Over the past few weeks, I’ve written about Barack Obama’s plan to kill Medicare Advantage, a successful public-private partnership that extends benefits and access for Medicare patients, in order to pay for the overhaul of the American health-care system.  We have personal experience with Medicare before and after buying into the Advantage program (which requires monthly premiums above those of Medicare Part B and D) and understand its value.  Karl Rove looks at the electoral consequences of killing the program, to which 20% of all Medicare recipients belong, and warns that it could cost as many as 23,000 votes per Congressional district:

Medicare Advantage was enacted in 2003 to allow seniors to use Medicare funds to buy private insurance plans that fit their needs and their budgets. They get better care and better value for their money.

Medicare Advantage also has built-in incentives to encourage insurers to offer lower costs and better benefits. It’s a program that puts patients in charge, not the government, which is why seniors like it and probably why the administration hates it.

Already, an estimated 10.2 million seniors—one out of five in America—have enrolled in Medicare Advantage. Mr. Obama is proposing to cut the program by nearly 20% and thus reduce the amount of money each will have to buy insurance. This will likely force most of them to lose the insurance they have now. Yet Mr. Obama promised in late July in New Hampshire that, “if you like your health-care plan, you can keep your health-care plan.”

There are roughly 23,400 seniors on average in a congressional district who have Medicare Advantage, but who face losing it if Mr. Obama has his way. That’s enough votes to tip most competitive House and Senate races.

Obama already has problems with seniors.  His polling numbers have dropped dramatically among older voters, who see his targeting of Medicare and Medicare Advantage as dangerous to their health-care coverage.   Continuing to press for its elimination will certainly motivate them to fight back at the voting booth in 2010.

The average difference between Democrats and Republicans in House races in 2008, by the way, was 22,979.  Bear in mind that the Democrats had several strong winds at their backs, including an unpopular Republican administration against which to run, Barack Obama’s ability to turn out voters for his historic campaign, and a sense that the Democrats hadn’t had a chance to lay out their agenda.  They managed to build a strong majority in the House with that average margin, which falls below Rove’s calculations of Medicare Advantage subscribers.

None of those strong winds will be at the backs of Democrats.  Obama won’t be on the ballot, and the midterms will be a referendum on his policies rather than his personality.  Nancy Pelosi and Harry Reid’s agenda has lost favor with the majority of Americans now that they’ve taken off the masks and laid it out for the nation to see.  Democrats no longer have Bush to run against, although they’ll probably still try to use him as a bogeyman — and will get spanked for doing so.  They can’t afford to lose 2,000 seniors in each district, let alone 23,400 — and seniors have the highest turnouts on Election Day.

This is as big a political loser as can be possibly imagined, and Blue Dogs should keep that in mind.