WILL MEDICARE MATTER?...

WILL MEDICARE MATTER? It may be a bad bill, but the Medicare Prescription Drug Program may not be the electoral club many Democrats were hoping it would be. New polling from the Kaiser Family Foundation shows that 8 out of 10 seniors are basically satisfied with the new benefit, hardly the sort of numbers congenial to a November counterattack. Two issues, however, may disrupt the calm. First up, seniors knowledge of the doughnut holes -- the period of a couple thousand dollars where all costs come out of pocket in an effort to discourage overuse of drugs before insurance kicks back in -- is spotty:

The survey tested seniors� knowledge about the Medicare drug benefit�s coverage gap, or �doughnut hole,� in which most plans stop paying for medications and seniors must pay the full cost of their prescriptions. One- third of seniors in a Medicare drug plan say that their plan has a coverage gap (34%); about as many say that their plan does not have a gap (36%); and the others say they did not know or refused to answer (30%). Nearly all plans have such a gap, though seniors receiving low-income assistance, including those receiving Medicaid, do not experience the gap due to government subsidies.

Those 30 percent who don't know or won't answer aren't going to be pleased when they find that they do indeed have a coverage gap. As for the 36 percent who think themselves exempted, I called Kaiser's Larry Leavitt to see if they could plausibly be from the low-income category that actually is exempted from the benefit. As of now, it looks possible, though not certain. So however you slice it, you're going to have a third to a half of seniors who get smacked with an unexpected coverage gap in a couple months, right in time for the election.

The other politically potent element of the plan is the HHS secretary's inability to negotiate down the price of drugs. That may turn out to be a powerful example of the GOP's corporatist slant and their willingness to elevate the needs of industry over those of the average American. Such an appeal can exist and resonate even in the absence of widespread discontent over the Medicare Part D plan. That said, these numbers suggest that Medicare, if it enters the calculus at all, will not be a high priority issue in the 2006 election.

--Ezra Klein

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