View all Articles
Commentary By Avik Roy

Newt is the Problem

On health-care entitlements, Newt has moved left.

Newt Gingrich’s rise to the top of the GOP polls is fueled, in part, by Republicans’ mistrust of Mitt Romney. Romney’s signature Massachusetts health-care law, the model for Obamacare, leads many to wonder whether Romney can challenge the president on this most important domestic issue. But any conservative who opposes Romney because of Romneycare should oppose Gingrich with thrice the intensity: Newt Gingrich is one of the principal abettors of the exploding health-care entitlement state we face today. Indeed, it’s not clear what would be worse for the cause of entitlement reform: Newt’s losing to Obama or Newt’s beating him.

"I wouldn’t switch my positions for political reasons," Gingrich recently told a South Carolina radio station, in an apparent attempt to draw a contrast between himself and Romney. And perhaps Newt is right. He doesn’t change positions out of a considered desire to attune himself to public sentiment. Apparently he changes positions based on what he had for breakfast that morning.

"On Monday, we would say we’re not going to give a $500 child tax credit to people who don’t have tax liabilities," said Sen. Lindsey Graham (R., S.C.) to National Review’s Brian Bolduc. "On Wednesday, he’d meet with President Clinton, and that position would change." Newt has displayed egregious unreliability on the issues with the highest stakes. As Bolduc recounts from the memoir of former speaker Denny Hastert (R., Ill.), "In May 1997 . . . Newt declared the GOP willing to separate tax cuts from other items in a balanced-budget deal that we were negotiating with Bill Clinton. That was news to us and represented a huge change in policy in less than twenty-four hours."

Schizo Newt has been on display this year on the nation’s most important fiscal issue: Medicare reform. Last spring, all but four Republican members of the House of Representatives drew air into their lungs and voted for Paul Ryan’s Path to Prosperity, the boldest set of entitlement reforms ever to pass a chamber of Congress, knowing that they would be savaged by Democrats for doing so. Weeks later, Newt Gingrich appeared on Meet the Press to denounce these Republicans for "imposing radical change" and engaging in "right-wing social engineering." It would be a Democratic dream to be able to hang the words of Gingrich, the Republican nominee for president, around every House Republican in a competitive district.

It was bad enough that Gingrich attacked the Ryan plan on substantive grounds. (Apparently, in Newt’s world, everybody is a radical except Newt.) Ryan’s painstakingly gradual reforms of Medicare are an outgrowth of bipartisan proposals offered under President Clinton and echo the formats of other popular federal programs such as the Federal Employees Health Benefits Plan and the Medicare prescription-drug benefit. Newt’s outburst shows us how the former speaker usually ends up destroying, rather than advancing, thoughtful conservative reforms.

Over the last year, Gingrich has changed his opinion of the Ryan plan at least three times. Only six weeks before he slammed Ryan on Meet the Press, Newt described Ryan’s plan in glowing terms. "Paul Ryan has stepped up to the plate," Gingrich told Bill Bennett on April 5. "This is a very, very serious budget, and I think rivals with [what] John Kasich did as budget chairman in getting to a balanced budget in the 1990s, just for the scale and courage involved . . . Paul Ryan is going to define modern conservatism at a serious level."

And in the days after the Meet the Press firestorm, Newt changed his opinion once again. In an interview on May 18, Gingrich said, "I would have voted for [the Ryan plan] and [would still] . . . I think [Ryan] is doing a really good job." But wait — didn’t he say the weekend before that Ryan’s plan was radical, right-wing social engineering? Apparently not. "Let me say, on the record: Any ad which quotes what I said Sunday is a falsehood."

As a single-sentence epitaph for Candidate Gingrich, that line is at least as good as John Kerry’s excuse that he "actually did vote for the $87 billion before I voted against it."

And we’re just getting warmed up. Newt Gingrich is the only candidate in the GOP presidential race to have explicitly endorsed a federal requirement that all individuals buy health insurance. He did so in 1993 when Republicans were seeking a way of showing that they, too, had a plan for addressing the problem of the uninsured.

When shown a video of his endorsement of a federal mandate by Greta Van Susteren in May 2011, Gingrich was defensive and abrupt. "That was a clip from 1993, when in fact, the conservative position was to have individual insurance, in opposition to Hillarycare — because she wanted everybody to be in government — but let’s get that out of the way, okay?"

Van Susteren asked if Gingrich’s position had evolved. "So I’m sure I understand: So are you saying in 1993, that there was some sort of hybrid of mandate or whatever, it was supported by the Republican party? And now, that was in response to the Clinton administration. And now you’ve changed, is that it?"

