Politics & Policy

Is Rand Paul’s Health-Care Stance Really Based on Principle?

Sen. Rand Paul speaks to reporters on health-care legislation, July 18, 2017. (Reuters photo: Jonathan Ernst)
Sometimes touting your principles is a politically expedient way to avoid accountability.

The greatest trick any politician can pull off is to get his self-interest and his principles in perfect alignment. As Thomas More observed in Robert Bolt’s A Man for All Seasons, “if we lived in a State where virtue was profitable, common sense would make us good, and greed would make us saintly.”

Which brings me to Senator Rand Paul, the GOP’s would-be Man for All Seasons. Paul emerged from the smoldering debris of the Republican health-care-reform train wreck as a figure of high libertarian principle, the shining “no” vote on any compromise that came short of full repeal.

“Look, this is what we ran on for four elections,” Paul told Neil Cavuto of Fox News. “Republicans ran four times and won every time on repeal Obamacare, and now they’re going to vote to keep it. Disappointing.”

I found many of Paul’s arguments and complaints entirely persuasive on the merits. But there have been times when I had to wonder if the merits were all that was driving him.

Was it just a coincidence that the bill was terribly unpopular in his home state of Kentucky, where more than one in five Kentuckians are on Medicaid?

This is the problem. When touting your principles is a politically expedient way of avoiding accountability, it’s hard to tell whether principles or expedience is in the driver’s seat. But not impossible.

Paul learned politics on the knee of his father, Ron Paul, a longtime Texas congressman and irrepressible presidential candidate. In the House, the elder Paul earned the nickname “Dr. No” because he voted against nearly everything on the grounds that it wasn’t constitutional or libertarian enough.

“I’m absolutely for free trade, more so than any other member of the House,” he told National Review’s John Miller in 2007. “But I’m against managed trade.”

So Paul opposed the Central American Free Trade Agreement and all other trade deals, not on Trumpian protectionist grounds but in service to his higher libertarian conscience, which, in a brilliant pas de deux, landed him in the protectionist position anyway.

Every time health-care proceedings moved one step in Paul’s direction, he seemed to move one step back.

Ron Paul loved earmarks. He’d cram pork for his district into must-pass spending bills like an overstuffed burrito — and then vote against them in the name of purity, often boasting that he never approved an earmark or a spending bill.

In 2006, Republicans proposed legislation to slow the growth of entitlements by $40 billion over five years. Democrats, as usual, screamed bloody murder about Republican heartlessness and voted against it. And so did Ron Paul — on the grounds the reform didn’t go far enough. Man, that sounds familiar.

Now I can’t say for sure that Rand Paul is carrying on the family tradition. He is different from his dad in many ways.

And yet: Every time health-care proceedings moved one step in Paul’s direction, he seemed to move one step back. Senator Ted Cruz offered an amendment that would open up the market for more flexible and affordable plans, like Paul wanted. No good, Paul told Fox’s Chris Wallace. Those plans would still be in the “context” of the Obamacare mandates.

“My idea always was to replace it with freedom, legalize choice, legalize inexpensive insurance, allow people to join associations to buy their insurance,” Paul said.

Sounds good. Except a provision for exempting associations from Obamacare mandates was already in the bill.

Paul insists he’s sympathetic to the GOP’s plight and its need to avoid a midterm catastrophe. (It would look awful if the party did nothing on health care at all.) His solution? Just repeal Obamacare now, and work on a replacement later. “I still think the entire 52 of us could get together on a more narrow, clean repeal,” he told Wallace.

That sounds like a constructive idea, grounded in principle.

And yet: That’s what GOP leaders wanted to do back in January. And one senator more than any other fought to stop them, and even successfully lobbied the White House to change course and do repeal-and-replace simultaneously. Guess who?

“If Congress fails to vote on a replacement at the same time as repeal,” Paul wrote back then, “the repealers risk assuming the blame for the continued unraveling of Obamacare. For mark my words, Obamacare will continue to unravel and wreak havoc for years to come.”

In the wake of the Senate bill’s collapse this week, Senate majority leader Mitch McConnell says he’s all for a clean repeal, and so does Rand Paul. For now.


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