RTFM: A Conservative User’s Manual for the Affordable Care Act

I haven’t exercised my atrophying writing muscles in a while, nor have I ever tried to put one of my favorite subjects—health reform—into a broader ideological context. So let me do both with a Gedankenexperiment. As I thought about this, it occurred to me that this couldn’t be accomplished in a single post but instead required a short series. We have a lot of policy ground to cover.

I invite you to follow me down the rabbit hole to an alternate future. The date is January 20, 2013. John Q. Republican, having vanquished Barack Obama the previous November, has just taken the oath of office. An ideal combination of neatly-coiffed hair and poll-tested doublethink, a perfect mix of charm and vitriol, John has clawed his way to power by achieving that rare feat of uniting the perpetually warring Republican clans: the socially conservative, God-fearing theocons; the Risk-playing neocons, belli-vangelists of truth, justice, and the American way; and the penny-pinching paleocons.

He’s done that in part by pledging himself to the defeat of their common foe: the dreaded Obamacare. But now in office, he finds that tossing a law off the books is more difficult than the campaign rhetoric would suggest. And he’s begun to feel the responsibility to govern. So how does he make the best of a bad situation? How can conservative President John Q. Republican pursue a conservative health policy agenda with the Affordable Care Act in place?

He's in luck. Far from being the ideological piece of legislation it's often portrayed as, the ACA is a pragmatic toolbox containing goodies even conservatives can use to advance their favorite ideas. In the next few posts I'll sketch out a User's Manual for the modern conservative looking to discover what the ACA can do for him: actions John Q. Republican could choose to take and even some outcomes likely to naturally unfold from the law. I think I'll be using policy positions from real-world presidential candidates and others just to keep us grounded. The exercise will give us a good opportunity to explore some interesting policy while we're at it.

So stifle those yawns and get poised on the edge of your seat.

Here's to the Academics

A few months back, conservatives took umbrage at the results of some social science research conducted by David Campbell and Robert Putnam. The duo's findings threw cold water on the right's preferred narrative framing the Tea Party as disgruntled small government types with a laser-like focus on fiscal policy:

More important, they were disproportionately social conservatives in 2006 — opposing abortion, for example — and still are today. Next to being a Republican, the strongest predictor of being a Tea Party supporter today was a desire, back in 2006, to see religion play a prominent role in politics. And Tea Partiers continue to hold these views: they seek “deeply religious” elected officials, approve of religious leaders’ engaging in politics and want religion brought into political debates. The Tea Party’s generals may say their overriding concern is a smaller government, but not their rank and file, who are more concerned about putting God in government.

Though these two were derided in some corners as egghead academics pushing a liberal agenda, the Republican primary is putting some of their findings to the test. And, surprise, they were spot on, as the candidacy of Rick Santorum is demonstrating. Santorum, of course, is a classic big government conservative, happy to wield the levers of government to advance a radical social conservative agenda. And there's no doubt he craves a significantly larger presence for religion in the public sphere and in public office. And the Tea Party is eating it up.

Writing yesterday in the libertarian magazine Reason, bona fide fiscal conservative Gene Healy (the vice president of the Cato Institute) seemed none too happy about the Tea Party turning out to be theoconservatives:

The Tea Party movement was supposed to represent an end to this sort of moralistic Big Government conservatism. Animated by "fiscal responsibility, limited government, and free markets," as the Tea Party Patriots' credo put it, the movement had supposedly put social issues on the back burner to focus on the crisis of government growth.

At one time, Santorum seemed to share this view of the Tea Party -- and it troubled him. In that same talk in Harrisburg, he said, "I've got some real concerns about this movement within the Republican Party and the Tea Party movement to sort of refashion conservatism and I will vocally and publicly oppose it."

Santorum needn't have worried: In this year's contests, he's regularly drawn more support from Tea Party voters than Ron Paul, who has been described as the "intellectual godfather of the Tea Party movement."

Exit polls show Santorum beating Paul among self-described Tea Party supporters in Iowa, South Carolina and Florida, trailing him only in independent-heavy New Hampshire and Nevada.

A recent Time magazine symposium asked leading thinkers on the Right, "What Is Conservatism?" Anti-tax advocate Grover Norquist offered this answer: "Conservatives ask only one thing of the government. They wish to be left alone."

Tell that to Santorum, whose agenda rests on meddling with other people, sometimes with laws, sometimes with aircraft carrier groups.

"This idea that people should be left alone, be able to do whatever they want to do," Santorum complained to NPR in 2006, "that we shouldn't get involved in the bedroom, we shouldn't get involved in cultural issues ... that is not how traditional conservatives view the world."

That version of conservatism has a new standard bearer, and he's rising in the polls.

Nice job on hitting the nail on the head, Campbell and Putnam.

JFK flashback

Have you heard? Democrats of yesteryear would've never followed the dogma of today's ultra-liberal Democratic Party. Unemployment extensions as a central piece of economic stimulus? Nonsense! What we need is to get back to the more conservative days of the Kennedy era.

From this day in 1961:

JFK Asks $1.2 Billion Jobless Aid

Washington (AP) - President Kennedy asked for billion-dollar action on his anti-recession proposals yesterday. He sent Congress two bills, one to extend unemployment benefits, the other to help children whose fathers are out of work.

The two bills would provide more than $1.2 billion of assistance to the unemployed. A third bill, calling for a boost in the minimum wage, will reach Congress today.

The most expensive bill in the package was the one on unemployment benefits. It temporarily would continue or reinstate payments to those who have exhausted all their benefits and still have no job.

Kennedy estimated this bill would provide $950 million for three million workers.

His second bill would authorize temporary help to needy children who fathers are unemployed. An estimate of the cost: $305 million for the 15 months of its operation

"The need for prompt enactment of this legislation is clear," Kennedy said in a letter that accompanied the two bills. The letter was sent to Speaker Sam Rayburn, D-Tex., and Vice President Lyndon B. Johnson, who presides over the Senate.

The White House said the minimum wage bill would include a formula for raising the floor to $1.15 an hour immediately and to $1.25 within two years. The present minimum is $1 an hour.

Oh.