Ideas and Trends: An 800-Pound Gorilla Charges Partners Over Medicare

Sheryl Gay Stolberg - The New York Times

November 23, 2003

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WITH 35 million members more than one-tenth the population of the United States -- AARP, the organization representing retirees, has long been the 800-pound gorilla in the Medicare prescription drug debate. So when the group endorsed a Republican-backed Medicare bill last week, Democrats reacted with anger and alarm.

Representative Nancy Pelosi of California, the Democratic leader in the House, complained that AARP was "in the pocket" of Republicans, and suggested that the group, which also sells insurance to its members, had a financial conflict of interest. Eighty-five House Democrats announced they would either resign from AARP, or refuse to join.

But behind all the Democratic barbs at the organization itself is a seismic political shift that represents a broader threat to the party's appeal to older Americans.

For decades, older Americans were reliable, and crucial, Democratic voters. As recently as last year, Senator Trent Lott, the former Senate Republican leader from Mississippi, derided AARP as a "wholly owned subsidiary" of the Democratic Party.

Yet today's older Americans are increasingly voting Republican, a trend that experts say will likely continue as the baby boomers age and the generation of Eisenhower replaces the generation of F.D.R.

"The oldest old are very Democratic, and they don't like the stance AARP has taken," said Susan MacManus, a political scientist at the University of South Florida. "But if you look at the coming wave of seniors, they are not monolithic from a partisan perspective. The organization can't just represent the oldest old Democrats, and I think that's what they are getting caught in the cross-hairs of."

Before making their endorsement, AARP officials conducted polls and focus groups of Americans 45 and older. The responses, they said, suggested support for a bill that would help the indigent and encourage employers to continue to provide the drug benefits they already offer.

Still, surveys of people eligible for Medicare, those 65 and older, have repeatedly found what Drew Altman, president of the Kaiser Family Foundation, calls "a big expectation gap" between what retirees believe the prescription drug bill offers and the limited coverage it actually affords. But in the end, with Congress willing to spend $400 billion over 10 years, on the first-ever Medicare drug benefit for retirees, AARP decided an imperfect bill was better than no bill at all.

"Well, we represent a constituency that doesn't have that much time to wait," said John Rother, AARP's chief lobbyist. "There was no prospect in the short term that we were going to get a better bill, and there was a real risk that we could end up with a worse bill."

The endorsement was a huge victory for Republicans, but it came at a price: the AARP demanded bigger subsidies for low-income people, and incentives for employers to continue offering drug benefits. On Friday, Senator Don Nickles, the Oklahoma Republican and chairman of the Senate Budget Committee, was asked what he thought of the endorsement.

"Well," Mr. Nickles replied dryly, "I think it cost a lot."

Gail Wilensky, who ran Medicare for the first President Bush, said the cost to Republicans would be well worth it. "It provides some cover politically to members of Congress who may be on the fence," she said.

But AARP's critics say its executive director, William D. Novelli, a former public relations man who took the helm of the organization two years ago, is playing a dangerous game by aligning himself so closely with Republicans.

Mr. Novelli, who wrote a forward to a book by Newt Gingrich, the former Republican House speaker, defended himself last week against Democratic claims that he was a "closet Republican."

"We intend to mend fences as soon as this is over," Mr. Novelli said of the Democrats on Friday.

The fundamental debate over Medicare is whether the program should be administered privately, as many Republicans prefer, or by the government, the preference of Democrats and the AARP. By promoting a Republican-backed bill, the AARP is assisting a political party whose long-term goals are at odds with its own.

Democrats say they are not worried about what the AARP switch will mean at the polls; they argue that the group's leadership is out of sync with its membership, and say voting against the organization will not hurt them.

"The threat of AARP has always been on two fronts: their ability to mobilize members at a local level, and their Good Housekeeping Seal," said Representative Rahm Emanuel, Democrat of Illinois and an opponent of the bill. "This notion that if you vote against it, you're going to have the AARP membership up in arms? I've not gotten a single phone call telling me that I'm wrong."

Mr. Altman, of the Kaiser Family Foundation, says it is too early to tell if the bill will be as unpopular with retirees as Democrats suggest. Should that happen, it would not be the first time. In the late 1980's, Congress, with AARP support, passed a law giving catastrophic health coverage to Medicare beneficiaries. But the program included an income-tax surcharge that enraged some vocal older Americans and was repealed.

The defining moment of that debate came in Chicago, in 1989, when a mob of angry retirees surrounded Representative Dan Rostenkowski, the chairman of the House Ways and Means Committee, and pounded on his car. The Chicago Tribune published a photograph of an elderly demonstrator sprawled across the hood of the congressman's sedan -- an image that Representative Janice D. Schakowsky, an Illinois Democrat and opponent of the Medicare bill, brought to the House chamber last week.

"This is a friendly warning," Ms. Schakowsky said she told her colleagues. "If you vote for this bill, I suggest you go get your running shoes, because this is not going to be popular with seniors."