But not for long. The supplemental premium quickly became an issue as more affluent Medicare beneficiaries got wind of it. Many of those retirees already had some semblance of the new coverage and resented being asked to pay for it for others.
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"It blew up," said Mr. Donnelly, who left the House, served as an ambassador and is now retired. "A lot of people in the United States already had this coverage. Almost every retired union member had the coverage through negotiated benefits."
In addition, the revenue from the new premium was projected to exceed what was needed and quickly build a surplus, feeding a perception that the catastrophic-care program was a backdoor route to reducing the deficit through a tax on retirees.
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To their chagrin, advocates and critics of the measure also discovered that many people who were supposed to be thrilled about the new plan misunderstood it and thought it was going to ease one of their great fears — the expense of living in a nursing home. When consumers came to realize that it did little to help with long-term care, enthusiasm dipped.
In a foreshadowing of the angry town hall-style meetings on health care in 2009, older voters began to protest the measure. They were inflamed by an aggressive direct-mail effort by the relatively new National Committee to Preserve Social Security and Medicare, which found itself fighting with the American Association of Retired Persons, a champion of the new law.
The dramatic climax came on Sept. 17, 1989, when Representative Dan Rostenkowski, the gruff and burly chairman of the Ways and Means Committee, was hectored in his Chicago district by a band of angry older voters. They surrounded and blocked his car and forced him to escape on foot before he could make his automotive getaway. A news crew caught the episode on camera.
The handwriting was on the wall. Authors of the bill tried to salvage it, but the House voted on Oct. 4, 1989, to repeal almost all of it. The Senate tried to retain the benefits but eliminate the supplemental premium. The House balked, leading to another vote to repeal in November 1989, as House members sat in the chamber with coats in their laps, eager to head home for the holidays.
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The experience made many lawmakers gun-shy about health care and slowed major policy changes for years until the approval of the Medicare prescription drug benefit in 2003 and the health care law now taking effect.
Mr. Pollack and others dismiss the notion that President Obama's health care law could be similarly repealed if the backlash becomes overwhelming, arguing that the costs are spread among many people and that the benefits flow to too many for it to be reversed. Many aspects of the law are already being widely taken advantage of, such as the ability to keep dependents on a family's health plan until age 26.
Mr. Archer agreed.
"This Congress and this president are too committed to it," he said. "But maybe if you get a few white-haired women to jump on the hood of someone's car, it might change things."
—By Carl Hulse, The New York Times.