Published Nov. 20, 2020


More than 4 in 5 older Americans strongly prioritize a political candidate’s Medicare policy stance when deciding whether to vote for them, and a significant number of older Americans say neither major political party truly cares about Medicare beneficiaries.

With the White House set to change from Republican to Democratic control in January, we surveyed nearly 1,000 Medicare beneficiaries to find out which political party they believe is better for the future of Medicare.

When asked to choose which major political party cares most about their well-being and will better manage the Medicare program, we found that the majority of senior voters chose the Democratic Party.

More Seniors Trust Democratic Candidates to Manage Medicare

We asked older adults which major political party’s leadership inspired more confidence in the way they administer the federal Medicare program.

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Graphic showing percentages of Medicare beneficiaries who trust either political party to administer Medicare

Half of all seniors surveyed said they were more worried about a Republican administration as it relates to Medicare, compared to 29% who reported being more worried about a Democratic administration negatively affecting Medicare. 

Around one-quarter of participants were neutral on the issue.

Over a Quarter of Republican Senior Voters Don’t Think Their Party Cares Most About Medicare Beneficiaries

When asked which political party they feel cares most about Medicare beneficiaries, the responses were largely split down party lines. However, while 94% of Democrats felt their own party cares the most about Medicare beneficiaries, only 73% of Republicans said the same about their own party.

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Graphic showing the percentages of Medicare beneficiaries who think either political party cares most about them

Independent senior voters leaned blue on the issue, with more than twice as many saying they believed Democrats cared more about Medicare beneficiaries than Republicans (46% to 21% of independents). 

“Democrats will destroy your Medicare, and I will keep it healthy and well!” - President Donald Trump, (Oct. 18, 2018)1


“The driver of our debt is the structure of Social Security and Medicare for future beneficiaries. We still have time, not just to save those programs, but responsibly structure them in a way that doesn’t impact current retirees...” - Sen. Marco Rubio (R-Fl.), (Nov. 29, 2017)2

1 out of every 3 independent older voters felt that neither party actually cares about Medicare beneficiaries. Overall, 1 out of every 10 Medicare beneficiaries who took the survey – regardless of their political affiliation – reported feeling this way.

“Democrats are fighting for the 65 million on Medicare.” - Sen. Chuck Schumer (D-N.Y.), (Oct. 14, 2020)3


“There will be no compromise on cutting Medicare & Social Security, period. That’s a promise.” - Joe Biden (D), (Jan. 20, 2020)4

Despite Efforts in Washington to Overturn the Affordable Care Act, Most Medicare Beneficiaries Support It

We asked participants if they support the Affordable Care Act (also called Obamacare) in its current form. Unsurprisingly, 92% of Democrats said they support the law, which was enacted under the Democratic Obama administration.

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Graphic showing the percentage of Medicare beneficiaries who support the ACA

Republicans were almost evenly split on the issue, with 48% who say they support the ACA in its current form and 52% who do not. Many Republican politicians have campaigned on repealing or amending the health care law, taking various legal efforts all the way to the Supreme Court three times between 2012 and 2020.

Among older independent voters, 55% support the current ACA, while 45% do not. 

These results mirror those of other surveys conducted in 2020.

The Kaiser Family Foundation’s (KFF) Health Tracking Poll reports that in October 2020, 55% of the American public favored the Affordable Care Act, compared to 39% who did not.5 The current reported level of public support for the ACA is at an all-time high and is up from less than 40% of the same KFF survey population just five years ago. 

Nearly 1 in 4 Beneficiaries Don’t Know What the Politically Volatile Part D “Donut Hole” Is

We asked Medicare beneficiaries how the Medicare Part D coverage gap, or “donut hole,” has affected their drug spending. As it turns out, 22% said they don’t even know what the Medicare Part D donut hole is. Another 22% said the coverage gap has cost them a considerable amount of money in previous years.

