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The radicalism of the current Republican Party – its ideological extremism, disdain for empiricism, the inability to share or modulate power – is, to me, the central problem in American life. In the long run, the resolution to nearly every policy problem depends on the GOP refashioning itself as a normal, non-pathological party. Ultimately that will have to happen from within, which makes the fate of the Republican reform project vital. I wrote about it in a review essay last year, and in a short profile of conservative apostate Josh Barro recently.

Some liberals like Mike Konczal (“Is There Really A ‘Conservative Reform’ Movement In Policy?,”) Ed Kilgore (“The Very Low Threshold For What Conservatives Consider ‘Reform,’”) and Michael Tomasky (“The GOP’s Pitiful Reformers”) have raised skeptical questions, the thrust of which is apparent from their headlines. I do think there is a conservative reform movement.

The question has been badly clouded by the inherent murkiness of the term “reform.” Reform is a loaded term that can mean a change of any kind, and nobody is perfectly happy with the status quo in a party that has lost the popular vote in five of the last six presidential elections. What’s more, given that the party’s troubles include a deserved reputation for anti-intellectualism, “reform” has taken on a kind of cachet signaling intelligence, especially since the most prominent and earliest “conservative reformers” are indeed extremely smart. As a result, the label as being claimed by or applied to even conservatives who mainly defend the party’s current policies (Yuval Levin, Avik Roy) or even those who want to make it a more extreme version of its current incarnation (Arthur Brooks, Ben Domenech.)

So even though there is no single objective meaning of the phrase, I think there is a “conservative reform” movement with a definable objective: to give the Republican Party’s domestic agenda a more egalitarian (or, at least, less inegalitarian) slant.

I’d define the origins of this movement as Ross Douthat and Reihan Salam’s article, and then book, articulating a major change in the course the party had been following since the late 1970s. That course is an increasingly relentless focus on protecting and expanding the economic interests of the richest 1% of the population. Douthat and Salam argued that Ronald Reagan’s anti-tax, anti-regulatory agenda was an appropriate response to the world of 1980, but the world had changed, and the continued Reaganite agenda was both substantively outmoded and a political liability. To be sure, their argument involved less of a frontal challenge to the premises of the anti-tax, anti-regulation agenda than just finding other stuff for the party to care about.

When it came out, during George W. Bush’s second term, this was almost a completely novel argument to make from within the conservative movement, which had long entertained internal dissent on social and foreign policy but not on the primacy and correctness of its economic agenda. In the years since, other conservatives have joined versions of this critique. But, crucially, even as it has gained intellectual traction, this critique has lost ground within the party, which responded to the failures of the Bush years not by modulating its anti-egalitarianism but by ramping it up.

The widening fissure between the goals of the conservative reform movement and the actual agenda of the party has created an uncomfortable dilemma for the reformers. In my Barro profile, I argue that the reformers are mainly divided over how to acknowledge this problem. For instance, the reformers tend to be uncomfortable with the party’s proposals to enact massive cuts to food stamps, Medicaid, and other programs for the very poor and sick. The glowing 2010 National Review story about Ryan’s budget by Salam and Barro omitted any mention at all of the plan’s enormous cuts to anti-poverty programs. Barro now pays a lot of attention to that aspect of the party program, while writers like Douthat and Salam don’t.

Ross Douthat yesterday sketched out a credible outline of the conservative reform agenda, which serves as further confirmation of the delicate balance he is trying to maintain. In 2005*, he and Salam urged Republicans to advocate universal health insurance, praising Mitt Romney’s Massachusetts program as a national model and also urging the expansion and reform of Medicaid. That of course became the model for Obamacare. Like other Republicans, they have turned against this model. Here is what Douthat urges now about the conservative reform approach to health care:

A repeal or revision of Obamacare that aims to ease us toward a system of near-universal catastrophic health insurance, and includes some kind of flat tax credit or voucher explicitly designed for that purpose.

“Repeal or revision” carefully elides the crucial question in the political debate. The conservative reformers have different kinds of health care reform schemes they would like to take the place of Obamacare. But, then, so do liberals. Any policy analyst can draw up a blue sky plan that’s technically superior to an actual program that has to cobble together 218 votes in the House and 60 in the Senate. Good policy in general, and good health policy in particular, is hard to pass into law.

It’s true that many elected Republicans have different ideas for alternatives floating around, but those ideas all carry political vulnerabilities, which is why the party has avoided embracing them. The reformers like to note that, freed from political constraints, a figure like Ryan could be more productive. That’s true. So could Obama. The actual Republican health care position is to restore the pre-Obamacare status quo. That’s the policy the party voted to enact 37 times, and the policy it enshrined in its sacred Ryan budget.

The question is whether repealing and not replacing Obamacare would be a good idea. Reformers like Douthat and Salam devote thousands of words to explaining why their preferred reform is better either than Obamacare or the Republican status quo ante plan. They don’t like to talk about whether Obamacare is better than nothing. (I couldn’t recall Douthat ever having written this, and over email he confirmed he hadn’t.) That Obamacare is not merely imperfect but illegitimate and evil has become a necessary emotional entry point into the conservative movement.

When I interviewed Salam for my Barro profile, he was admirably candid about the political delicacy of his mission, which he described as being “part of a team” and “politically engaged.” What’s more, I’m not sure he’s wrong, either. The bluntness of a Barro, or a David Frum or Bruce Bartlett, is intellectually clarifying, but does tend to result in a hasty excommunication and foreclose the possibility of working from within. You could argue that the party is simply so pathological that the only avenue for its reform is for non-extremists to essentially go into exile until it reforms itself. You could also argue that the role of a journalist is not to work through political channels at all. On the other hand, the prospect of a major party utterly devoid of smart people possessed of even modestly egalitarian instincts is a frightening prospect, too. I try to remind myself of the importance of their task when I’m being driven to distraction by the conservative reformers’ methods.

*Update: Douthat points out that the book version took a more skeptical stance toward Romneycare than the original article that spawned it. I was citing the article, not the book.