Obamacare was supposed to be President Barack Obama’s legacy. But it’s looking like a political millstone.
The mammoth and unpopular health insurance overhaul weighed down Democrats in 2010 when Republicans helped turn seniors to their side.
And now Democrats have unexpectedly had to play defense over Obamacare’s Medicare cuts even as Mitt Romney picked Congressman Paul Ryan as a vice-presidential running mate and drew attention to unpopular Republican plans that cap future Medicare spending.
Central to the Republican attack: Obamacare cut $716 billion in anticipated Medicare spending over a decade. Republicans are driving the message home in TV ads and robocalls bashing Democrats.
“This could cost us the election,” Kelly Ward, the Democratic Congressional Campaign Committee’s political director wrote in a fundraising email last week. “We have to get the facts out to voters immediately.”
The first Democratic talking point: Ryan’s Medicare plan signed off on the very Obamacare cuts that Republicans are now bashing.
Obama’s campaign defended itself Friday in an ad that said the “the non-partisan AARP says Obamacare ‘cracks down on Medicare fraud, waste, and abuse,’ and strengthens guaranteed benefits.”
On Saturday, Ryan kept up the anti-Obamacare pressure in his first presidential-campaign trip to Florida, where he spoke at the Republican-friendly retirement community The Villages, along with his mom, a part-time Lauderdale-by-the-Sea resident.
The Obamacare cuts to Medicare haven’t yet reduced services and are structured in such a way that they’re not supposed to hit benefits, at least in the short term. Medicare spending is actually forecast to increase in 2012 at a higher annual rate than the average annual increase over the prior five years.
The cuts are targeted at insurance companies and hospitals, not beneficiaries. Whether they’ll reduce services in future years is an open question.
Romney’s ad, however, makes it sound as if the cuts directly hit current Medicare recipients.
“You paid in to Medicare for years — every paycheck. Now, when you need it, Obama has cut $716 billion dollars from Medicare,” the ad says.
But beyond the $716 billion number, most facts and figures might not matter. Republicans and Democrats say voters will make their decision on whom they trust more, not whose plan has every single detail spelled out. Neither side is willing to admit that Medicare, assuming taxes aren’t raised, will have to experience actual cuts in future benefits.
Republicans charge Democrats with “stealing” from Medicare to expand government, namely Medicaid, the expensive health insurance program for the poor that would be capped under Romney and Ryan, whose plan trims about $810 billion from the program over a decade.
Democrats charge Republicans with “shredding the social safety net” to pay for tax cuts for millionaires. Medicaid, they note, has paid for up to two-thirds of daily nursing home expenses in Florida, where 3.3 million people receive $21.4 billion of the program’s benefits.
The battle lines are thus clearly drawn over who’s plan is worse for retirees. And the winner of that argument could win the White House.
It’s an issue of great importance in Florida, a must-win state for Republicans where nearly 3.4 million annually receive $25.2 billion in Medicare services. More than half the electorate in Florida is 50 or older.
Right now, Romney might be winning the public-relations war in Florida, according to a poll from Rasmussen Reports, which has a reputation for leaning Republican. Asked which plan “scares you more,” the poll found 54 percent of Florida seniors said Obamacare, while 34 percent said the Ryan plan. Overall, 48 percent were more scared of Obamacare and 41 percent were more worried about Ryan’s plan, which is the backbone of Romney’s proposal.
The Ryan-Romney plan, which has few details compared to Obamacare, would give new recipients a capped subsidy through Medicare to buy private insurance in 2022, and would only impact those who are currently under age 55. That distinction should allay concerns of seniors and those about to retire.
But a poll last year by the Pew Research Center, which sampled more Democrats than Republicans, found that 51 percent of those 50 and older opposed Ryan’s Medicare changes, while only 29 percent approved.
Obamacare remains unpopular, too. A Miami Herald poll last month showed support for Obamacare was weakest among likely Florida voters older than 65. Overall, 52 percent supported and 43 percent opposed Obamacare; 56 percent felt it would make healthcare worse or have no effect.
A Florida poll released last week from Purple Strategies, a bipartisan consortium of consultants and pollsters, showed Romney remained essentially tied with Obama 48-47 percent in Florida. Voters split evenly 44-45 percent over who would do a better job protecting Medicare.
