The Tea Party's Achilles' Heel

By YUVAL LEVIN AND PETER WEHNER, WSJ

The tea party movement has been a profoundly positive force in American political life. It has recast the political debate to put the country's fiscal problems front and center, helped to drive a historic midterm election, and begun to put the brakes on the Obama administration's reckless spending.

Two years ago, all the focus in Washington was on how much to spend; today it is on how much to cut. The tea party freshman in the House of Representatives, together with more senior like-minded members, prevented the Republican leadership from agreeing to deals that would have increased taxes in exchange for largely illusory cuts. As a result, the debt-ceiling deal was significantly better than it would otherwise have been. Next year, discretionary spending will be, in absolute terms, less than it was this year—a small first step, but an important one.

But the next test, and the real test, for the tea party movement is whether it can channel its energy into entitlement reform—and specifically the reform of Medicare. The reason is simple: Our debt explosion is a health-entitlement explosion. Between now and 2050, according to the Congressional Budget Office, spending on federal health programs—Medicare, Medicaid and the new ObamaCare entitlement—will grow to 13% of gross domestic product from 5.6%, while all other federal spending combined will actually decline as a share of the economy.

The crushing and unprecedented coming debt crisis—which will see the national debt grow to more than twice the size of the economy, strangling our economic future—cannot be averted unless health-care costs are brought under control, and that cannot be done unless the basic structure of the Medicare program is reformed. If we ignore Medicare, we ignore the debt problem.

Unless the tea party movement is willing to step up to the plate on this issue, its members cannot really be considered champions of limited government or defenders of America's future prosperity. There is a very real danger that members of the movement will get distracted by side issues (cutting foreign assistance, for example, which wouldn't move the needle on our long-term debt) or will cling to untenable stands (opposing in principle any increase in the debt ceiling) while avoiding the entitlement debate.

Rep. Michele Bachmann (R., Minn.), winner of the Iowa straw poll and a heroine of the tea party movement, is a perfect example of this. She claims she has a "titanium spine" when it comes to fiscal matters, portraying herself as a crusader on behalf of smaller government. But is she really?

Rep. Paul Ryan (R., Wis.), chairman of the House Budget Committee, has put forward a plan that would transform the fee-for-service structure of Medicare, which is the chief driver of inefficiency in our health-care system, into a system of defined-contribution health benefits. It is the best, most far-reaching reform of health-care entitlements on the table. Yet when asked about Mr. Ryan's Medicare plan, Mrs. Bachmann's titanium spine seems to fold.

She has said she supports the Ryan budget's discretionary cuts but puts "an asterisk" over its Medicare reform. "We have to make sure going forward with senior citizens, that we're focusing on a higher quality of life, dealing with cures for instance for senior citizens," she told one interviewer.

If Mrs. Bachmann is worried that Mr. Ryan's reforms would not address her concerns, then there are other approaches to choose from. But she has declined to offer or endorse any, expressing only vague support for a small increase in the retirement age and greater means testing—neither of which would make a real dent in Medicare's growth, since neither would reform the grossly inefficient payment system that causes costs to explode throughout the health sector. An asterisk is not enough.

Meanwhile, Mrs. Bachmann voted against not only the debt-ceiling deal engineered by Speaker John Boehner (R., Ohio) but also the House Republican Study Committee's "Cut, Cap, and Balance" bill on the grounds that they didn't cut government spending enough.

A posture of bold fiscal conservatism is simply not compatible with timid evasions on Medicare reform. The combination may be politically convenient, but it is substantively incoherent. And it's not just Mrs. Bachmann who has done this—most of the GOP presidential candidates have as well. Virtually every speech they give is laced with promises to tame our deficit and debt, to scale back the size, scope, reach and cost of government. Yet they have little to say when it comes to fixing the fundamental structure of our health entitlements. They want to will the ends but not the means to those ends. And that just won't do.

There are of course serious political dangers in tackling entitlements. But a responsible governing party needs to confront not only our easiest problems but also our most important ones. The tea party movement has been indispensable in forcing Republicans (and through them forcing Washington) to start reversing the rampant spending of the last few decades. It can now do the same with respect to the far greater spending explosion looming over the next few decades—holding politicians, including presidential candidates, to a high and principled standard when it comes to addressing our fiscal problems. It can educate voters about our entitlement crisis and demand that office holders and candidates explain what they will do to fix the problem, and especially to reform Medicare.

If the tea party movement does this, it will take its place among the great, constructive political movements in U.S. history. If it doesn't, it will be judged to have been fundamentally unserious when it came to reining in the spending Leviathan.

Mr. Levin is editor of National Affairs and a fellow at the Ethics and Public Policy Center. Mr. Wehner is a senior fellow at the center and a managing director of e21.