Thursday Themes

Well, the Senate voted against the House GOP spending bill AND the Senate Democratic alternative, leaving us without a budget and with no clear direction in sight. No Dems supported the GOP bill, but three GOP Senators voted against it because it didn't cut enough. Ten Dems voted against the Dem alternative. They now have until March 18 before the current funding expires. It is likely that there will be another temporary extension, perhaps through April 15. The Democrats are now saying tax increases and entitlement reform have to be on the table. The GOP prefers to just focus on getting a budget through September. But the parties are talking, with the White House actively involved. Still, GOPers attack the White House for not being involved enough. I love Ben Nelson's (D-NE) line: "One bill cuts too little. The other has too much hate."

Meanwhile, a small bipartisan group of Senators is working on a deficit- cutting proposal that would involve taxes and entitlements, and this proposal is picking up some steam.

Still, there are conservative GOPers who would be willing to negotiate away some cuts if they could make gains in social programs -- defunding health reform, Planned Parenthood, and overturning environmental regulations. So then this isn't about jobs and the economy? Hmm. In any event, it makes compromise difficult for the House GOP.

HHS Secretary Sebelius says that defunding health reform would essentially shut down Medicare Advantage Plans. Currently, health reform is the only law authorizing payments to the private Medicare HMOs, so without that, it may be that no such payments can be made. For the record, I don't find this to be a very convincing argument.

Meanwhile, the Justice Department has asked the Eleventh Circuit to expedite its appeal of the Florida judge's ruling striking down the law, which sets the stage for a summer confrontation.

And policymakers are struggling to define the "essential benefits" package under the health reform law. This will set the standard for what must be included in insurance policies offered through the Exchanges, thereby also driving the cost of those policies. The Institute of Medicine has been charged with making a proposal to the Department of Health and Human Services, after which HHS will issue regulations.

The FDA approved a new drug for lupus -- a wonderful accomplishment that stems from the human genome project. The FDA also has said it is going to study whether anesthesia causes cognitive problems in children.

And that's it for now, folks. Have a great day. Jennifer