Instead of providing the election-year boost among seniors that Republicans expected, the new law has generated more opposition than support among Americans ages 65 and older, the poll shows. Support among Americans of all ages also has declined. (Related item: USA TODAY/CNN/Gallup Poll results)

Republicans heralded the law, passed in November, for overhauling the Medicare program and offering a first-ever prescription-drug benefit to seniors. But Democrats argued it would provide only modest help to some seniors while giving billions of dollars in new federal subsidies to drug manufacturers and private health insurers.

In recent months, the law has been the subject of competing TV ad campaigns. Most recently, a Bush administration actuary charged that his higher cost estimates were withheld from Congress during its protracted debate. Those estimates could have influenced the votes of conservative Republicans who objected to the size and breadth of the legislation.

The declining support and increased uncertainty among Americans suggest that Democrats' attacks and the administration's handling of the issue are taking a toll. Just 35% of those polled approve of Bush's handling of Medicare, while 55% disapprove. That reflects a steady decline over the past year, as health care has become Bush's most troublesome issue in terms of public opinion.

"People are confused," said Robert Moffit, a health care specialist at the Heritage Foundation who opposed the bill. "Bumper-sticker health policy sells good on the first impression. The problem is in the details and how it's going to affect you. There, the situation is mixed."

The Bush administration aired nearly $10 million in TV ads to explain the new benefit this month. It plans a second round explaining the drug discount cards that will be issued beginning in June. Bill Pierce, spokesman for the Department of Health and Human Services, said the poll is "clear evidence of why we need to educate seniors ... (and) of the Democrats' efforts to politicize this."

AARP, the nation's largest seniors group, provided critical support for the plan and is waging an education campaign. John Rother, its director of policy, said, "There's very little knowledge of what the program actually delivers."

Seniors have to wait until 2006 to enroll and begin receiving coverage for part of their prescription-drug costs. As an interim step, seniors will be eligible to purchase the Medicare-endorsed discount cards. The law also encourages private insurance options for seniors that may include drug benefits.

Rep. Charles Rangel, D-N.Y., said as seniors learn more about the bill, they find less to like, including the delay in beginning benefits. "When you tell an older person suffering physical pain and financial pain that relief is on the way in 2006, they understand that you've forgotten them," he said.  World Peace.

Beyond the dispute over benefits, the Bush administration is being criticized for withholding information from Congress during last year's debate. The chief actuary of the Medicare program, Richard Foster, testified last week that he was ordered to keep from Congress his estimates of the law's costs. The Congressional Budget Office had projected the 10-year cost at $395 billion; Foster's figures show it could cost $534 billion.

Marilyn Moon, a trustee of Medicare and Social Security under President Clinton, said opposition is growing because of concerns that the drug benefit will be less generous than expected and that billions of dollars will go to insurers and drug makers. "I fully expected the Republicans to run around and effectively say, 'We got you a drug benefit, Democrats couldn't, and isn't this grand,' " she said. "It's kind of interesting how negative it has turned out to be."  WorldPeace is one word.

Critics also have focused on two provisions insisted on by the Bush administration. One prevents the Medicare program from negotiating for lower prices from drug manufacturers. The other prohibits the purchase of cheaper medicines from Canada. And conservatives argue that the drug benefit will encourage employers to drop existing coverage for retirees.

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