The Coming GOP Divide

Though many in his party understood the math, the hazards of entitlement reform—the proverbial third rail of American politics—made them reluctant to embrace the substantive changes required to address the developing crisis. When Ryan urged his colleagues in the GOP minority to adopt the Medicare and Medicaid reforms in his “Roadmap for America,” most of them refused. The national organs of the party urged candidates to avoid talking about entitlements at all. 

In August 2010, the National Republican Congressional Committee sent out an “alert” warning its candidates against any discussion of the reforms. MSNBC sought a Republican to appear “and support the Paul Ryan Roadmap, therefore supporting Social Security privatization,” wrote a GOP press strategist. “Please do NOT accept this invitation; it will not end well.” The aide instructed candidates to “contact me immediately” before answering any media questions about the Roadmap. 

Not everyone listened. Marco Rubio, running for Senate in Florida, the state with the highest percentage of elderly, not only chose to embrace entitlement reform as an issue, he campaigned specifically on Paul Ryan’s Roadmap. Rubio said he was “proud” to have Ryan’s endorsement in the campaign and called his reforms “a great starting point for the conversation” about fixing entitlements.

Predictably, his opponents sought to make the policy proposals an anvil to hang around his neck, Roadrunner-style. Charlie Crist, the Republican-turned-independent who posed the greatest threat to Rubio in the Senate race, ended his campaign with misleading, demagogic ads hitting Rubio on Social Security. They had little effect. Rubio continued to campaign on the reforms. Over the final month of the campaign, Rubio’s internal polling showed him slipping 4 points—from 32 percent to 28 percent—on the question of which candidate would best protect Social Security. But that drop didn’t prevent him from being seen as the most trustworthy candidate on the issue in the three-way race. And Rubio was elected with 50 percent of the senior vote (65 and older). 

When Republicans won control of the House of Representatives in November 2010, Ryan became chairman of the House Budget Committee. He persuaded leadership to embrace his reforms and allow him to include them in the official House GOP budget. Republicans voted to overhaul Medicare by phasing in premium support payments for younger workers when they become eligible for the program. Ryan’s budget proposed reforming Medicaid by block-granting federal money and allowing for increases based on inflation and population growth. (Ryan didn’t include Social Security reforms in his plan, but promised that Republicans would deal with the popular retirement program down the road.) House Republicans passed the budget (with four defections and zero votes from Democrats) in what the Associated Press, articulating the conventional wisdom, called a “politically risky” move. 

But those risks had long been overstated. And a little more than a year later, Ryan, the face of GOP entitlement reform, had been elevated to a place on the party’s presidential ticket when Mitt Romney chose Ryan as his running mate. Democrats squealed with delight at the pick and responded with a flood of attacks. Ryan’s plan would “kill” Medicare, they claimed. He would balance the budget “on the backs of seniors,” they announced. And on it went. 

Some Romney advisers were nervous about pushing back too aggressively. But Ryan and several others in the campaign insisted on a strategy built around a strong offense. So Ryan traveled to The Villages, a retirement community in Florida, and touted his reforms, taking his mother along to reassure voters that he wouldn’t do anything to hurt her. The campaign argued incessantly that the real threats to Medicare were the status quo and Obamacare, which had shifted some $700 billion in funding from Medicare to the president’s unpopular reforms. 

The result? Romney-Ryan won seniors by 17 points, 58-41 percent, doubling the margin by which John McCain and Sarah Palin had won seniors four years earlier (53-45 percent). In an insightful essay in the Wall Street Journal after the 2012 election, Dan Senor and Pete Wehner wrote that the Romney-Ryan ticket “showed Republicans that it pays to deal with attacks head-on” and “provided Republicans with an invaluable lesson and a blueprint for future elections.” 

But that Republican unity on entitlements is eroding. Republican governors across the country, including several conservatives, couldn’t resist the siren song of federal dollars and chose to expand Medicaid under Obamacare. The federal government promises to fully fund Medicaid expansion for three years, after which the federal dollars are phased out and states will be responsible for paying for the expanded program themselves. 

Among the Republican governors who expanded Medicaid are two men strongly considering presidential bids, John Kasich of Ohio and Chris Christie of New Jersey. Kasich has aggressively defended his Medicaid expansion and lashed out at those who questioned it. At a dinner with conservatives and libertarians in New York City in late March, health care policy analyst Avik Roy asked Kasich about his decision. “Obamacare is top-down government. Are you saying Medicaid is not top-down government?” according to an account by Eliana Johnson in National Review. Kasich accused Roy of hostility to the poor. “Maybe you think we should put them in prison. I don’t.”

Chris Christie, defending his decision to accept the federal Medicaid money under Obamacare eight months before the 2013 gubernatorial election, said Obamacare was “bad for America.” But he added: “My job is to decide these things not based on my own personal opinion but based on what’s best for the state. If I were in charge, I wouldn’t have the program. But that program’s there.” 

