You won’t find the word “Medicare” in the section of Republican Linda Lingle‘s campaign website that spells out her issues.

And yet, if her opponents have their way, Medicare — the federal medical insurance program for people who are aged 65 and over — may be a defining issue of the race for Daniel Akaka‘s open U.S. Senate seat.

The Democratic Senatorial Campaign Committee (DSCC) is already trying to pin Lingle down on the controversial issue. Some national Republicans have proposed major changes to the entitlement program in light of the long-term challenge of continuing to pay for it.

Democratic opponents Ed Case and especially Mazie Hirono have been outspoken in their support for Medicare, and a powerful advocate group for seniors has noticed.

“Hirono is a known quantity on Medicare — she has consistently voted in support in Congress — and Case has always been very open to working with us, though mainly with Social Security,” said Barbara Kim Stanton, executive director of AARP Hawaii. “But Case is aligned with us on Medicare. We are yet to find out where Lingle stands, but we are very, very interested to know.”

Another DSCC Salvo

The AARP may have more to go on, now that Lingle has shared her Medicare views following an attack Monday from the DSCC. Here’s an excerpt from the DSCC’s press release:

As she embarks on the third week of her candidacy, Linda Lingle is still refusing to say where she stands on President Obama’s jobs plan or her party’s budget plan, which would turn Medicare into a private voucher system in order to pay for more tax breaks for oil companies and the wealthiest Americans. Two weeks ago, Lingle said she couldn’t take a firm position because she had not read the proposals.

The DSCC, which bills itself as “the only organization solely dedicated to electing a Democratic Senate,” ties its criticism to a GOP budget plan proposed by Congressman Paul Ryan of Wisconsin that “would have serious consequences for Hawaii.”

DSCC spokesman Matt Canter charged, “Instead of standing up for Hawaii seniors, Linda Lingle still refuses to criticize her party’s extreme plans to balance the budget on the backs of seniors by gutting Medicare.”

Lingle Fires Back

Asked to respond, the Lingle campaign sent Civil Beat a detailed statement from Lingle that focused mostly on her support for Medicare.

She said she does have “some concerns” with the proposed Ryan budget, but noted that “the discussion is somewhat moot” because the Ryan budget was defeated in the Senate.

“It is important to point out that I remain committed to protecting our seniors,” Lingle said. “I understand the importance of a fiscally sound medical insurance system for our seniors in Hawaii and throughout the nation. That is why, as Senator, I would abide by the following guidelines when examining proposals to sustain the Medicare program:

• Seniors and the disabled currently covered by Medicare should continue to receive the health care and support they have been promised;

• Reimbursement rates should be set at a level that encourages doctors to treat Medicare patients by covering a fair proportion of the doctor’s costs;

• Audits of Medicare claims, which currently cover only an estimated 5 percent of all claims, must be significantly expanded to discourage waste and fraud in the system;

• There should be early agreement on when future beneficiaries will be expected to pay higher deductibles so that people currently in the workforce can plan in advance for higher out-of-pocket expenses; and

• Tort reform should encompass medical malpractice legal reforms. The current system drives up costs by forcing doctors to order unnecessary or duplicative tests as a form of defensive medicine and patients are subjected to needless medical procedures.

Huge Voter Bloc

The issue of Medicare is of particular importance to a powerful constituency.

Citing data from the Centers for Medicare & Medicaid, the AARP’s Stanton noted that more than 186,000 people in Hawaii were enrolled in Medicare in 2009.

“That’s 99.3 percent of all Hawaii seniors,” said Stanton. “Every candidate knows that the 50-plus voting population votes in larger numbers that any other age group. They are expected to count for 56 percent of all votes cast — it’s huge.”

The high turnout rates gain greater significance, Stanton said, because of Hawaii’s historically low voter turnout rates.

“We are always teetering for last place or very close to the bottom,” she said. “A lot of people don’t vote here, but the seniors understand what’s at stake, and they vote in huge numbers.”

Stanton predicts Medicare will be a “hot issue” in the 2012 election.

“Because so many of our seniors depend on Medicare, and with rising health care costs and the already high cost of living in Hawaii, seniors will care immensely about Medicare,” she said. “Any congressional candidate it will absolute be a top-of-mind issue.”

Caring for Kupuna

AARP is nonpartisan and it does not endorse, give money to or campaign for candidates. But it does conduct “voter education.”

Lingle is no doubt aware of the voting rate of seniors.

In her response to the DSCC, Lingle said, “If elected, I will work across partisan lines to protect Medicare and Social Security to protect our senior citizens, or kupuna, as we say in Hawaii.”

Case and Hirono are of like mind when it comes to Medicare.

“Our economy and jobs, our federal budget, taxes and spending, and Social Security and Medicare are among the most critical issues facing our country,” Case said in an email to Civil Beat. “They have a real impact on real people throughout Hawaii, as I’ve heard up close and personal throughout my statewide talk stories. They should be and will be front and center in this U.S. Senate campaign, and every voter deserves to know that each candidate understands the main proposals and where the candidate stands.”

Hirono says she places similar importance on protecting Medicare.

“Everywhere I go across Hawaii, the top issues people care about are how are we going to create jobs and stand up for our kupuna,” said Hirono through a campaign spokesman. “I will continue to fight to protect Social Security and Medicare. That’s what’s at stake in this election and those are the priorities I’m fighting for. Hawaii needs a senator who’s on our side, and whose priorities are crystal clear.”

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