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Health care hypocrisy with a twist

Associated Press

Peggy Noonan, a prominent Republican pundit at the Wall Street Journal, ran into a little trouble last week trying to discuss health care policy she mistakenly thinks she understands.

Indeed, as Ezra Klein explained yesterday, "Noonan's column is a beautiful example of a writer so intent on criticizing Obamacare that she's missed the fact that the law is doing precisely the thing she wants done. A reasonable reader of Noonan's column would end up loathing 'Obamacare' and hoping for a replacement that looks like, well, Obamacare."

At issue is something called Community First Choice, a new part of Medicaid that expands access to at-home care for the disabled. It's a major breakthrough, which Noonan thinks she doesn't like, but when she fleshed out her concerns, it sounded like Nooan was calling for changes that are already in the law.

Indeed, as it turns out, Community First Choice is all over the news, and Noonan isn't the only one whose opposition isn't quite as consistent as previously thought.

Gov. Rick Perry wants to kill Obamacare dead, but Texas health officials are in talks with the Obama administration about accepting an estimated $100 million available through the health law to care for the elderly and disabled, POLITICO has learned.

Perry health aides are negotiating with the Obama administration on the terms of an optional Obamacare program that would allow Texas to claim stepped-up Medicaid funding for the care of people with disabilities.

The so-called Community First Choice program aims to enhance the quality of services available to the disabled and elderly in their homes or communities. Similar approaches have had bipartisan support around the country. About 12,000 Texans are expected to benefit in the first year of the program.

Now, the knee-jerk reaction to this is probably to accuse Perry of simple hypocrisy -- he claims to be disgusted by the Affordable Care Act, and yet here he is seeking funds through the federal system he holds in contempt.

On this angle, I'm inclined to cut the Texas governor some slack. Federal officials are making resources available to states, and it's tough to blame Perry for thinking to himself, "Well, if the money is just sitting there, I might as well help some of my constituents, whether I like the law or not."

But there's another angle to this that I find more problematic.

Consider a related example. Remember the Recovery Act? In 2009, Democrats approved an economic stimulus package that was chiefly responsible for ending the Great Recession, and which made all kinds of investments available nationwide. Nearly every congressional Republican rejected the effort, but nevertheless sought stimulus money for their states and districts.

What was wrong with this? Not much -- the money was going to be spent anyway, so it stands to reason they'd look for a piece of the pie. The trouble came when these same congressional Republicans told the Obama administration, "Spend the money on my constituents and it'll create jobs and boost the economy." GOP lawmakers tried to have it both ways -- they said government spending hurts job creation and stunts growth, except when it's government spending in their preferred area.

And that's the problem I have with Perry. The far-right Republican governor has said the dreaded Obamacare is an outrageous, tyrannical "monstrosity" that will hurt the country and is incapable of improving Americans' lives. And now that same governor is saying he wants some Obamacare cash because, as it turns out, the law is capable of improving Americans' lives after all.

That's a position that's impossible to take seriously.

Peggy Noonan thinks she knows what Community First Choice is, but doesn't. Rick Perry, on the other hand, apparently knows what Community First Choice is and wants to take advantage of its resources, and would prefer if we overlooked the inconsistency of his positions.