New Medicare Law May Sway November Vote

WASHINGTON —  Almost half of Medicare recipients dislike the new prescription drug law, and nearly 3 in 10 seniors and disabled persons say the issue will influence their vote for president, according to a national survey released Tuesday.

The survey suggests that there are “maybe a half-million seniors” who might swing their votes to Democratic candidate John F. Kerry and another “1 million to 2 million whose votes might be up for grabs on this issue,” said Drew E. Altman, president and chief executive of the private, nonprofit Kaiser Family Foundation.

Given those numbers, if the race between Kerry and President Bush remains close, seniors’ views of the Medicare law could be a decisive factor in the Nov. 2 election, said Robert J. Blendon, a professor of health policy at the Harvard School of Public Health.

The national survey of 1,223 Medicare beneficiaries, conducted by the Kaiser foundation and the Harvard school shortly before last month’s Democratic National Convention, indicated that 47% of Medicare recipients had an unfavorable view of the law, while 26% had a favorable view.

Eight months after Bush signed the measure into law, 1 in 4 participants in the government healthcare program for seniors and disabled people said they do not know enough about it to have an opinion.

The survey results are the latest in a series of indicators suggesting that the Bush administration and Republican lawmakers, who worked hard for the passage of the reform measure, are reaping few, if any, political benefits from it.

While conventional political wisdom holds that “something done is better than nothing, that isn’t what the results would suggest today,” Blendon said.

Instead, he said, opposition to the Medicare law has energized Democratic seniors, whose votes could help Democratic House candidates in close races.

Administration officials said they were not troubled by the survey results.

“We find a lot of encouraging signs in this poll,” said Kevin Keane, assistant secretary for public affairs at the Department of Health and Human Services.

Despite “all the political demagoguery that has taken place,” Keane said, “the survey shows that seniors believe the new benefits will be helpful ... and they want to know more about them. They don’t want those benefits taken away. That’s a very positive sign.”

According to the survey, which has a margin of error of plus or minus 4 percentage points among seniors and plus or minus 10 percentage points among the disabled on Medicare, 2 of 3 beneficiaries want Congress to go back and improve the law.

Specifically, those who disapprove of the law say that its benefits are not generous enough, that it is too complicated and that private health plans and drug companies stand to benefit more than the nation’s 41 million Medicare recipients.

Only 3 in 10 of those on Medicare believe that the law’s benefits -- partial coverage of prescription drug costs for those who choose to participate in that program, a voluntary prescription discount card available until the drug benefit takes effect in 2006, and new coverage for some preventive health services -- will help them personally.

By overwhelming numbers, respondents support two measures to lower drug prices that are opposed by the administration and a majority of Republican lawmakers and supported by Kerry and most Democrats.

Fully 80% favor allowing the government to negotiate with manufacturers for lower prices, an action the law expressly prohibits. And 79% support changing the law to allow the legal importation of lower-priced prescription drugs from Canada.

Strong majorities clearly reject the administration’s arguments against importation, with 66% saying it would not reduce drug quality, 62% saying it would not expose Americans to unsafe drugs, and 71% saying it would not reduce manufacturers’ commitment to drug research and development.

The Medicare law required the administration to establish a task force to research the issue of reimportation, so called because it largely involves the return of drugs that were manufactured in the United States and sent to other countries. The task force held several meetings this year and was working on a report that would tell Congress whether it was possible to safely import prescription drugs from other countries and what new government resources and processes would be needed.

“We acknowledge that’s on their mind,” Keane said, but “reimportation is a separate issue” from the Medicare law.

“We have to protect people’s safety whether they think it’s an issue or not,” he said.

Altman said the survey clearly points to a need for the government to invest in more individualized outreach and education efforts.

Although the administration has spent tens of millions of dollars on advertising, brochures and the 800-MEDICARE telephone line, and more than half of Medicare recipients say they have heard or read “some” or “a lot” about the new law, an equal proportion -- 56% -- say they understand it “not too well” or “not well at all.”

“Public education won’t ... solve all the problems in this law,” Altman said, “but clearly it is needed.”