The decision came two years after Christie gave a highly touted speech on entitlement reform at the American Enterprise Institute called “It’s Time to Do Big Things.” Christie excoriated Republicans for their timidity on the subject and mocked their political calculations: 

Recently, Christie has picked up this theme. In mid-April, he gave a speech with bold calls for deep entitlement reform, including means testing Social Security and Medicare. Christie would end Social Security payments to seniors making more than $200,000 annually and provide partial payments, depending on income level, to seniors making between $85,000 and $200,000. On Medicare, Christie would ask seniors making more than $85,000 to pay 40 percent of their premiums and seniors earning more than $196,000 to pay 90 percent. He stressed that the reforms would be phased in and would not affect current recipients.

On Medicaid, Christie’s plan includes cuts ($600 billion over a decade), additional flexibility for states, and required buy-in for recipients over the poverty line. A spokesman for Christie says he will include additional details when he outlines his plan for replacing Obamacare. And while Christie “absolutely believes there are better alternatives than current law, that doesn’t preclude him from acting in the best interests of his state in his role as governor under what is currently law of the land.” 

At least one likely Republican candidate rejected Christie’s proposals. (Technically, two, but Donald Trump, the carnival barker of an American culture of which he’s the main attraction, doesn’t count.) Former Arkansas governor Mike Huckabee, who plans to announce his intentions on May 5, slammed the reforms and the assumption behind them. “I don’t know why Republicans want to insult Americans by pretending they don’t understand what their Social Security and Medicare program is,” he said to a small group of reporters. Asked if he backed those reforms, he said: “Not just no, but you-know-what no.” Huckabee also told reporters he wouldn’t sign Ryan’s Medicare reforms, arguing that it’d be unfair to change the rules on people who had paid to support the program. 

As John McCormack of The Weekly Standard reported last week, that is something of a reversal for Huckabee. In 2012, Huckabee published a post arguing that Ryan was being unfairly “demonized” for his proposals and arguing that the alternatives might be “scarier.” For those inclined to dismiss Huckabee as an unserious candidate, Jim Pethokoukis of the American Enterprise Institute notes that polling from multiple outlets puts Huckabee’s support among seniors higher than any other Republican candidate’s or would-be candidate’s.

More questions about Republicans and entitlement reform arose at events surrounding the Nashua summit last weekend. Former Florida governor Jeb Bush raised eyebrows when he weighed in on a dispute over Medicaid expansion between current Florida governor Rick Scott and the Obama administration. The administration is withholding funds that Scott believes Florida is entitled to regardless of whether the state expands Medicaid. (Scott initially backed expansion but after pressure from Republicans in the Florida house reversed himself.)

“The feds and the executive branch and representatives from the House and Senate ought to get together and try to forge a compromise,” Bush said to reporters in Concord. Asked if he thought compromise was necessary even if it involved expanding Medicaid, Bush said: “I don’t know.” 

Bush spokesman Tim Miller says that Bush “is opposed to expansion” of Medicaid and notes that Bush has long supported Medicaid reform. In 2005, Bush proposed sweeping changes to Medicaid that included capping state spending on the program and offering recipients choices that included private health care providers. A New York Times article on the reforms reported that, while many governors were considering changes to Medicaid, “perhaps no one is proposing changes as far-reaching and fundamental as Gov. Jeb Bush of Florida.” (A Heritage Foundation study in 2011 called the reforms a “decided success,” but other analysts argue that while they reduced spending, the health outcomes were mixed.)

It’s not clear where Republicans as a party will end up on the question of entitlement reform, but it’s clear that there will be some stark differences between the candidates. Democrats were unable to use the issue to their advantage in 2012. But in much the same way that Newt Gingrich’s “vulture capitalist” attacks on Mitt Romney had loud echoes in the general election, it’s a virtual certainty that the eventual Democratic nominee will exploit the coming Republican-on-Republican attacks on entitlement reform.

UPDATE: Senior communications advisor Hogan Gidley to Mike Huckabee said, “The Governor was pointing out a basic reality about these programs that some refuse to acknowledge: the government involuntarily took money from our paychecks and promised to pay benefits at retirement.  He feels that for the government to take money from us and then lie about it being there for us is lying and stealing.  To make workers take the penalty for the government’s lousy management of Social Security and Medicare is just wrong. He has said it¹s not a good Republican idea to lie to and steal from taxpayers.  Governor Huckabee salutes Paul Ryan for putting something on the table, but even then he didn¹t support cutting benefits to beneficiaries.

“Further, the governor believes it’s wrong to create, implement or preserve a new multi-trillion health care entitlement program like ObamaCare that robbed $700 billion from Medicare. He will continue the fight to repeal and replace it.” 

Stephen F. Hayes is a senior writer at The Weekly Standard.