This article is a section of a longer paper on Direct Primary Care (DPC) that was introduced in an earlier piece -- Health Plan Rorschach Test: Direct Primary Care. The following excerpt from that article briefly explains DPC if it's a new concept. Click through the previous link for additional context. Despite its inclusion in Obamacare, Direct Primary Care (DPC, aka Concierge Medicine for the Masses), it's surprising how few health insurance executives know about DPC. DPC  is a model of paying for primary care outside of insurance. The individual or organization paying for healthcare pays a monthly fee (like a gym membership) for all primary care needs. Generally, DPC providers say they can address 80 or more of the top 100 most common diagnoses. [Contact me via LinkedIn if you'd like a copy of the full seminal study on the Direct Primary Care model - excerpts will be published on Forbes] Regulatory Trends Prior to the inclusion of DPC into the Affordable Care Act, these practices were on their own to ensure they were within the bounds of existing provider regulations. The inclusion of DPC is very brief and leaves much to the states as to how to interpret and administer the law's DPC clause. Reported by Forbes.com 3 hours ago.

KENNEBUNK, Maine--(BUSINESS WIRE)--Health plans are making important decisions about investment in products and markets these days, charting a course to thrive as the health insurance industry transforms. They are keeping a close eye on state decisions about Exchanges and Medicaid expansions. Furthermore, companies are applying demographics and competitive insights to help them develop successful business strategies. New Commercial markets and state Medicaid opportunities have definitely capture Reported by Business Wire 3 hours ago.

DEERFIELD, Ill.--(BUSINESS WIRE)--Walgreens (NYSE: WAG) (Nasdaq: WAG) and the Blue Cross and Blue Shield Association (BCBSA) today launched a national campaign to educate consumers about the new health care reform law and provide them with key information on how to access coverage and understand other changes they may experience as a result of the Affordable Care Act (ACA). The campaign centers on a new website, LearnAboutReform.com, which offers consumers helpful information about the new ways Reported by Business Wire 2 hours ago.

Health Care Blog Donates Advertising Revenues to Help Cancer Veteran pay off Medical Debt in Colorado

CHICAGO, IL. (PRWEB) July 10, 2013

According to the CDC, one in three Americans report that their family is experiencing the financial burden of medical care; a statistic that has been commonly referenced during the health care reform debate. iHealthcareupdates.com announced today Clifford Bruce of Divine Colorado as the recipient of this quarter's iHelpCare donation Program. iHealthcareupdates.com directly paid 100% of Clifford’s outstanding medical bill to the Denver VA Medical Center. “Supporting those in need with financial difficulties due to Medical challenges is critical to helping support our veterans, and that’s why I am so pleased to announce this donation recipient today.” said CJ Evrard program founder.

Clifford Bruce is a 62-year-old veteran, who spent the last several years battling various medical issues, and most recently was diagnosed with Prostate Cancer.

Clifford spent many years working in the real estate field; however following the country’s economic downturn, Clifford fell on difficult times financially & health wise. In the summer of 2012 Clifford was diagnosed prostate cancer.

Clifford has been unable to pay his outstanding debt and lives in constant fear his current wages will be garnered due to his outstanding medical debt to the VA Medical Center. Clifford spent years travelling across the country for jobs to keep himself afloat and his medical bills at bay. Clifford is in a state where he earns too much for government support, but not enough to cover rent, and day-to-day living.

After an interview with applicants Clifford Bruce was selected from the top entries reviewed by ihealthcareupdates.com staff.

The “iHelpCare Donation Program” established in 2012 helps support individuals and families through a one time financial donation paid directly to a Hospital, Doctor, Clinic, Medical Center, Insurance Company or other health facility. The awarded amount is a minimum of a $1000, and can go as high as 50% of the advertising revenue during the application period. The donation program provides up to 4 donations each year to individuals in need.

For more information about health care reform, wellness and other related topics, visit http://www.ihealthcareupdates.com. Questions about the HelpCare Program can be submitted to helpcare(at)ihealthcareupdates(dot)com.

