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So Rush Limbaugh thinks our Missouri Senator Claire McCaskill is a “commie babe liberal“? Lordy! Sure fooled me. I can’t speak to the “babe” epithet, but nobody’s really a “commie” nowadays. It’s passé. McCaskill might be mildly liberal, although I think that she’s been pretty careful to try to hew to the right-of-center line with only tiny detours leftwards now and then. If labels were strictly a function of policy positions, I suppose I’d be inclined to describe her as similar to that old standby, the “Rockefeller Republican” with a little feminist leavening. But these days, of course, we Democrats make do with what we can get.

To make that point even clearer, McCaskill proved that it takes a centrist to know a centrist policy when she pointed out that Obamacare is a mild-mannered and moderate plan that lines up with many GOP preferences. In McCaskill’s words it is Ryancare for the non-elderly:

“The irony of this situation is that these are private insurance companies people will shop to buy their insurance. It’s not the government,” she told KMOX of St. Louis on Wednesday. “It’s exactly what Paul Ryan wants to do for Medicare.”

TPM explains the seeming GOP cognitive dissonance about Obamacare in terms of the underlying agendas of progressives and conservatives:

McCaskill’s point is an important one that exposes the real nature of the underlying fight over how to fix health care. The progressive ideal is a single payer system, a la Medicare, but for everyone. The conservative ideal is a deregulated market-based system with a diminished federal role. The Affordable Care Act, despite the right’s protestations of socialism, is a middle ground between the two. And the insurance exchanges mirror what the Ryan plan does to Medicare – as Speaker John Boehner (R-OH) and Sen. John Cornyn (R-TX) have conceded.

These awkward admissions reveal that the broader fight is really about which direction to move vis-a-vis national health policy. Conservatives hate Obamacare because, by setting up regulated, subsidized exchanges for the public at large, it moves the existing system away from their goal of rolling back federal health care programs. Liberals hate Ryancare because, by replacing Medicare with a subsidized private insurance market, it constitutes a leap backwards from the current state of affairs.

As TPM’s Sahil Kapur implies above, no matter how big a backwards step Ryancare might represent, Obamacare still constitutes a mighty step forward for American health care overall given the nature of the previous status quo. It represents a necessary compromise in light of the rightward drift of American politics over the past couple of decades, which has created an environment in which a middle-aged, middling moderate pol can be described by a nasty-mouthed shock-jock as a “commie liberal babe.”