COMMENTARY | Even after the special election results in NY 26 Tuesday, Republicans in Congress stand by their man. In a Senate vote Wednesday, only five Republicans broke from party ranks and voted with Democrats in opposition to the Ryan proposal to fundamentally change the way Medicare is administered.
One has to wonder if the public outrage over the Ryan plan has to do with the vouchers, or Premium support as Republicans call it, or if the public genuinely thinks that the plan is just bad. Either way, congressional Republicans have signaled that they support it. Out of 287 congressional Republicans, only nine cast votes against the way we administer healthcare to our seniors. 235 House Republican members voted in favor or the proposal along with 40 Republican senators supporting the plan. Two Republican senators declined to vote. That's a staggering 95.8 percent who are walking the party line. In contrast, Senate Democrats voted with Senate Republicans to reject President Obama's budget 97-0.
Rep. Ryan and his Republican colleagues think that the problem with Medicare is a messaging problem. The House Budget Committee released a video, complete with graphs and charts, to show how the plan does not destroy Medicare as we know it, but rather "saves" it. The Republican Party is usually excellent at getting out its message, but on this issue members seem to be scrambling to find the right tone.
The storm that Republicans are facing is one which they have never navigated. With so many seniors depending on Medicare to survive, the program is very popular. This program can not be equated to a "Cadillac Queen" welfare program; there is popular support for it among a convincing number of Americans. The only option Republicans have is party unity as they seek to re-brand a widely unpopular proposal. This is a different environment than the Republicans used to their benefit by opposing the Affordable Care Act. The message machine will not be able to overcome the fact that Medicare is fully operational and people know directly how they and future generations will be impacted by changes in the program.
The Republican Party is unified in support of this issue even if the American public overwhelming disagrees with any changes. However, there is reason to believe it is all about messaging. A recent Kaiser Family Foundation poll found that Americans were unsure what the terms "voucher" and "premium support" meant. Republicans are mounting the effort to fully educate the public and the proposed benefits of increased choices in the health care market with "premium support," while Democrats counter by saying the vouchers provide no protection against the rising costs of insurance plans.
Phil Galewitz with Kaiser Health News reports that when respondents are told what the terms mean, support for the planned "premium support" rises from 46 percent to 54 percent In the same poll, when respondents are told what the term "voucher" means, support for leaving Medicare alone rose from 50 percent to 58 percent. Clearly it is about messaging.
Both Democrats and Republicans agree that changes to Medicare are needed to increase sustainability, but they disagree over what changes are necessary. Republicans will have a hard sell if they continue to propose slashing Medicare benefits to reduce taxes for the wealthiest Americans, but if they can decide to leave the rates alone and educate Americans through messaging, they just might weather the storm.
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