When conservatives try to convince uninsured young people to opt out of Obamacare, they have one huge ulterior motive.
It's not that they think it's wise for people -- even supposedly invincible youth -- to be without health insurance on the merits. It's that they see a mass youth revolt against the mandate and out-of-pocket insurance cost as their last hope for breaking the Affordable Care Act.
As we've detailed here a few times, the core of the law -- the part that will guarantee that uninsured people can purchase affordable coverage -- won't work right if the risk pool is skewed sick and old. Thus, a major effort is underway by the White House to ensure that about a third of all new beneficiaries are under 35 years old.
But that also explains the counter-effort -- spearheaded by conservative groups like Americans for Prosperity -- to convince the same group of people to Just Say No to Obamacare.
They're correct to identify the law's reliance on a critical mass of young enrollees as a real vulnerability. But their effort to exploit this vulnerability at the expense first of young people, and then by extension of everyone else who plans to enter the insurance exchanges in the next several months, is morally repugnant -- and in many cases, symptomatic of hypocritical cowardice.
I'm no fan of the GOP's determination to leave all of the ACA's technical flaws in place with the explicit goal of decreasing the law's popular support, and thus increasing the likelihood that it collapses under its own weight or becomes vulnerable to repeal. But using tremendous resources to persuade unsure young people to leave their health and financial well-being at risk is categorically different.
These conservatives are effectively admitting that the law will likely work if the people they're targeting ignore them, and that their attempts to repeal the law through democratic channels will never work. So they're taking a two-pronged approach: First, they appeal to young people's near term financial interests in the hope that they'll leave themselves vulnerable longer-term to an eventual illness or accident (other true facts include that you can save money on housing by being homeless, food by not eating any of it, clothes by walking around nude all the time); then they argue that skipping Obamacare serves the greater good of undermining the law.
But perhaps in their haste and zeal these conservatives never stopped to consider the consequences of their arguments, whether or not they have any short- or long-term impact on the viability of Obamacare.
According to the National Cancer Institute, the incidence of cancer among 25-29-year-olds is 1 in 2,000. Among 30-34-year-olds it's 1 in 1,250. The death rates for the same age brackets are about 1 in 15,000 and 1 in 9,000, respectively. If conservatives successfully persuade 10,000 young people to skip Obamacare, a few are likely to end up financially ruined and/or dead. And that's not counting myriad other ailments and tragedies that might unexpectedly befall them before they age out of "invincibility" and begin counting on the next generation of young people to cross-subsidize their coverage.
Call it the real Obamacare death panel.
"I'm almost aghast that any group would take that perspective," said Clint Murphy, a GOP aide turned Georgia realtor who was diagnosed with testicular cancer in 2000 at the age of 25. "It's not the attitude people I supported over the years had about government."
Murphy told his story, and discussed his discomfort with GOP opposition tactics, with the Atlanta Journal Constitution this weekend. He spoke to me Monday specifically about the "skip Obamacare" campaigns, and the potential consequences for the young people who are ultimately persuaded by them.
Fortunately, Murphy had insurance at the time of his illness. One thing that unites most, if not all, of the conservatives organizing and promoting the skip Obamacare campaigns is that they do, too. But it defies credulity that they'd skip the ACA's benefits themselves if their coverage lapsed, or will encourage their own young-adult children to stay uninsured when enrollment begins in October.
In that sense, they're exhibiting the same kind of moral cowardice that marked Vietnam War advocates who set aside their convictions and found themselves or their children safe passage to Canada: Undermining Obamacare is a civic duty, they think, unless their family happens to need it.
"It's unconscionable to me," Murphy said. "Are they really so obsessed with being against Barack Obama that they would encourage people to absolutely go without health insurance when given the opportunity to buy it? That makes absolutely no sense. None. There's no logic behind it, they should be ashamed of themselves."