About iHealth Care Updates

iHealth Care Updates is an online information portal aimed at providing information relevant to Health Care Reform, health care, and wellness. Common topics covered include health insurance, Medicare, Medicaid, veteran’s benefits, student health and the Affordable Care Act. For more information and updates, visit http://www.ihealthcareupdates.com. Reported by PRWeb 2 hours ago.

Tips for Small Business Human Resources on How to Transition to Defined Contribution Health Benefits

Park City, Utah (PRWEB) July 10, 2013

Today, Zane Benefits, the online alternative to group health insurance, published new information on changing to defined contribution.

According to Zane Benefits’ website, small business HR managers can effectively facilitate the shift from defined benefits to consumer-driven models and defined contribution health plans. There are four tips on how to successfully shift to pure defined contribution health plans.

1. Understand and Prepare for Health Care Reform: According to Zane Benefits’ website, HR needs to understand the organization's obligations, and opportunities, with health care reform. There are numerous resources available on health care reform compliance for small businesses.

2. Educate Employees on the Benefits of Defined Contribution: Take the time to educate employees on how defined contribution health plans work, and how employees will benefit. This will contribute to their understanding and happiness with the defined contribution health plan. Work with your defined contribution software provider to offer employees tailored resources, such as webinar training sessions, online account access, and help and support tutorials.

3. Communicate with Employees Early-On & Frequently: Keep the communication open between HR and employees, and check in frequently. Many organizations make assumptions about what employees prefer or understand when it comes to benefits. By keeping communication open, HR can address questions early-on in the transition, and measure their overall satisfaction in the long-term.

4. Provide a Health Insurance Broker or Consultant to Help Employees: With pure defined contribution, employees purchase their own individual health insurance. This is a new experience for many employees. Make a health insurance broker available to employees to help them select and purchase plans. This will help employees choose plans that best fit their individual needs, and help them see the value in the change to a defined contribution plan.

Click here to read full article.

--

About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangements (HRAs) and defined contribution health care. The flagship software provides a 100% paperless administration experience to small businesses and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit http://www.zanebenefits.com. Reported by PRWeb 2 hours ago.

BOSTON--(BUSINESS WIRE)--Report on Health Insurance Plans Reveals a Lack of a Centralized Benefits Plan Management System as a Serious Strategic Deficiency When Implementing ACA Compliance Reported by Business Wire 2 hours ago.

The Obama administration has quietly rolled back requirements for state health benefit exchanges to verify the incomes and health insurance status of consumers during the first year of operations. Under the Affordable Care Act, low-income individuals who do not have access to health insurance through an employer are eligible for subsidized coverage. Proposed rules would have required exchanges to verify the income status of applicants and do random checks to determine their access to employer-based… Reported by bizjournals 40 minutes ago.

Independent report by Greenlight reveals over 5% of the 2.5 million insurance-related searches made on Google UK in May pertained to pet insurance compared to 3.8% for health insurance

London (PRWEB UK) 10 July 2013

There were more searches made online for pet insurance than for health insurance, reveals the latest independent report from leading digital marketing agency, Greenlight.

The PFMA (Pet Food Manufacturers Association) estimates 13 million households have at least one pet. With various news reports about the cost of vet treatments going up and the cost of the average annual pet insurance policy over the past five years having increased to £223 compared to £166, it is little wonder consumers are shopping around and looking online for the best deals.

The agency’s latest “Insurance Sector Report – Issue 16”, which analysed the most popular terms consumers used when they went to online to look for motor, travel, home, pet and health insurance in May, reveals that of the 2.6 million queries made on Google UK for insurance-related products, 142,671 (5.5%) pertained to insurance for pets compared to 98,142 (3.8%) for health insurance.

Interestingly, 16% of pet insurance-related searches were made using tablets & smartphones, whilst the majority, 84%, were made via computers.

