AARP faces test on healthcare reform

President Barack Obama’s ability to secure healthcare reform may depend on the clout of the AARP, the influential lobby for older Americans.

If history is any guide, Obama will need the AARP if he is ever going to get the elderly on board his healthcare plan. But despite spending tens of millions of dollars on pro-reform advertising and an aggressive public-relations and grassroots campaign, the AARP hasn’t built up that support.

{mosads}The end of the national debate over healthcare reform, whatever the outcome, could mark a seminal moment for the AARP, a 51-year-old powerhouse that boasts a membership of more than 35 million people and has offices, operatives and a volunteer ground force in every state.

“You have to get that segment of the population behind it,” said Cheryl Matheis, the AARP’s senior vice president for health strategy.

“I don’t think that there is another source that our members find more credible for information than the AARP,” Matheis said. “If our members are not supportive of this, I don’t see another organization who can make them supportive.”

The AARP has no political action committee, does not make campaign contributions and does not endorse candidates but is well known for its lobbying, communications and organizing prowess.

The group has been using every tool at its disposal to win public support for overhauling the healthcare system. On its own and through partnerships with business and labor groups, such as Divided We Fail, the AARP has spent big on healthcare reform.

Failure to successfully marshal these resources to win over dubious older Americans would be a significant defeat for the AARP, which is not accustomed to losing big battles.

The AARP’s efforts haven’t gone over well with all of its members. According to reports by CBS News and the Associated Press, about 60,000 people have quit their AARP memberships since July 1. That represents just a fraction of the AARP’s membership — and the group told the AP that it gained 400,000 members and renewed 1.5 million current members during the same time period — but it underscores the political risks the group is taking. The AARP endured similar protests over its stances on Social Security reform and Medicare Part D.

Complicating the AARP’s mission is that it serves two groups of people within its membership that both would be affected by reform.

First are those old enough to be on Medicare, who want their benefits protected and their costs controlled. Second are those between 50 and 64, who want access to more affordable insurance with better benefits than they can get now in a system that charges much more for older and sicker people or denies them coverage entirely.

Though the AARP has not formally endorsed Obama’s healthcare platform nor any of the bills in Congress, the group has stood as a staunch proponent of many of the common elements in Democratic proposals, such as the creation of a health insurance exchange and the availability of subsidies for low-income people.

“Our decision to support or not support something makes a huge different in our members’ opinion,” Matheis said. An endorsement may yet come but the group has not won absolute assurance from Democrats on key issues.

The AARP wants to make sure the bill would not add any new cost-sharing obligations for Medicare beneficiaries or that new insurance regulations would allow plans to charge much higher rates for older people. The group is also piqued that the bills so far would not speed access to cheaper versions of biological drugs as fast as it wants.

The benefits of an AARP endorsement can hardly be overstated; nor can the perils of its opposition. In 2005, the AARP handed the GOP a loss when it helped kill President George W. Bush’s proposal to add private accounts to Social Security. Two years before, the group beat back Democrats and endorsed the GOP-crafted Part D drug benefit for Medicare.

Obama clearly understands that he stands to gain from an alliance with the AARP.

When he announced in June that his administration had struck a deal with the drug industry that would cut prescription costs for people on Medicare, he invited AARP President and CEO A. Barry Rand to introduce him at the White House.

The president also appeared at an AARP forum in July and continues to hype the new Medicare benefits his plan would create — and to insist that older Americans will be better off with healthcare reform.

On the stump, Obama routinely mentions the AARP’s support for the drug-industry deal. Last week, he went too far for the AARP’s tastes and asserted the group had endorsed the healthcare bills in Congress, prompting a swift and strongly worded statement from the AARP denying it had made any endorsement.

The AARP’s PR blitz dates back to last year’s presidential campaign and to Democratic efforts since 2007 to expand the Children’s Health Insurance Program.

The AARP’s grassroots and public-relations work is backed by a massive lobbying budget, nearly all of which goes to the AARP’s staff of more than 50 registered lobbyists. In the first two quarters of this year, the AARP spent $9.4 million on lobbying, the ninth most of any organization. Last year, only the U.S. Chamber of Commerce and Exxon Mobil spent more than the AARP’s $27.9 million.

{mosads}Up to this point, older voters aren’t buying what Obama and the AARP are selling, according to several opinion polls.

A majority of people 50 or older opposed Obama on healthcare, a CNN/Opinion Research Corp. survey found. In a Gallup poll, substantially more older people thought healthcare reform would worsen, or at least not improve, their access to care and the quality of the services they receive.

To counter this skepticism, the AARP has begun defending healthcare reform against specific attacks, something Matheis says the group will do more of in the coming months.

The AARP’s latest multimillion-dollar national advertising and grassroots campaign targets what it terms “myths” about healthcare reform, including the claim that the new end-of-life counseling benefit in the House bill is a mechanism to deny care to the elderly and sick and that Medicare benefits will be cut to pay for covering the uninsured.

Perhaps more important than the ads, the AARP is ramping up its outreach efforts to members across the country.

Coinciding with Congress’s return to Washington in early September, the AARP will distribute 8 million pieces of mail highlighting the benefits of healthcare reform, with a focus on Medicare. Prior to that, the group plans a 1 million-piece mail campaign as part of its “myth-busting” efforts.

The AARP also is staging scores of town halls, other community events and “tele-town halls.” Like lawmakers, however, the AARP has not been immune to angry displays at its public events. After protests disrupted a town hall in Dallas last week, the AARP canceled a series of similar events in northern Texas.

This story was updated at 1:19 p.m.