Supreme Court Upholds Bill Nelson’s Massive Tax Increase & Medicare Cuts On Florida Seniors

Decision Sets The Stakes For November’s Election

Two years after U.S. Senator Bill Nelson (D-FL) made clear that passing President Obama’s massive health care bill would mean “unconscionable” cuts to Medicare for Florida seniors, the Supreme Court today has affirmed Nelson’s decision to put President Obama’s agenda ahead of Florida seniors and small businesses.  In doing so, the Court has made clear what is at stake in November’s election.

“The Supreme Court’s decision makes clear that Bill Nelson was not telling the truth when he promised that his massive health care bill would not increase taxes on Florida families and small businesses.  The stakes are now clear in this election – the only way to stop the massive tax increases, government spending, and cuts to Medicare contained in ObamaCare is to replace liberal Bill Nelson in Washington,” National Republican Senatorial Committee (NRSC) spokesman Jahan Wilcox said today.  

BACKGROUND…. 

Supreme Court Affirms Bill Nelson Broke His 2009 Promise Not To Raise Taxes

Individual Mandate ‘Considered A Tax,’ Hits Middle Class Families

CONGRESSIONAL BUDGET OFFICE: At least 75% of individual mandate penalties fall on those making less than $250,000. (“Estimated Distribution Of Individual Mandate Penalties Under The Patient Protection And Affordable Care Act,” Congressional Budget Office & Joint Committee On Taxation, 11/20/09) 

• SUPREME COURT: “…the shared responsibility payment may for constitutional purposes be considered a tax… read as imposing a tax on those who go without insurance.” (Supreme Court Of The United States Syllabus, National Federation Of Independent Business Et Al. V. Sebelius, Secretary Of Health And Human Services, Et Al., 6/28/12)

Nelson Voted To Kill An Amendment That Would Have Removed The Mandate

Nelson Voted To Kill An Amendment That Would Have Removed The Individual Mandate From The Health Care Bill. “Baucus, D-Mont., motion to table (kill) the Ensign, R-Nev. amendment no. 3710 that would repeal provisions of the 2010 health care overhaul law that provide for IRS penalties for certain taxpayers that do not obtain basic health insurance coverage.” (H.R. 4872, CQ Vote #101: Motion agreed to 58-40: R 0-40; D 56-0; I 2-0, 3/25/10, Nelson Voted Yea)

Orlando Sentinel: “Supporters Of The Individual Mandate, Including Democratic Sen. Bill Nelson Of Florida, Insist Lawyers In Congress Have Thoroughly Researched It And Are Confident It Passes Constitutional Muster. There Are Many Lawyers Beyond Capitol Hill Who Agree.” (Editorial, “Clear Up Reform Doubt,” Orlando Sentinel, 1/8/10)

Nelson Voted Against An Amendment In The Finance Committee Markup That Would Have Required Any Taxpayer Who Requested An Exemption From The Individual Mandate Be Granted An Exemption. “Bunning, R-Ky. – Amendment that would require that any taxpayer who requests an exemption on their tax return from the ‘personal responsibility’ excise tax — imposed on individuals who do not obtain health insurance — be granted an exemption.” (S. 1796: Rejected 9-14: R 9-1; D 0-13; I 0-0, 9/24/09, Nelson Voted Nay)

Nelson First Claimed It Was “Unconscionable” To Cut Florida Seniors’ Medicare

During A Finance Committee Markup, Nelson Called It “Unconscionable” To Ask Seniors To Give Up Their Existing Medicare Advantage Benefits. BILL NELSON: “But I don’t think that it’s the right thing to ask senior citizens to give up their existing Medicare Advantage benefits because there are hundreds of thousands of senior citizens who didn’t conceive of Medicare Advantage but who have come to rely on it. And I intend to offer an amendment that will shield them from benefit cuts. It’ll be called a grandfather, to grandfather them in. … And to suddenly whack it away from the, I think, is unconscionable. You can’t punish the seniors who signed up. And if changes must be made for the future solvency of Medicare, then I think those seniors ought to be grandfathered in.” (Senator Bill Nelson, Remarks At Senate Finance Committee Health Care Hearing, 9/22/09)

