- - Friday, February 28, 2014

Nothing clarifies the mind, with apologies to Dr. Johnson, quite like a fight for survival. Sen. Joe Manchin, a Democrat, arrived at his moment of enlightenment contemplating the likelihood of West Virginia voters returning to the Senate someone who voted to preserve Obamacare. He told a home-state paper, the Beckley Register-Herald, the other day that he would “vote tomorrow” to repeal the law. A day later, presumably after being taken to the woodshed by Harry Reid, Mr. Manchin returned to a state of confusion with a retraction. “I have never supported repealing [Obamacare],” he said.

Mr. Manchin would have been the first Democratic senator to break ranks. Other red-state Democrats are likely to have a lasting epiphany now that the Centers for Medicare and Medicaid Services have announced a 4 percent payment cut for the popular Medicare Advantage Program. Medicare Advantage was introduced in 1997 to enable patients to work within a network of providers in a private health plan that generally offers more benefits with lower out-of-pocket expenses.

The administration’s cuts will affect nearly 16 million seniors, nearly a third of all Medicare enrollees. Aetna has over a million Medicare Advantage customers and has warned them to expect changes in their doctors and higher premiums. Other insurers, foreseeing the impact of the cuts, have eliminated participation in the program.

This is a disaster for Democrats and a fortunate turn of events for Republican prospects. Seniors read the newspapers and vote, and millions of them are not likely to take kindly to the political party that takes their doctors away from them. Rep. Joe Pitts of Pennsylvania, a Republican, reminds them that the $300 billion in cuts is another broken promise by the president. “The cuts announced today,” said Mr. Pitts, “will only exacerbate the effect this will have on the health care of millions of our nation’s seniors, leaving them with higher costs and fewer choices.”

When vulnerable Democrats like Sen. Kay Hagan of North Carolina decry the cuts they voted to make, they’re not credible. The lineup of Democratic senators on life support, including Mary Landrieu of Louisiana and Mark Pryor of Arkansas, sent a sharp note to the administration expressing “serious concerns” about the impact of the cuts. “We are strongly committed to preserving the high quality health plan choices and benefits that our constituents receive through the [Medicare Advantage] program,” they wrote.

They should have thought about that before they went all-in for Obamacare. Not only did Mrs. Hagan and other signers vote in 2010 to block a measure offered by Sen. Orrin Hatch, Utah Republican, to protect the program from the Obamacare axe, she did it twice. The Hatch amendment would have prohibited cuts to Medicare Advantage if the chief accountant for the Department of Health and Human Services certified that 1 million Medicare Advantage beneficiaries would lose their coverage.

Endangered Democrats were not concerned about senior health care programs only a few years ago, but now their polling numbers are plunging, and they’re terrified. They know they have to do more than write a letter to the editor to feign concern. Hundreds of thousands of Americans have lost their insurance and doctors. Now additional seniors will lose theirs. When the employer mandate takes effect, millions more will realize how cynical the president’s lie about “keeping your doctor” was.

This is the moment endangered Democrats could profitably share their moment of clarity. Democratic senators marooned in red states can either stand with the president and continue to support Obamacare, or they can stand with their constituents and keep their jobs. They can’t do both.