Last week Ramesh Ponnuru suggested that I was too hard on the Republican congressional majority of yore for not taking robust action on health insurance reform:

[T]he actual Republican record on health care belies the do-nothing label. A Republican Congress passed a health-insurance-portability law in 1996 and created the children’s-health-insurance entitlement in 1997. In 2003, a Republican Congress and a Republican president created tax-sheltered Health Savings Accounts, a prescription-drug benefit for senior citizens, and a market-friendly component of Medicare.
Not all of these policies were wise, so Klein’s criticism has more force: “While they were in power, Republicans squandered an opportunity to push free market health-care solutions.” But how much opportunity was there, really? Republicans were unable to overcome Democratic filibusters of their proposals to reform medical-malpractice laws and to allow small businesses to band together across state lines to buy insurance. There is no reason to think that bold, free-market reform would have fared better. Republicans should still have tried. It might have helped educate the public about the issue and thus prepared the ground for the Obamacare debate. But Republicans never had enough senators to reform health insurance.

This is an excellent point. The 2001 tax cuts did attract at least some Democratic support in the Senate, but that might have been a special case. (Also, it was passed via the reconciliation process.) It’s hard to imagine President Bush using the post-9/11 moment to pass a sweeping health bill. After the 2004 election, my sense is that congressional Democrats sensed that a comeback was within their grasp, hence the disciplined refusal to cooperate meaningfully with congressional Republicans or the White House on issues apart from immigration reform, and that of course was a wedge that divided the Republican coalition.