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Even though the health insurance program for senior citizens and the disabled survived the initial phase of the debt-ceiling deal without suffering  cuts, in the next round.

But efforts to change Medicare have traditionally drawn , especially from sought-after senior citizen voters. So, as the 2012 election draws closer, will this hold true? Or are deficit worries now making changes more palatable?  KHN checked in with Democratic pollster Celinda Lake, president of , for her take on the current dynamics of Medicare’s public image.

Her bottom line: It is an even more important political issue now than in the past. “It’s not just a seniors’ issue by any matter or means,” she said. The Medicare changes in the advanced by House Budget Committee Chairman Paul Ryan, R-Wis., “really elevated it, because it was such a clear distinction” between the Democratic and Republican positions. ”You saw it play out in the [congressional election in May]. And it is the top testing message in congressional races right now,” Lake added.

She’ll be watching how aggressively Democrats rally around protecting Medicare but believes it will be harder for the party “to draw the distinction that many of us believe in” because President Barack Obama talked about Medicare cuts in the context of the budget deal. “So I think it’s going to depend on how strong a stance Democrats take or whether they muddle it.” Regardless, she adds, “it has the potential to be THE voting issue in 2012.”

And how does the trigger provision — the one that says if the super committee doesn’t come up with a deal, Medicare providers will be cut 2 percent — play?

“Not very well,” she said, “because voters don’t believe it. … Voters really like their doctors. And the older you are, the more you like your doctors.”

Seniors have real concerns about whether their physicians will continue to be able to afford to see Medicare patients.  Also, hospitals in “getting out the message — rightly or wrongly” that their Medicare payments are being cut. “So, we have a remarkable number, frankly, of seniors who will raise that issue,” she added.

When it comes to Medicaid, she sees definite changes. “I don’t know that the voters completely understand it,  but one thing we are seeing is that that they or someone in their family has used Medicaid, which was never true before, so that’s amazing.”

Because of the Medicaid funding battles that have played out in many states, a record number of voters, she said, now views it “as a program that helps seniors, helps nursing homes,  helps children  …  so I think people are becoming much more protective of Medicaid.”

Lake’s takeaway message, though, focused on who she sees as the “key voter” in 2012. “It’s gonna be independent women, particularly independent women over 50,” she said. And, “they are very, very adamant about Medicare, and also tend to become the strongest supporters of Medicaid.”