Remember back in 1998 how it looked as though the HMO and patients' rights issue would turn the political tide for Democrats?

Yet, despite single mom Helen Hunt's much-cheered blast at HMOs in the 1997 hit movie "As Good As It Gets," Democrats picked up only four House seats and no Senate seats in 1998.

Moreover, voluntary reforms by health plans combined with doctors turning their rage from HMOs to trial lawyers took the wind out of the movement to legislate requirements on patients' rights.

This year, Republicans hope the Democrats' campaign against President Bush's Medicare prescription drug plan will fizzle similarly and that the GOP can hold on to the recently acquired loyalty of America's seniors.

No Republican involved in the matter can deny that the launch of Medicare Part D has been rocky, beset as it is with confusion, delays, red tape and nonstop terrible press notices.

Riding that wave, and sensing an opportunity to win back the senior vote, Democrats have been on the warpath, scheduling 100 events over the congressional Presidents Day break to denounce the program, accuse Republicans of selling out to drug and insurance companies and demand an extension of the no-penalty sign-up deadline past May 15.

However, Republicans are fighting back by accusing Democrats of trying to scare seniors away from a benefit that will help them and by pointing to encouraging sign-up and cost-saving statistics and unpublicized poll results.

"The Democrats hope they can use this as a campaign issue," Ways and Means Chairman Bill Thomas (R-Calif.) told me in an interview. "But this is a program that was 10 years overdue and we got it enacted in a hostile environment.

"I'm kicking our guys (in the Bush administration) because we didn't do the rollout smoothly, but go back and read the headlines and stories from 1966 and 1967, when Medicare was first rolled out," he said.

"You have problems with a massive new program. And yet, not two months into the program, we have swallowed a big chunk of the problems. It's a manageable thing. And anybody who thinks that this is going to be a hot-button campaign issue eight or nine months from now ... is going to be mistaken again."

Thomas, one of the key authors of the prescription drug plan, said much of the early confusion reported by the media stemmed from the number of private insurance plans offered to seniors -- 560 nationwide, according to the White House, and at least 40 in any region -- and the choices that it entailed.

"It's true, it's a little more difficult because you do have a degree of choice," he said, "but the original complaint you heard was that there wouldn't be any choices."

According to Medicare officials, competition between drug plans has reduced the average premium paid by seniors from an expected $37 per month to $25 a month and will reduce seniors' average annual drug outlays by $1,100 to $1,300 per year, with lower-income seniors getting drugs practically free.

Thomas disputed Democratic claims that prices would be lower if the government could directly negotiate prices with drug companies instead of operating through private insurers, and he said the array of drug choices under Medicare is much wider than at the Veterans Administration, which mandates prices.

White House officials keeping daily track of prescription drug sign-ups say that total coverage is now up to nearly 26 million out of 43 million eligible, with 28 million to 30 million expected by the end of the year.

Five million seniors who previously were without any drug coverage have signed up either for private plans or Medicare's HMO plan. Sign-ups for the third week of February numbered 546,000 and the week before, 543,000.

Polling results on the drug plan have been mixed. On Friday, The Wall Street Journal published results showing that among all adults, only 15 percent have a favorable opinion of the drug plan, while 31 percent are unfavorable and 54 percent uncertain.

Among seniors, 77 percent said it was "too complicated and confusing." Fifty-six percent said it would help seniors who did not have drug coverage, but only 23 percent said it would help them personally.

However, White House officials noted that Wall Street Journal/Harris Interactive poll results that were posted only on the Internet showed that 79 percent of adults approve of the drug benefit overall and 59 percent of enrolled seniors believe it will save them money.

Politically, though, the poll that counts comes this November. In 2004, exit polls showed that persons over 65 voted for Bush by a margin of 51 percent to 48 percent, an improvement of five percent over 2000. Seniors have preferred GOP congressional candidates in every election since 1994, though in 2002, by a margin of just 50 percent to 49 percent.

Right now Bush's Gallup poll approval rating among seniors is only 36 percent, three points below his national average. Seniors usually make up nearly 20 percent of the electorate in midterm elections. So, Republicans have a lot of convincing left to do before November.



(Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill.)

Copyright 2006, Roll Call Newspaper

Distributed by Newspaper Enterprise Assn.

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