Gingrich’s response was classic Newt. "No, no," he said. "I’m saying that 18 — imagine this in your own case. I’m saying that you see a 20-second clip from 18 years ago, when you were fighting Hillarycare, and when virtually everybody in the conservative movement was united in trying to stop Hillarycare. Now, nobody at that time was talking about the Tenth Amendment. Nobody at that time was talking about these kind of constitutional issues. But to jump from that and say, ’Gosh, if Newt said this in 1993, he must be for Obama’ — skipping, by the way, two-and-a-half years of active, consistent opposition to Obamacare? I mean, I think the kind of amnesia that Washington gets into is, frankly, silly."

It’s unclear which is a worse indictment of Gingrich’s governing style. Is it worse that Gingrich, who was about to become second in line to the presidency, was ignorant of the obvious constitutional problems with the federal government’s forcing everyone to buy a private product? Or is it worse that Gingrich was willing to promote the adoption an unconstitutional measure purely for the tactical reason of "trying to stop Hillarycare" ? It’s as if Gingrich were to say, "Don’t believe anything I say when I’m trying to oppose a Democratic policy initiative. I’m not sincerely interested in providing an alternative solution, so trampling the Constitution to thwart Democrats is no big deal."

Note, too, Newt’s go-to gambit for addressing the inconsistencies in his record: evade the question and attack the questioner as a member of the Washington conspiracy against constructive dialogue. This tactic works best against liberal or centrist reporters, whom Republican voters dislike. But make no mistake: It is most often a way for Gingrich to avoid difficult questions. It’s a technique that can work against pliable journalists in a Republican primary, but he won’t get away with it in a general election against President Obama.

And then there’s Gingrich’s turbulent four-year tenure as speaker of the House, in which he was as responsible as anyone for the growth of federal health-care entitlements to their current unsustainable levels.

In 1997, the Gingrich-led House of Representatives passed legislation creating the State Children’s Health Insurance Program, or S-CHIP, which was then the largest statutory expansion of Medicaid since the program was founded in 1965. Today, thanks to Newt Gingrich, nearly 4 in 10 children in the United States are on Medicaid. Many of those kids were forced off of higher-quality private-sector health coverage and forced into the Medicaid ghetto, where poor children die of toothaches due to inadequate care.

Another dubious part of the 1997 Gingrich-Clinton budget deal was the Medicare Sustainable Growth Rate, in which the Gingrich-led House passed what has become one of Washington’s favorite accounting gimmicks: pretending to drastically cut Medicare payments to doctors and hospitals in the future, so as to make the long-term budget outlook appear better than it is, while in reality passing "doc fix" legislation each year that keeps Medicare payments on their prior trajectory. The "doc fix" that Congress is contemplating for 2012 will cost $22 billion, a figure that goes up over time as the gap widens between what the 1997 law prescribed and what Medicare costs today.

The Sustainable Growth Rate has been useful for one thing: letting Democrats have it both ways. They get to claim that Obamacare is "fiscally responsible" because the Congressional Budget Office includes these fictional Medicare cuts that never materialize. At the same time, Democrats can pillory the Paul Ryan plan as, to borrow a phrase, "radical, right-wing social engineering," because its reductions in Medicare spending might actually go into effect.

Indeed, Democrats got to use the same playbook in 1997, painting Gingrich Republicans as being mean to seniors, even though Gingrich didn’t actually make a dent in the problem of Medicare’s runaway growth. This is a pattern that recurs in Gingrich’s record.

Worst of all was Gingrich’s conduct during the 1995 government shutdown, a catastrophic failure that directly caused a decade of Republican spending indiscipline. Pres. Bill Clinton refused to sign Gingrich’s balanced-budget legislation, which included $270 billion in Medicare cuts (using something, incidentally, quite similar to Paul Ryan’s plan), $183 billion in Medicaid cuts, and $245 billion in tax cuts. Clinton portrayed the Republicans’ proposal as cutting taxes for the wealthy while undercutting Medicare and Medicaid.

Initially, it appeared that Republicans were winning the public debate. But then came the infamous comment by Gingrich that Clinton’s decision to put him on the back of Air Force One during a trip to Yitzhak Rabin’s funeral was "part of why you ended up with us sending down a tougher continuing resolution" budget bill, ending any hope of compromise and guaranteeing the shutdown. Leon Panetta, Clinton’s chief of staff at the time, called it "bizarre." "Everybody knew this was about a funeral . . . and even if [this was a snub], which it isn’t, why would you want to shut down the government because you feel snubbed?"

From that point onward, Gingrich was on the defensive. Clinton held firm, and Gingrich caved. Once again, Gingrich had achieved the worst of all possible outcomes: He’d successfully branded Republicans as anti-government radicals, willing to shut down the government, while accomplishing little of policy substance. Clinton was

reelected, in part due to his defeat of Gingrich in 1995, and Republicans, scarred by this experience, spent the next ten years avoiding any tough fights over the size of government.

