How the Politics of the 1890s Explain the GOP’s Health Care Woes

The dream of the '90s isn't just alive in Portland...

Amid news that the GOP is trying once again to restart negotiations over their failed ObamaCare “repeal and replace” measure, it’s worth noting that the party’s problems with health care go beyond schisms within the party and Trump’s incompetence. They go to the heart of how seemingly dry public policy issues take on a morality that transcends the actual issues in question.

The country faced a similar dilemma in the 1890s over vexing questions of economic policy. At the time, like a political version of “Freaky Friday,” the personalities of the two major political parties were reversed, Under the leadership of Grover Cleveland, the “Bourbon” Democrats were the party of big business, small government and states’ rights. The Republicans were just emerging from the political wilderness and coalescing into what would become the activist party of the Progressive era, in favor of expanded federal powers, increased government regulation, and rights for women, children and labor.

The two big issues of the day were the tariff and the money supply. The Republicans generally favored tariffs to protect farmers and eastern manufacturing interests and to raise revenue for the federal government. They were also in favor of adding silver to the currency supply to make it more elastic, which would loosen the hold of Eastern financial interest over interests rates and free up credit for small businesses and farmers.

The Democrats opposed tariffs both as an imposition on the functioning of the free market and as a way to starve the federal government of revenue so it couldn’t do things like expand infrastructure. Throughout much of the 1880s, the Democrats used a series of procedural maneuvers to hamstring Congress, delaying progress on reforms the country needed in order to keep pace with the industrial revolution and the increasing urbanization and interconnectivity of life.

In 1888, the Republicans finally broke through and gained control of the presidency and Congress and passed a number of historic bills, including the Sherman Silver Purchase Act, which reintroduced silver into the currency supply, and the McKinley Tariff Act, the Republican attempt to modernize the tariff schedule. They also passed a long-awaited pension for Civil War veterans and the Sherman Anti-Trust Act.

The Democrats dubbed the 51st Congress the “Billion Dollar Congress,” charging Republicans with overtaxing Americans to spend money on unneeded, big-ticket items. They massacred them in the mid-terms and sent Grover Cleveland back to the White House in 1892. Suddenly in charge again after running against the tariff and the Silver Act, they, like today’s GOP, were in the hook to make good on their promises of returning America to better, simpler days without government interference.

Then, the worst depression of the nineteenth century, the Panic of 1893, hit. The Democrats put all their efforts into repealing the Silver Act, which it blamed for the country’s financial difficulties. But when that didn’t end the panic, they had no actual policy ideas on how to right the economy. The Bourbons were doomed. By 1896, it was the beginning of a period of Republican ascendency and activist government.

Sound familiar? As As Mark Schmitt notes in Vox:

Long before Donald Trump came along, the Republican Party ran four election campaigns — 2010, 2012, 2014, and 2016 — on the promise to rid the country of the hated and oppressive Affordable Care Act … In three of those four elections, they captured another arm of government, all on the promise of ACA repeal: the House in 2010, the Senate in 2014, and the White House in 2016. … Every time you read about how many House and Senate seats, how many statehouses, how many thousands of seats in state legislatures turned Republican since 2008, think about how many of them swung on the backlash against the Affordable Care Act.

But like the 1890s Democrats, who couldn’t explain how repealing the Sherman Silver Act would help modernize the country’s currency system, “the Republican Party never fully articulated an alternative, beyond phrases like ‘patient-centered’ or ‘market-based.’… And then, when the moment came, when Republicans finally had full control of government, it took barely two months for them to admit they hadn’t really thought it through.

What the Republicans were successful at, says Schmitt, was winning on the issue of repealing the ACA:

…if the goal was to win election after election, and virtually wipe out the Democratic Party across much of the country, while never actually engaging with the tough questions of health care, then it succeeded beautifully.

But there’s a reason the GOP is now stuck on health care that goes even beyond the fact that the party doesn’t really have any policy ideas beyond a few talking points. It’s because at some point the actually policy questions embedded in the ACA became symbolic of larger moral questions about government control of private life and who makes decisions about life and death.

The same thing happened in the nineteenth century, says historian Robert Wiebe, when seemingly dry technical questions about currency and tariffs assumed an “eternal quality that set them apart as touchstones of public morality,” encapsulating anxieties about about far-off forces like banks and the federal government that increasingly controlled the lives of Americans.

And once issues enter this zone, they become irremediable by the mere tools of legislation and public policy. So today’s Republicans, who elevated policy questions about the delivery of health care into the great moral cause of our time, shouldn’t be surprised when they find that no amount of negotiations will find a solution.