A highly-flawed bill that would provide a limited prescription drug benefit to seniors at the same time as it changes Medicare in some highly undesirable ways seems likely to pass Congress fairly soon. The changes in Medicare are lucidly dissected by Paul Krugman today in The New York Times. The many problems with the bill as a whole are analyzed in detail by Jeanne Lambrew of the Center for American Progress.

If the bill does pass, it will likely be with the assistance of a number of moderate Democrats who have concluded that a bad bill is better than no bill at all. To a large extent, they are motivated by the perception that any bill that passes will be popular and they need to seek political cover, lest they be accused of failing to support an important new benefit.

But is this perception correct? Polling data from the last five months or so suggests it might not be.

November, 2003

As DR recently discussed, November Pew Research Center data show clearly that the political views of Democrats and independents are converging on one another and pulling away from the Republicans. That is, it’s not just that Democrats and Republicans are becoming polarized against one another–the conventional wisdom–but that Democrats and independents (two-thirds of the electorate) are becoming polarized against Republicans.

The Pew study shows Democrats and independents converging in their declining support for an assertive national security policy, in their increasingly negative views of their personal financial situation, in their growing worries that a prescription drug benefit for Medicare won’t go far enough and in their increasingly skeptical attitude toward business. In each case, Democrats and independents now hold views much closer to one another than to Republicans, who are off on their own trajectory.

October, 2003

A story in the October 19 New York Times discussed the fall in Bush’s approval ratings among seniors. October CBS News/New York Times poll had Bush’s approval rating at just 41 percent among those 65 and older, a fall of 22 points since May.

That’s very bad news for President Bush. Seniors were his worst age group in 2000 (he lost them 50 percent to 47 percent) and if he does much more poorly among them in 2004 that could doom his re-election chances.

Of course, Bush’s strategists hope that passage of a prescription drug benefit for Medicare will stop the bleeding among senior voters. But will it? In an October Washington Post poll, his approval rating on prescription drugs for seniors was an abysmal 35 percent. And the last time the prescription drugs bill was discussed intensively, in the last half of June, his overall approval rating among seniors dropped 12 points.

As savvy nonpartisan analyst Charlie Cook has pointed out, “If the prescription drug benefit is a factor in next year's election, it will be as an albatross around the necks of Republicans and the Bush administration." He argues that what seniors want is a drug benefit like a Fortune 500 company might provide--modest premium, minimal co-pay, no gaps and unlimited coverage--and they want it provided through Medicare. What they're likely going to get doesn't look anything like that and when they figure this out--and Cook thinks they will--it will be the Republicans who'll pay the price.

That judgement seems sound. Democrats should be able to do very well with senior voters in 2004 and, if they do, Bush will have to make up that deficit among other age groups, which could be very tough. Especially if Democrats push the other health care issue: the cost, availability and coverage of health insurance. In the same October Post poll, Bush’s approval rating on this issue was just 31 percent with 60 percent disapproval.

July, 2003

The GOP’s political plan on Medicare prescription drugs is clear enough. Give seniors a prescription drug benefit and they’ll move toward the Republicans as the party that can get things done for seniors.

But what if they don’t like it? Then you get blame instead of credit and the whole political scheme just might fall apart. Two July Gallup reports suggest this a real possibility.

According to the report on attitudes toward Medicare reform, seniors opposed, by 69 percent to 24 percent, an effort to shift most Medicare recipients into managed care plans. And, by 63 percent to 20 percent, seniors believed the new Medicare bills being considered by Congress will not do enough to help pay the cost of prescription drugs. It seems unlikely that more widespread understanding of the actual provisions in a final bill will modify that negative judgement—indeed, based on what’s likely to be in that bill, that negative judgement could well be accentuated.

That could set up a perverse situation in which the more attention seniors pay to the prescription drugs bill, the worse it will be for Bush and the Republicans (not exactly what Rove and Co. had in mind). Maybe that has already happened. According to the Gallup report on Bush’s job approval, his rating dropped twelve points among seniors in the last half of June, precisely the period when coverage of the Medicare prescription drug bills was most intense.