November 21, 2013 in Opinion

Dana Milbank: Fear tactics may drive up health care costs

Dana Milbank
 

House Republican leaders could not have been more blatant in their attempts to frighten Americans if they had emerged from their weekly meeting wearing hockey masks and carrying chain saws.

“The American people are very, very worried,” Majority Leader Eric Cantor of Virginia proclaimed to the cameras after emerging from Republicans’ gathering Tuesday morning. “Moms and dads are worried that they’re going to lose their health care plan. … Individuals who are going onto the HealthCare.gov website are beginning to fear that perhaps their identity will be stolen.”

Of course Americans are worried and fearful. It was all I could do to keep my knees from knocking as I stood in an alcove in the Capitol basement, listening to Republican leaders describe all the terrible things that Obamacare has produced:

“Cancellation notices. … Broken promises. … Premiums are going right through the roof,” said House Speaker John Boehner of Ohio.

“You won’t be able to keep your doctor,” warned Majority Whip Kevin McCarthy of California.

And the caucus chairwoman, Cathy McMorris Rodgers of Washington, spoke of “helpless” constituents put “on the casualty list” and doubtful about getting medical care.

Trembling with fear, I walked through an underground tunnel from the Capitol to the Rayburn House Office Building, where another hearing on Obamacare was just getting underway.

“Right now,” Rep. Tim Murphy, R-Pa., who held the gavel, announced from the dais, “HealthCare.gov screams to those who are trying to break into the system: If you like my health care info, maybe you can steal it.”

Rep. Michael Burgess, R-Texas, added his considered opinion that, “rather than getting better, it may be getting worse” for the Obamacare rollout. “These initial problems break the surface of the deeper issues that lie ahead for not just the law but for the American people that must live under the law.”

Let’s hope the new health care plans have generous coverage for anti-anxiety medication.

The Republicans’ scary-movie strategy has some logic to it: If they can frighten young and healthy people from joining the health care exchanges, the exchanges will become expensive and unmanageable. This is sabotage, plain and simple – much like the refusal by red-state governors to participate in setting up the exchanges in the first place. But those sabotaging the new law should be careful what they wish for: Instead of killing the law, they are likely to make it more expensive to taxpayers. Their efforts could have the effect of turning Obamacare, which relies on private insurance and the free market, into just the sort of big-government entitlement Republicans were worried about in the first place.

If they succeed in scaring people away, the ones who join exchanges are likely to be older and sicker, making the insurance pool costlier to insurers. As Larry Levitt, a senior vice president of the Kaiser Family Foundation, explained to me, if costs are more than 3 percent higher than anticipated in the first few years of Obamacare, the federal government will have to pick up at least half of the additional expense.

If the exchanges continued to attract only the elderly and the sick in future years, premiums would rise and the only people likely to remain in the program will be those who qualify for the federal subsidies, which would increase sharply because individual contributions are limited to a percentage of the recipient’s income.

“The more successful opponents are at discouraging young and healthy people from enrolling, the bigger share of the cost the federal government will end up covering,” Levitt said. “The implication of encouraging young and healthy people to sit on the sidelines is that costs are shifted to the federal government.”

Republicans, of course, hope their sabotage will lead to the program’s repeal. But the exchanges are unlikely to fail; they are working more or less as intended in states that have supported the launch. The likelier outcome: Republicans will achieve nothing but an increase in the federal deficit, about which they profess to be concerned.

At the end of his spooky session with the press, Boehner was asked if he had plans to pass any health care legislation before the end of the year. He had nothing to propose other than the ongoing effort to elevate the fear factor. “No decisions on what it is that we may or may not do,” he said. But one thing is certain: “Our members are going to continue to collect stories.”

It’s a safe bet they will be selected from the horror genre.

Dana Milbank is a columnist for the Washington Post. Follow Dana Milbank on Twitter, @Milbank.


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