By Jeffrey Young - 04/08/10 10:00 AM EDT
The AARP, the Obama administration and lawmakers are trying to convince skeptical older voters of the benefits of healthcare legislation before they go to the polls in November.
Their strategy involves selling seniors on the enhanced prescription drug and prevention benefits and easing their worries over the future of Medicare.
A Gallup poll released two weeks ago found just 36 percent of people 65 or older thought the healthcare law is a “good thing,” compared to 54 percent who said it is a “bad thing.”
Older voters tend to be a reliable presence at the polls, and Democrats are trying to stave off losses in both chambers of Congress.
Republican criticisms of Democrats using nearly $500 billion in Medicare spending cuts to finance new coverage for the uninsured fueled seniors’ anxiety. And the GOP has vowed to make healthcare reform an election issue.
“We’re going to have an environment that off and on will be politically charged,” said Nancy LeaMond, executive vice president for social impact at the AARP. “Our hope is that the environment will be more conducive to talking about the facts, though we know there are going to be attempts to scare our members.”
“Negative messages always seem to break through more than positive ones,” Rep. Debbie Wasserman Schultz (D-Fla.), part of Speaker Nancy Pelosi’s (D-Calif.) leadership team, said in an interview last week.
About one-third of the residents in Wasserman Schultz’s South Florida district are older than 60, according to her office. “They’ve been sold a bill of goods by opponents of this legislation,” she said.
Like other Democratic lawmakers who supported the healthcare legislation, Wasserman Schultz plans a multifaceted campaign to promote the law’s benefits for older people: “Outreach, outreach, outreach,” she said.
In addition to distributing direct mail packets explaining the law to households, Wasserman Schultz will participate in a series of town hall meetings, some of which will focus on senior issues, and visits to seniors centers and similar facilities. Underscoring the challenges involved, Wasserman Schultz encountered some hostility at a townhall meeting she hosted Monday night.
To counter the anti-healthcare reform message, Obama and his allies are highlighting the new or improved benefits under the law.
“I want seniors to know, despite some of the stuff that’s been said out there, these reforms don’t cut into your guaranteed benefits,” Obama said last week. “What they do is eliminate co-payments and deductibles for preventive care, like checkups and mammograms. You will be getting those for free now.”
Perhaps the biggest selling point for Medicare beneficiaries is the gradual phasing-out of the so-called doughnut hole coverage gap that is currently part of the Medicare Part D drug benefit; this year, beneficiaries who fall into the gap will receive a $250 rebate.
“We think that closing the doughnut hole over time is going to be exceedingly important,” LeaMond said.
In addition, advocates of the law are trumpeting enhanced prevention and wellness benefits such as a free annual physical and expanded access to home- and community-based medical and assisted-living services.
“This is the part where we have to be able to explain to our members the specifics as it applies to them,” LeaMond said. “We’re going to have to move very quickly from a lot of general or even hypothetical questions to very specific case questions.”
AARP publications, such as its bulletins and monthly magazine, go to tens of millions of people and the organization has vast financial, technological and grassroots networks through which to disseminate information.
The AARP has also launched a website dubbed “Get the Facts” and a question-and-answer column to provide members with information about the law.
“AARP will use all of our communication channels — from our publications and website to in-person events — to make sure that our members and all older Americans have reliable information about what they can expect — and how they can benefit — from healthcare reform," AARP Senior Vice President Drew Nannis said in a statement Wednesday.
The most obvious potential short-term drawback for seniors is the possibility of cutbacks in the Medicare Advantage program, through which private insurance plans offer plans.
The healthcare law significantly scales back the federal subsidies available to Medicare Advantage plans that make them cost, on average, 12 percentage points more per beneficiary than traditional Medicare. Democrats have been chipping away at these subsidies, which they dub “overpayments,” since 2007. The new law would gradually reduce the subsidies to the same amount it would cost to enroll someone in traditional Medicare.
Republican proponents of the private Medicare Advantage plans, as well as the insurance companies that provide them, maintain that slashing the subsidies will result in many plans exiting the market, reducing benefits or raising premiums. The Congressional Budget Office partly backs up this contention, concluding that 1.5 million fewer people will be covered by Medicare Advantage plans by 2019.
The law is having an effect on the Medicare Advantage market already: The Centers for Medicare and Medicaid Services announced Monday that the rates for the plans would freeze next year at 2010 levels.
The Medicare Advantage market will be going through a shift in the coming years, acknowledged Alfred Chiplin, senior policy attorney at the Center for Medicare Advocacy, but not in all geographic areas and not all at once.
“You’ve got bits and pieces that go into effect in time,” Chiplin said. “There’s going to be a lot of jockeying around.”