PALM HARBOR, Florida | Fri Jan 27, 2012 4:09pm EST (Reuters) - There's one small-government idea that Republican presidential candidates are reluctant to discuss in this retiree-heavy state: their plans to rein in health care costs for the elderly.

Newt Gingrich and Mitt Romney, front-runners for the Republican nomination to face President Barack Obama on Nov. 6, both support reforms to the Medicare government health insurance program for the elderly that could help set federal spending on a sustainable course.

But the idea risks alienating the elderly voters who dominate the party's nominating process and are happy with the current program.

"The last thing that I would do if I was campaigning in Florida is even hint that something might happen to Medicare," said Mark Brewer, a political science professor at the University of Maine. "The word wouldn't even cross my lips."

In Florida, where the average Republican primary voter is 66 years old, that appears to be the case in the weeks leading up to the state's primary on Tuesday.

AARP, a senior citizens group that counts 37 million members over the age of 50, has dispatched volunteers to try to get Romney and Gingrich to offer details of their proposed reforms at campaign stops. They've had little success.

"Given the age of the primary voter, we're a little surprised that they haven't addressed these issues more fully and more directly," said Nancy LeaMond, the organization's executive vice president.

That the candidates are circumspect on the issue points to a fundamental tension within the Republican Party. Voters over 65 years old are the electorate's most reliably Republican segment, but their enthusiasm for scaling back government wanes when it comes to programs that directly affect them.

"They'd like to see things remain the same in terms of Social Security and Medicare," said Pam McAloon, president of the North Pinellas Republican Club, which represents a retiree-heavy stretch of suburban Tampa.

A defining issue

As the campaign heats up, Democrats and Republicans face strong incentives to campaign against one another's health reform plans.

Public unease over the cost and scope of President Obama's 2010 health care overhaul helped Republicans win control of the House of Representatives later that year, thanks to strong support from voters over 65 years old. Democrats hope to win them back this year by hammering a Republican plan that would gradually turn Medicare into a voucher program.

Both sides have played fast and loose. The nonpartisan watchdog group PolitiFact awarded its "Lie of the Year" in 2011 to Democrats for mischaracterizing the Republican plan. Republicans got the 2010 award for distorting Obama's plan.

The issue also presents a clash between demographics and ideals. Younger voters, the most reliably Democratic segment, are more likely to back private retirement accounts and other market-based plans floated by Republicans, according to the Pew Research Center. Older voters, the most reliably Republican, are least likely to support those ideas.

Given older voters' outsized role — they made up 13% of the population but 21% of the electorate in 2010 — politicians must tread carefully.

"It is a fundamental problem for American politics," said Andrea Louise Campbell, a political science professor at the Massachusetts Institute of Technology. "The need to attract seniors is a barrier for elected politicians."

Enactment of the Social Security pension in the 1930s and Medicare in the 1960s under Democratic presidents for decades made elderly voters a reliably Democratic voting bloc.

That has shifted in recent years as voters who share the small-government ideals of Republican President Ronald Reagan neared retirement. Retirees backed Republican presidential candidate John McCain in 2008, while voters under 65 backed Obama. Seniors voted Republican by a wider margin in the 2010 congressional elections.

(Editing by Marilyn W. Thompson and Doina Chiacu)

© 2010 Thomson Reuters. Click for Restrictions.

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