In his influential “The Road to Serfdom,” the economist Friedrich Hayek argued that the state should “assist the individual in providing for those common hazards of life” — among them poor health and unexpected accidents. And in his illuminating analysis of Ronald Reagan’s legacy, “The Working Class Republican: Ronald Reagan and the Return of Blue-Collar Conservatism,” the political scientist Henry Olsen uncovered some timely insights. “Any person in the United States,” Reagan said in 1961, “who requires medical attention and cannot provide it for himself should have it provided for him.”

These sentiments conflict with recent iterations of Republican health care reform. The “full repeal” bill is nothing of the sort — it preserves the regulatory structure of Obamacare, but withdraws its supports for the poor. The House version of replacement would transfer many from Medicaid to the private market, but it doesn’t ensure that those transferred can meaningfully purchase care in that market. The Senate bill offers a bit more to the needy, but still leaves many unable to pay for basic services. In the rosiest projections of each version, millions will be unable to pay for basic health care. This wasn’t acceptable to Reagan in 1961, and it shouldn’t be acceptable to his political heirs.

— J. D. Vance