The most popular terms used to look for pet insurance varied by device. On computers, ‘pet insurance’, ‘dog insurance’ and ‘compare pet insurance’ were the three most popular search terms.

However, on mobile devices, it was somewhat different with the terms ‘pet insurance’, ‘dog insurance’ and ‘cat insurance’ proving most popular.

Greenlight also analysed the most visible sites for pet insurance searches in the organic* and paid listings**.

On both computers and mobile devices, petplan.co.uk was the most prominent site in the organic listings. It was visible to 92,207 of pet insurance-related queries made via computers which secured it a 77% share of visibility. Comparethemarket.com followed with 75% then moneysupermarket.com with 67%.

However, on mobile devices, whilst petplan.co.uk and comparethemarket.com also ranked first and second in Greenlight’s league table, attaining an 81% and 77% share of voice in natural search, respectively, tescobank.com took third spot with a 65% share of visibility. Moneysupermarket.com meanwhile came in sixth with a 50% share of visibility.

In the paid listings, gocompare.com was the most visible advertiser on computers dominating with a 90% share of voice whilst on mobile devices, it was animalfriends.org.uk, securing a 79% share of visibility.

Greenlight’s report also ascertained the most visible brands on Social Media networks. Money Saving Expert was the most visible brand followed by confused.com then Aviva, which also had the largest number of likes on its Facebook page.

ENDS

Notes to Editors:

*Natural Search - Listings in search engine results pages that appear because of their relevance to the search terms

**Paid Media – An Internet advertising model used on websites, in which advertisers pay their host only when their ad is clicked. With search engines, advertisers typically bid on keyword phrases relevant to their target market.

Greenlight’s ‘Insurance Sector Report – Issue 16’ profiles search behaviour in this sector. It assesses which brands, websites and review sites are the most visible in Natural Search, Paid Media results and Social Media and hence have the greatest share of consideration when searchers go to Google UK to look for motor, travel, home, pet and health insurance. Comparisons for searches made via Computers (laptops/desktops) and Mobile Devices (tablets & smartphones) are given for each.

Greenlight’s research covers the following industries and sectors:

CONSUMER ELECTRONICS
PERSONAL CARE - Beauty
HOME GOODS - Home & Garden
CLOTHING & ACCESSORIES - Fashion Retail / Sports Retail
CONSUMER SERVICES - Online Dating / Entertainment
GAMING & GAMBLING - Online Gambling
FINANCE - Personal General Insurance / Life Insurance / Retail Banking
TRAVEL & HOSPITALITY – Holidays / Hotels / Flights / Car Hire / Cruises
UTILITIES - Energy
REAL ESTATE – Property (Residential)
RECRUITMENT
TELECOMS – Telecoms

To arrange an interview or for further information about this report, Greenlight’s research portfolio or bespoke reports, please contact:

Krishna Rao
T: +44 (20) 3326 6232
E: krishna.rao (at) greenlightdigital (dot) com

About Greenlight:

Greenlight is a leading independent digital marketing agency. With over 100 blue-chip clients including Santander, New Look, Sky and ghd, Greenlight is a leader in the digital marketing space, and is recognized worldwide for its commitment to delivering record ROI for its clients and investing in the future.

Greenlight is considered the premier thought leader in the sector publishing widely read industry reports, original research and speaking at trade events. Founded in 2001, Greenlight is headquartered in London, with offices in New York.

Web: http://greenlightdigital.com
Twitter: https://twitter.com/GreenlightMKTG Reported by PRWeb 35 minutes ago.

Three years ago, the Catholic Health Association, whose members run hospitals and nursing homes across the country, backed passage of the federal health law. The U.S. Conference of Catholic Bishops, which represents the hierarchy of the church, opposed it. The groups remain divided over the law's requirement for most employer-based health insurance plans to provide women with contraceptives. Reported by NPR 25 minutes ago.

