GOP health care bill recycles tired moralizing about poor

Conservatives are a curious bunch. They profess a sunny faith, most of the time, in the unique power of free markets to lift society’s poor and afflicted. Yet when markets fail and government steps in to deliver social goods or services, to alleviate suffering or poverty or misdis-tribution, conservatives switch their tune to moral outrage.

Case in point: the current debate over repealing and replacing the Affordable Care Act. The health care system set up by this law, commonly known as Obamacare, is not perfect but it made huge strides toward decreasing the number of uninsured Americans and putting a brake on the spiraling trend of national health care costs.

Some conservatives hate Obamacare because of the president whose namesake it is. Others hate it because they think anything the government does to soften the blows of free-market discipline is immoral. And, of course, Obamacare operated through a framework of taxes and mandates and regulations — all things that good conservatives execrate.

The problem is, Americans now mostly support the proposition that all citizens are entitled to health care, and that this can only be accomplished with large-scale government intervention.

So Republicans in Congress face an unsavory choice: to simply repeal Obamacare or to repeal it and replace it with an ersatz version. The GOP’s American Health Care Act seeks to repeal many of the taxes that paid for the Affordable Care Act. It limits future access to Medicaid for poor enrollees. It increases the burden of insurance premiums on older enrollees.

The AHCA is rightly being derided as a cruddy facsimile of Obamacare that massively shifts wealth from the lowest income brackets to the highest. The rationales are grounded in that old conservative disposition to blame the poor for their poverty. Just listen to them. Recently, Rep. Jason Chaffetz, a Republican of Utah, dismissed the idea that the jacked-up premiums would hurt the poor. These people, he explained, just need to forego buying the latest iPhone.

A few days prior, Rep. Roger Marshall, of Kansas, claimed that poor people “just don’t want health care and aren’t going to take care of themselves.”

Both Marshall and Chaffetz have since walked back their comments.

This is a narrative we’ve been hearing for years. Republicans, and a lot of Democrats, too, blame low-income people for their own troubles while failing to address low wages, educational gaps and a range of economic factors that aren’t easily explained by simplistic moralizing.

Such thinking has led to awful public policy. It accounted for Bill Clinton’s Personal Responsibility and Work Opportunity Reconciliation Act 1996 to reform welfare. It now inspires the GOP’s dismal health care “reform.”

Most who go without health insurance do so for one of two reasons: They either believe they are too healthy to need it, or they can’t afford it. Obamacare addressed both of these issues.

When devising public policy, we need to take this perspective: “There but for the grace of God go I.”

If we did, our health care and educational systems would be geared to ensure security and opportunity for all, and that none would have to suffer simply because they are poor.