Older Americans are confused and unhappy about upcoming changes in the federal Medicare health program, according to a nonpartisan survey released on Tuesday that indicates the issue could help Democrats win the November vote.

The Kaiser Family Foundation-Harvard School of Public Health found that 47 percent of the 1,223 Medicare beneficiaries surveyed had an unfavorable view of Medicare reforms like the prescription drug benefit, 26 percent viewed the reforms favorably, and 25 percent said they didn’t know.

The drug benefit will be implemented in 2006.

Even Republicans were closely split, with 38 percent in favor of the reforms and 36 against them.

The health policy experts who did the poll noted that the big three issues in the presidential campaign now are the economy, Iraq and terrorism.

But if the race remains virtually deadlocked by September, President Bush and his Democratic challenger Sen. John Kerry of Massachusetts are more likely to put more emphasis on issues such as health costs, Medicare and education - issues that may well favor Kerry and Democrats running for Congress.

Medicare “activates older Democrats - they care about it,” said Harvard public health expert Robert Blendon, who helped conduct the survey. Blendon said that in a very close election, as in 2000, small segments of the voting population who care about specific issues like Medicare could be decisive.

Kevin Keane, a top Health and Human Services official, said that he thought seniors would have a more favorable attitude toward the reforms once the benefits are in place.

The survey found that two-thirds want Congress to fix and improve the Medicare law, while only one in 10 favored its repeal. Large majorities favored allowing legalizing drug imports from Canada and letting the federal government negotiate lower prices with drug makers.

Among one-fourth of the respondents who said the drug benefit law would affect their presidential vote in November, Democratic challenger Massachusetts Sen. John Kerry had a seven percent lead over Bush.

And among independents, 11 percent said they would be more likely to vote for Kerry while zero percent said they would be more likely to vote for Bush.

For House races, Democrats had a 12 percent edge.

The survey was conducted in June and July and had a four point margin of error.