Dems Face Senior Angst on Health Care

Democrats have a senior citizen problem

By Chris Frates and Victoria McGrane
|  Wednesday, Aug 12, 2009  |  Updated 4:30 AM PDT
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Seniors vote in larger numbers than any other demographic. So Obama can't afford not to win them over.

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Democrats have a senior citizen problem.

Frustrated older Americans are packing the town halls on health care. They are incredibly passionate about their Medicare benefits. Polls show senior citizens largely disapprove of health care reform ideas so far.

And of course, they vote — in larger numbers than any other demographic.

But so far, Democrats have focused much of their health care sales pitch on middle-class Americans and the uninsured — a slight that has been noticed by senior citizens, who hold great influence with members of Congress.

At his Tuesday town hall event in New Hampshire, President Barack Obama made a point to reach out to seniors, noting the low support in polls for his health care proposals.

“We are not talking about cutting Medicare benefits,” Obama said, trying to assuage the audience.

But Obama is talking about finding hundreds of billions in savings from Medicare — cuts supporters say will trim fat from the program — including slashing $156 billion in subsidies to Medicare Advantage, a privately-administered Medicare program. 

“Seniors are one of the most attentive and engaged constituencies, especially on health care issues, and we’ve seen that in the Medicare Advantage programs,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans.

A July 31 Gallup poll found that just 20 percent of Americans aged 65 and older believe health care reform would improve their own situation, noticeably lower than the 27 percent of 18- to 49-year olds and 26 percent of 50 to 64-year olds who say the same.

The senior citizen problem could pose a serious problem for the 2010 election cycle.

Older Americans turn out in much higher numbers than other age groups during midterm elections. In 2006, the 55-and-older age group still had the highest voting rate of any age group, at 63 percent, even though younger voters turned out in record numbers for a midterm, according to Census data. Half of all votes cast in the 2006 midterms were from voters aged 50 or older, according to AARP. And one out of four were AARP members.

But voting statistics only tell part of the story. Look at the faces at these chaotic congressional town hall events across the country. They are the faces of older Americans who paid into Medicare most of their working lives and are now enjoying the health care benefits they believe they’ve earned for their senior years.

They exhibit a vocal distrust of the government taking a larger role in health care — despite the fact that the very popular Medicare program is run by the government.

Obama’s problem with senior citizens isn’t new. Polls showed that John McCain bested Obama among seniors, even though Obama made gains across almost every other demographic.

Some experts say the real problem is that Democrats haven’t done enough to address seniors’ concerns to date, allowing the perception to grow that seniors will lose under reform.

Proponents haven’t talked enough about how health reform will benefit seniors, said Jeff Blum of USAction, a progressive grass-roots organization pushing health reform.

“We were vulnerable, and that was a mistake on the part of us promoting health reform,” Blum said. “The opposition found an opportunity and ran with it.”

Critics say the proposed $380-billion Medicare cuts in the House bill — including cuts to the privately administered Medicare Advantage program — will lead to long waits for care, doctors dropping patients and doctors deciding if their older patients “are worth the cost,” as one TV and Web ad from the 60 Plus Association warned.

 

“Why would you want to cannibalize Medicare in order to create a new plan? Why wouldn’t we fix Medicare first? I think those are the concerns that are being raised,” Sen. John Cornyn (R-Texas), chairman of the National Republican Senatorial Committee, said during a conference call Tuesday.

The proposed cuts to Medicare Advantage are real, but Democrats are also fighting full-blown myths that have gained traction, attacks claiming that reform would create government "death panels" authorizing euthanasia.

The rhetoric is designed to rattle seniors already nervous about health care because they pay a higher percentage of their income for health care than younger Americans and face rising costs on fixed incomes, said Jim Dau, a spokesman for AARP.

“Some are simply trying to derail health care reform by targeting seniors, by scaring them making them frankly more dubious, more nervous,” said Dau.

On Tuesday, Obama tried to debunk some of the myths himself.

He dismissed rhetoric about “death panels” that would “pull the plug on grandma because we've decided that … it’s too expensive to let her live anymore.”

“I am not in favor of that,” Obama said, explaining that the actual bill language would merely green-light Medicare to reimburse doctors for counseling patients who choose to receive counseling on end of life options, like hospice care. Obama even mentioned that this type of provision is backed by Republican Sen. Johnny Isakson of Georgia.

As for Medicare cuts, Obama repeatedly assured seniors that their benefits are not on the line. The bills under consideration are intended to help more seniors on Medicare afford drugs and provide some people who are not yet Medicare eligible with subsidies to pay for private insurance. The bill also eliminates co-pays for preventative care like cancer screenings and makes generic drugs more affordable, supporters say.

Obama explained that the proposed cuts aim to make Medicare more efficient, such as eliminating the $156 billion given to private companies for Medicare Advantage plans, which the president called a “giveaway.”

“Seniors who are listening here, this does not affect your benefits,” Obama said of the proposed cuts. “This is not money going to you to pay for your benefits; this is money that is subsidizing folks who don't need it.”

Labor unions are also trying to sell seniors on the plans. Dennis Rivera, the health care point man for the Service Employees International Union on health care, said the union is taking its message directly to seniors through conference calls and house visits because town halls have become so easy to disrupt.

“If we do not reorganize the health care system, we’re going to run out of money and all the programs are going to collapse and we are going to have dramatic problems down the road,” Rivera said.

It’s a powerful message, if Democrats and their allies can get it to stick.

“The key to getting seniors on board is convincing them that steps that will reduce health care costs in health reform will also ensure the solvency of Medicare in the long run. That’s what flips them from anxious to supportive,” said Drew Altman, president and CEO of the Kaiser Family Foundation.

But the legislation’s critics continue their own campaign for seniors’ hearts and minds.

America’s Health Insurance Plans, a trade group for insurers, contends that slashing $156 billion from private Medicare Advantage plans would have a significant impact on seniors.

“Seniors have been told that their coverage is not going to change and if they like their coverage they can keep it,” Zirkelbach said. “The fact of the matter is that if these cuts to Medicare Advantage go through, seniors are going to face increased premiums, reduced benefits and, in some parts of the country, they’re going to lose access to their Medicare Advantage plan all together.”

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