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GOP: Extend FL shield to all

By Carol Gentry
12/8/2009 © Health News Florida

A cushion for 800,000 Florida seniors against steep cuts to Medicare Advantage plans under the pending Senate health bill would be extended to all beneficiaries enrolled in the plans under an amendment introduced Monday afternoon by Republican Sen. John McCain.

McCain said that all 10.6 million Medicare Advantage plan members nationwide should benefit from the “grandfather” clause placed in the health package during Finance Committee deliberations by Florida Sen. Bill Nelson, a Democrat.

The Arizona Republican said his amendment was intended to let those enrolled in private Medicare plans "continue to benefit from the lower cost-sharing, wellness programs, and vision, hearing, and dental benefits that they have come to rely on."

But Democrats said the amendment’s real intention was to gut health reform, since it would take away money that’s needed to subsidize coverage for the uninsured. It takes away about $117 billion over 10 years, Kaiser Health News reported last month.

The payments to private managed-care plans, which were originally funded as a way to cut costs in Medicare, have risen until they now exceed the payments under traditional Medicare by about 14 percent, according to the Medicare Payment Advisory Commission, an advisor to Congress.

“We in Congress have caused these overpayments,” as Sen. Max Baucus says. “We need to fix it.”

But the plans are popular, especially in Florida, where Medicare payments are so much higher than the national average that in some counties plans give beneficiaries memberships at zero premium and even offer money back, along with free gym memberships.

Nelson wanted to shift $10 billion of the $117 billion to provide a temporary buffer for high-cost areas. He also wanted to offer bonuses to plans that had good outcomes.

“Sen. Nelson worked hard to help seniors in Florida and elsewhere, and he isn’t going to apologize for that,” said his communications director, Dan McLaughlin. “His amendment protects Medicare Advantage beneficiaries in areas based on high cost of treatment and numbers of seniors. Naturally, states like Florida, New York and California are affected.”

But Sen. Charles Grassley, R-Iowa, said that propping up the high-cost areas is unfair to “higher-quality, rural areas” that make efficient use of taxpayers’ dollars. “That doesn’t sound very efficient or very fair to me,” Grassley said.

He said Nelson engineered a “backroom deal” to protect his own constituents from the same cuts that he was defending in other areas. 

--Carol Gentry, Editor, can be reached at 727-410-3266 or