Monday Musings

It seems like the week-ends only get shorter. But we have two holiday week-ends coming up, so something to look forward to. And here's the news:

Craziness over the payroll tax cut. There was a deal on Friday -- a two month extension of the payroll tax cut, unemployment and the delay of a major cut in Medicare reimbursement that included speeding up the GOP-favored Keystone Pipeline. But Speaker Boehner says not so fast. He doesn't want a short-term deal and his members liked it even less. But the Senate is supposedly out of session until after the holidays, so if the House doesn't pass the Senate version, does that mean we start the year off with reversion to the regular payroll tax as in years gone by? That's how the White House is painting this -- take the deal or take responsibility for having no tax cut. But the deal increases fees on housing mortgages and refis -- how is this a good thing for the already flagging housing market? And Senate Minority Leader McConnell -- who cut the deal, with the blessing of Speaker Boehner -- now says maybe Dems should be open to alternatives, although Senator Reid says he's not reconvening the Senate over the holidays. Of course, that's not the GOP's objection, but it is a concern. This should be interesting.

In a potentially disastrous move, the Department of Health and Human Services has proposed allowing the states to set their own Essential Health Benefit package, the floor for what all insurance must cover to be sold through the Exchange starting in 2014. Not only does this transfer massive power to Exchange boards, but it allows states like Mississippi and Florida to be stingy when setting requirements. But surprisingly, this proposal hasn't brought the strong opposition I would have anticipated from the advocacy community.

Meanwhile, although some states are moving things along, there are questions about whether they will make the deadline for creating an exchange, and whether the feds will be ready to step in if the states aren't up and running. This is a real worry. There's a lot to do between now and 2014. And the health reform law will be under fire in the election, at the Supreme Court, and in Congress in 2012 -- it will be a tough year for those of us who are committed to coverage of people with pre-existing conditions in 2014. And as long as healthcare execs are the highest paid CEOs, we aren't going to make the progress in controlling costs that we should be making.

A medical practice in California is now charging $350/year for administrative expenses. If you want them to take care of your prior authorizations, provide medical records when needed, fight with your insurance company for you, you have to pay this extra fee. Is this a sign of the future? Ugh.

The painful cycle of eczema -- a nasty chronic skin ailment.

And that's it for today -- a slow news day, perhaps a sign of things to come as we move into the holidays? No news is good news!

Have a great day! Jennifer