Monday Quickie

 I'm not feeling well, and I'm behind in my work, so today will be just a quickie.  I have to find a way to stop working from 4:30 am to 9 pm every night, as I have done for the past 3 weeks.  For today, that means a quicker than usual blog post.

Cautious optimism in Texas as residents hope the State will do the right thing and participate in the Medicaid expansion and the rest of health reform.  Governors in Nebraska, New Hampshire, and South Carolina are saying they won't participate because they can't afford the 10% that they would have to gradually start paying from 2016 to 2020 -- until then, it's 100% federally funded.  Governors in Wisconsin and Louisiana say they will wait until after the November election before beginning implementation.  Governors in Ohio, New Jersey, Mississippi are tentative.  Florida says they won't implement either the Medicaid expansion or the exchange, although the feds will be setting up exchanges in states that don't set up their own.  Choosing not to take federal money to cover the poorest of the poor will leave millions uninsured and hospitals will lots of unpaid bills as uncompensated care payments are phased out on the premise of universal coverage.  So hospitals are urging states to accept the Medicaid expansion.  The White House believes most states will accept it.  I think it's up to us to make sure our state officials know we want them to take the billions of dollars of federal money to improve the health of the poorest residents.

Ted Kennedy's widow says he would have told us to roll up our sleeves and get to work on implementing reform -- and there is an awful lot of work to be done, even in states like Connecticut, that have been hard at work already.  Indeed, in states that have done nothing to move towards implementation, it will be difficult to meet the law's deadlines.

Senate Minority Leader McConnell says covering 30 million uninsureds is not the issue.  Really?  I thought it was the only issue.

And if you're really a Supreme Court wonk, the reports that Chief Justice Roberts switched his vote about a month ago, deciding to vote to uphold the law are interesting.   I suspect we won't know for sure until one of the sitting Justices retires and writes her/his biography. 

There is other news, believe it or not. 

California is moving Medi-Cal (Medicaid in California) to managed care, causing disruptions in service for the uninsured.

Sunscreen forbidden at school or camp.  Are you kidding me? Really?

That's it for today.  Have a good one.  Jennifer