Pulling it Together: Seniors and Health Reform

It is widely believed that seniors are antsy about the new health reform law. And there is heightened interest in how seniors feel about the law in the political world because they are more likely to vote in midterm elections.  About 48% of the electorate said they voted in the 2006 midterms while about 63% of seniors said the same.  Our June and July tracking polls shed light on seniors’ views on health reform and their implications.

First, while seniors are in fact more negative towards health reform than the rest of the public, the difference is not huge on key questions.  For example, in our July poll 35% of seniors said they or their families would be worse off as a result of the law compared with 27% of people under 65 who said the same thing.  Fifty seven percent of seniors either said they would be better off (20%) or that the law would make no difference to them (37%).  Seniors split along partisan lines on the health reform law just like the rest of the public.

In our June poll 45% of seniors who said they were most likely to vote in the midterm election said they were either much more likely or somewhat more likely to vote against a candidate who voted for the law.  That compared with 28% who said they were more likely to support a candidate who voted for it, a notable 17 percentage point difference.  But many other factors come into play in local races other than seniors views on health reform.  Seniors said the candidates’ personal qualities (cited by 31%); the direction of the nation as a whole (31%); and the candidates’ stands on the issues (29%) all would influence their votes.  That last category includes all issues and significantly, only 13% of seniors said health care would be the most important issue to their vote (11% of people under 65 said the same thing).  A district would have to have a very close race, lots of seniors who vote, few other competing issues, and a candidate who succeeds in making his or her opponent’s vote on health reform a hot issue for senior’s votes on health reform to play a significant role in a race.

The emphasis on seniors’ opposition to health reform is at least somewhat over played.  Seniors certainly are more negative than the under-65 population, but only a small percentage sees health reform as a voting issue for them.  It is more accurate to say that seniors are split on the legislation like the rest of the country but leaning somewhat more negative, and it would take a perfect storm of factors in a local race for seniors’ views of health reform to swing a race.

The second big finding in the tracking poll — the huge misconceptions many seniors have about elements of the legislation, some of them manufactured during the debate.  A year after the town meeting wars of last summer, a striking 36% of seniors said that the law “allowed a government panel to make decisions about end of life care for people on Medicare”, and another 17% said they didn’t know.


But the misperceptions were not limited to death panels. Fifty percent said the law cut benefits previously provided to all people on Medicare when it does not, and another 16% didn’t know.  Only 33% knew that it eliminated copays and deductibles for many preventive services under Medicare, 26% that it provided bonus payments to doctors who provide primary care services under Medicare and 14% that it would extend the life of the Medicare Trust Fund (by twelve years according to government estimates).  Higher percentages, but still not big majorities, knew about some other features of the law.  For example, 50% knew that the law would gradually fill the donut hole.  The big question: how would seniors’ views about the law change if they did not have these misperceptions and were better informed?  We can’t say for sure.  What we can say is that as we move from a combative legislative debate to what is likely to be an equally heated election season; seniors’ misperceptions and lack of knowledge about some key elements of the law remain profound.  A poll released this week by the National Council on Aging also showed high levels of misperception by seniors.

It is the finding in our July tracking poll that more than one-in-three seniors still believe there are death panels in the health reform law that we should worry about most.  It’s not only that it is the most egregious misconception, but it shows how debate about public policy can be manipulated in the echo chamber of the 24-second news cycle with apparent lasting effect.  Seniors’ opinions and votes could be targets again as we move beyond the midterms to a potential debate about deficit reduction and changes to Medicare and Social Security.  These issues are even more salient and personal to seniors so we could see similar dynamics play out in another policy debate soon.

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The independent source for health policy research, polling, and news, KFF is a nonprofit organization based in San Francisco, California.