nixon’s proposal as nothing more than a bonanza for the insurance industry that would create a two-class system of health care in America. But after Nixon won reelection, Kennedy began a series of secret negotiations with the White House that almost led to a public agreement. In the end, Nixon backed out after receiving pressure from small-business owners and the American Medical Association. And Kennedy himself decided to back off after receiving heavy pressure from labor leaders, who urged him to hold out for a single-payer system once Democrats recaptured the White House in the wake of the Watergate scandal.

When you treat Nixon’s proposal, or John Chafee’s proposal, or Bob Bennett’s plan, you’re being willfully conned. Republicans have an interest in pretending to favor some alternative to progressive health care reform when in fact their offer to the uninsured is “nothing.” For the same reason, the argument doesn’t work as a “gotcha,” because most Republicans never actually favored their nominal proposals, so it’s not as if going along with the scam is going to make anyone moderate their opposition.

As we’ve discussed before, calling Travaglinicare a “Republican” plan has similar problems. We can debate whether it was more liberal than the ACA; the different baselines don’t make the comparison particularly useful. But even if we assume arguendo than it was, the crucial problem with calling it a “Republican” plan is that it was passed by veto-proof supermajorities of Massachusetts Democrats. Yes, Romney decided to make a deal rather than just veto every single aspect of the legislation, as Nixon might have in that different era had Congress been able to pass anything. But this doesn’t make Travaglinicare a “Republican” plan any more than the support of some congressional Republicans for Social Security or the Civil Rights Act makes them “Republican legislation.” (And the term would actually be more accurate when applied to the CRA; Dirksen actually did support many civil rights provisions ex ante, his support was more important to the passage of the CRA than Romney’s was for passing Travaglinicare, and he didn’t repudiate it immediately after it passed.)

In conclusion, calling the ACA a “Republican plan” is 1)wrong, and 2)doesn’t work unless the objective is to give Republicans a pass for steadfastly opposing any health care reform. So can we please stop it? Federal Republicans don’t favor any kind of decent health care reform and never have. Pretending otherwise is dishonest and pernicious.

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