Familiar Medicare talking points pop up in tight congressional races

Healthcare has not been at the forefront of Iowa's tightly contested Senate race between Democratic Rep. Bruce Braley and Republican state Sen. Joni Ernst. But last week, the National Republican Senatorial Committee started running an ad attacking Braley on Medicare as part of a $3.3 million advertising buy in the state.

“Bruce Braley voted to cut $700 billion from Medicare to support Obamacare,” Darlene Blake, a senior citizen living in Des Moines, says in the spot. “That's just not fair. We paid in. We paid for it. That should be there for us. It's hurting a lot of people.”

The charge of slashing $700 billion from Medicare has become a staple of Republican attack ads since passage of the Patient Protection and Affordable Care Act. The NRSC is running similar ads in Georgia charging that Medicare cuts are part of Democratic challenger Michelle Nunn's “liberal agenda.” Crossroads GPS, a conservative independent expenditure group, recently released an ad pillorying Sen. Mark Pryor (D-Ark.), who is among the most endangered incumbents in the country, for Medicare cuts. And former Republican National Committee chairman Ed Gillespie, who's waging a long-shot bid to take out Sen. Mark Warner (D-Va.), also lobbed the Medicare cuts charge in a recent campaign e-mail explaining why he opposes the ACA.

The charge of $700 billion in cuts isn't entirely baseless, but it lacks context. The reference is to reduced growth in Medicare spending that was projected to take place under the ACA. Given that pundits on both sides of the aisle agree that the program for seniors is on a financially unsustainable course, reducing the growth in spending is typically seen as a positive development. A big chunk of the cuts come from reducing payments to Medicare Advantage plans by roughly $150 billion, which before the ACA had cost as much as 114% more per beneficiary than the traditional fee-for-service program.

“Not all cuts are created equal,” said Ed Howard, executive vice president of the Alliance for Health Reform, a not-for-profit group that monitors implementation of the federal healthcare law. “Almost every healthcare economist agrees that Medicare Advantage plans had been overpaid. Moving that number down to something comparable to what fee-for-service Medicare would have paid is something that over the years has gotten bipartisan support in Congress.”

Polling data shows the Iowa Senate contest is deadlocked. It's among nine Senate contests that the Cook Political Report rate as tossups and that will determine which party runs the Senate in 2015. The GOP needs to pick up six seats to take control.

Follow Paul Demko on Twitter: @MHPDemko