A 50-something editor friend reached out last week to say that he had just gotten "the call." Apparently employers have decided it's less messy to call you at home to let you know you've been laid off instead of the old way of tapping you on the shoulder at 2 p.m. on a Friday and asking you to stop by the Human Resources office where a stack of papers and the end of your job awaited. Doing it the new way presumably cuts down on those tearful goodbyes and disruptions to the work day. Employers are such a compassionate lot, right?

Anyway, having walked in this guy's boots myself in 2009, I knew exactly what was causing him to quake when he called: The two H's.

"You're mostly worried about health insurance and losing your house, right?" I asked him.

Bingo.

Those two things are always the principal boogeymen who haunt your dreams when you get "the call." It took me a while, but I speak from experience when I say that while the solution to those worries isn't perfect, at least there is one. And to be frank, there is something much bigger you should be focused on. But first, let's dispense with the two H's.

Health insurance: If you are laid off, you are in most cases eligible for COBRA, the federal Consolidated Omnibus Budget Reconciliation Act that lets displaced workers buy into their former group health plan. Since a lot of companies require that you foot the whole premium bill, it isn't cheap, but at least you have access to health care. Professional trade groups and university alumni groups have also stepped up and may be able to help; call up your college and ask. There are even some freelance groups that are now offering health insurance. I know one woman who moved to Massachusetts because that state offers financial help to pay for health insurance to the unemployed. For the most part, someone like my recently laid-off friend is going to find health insurance. Dispense with Worry #1, I told him.

As for the second biggest fear -- losing your house -- you'd be surprised how unlikely this prospect is. At the risk of sounding flippant, you missed the worst of the storm. From 2008-2011, people got into trouble with their mortgages because their loan rates adjusted after they lost their jobs and housing values plummeted. At the moment, the housing market is pretty hot. Chances are, you aren't upside down on your loan and probably have some equity in your house -- which means you can always sell it if you have to. Your only real goal here is to hang on. And that's not the big deal you fear.

Why? Because most of us tend to spend to capacity. We earn a dollar and we find something to buy with a dollar. That spending attitude changes when you lose your job. Instead of your freewheeling spending ways, you need to start with a zero-based budget. You make a list of all your monthly expenses and draw lines through the ones you can do without. Then you make a second list of all your income -- including the unemployment insurance you will be collecting, as well as any severance package amount divided by 12 (for a year).

In my friend's case, the money coming in will cover most of his mortgage and essential expenses for at least a year even if he didn't earn a nickel. And he has enough savings that a carefully watched slow withdrawal -- while not ideal -- will ensure that the bank wouldn't be foreclosing on him anytime soon. So for the short-term, he can breathe a bit easier.

But what my friend -- who has a wife and child -- has yet to come to grips with is a much bigger problem, one shared by a lot of post-50 people who lose their long-time jobs: His skills set is obsolete and has very little value in today's market. It's a big ouch to hear, I know.

Even worse, if he spends a lot of time looking to replace his old job in what is now a dwindling field, he is likely to burn through his savings and still not have a job. And then he's going to really be in trouble. How do you accept that you won't be able to work in the field you loved and spent 30 years? The only way is to open your eyes and your heart to the next chapter and just do it. Yes, I'm practicing tough love here, but I've seen too many journalists friends spin their wheels and try and find jobs that don't exist anymore.

The reality is that my friend needs not just another job, but a job in a field that is hiring. And to get one of those, he probably needs to go back to school first. I asked him if he'd ever considered nursing or a job in health care delivery. Yes, I'm serious. Forbes proclaimed registered nurses the No. 1 job with the brightest prospects and I had a chance to chat up many a nurse during my daughter's recent hospital stay. They work three 12-hour shifts a week, bring down good money, and totally love having four days off every week. With the population aging, there will never be a shortage of good nursing jobs.

For the blood-squeamish, there are also degrees in computer science. The Bureau of Labor Statistics says software developers earn on average $90,530 a year, and the BLS expects a 30 percent increase in the number of jobs by 2020.

