Senate majority leader Mitch McConnell’s plan to force a vote on his health-care bill went foul from the start. The “Better Care Reconciliation Act,” devised in secret, turned out to be as harsh and as unpopular as its House counterpart. It stripped health insurance from 22 million people, raising most people’s premiums, particularly those of older and low-wage workers, and gutted Medicaid to pay for tax cuts for the very rich. There is no real mystery as to why this was a hard sell.
McConnell had to postpone the vote due to lack of support, but he hasn’t given up. The backroom wheeling and dealing, bribing and arm-twisting is ramping up, and McConnell may yet succeed, as Speaker Paul Ryan eventually did in the House. But regardless of the outcome, one thing should not be lost in the fray: This is what they believe. The Senate and House health-care bills are perfect expressions of the modern-day Republican project.
Don’t be fooled by the focus on Republican dissenters. The Republican health-care bill in the House got 217 Republican yes votes; only 20 Republicans voted no. (No Democrat supported the bill.) Nine Republican senators publicly oppose McConnell’s bill, though several of them are against it because it’s not harsh enough. At the end of the day, a large majority of the caucus still supports McConnell’s plan to enact a large tax cut for the very wealthy, and pay for it by stripping Medicaid and health-insurance subsidies from millions of people.
But outside the Senate chamber, the reverse is true. Most Americans oppose rolling back Medicaid. That is central to the Republican purpose, the essence of right-wing market fundamentalism. The Republican health-care debacle is a clarifying moment of truth.
In Paul Ryan’s formulation, society is divided between the “makers” and the “takers.” The “takers” are those who benefit from public social programs like Social Security, Medicare, Medicaid, food stamps, college-tuition assistance, and so on. In Ryan’s world, these people are a drag on the “makers” who are taxed to pay for the programs. Our economy produces optimum results when each is free to pursue his or her own self-interest, under this theory.
The Republican project is thus to free up markets by rolling back government social provisions and lowering taxes, particularly on the rich. The reality, of course, is that the rich and powerful use state power to rig the economy for their own benefit, including massive subsidies exacted by entrenched interests.
In a January 2010 speech at Hillsdale College, Paul Ryan denounced Barack Obama’s efforts to expand access to health care. “The national health care exchange created by this legislation, together with its massive subsidies for middle income earners, will be the greatest expansion of the welfare state in a generation and possibly in history.” Americans, he warned, “once took pride in being responsible for their individual well-being and for governing themselves in freedom. They are now to become passive subjects of government leaders, wheedling for hand-outs, more concerned about their security than their liberty.”