Here in Florida, Mitt Romney's choice for his Republican running mate has caused perhaps more commotion than in any other state.
Wisconsin Rep. Paul Ryan has promised to "end Medicare as we know it." Not surprisingly, that's a hot issue in the Sunshine State, where so many seniors come to retire. But in the days since Ryan's selection, the impact on Romney's campaign remains unclear.
"It absolutely will drive some voters away from him. How many is difficult to predict," said William March, a longtime political reporter for The Tampa Tribune. "The one aspect of the Medicare controversy and Paul Ryan as running mate is that this has allowed the Democrats to go on the offensive on the health care issue, whereas they had been playing defense."
Playing defense because Obama's health care overhaul is extremely unpopular in Florida, by margins of 60 percent or more in polling. As a mandate, people don't like it. But when it comes to the actual benefits of the plan, it seems the situation is much more complicated.
"You have here thousands and thousands of elderly people who are now getting the free preventive care services — annual wellness checkups, mammograms, colonoscopies and so on — getting those services free with no co-pay, as the plan now requires," March said. "So when you separate out what the plan does from the plan itself, it’s more popular."
So, this week, we met with a group of seniors in Tampa to hear their thoughts on health care policy and how it will influence their decision on Election Day. We visited University Village, a sprawling senior living community about 10 miles from downtown, where people come from all around the country to retire, and heard the concerns of three of its residents:
Terrell Sessums, 82, leaning toward Obama
"There are a plethora of issues that I’m interested in. I guess the paramount ones have to do with the economy, Medicare, to some extent Social Security."
Ken McGill, 82, supporting Romney
"My biggest concern in this election is our drifting to the socialistic side of government. I’m concerned about the new health care law and our lack of information concerning it."
Ann Cook, 85, supporting Obama
"I am concerned about Medicare, Medicaid and I’m not one of these people terrified that a few pennies I pay in taxes might go to help somebody else."
We started by asking the three if they are worried about the future of Medicare, should Romney be elected. The controversy over the Ryan plan is that it would evolve Medicare into a voucher program to give future retirees a fixed amount to pay for health care.
Sessums: For my lifetime probably not. I’m more concerned for my children and grandchildren. I think Romney’s made it very clear that the first thing he wants to do is repeal Obamacare. We pay more than anybody else in the world for health care and get some of the worst results. Primarily because we have a large reservoir of people who have no coverage.
Now Obamacare, if you want to call it that, does something that Mitt Romney did in Massachusetts. It contains the individual mandate requiring people to get coverage. Otherwise, we’re paying for it right now.
Cook: I understand that the Affordable Health Care law does slow the growth of Medicare, which is a good thing. I think it’s been intelligently formulated and not well enough understood. I imagine there are other changes that will have to be made to the program over time.
But I think intelligent people can get together and fix it without taking a meat axe to it. And I do not want to see vouchers come. I do care what happens to the generations after myself. I think if even a lot of people went to a voucher system, that would reduce the base, and I think it would make it work much less smoothly. And I think that’s a very risky situation; you do not have real security if you have a voucher program.
McGill: I don’t think the voucher system is even on the table and won’t be on the table, whether Ryan believes it or not.
McGill is the only senior we spoke to who belongs to an HMO. He says that when Obamacare is implemented next year, the relative cost effectiveness of plans like his will be lost.
McGill: There’s no doubt about that I’m going to pay several thousand dollars more next year in health care costs.
I have spent, I think, $3,100 this year on health care issues. That comparison to my neighbor here is probably several thousand less than what he’s paying on traditional Medicare and supplemental insurance. I think the ultimate solution is to encourage more HMOs, where the burden of carrying things out rests not with government but with the insurer.
Sessums: I think Medicaid would be largely replaced if people are required to have insurance under the Affordable Health Care Act.
Let me make my position clear: I think the Affordable Health Care Act is a significant improvement over the status quo and I would support it. But I don’t think it’s the ideal. If I were the dictator I would have had a single payer system, everybody covered by Medicare, let the insurance industry cover the supplemental market.
McGill: As I understand the Medicare bill, if you can’t pay, you will still get coverage. We are going to reinsure those people who have no insurance today. And if it’s somewhere between 30 and 60 million, nobody knows for sure, but let’s just take the figure of 45 million people who will be added to the rolls.
So, I mean, we’re not looking at a tremendous savings as they’re telling us for this new health care. We’ll probably be right back where we were.
It is too early to say if Romney's choice of running mate is likely to drive older voters away from the Republican Party in this swing state, where seniors make up a disproportionate chunk of the electorate, and also are more likely to turn out to vote.
But as March, of the Tampa Tribune points out, a huge number of voters don't have to be driven away to have a huge effect on the outcome.
"This is Florida, and this election is going to be extremely close; it’s going to be within the margin of error almost certainly," he said. "And anything that causes a 1, 1.5, 2 percent swing can change the outcome of the election."
This program aired on August 28, 2012.