Republican Medicare Plan Could Shape 2012 Races

Republicans acknowledge that the vote is risky, and party strategists have warned House leaders about the dangers, aides said. But Republicans are calculating that the political ground has shifted, making the public, concerned about the mounting national debt, receptive to proposals to rein in costs by reshaping the program.

Newt Gingrich, a former House speaker exploring a bid for the Republican presidential nomination, said proposing a major overhaul of entitlement programs was not as politically fraught as it might have been a decade ago. But he said Republicans must be vigilant in defending their actions and mindful that Democrats were poised to attack.

“I think it is a dangerous political exercise,” Mr. Gingrich said in an interview Monday. “This is not something that Republicans can afford to handle lightly.”

Democrats are preparing to try to brand Republicans as proponents of dismantling the Medicare system if they vote for the party’s budget, which advocates converting the program from one where the government is the insurer into one where the government subsidizes retirees in private insurance plans.

Republicans say that without such changes, Medicare will not be financially sustainable in the long run as the population ages and medical costs continue to rise.

The House is scheduled to vote on the Republican budget, developed by Representative Paul D. Ryan, Republican of Wisconsin and the chairman of the Budget Committee, by the end of the week.

Representative Steve Israel, the New York Democrat leading his party’s House campaign operation, called the budget vote “the moment of truth” for House Republicans in 14 Democratic-leaning districts that backed John Kerry for president in 2004 and 61 that went for Barack Obama in 2008.

“We are going to use the budget to prove to Americans that every time Republicans choose to protect oil company profits while privatizing Medicare for seniors, seniors will chose Democrats,” Mr. Israel said.

He and other party strategists say they believe the Republican stance on Medicare could be particularly persuasive against incumbents in states like Florida, Illinois, Michigan, New York, Ohio and Pennsylvania. It could carry extra potency, they say, because Republicans hit Democrats hard in the 2010 midterms on cutting Medicare as part of the new health law and Democrats now intend to turn that message back on them.

President Obama is expected to enter the debate over entitlement spending in a speech on Wednesday and could offer his own views on how to control Medicare costs. But he is expected to go nowhere near as far as Republicans did in the Ryan budget.

Republicans say the willingness of the White House to talk about entitlement changes could reinforce the Republican claim that steps need to be taken to preserve Medicare, limiting the ability of Democrats to attack and making the debate mainly about what the steps should be.

Democrats are looking to the budget vote to reshape the election landscape much as President George W. Bush’s proposal to overhaul Social Security did in 2006, particularly among older voters and independents who deserted Democrats in 2010.

A fund-raising e-mail sent Monday by the Democratic Congressional Campaign Committee warned recipients that the Ryan budget would “end Medicare as we know it and force seniors to clip coupons if they need to see a doctor.” It added, “Meanwhile, the wealthy would receive another tax cut.”

Republicans say Democrats are exaggerating the impact of any vote. They say their party has a credible response that the budget preserves Medicare for future retirees since it could collapse under runaway costs if left unchanged. Americans now 55 or older would still be covered under the existing program.

“If there is one thing we can understand from Democrats right now it is that they are willing to stop at nothing to scare America’s seniors,” said Paul Lindsay, a spokesman for the National Republican Congressional Committee. “It demonstrates their unwillingness to tell the American people the truth when it comes to the looming debt crisis facing this country.”

Some first-term House Republicans who could be on the front lines do not seem overly anxious about the budget vote, saying that is what they came to Washington to do.