Nelson Said It Was “A Non-Starter” To Tell Senior Citizens They Have To Give Up Their Medicare Advantage. NELSON: “But I don’t think it’s a good thing to go in and to tell these senior citizens what you have now, you’ve got to give up. That is a non-starter. And it is particularly a non- starter to any senior citizen that is having difficulty meeting — making financial ends meet. So what I want to do is to say those senior citizens that have it, you’re not going to lose it.” (Senator Bill Nelson, Remarks At Senate Finance Committee Health Care Hearing, 9/24/09)

But Then Nelson Voted Against Amendments That Would Have Prevented The Medicare Cuts

In 2010, Nelson Voted To Kill An Amendment That Would Have Prevented Cuts To Medicare Advantage. “Baucus, D-Mont., motion to table (kill) the Hatch, R-Utah., motion to commit the bill to the Finance Committee with instructions that it be reported back with changes that would prohibit cuts to the Medicare Advantage program and provide for an offset if the Health and Human Services Department certified that at least 1 million Medicare Advantage program participants would lose benefits under the changes in the reconciliation measure or the 2010 health care overhaul law. The bill would make changes existing health care law, revise student lending procedures and provide new revenue-raising provisions.” (H.R. 4872, CQ Vote #72: Motion agreed to 56-42: R 0-40; D 54-2; I 2-0, 3/24/10, Nelson Voted Yea)

In 2009, Nelson Voted Against A Motion That Would Have Allowed Medicare Advantage Enrollees To Retain Their Existing Benefits. “McCain, R-Ariz., motion to commit the bill to the Finance Committee with instructions that it be reported back with changes that would allow all Medicare Advantage enrollees to retain their existing benefits.” (H.R. 3590, CQ Vote #370: Rejected 42-57: R 40-0; D 2-55; I 0-2, 12/8/09, Nelson Voted Nay)

Nelson Skipped A Vote In Committee That Would Have Prevented Medicare Cuts

Nelson Skipped A Vote In The Finance Committee On An Amendment That Would Have Prevented Medicare Cuts In The Bill. “Kyl, R-Ariz. – Appeal the ruling of the chairman that the Kyl amendment was not germane.” (S. 1796: Rejected 8-8: R 8-0; D 0-8; I 0-0, 9/23/09, Nelson Did Not Vote)

The Kyl Amendment Would Have Struck Provisions That Would Cut Medicare Spending. “Kyl, R-Ariz. – Amendment that would strike certain provisions of Title III, the portion of the bill that deals with Medicare. It would strike certain provisions that would cut Medicare spending.” (S. 1796: Ruled not germane, 9/23/09)

And Then Bill Nelson Proudly Voted For ObamaCare

Nelson Voted To Pass The Senate Version Of The $2.5 Trillion Obama-Reid Health Care Bill. (H.R. 3590, CQ Vote #396: Passed 60-39: R 0-39; D 58-0; I 2-0, 12/24/09, Nelson Voted Yea)

• Nelson Provided The 60^th Vote To Invoke Cloture On The Senate Health Care Bill. (H.R. 3590, CQ Vote #395: Passed 60-39: R 0-39; D 58-0; I 2-0, 12/23/09, Nelson Voted Yea)

• Nelson Voted To Pass The Health Care Reconciliation Bill. (H.R. 4872, CQ Vote #105: Passed 56-43: R 0-40; D 54-3; I 2-0, 3/25/10, Nelson Voted Yea)

Nelson: “It Has Been Said By Many Folks In Many Different Ways That We Are Not Put On Earth For Ourselves, But We Are Placed Here For Each Other. Well, Here We Are, And Here We Are Debating Legislation That Stands To Improve The Lives Of Tens Of Millions Of Americans. So Despite Its Flaws, I Will Vote To Pass This Legislation.” (Senator Bill Nelson, Congressional Record, S1962-1963, 3/24/10)

ADDITIONAL BACKGROUND…. 

