Matt Miller: The GOP’s Obamacare youth hoax

August 21, 2013

It’s rare for a political party to trumpet a position that unintentionally reveals its myopia, incoherence and expediency. Yet such is the trifecta with the Republican campaign to call attention to Obamacare’s young “victims.”

Republicans are obsessed with the supposed injustice being done to some healthy young people who will effectively subsidize their sicker elders when Obamacare’s individual mandate takes effect.

The crusaders are nothing if not convinced of the righteousness of their cause. “The whole scheme is enlisting young adults to overpay, so other people can have subsidies,” Dean Clancy, a vice president at FreedomWorks, told my Post colleague Sarah Kliff. “That unfairness reminded us of the military draft.”

Conservatives are therefore urging young Americans to resist. “I’m burning my Obamacare draft card,” runs one theatrical riff from a group called Young Americans for Liberty, “because I’m too busy paying student loans to pay for somebody else’s health insurance.” Republican policy advisors have urged the party to make such child abuse a big part of their anti-Obamacare message.

Sounds like a sexy argument, except for one thing. Republicans seem to have forgotten where most people aged 19 to 34 get health coverage: from their employer. And at virtually every company, young people pay the same premiums as employees who are much older than they are and who get more expensively sick than they do. In other words, the evil cross-subsidy Obamacare’s foes are storming the barricades to roll back already exists, at vastly larger scale, in corporate America.

These youngsters are already in chains! They’ve been put there by the private sector! And, inexplicably, young employees have entered this servitude of their own volition. (To extend the GOP’s draft analogy, it turns out there’s a voluntary army of health care masochists from sea to shining sea.)

How could injustice on this scale escape the GOP’s searing moral scrutiny?

After all, the president is only hoping thatabout 2.7 million young people will purchase coverage in the new exchanges. But 20 million Americans between the ages of 19 and 34 get coverage from their employer right now, according to an analysis by the Kaiser Family Foundation.

If you’re keeping score, that makes employer-based health care’s cross-subsidy about eight times more evil than Obamacare’s.

How does it work? Compare a typical, strapping young employee of 28 to her broken- down 58-year-old colleague. These two employees have very different annual health expenses. Yet under the nefarious plot known as “group health insurance,” they basically pay the same premiums. It turns out every big company in America is essentially a socialized health care republic, in which the young subsidize the old, and the healthy subsidize the sick — all of whom pay the same premiums for the same plans.

Similar dynamics explain why, in the federal health-care plan, spry 42-year-olds like Marco Rubio and Ted Cruz subsidize 79-year-old geezers like Chuck Grassley and Orrin Hatch.

Maybe that’s why Cruz always seems so angry.

The U.S. spends more than other countries on health care. (Ann Telnaes/The Washington Post)

Of course, most people in civilized nations know and accept that this is how insurance works. But Republicans nowadays aren’t like most people in civilized nations. They think Obamacare is a form of injustice akin to slavery. Which makes employer-provided health care slavery on steroids. Where’s the outrage? If conservatives were consistent and principled, they would devote far more time and effort to liberating 20 million young Americans from the socialism baked into employer-based insurance and look past the Obamacare exchanges as a puny sideshow.

But, alas, conservatives are not consistent and principled, save for their consistent determination to hurt the president politically.

It would be better if all those smart GOP thinkers devoted their talent and energy to the question of how they would expand coverage to the 50 million uninsured — but to raise that question is to enter the policy cul de sac in all its delicious irony.

Because the answer to that question is RomneyObamacare, the only sound way (as Republicans rightly taught us) that a country can move toward universal coverage using private health plans. The GOP could offer a tweaked version with slightly fewer regulations. Or structure it to offer universal catastrophic coverage to save money. But if Republicans were serious, they’d offer the same basic reform architecture.

So Republicans choose not to be serious. And it shows.

In the end, the GOP’s Obamacare youth hoax shows how silly a party can look when a political focus on one corner of a policy leads it to latch on to “insights” that utterly miss the big picture. It’s a reminder, if we needed another, of how close the connection can be between ideology and idiocy.

Read more from Matt Miller’s archive or follow him on Twitter.

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