The Lesson That Republicans Will (Probably) Take From the 2018 Midterms

There’s got to be a Better Way. Photo: Mark Wilson/Getty Images

The Republican Party spent the closing months of the 2018 campaign broadcasting its unconditional support for preserving subsidized health insurance for people with preexisting conditions — while asking a federal court in Texas to eliminate subsidized health insurance for people with preexisting conditions.

This two-step earned the party some scattered applause Tuesday night. By pretending that he cared more about safeguarding working-class cancer patients access to insurance — than safeguarding his own access to the Koch Network’s coffers — Josh Hawley managed to oust Claire McCaskill from the Senate, while lobbying the judiciary to make chemotherapy a luxury good.

But Republicans who had participated in the the party’s more visible efforts to throw millions of Americans off of health insurance — which is to say, members of Congress who voted to repeal Obamacare — were less fortunate.

Despite enjoying the benefits of historically low unemployment, and a historically gerrymandered battlefield, the Republican Party lost more House seats to Democrats in 2018 than in any midterm election since Watergate. And while antipathy for Donald Trump was certainly a major factor in the outcome, so was outrage over the GOP’s failed attempts to kill the Affordable Care Act: In exit polls, health care was by far voters’ most commonly cited “top concern.”

Now, some Republicans are wondering whether prioritizing the passage of health-care reforms — that were too unpopular to honestly describe in public — might have been a mistake:

Former Representative Pat Tiberi of Ohio, a long-serving Republican who resigned in January to take a private-sector job, said Republicans had “overreached” and handed Democrats a decisive advantage on health care as a political issue.

“We probably should have taken on infrastructure in a bipartisan way first and then maybe tax reform next, rather than health care first,” Mr. Tiberi said.

It’s unclear how many of the GOP’s surviving House members harbor such regrets. But it seems safe to assume that the precedent set by the Obamacare repeal — one of legislative failure, followed by a devastating political backlash (which the GOP donor class proved incapable of immunizing the rank and file against) — will loom large the next time GOP congressional leaders try to rally their members around gutting the welfare state.

And as it looms, advocates for slashing “big government” will likely face an additional obstacle: The Republican Party is becoming increasingly dependent on the votes of (in Paul Ryan’s parlance) “takers.”

On Tuesday, Democrats evicted the GOP from damn near every well-educated suburb the party had previously called home.

When the new Congress is sworn in next January, Team Blue will represent 81 percent of House districts with the highest shares of college graduates, while Republicans will speak for nearly 60 percent of the districts with the lowest levels of educational attainment.

Illustration: The Wall Street Journal

Education is not a perfect proxy for socioeconomic status. There are plenty of well-compensated business owners whose offices bear no framed diploma. But in the aggregate, the Republican Party has been trading wealthier whites for poorer ones for more than a decade now, and the 2016 election accelerated that realignment. Tuesday’s results suggest that Hillary Clinton’s strength in historically Republican, affluent suburbs was not a one-off aberration. As America’s upper-middle class grows more diverse, and the GOP grows evermore beholden to Evangelical Christians and nativists, college-educated suburbanites are turning steadily bluer.

Illustration: The Wall Street Journal

The Republican Party’s voters have never been natural constituents for its “small government” agenda — because there hasn’t been a majority coalition for Charles Koch’s fiscal priorities since ownership of a large estate stopped being a precondition for the franchise. But when the GOP claimed the loyalty of the lion’s share of the upper-middle class — and top marginal tax rates were higher than they are now — the party had some scintilla of a mandate to let Grover Norquist’s will be done.

But today, the GOP is the party of the elderly and economically dispossessed white people (and, in smaller numbers, veterans and cops). Which is to say: It represents the primary beneficiaries of the welfare state, the one category of Americans that actually has (and loves) socialized medicine, and some of the most powerful public-sector unions in America.

To be sure, the very existence of this realignment is a testament to the loose relationship between any given voting bloc’s material interests and its partisan preferences. But it’s worth remembering just how thoroughly Obamacare repeal failed in the Senate last year. It is true that “skinny repeal” went down by a mere three votes. But full repeal — which is to say, the bill that would have actually rolled back the welfare state by gutting funding for Medicaid and Obamacare subsidies — failed by nine. Further, while many interpreted Susan Collins and Lisa Murkowski’s opposition to ACA repeal as an expression of their personal, ideological moderation, those two senators also happened to represent heavily rural states whose hospital systems are deeply dependent on Uncle Sam’s largesse. Meanwhile, most congressional Republicans have shown approximately no appetite for taking action on entitlement spending. All of which suggests: Even a party as ruthlessly servile to its billionaire patrons as the GOP still has to worry a little about its constituents’ material needs.

And while the Trump administration has had little trouble disregarding those needs in the (relatively) opaque realm of regulatory policy, the America’s legislative process, with all its veto points and visibility, has proven to be less conducive to that project.

Going forward then, it’s hard to see how the Republican Party will ever make significant legislative progress on paring back the New Deal state (barring a fiscal crisis and/or hyperinflation). But that doesn’t mean that the GOP will learn to stop worrying and love the safety net.

During oral arguments in September, Texas district court judge Reed O’Connor strongly indicated that he agreed with Josh Hawley, and the other Republican state attorneys general, who had brought a legal challenge to the ACA before him: Congress’s repeal of the individual mandate did, in fact, require the judiciary to strike down Obamacare in its entirety.

For some strange reason, O’Connor did not release his official ruling in the long interval between the close of arguments, and the 2018 midterm elections — during which time, Hawley campaigned on his heartfelt commitment to protecting the good parts of Obamacare. Now, Hawley’s election — along with the GOP’s other gains in the Senate — will allow Donald Trump to pack the judiciary with Reed O’Connors. And that should allow the GOP to outsource the unpleasant task of lowering its own voters’ living standards to unelected judges.

Republicans came nine votes short of repealing Obamacare in the Senate. They were only one vote short of doing so through the Supreme Court.

What the GOP Will (Probably) Learn From the 2018 Midterms