Losing your job at 51 is a tough nut to swallow. The unwillingness to accept a change in what you do for a living is what chokes you though, not the nut.

Earlier on Huff/Post50: Reported by Huffington Post 2 days ago.

Providing an HRA for Health Insurance Can Save a Business and Employees on the Cost of Health Insurance

Park City, Utah (PRWEB) July 11, 2013

Today, Zane Benefits, the online alternative to group health insurance, published new information on HRAs and bonusing employees for health insurance.

According to Zane Benefits’ website, small businesses who do not offer health benefits often consider giving employees a salary bonus to help them pay for their individual health insurance. Small businesses who consider this have often been:


· Priced out of group health insurance,
· Cannot meet minimum participation requirements, and/or
· Do not know about small businesses health insurance alternatives such as stand-alone health reimbursement arrangement plans (HRAs).

According to Zane Benefits’ website, providing salary bonuses to employees may seem cheaper and simpler than reimbursing health insurance premiums through an HRA. But, there is one major consideration favoring an HRA for small businesses: Tax savings.

By offering an HRA instead of giving bonuses to employees for health insurance, both the small business and employees save money.

Click here to read full article.

About Zane Benefits

Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangements (HRAs) and defined contribution health care. The flagship software provides a 100% paperless administration experience to small businesses and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit http://www.zanebenefits.com. Reported by PRWeb 2 days ago.

PADUCAH, Ky. -- Ever since the U.S. government's uranium enrichment plant started hiring in 1951, there has been a Buckley helping to run it. Before his sons, a daughter-in-law and a grandson clocked in, Fred Buckley, now 86, would travel three hours a day from his home in West Tennessee to make $1.46 per hour as a plant security guard.

It felt to Buckley like he was back in the Army, working with a close-knit group of men on a secret mission. He'd served in World War II -- after a few weeks of basic training, he ended up on the front lines at the Battle of the Bulge. He rose quickly from infantryman to staff sergeant to squad leader. The job at the plant promised the safety of a stable income and a sense of purpose at the dawn of the Cold War. One month before he started, the first of his two sons was born.

It seemed like Paducah was being reborn too. As new workers from neighboring Illinois, Ohio and Tennessee showed up, the small city in Western Kentucky faced a housing shortage. "So many people came in, you know?" Buckley told The Huffington Post. "Anything that had a roof on it -- chicken house, any kind of outbuilding, they were in it."

Room rates tripled until local officials imposed rent control. Home construction blanketed the city, while trailer parks rose up on cinder blocks throughout the surrounding county. More than 1,100 homes were built while Buckley waited for his chance to move to the Paducah area. After more than six years, he found a one-story, two-bedroom white frame house on a corner lot off Highway 60, just three miles from the plant. He still lives there today.

The flood of well-paid men had ramifications well beyond the homebuilding industry, lifting almost every business in the region. Even the local brothel expanded.

Paducah embraced the plant and its patriotic celebration of nuclear power. It called itself "The Atomic City" and envisioned thoroughfares bright with shiny, pastel-colored automobiles, a downtown humming with Cold War money. "The plant just made the town, you know?" Buckley says. He still remembers when they first raised the American flag in front of the plant's administration building. He was there, standing at attention.

Fred Buckley (left) with the Paducah plant union's vice president, Jim Key.

Nobody understands the plant's importance more than Mitch McConnell. For the past 30 years, the Senate minority leader, now 71, has been the plant's most ardent defender in Washington. The Republican lawmaker knows its 750 acres located just 12 miles from downtown. He's walked its grid under the haze of the ever-present steam cloud emanating from its cooling towers. He grasps its history, its hold on the imaginations of men like Buckley. No other jobs in Western Kentucky presented the opportunity to use more electricity than Detroit and more water than New York City every day of the week.

The senator has remained loyal to the plant and its workers, keeping it running on federal earmarks and complicated deals with the Department of Energy to convert its core function from producing warheads to mining nuclear waste to create electricity. At least in Paducah, McConnell is not the "abominable no-man," the sour-faced persona of Washington gridlock. He is an honorary union man. "He's been the best friend to the plant we've had over the years," Buckley says. "He went above and beyond the call of duty for the union."

