Nelson's Medicare Advantage deal cut from health care reform

WASHINGTON — House and Senate leaders on Thursday said a provision sparing about 800,000 Floridians from cuts in Medicare Advantage will not be part of the final health care bill, a blow to Sen. Bill Nelson.

But the Florida Democrat was not ready to concede defeat. "It's just in a different form," he said without elaborating, adding he was studying the numbers.

In a proposal branded "Gator-aid" by critics, Nelson said he wanted to grandfather in those who already get extra coverage under Medicare Advantage, such as eye care and gym memberships.

It was one of several provisions senators inserted to benefit their home states. "People are enraged. They should be. It's sleaze. It's Chicago-style sausage making," said Sen. John McCain, R-Ariz., an early critic of Nelson's add-on.

The proposal put Nelson at odds with other Democrats, who say Medicare Advantage costs have compounded the nation's health care woes. Nationwide, more than 10 million people are enrolled in the private plans, compared with nearly 45 million mostly elderly people covered under traditional Medicare.

The government is paying Medicare Advantage providers 14 percent more than typical fee-for-service Medicare providers (a contrast from years ago when it was cheaper than Medicare) and companies get to pocket some of that while providing some of the extras like gym memberships.