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After ObamaCare and RomneyCare, add another name to the list of politically toxic U.S. health program overhauls: RyanCare.

The Medicare reform plan devised by Republican congressman Paul Ryan was supposed to endear voters to the GOP as the one party gutsy enough to take on sacred cows for the greater good of deficit reduction.

Instead, the Ryan plan has Democrats giddy at their sudden luck. On Tuesday, their party won a special election in an upstate New York district considered one of the safest GOP seats in Congress by successfully casting Mr. Ryan's April budget proposal as a bid to "essentially end Medicare."

The loss represents a stunning reversal for Republicans, who spun concerns about future Medicare cuts contained in President Barack Obama's health-care law to trounce Democrats in last fall's midterm elections. But it also illustrates the intractability of so-called entitlement reform, as voters continue to recoil at the prospect of losing iron-clad Medicare benefits.

Reforming the federal health plan for seniors - whose costs are projected to surge with the retirement of the baby boom generation - is the sine qua non of putting the United States on a sustainable fiscal footing.

The GOP defeat further diminishes the odds that Congress and the White House will agree on a credible plan to overhaul Medicare before the 2012 election. Democrats may feel they have too much to gain by stalling.

"Democrats have found a powerful heuristic [tool]with which they will likely wage campaigns in the 2012 cycle: They are going to attack Republicans on Medicare," offered Joshua Dyck, a political science professor at the State University of New York at Buffalo. "It may be a very convincing mechanism to mobilize Democratic voters."

Indeed, the Ryan plan has served as a rallying cry for Democrats to energize the party's base, whose diminished turnout at the polls contributed to massive Republican midterm electoral gains in 2010.

Mr. Ryan's proposal to turn Medicare into a voucher program was the defining issue in the election to fill the vacant House of Representatives seat in New York's 26th District, which runs from the Buffalo suburbs to near Rochester. But Prof. Dyck cautioned against reading too much into Democrat Kathy Hochul's four-percentage-point victory over Republican Jane Corwin.

A third candidate, who ran on a Tea Party ticket, captured more than 9 per cent of the vote, with most of it likely coming at Ms. Corwin's expense. And overall voter turnout hovered at less than 25 per cent.

"I wouldn't confuse voter mobilization with voter conversion," Prof. Dyck added, noting that Democrats were more successful in tapping into their base than winning new supporters in a staunchly Republican district.

Still, the result sent shock waves through Washington, planting further doubts among Republicans about the liability they may have incurred by backing the Ryan plan too vocally.

Mr. Ryan's Path to Prosperity became the GOP's official 2012 budget proposal. The plan to cut $5.8-trillion (U.S.) in spending by 2021 sailed through the House last month with only four Republicans voting against it.

Under the plan, Medicare would be transformed starting in 2022, when seniors would receive a lump sum, based on their income, that they could put toward the purchase of private health insurance. Currently, Medicare directly pays about 80 per cent of seniors' health-care costs.

Seniors' out-of-pocket expenses would likely rise under the Ryan plan. But the GOP figured it could mute opposition by promising that only Americans currently under the age of 55 would be affected. That nuance was lost on many voters in New York's 26th.

"If you can scare seniors into thinking that their current benefits are being affected then that's going to have an effect. And that is exactly what took place," Mr. Ryan responded on Wednesday. "It's demagoguery."

The fate of Mr. Ryan's plan looked dim even before Tuesday's vote. But Senate Majority Leader Harry Reid seized on the Democratic victory in New York to further embarrass the GOP. He scheduled a quick Senate vote on the Ryan plan on Wednesday. Five Republicans joined the Democratic majority to defeat the plan 57-40.

Former House speaker Newt Gingrich, who is seeking the GOP presidential nod in 2012, sparked a party-wide dust-up by likening the Ryan Medicare plan to "right-wing social engineering." Pundits immediately deemed his May 14 comments, which seemed at odds with the current ideological shift in the party, a fatal blow to his nomination bid.

Instead, after Tuesday's vote, Mr. Gingrich is looking prescient and politically wise.

"Maybe in the end, Newt is one of the winners. ... He saves some credibility," Prof. Dyck said. "Here's the old experienced conservative saying to these young ideologues: 'Be careful how you proceed. Voters can throw you out just as quickly as they put you in.' "

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