Daniel Larison makes some good points here, but I think he goes too far in saying that the midterm election results will have little to do with Obama's policies or out-of-control government spending. First, a constituency doesn't have to be perfectly logically consistent to exist. Since Reagan, Republicans have won votes from people who claimed to want to cut government and also those who want to protect government programs from which they benefit -- and these voters are often the same people.
So it is actually not surprising that people might simultaneously object to the size and cost of the Obama health care law and its Medicare cuts, just as people simultaneously objected to the Clinton health care plan's expansion of the federal government and its Medicare cuts. There's always that possibly apocryphal quote from the little old lady who didn't want the government messing with her Medicare. Even Pat Buchanan, who employed strict constitutionalist rhetoric while running to the right of the Gingrich Republicans in 1996, criticized the Gingrich Republicans' proposed Medicare cuts. Informed conservative activists are probably more anti-spending than ever before.
Ordinary people who are not politically active beyond voting and aren't systematic ideological thinkers often have conflicting impulses: they understand that the federal government's practice of spending money it doesn't have is irresponsible but they also want something in return for the taxes they pay rather than see the money go to somebody else. More troubling is the Republican candidates who will actually have to govern if elected running on platforms that bash big government in theory but rule out cutting any major spending program in practice, especially entitlements. How Tea Party activists react to such Republicans will be an important test.
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