Less than three months old, last year's sweeping Medicare reform legislation may already be coming back to haunt President Bush and provide fodder for Democratic presidential challengers.
When Bush signed the Medicare bill last December, it appeared he had gained a major political victory by stealing Medicare from the Democratic Party, long viewed as the party of healthcare issues. But in a testament to how quickly a storm can brew in Washington politics, the newly minted legislation has instead become a burden to the administration.
In a year in which healthcare is a top voter concern, there is no consensus on how much of a liability the Medicare backlash has become for the president, but there is a sense that it could potentially hurt Bush in November.
"The question really hinges ... on the number of seniors who stand to see a diminution in their drug costs," said Edmund Haislmaier, a visiting research fellow at the Heritage Foundation, a conservative policy think tank. "I don't think it will hurt with this election because there will be other issues" that the public will be equally concerned about, Iraq and the economy, he said.
Robert Blendon, a professor of health policy and political analysis at Harvard University's School of Public Health, said it may be too early to tell whether the issue will gain traction, but "it clearly has emerged as an issue for Democrats ... who can say clearly this bill isn't as good as the administration had advertised."
Dissent is coming from members of Bush's own party who are angry over the new higher price estimate for the legislation, as well as Democrats, who were already assailing the legislation as a gift to managed-care companies and drug manufacturers. The administration's Office of Management and Budget priced the legislation at $534 billion, $139 billion more than the Congressional Budget Office's $395 billion price tag (Feb. 2, p. 10).
In response, Sen. Lindsey Graham (R-S.C.) said he would soon introduce legislation to bring the cost down to the CBO estimate by capping the prescription drug outlay. "Even I was surprised at how quickly and dramatically the projected costs of the program spiked," Graham said in a news release.
Democrats, meanwhile, have questioned when the administration knew about the price discrepancy and whether it withheld that information from Congress while legislators were voting on it. The administration has also been pelted for an ad it developed to tell the public about the Medicare law. Though HHS is required to publicize the changes, some have said the ad misrepresents what the Medicare law does and looks more like a political ad. Concern prompted CBS to pull the ad, but late last week, after changes were made, CBS agreed to run it. The new version includes an asterisk and the words "savings vary" when it asserts that the new law will save money for seniors. Nonetheless, the General Accounting Office is investigating whether the administration developed the ad for political purposes.
Meanwhile, a survey was released last week that shows voters are losing confidence in the president over healthcare issues. According to the survey by the Gallup Organization, public disapproval of Bush's handling of healthcare matters jumped by 13 percentage points in one year, to 57% from 44%. The survey of 1,001 adults was taken from Jan. 19 to Feb. 1 and found that 35% of respondents approved of his work, down from 46% from a year ago.
So far, Democratic presidential candidates have been relatively muted in their criticism. Former Vermont Gov. Howard Dean withdrew from the race, narrowing it to a contest between Sens. John Edwards (D-N.C.) and John Kerry (D-Mass.). Front-runner Kerry, like Edwards, voted against the Medicare legislation, saying it gives seniors "a raw deal," while Edwards has called on Bush to explain the $139 billion cost difference in the Medicare law.