The most surprising aspect of the current health-care debate, for me, has been how Republicans have essentially given up on making the conservative case for their bills. They aren’t even arguing that the free market would lead to higher-quality care, efficiency and medical advancements, as the GOP of old might have. Instead, they are trying to obscure the reality that their bills would cut Medicaid by hundreds of millions of dollars (versus where funding is currently set) and would increase the number of uninsured Americans by potential 20 million or more.
Part of this is because that’s a losing argument. The reality of entitlement programs and government benefits is that, once they are instituted, it’s very, very difficult to get rid of them or even scale them back. Just look at what happened to the GOP when it suggested privatizing Social Security last decade.
That political reality has also basically forced Republicans to concede this point: that people being uninsured is a very bad thing, and that cutting funding to Medicaid is a bad thing.