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Obama Turns Up Heat in Battle for Senior Hearts and Minds

By John Reichard, CQ HealthBeat Editor

President Obama struck back Tuesday at Republican claims that the health overhaul law will harm seniors by cutting close to half a trillion dollars from Medicare, saying his opponents would roll back provisions to fill the gap in Medicare drug coverage and end out-of-pocket charges for preventive care.

Republicans have put the administration on the defensive by emphasizing the Medicare cuts, a potent argument because seniors are uneasy about the law and are more likely than other voting blocs to cast ballots in midterm elections.

Appearing in a town hall-style forum at a senior center in suburban Maryland, Obama sought to reframe the issue. Republicans are aiming to repeal the improved Medicare benefits in the law, he said, including provisions to gradually eliminate the gap in Medicare prescription drug coverage known as the "doughnut hole."

Obama also sought to weaken one of the strongest GOP talking points against the law — that its big cuts to Medicare Advantage plans will harm seniors — by likening those attacks to discredited claims that the law will create "death panels" to ration care.

And he sought to undermine the concept of Republicans as defenders of Medicare by implying some in the GOP would "voucherize" the program.

The administration also is trying to win the goodwill of seniors by pledging tough efforts to curb fraud in Medicare. Congressional Democrats are joining in the effort, with House Ways and Means Health Subcommittee Chairman Pete Stark of California announcing a June 15 hearing targeting "waste, fraud, and abuse" in Medicare.

While anti-fraud efforts can generate significant savings, they fall far short of being able to assure the solvency of Medicare.

Obama began the event in Wheaton, Md., televised on C-SPAN and linked in with similar senior events elsewhere, by highlighting the case of a breast cancer patient named Fran whose prescription drug costs put her in the coverage gap.

"You've just heard Fran's story," Obama said. She "was forced to pay the entire cost of the medicine she needed out of pocket. That came to thousands of dollars, forcing her and her husband to cut back everywhere else."

He said, "Beginning this week, tens of thousands of seniors who fall into the doughnut hole, like Fran, will receive a $250 rebate check to help you cover the cost of your prescriptions." Then in 2011, "you'll get a 50 percent discount on the brand-name medicine that you need — 50 percent." And "by 2020 this law will close the doughnut hole completely."

Also, "next year, preventive care — including annual wellness visits for Medicare beneficiaries, certain screening services like mammograms — will be free," Obama added.

Tight reimbursement for private health plans in Medicare in the late 1990s led many HMOs to withdraw from the program, forcing hundreds of thousands of seniors to return to traditional Medicare or to pick another plan. The overhaul law's provisions to equalize payments for private health plans and providers in traditional Medicare may similarly rock the Medicare Advantage program.

"This has been an area where probably there's been the most misinformation and concern, after the death panels," Obama said at the Wheaton event.

He sought to put the blame for any disruptions on insurers, claiming the extra money received by private health plans from Medicare goes to CEO salaries and profits and that taking it away shouldn't lead to reductions in the added benefits seniors get from the plans or raise their premium charges.

"Last week, Secretary Sebelius reminded insurance companies that we've got the authority to review and reject unreasonable rate increases for Medicare Advantage plans, and she put them on notice that we will exercise that authority," Obama said.

Senate Minority Leader Mitch McConnell of Kentucky blasted back at a news conference Tuesday afternoon, saying the president "began today an effort to try to sell an extraordinarily unpopular health care bill to the American people."

The $250 checks will "be sent to a small percentage of seniors. Of course that does not address the issue of how many additional seniors, probably three or four times that many, will see their benefits reduced through the cuts in Medicare Advantage," he said.

McConnell added that "some of you have written about this major PR campaign to try to make something that's immensely unpopular popular, including a combination of taxpayer money and privately raised money."

He said that "this level of cynicism is not unheard of in Washington," but added that he regretted "the willingness to use the levers of government for a purpose that seems to me is highly questionable."

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