Challenged on Medicare, G.O.P. Loses Ground
ORLANDO, Fla. — Maria Rubin is one of the coveted independent voters in this swing state — so independent that she will not say whether she is voting for President Obama or Mitt Romney. She does share her age (63) and, more quickly, her opinion on Medicare: “I’m not in favor of changing it, or eliminating it.”
Her attitude speaks directly to one of the biggest challenges facing the Republican ticket this year: countering the Democrats’ longstanding advantage as the party more trusted to deal with Medicare.
In the 2010 Congressional races, successful Republicans believed that they had finally found a way to do that, by linking the program’s future to Mr. Obama’s unpopular health insurance overhaul and accusing Democrats of cutting Medicare to pay for it. This summer Mr. Romney resumed the offensive, eventually joined by his running mate, Representative Paul D. Ryan.
Initially, polls suggested that the Republican strategy was working. Democrats fretted that Mr. Romney would win the retiree-heavy Florida and increase his support nationwide among older voters, who lean Republican anyway. David Winston, a Republican pollster, wrote a month ago of “a structural shift in the issue” that left the parties in “a dead heat” and Mr. Obama unable to mount an effective response.
But in recent weeks Mr. Obama and his campaign have hit back hard, and enlisted former President Bill Clinton as well, to make the case that the Romney-Ryan approach to Medicare would leave older Americans vulnerable to rising health care costs. Now their counterattack seems to be paying off.
The latest New York Times/CBS News poll, conducted over the last week, found that Mr. Obama held an advantage over Mr. Romney on the question of who would do a better job of handling Medicare. That is consistent with other recent polls and is a shift from just last month, before the parties’ national conventions, when the two men were statistically tied on the issue.
At the heart of the conflict is the proposal backed by Mr. Romney and Mr. Ryan to change the way Medicare works in an effort to drive down health care costs and keep the program solvent as the population ages. Under their plan, retirees would get a fixed annual payment from the government that they could use to buy traditional Medicare coverage or a private health insurance policy. Supporters say the change would hold expenses down by introducing more competition into the system.
Critics say the fixed payments might not keep up with rising insurance costs and could leave older Americans facing cutbacks in care or paying more out of their own pockets. Democrats contend that Medicare’s rising costs can be held down within the existing system.
In the Times/CBS poll, more than three-quarters of voters favored keeping Medicare the way it is rather than switching to a system like the one backed by Mr. Romney and Mr. Ryan. From the White House on down, Democrats are calling the Republican approach a “voucher” plan, suggesting that it borders on privatizing the system; Republicans prefer the term “premium support.”
As that poll result reflects, the Democratic message is resonating with voters like Ms. Rubin, who joined other independent and Democratic voters last week to hear Mr. Clinton make his pitch for Mr. Obama’s re-election in the packed ballroom of a resort hotel here.
“I don’t trust anybody who says ‘voucher,’ ” said Gary Fieldsend, 62, a recently retired employee at a Navy shipyard who was vacationing here with his wife Pamela, 64. The Fieldsends, from New Hampshire, another swing state, describe themselves as Democratic-leaning independents, and both said they were voting for Mr. Obama.
“I think it’s very important that we keep it under control on cost,” Mr. Fieldsend said. “But you have to cover people. Even if you’ve got millions of baby boomers, you’ve got to find a way to do it.”
Given the political risks, Mr. Ryan, the House Budget Committee chairman, this year changed his 2011 budget passed by the House from a plan that would have made private insurance the only option available to beneficiaries to one that offered a choice between traditional Medicare or private coverage.
Democrats focused heavily on Medicare at their convention and have kept up the assault since then. Last weekend in Kissimmee, Fla., Mr. Obama spoke of Republican plans for “voucherizing Medicare,” while Vice President Joseph R. Biden Jr. says Republicans will institute “vouchercare.” Mr. Obama will address AARP’s annual convention this week by satellite; Mr. Ryan will appear in person.
And soon, strategists say, Democrats will buttress their Medicare message by charging that a Romney-Ryan administration could also seek to alter Social Security, the other popular entitlement program. They will point out Mr. Ryan’s support in 2005 for President George W. Bush’s proposal to allow workers to divert Social Security payroll taxes into private accounts, a plan that flopped even though Republicans controlled both houses of Congress.
It is a paradox of recent politics that despite Democrats’ usual advantage on Medicare, voters 65 and older are the age group least supportive of Mr. Obama and his party. His challenge is to depress Mr. Romney’s support among older voters by raising doubts about Republicans on Medicare.
“It’s pretty clear that Medicare is the one issue that could dislodge the Republicans’ headlock on those voters,” said Andrew Kohut, the president of the nonpartisan Pew Research Center.
“The Republicans brought it back to life,” Mr. Kohut added — first by House Republicans’ approval this year and last of the Ryan budgets, which died in the Democratic-controlled Senate, and most of all by Mr. Romney’s elevation of Mr. Ryan to the presidential ticket.
Medicare is an especially resonant issue in Florida, and Mr. Ryan has appeared in the state with his mother, a Medicare beneficiary, to emphasize the message that Republicans are trying to preserve the program, not end or curtail it.
So it was no accident that Mr. Clinton’s first post-convention trip as a surrogate for Mr. Obama was to Florida. Or that he was preceded here last weekend by Mr. Obama, who made four stops in the state and will return again this week.
Mr. Clinton brought up Medicare Advantage, a private insurance option for Medicare beneficiaries that is used by 2.1 million Floridians. Begun late in the Clinton administration as an experiment to cut costs through market competition, Medicare Advantage has instead proved more costly than regular Medicare.
The 2010 health care law reduced Medicare subsidies to insurance companies to help save $716 billion over 10 years, which added eight years to the program’s financial life. But Republicans have been on the attack since, charging Democrats with robbing Medicare beneficiaries to pay for “Obamacare.”
Mr. Clinton pointed out that a record number of insurance companies and beneficiaries now participate in Medicare Advantage, and that premiums are lower. “So if the president was trying to wreck Medicare Advantage, he did a poor job of it because it’s in the best shape it’s ever been in,” Mr. Clinton said.
Then he repeated one of the biggest applause lines of his nationally televised address at the Democratic convention in Charlotte, N.C. Noting that Mr. Ryan is attacking the $716 billion in savings although his budgets also included them, Mr. Clinton quipped, “You got to give it to Congressman Ryan — it takes real brass to attack somebody for doing something he did.”
For now, the Romney campaign has stopped running advertisements attacking Mr. Obama on Medicare. But House Republicans are continuing to press the issue.
A commercial in Iowa, for example, accuses Representative Leonard L. Boswell, a Democrat, of taking $716 billion “from current recipients of Medicare to take care of a government takeover of health care that benefits other people.”
Democrats are striking back. Representative Bruce Braley of Iowa last weekend became the first Democratic Congressional candidate to run an ad featuring Mr. Clinton’s folksy convention put-down of Republicans. It features Mr. Clinton saying: “Democrats didn’t weaken Medicare. They strengthened Medicare.”
Instead of Mr. Clinton, the Obama campaign is using a similar testimonial from AARP in its ads for the president.
“We were going to talk about Medicare whether they brought it up or not,” said Joel Benenson, a pollster for the Obama campaign. Republicans, he said, “were trying to get ahead of an issue that was a big problem for them. And it is a big problem for them, especially after they put Paul Ryan, the author of the voucher scheme, on their ticket.”
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