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Graphic showing percentages of Medicare beneficiaries who have been impacted by the Part D donut hole coverage gap

The donut hole is a temporary prescription drug coverage gap that a Medicare beneficiary enters after spending a certain amount of money out of pocket on medications covered by their Medicare drug plan.

When a beneficiary is in the donut hole, they receive less coverage for their prescription drugs until spending enough money to reach what’s called the catastrophic coverage phase, at which time they escape the donut hole and pay lower out-of-pocket drug costs for the rest of the year. 

Presidents from both political parties have played a role in how the coverage gap affects Medicare beneficiaries’ out-of-pocket drug spending.

  • In 2003, President George W. Bush championed legislation that introduced Medicare Part D prescription drug coverage, which included the donut hole coverage gap.

  • The Affordable Care Act, enacted by the Obama administration, launched a schedule to gradually lower the costs in the coverage gap each year until reaching a minimal amount in 2020.

  • The Trump administration’s 2017 budget accelerated the closing of the Part D coverage gap, moving it forward a year to 2019. 

More than half of our respondents (56%) said the Part D donut hole coverage gap has not affected them. The reason for this could be that they are not enrolled in a Part D plan or they don’t typically spend enough money on drugs to reach the coverage gap.

Although the donut hole “closed” in 2019, the remaining moderate coverage gap can still affect a beneficiary’s finances. Many would likely welcome additional reform and would benefit from more awareness on the subject.

Both Major Parties Have Shaped Medicare Over the Years

Medicare was born under Democratic President Lyndon B. Johnson in 1965, but each major political party has played a role in its evolution. 

  • Republican President Richard Nixon expanded Medicare coverage in 1972 to include people under the age of 65 who had disabilities.

  • The Omnibus Reconciliation Act of 1980, which expanded home health services and brought Medigap under federal oversight, was enacted under Democratic President Jimmy Carter.

  • In 1988, the Medicare Catastrophic Coverage Act was passed under Republican President Ronald Reagan, which implemented an out-of-pocket spending limit for Medicare. One year later, under fellow Republican President George H.W. Bush, the law was repealed.

  • Democratic President Bill Clinton signed the Balanced Budget Act in 1997, which extended the life of the Medicare Trust Fund by 10 years and added new coverage benefits to the program.

  • Republican President George W. Bush signed the Medicare Prescription Drug Improvement and Modernization Act of 2003, which introduced the Medicare Part D program that provides prescription drug coverage.

  • Democratic President Barack Obama’s Affordable Care Act added a number of free preventive benefits to Medicare, implemented a closing of the Part D “donut hole” coverage gap and further extended the solvency of the Medicare Trust Fund.

  • Republican President Donald Trump accelerated the closing of the Part D coverage gap and initiated the “most favored nation” clause to help curb prescription drug costs.

Methodology and Notes

This study was conducted on November 11th, 2020, using an audience pool gathered using MTurk, a polling tool. The total survey included 935 respondents. To qualify, respondents needed to be 65 years of age or older and a Medicare beneficiary. 

Participants were filtered based on completion time and failure to follow written instructions within the survey. 420 participants identified as Democrats, 321 as Republicans, 173 as independents and 21 who identified as “Something else.”

Margin of error: +/- 4% (95% confidence interval)

This survey relies on self-reported data.


1 Retrieved from

2 Retrieved from

3 Politico. Full video of Playbook Interview: Sen. Marco Rubio [video]. (Nov. 29, 2017). Retrieved from

4 Newhauser, Daniel. (Oct. 16, 2020) Biden: Bernie Is Lying About My Position on Social Security. Vice News. Retrieved from

5 Kirzinger, A. et al. (Jan. 20, 2020) KFF Health Tracking Poll – October 2020: The Future of the ACA and Biden’s Advantage On Health Care. Kaiser Family Foundation. Retrieved from

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Our research reports analyze a number of issues important to seniors, from health perceptions, medical communication, health habits, and more.