Matt Miller - The Archives
Preexisting conditions for the GOP
The Washington Post, March 24, 2010

Although not a single Republican voted for Bill Clinton's economic plan in 1993—because it raised taxes on the top-earning 2 percent of Americans—it was impossible to prevent GOP doomsayers from benefiting from the epic expansion that followed. Yes, Republicans had insisted that Clintonomics would wreck the economy, crush small business, usher in socialism—you know, the usual. But the rising tide (and 22 million new jobs) raised all boats, even phony, hyperventilating, wrong-as-wrong-can-be boats. There was no real way to make the GOP eat its words.

With health reform, however, Democrats can at last give Republicans a chance to live up to their principles.

It's time to demand that GOP leaders, candidates and other would-be Obamacare repealers take a pledge. It should be simple. Something like: "Because I believe so strongly that Democratic health-care reform is a calamity for the country, I hereby vow that neither I nor anyone in my family will take advantage of the protections offered by this law." Those pledging would of course voluntarily surrender their current group health coverage and be thrown into the unregulated market for individual health insurance, so as to swim in the same sea of insecurity as their constituents. A quickie law would be passed allowing insurers to treat pledge-taking Republicans and their families under prior rules, exempting them from the reforms just signed into law by the president.

Perhaps you're thinking this would be cruel. Should we really punish Mrs. Debbie Boehner if she has a preexisting condition? If one of Mitch McConnell's daughters develops a disease that puts her over the lifetime cap in one of the plans the minority leader favors—the kind that would give his daughter more "skin in the game"—wouldn't that be too harsh? What if the McCain brood came down with uncoverable blights? Come to think of it, where is Sarah Palin's family getting coverage today? Thank goodness being on the ticket was her ticket to riches—as a former state employee whose COBRA coverage is running out, she'd soon be out of luck. (Maybe a small-government GOP fix would be to name every uninsurable American a vice presidential candidate, so they could cash in and afford . . . well, maybe not.)

Still, one man's "harsh" is another's "accountability." And no one argues more sternly than Republicans that behavior should have consequences. So I have no doubt these principled warriors of the right would do their duty. Rather than submit their loved ones to the character-corroding clutches of Obamacare, they would urge their kin to buck up and go to the poorhouse stoically—and, if need be, to meet their maker with their love for freedom intact.

I can hear Republicans whining already. Oh, but we liked the part of health-care reform about preexisting conditions. And the part about ending lifetime caps on coverage. And vanquishing bankruptcy due to illness. And fixing the prescription drug "doughnut hole." And letting kids stay on their parents' policies until age 26. And stopping brazen insurer rescissions. And "and," and "and," and "and." Tell you what, GOP—I didn't hear about all that stuff you liked between the cries of "doom" and "Armageddon" before the vote.

And what didn't you like, exactly? Basically two things. Expanding coverage to 32 million of the 50 million uninsured. Just wasn't high on your list. And you didn't like the things you have to do to pay for that—i.e., raise some taxes and cut some spending. That's what adults (you know, people who are trying to govern) do.

Oh, and you didn't like that mandate to buy health coverage. But follow the bouncing ball. If you want (1) private insurers to remain at the heart of the system, while (2) getting them to stop the nasty stuff catalogued above, you (3) have to get everyone into the insurance pool—the healthy and the less healthy. That's the only way the whole thing works. The only way to make sure that happens is to require it (and to help less well-off folks pay for it). This can be explained to a reasonably intelligent 12-year-old. And thus, with any luck, to the average voter in the months ahead.

I can't wait to see which Republican politicians jump at this chance to live out their convictions. In the meantime, the people who love them should be grateful that progressive policy helps hypocrites as a byproduct of helping everyone else. Even when, as our vice president might say, the scale of the hypocrisy gets to be pretty . . . big.