Winning the Medicare fight

Republicans, who have been quaking in fear as they contemplate the political damage wreaked by their nearly unanimous embrace of Paul RyanPaul Davis RyanCheney takes shot at Trump: 'I like Republican presidents who win re-election' Cheney allies flock to her defense against Trump challenge Paul Ryan researched narcissistic personality disorder after Trump win: book MORE’s Medicare-destroying budget, breathed an undeserved sigh of relief after a Gallup poll found voters evenly split between President ObamaBarack Hussein ObamaObama says US 'desperately needs' Biden legislation ahead of key votes Obamas to break ground Tuesday on presidential center in Chicago A simple fix can bring revolutionary change to health spending MORE’s deficit-reduction plan and that offered by Rep. Ryan (R-Wis.). Nonetheless, that poll, together with other recent surveys, offers some important warnings for Democrats.


Gallup’s findings seemingly suggested Republican fears were exaggerated. The pollsters’ analysis noted that “Ryan’s plan includes a complete restructuring of Medicare for people younger than 55.” Nevertheless, to Republicans’ evident glee, Gallup reported, “Pluralities of middle-aged Americans as well as those 65 and older prefer Ryan’s plan to Obama’s.”

Republicans took heart from these findings too quickly. Nowhere does the question explain, or even reference, Ryan’s Medicare plan. Respondents were simply asked which was “the better long-term plan for dealing with the federal budget deficit — the Republican plan put forth by Congressman Paul Ryan or the Democratic plan put forward by President Barack Obama?” Voters dividing evenly on which party is better at dealing with the deficit should surprise no one. Indeed, if these numbers contain any surprise, it is that Democrats perform as well as they do on this traditionally pro-GOP issue.

Other data make clear that central aspects of the Ryan/Republican proposal are deeply unpopular. According to a Kaiser poll, 57 percent oppose any reduction in Medicare spending to help reduce the federal deficit, and another 32 percent would countenance only “minor” spending reductions. An ABC/Washington Post poll found 78 percent opposed cuts in Medicare spending to “reduce the national debt.”

While Republicans, who marched almost in lockstep in support of the Ryan plan, err grossly in taking solace from the Gallup poll, Democrats too have lessons to learn from this poll and other recent data.

First, shorthand rarely works — and certainly doesn’t work here. Vague references to the “Ryan plan” mean almost nothing to voters.

Similarly opaque references to “vouchers” likewise fail to galvanize public anger. According to the Kaiser poll, just 12 percent have any idea what “premium support” means, and an equally anemic 30 percent claim to know what vouchers are in the context of Medicare. In another test, use of the word “voucher” increased opposition to the Ryan plan by a single point. Even “privatization” fails the test. These terms may rally the informed base, but they carry little meaning to the wider electorate.

Second, some of the concepts Democrats find abhorrent are not quite so loathsome to voters. When Kaiser explained premium support — “people choose their insurance from a list of private health plans … and the government pays a fixed amount toward that cost” — voters divided about evenly between keeping Medicare as it is and adopting that alternative.

Of course, when the policy choices are somewhat arcane and theoretical, question wording can make a big difference. When the ABC/Post poll offered a somewhat different explanation — “people over 65 would receive a check … from the government each year for a fixed amount they can use to shop for their own private health insurance policy” — opposition to the change was overwhelming (65 percent to 34 percent).

While neither shorthand nor wonky explanation works, clear, crisp arguments do raise voters’ hackles about the GOP’s Medicare plan. The core message focuses on cutting Medicare benefits and putting insurance-company bureaucrats in charge of seniors’ healthcare. 

When Kaiser put these arguments to voters, as well as the GOP view that its plan would reduce the deficit, save Medicare and encourage competition, Americans rejected the Republican plan by 68 percent to 24.

This is a debate Democrats can win decisively, but only with an oft-repeated and carefully honed message in place of shorthand and jargon.

Mellman is president of The Mellman Group and has worked for Democratic candidates and causes since 1982. Current clients include the Majority Leader of the Senate and the Democratic Whip in the House.