Yet the temptation to claim a “status quo” outcome from the election ignores broader trends in this year’s health and Medicare debates, according to longtime congressional observers.

The similarities for the upcoming 113^th Congress are evident: Republicans will hold comfortable control of the House, while Democrats have added to their narrow majority in the Senate. And the prospective agenda will seem familiar, although the deadlines for action are more pressing on a host of fiscal and entitlement issues.

This election is likely to have consequences—in both explicit and more nuanced ways. For example, the Democrats’ continuing control of the Senate likely preserves President Barack Obama’s health law, though they might seek minor modifications. The GOP-dominated House will continue to press for major cost savings from entitlements to avoid the end-of-the-year deadlines that have been imposed for spending cuts and tax increases. And both sides will likely claim mandates from the election results.

Republicans, for example, have exulted not only in their continuing House majority but also in their ability to withstand Democrats’ harsh attacks on their budget blueprints, which called for major changes in Medicare. “There is no evidence that the Democrats’ message got through,” said a senior House GOP leadership aide. “Our House Republican position has become stronger.”

Speaker John A. Boehner said Tuesday night that the results showed that “the American people have also made clear that there is no mandate for raising tax rates,” and he embraced the House-passed GOP budget “that begins to solve the problem.” But he struck a more conciliatory tone Wednesday afternoon, saying, “If there is a mandate in yesterday’s results, it is a mandate for us to find a way to work together on solutions to the challenges we face together as a nation. My message today is not one of confrontation, but of conviction.”  

Even veteran Republican insiders concede that the GOP should be careful not to view the campaign skirmishes over Medicare as a complete victory. “The result is muddled,” said Bill Hoagland, a longtime senior Senate GOP aide who recently became senior vice president of the Bipartisan Policy Center. “The Democrats’ complaints didn’t have much leverage. But the result will be short of an endorsement [of the House GOP budget] by voters….Any proposal to limit Medicare will be analyzed carefully in its impact for cost-sharing” for beneficiaries.

Obama reached out to Republicans in his election speech. “Tonight you voted for action, not politics as usual …,” he said. “And in the coming weeks and months, I am looking forward to reaching out and working with leaders of both parties to meet the challenges we can only solve together.”

But congressional leaders were more circumspect, including on their views of health care issues.

When House Budget Committee Chairman Paul Ryan, R-Wis., was tapped by Republican presidential nominee Mitt Romney to be his running-mate, Democrats claimed that they would benefit from the increased focus on the Ryan-crafted budget. But Democrats and their allies concede that their rhetorical attacks largely fell short.

“I had felt that Medicare would have a big impact on the election. That didn’t happen,” said John Rother, president of the National Coalition on Health Care. “Admittedly, Republicans had a complicated proposal. But Democrats could have done more to raise the fear factor. I don’t think that [their point] got through that the proposal would erode the core benefit promised” in Medicare. He added that this year’s campaign revealed a growing political trend: “Issues have become less important than partisan ID, especially in moving voters.”

The House Democrats’ failure was not from lack of effort. Of the more than 100 video advertisements that the Democratic Congressional Campaign Committee ran this fall in battleground House districts, roughly half focused on health-care issues—chiefly Medicare.

“Keith Rothfus praised a plan that would end our Medicare guarantee … costing seniors an extra $6,400 more a year,” said a typical DCCC ad that was designed to defeat the GOP challenger to Rep. Mark Critz, D-Pa. A similar ad attacked freshman Rep. Ann Marie Buerkle, R-N.Y., for having “voted to essentially end Medicare … end guaranteed Medicare benefits …[and] put the insurance industry in charge….” Rolfus won; Buerkle lost.

Democratic analysts contended that their disappointing showing in the House resulted from other factors, such as local issues, the impact of redistricting, plus the advantages of incumbency in many cases. “We won the policy argument. We would welcome the Republicans continuing an argument that has been rejected politically,” said a veteran House Democratic leadership aide.

