Back in November of 2003, the White House was worried. So were House Republican leaders.
At issue: President George W. Bush had to use all of his political clout to get enough House Republicans to pass his proposed Medicare prescription-drug benefit. Many House Republicans balked at the cost, and some had to be confronted on the floor to get them to vote for the largest entitlement expansion since the Great Society programs of the 1960s. One House member said she hid out, avoiding making contact with House leaders. At one point, the vote was stopped, and the clock and even the C-SPAN cameras were frozen for three hours so GOP leaders could round up the votes. One of the votes for the package was Rep. Paul Ryan, R-Wis. Despite a shaky start, the benefit, also called Medicare Part D, proved immensely popular—and expensive. According to a report by the then-Comptroller General David Walker, the benefit contained $8 trillion in unfunded liabilities. (Current estimates have it more in the $7 trillion range.)
The prescription-drug benefit may be the most pertinent example, because so many Republicans balked at its price tag and its expansion of the federal role in health care. (Many Democrats liked the idea of a drug benefit for seniors but did not like the restrictions on the federal government negotiating prices for pharmaceuticals that might have kept the cost of drugs down, as it has for, say, Veterans Affairs.) Any number of notable Republicans bucked the president, including some who ran for president this year, such as Rep. Ron Paul, R-Texas, and Rick Santorum, then the junior senator from Pennsylvania.
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