By Jeffrey H. Birnbaum and Claudia Deane
Washington Post Staff Writers
Wednesday, April 12, 2006
Millions of senior citizens have not signed up for and do not know much about Medicare's new prescription drug benefit, but among those who have enrolled, three-quarters said the paperwork was easy to complete and nearly two-thirds said the program saved them money, the latest Washington Post-ABC News poll shows.
The findings underscore the challenge the administration faces in persuading large numbers of seniors to participate in and support the program, the largest expansion of a government social benefit in decades. But it also unmasks a political opportunity among older voters for President Bush and the Republicans if they succeed.
This possible gain was one reason why Republican strategists were eager to pass the long-delayed drug benefit originally in 2003. But many Democrats are convinced that Republicans misjudged. They have attacked the program as too complex and costly, and say it was written to benefit pharmaceutical companies more than consumers.
Bush defended the plan yesterday in front of seniors in Missouri and Iowa. "We had people say the prescription drug plan is just simply a hollow promise, or the bill will leave millions of seniors worse off," he said in Jefferson City, Mo. "That's not the facts. See, when you cut through all the rhetoric and look at the results, I think people are going to be amazed at what's available."
The multibillion-dollar program, called Medicare Part D, subsidizes prescription drugs for the disabled and for people 65 and older. So far, 29 million Americans have enrolled, leaving at least 8 million -- and as many as 14 million by some estimates -- still eligible.
The program's size and novelty have divided the public, according to the poll. Forty-one percent of those polled approve of it, while 45 percent disapprove. Seven in 10 seniors think that the May 15 signup deadline should be extended, an action that would require a vote of Congress, a Medicare spokesman said.
But as government officials and a variety of nonprofit and commercial entities labor to explain Part D to seniors, the public's view of how Bush is overseeing the program has risen modestly. Over the past month, public approval of the president's handling of the plan increased to 37 percent from 32 percent, bringing him close to the 38 percent level that he had when the new benefit took effect in January.
The drug benefit is being accepted more warmly by those who stand to take personal advantage of it than by the public at large. Half of the seniors polled approve of the plan, compared with 41 percent who disapprove. Moreover, six in 10 seniors acknowledge that they do not know much about the program.
Sharon Tuller of Des Moines was reluctant to sign up because she had heard horror stories about the paperwork. But she learned from a friend about a nonprofit group that made the process painless. She and her husband, a retired school administrator, made an appointment with the group and completed their sign-up in just 20 minutes. "We thought it was going to be this horrible experience," said Tuller, 66. "It turned out to be quite the opposite."
Retiree Nancy Hooper of Williamsburg, Iowa, 67, worried that the savings from Part D would not be worth the hassle -- or the extra premium. But the cost of medications for herself and her husband were reduced by more than half, even after figuring in their $53.10 monthly premium. "I was so happy," she said.
Other seniors are reluctant to take the plunge, however. Yvonne Brayton, 84, a widow in Rensselaer, N.Y., is one of them. She takes eight prescription medications and has decided to stay with her private insurance coverage. Medicare's drug program is "a big mess," she said.
Seniors continue to fret over whether to join. Robert M. Hayes, president of the Medicare Rights Center, said his telephone operators were so besieged by anxious seniors that he brought in social workers to counsel them on "stress disorders."
But the intensity of concern has diminished. AARP, a senior citizens organization that backed the drug benefit in Congress, lost about 60,000 members over the issue. But such protest departures have stopped, said David P. Sloane, AARP's top lobbyist, and have been replaced by requests for information about how the program works.
Still, opinions about the program, which passed Congress in 2003 by narrow margins and over substantial Democratic opposition, remain heavily influenced by partisanship.
According to the Post-ABC News poll, a majority of Republicans (56 percent) said they approve of the new benefit, while a similar majority of Democrats disapprove. Most Americans say the Republicans deserve the credit, or the blame, for the new program.
At the same time, the poll suggests that Part D is not shaping up as a major factor in the upcoming elections. The issue ranks well below hot-button topics such as Iraq and the economy: 59 percent say it will be important in their vote, compared with 83 percent for Iraq and 80 percent for the economy.
A total of 1,229 randomly selected adults, including 386 respondents 65 or older, were interviewed by telephone April 6 to 9 for this survey. The margin of error is plus or minus three percentage points for the overall results, and plus or minus five percentage points for the results based on the responses of all seniors.
Bush yesterday made light of his political woes while explaining why he had Medicare participants speak for him. "See, one way to convince people to take a look is to have others talk about the benefits of the program," he said. "They probably got a little more credibility than I do."
"Yeah," said Missourian Helen Robinette, sitting next to him, prompting laughter from the crowd.
Bush turned to her. "You don't have to agree with that," he joked.
As he made the case for his Medicare plan, Bush also came to assist two Republicans running in the fall. At the Missouri event, he was shadowed by Sen. James M. Talent (Mo.), who faces a tough challenge. Bush called him "a straight shooter." And in the evening, the president headlined a Des Moines fundraiser for Rep. Jim Nussle (Iowa), who is running for governor.
Staff writer Peter Baker and polling director Richard Morin contributed to this report.