They also sought to defend the strategic decisions of Democratic Minority Leader Nancy Pelosi, D-Calif., who was instrumental in enacting the health-care law in 2010 when she was speaker, and in leading the attacks on the House GOP budget in the past two years. The disappointing results fueled continued speculation that Pelosi may step down from her leadership post. Her likely successor would be Minority Whip Steny Hoyer, D-Md., who has been far more supportive of bipartisan efforts to seek a “grand bargain” on the budget deficit—including entitlement cutbacks.

Veteran observers of health-care policy said that the campaign paid unexpectedly little attention to those issues, despite the efforts of both parties. “I was wrong when I wrote [in August] that Congressman Ryan’s selection would be a game-changer,” said Robert Blendon, a professor of public health and political analysis at Harvard University. “At the end of the day, it did not play out that way. The Republican counter-strategy focused on the $716 billion in the Affordable Care Act that they said Democrats moved from Medicare.”

Hoagland said that Republicans are unlikely to make much progress with their promises to repeal the Affordable Care Act, especially with the success of Obama and Senate Democrats. But he added that “there will be opportunities for fiscal changes” in that law, with pressures from both parties. “It’s not written in stone.”

Blendon added that Democrats scored a significant win because the election results make it virtually certain that the 2010 health-care law will be implemented. “The campaign hasn’t moved the views of a single person,” he said. “But I don’t agree that this is a status quo election. There will be a significant change in American health policy, starting in 2014.”

This article was produced by Kaiser Health News with support from .

This <a target="_blank" href="/medicare/analysis-medicare-politics-democrats-republicans/">article</a&gt; first appeared on <a target="_blank" href="">Â鶹ŮÓÅ Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

The two Senate nominees bring to the contest an unusual level of health-care expertise, helping focus the issue in the Badger State more than has been the case in other states. Voters’ responses ultimately may help to point the way to middle ground on policy changes, say pollsters and others who have studied the race.

Rep. Tammy Baldwin (D-Wis.) delivers opening remarks at a House Committee on Education and the Workforce meeting (Photo by House Committee on Education and the Workforce Democrats via Flickr).

Democratic Rep. Tammy Baldwin has been an outspoken liberal during her 14 years in the House and is a veteran member of the Energy and Commerce Committee, where she promoted a Canadian-style, single-payer health care financing system.

She wrote during the 2009 congressional health care debate that including a public insurance option “will make health care affordable by increasing competition, providing more choices and keeping the insurance companies honest.”

Republican Tommy Thompson was an innovative governor for 14 years before he became President George W. Bush’s Secretary of Health and Human Services. He was instrumental in the 2003 enactment of Medicare prescription-drug coverage. During the 2009 congressional health care debate he urged a bipartisan effort to “address the health care crises” in an article he wrote with former House Democratic Leader Richard Gephardt of Missouri.

Neither Baldwin nor Thompson got their way when President Barack Obama in 2010 signed the Affordable Care Act. And in some ways, their current contest to replace retiring Democratic Sen. Herb Kohl has revived that harsh partisan conflict over health care and the 2010 congressional campaign—which resulted in major Democratic setbacks, including the defeat of Wisconsin’s long-time progressive senator Russ Feingold. Thompson blasts Baldwin for supporting a “government takeover of Medicare” and she and her allies have blistered him for his support for changes to Medicare.

Those conventional partisan dynamics are highlighted in broadcast ads by the candidates’ allies this month.

Former Wisconsin Governor and current Republican candidate for the state’s U. S. Senate seat Tommy Thompson visits with workers and guests at Reed Switch Developments Corp. in Racine, Wisconsin (Photo by Scott Olson/Getty Images).

“Tommy [Thompson] says he’s the best person to do away with Medicare and turn it into a costly voucher program,” according to a spot aired by the American Federation of State, County and Municipal Employees.

Crossroads GPS, which was organized by Republican strategist Karl Rove, has run an ad that attacked Baldwin for having “pushed an extreme takeover of your health care. It would go beyond Obamacare to create a government controlled health system.”