The Cost Of ObamaCare To Florida Alone

The Heritage Foundation Estimates From 2014 To 2020 ObamaCare Will Cost Florida An Additional $1.569 Billion. (Edmund Haislmaier and Brian Blasé, “Obamacare: Impact On States,” The Heritage Foundation, 7/1/10)

In 2014, According To A Florida State Senate Analysis, ObamaCare Will Cost Florida $142 Million. “The costs of PPACA to Florida Medicaid will be significant. Florida is expected to have over 379,000 new enrollees from the expanded PPACA Medicaid population in 2014, at a cost of $1.5 billion (of which $142 million will be paid by the state), bringing the total cost of Medicaid that year to $25 billion.” (SM 1854, Florida State Senate, 2/17/12)

• By The End Of The Decade, ObamaCare Will Cost Florida $1 Billion Annually. “By 2019, Florida Medicaid will have 1.9 million additional enrollees, at an additional cost of over $7.7 billion (of which $1 billion will be paid by the state). In subsequent years, the state share may increase.” (SM 1854, Florida State Senate, 2/17/12)

Florida Sued The Federal Government Challenging The Constitutionality Of ObamaCare. (Brandon Stewart, “List Of 27 States Suing Over ObamaCare,” The Heritage Foundation’s “The Foundry”, 1/17/11)

The Obama Administration Denied Florida’s Request For A Waiver From ObamaCare’s Medical Loss Ratio Rule. “The Obama administration on Thursday rejected Florida’s request for a waiver from Democrats’ healthcare law.  Florida is the fifth state whose insurers have been denied an exemption from the medical loss ratio provision that requires them to spend at least 80 percent of premiums on medical care or give rebates to consumers. Florida had asked for an MLR adjustment allowing insurers to meet lower thresholds of 68 percent in 2011, 72 percent in 2012 and 76 percent in 2013.”  (Julian Pecquet, “Obama Administration Rejects Florida’s Request For Health Law Waiver,” The Hill, 12/15/11)

In 2010, Healthcare Spending In Florida Accounted For $61.8 Billion, Or 8.26 Percent Of The State’s GDP. (“Gross Domestic Product By State (GDP By State) Interactive Maps,” Bureau Of Economic Analysis, Accessed 5/20/12)

Obamacare Is Harming Florida’s Seniors

Non-Partisan CBO Director Says ObamaCare Gives “Less Generous Benefit Packages” To Medicare Advantage Recipients Forcing Seniors “To Dig Deeper Into Their Wallets.” “A Medicare official concedes that seniors may have to dig deeper into their wallets next year thanks to the health care law. The new analysis obtained by POLITICO finds the health care overhaul will result in increased out-of-pocket costs for seniors on Medicare Advantage plans. Richard Foster, the actuary for the Centers for Medicare and Medicaid, also tells Senate Republicans that the overhaul will result in ‘less generous benefit packages’ for Medicare Advantage plans next year. Foster is independent from the administration and non-partisan.” (Jennifer Haberkorn, “Medicare: Reform May Cost Seniors,” Politico, 10/13/10)

The Health Care Law Jeopardized The Benefits Of 800,000 Florida Seniors On Medicare Advantage. “The health care bill that the U.S. Senate passed on Christmas Eve included a gift to 800,000 Florida seniors who have Medicare Advantage plans rather than traditional Medicare. It allowed their insurance providers to keep the higher payments put in place during the Bush years, protecting extras that many members enjoy, such as dental coverage and vision care. The House’s reconciliation ‘fix’ bill, slated for a vote Sunday, would remove that preferential treatment. … Now, if the House reconciliation bill passes, Florida seniors on Medicare Advantage plans would bear the same cuts as Medicare Advantage customers in the rest of the nation.” (Stacey Singer, “Seniors Set To Lose Medicare Advantage Perk,” Palm Beach Post, 3/20/10)

Florida Is A Heavy User Of Medicare Advantage Plans. “But those cuts may be felt more deeply here, according to some estimates. Florida is a heavy user of Medicare Advantage plans, HMOs and PPOs offering services that are reimbursed mainly by the federal government.” (Stacey Singer, “Seniors Set To Lose Medicare Advantage Perk,” Palm Beach Post, 3/20/10)

