Sunshine State Foggy on Medicare Reform

In no state do seniors make up a more generous slice of the population than Florida, that balmy retirement destination under the palms. So nowhere should the recent reform of Medicare have deeper, more durable consequences on how people vote.

Once, that is, that Florida’s nearly 2.8 million residents age 65 and older figure out exactly what has changed, and how it affects them. “People are bewildered by it; they don’t know what’s happening to their health plan,” said Nana Klein, 85, a retired New York state civil servant who keeps track of senior-related legislation for the AARP chapter in this suburb of Fort Lauderdale.

Depending on who’s doing the talking, by presiding over the greatest transformation of Medicare in its 38-year history, President Bush has outfoxed the Democrats and made major inroads in their voter base to reinforce his chances for reelection in 2004, or he has presented America’s elderly with a prettily wrapped time bomb that will damage their interests in the long run.

“In essence, this reform stinks,” said Frank Kaiser, a 68-year-old Clearwater man who runs Suddenlysenior.com, a Web site devoted to senior issues. “It’s the biggest Medicare fraud in history, but most seniors won’t realize that until 2006. It has booty for the insurance companies, giveaways for the drug companies. It’s got stuff for everybody -- except seniors.”

Bruce Vogel, an economist at the University of Florida in Gainesville, offered a radically different, and much more favorable, view. “It’s an increased Medicare subsidy for seniors,” said Vogel, an associate professor in the university’s department of health policy and epidemiology. “Most seniors are eventually going to see some benefit.”

Complicating forecasts of the law’s political fallout is the fact that its centerpiece -- the creation of long-sought Medicare prescription drug coverage for America’s seniors -- won’t kick in for two more years, long after election day 2004.

“It could be a problem if Democrats get their message out that this is a poison pill for Medicare,” said Jim Kane, a Fort Lauderdale-based pollster. “Public opinion has not really formed on it yet.”

Bush barely won Florida in 2000 after a contentious recount, and the state remains key to Republican strategists’ plans for victory next year. According to a recent poll conducted for a number of Florida newspapers and published Friday, 53% of the state’s voters now approve of the job Bush is doing as president, but just 43% expressed willingness to cast ballots to award him a second term.

Kane said that thanks to Bush’s efforts to expand Medicare’s benefits to include prescription drugs, the president should see some rise in popularity, in the short run at least, among seniors, who constitute 35% of all of the Floridians registered to vote. But Kane said it was impossible to say how long the upswing would last, or whether it would be followed by a backlash.

“Seniors care about two things: Social Security and health care,” said Kane. “They live from hand to mouth, many of them. Their incomes are limited. Their medical bills get higher every year; their prescription drug bill gets higher every year. And if they get upset, that’s what they vote on.”

U.S. Rep. E. Claw Shaw Jr., a Fort Lauderdale Republican, lauded the changes to Medicare as a clear boon to seniors and to his party. But he has been holding town hall meetings throughout his South Florida district, bringing along charts and handouts, to extinguish what he termed “the fires of misinformation” about the new law.

Many of Shaw’s constituents are older people living in condominiums and retirement communities along South Florida’s Atlantic Coast, sometimes on modest fixed incomes.

“I’ve literally seen people at the prescription counter deciding which box of pills to give back,” the congressman said. Under the new Medicare law, seniors will be able to purchase a drug discount card starting in 2004 and there will be “some immediate relief,” Shaw said.

The lawmaker observed with a chuckle that a Republican president and Republican-controlled Congress agreeing to expand a huge social program that was a keystone of Lyndon B. Johnson’s Great Society “is kind of like Nixon opening up China.”

“It’s really quite astounding, and I think it’s really going to be to the president’s benefit,” said the Florida Republican, who chairs the House subcommittee on Social Security. “The basic reason Democrats didn’t go along with it was that it was basically the president’s bill.”

In stark contrast, Democrat Bill Nelson, Florida’s junior senator, said he opposed the law because, after study, he concluded it was not in the best interests of seniors or the continued health of Medicare itself. There may be a period of favorable feelings about the law, he said, but they won’t last.

“There will be goodwill for 2004 and 2005, and then when the notices start going out in late 2005 about exactly what the drug benefits are [under the changes to Medicare], you’re going to start to hear senior citizens saying, ‘You mean I’m paying $3,900 for a $5,000 benefit?’ ” said Nelson. “

Until actual prescription drug benefits kick in and they can judge the law’s effectiveness for themselves, seniors in Florida and throughout the country will be subjected to a cacophony of opinions about how beneficial or harmful the changes to Medicare are.

“At some point, people are going to realize that this was not an earth-shattering reform,” predicted David Hedge, professor of political science at the University of Florida. “It put in place a small Medicare prescription provision that will give some, but not a whole lot, of relief to America’s elderly.”

Ernie Hartless, president of Local 731 of the International Assn. of Machinists in Jacksonville, is one Florida senior who has already made up his mind. He’s against the new law, which he said would benefit few working-class.”I think it’s all political to help the president get reelected,” said Hartless, 69. “The sad part is, people won’t find out how bad it is until after the election. In the meantime, Bush can wave his flag and say, ‘I got you a prescription drug plan.’ ”