Medicare fix might hurt GOP

WASHINGTON – Only months ago, congressional Republicans thought the new Medicare prescription drug benefit would help them make political inroads among traditionally Democratic senior citizens. Instead, they are facing a potentially damaging backlash among members of that crucial voting bloc, their families and even conservative activists dismayed over the program’s bungled launch.

Georgia Rep. Jack Kingston, a member of the GOP leadership, has held at least 10 workshops to help his elderly constituents navigate the complex drug plan, and he implored his Republican colleagues to do likewise.

“There’s a tremendous opportunity for members of Congress to go out there and be the white knights – to listen, answer questions and get in the weeds with their constituents,” he said. “But for members who feel they don’t want to bother, they are going to hear from those voters in November.”

“It’s no windfall politically,” said Rep. Philip Gingrey, R-Ga., a physician who voted for the program. “It could hurt us, but sometimes doing the right thing does hurt.”

Some Republicans think the problem will blow over once the inevitable kinks are worked out. But recent opinion polls cast doubt on such optimism. They suggest that, even among Republicans, support for the program has eroded.

Democrats on Thursday stepped up their criticism of the program, which they said benefits big drug and insurance companies at the expense of the elderly. They also called for congressional action on the many start-up problems. Hundreds of thousands of seniors – mostly low-income – have had trouble getting their medicines, and many have been overcharged. More than 20 states have jumped in with emergency assistance.

“This Medicare bill is the biggest government fiasco in recent memory,” said Sen. Charles E. Schumer, D-N.Y., chairman of the Democratic Senatorial Campaign Committee.

Republicans also are facing criticism from conservative activists who opposed the program’s creation in the first place. They see it as an emblem of how the GOP – after more than a decade in power – has betrayed conservatives’ commitment to small government.

“The fallout is likely to be huge,” said an aide to a prominent conservative member of Congress who asked not to be named because he was not authorized to speak for his boss. “It’s likely to anger seniors, while reminding the conservative base about the big-government approach that Republicans took to health care.”

Thus far, polls show no stampede of elderly voters to the GOP. And according to polling by the Pew Research Center on People and the Press, the percentage of conservative Republican voters who approved of the drug plan dropped from 66 percent in December 2003 to 54 percent in December 2005; approval by moderate Republicans dropped even more over those two years, from 74 percent to 56 percent.

“It hasn’t been the big political plus they hoped for. The question is whether it will be a minus,” said Drew E. Altman, president of the Henry J. Kaiser Family Foundation. “That is what is at stake in this early implementation period, which is not going so well so far.”

Congress voted in 2003 to expand Medicare to cover prescription drug costs, but delayed its implementation until Jan. 1, 2006, to allow time to set up the complex program. Most Medicare recipients were given until May 15 to sign up for the program, which is voluntary. But several million Medicare recipients who also qualify for Medicaid, which serves the poor, were automatically moved into the new program on Jan. 1. The number of people involved in that one-day transition has contributed to many of the start-up problems.

Many senior citizens have been overwhelmed by the complexity of the program. Medicare’s information lines are jammed. Because of data errors, pharmacists have been unable to determine in many cases whether low-income beneficiaries were even covered. And the poorest beneficiaries have faced the biggest problems.

Democrats sense a political opportunity, especially at a time when the GOP is reeling from ethics scandals, internal squabbling and a leadership shake-up in the House.

The drug benefit issue already has been used against some congressional Republicans in their re-election campaigns. Democrat Christopher S. Murphy is campaigning against Rep. Nancy L. Johnson, R-Conn., by criticizing her leading role in creating the program.

“This is nothing but a massive giveaway to the drug industry,” Murphy says on his campaign Web site. “Every senior citizen and hard-working American family should be offended that our government is giving away our health care system to the multibillion-dollar drug industry.”

Rep. Rahm Emanuel, D-Ill., chairman of the Democratic Congressional Campaign Committee, predicts that complaints about the program will intensify as seniors bump up against a limitation on benefits known as the “doughnut hole” – a big gap in coverage of drug expenses.

“If you think they are mad now, you ain’t seen nothing yet,” Emanuel said.

Senate Democrats on Thursday proposed legislation to address the start-up problems.

One bill would provide federal reimbursement to the states that are stepping in with emergency funding for low-income seniors. The Bush administration has said states must look to the private insurance companies for reimbursement, although Washington would support such recovery efforts. A second bill proposes longer-term fixes, including staffing sign-up locations with trained Medicare employees and improving the agency’s telephone hotline.

The bill to compensate states drew two Republican co-sponsors, Sens. Olympia J. Snowe of Maine and Norm Coleman of Minnesota. But other Republicans have taken a wait-and-see attitude, arguing that the federal agency that runs Medicare should try to solve the problems administratively before Congress acts

“It’s too early to commit to any legislative options,” said Senate Finance Committee Chairman Charles E. Grassley, R-Iowa. Still, he acknowledged the seriousness of the problems besetting the program.

“It’s unacceptable that some of the poorest, sickest people are having the most trouble, and it’s not what Congress intended,” Grassley said.

Republicans have a huge stake in the program’s success because it is one of the biggest domestic accomplishments of the Bush presidency – one they hoped would make it harder for Democrats to mount their traditional attack on Republicans as hostile to the elderly.

The big test of the program may not come till later in the year, after people see what is and is not covered.

“I don’t know that the rocky start is as important as what people see at the end of the day,” said Tony Fabrizio, a GOP pollster. “The real rubber meets the road when they see what their expectations were versus what they actually get.”