Republican vice presidential candidate Paul Ryan is barnstorming the country, promising to repeal every provision of the Affordable Care Act if the Romney/Ryan ticket is elected. He savages Obamacare as “irresponsible,” an example of “Washington’s reckless spending spree” and has warned repeatedly that it would place the “federal government squarely in the middle of healthcare decisions.” Explaining his “philosophical difference” with Democrats, Ryan told ABC News this summer that he would seek to repeal the “entire law” because healthcare rights come from “nature and God,” not the government.
But a letter he wrote to the Obama administration may undermine this message.
On December 10, 2010, Ryan penned a letter to the Department of Health and Human Services (HHS) to recommend a grant application for the Kenosha Community Health Center Inc. to develop a new facility in Racine, Wisconsin, an area within Ryan’s district. “The proposed new facility, the Belle City Neighborhood Health Center, will serve both the preventative and comprehensive primary health care needs of thousands of new patients of all ages who are currently without health care,” Ryan wrote.
The grant Ryan requested was directly funded by the Affordable Care Act.
The letter, among several exclusively obtained by The Nation and the Investigative Fund at the Nation Institute through a Freedom of Information Act request, is a stark reminder that even the most ardent opponents of Obamacare privately acknowledge many of the law’s benefits.
Federally funded health clinics have long provided a broad range of vital medical, dental and mental health services to underprivileged communities across the country, regardless of a person’s ability to pay. To meet the goal of expanding coverage, the Affordable Care Act provides for a sweeping expansion of such clinics, including $9.5 billion for operating costs to existing centers and $1.5 billion for new construction.
Despite Ryan’s quiet support for an Affordable Care Act clinic grant in his district, the Wisconsin Congressman’s promise to repeal Obamacare would undermine the law’s plan to rapidly grow the health clinic system in America by withdrawing the necessary funds. The Ryan budget would also decimate other federal subsidies for health clinics, according to an analysis by the Center on Budget and Policy Priorities.
Ultimately, the Kenosha Community Health Center did not win the Obamacare grant recommended by Ryan. (The center did get about $766,040 from President Obama’s stimulus program, another major piece of legislation opposed by Ryan.)
Brendan Buck, a spokesman for the Romney/Ryan ticket, confirmed Ryan’s recommendation letter but dismissed any talk of hypocrisy by claiming that the health clinic program was “created by President Bush, not Obamacare.”
The Nation, however, has confirmed with officials that the New Access Points grant Ryan sought was solely funded by the Affordable Care Act, not the Bush administration. The Affordable Care Act was crafted so that it would bypass the regular appropriations process and create a multiyear fund to finance a rapid expansion of community health clinics. Ryan’s request asked specifically for money from this fund.
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It’s worth noting that before Republicans broadly agreed to oppose any healthcare reform proposal embraced by President Obama, the party did support access to healthcare through clinics. Federal health centers were created under legislation signed by President Franklin Roosevelt and supported by every president for the past seven decades. Presidents Bill Clinton and George W. Bush both requested federal dollars for the New Access Points grant program, now vastly expanded under the Affordable Care Act.
The modern Republican Party has made opposing the entire Affordable Care Act, even health clinics, a central plank in its platform. The reversal on community health clinics reached a fevered pitch in May of last year, when the GOP specifically targeted Obamacare clinics with repeal legislation. Texas Congressman Michael Burgess, who admitted during a Rules Committee hearing that a federally funded clinic would help his constituents in east Fort Worth—an area he said has an infant mortality rate comparable to Libya—led the repeal vote. Baffled Democratic Congress members in the committee room implored the GOP to preserve a program it had gone on record as supporting only a few years before. Ryan voted “aye” on the repeal.
An outline of the health reform “replacement” legislation advanced by Mitt Romney and Ryan—mostly centered on proposals to gut state and federal health insurance regulations by allowing insurance providers to sell coverage across state lines—makes no mention of health clinics.
Ryan isn’t alone in shaking his fist at healthcare reform with one hand while extending an open palm behind closed doors. As I reported more than a year ago in ThinkProgress, even Hal Rogers, a conservative Representative from Kentucky, and former Senator John Ensign, a rising star in the Republican Party before he resigned in disgrace, wrote letters asking for healthcare reform grants while calling for absolute repeal. As he publicly denounced healthcare reform as “socialistic” and a “monstrosity,” Rogers requested Obamacare funds for a nursing clinic in rural Clay County. The money, Rogers said in a letter to HHS, would “provide critical care in an area in extreme need of access to adequate health care.” Ensign recommended an application for a physician training grant made possible through the Affordable Care Act. Rogers and Ryan have voted to repeal the entire act on nearly thirty occasions in the last two years.
“I don’t know what’s the bigger sin,” says Tom Perriello, a former Democratic Congressman who championed health clinics as a supporter of the Affordable Care Act. “The hypocrisy of asking for funding from a program while seeking to repeal it, or that the Republicans have been so much more committed to hurting the president than to helping people that something as uncontroversial as funding for community health centers must be requested in secret.” (Full disclosure: Perriello is counselor for policy at the Center for American Progress, where I worked as a blogger.)
In addition to undercutting his message on Obamacare, the letter may also add to an emerging narrative that Ryan has a double standard when it comes to critiquing major Obama policy achievements. The revelation about his request for Obamacare funds comes in the wake of a similar controversy stemming from his lobbying for stimulus grants while denouncing Obama’s stimulus act to the press. When these grant requests came to light, Ryan first denied responsibility for them but later acknowledged that his office had sent the letters.
Republicans have praised Ryan for his willingness to embrace cuts to popular government programs and for being a “consistent conservative.” The fact that he has privately pleaded with the Obama administration for funds from the president’s signature policy accomplishments could unravel that conceit.
