The ad running in West Virginia opens with a harrowing scene: An elderly woman waits in a doctor’s office for test results.
Reading from a chart, the doctor delivers the bad news: Sen. Joe Manchin (D-W.Va.) “is negotiating a bill that would strip nearly $300 billion from Medicare.” Research on the treatment the woman is receiving “may be stopped.”
“I wish I had better options for you, but I really think it’s time you started talking to your family,” the doctor adds before walking away and leaving the woman stunned.
The not-so-subtle implication of the ad: The Manchin-crafted economic deal the Senate will vote on this weekend is going to kill grandma.
The 30-second spot from the Center for Innovation and Free Enterprise, targeting the Democrat who crafted the party’s ultimate legislation delivering what’s left of President Joe Biden’s economic agenda, the so-called Inflation Reduction Act, is one of a slew of last-minute ads from conservative and pharmaceutical industry groups aiming to scare senior citizens by falsely implying Democrats are planning to cut Medicare.
The line, which has also been picked up by some Republican politicians, twists the reality of the legislation, which gives Medicare the ability to use its buying power as the nation’s largest health insurance provider to negotiate lower costs from drug companies. That’s projected to save Medicare $300 billion over the next decade ― savings that will go to continuing subsidies for health insurance, reducing the deficit and fighting climate change.
Democrats hope to pass the legislation in the Senate as early as this weekend and for Biden to sign it into law not long after. It would represent a significant achievement, even with the many compromises and concessions that went into the final version, in part because the pharmaceutical industry has been fighting these sorts of reforms literally for decades.
And they are still fighting now. The pharmaceutical industry has spent more than $545 million on lobbying over the past two years as it seeks to kill the effort to lower drug costs, plus millions more on television and digital ads through an array of nonprofit groups.
But lately they have been focusing more on the claim that Democrats are stealing from Medicare to fund other programs. The argument’s target is seniors, three-quarters of whom said in a July AARP poll that protecting Medicare was very important to their vote.
The Washington Post, Kaiser Health News and the Committee for a Responsible Federal Budget have all called the arguments false or misleading ― a verdict several experts echoed in conversations with HuffPost.
“The reductions that are occurring in Medicare spending have the effect of lowering costs for people on Medicare,” said Tricia Neuman, senior vice president at the Henry J. Kaiser Family Foundation. “It’s not really taking money from Medicare. It’s lowering prices so that Medicare and people covered by the program end up spending less.”
The claims about stealing from Medicare also leave out a very important piece of context: Other parts of the legislation would strengthen the program’s financial protection for seniors. That includes a provision that would cap out-of-pocket spending on drugs at $2,000 a year, providing much-needed relief to seniors with serious medical problems.
“People on Medicare who take very expensive drugs for conditions like cancer and rheumatoid arthritis and MS can spend thousands and thousands of dollars, even when they’re covered under a [Medicare drug] plan, because there’s no hard cap on out-of-pocket spending,” Neuman said. “This establishes a $2,000 cap, which should provide real peace of mind.”
Claims about raiding Medicare have also cropped up in ads from groups directly funded by PhRMA, the drug industry’s trade and lobbying group. America Next, a group founded by former Louisiana Gov. Bobby Jindal (R); the 60-Plus Association, a group that aims to be a conservative counterpart to the AARP; and the conservative group American Commitment are all airing ads with similar claims. PhRMA has funded all three groups in the past.
The ad buy in West Virginia is significant: about $500,000 over two weeks, according to a Democrat tracking media buys. And it’s just part of a barrage of advertising aimed at Manchin and Sen. Kyrsten Sinema (D-Ariz.), who said late Thursday that she would join in supporting the Inflation Reduction Act with some minor changes.
“This ad is blatantly lying,” said Sam Runyon, a spokesperson for Manchin. “West Virginia seniors know Sen. Manchin has worked tirelessly to protect Medicare and reduce prescription drug costs. In fact, the Inflation Reduction Act will ensure more than 317,000 West Virginians are paying less for their prescription drugs.”
Other Democrats are also scoffing at the argument. “Republicans claiming that cutting drug prices is actually a cut to Medicare would be like claiming that bringing down gas prices is actually reducing the value of your car,” said Jesse Ferguson, a Democratic consultant who regularly works on health care messaging.
