Analysis: Democrats Hit Reset on Health Care


WASHINGTON (AP) – Weary of getting pounded over the new health care law, Democrats are hitting the reset button for next year's elections.

They're changing the subject to Medicare.

Divisions over the health care overhaul appear irreconcilable, but polls show Americans of all political leanings feel protective of Medicare.

President Barack Obama's latest debt plan for Congress, issued last week, signals he's on board with the shift.

Gone is a proposed increase in the Medicare eligibility age the White House put on put on the table in earlier discussions with House Speaker John Boehner. Instead, Obama threatened to veto Medicare beneficiary cuts unless Congress also raises taxes on the rich.

Publicly, Republicans say bring it on. While they were nervous over the skeptical public reaction to their Medicare privatization plan this spring, they now insist they can hold their own in a debate. After all, Obama himself acknowledges that Medicare is headed toward insolvency.

It's hard to see anything but the economy mattering to voters in 2012, but Medicare may be different.

It's perennially a top issue for older voters, who turn out more regularly than younger people and are up for grabs.

Voters 60 and older have swung between Republican and Democratic candidates over the last six House elections, according to Robert Blendon, a professor at the Harvard School of Public Health who tracks public opinion on health care.

"Democrats are not going to move a lot of people by focusing on the (health care law) but the Medicare issue could swing a group that has been voting Republican," Blendon said.

In 2010, Democrats paid the price for using $500 billion in Medicare cuts to finance coverage for the uninsured under Obama's health care overhaul. Older voters saw tapping Medicare as a threat, and they helped deliver the House to Republicans.

Democrats want to return the favor in 2012, and they believe the House-passed GOP budget gives them a way.

The plan by Budget Chairman Paul Ryan, R-Wis., called for replacing Medicare for future retirees with a voucher-like payment.

Current retirees – about 48 million beneficiaries – could still keep Medicare largely the way it is now. But people now 54 and younger would go into a new program when they become eligible for Medicare. They would get a government payment to pick from a range of regulated private insurance plans.

The Congressional Budget Office found that within 20 years, 65-year-olds would on average be on the hook for more than two-thirds of their health care costs, almost a mirror-image of the financial split between current beneficiaries and Medicare.

As expected, the House plan went nowhere in the Democratic-led Senate.

No harm, no foul?

Not if Democrats have their way. Their message to seniors: The Ryan budget will become reality if the GOP wins the White House and full control of Congress.

"This is not a theoretical issue, it is a place where Republicans have taken votes that are very unpopular," Democratic pollster Celinda Lake said. "It would be foolish of Democrats to waffle on this issue."

Republicans say they're not backing down. According to the top domestic policy expert for 2008 GOP presidential candidate John McCain, his party was right to take on Medicare, but the timing was off.

"The lesson of the House budget was that it's premature to start offering solutions when you haven't educated the American people on why you can't sustain the status quo," said economist Douglas Holtz-Eakin, now president of the American Action Forum, a conservative public policy center.

Holtz-Eakin doesn't think Republicans harmed themselves. Medicare's long-term financial problems are well known. If Obama and the Democrats are going to criticize Ryan's solution, they have to spell out a fix of their own. And those fixes almost surely would require painful cuts for beneficiaries.

The top GOP presidential candidates have jousted with one another over who would be quicker and more effective in overturning Obama's health care law. Less clear is what they would do about Medicare.

Texas Gov. Rick Perry has been criticized for comparing Social Security to a Ponzi scheme. His stance on Medicare could prove just as controversial. A law he signed this year calls for the federal government to turn over Medicare and Medicaid to groups of states.

Former Massachusetts Gov. Mitt Romney praises the House GOP budget as an honest attempt to save Medicare. He says his own plan will differ but share the same objectives.

There is a wild card.

The Supreme Court now appears more likely to hear arguments on the constitutionality of the health care law in time to deliver a decision before voters go to the polls next year. Lower courts are split, and whichever way the top court rules, it will send shock waves through the political contests.

EDITOR'S NOTE – Ricardo Alonso-Zaldivar covers health care issues for The Associated Press.

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