Up until the tea party-led ban on earmarks a few years ago, McConnell played out this dichotomy across Kentucky. In Washington, he voted against a health care program for poor children. In Kentucky, he funneled money to provide innovative health services for pregnant women. In Washington, he railed against Obamacare. In Kentucky, he supported free health care and prevention programs paid for by the federal government without the hassle of a private-insurance middleman. This policy ping-pong may not suggest a coherent belief system, but it has led to loyalty among the GOP in Washington and something close to fealty in Kentucky. It has advanced McConnell's highest ideal: his own political survival.

McConnell's hold on Kentucky is a grim reminder of the practice of power in America -- where political excellence can be wholly divorced from successful governance and even public admiration. The most dominant and influential Kentucky politician since his hero Henry Clay, McConnell has rarely used his indefatigable talents toward broad, substantive reforms. He may be ruling, but he's ruling over a commonwealth with the lowest median income in the country, where too many counties have infant mortality rates comparable to those of the Third World. His solutions have been piecemeal and temporary, more cynical than merciful.

And with McConnell's rise into the GOP leadership, his continuous search for tactical advantage with limited regard for policy consequences has overrun Washington. McConnell has more than doubled the previous high-water mark for the number of filibusters deployed to block legislation, infamously declaring that his "top political priority" was to make President Barack Obama a one-term president. This obstruction has had serious consequences, as the Great Recession grinds on and large-scale problems like climate change march inexorably forward. Congress has failed to address the nation's most pressing challenges, and America has come to look more and more like McConnell's Kentucky.

At the Paducah plant, and throughout the Bluegrass State, McConnell's influence is a complicated, even poisonous one. As other aging nuclear facilities have been shuttered, Paducah has groaned its way into the 21st century. The plant has become a barely functional relic in the midst of a decades-long power down. The town's post-war pastels have given way to rust, padlocks and contaminated waterways. After three decades under McConnell, Kentucky residents are wondering whether his survival is good for them.

Up for reelection again in 2014, McConnell faces dismal polling numbers. In January, a Courier-Journal Bluegrass Poll found that only 17 percent of residents said they were planning on voting for him. A recent Public Policy Polling survey showed him tied in a hypothetical race against Alison Lundergan Grimes, Kentucky's Democratic secretary of state, weeks before she announced she was running on July 1. Today, McConnell finds himself at both the most powerful and most vulnerable moment of his career. He faces not only a Democratic opposition out to avenge McConnell's attacks on Obama, but an energized tea party unhappy with the GOP establishment and independents disgusted with Washington.

Keith Runyon was a veteran reporter and editorial page editor for the Louisville-based Courier-Journal, Kentucky's dominant statewide paper, which has generations of close personal ties to state and national Democrats. He witnessed McConnell's rise in Louisville and its suburbs of Jefferson County. He met his future wife, Meme Sweets, when she worked as McConnell's press secretary after his election as the county's judge-executive. Runyon came to know McConnell well. He says that McConnell was not always such a ruthless partisan obstructionist.

"It was not the local Mitch McConnell that became the problem," he told HuffPost. "It was what he became when he went to Washington."

In 2006, the former editor and publisher of the liberal Courier-Journal, Barry Bingham Jr., 72, "was dying and knew it," Runyon says. A week before his death in early April, he summoned Runyon to his home.

When he arrived on that balmy morning, Runyon recalls, Bingham was sitting up in a chair in his library. A breeze was drifting in through the windows. Among the many things Bingham wanted to talk about, the paper's early support of McConnell was one them. "He looked at me and he said, ‘You know, the worst mistake we ever made was endorsing Mitch McConnell' in 1977."

