Two-Party Prescription for Winning Seniors: The Medicare Drug Program

By Will Lester

Public opinion about the Medicare prescription drug program is caught in a tug of war between the perceptions of millions of seniors who have signed up for the program and those of millions more seniors and soon-to-be seniors watching from the outside.

In a midterm election year, Republicans hope the new Medicare prescription drug benefit could help them win the loyalty of seniors for the midterm elections and beyond. Democrats hope to capitalize on lingering confusion and suspicion about who benefits most—seniors or big business. Caught in the middle are pollsters, trying to sort through the mixed signals to figure out the impact of prescription-drug politics on the midterm elections.

"I believe it is too early to definitely assess the outcome," said Robert Blendon, an expert in public opinion at the Harvard School of Public Health. "Millions of seniors have not signed up for the program, and many have barely used the benefit."

Public opinion could be influenced by several events: how the May 15 deadline for signing up without penalty has been handled, how respondents deal with the gap in coverage known as the "doughnut hole," and future rate increases.

President Bush and the Republicans made a bold bid in late 2003 to win long-term support of seniors with the passage and signing of a Medicare prescription drug plan. The plan, with an initial estimated $400 billion price-tag over ten years, gives seniors a chance to save money on prescription drug bills, while giving private insurance companies a big role in the program.

Early problems with the program startup in 2006 gave Democrats hope the GOP plan would backfire. As more seniors have enrolled, recent polling has suggested enrollees have grown more positive, giving the GOP renewed hope.

Sorting through the impact of sweeping changes in the Medicare program has proved to be a challenge for pollsters. Their first efforts were inconclusive—suggesting that the public was still trying to figure out what the new benefit would mean for them. The initial response to polling varied dramatically, depending on the question asked.

• An ABC News/Washington Post poll in October 2003 asked, “Would you support or oppose a new federal program that would help pay prescription drug expenses for senior citizens, at a cost of $400 billion over the next ten years?” The poll found 75 percent supported the plan and 20 percent opposed it.

• A Quinnipiac poll asked people in March 2004, “Do you think the Medicare bill affecting prescription drugs for senior citizens passed by Congress last year (2003) will be good for seniors, bad for seniors or haven't you heard enough to say?” A fifth (20 percent) said good, a fifth (22 percent) said bad, and more than half (54 percent), said they hadn't heard enough to say.

• Polling by the Kaiser Family Foundation released in August 2005 asked, “Given what you know about it, in general, do you have a favorable or unfavorable impression of this new Medicare prescription drug benefit?” The poll found about a third of seniors polled (32 percent), had a favorable view of the plan, and about a third (32 percent), had an unfavorable view, while the rest were undecided.

• A poll just released by Kaiser in late April 2006 showed about three in ten seniors had a favorable view and almost half had an unfavorable view, with about a fifth undecided. According to these new findings, seniors’ opinions were about equally derived from news accounts about the plan and actual experiences with it.

"We have seen seniors’ understanding of how the benefit would impact them personally grow over time, but we haven't seen seniors’ favorability toward the benefit warm up," said Mollyann Brodie, director of polling at the Kaiser Family Foundation. “This may change as seniors have more direct experience with the new Medicare drug plans." The April Kaiser poll found that most who had enrolled in a Medicare drug plan were satisfied with their plan and were not having trouble getting the drugs they needed.