As Brian Bolduc recalls in his Gingrich profile, erstwhile Gingrich acolytes such as Tom Coburn (R., Okla.) saw Newt change before their eyes. "Before the government shutdown, we thought Newt Gingrich was invincible. After the shutdown, however, he was like a whipped dog who still barked, yet cowered, in Clinton’s presence."

But that’s all in the past, some say. What about Gingrich’s proposals for reforming health-care entitlements today? Gingrich, like nearly everyone in the Republican field, has endorsed block-granting Medicaid, and that’s great. But it’s Medicare that is the most difficult and most dangerous federal entitlement, and the one that anyone sincere about taming the growth of government must tackle.

And it is here that Newt, for all his sound and fury, signifies nothing. He proposes to give seniors "the option to choose, on a voluntary basis, either to remain in the existing program or to transition to a more personalized system in the private sector, with greater options for better care." But that’s exactly what seniors have today: They can choose between traditional, 1965-vintage Medicare (Parts A and B), or choose a more market-oriented version called Medicare Advantage (Part C).

As the Wall Street Journal puts it, Gingrich’s approach to our most important fiscal challenge is "merely a gloss on Medicare Advantage, which has done some modest good . . . but without turning the fiscal battleship." Indeed, in a Friday interview with Ben Domenech, Gingrich conceded that his program is designed as a modest tweak to Medicare Advantage, and decried Ryan’s plan as "suicidal":

“What I was saying [about Paul Ryan’s plan] was in answer to a very specific question, which was: If there’s a program which is very, very unpopular, should Republicans impose it, and my answer was, no! When we passed welfare reform, 92 percent of the country favored it, including 88 percent on welfare. Reagan ran to be a popular president, not to maximize suicide . . .

So, let’s take the example. Where I think Ryan’s onto something I actually support, which is that you ought to have a premium-support option, I wouldn’t do it in ten years, I would do it next year, but I would do it as a voluntary program. And then I would go to the insurance industry and say to them, "Is there a way you could make a premium-support option really desirable?" Well it turns out that Medicare Advantage has 25 percent of the market despite the opposition of the bureaucracy. So if you had a bureaucracy that favored market-oriented systems, you might actually get to 50 percent much faster than you think.”

This sounds nice in theory, but as a matter of policy, it’s wrong. Medicare Advantage has 25 percent of the market in part because, prior to Obamacare, the government paid 14 percent more for a senior in Medicare Advantage than for one in traditional Medicare. (Obamacare significantly trimmed this subsidy.) Medicare Advantage has many qualities, but it has not reduced Medicare spending at all.

So why does Newt think his plan is an improvement? "If [retirees] select the personalized system, beneficiaries would receive support to cover their private-sector premiums. Giving all seniors the option to choose their insurance provider will improve price competition and help lower costs for the program."

But this isn’t true. If you give seniors a choice between a fully subsidized government-run program and a partially subsidized private-sector program, the vast majority will choose the greater subsidy. Premium-support plans will always be at a structural disadvantage compared with fully subsidized, traditional Medicare. Gingrich’s proposal, such as it is, would doom premium support to failure.

If you really want to give people the choice between a Ryan-style system and traditional Medicare, the only plausible way to do so is to adopt competitive bidding, an approach advocated by Yuval Levin, Reihan Salam, and others. It’s an approach that Mitt Romney recently has signaled some interest in. But Gingrich is expressly opposed to this idea, because he sees it as too politically risky.

Mark Steyn once called Gingrich "a lily-livered ninny whom everyone thinks is a ferocious right-wing bastard." Mitt Romney gets criticized for moving rightward since he was governor of Massachusetts. But when it comes to Medicare reform, the nation’s greatest fiscal challenge, Gingrich has in fact moved leftward. In 1993, he advocated a full-on, Swiss-style voucher system for Medicare; today, Ryan’s far milder plan is too radical for Newt’s tastes.

To give credit where it is due, Gingrich did pass landmark welfare-reform legislation in 1996. Today, though Social Security poses a far lesser danger to the nation’s long-term fiscal stability, Gingrich’s plan for Social Security reform is bold and attractive.

Former congressman Chris Shays (R., Conn.) probably captured the strength and weakness of Newt best in comments to Bolduc: "He’s a true entrepreneur in the classic sense. You can launch the business, but you can’t necessarily run it." Gingrich brought us a once-unimaginable House GOP majority but ended up using that majority to expand, rather than shrink, the size of government.

There can be little doubt that a Gingrich presidency would bring us more of the same: sudden, dramatic shifts in policy strategy, with a lot of overheated rhetoric, undermined by unilateral legislative concessions. Newt Gingrich would tarnish the conservative brand for a generation. Republicans can, and must, do better.

This piece originally appeared in National Review Online

This piece originally appeared in National Review Online