Democratic Stealth Care

With the nation preoccupied by the financial crisis, Democrats have been quietly working to nationalize health care.

Tom Daschle is still waiting to be confirmed as secretary of health and human services, not that he's in any rush. Democrats are already enacting his and Barack Obama's agenda of government-run health care -- entirely on the QT.

This was the real accomplishment of this week's House vote for the $819 billion "stimulus," and is the overriding theme of Congress's first month. With the nation occupied with the financial crisis, and with that crisis providing cover, Democrats have been passing provision after provision to nationalize health care.

If Democrats learned anything from the HillaryCare defeat, it was the danger of admitting to their wish to federalize the health market. Since returning to power, they've pursued a new strategy: to stealthily and incrementally expand government control. "What no one is paying attention to in the [stimulus]," says Wisconsin Rep. Paul Ryan, "is that Democrats are making a big grab at the health-care sector."

It began one week after the swearing-in, when Nancy Pelosi whipped through a big expansion of the State Children's Health Insurance Program. The Schip bill was Democrats' first stab at stealth expansion, unveiled in 2007, though vetoed by George W. Bush.

Initially designed for children of working-poor families, this new Super-Schip will be double in size, and even kids whose parents make $65,000 a year will be eligible. The program will also now cover pregnant women and automatically enroll their new arrivals. The Congressional Budget Office estimates 2.4 million individuals will drop their private coverage for the public program.

Still, it's the "stimulus" that has proven the real gift horse -- a behemoth that has allowed Democrats to speed up the takeover of health care under cover of an economic crisis. They initially claimed, for instance, the "stimulus" would provide Medicaid money to states struggling to pay existing bills. What in fact it does is dramatically expand the number of Americans who qualify for Medicaid.

Under "stimulus," Medicaid is now on offer not to just poor Americans, but Americans who have lost their jobs. And not just Americans who have lost their jobs, but their spouses and their children. And not Americans who recently lost their jobs, but those who lost jobs, say, early last year. And not just Americans who already lost their jobs, but those who will lose their jobs up to 2011. The federal government is graciously footing the whole bill. The legislation also forbids states to apply income tests in most cases.

House Democrat Henry Waxman was so thrilled by this blowout, it was left to Republicans to remind him that the very banking millionaires he dragged to the Hill last year for a grilling would now qualify for government aid. His response? A GOP proposal to limit subsidies to Americans with incomes under $1 million was accepted during markup, but had disappeared by final passage. In this new health-care nirvana, even the rich are welcome. CBO estimates? An additional 1.2 million on the federal Medicaid dime in 2009.

The "stimulus" also hijacks Cobra, a program that lets the unemployed retain access to their former company health benefits -- usually for about 18 months. The new stimulus permits any former employee over the age of 55 to keep using Cobra right up until they qualify for Medicare at age 65. And here's the kicker: Whereas employees were previously responsible for paying their health premiums while on Cobra, now the feds will pay 65%. CBO estimates? Seven million Americans will have the feds mostly pay their insurance bills in 2009.

The bill even takes a whack at the private market. Under the guise of money for "health technology," the legislation makes the government the national coordinator for electronic health records, able to certify what platforms are acceptable. This is an attempt to squelch a growing private market that is competing to improve transparency and let consumers compare providers and costs. In liberal-world, only government should be publishing (and setting) health-care prices.

Add it up, and Democrats may move 10 million more Americans under the federal health umbrella -- in just four weeks! Good luck ever cutting off that money. Meanwhile, the Democratic majority is gearing up for a Medicare fight, where it may broach plans to lower the eligibility age to 55. Whatever costs accrue, they'll pay for by slashing the private Medicare Advantage option.

Mr. Obama will, of course, offer his health-care reform at some point. But he's clearly happy to get what he can, when he can. Despite talk of entitlement reform, he's voiced no disapproval of this vast new health-care grab. And don't forget he chose Mr. Daschle, who appreciates stealth himself. In his 2008 book outlining his health-care reform, he offers his party two pieces of political advice: Move fast, before there can be a public debate, and write as vague a bill as possible.

Guiding all of this is the left's hope that by the time America wakes up to what's happening, it'll be too late. Democrats might be on to something.

Write to kim@wsj.com
source: online.wsj.com