On TPM EDBLOG, Josh Marshall writes that the health-care goalposts were moved while Republicans weren’t looking.

“The problem is that over the course of seven years Republicans have essentially accepted the premise of the ACA: which is to say, the people who got coverage under the ACA should have coverage.”

I disagree.  Disagreeing with Josh Marshall is not done lightly, but here is my problem.  The health-care debate, for Republicans, never was about health care.  Republicans couldn’t care less about health care.

For Republicans, this is about government.  House Ways and Means Committee Republicans Kevin Brady and Greg Walden, when they rolled out their “replacement” for the Affordable Care Act (ACA), couldn’t stop talking about returning “choice” and restoring “freedom” to Americans.  “Choice” and “freedom” are code words for less government, at least to “drown it in the bathtub” patriots.

Even the word “government” is code.  Large, powerful institutions are a positive good when they protect property rights.  But “government,” for bathtub patriots, is code for the regulation of property and power to protect the poor and the weak: clearly a bad thing.

The ACA is a nightmare for Paul Ryan or any other Republican.  It is a reminder to the populace that government can do good things for people, which makes it harder to explain wanting to drown it in the bathtub.  That Ryan pretends to want to replace the ACA rather than just repeal it shows that the emerging split is not between true conservatives and health-care-for-the-people heretics but between true conservatives and practical conservatives.  

Ryan and the other “replacement” Republicans have decided that it is more important to be re-elected than to be pure.  How hard can it be, at that point, to pretend to agree that the government should help the poor get health care?  And it is pretending.  Meanwhile, they bide their time, tolerating “replacement,” tolerating Social Security, tolerating Medicare and Medicaid and other government programs that help the people until they can find a way around this stifling, obnoxious democracy stuff.    

So, that is where I disagree with Josh Marshall: I think he credits Republicans with far too much humanity.