NEWS ANALYSIS : GOP’s Lid on Medicare Proposals May Backfire : Congress: Secrecy surrounding Republican reforms is reminiscent of Democrats’ doomed efforts last year. Support of wary public for cost cuts needed.

It is a health care crisis of the first order and requires nothing short of a massive government effort to save the system. Apocalyptic language is used to describe the problems but those working to fix them hold their solutions close to the vest, relying on a small cadre of experts working feverishly in virtual secrecy. Their intentions will be shared with the public only after details become final.

A description of how President and First Lady Hillary Rodham Clinton went about developing their ill-fated health reform agenda?

Certainly.

But with an eerie sense of deja vu , a very similar process also is being embraced by congressional Republicans as they plot their own, high-stakes drive to revamp Medicare.

And just as the controversial process itself helped doom Clinton’s sweeping agenda last year, the current GOP tactic also could backfire if it fails to win the support of a wary public, especially the nation’s powerful senior citizens.

Such a development would have far-reaching consequences:

Failure to control Medicare costs would in all likelihood kill any chance of the GOP making good on its promise to deliver a balanced budget in seven years. And Republicans might well pay a high price at the polls in 1996--just as Democrats did in 1994, in part, because the promised Clinton health reform initiative collapsed.

Already, Democrats are mounting an all-out assault on GOP intentions to wring $270 billion in savings from Medicare by 2002, saying that seniors inevitably would have to pay more and get less. They plan to escalate such rhetoric in the days ahead as Medicare’s 30th anniversary on Sunday approaches.

But Republicans, by developing their specific plans in secret, are exposing themselves to attack not only on substance but also on process--a potentially lethal 1-2 punch, as the President and the First Lady discovered last year.

Republicans say that they are going about the task of developing complex legislation in a time-honored Capitol Hill manner--with members and staffs working behind closed doors, consulting closely with key interest groups.

“These are members of Congress--they are accountable,” said one senior GOP House aide. “All this stuff about secrecy--it’s a lot of smoke.”

Rep. Bill Thomas (R-Bakersfield), chairman of the House Ways and Means subcommittee on health, added: “And my wife isn’t running the show.”

His pointed reference was to Mrs. Clinton, who chaired the 500-member White House task force on health care reform, which produced a 1,342-page reform agenda that was so complex and controversial that it was dead by the time it reached Congress.

With Republicans now running both the House and Senate, it’s the Democrats who are on the outside looking in. And they clearly do not like the direction in which things are headed on Medicare.

“They are making a big mistake designing radical changes that affect millions of people in secret,” said Rep. Henry A. Waxman (D-Los Angeles).

It is an open secret that Republicans will wait until after Labor Day to unveil their detailed proposals, which they say will not only help balance the budget but also prevent the health insurance program for seniors from going bankrupt by 2002 as predicted by Medicare’s own overseers.

By waiting until September--and thus incorporating the reforms into the annual budget process--Republicans hope to ram through the changes before Democrats can mount sufficient opposition. (A new federal budget must be approved by Oct. 1, the beginning of the 1996 fiscal year.)

A key House Republican aide, who asked for anonymity, conceded as much in an interview. The GOP staff member said that by keeping details under wraps--indeed the specifics are still being developed--the GOP has been able to avoid what he called the fatal “pummeling” that Clinton’s plan encountered from virtually every interest group in Washington.

The aide also noted that, during the health reform drive of 1993-94, members of Congress “were hit by multiple recesses,” during which constituents at home had numerous opportunities to express their anxiety, if not flat-out opposition, to comprehensive reform.

Republicans do not intend to let that happen to them and so far that strategy seems to be working, he said.

“I don’t think it’s an accident that we have yet to see one detail,” acknowledged Senate Minority Leader Tom Daschle (D-S.D.).

GOP leaders insist any delays in releasing specifics are just, in Thomas’ words, “a function of how much dang work is involved.”

Rep. John A. Boehner (R-Ohio), chairman of the House GOP Conference, added: “Right now, there are no details. There are just a lot of options being considered. After Labor Day, it will all start coming together.”

Republicans say that they can achieve $270 billion in savings--and prevent Medicare’s hospital fund from going into bankruptcy by 2002--by slowing the program’s annual growth rate from the current 10% to 6.4%.

The broad outlines of how they would change Medicare are hardly unknown, although the precise details remain to be seen.

For instance, the Republicans clearly will offer financial incentives to move seniors from fee-for-service plans into less expensive managed care networks. But just how much more seniors may have to pay to retain the fee-for-service option is unclear.

Republicans maintain that their plans not only will preserve the long-term fiscal integrity of Medicare but also give seniors greater choice and flexibility. But skeptics say that the savings sought by the GOP cannot be attained without deep cuts in service and greater out-of-pocket costs for the nation’s 35 million seniors.

Amid the vacuum of hard data, Democrats are just beginning to focus on what they view as the new, self-inflicted chink in the GOP legislative armor: the silence surrounding the plans.

“What we haven’t heard is a specific plan as to how these Medicare cuts will be made,” said Sen. Bob Graham (D-Fla.). He demanded of the GOP: “Put on the table the specifics.”

Such growing Democratic frustration also was expressed on Monday by House Minority Leader Richard A. Gephardt (D-Mo.). Somewhat ruefully, he conceded: “The Republicans have been skillful in keeping away from them [seniors and the public] what is really being proposed here.”

But Thomas dismissed such talk as rhetoric. “They are just being narrowly partisan” while trying to gain political advantage, he said.