The campaign — in a state with historically deep pockets of  progressive and conservative legacies — has taken shape in the shadows of two other key political developments: A costly recall election earlier this year in which liberals and national labor groups sought unsuccessfully to remove Republican Gov. Scott Walker and local GOP Rep. Paul Ryan’s rise as the leading advocate of conservative views on health and retirement issues and his selection as presidential nominee Mitt Romney’s running mate.

Ryan, 42, has described himself and the often confrontational Walker, 44, as “protégés of the Tommy Thompson farm team,” but the 70-year-old Thompson has sought to distance himself from their policy embrace on broad social issues. Although he has called for overturning the health law and has endorsed the concept promoted by Ryan to give seniors premium supports to buy health coverage in order to keep the system from running out of money, Thompson also has said he would want significant revisions in that plan, such as increased federal payments and an expanded pool for high-risk patients.

“I am here to save Medicare, Medicaid and Social Security, but you have to make some adjustments,” he told the Milwaukee Press Club this month.

Baldwin has been a fierce advocate for keeping the health law and for preserving Medicare’s current structure. 

A  released Wednesday found that the race was dead even.

Yet despite the divisive campaign, a poll early this month by the school shows movement among voters in two ways that suggests the public may be beginning to break away from the health care polarization of the two parties and may be more accepting of change:

–Respondents split 46 percent to 45 percent on whether they approve or disapprove of the Affordable Care Act. When the survey in May asked how the Supreme Court should rule on the law’s constitutionality, 33 percent said that they wanted to keep the law, and 57 percent said that it should be overturned—in whole, or in part.

–65 percent of respondents said that they want Medicare to “continue as it is today, with the government guaranteeing seniors health insurance and making sure that everyone gets the same defined set of benefits.”But the next question in that poll revealed that 51 percent said that “major changes will be required because the current system is too expensive to continue as it is,” and only 45 percent said that Washington can “find ways to continue to support the current Medicare system.”

“The negative stereotype is that people want to have their cake and eat it too,” said Charles Franklin, the poll director. “But they are aware of the difficulties of paying for the system. This results in a tension for people who support the current system, but see it as hard to finance…. 20 to 25 percent want current Medicare, but say major change is required.”

Similar trends have been evident in recent national polling on health-policy issues, including a by The Kaiser Family Foundation, which found “malleable” public support for sweeping Medicare change. More than a quarter of the respondents wanted to keep Medicare the same and 37 percent favored change. But another 25 percent switched from wanting to keep the current system after being told that change in the system “is needed to sustain Medicare for future generations.” (KHN is an editorially independent part of the foundation.)

Those tensions are reflected in Wisconsin’s Senate contest, according to Ted Marmor, a Yale University political science professor emeritus and scholar on the modern welfare state.

“With Baldwin versus Thompson, you have a moderation of those choices” compared to the national debates on health and Medicare, Marmor said in an interview. “Thompson won’t say that he’s for vouchers to pay for Medicare because he knows that Baldwin would attack him for that. Nor will Baldwin be as bold as Vice President Joe Biden [in the Oct 11 vice-presidential debate] in rejecting solutions to Medicare….This means that the broader public debate is becoming less idiotic.”

Candidates in other high-profile Senate contests, by contrast, have handled these issues with the equivalent of sound bites.

In close Senate contests in liberal-leaning Massachusetts and Connecticut, Marmor said, Elizabeth Warren and Rep. Chris Murphy have taken “traditional Democratic positions,” while Republicans Sen. Scott Brown and Linda McMahon “want to be more fiscally responsible.” With a similar shift by Romney after last summer’s national conventions, Marmor added, the public debate has shifted toward the center.

Marmor added that he was heartened by the muted attacks in the presidential campaign. “The clarity of the differences between Democrats and Republicans has been blurred in the past weeks,” he said.

This <a target="_blank" href="/medicare/wisconsin-senate-candidates-health-care/">article</a&gt; first appeared on <a target="_blank" href="">Â鶹ŮÓÅ Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">