Florida Sen. Mel Martinez's flip-flop on Medicare vote is mott

Florida Sen. Mel Martinez's flip-flop on Medicare vote is moot

Florida Healthcare Insurance

WASHINGTON - Nobody wants to be on the bad side of grandma and her doctor -- as U.S. Sen. Mel Martinez demonstrated Wednesday.

Intensively lobbied by Florida seniors and doctors to change his vote and roll back a major cut in fees for doctors who treat Medicare patients, Martinez flipped. But only after it was clear his side had lost.

Perhaps inspired by a surprise visit from cancer-stricken Sen. Ted Kennedy -- his first Senate appearance since brain surgery in June -- the Senate voted 69-30 to cut off debate on the bill, a vote that by previous agreement also approved the bill. The margin is enough to overcome a promised presidential veto.

Nearly two weeks ago, a similar cloture vote, which requires 60 votes, failed 58-40. Martinez was one of nine Republicans who voted "no" -- and switched positions Wednesday.

Two hours earlier, he had told a reporter he had no intention of changing his vote, even though it meant doctors treating Medicare patients would see their fees cut by 10.6 percent beginning next week.

"From time to time, we have to do what we think is the right thing," Martinez said.

Then came the wholesale switch by Republican senators.

"The measure we moved forward today does not provide the kind of solution doctors deserve," Martinez said in a statement afterward, "but this is the only option to stop doctors in Florida from having their pay cut by 10.6 percent. It is also the only option to ensure that seniors continue to have uninterrupted access to health care."

Before the vote, doctors said they would have to stop taking new Medicare patients or even stop seeing Medicare patients at all. The government health insurance program covers 3.15 million Floridians.

"It's going to significantly reduce access to [health] care for Medicare patients," said Egerton K. van den Berg Jr., an Orlando cardiologist. "You can't afford to take care of those patients."

Advocates for seniors agreed.

"It doesn't do you a lot of good to have Medicare and not have a doctor to go to," said Jeff Johnson, head of AARP Florida. He said 10,000 members called or e-mailed Martinez and Sen. Bill Nelson, D-Fla., who already supported the bill.

Why did Martinez originally oppose the bill?

To restore the Medicare fees, it cuts payments to private insurers who sell Medicare Advantage programs by about $13.5 billion over five years, according to the Congressional Budget Office.

About 856,000 people in Florida are enrolled in Medicare Advantage.

The Bush administration likes the program, which operates like a health-maintenance organization, because it's not government-run, but Democrats say the payments to insurers are too generous.

Martinez's staff said the cuts would result in about 150,000 Florida seniors being dropped by their insurance companies.

"It's not an easy decision to come to because you don't want the doctors to get a cut," Martinez said about his earlier vote, adding that he was trying to force a compromise. He blamed Senate Democratic Leader Harry Reid for pushing "a political exercise."

The bill passed the House 355-59 with bipartisan support. President Bush now must decide whether to follow through on his veto threats.