Play Live Radio
Next Up:
0:00 0:00
Available On Air Stations

Nelson takes heat in Medicare debate

By Carol Gentry
12/9/2009 © Health News Florida

The Senate Tuesday defeated a motion by Sen. John McCain that would have sent health reform back to committee, effectively killing it, but used Florida Sen. Bill Nelson as a verbal punching bag in the process. Earlier in the day, the state’s senators split their votes in defeating an amendment on abortion. 

The flap over Nelson concerned a move he made in the Finance Committee weeks ago that temporarily shelters most Florida members of Medicare Advantage plans from a sudden reduction of federal payments to private Advantage plans that could affect the extras they now receive -- dental, vision, gym, premium refunds, etc. (See previous Health News Florida article.) 

One aim of reform is to begin reducing the wide geographic variation in Medicare payment rates, which has led to winners and losers in Medicare Advantage plans' costs and extras. When that happens, the effects will be felt in Florida; the Nelson language cushions the blow during the transition for his constituents.

But other senators wanted in on the deal, including Pennsylvania's Arlen Specter. So McCain took advantage of the situation, saying that he wanted to extend the Nelson deal to all Medicare Advantage (MA) members in all states. He couched it as a simple matter of fairness.

He and other GOP senators said Nelson had gotten a "sweetheart deal" behind closed doors and that his actions showed Nelson knew that cuts in MA payments were going to be hurtful to seniors, even as he supports the Democrats' health reform bill, the Patient Protection and Affordable Care Act. (See the half-hour of GOP speeches at C-Span, .)

McCain used Nelson's own words, published in the New York Times in September, against him. When the fund-reduction to MA plans was made part of the bill in the committee proceedings and Nelson introduced his amendment, he was quoted as saying, "It would be intolerable to ask senior citizens to give up substantial benefits they are enjoying under Medicare."

"What's good enough for the seniors of Florida should be good enough for the seniors of Texas," said Sen. John Cornyn during Tuesday's speeches.

Nelson didn't bother to defend himself against the Republicans' slaps, at least not on the Senate floor. His communications director, Dan McLaughlin, sent an e-mail saying his boss has no apologies:
"His amendment protects Medicare Advantage beneficiaries in areas based on high cost of treatment and (a high percentage) of seniors. Naturally, a state like Florida is affected..."
McLaughlin noted that McCain's motion to send the entire health care bill back to committee was "a not-so-subtle move designed to kill the entire piece of legislation."

In their speeches, the Republican senators made claims that were way overblown, according to an NPR FactCheck. McCain said the MA plans were suffering cuts of 64 percent, but FactCheck's report indicated that the removal of $117 billion from a 2-trillion-dollar program is more like a 5 percent cut. 

The inspector general for the agency that runs Medicare and an advisory commission to Congress have both said that cuts are warranted, since MA payments are running 14 percent over the cost of traditional Medicare.

The vote on the McCain motion failed 42 to 58. 

--Carol Gentry, Editor, can be reached at 727-410-3266 or by e-mail.