Almost One-Third Of The Nations Medicare Advantage Customers Are In Florida. “It has been a popular program here since it was introduced in 2003. Almost one-third of the nation’s Medicare Advantage customers are in Florida, Zirkelbach said.” (Stacey Singer, “Seniors Set To Lose Medicare Advantage Perk,” Palm Beach Post, 3/20/10)

The Cuts To Medicare Advantage Were Projected To Throw Nearly 5 Million Seniors Off Their Private Plans Over The Next Five Years. “And though cuts to Medicare Advantage are projected to throw nearly 5 million seniors off of their private plans over the next five years, those plans with top scores for quality will endure and thrive as they are paid bonuses.” (Stacey Singer, “AARP Defends Law, Medicare ‘Savings,’” Palm Beach Post, 3/26/10)

The Spokesman For America’s Health Insurance Plans Said The Medicare Advantage Cuts Would Have “A Devastating Impact.” “‘That is going to have a devastating impact,’ said Robert Zirkelbach, press secretary for America’s Health Insurance Plans. ‘Seniors in Medicare Advantage are going to see higher premiums, reduced benefits, and many seniors will lose benefits entirely.’” (Stacey Singer, “Seniors Set To Lose Medicare Advantage Perk,” Palm Beach Post, 3/20/10)

Florida Hospitals Said The Medicare Cuts Were “Dramatic”

Florida Hospitals Were Forced To “Belt-Tighten” Because Of Cuts To Medicare And Medicaid. “For the rest of the hospital industry, the coming year may be one of belt-tightening. That’s because hospitals in Florida and many other states face cutbacks in how much money they will receive from Medicaid (the federal-and-state-funded insurance program for the poor and disabled) and Medicare (the national insurance program for the elderly).” (Linda Shrieves, “Hospitals Brace For Medicare, Medicaid Cuts,” Orlando Sentinel, 1/9/11)

Bruce Rueben, President Of The Florida Hospital Association: “There Are Dramatic Cuts Proposed For Both Programs, So We’re Planning As Best We Can For All Of That.” (Linda Shrieves, “Hospitals Brace For Medicare, Medicaid Cuts,” Orlando Sentinel, 1/9/11)

As Of 2010, Florida Had 3,307,686 Medicare Recipients. (Kaiser Family Foundation Website, www.statehealthfacts.org, Accessed 1/10/11)

Eighteen Percent Of Floridians Are Enrolled In Medicare – Higher Than The National Average Of 15 Percent. (Kaiser Family Foundation Website, www.statehealthfacts.org, Accessed 1/10/11)

As Of 2010, Florida Had 1,000,565 Medicare Advantage Recipients. (Kaiser Family Foundation Website, www.statehealthfacts.org, Accessed 1/10/11)

Insurance Premiums Increasing Under ObamaCare

In 2012 Miami Has The Most Expensive Healthcare In The Nation, With A Milliman Index of $24,965, 120.4% Of The National Average. (“2012 Milliman Medical Index,” Milliman, Accessed 5/15/12)

In 2012, Florida Is Expected To See An 8 Percent Increase In Employer-Sponsored Health Insurance Costs. “The cost for employer-sponsored health insurance in Florida is expected to increase 8 percent next year or about half that if companies offer higher deductible plans, according to a national survey by Mercer, a benefits consulting company.” (Liz Freeman, “Study: Florida Workers Face 8 Percent Health Insurance Cost Hike Or Higher Deductible,” Naples News, 11/21/11)

The University Of North Florida Area Director For The Small Business Development Said ObamaCare’s Mandates On Insurance Companies Will “Drive Up Premiums.” “Reform contains the immediate ending of several practices health care insurance companies used to hold down costs. The law includes a requirement to cover children through age 26, ending of the rejection of people who have pre-existing medical conditions and the placement of caps on what policies pay out. ‘One of the things all this will do is drive up premiums,’ Hagan said.” (Kevin Turner, “Health Care Reform May Not Offer Enough To Small Businesses,” The Florida Times-Union, 4/25/10)

