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I think Josh Patashnik gets this basically right:
The conservative health care strategy works like this: endorse subsidies in theory, since it would seem unacceptably heartless to simply say that people who can't afford medical care shouldn't get it. Then, whenever anybody proposes a plan to actually implement subsidies, vehemently oppose it without offering any alternative plan to expand coverage. (Which is what California Republicans are doing.) In other words, let states experiment--except when they actually do.Right. When it comes to health care, conservatives use policy the way pick-up artists use astrology: It's something to talk about while they try to screw you.