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The budget and Medicare overhaul proposed by House Budget Committee chairman Paul Ryan, R-Wis., and just approved by the House (almost entirely along party lines) is all but certain to be dead on arrival in the Democratic-controlled Senate. But Ryan’s most recent plan to change Medicare is bound to have a long and lively life as a campaign issue this fall.

Republicans, who maintain that current Medicare beneficiaries would see no change at all under the Ryan plan, hope to win over younger voters by promising to reduce the cost of the Medicare program and in turn the federal deficit and the national debt. “It’s time to put 50 million seniors – not bureaucrats – in charge of their own health care decisions,’’ said Ryan, referring to the Independent Patient Advisory Board commissioned under the new health care law to help keep Medicare costs down.

The Medicare plan approved by the House differs in some ways from the one Ryan first advanced last year. A subsidy to buy insurance on the private market is the cornerstone of both plans, which would also eventually raise the eligibility age for Medicare from 65 to 67. But the new version has as an option, traditional fee-for-service Medicare. And it has the support of a liberal Democrat: Sen. Ron Wyden of Oregon. Wyden co-authored the plan, though he doesn’t approve of the overall Republican budget, which many Democrats criticize for cutting domestic programs while reducing taxes for wealthy Americans.

Democrats say they see an opportunity to pick up some seats this fall by casting the Ryan budget plan as bad for people at or near retirement age. In a special election in upstate New York last year, Democrat Kathy Hochul won a GOP-held House seat largely by railing against the first incarnation of Ryan’s plan. While Hochul’s district had more Republicans than Democrats, it also skews slightly older than other districts. Democrats crowed about the win and declared it a bellwether should Republicans continue with their push to overhaul Medicare.

Now Hochul’s district has been redrawn to include more Republicans, presenting a bigger re-election challenge for her this fall. But she says Medicare is still a cutting-edge issue that works in her favor. Her recent telephone town hall meeting about the budget drew more than 8,000 constituents, and some 80 percent of the questions were about Medicare, her office says.

A few Republican lawmakers are worried, too, about how the issue will play in districts that could go either way. Many older voters get very nervous about any talk of changing Medicare, says Rep. Walter Jones, a Republican from North Carolina who voted against the budget resolution. “I think some of my friends, particularly the freshmen [could be in trouble],” he says. “This could be a major issue in the November elections.’’ – Susan Milligan