Across Massachusetts, senior citizens are writing letters to newspapers demanding that their representatives in Congress protect a form of health insurance called Medicare Advantage.
At least that's what newspaper editors are supposed to think.
Some of those seniors are unaware that they have sent any such letters to newspapers. Some of them hadn't even heard of Medicare Advantage.
"I did not write a letter to the editor. It's not from me," said Gloria Gosselin, 75, of Lawrence.
Gosselin's name was on one of three strikingly similar letters touting the Medicare Advantage program that were sent to The Eagle-Tribune.
Writers of letters to the editor are routinely contacted by newspapers to make sure letters are legitimate. In this case, they weren't.
All three of the purported authors of the letters said they had no idea their names were being used to advocate for the health insurance program.
The letters were, in fact, composed and sent by the Boston office of a national political consulting firm attempting to create the appearance of a "grass-roots" movement for Medicare Advantage.
Such campaigns are referred to in the news industry as "Astroturf" — that is, phony grass roots.
Usually, such letters come from people who simply click a "Take Action" button on a political Web site, which results in a form letter being sent to their local newspaper. Few newspapers will knowingly publish such letters.
"There are several things wrong with it," said David Holwerk, president of the National Conference of Editorial Writers, a newspaper industry group. "Most newspapers get more letters than they can print. You want to print the ones that people have gone through the effort to write themselves."
But those people are at least aware that a letter will be sent in their names. The Medicare Advantage campaign is unusual in that the "letter writers" said they weren't aware they were participating in political advocacy at all.
One of the letters came from William Morin of New Bedford and was addressed to the "New Bedford Eagle-Tribune."
No such newspaper exists. The street address on the letter was that of The Eagle-Tribune's North Andover office.
"I wonder who did that. New Bedford Eagle-Tribune — I've never heard of it," said Morin, who is 88 years old.
A letter supposedly from Ana Abascal of Lawrence said she "wanted to express how important my Medicare Advantage health plan is to me and other fixed-income seniors in my community."
But when contacted by The Eagle-Tribune, Abascal was shocked and concerned to learn someone was using her name on a letter to the editor. She did not know what the Medicare Advantage plan was.
A tip-off to the true origin of the letters came when The Eagle-Tribune received a call from a man who turned out to be an intern at the Boston office of the Dewey Square Group, a national political marketing and consulting firm.
The man, who identified himself as Noah, wanted to know if Gloria Gosselin's letter had been published. Asked what interest he had in the letter, Noah replied that he was Gosselin's grandson.
Gosselin does not have a grandson named Noah working in Boston. Her only grandson is a student at Central Catholic.
The Dewey Square Group was founded in 1993 by three veteran Boston political campaigners with Democratic ties. One of the founders, Michael Whouley, was a strategist on John Kerry's 2004 presidential campaign.
The Dewey Square Group specializes in grass-roots campaigns, building such overwhelming support from ordinary citizens for a public policy position that politicians are brought into line. America's Health Insurance Plans, an industry trade group, hired Dewey Square to defend the Medicare Advantage program.
Medicare Advantage is a government funded, private alternative to Medicare. Seniors can opt out of traditional Medicare coverage in favor of a range of health plans offered by private insurers. Seniors pay a premium for the private coverage but in return, supporters say, get more extensive health coverage than provided under traditional Medicare.
Government payments to insurers supplement the cost of providing the insurance.
Critics of Medicare Advantage argue that it costs much more to treat patients with the private plans than under traditional Medicare. And that, they say, is a poor and inefficient use of taxpayer dollars.
Democrats in Congress and President Barack Obama have proposed slashing funds for Medicare Advantage and using the savings to expand health care coverage for all. Obama's budget has $680 billion targeted for health care reform; $177 billion of that would be taken from Medicare Advantage.
Insurers fight back
Health insurers are fighting what would be a huge hit to their bottom lines. Their strategy: Get seniors talking to members of Congress about the importance of Medicare Advantage.
Under the banner of "The Coalition for Medicare Choices" (www.medicarechoices.org), Dewey Square operatives are bringing seniors to "Medicare Advantage Community Meetings," featuring "free food" and "door prizes," with congressmen and senators, and offering them sample letters to Congress or local newspapers.
Two spokeswomen for the Dewey Square Group insist the campaign is legitimate, even if the seniors have no recollection of sending or signing such letters.
Perhaps, suggested Dewey Square's Mary Anne Marsh, the time that elapsed between the meetings when the seniors saw the letters and the letters' arrival at the newspaper may have clouded some memories.
"No one's trying to pull the wool over anyone's eyes," Marsh said.
So how can there be legitimate grass-roots support for Medicare Advantage when some of the seniors involved say they've never heard of the program?
Lynda Tocci, who is managing the campaign, said the seniors may only recognize the name of the health plan they joined under Medicare Advantage.
"They don't know what Medicare Advantage is but they know their health plan and they like it."
Those who oppose the spending of public money on Medicare Advantage question the legitimacy of the Dewey Square Group campaign.
Judith Stein of the Center for Medicare Advocacy said using the elderly to advocate for a program without their full awareness and consent is "an outrage."
The Connecticut-based group would rather see taxpayer money put into an expansion of traditional Medicare.
"It's a misuse of the trust these plans have with their enrollees," said Stein, who has 30 years experience advocating for Medicare clients. "It borders on being fraudulent. It calls into question the good will and intent of those Medicare plans that are launching such an effort."
Stein said she has seen no true grass-roots effort to support Medicare Advantage.
"Are there individuals who are helped by Medicare Advantage? Sure," she said. "But the vast majority of individuals are better off in traditional Medicare than in a Medicare Advantage plan."
Marsh said the support for Medicare Advantage is there. Working with seniors to express that support is difficult.
Seniors fearing scams may be distrustful of outreach efforts. They face financial, health and other challenges that make it difficult for them to advocate on their own behalf.
"That's why it's important we get them these benefits," Marsh said. "Perhaps this effort is not perfect. But it is a transparent, honest and truthful effort. To have it portrayed as anything else is disingenuous."