Sahil Kapur at TPM has a fine report today looking at how hatred of Obamacare has become such an ideé fixe in the Republican party that even the mildest possible concession—or failing to be sufficiently enraged in one’s condemnation of the law—has become grounds for a harsh primary attacks:

[One] victim is Sen. Mike Enzi (R-WY), who is fending off a primary challenge from Liz Cheney in 2014. An outside group called Americans for Job Security last week released an ad attacking him for praising the concept of insurance market exchanges — the vehicle for Obamacare, which was modeled on conservative principles — early in 2010. “These exchanges can be good,” Enzi said then, in a clip that the ad repeatedly plays.

“Good?” says the narrator in the 30-second ad. “Wyoming’s Obamacare exchange has the most expensive premiums in the country, and it’s marred by glitches. Tell Mike Enzi we don’t like these liberal, big government Obamacare exchanges.” The attack forced Enzi’s campaign to defend him by touting his efforts to “stop the worst parts of the law.”

…[AEI scholar Norman] Ornstein summed it up this way: “These are the talking points and if you don’t apply them, then you’re a traitor.” He confessed that he’s “never seen anything like that before. I mean, you can certainly find party litmus tests…But this has been taken to a level that I think is almost bizarre.”

The comparison everyone is making is to McCarthyism in the 1950s, but there are some notable differences. The McCarthy era was all about nutty right-wing witch hunts, heavily laden with antisemitism and paranoia about fluoridated water and vaccines, led by an alcoholic, power-mad bully. But more to the point, red paranoia was widely shared throughout society. Both parties were fervently anti-communist. There really was a Soviet Union, which really did have nuclear missiles and an extensive spying apparatus. There really was terrible anxiety about another world war.

Whereas the Republican Obamacare purity rituals are restricted to their party only, and from the outside are frankly bizarre. They treat a moderate, incremental reform of the healthcare sector, based largely on Republican ideas, like New Lefters treated Nixon’s bombing of Cambodia. I’m reminded more of Maoist “struggle sessions,” where enemies of the party were publicly beaten and forced to confess their ideological crimes, real or imagined.

But in any case, the historical analogies one reaches for to describe this trend are telling in themselves. The GOP culture is quite ill, and shows little sign of improving anytime soon.

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Follow Ryan on Twitter @ryanlcooper. Ryan Cooper is a national correspondent at The Week. His work has appeared in The Washington Post, The New Republic, and The Nation.