Floridians Are Losing Their Insurance Policies

Several Insurance Companies Stopped Covering Florida’s Kids Thanks To ObamaCare. “Some major health insurance companies have stopped issuing certain types of policies for children, an unintended consequence of President Barack Obama’s health care overhaul law, state officials said Friday. Florida Insurance Commissioner Kevin McCarty said in his state UnitedHealthcare and Blue Cross Blue Shield have stopped issuing new policies that cover children individually.” (Ricardo Alonso-Zaldivar, “Some Insurers Stop Writing New Coverage For Kids,” The Associated Press, 7/23/10)

In Florida, All Insurance Carriers Have Stopped Offering “Child-Only Insurance.” “One of the largest insurance markets in the country, Texas, has seen all their carriers drop child-only health insurance, as have other large states including Florida and Illinois.” (Sarah Kliff And J. Lester Feder, “Child-Only Health Plans Endangered,” Politico, 1/27/11)

Taxes/Effect On Businesses & Jobs

MLR Waiver Denial “Destroyed” Businesses, Led To Layoffs Among Florida Insurance Agents. “Naples insurance agent Mark Fiacable says a part of the federal health care act destroyed his business and caused him to lose his home. Joan Galletta, who works at a Jacksonville insurance agency, says the same provision of the law led to staff cutbacks and a co-worker who left the industry because revenue decreased. In Pompano Beach, insurance agent William Kohn says he can’t afford to hire an assistant, which is affecting the quality of service at his business. They all blame their losses on a portion of the federal health care law that mandates insurance companies spend at least 80 percent of premium dollars from individual plans on medical costs. Companies that failed to meet the threshold in 2011 must issue rebates to customers this year.” (Tia Mitchell, “Florida Insurance Agents Protest ‘Medical Loss Ratio’ Provision In Health Care Law,” Tampa Bay Times, 1/7/12)

Florida Medical Device Company CEO Said ObamaCare’s Medical Device Tax Will Lead To “Layoffs And Less Investment” And Smaller Companies Will “Ow[e] More In Taxes Than They Earn In Profit.” “‘The way the bill is currently written, the impact of the device tax will have some smaller medical device companies owing more in taxes than they earn in profit,’ said Matt Solar, C2C’s chief executive officer. ‘The overall effect will be layoffs and less investment in research and development. This needs to be fixed.’” (Wayne T. Price, “Tax A Concern In Medical Device Field,” Florida Today, 4/7/10)

• Florida Software-Engineering Firm CEO Doesn’t “See The Benefit” Of The Medical Device Tax And Says “It Will Really Hurt Device Development.” “Lee Krause, chief executive officer of Melbourne-based Audigence Inc., a software-engineering firm for hearing aid systems, said while the impact on the tax will not affect his company, as an entrepreneur in a medical field he sees where it might stifle innovation and research. ‘In general I don’t see the benefit in creating this device tax and agree it will really hurt device development,’ Krause said.” (Wayne T. Price, “Tax A Concern In Medical Device Field,” Florida Today, 4/7/10)

Tanning Salon Owner In Jacksonville Said Fighting The Tax Is Like “David Vs. Goliath” Because Tanning Is “Not An Extremely Lucrative Business.” “Nermin Dedic, owner of Sol Us, which has seven salons in Jacksonville, describes the tanning industry’s battle against the lobbying efforts of other groups as a David-versus-Goliath-type fight, in which tanning salon owners can’t compete. ‘It’s not an extremely lucrative business,’ he said. ‘So we’re not able to afford things like that where you have lobbyists in Congress so you can do things like plastic surgeons did in completely eliminating the Botox tax.’” (Justin Pugh, “Tanning Salons Look At How New Taxes Will Affect Business,” The Florida Times-Union, 4/25/10)

Pharmacy Owner From Jacksonville Said ObamaCare’s Tax Credit To Help Small Businesses Pay For Health Insurance “Isn’t Enough To Help.” “Jacksonville small business owner Greg Carter said he favors health care reform but doesn’t think the reform bill President Barack Obama signed last month is going to help him. Between his two Jacksonville pharmacies, Carter employs 15, but he doesn’t provide health care insurance because he can’t afford it. And he said a tax credit in the reform bill designed for businesses like his isn’t enough to help.” (Justin Pugh, “Tanning Salons Look At How New Taxes Will Affect Business,” The Florida Times-Union, 4/25/10)

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