Obama faces a generation gap on healthcare reform

Older Americans worry that healthcare reform will affect Medicare. Younger Americans, who often lack good health insurance, are more supportive.

Part of the task facing President Obama in his push for healthcare reform is to bridge a generational divide.

Americans over 65 already are insured through Medicare, and many are worried that reform will hurt them more than it will help. Younger Americans are more likely to lack insurance or to be vulnerable to losing coverage, and they tend to be more supportive of reform ideas.

Obama's sales job, beginning in his prime-time speech Wednesday, is to reduce the fears of seniors about an erosion of Medicare and to persuade working-age Americans that the reforms will deliver benefits that are worth the cost.

The demographic divide is visible in a recent poll by CNN/Opinion Research Corp. The survey posed the question: "From everything you have heard or read so far, do you favor or oppose Barack Obama's plan to reform health care?"

Overall, the nation split almost right down the middle, with 48 percent favoring Obama's plan and 51 percent opposed.

But here's the breakdown on generational lines:

• Americans age 65 and up: 38 percent support the president on this issue.

• Age 50 to 64: 46 percent support.

• Age 35 to 49: 41 percent support

• Age 18 to 34: 60 percent support.

The progression through the age groups is somewhat uneven for several reasons.

Younger working Americans are the most likely to be unemployed or to have jobs that lack full health benefits. They are the only group that strongly backs the president in this poll.

Those in mid-career tend to be among the most job-secure, and they exhibit weak support for Obama's plan.

Opinion is closer to neutral in the 50-to-64 age range. In this group, workers aren't yet eligible for Medicare and generally face higher insurance costs than younger Americans if they lose work-related coverage. That may explain much of the difference between their opinions and those of surrounding age groups.

Republican opposition to the Obama reforms has tapped into the generational divide.

Late last month, Republican National Committee (RNC) Chairman Michael Steele urged a "senior's health care bill of rights." One piece is a pledge not to cut Medicare benefits.

"President Obama and Congressional Democrats are promoting a government-run health care experiment that will cut over $500 billion from Medicare to be used to pay for their plan," says a statement on the RNC website.

Defenders of Democrat-led reforms say Republicans are exaggerating the threat to Medicare, at least in the specific bills now under review.

This debate highlights just one facet of healthcare reform's difficult politics.

Many Americans still say major reforms to the system are needed, but the number has shrunk – from a majority down to 45 percent of the public – as details have been debated this summer.

Still, many economists say doing nothing is a poor option. The trend line of the status quo is this: millions of Americans lacking coverage they would like to have, and a soaring healthcare tab in tax dollars and private spending.

That rising cost burden will be borne chiefly by those now young, which may also explain part of the generational divide. It's not clear that any legislation this year will do much to rein in the price of care, but it is clear that the current system has allowed runaway costs.

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