There is a long history of political messaging designed to scare seniors about threats to Medicare, some real and some imagined.
A 2012 video from a progressive group famously depicted an actor playing then-GOP vice presidential nominee Paul Ryan pushing a grandma off a cliff as a way to dramatize his proposals to cut Medicare and change it to a voucher program. And some Democrats used similar messaging ― that Medicare savings were actually cuts ― to attack former President Donald Trump.
Accusations of stealing from Medicare to finance other programs were also a regular feature of right-wing attacks on the Affordable Care Act, which ― again, like the proposal now before Congress― reduced Medicare spending by reducing what the program paid parts of the health care industry.
The attacks Republicans and their allies are launching now aren’t likely to stop when the debate over legislation ends. Instead, Republicans have signaled that they plan to echo the attacks against Democrats up for reelection in 2022 ― a GOP poll outlining attacks on Sen. Mark Kelly (D-Ariz.) included the line.
“They’re taking $280 billion out of Medicare. They’re going to reduce lifesaving drugs for people. And we know Medicare is going bankrupt,” Sen. Rick Scott (R-Fla.), the chair of the National Republican Senatorial Committee, told HuffPost. “This is just a war on seniors.”
Seniors are the most reliable voting bloc in the United States and are especially crucial during midterm elections, when younger voters often drop out of the electorate. During the 2018 midterms, voters 50 and older made up 60% of the electorate.
And if there’s one issue that reliably gets seniors’ attention, it’s health care, because they are more prone to illness and injury ― and more vulnerable to high medical bills.
More than a third of seniors say they are “concerned” or “extremely concerned” about high medical costs, according to a sweeping survey last year by West Health/Gallup, and 12% said they or a family member went so far as to skip recommended care because of the price.
An underlying reason for this financial exposure is that drugs cost a lot more in the U.S. than they do in peer countries, where governments have the power to set prices directly or negotiate directly with drugmakers. The legislation Democrats hope to pass would allow the federal government to finally have a version of that kind of power.
The authority would cover a limited, narrow class of drugs and affect only the prices that Medicare pays. The process wouldn’t start for a few years and even then it would ramp up gradually.
But future lawmakers could expand the scope of the government’s negotiating power, and that possibility, as much as any immediate real-world impact, is a big reason why the drug industry and its allies are so desperate to block the provision.
The industry also opposes a related feature of the bill that would penalize drugmakers who raise prices faster than the rate of inflation. That feature would apply to commercial insurance as well as to Medicare, although Democrats are waiting anxiously to see whether the Senate parliamentarian rules that the private insurance part is consistent with special procedural rules about what can and can’t be part of the legislation.
The drug negotiation provisions appear to be extremely popular, if the polls are indicative. In one particularly telling survey last year, the Kaiser Family Foundation presented a series of arguments for and against drug price negotiation. Support was overwhelming, and there wasn’t even that much of a partisan disparity, with more than 70% of self-identified Republican respondents saying they were in favor of it.
The other provisions of the legislation are less controversial. In addition to the new $2,000 cap on out-of-pocket expenses, there’s a proposed expansion of a program that provides low-income seniors with extra insurance coverage and a guarantee that vaccines would be free for Medicare beneficiaries. Today, many vaccines require copayments under Medicare, which, even when modest, can discourage seniors from getting them.
Although those provisions have gotten a lot less attention than the Senate negotiation process for the legislation, they would offer significant ― and more immediate ― help. They would also require new government spending, which is one reason they’re all part of one package.
The money Medicare would be saving, through negotiated prices and limits on inflation, would help finance the vaccines, extra help for low-income seniors and that $2,000 cap on out-of-pocket expenses.
That’s one reason Lovisa Gustafsson, a vice president at the Commonwealth Fund, told HuffPost it’s wrong to think of the legislation as cutting benefits.
“It’s not taking away your coverage or something along those lines,” Gustafsson said. “It’s one of those rare occasions where you are able to save money, to spend less, but also to improve things for patients. … It’s kind of an all-around win for everyone ― except the pharmaceutical industry.”