Seniors on front line of health-care battle

In the television commercial, the camera pans slowly over a worried-looking elderly woman.

"Most people agree that we need to reform health care," a narrator begins in the 30-second spot, "but is it right to ask more than 10 million seniors on Medicare Advantage for more than their fair share?"

Even as House Democrats today revealed their version of a major overhaul to the nation's health-care system, activists on both sides of the debate were marshaling a potent force to push their viewpoints.

The force? Senior citizens.

Polls have indicated that concerns about the overhaul are strongest among senior citizens, an influential bloc because people 65 and older are the most reliable voters. Their power is magnified in midterm elections because turnout is usually much lower than in presidential years.

That is why America's Health Insurance Plans, a trade group, is spending millions to run these advertisements in 10 states, including Pennsylvania, which has one of the largest populations of senior citizens in the nation.

And it is why a tiny band of elderly activists, marshaled by two statewide organizations promoting President Obama's plan, rallied briefly outside the headquarters of Cigna Corp. in Philadelphia today.

"I get so angry I see red," said one of them, Clara Jellinek, 83, of Center City. She said the advertisements were confusing and intended to scare senior citizens. "They are very effective."

She said senior citizens would be helped when more people were covered and when their choices included a government option, which insurers such as Cigna oppose.

Cigna spokesman Christopher Curran referred questions to AHIP, the trade group.

Today was pivotal in Democrats' attempts to answer Obama's call for legislation to remake the health-care system by extending insurance, ending industry practices such as denying coverage on the basis of existing medical conditions, and slowing the growth of medical spending.

The overhaul will be funded in large part by cuts to the Medicare Advantage program.

Most senior citizens are eligible for Medicare, a federal health insurance program funded by the government. But Medicare does not cover everything.

Seniors can keep Medicare, buying Medigap policies to fill the holes. Or they can choose Medicare Advantage plans from insurers such as Independence Blue Cross.

Under Medicare Advantage, the government subcontracts with insurance companies to handle paperwork, manage care, plug gaps, and provide various extra services, such as drug and dental. The insurers also charge premiums and co-pays.

The federal government reimburses the insurers an average of 12 percent more than it would cost to fund plain-vanilla Medicare.

Washington policymakers, especially Democrats, say the extra reimbursement is wasteful and adds to insurers' profits without providing enough benefits for the bucks. Insurers disagree and say cuts to the program, including those to fund the overhaul, would push insurers out of the business.

"Seniors will be shocked when they see the higher costs and reduced coverage," said Robert Zirkelbach, an AHIP spokesman. He said critics of the ads were trying to trick seniors into thinking they would not be hurt by changes to Medicare Advantage.

In Pennsylvania, 864,000 seniors on Medicare, or nearly four in 10, use Medicare Advantage plans, one of the highest rates in the country, Zirkelbach said.

Meanwhile, all versions of the health-care legislation contain a provision sure to be popular with senior citizens - a way to help them offset drug costs.

To be sure, the issue is confusing, and that can help or hurt, depending on how activists on both sides handle their messages.

"Nobody knows the ins and outs," said Mary Himmelreich, 80, who leads a group of 125 senior citizens in Northeast Philadelphia. "We're not stupid, but I don't think anybody understands it."