The notion that conservatives not only oppose liberal health care reforms but are vigorously working to deny Americans access is a popular one on the left. If you don't support Obamacare, you are basically endorsing murder. A recent contemptible piece in The New Republic, which argues that Democrats should—without any evidence, if necessary—blame the unfortunate deaths of Americans on the rival political party, is perhaps the pinnacle of this brand of absurd demagoguery. Alan Grayson mainstreamed.
Although, it's also the unspoken starting point for many pundits, including The Washington Post's Greg Sargent, who believes he's detected a seismic shift within Republican ranks:
"Republicans remain gung-ho for repeal, and continue to insist Obamacare is destroying the lives of millions, if not American freedom itself. And yet, Republican Senate candidates are increasingly sounding like Obamacare's most ardent supporters in one key way: they are rhetorically embracing the imperative of expanding affordable health coverage to those who need it."
Two small problems with that contention: 1) It is possible to deem Obamacare destructive policy and still support "expanding affordable health coverage," and 2) the GOP has been using the exact same rhetoric Sargent points to from the beginning of the debate. And I mean exactly the same.
The majority of Americans believe that Obamacare is detrimental to the health care system yet, one assumes, many of them believe extending "health coverage" to everyone is a worthy cause. There are— and I realize this might be inconceivable to some—other systems that deliver affordable, high-quality services and products to lots and lots of people. Presumably, most of you have bought food or clothing without an individual mandate in a highly regulated government exchange? This kind of delivery system may seem excessively chaotic, antiquated or even unfair to you, but it's worth mentioning that the moral objective of those who support competitive markets over contrived technocratic schemes is probably just as good as yours.
Now, Republican Senate candidate Tom Cotton's recent comments—"We want every American to have quality, affordable access to health care"—were the grist for the left's proposition that the GOP is in the midst of abandoning its position on Obamacare. But the only possible reason you could believe Cotton's words are, in Sargent's words, "increasingly sounding like Obamacare's most ardent supporters" is that you haven't been paying attention to the debate.
OK, not the only reason. Liberals such as Sargent are trying to create the perception that there is a widespread capitulation among conservatives on the "big idea" leading up to the 2014 midterms.
Obamacare, fait accompli. But Republicans (and I think they're misguided) have never argued about the big idea. The GOP has never been able to settle on a set of reforms because of well-known internal differences. Rhetorically, though, Republicans have been using the same exact formulation as Cotton did.
In 2009, at the height of the Obamacare debate, all Republicans were rhetorically embracing the imperative of expanding affordable health care:
Roy Blunt: "Make quality health care coverage affordable and accessible for every American."
The title of a news conference by John Boehner: "Boehner, House GOP Outline Plan to Make Health Care More Affordable & Accessible for All Americans."
Dave Camp at CNN.com: "These and other measures will ensure every American, regardless of income, regardless of where they choose to live, regardless of pre-existing conditions or past illness, will have access to affordable, quality health care."
Paul Ryan's plan to replace employer-provided health insurance with a refundable tax credit available to every American was, in essence, a call for universal coverage. Even the more conservative plan offered by the Republican Study Committee promised tax reform that "allows families and individuals to deduct health care costs, just like companies, leveling the playing field and providing all Americans with a standard deduction for health insurance."
Workable? That's another debate. Rhetorically embracing the big idea? Yes.