Once upon a time, conservatives believed in a limited federal government and fiscal restraint. They still do, though it increasingly seems that those principles are means rather than moral ends — conservatives argue for those principles because they’ll lead to a better world, instead of just saying those are the proper principles of a government that is just.

On Monday, when the Congressional Budget Office released its analysis of the Senate healthcare bill, there was weeping and gnashing of teeth in Republican offices: The CBO forecast the bill would eventually lead to 22 million fewer people having health coverage.