Many Democrats grouse that, were it not for Obamacare, they wouldn’t have faced a senior backlash in 2010 and would have more standing among seniors to attack the Romney-Ryan plan. Democrats hope that Obamacare’s negatives are old news and that the Romney-Ryan plan will suffer a worse fate in 2012 than Obamacare did two years ago.
Republicans are concerned that their ticket will take a beating over the Ryan plan. Politico reported GOP discontent on Capitol Hill, where House Speaker John Boehner hosted a conference call to settle “jittery Republican members.”
“I don’t know if I would have been courageous enough to make that pick. But I admire Mitt Romney for doing it,” said Republican consultant Alex Castellanos, with the Purple Poll. “He didn’t pick Ryan to make a political sale. It was to fix the government. The CEO hired a CFO.”
Now, Castellanos said, the challenge is to “focus on the economy and move forward.” But that gets tougher because Ryan was picked two weeks before the Republican National Convention in Tampa at month’s end, giving opponents time to negatively define Ryan and his plan without the benefit of the primetime national stage to control the dialogue.
The Purple Strategies poll showed Ryan, who has helped the ticket’s fundraising explode, is a plus. He’s viewed more favorably than Romney, Obama or Vice President Joe Biden. A Florida poll by Survey USA found Ryan was viewed more favorably than unfavorably by Florida voters, including seniors.
However, though he’s seen favorably in Florida right now, Ryan’s pick hasn’t boosted the overall fortunes of Romney’s ticket in the state. The Purple Poll showed Obama’s ticket picked up 2 percentage points since July. But nationwide, approval shifted 3 points nationwide in Romney’s favor in that poll. Overall, according to a New York Times analysis of multiple polls, Ryan has boosted the ticket just 1 point in Romney’s favor; the average “bump” is usually 4 points.
Pollster John Zogby, who used to conduct Florida surveys for the Miami Herald, reported a nationwide poll showing the Romney ticket got a “Ryan bump” of seven points — buoyed largely by a surprising increase of Republican-ticket support among 18-29 year old voters.
Zogby said the numbers are sure to change. And other polls indicated Ryan wasn’t much help.
Zogby said the Ryan proposal might prove more unpopular than Obamacare, which contained highly popular provisions giving seniors more prescription drug benefits, covering more people and forcing companies to insure people with pre-existing conditions.
Democrats thought that would be a winner at the polls. It wasn’t in 2010.
Republicans framed Obamacare as Medicare-cutting government intrusion that also mandate people buy health insurance -- a proposal ironically based on Romney’s Massachusetts health plan. A few falsely said the plan called for “death panels.”
“The irony for Obama is that he’s one of the best story tellers that we’ve seen in the presidency and he happens to be particularly inept in telling the story of Obamacare,” Zogby said. “It’s not that he lost control of the dialogue. He never had it.”
Obama played politics with Medicare as well, in 2008, when he bashed rival John McCain in an ad that accused the Republican of wanting to gut the program. The independent website FactCheck.org called the ad false; McCain didn’t want to cut benefits — just slow the program’s growth rate and attack fraud.
Obama adopted those very principles a year later in Obamacare, using McCain’s defenses about not cutting benefits.
The Obamacare reductions target hospital reimbursement rates, require an independent board to propose cost savings that don’t ration care and scale back payments to private insurers in Medicare Advantage that wound up costing taxpayers more for each beneficiary compared to traditional Medicare.
It’s unclear how Romney’s plan would make Medicare more solvent because he wants to reverse the Obamacare cuts that helped extend the life of the program.
Medicare spending for 2012 is scheduled to weigh in at $586.1 billion, a 7 percent jump that’s higher than the five-year annual average increase of 6.2 percent, according to data from the annual report of the trustees overseeing Medicare’s trust funds.
The board cast a jaundiced eye on how real some of the savings would be because they would take “unprecedented improvements” in the health system. Also, the board’s report suggests that some of the cuts could eventually hurt “the availability and quality of health care. over time” for Medicare recipients.
That would be a real cut. And right now the measures are considered a savings.
Former Rep. Ron Klein, who lost his Palm Beach County-based congressional seat in 2010 amid the Obamacare debate, said he believed this election would be different with the sole focus on Medicaid. He certainly hoped there wouldn’t be a repeat in 2012.
“The Republicans did a much better job being on the attack,” Klein said. “The points of our side got lost in the translation.”