Mike Pence is one of the few people to get talked up for president by Mallard Fillmore, a cartoon duck who hates Barbra Streisand, Michael Moore and Nancy Pelosi. Pence was a congressman from Indiana, now he's the state's governor. He's a conservative who delights other conservatives by being very earnest about topics the rest of us consider odd and far-fetched, like America's dark collectivist future. But now his side is mad at him because he just said yes, kind of, to Obamacare.
Obamacare makes more people eligible for Medicaid, but a state's governor has to accept the money that pays for the extra insurance. Live in the wrong state and you'll find that qualifying under the new rules doesn't do you any good—your governor told Washington the funding wasn't welcome. Many states have such governors, all of them Republican. Pence chose not to be of their number. He's rejiggered some rules and stuck a new name on his state's Medicaid set-up (the Healthy Indiana Plan, also called HIP 2.0). But the federal money is coming in and it's going to the people that the federal government wants it to get to. The Heritage Foundation, maybe the best known of the right-wing think tanks, called Pence's move a “disappointment” and “dangerous.”
A governor proves wobbly about Medicaid expansion. Another governor, Bobby Jindal of Louisiana, says opposition to the entire Obamacare package is suffering from rot. The governor, or his ghostwriter, warns readers at FoxNews.com that “many conservative ‘thinkers’ in Washington have given in to Obamacare fatalism. They may not say so in public, but they fully believe that talk of the law’s repeal exists only in the land of unsophisticated rubes.” Jindal takes as given that his fellow conservatives are willing to talk bullshit about Obamacare. He may be right. Notice that the Indiana plan, the one that appalls the Heritage people, is billed by Pence's office as a set of “private, market-based Medicaid reforms.”
One finds Republicans pulling this sort of stunt when it comes to health care. Names get switched around. Obamacare itself could be reasonably described as a market-based reform, given that most of it is geared to letting consumers pick and choose among health insurers. But the Republicans decided to say it was collectivist. Now a number of the Republicans, those trying to survive outside the South and the Plains States, tell us that their tinkering with Obamacare represents market-based innovation.
For years Republicans have been talking around an uncomfortable fact. Not global warming—they kicked that one into a corner and proceeded to piss on it. But health care is pushier. It's a problem that crowds into the present tense, as in “I'm screwed!” You may like the free market, but it works like shit when it comes to making sure that everybody—healthy and sick, rich and poor—gets health care. Having the health insurance industry act on a strictly business basis doesn't produce a miraculous confluence of interests. It produces a good deal of misery.
This is something everybody knows. The result is that Obamacare, after years of unfortunate headlines about its passage, implementation and allegedly disastrous consequences, is settling in as an accepted fact of the landscape. Polls find that the jaundiced, disappointed public doesn't want to repeal Obamacare, just prop it up with some fixes, the way Obamacare propped up the health care sector. We're used to Congress, Hollywood, the Internet, news media, even Wall Street. Americans don't see a need to replace a huge malfunctioning organism just because it malfunctions. We're used to life with a teetering mess.
For a great while the health care system was on that list too, but the deaths and bankruptcies kept piling up. Then somebody did something and we lurched through the embarrassing but necessary convulsion known as passage of the Affordable Care Act. Now Americans look about them and size up life under the new order. They're sure it can't be good, but they don't expect much. At least the insurance companies can't bounce you for preexisting conditions. You don't have to live in fear of them—that's over. Anybody who tries to put things back the old way will find themselves politically fried, third-railed like an advocate of middle-class tax hikes for sex-ed. But they have to say something. Why not “private, market-based Medicaid reforms”?