*MODERATE MITCH*

Squint long enough and hard enough, and you can see vestiges of the young, moderate McConnell in his funneling of federal money toward Kentucky projects. This is the McConnell who forged a political identity at the elbow of Kentucky's iconic reformer Republicans, the McConnell who didn't just admire Martin Luther King Jr., but made a point of witnessing the March on Washington from the Capitol steps and later spoke up for the cause on his University of Louisville campus.

In the summer before he began law school at the University of Kentucky, McConnell went to Washington as an intern for Kentucky's beloved Republican statesman, Sen. John Sherman Cooper. The senator had helped draft the first legislation for federal education aid, had fought school discrimination and had been a co-sponsor of the bill that created Medicare. He'd been hit with a lot of flak back home for the health care legislation, but his experiences taught him a bleak lesson.

"I noticed that the old country doctors and the country officials -- people who had been out in the country and had seen the plight of the people who live in the hollows and down the dirt roads -- they were for it," Cooper told reporters in 1972. "And I remembered my experiences as county judge in Pulaski County, when I'd go out in the county and see these people -- desperate, hungry, sick and nowhere to turn, and no one to help them except the old country doctors. You just can't let people go hungry. You can't just let them lie there sick, to die. Not in this country. Not with all we've got."

Cooper had also been an ardent supporter of one of Lyndon Johnson's signature achievements, the Civil Rights Act of 1964, and helped defeat the filibuster against it. The summer after his internship, "Cooper grabbed a visiting McConnell by the arm and spontaneously took him to the Capitol" where the two watched Johnson sign the Voting Rights Act of 1965, according to John David Dyche's Republican Leader, a biography of McConnell.

McConnell later joined Marlow Cook's campaign for Senate in 1968, as a field organizer at colleges across the state. By the time he was through, every campus had a Cook group. "I think he believed in what we were doing," Cook says. "He believed that we were trying to bring a moderate Republican to succeed a moderate Republican. As a Republican, I was the one that could do that."

After the successful campaign, McConnell joined Cook's staff in Washington where he worked with the senator to pass the Equal Rights Amendment, which would have guaranteed equal rights for women. Cook says McConnell and his staff all "had to work like hell on it." The amendment passed but ultimately failed to be ratified by enough states to be written into the Constitution. Cook had been the only Republican leading the deeply controversial effort. "We were fighting the likes of Phyllis Schlafly that didn't want women in the military," Cook explains. "All the churches were against it."

John Yarmuth, another young reform-minded Republican, crisscrossed the state with McConnell campaigning for Cook, and remembers McConnell as pro-choice and a supporter of Planned Parenthood. Yarmuth says that after his stint with Cook, McConnell boasted about his work on behalf of the Equal Rights Amendment. Yarmuth himself is now serving a fourth term in the House of Representatives, after switching parties to become a Democrat in the mid-1980s.

Back home, Louisville in the 1970s was experiencing a progressive heyday. The city's new Democratic mayor, Harvey Sloane, a doctor by trade, had spent two years in Appalachia as part of President John F. Kennedy's health care initiative. In Louisville, he set up a health center that served primarily African Americans in the West End neighborhood, which helped him launch a political career. As mayor, Sloane started an emergency medical service and helped create a public transportation system. Neighborhoods began to invest in historic preservation. The county started an ecology court to tackle environmental crimes.

"The community was in a can-do frame of mind," Sloane recalls. "Those were times where people were willing to step up to the plate."

The city still had plenty of problems that needed solving, of course, with deeply entrenched racism at the forefront. In 1975, courts ordered local officials to implement a new busing program in an effort to desegregate the school system. For a time, uglier forces prevailed. The Klan showed up and mass anti-busing demonstrations were held. After a calm first day of school, mobs burned buses, attempted to block firefighters from putting out blazes and attacked the police. The National Guard had to be brought in to restore order.

McConnell had witnessed government's righteous potential under Sens. Cooper and Cook, and he wanted to lead it. As Dyche notes in his biography, McConnell tried to distinguish himself during Watergate by coming out for campaign finance reform in a Courier-Journal op-ed: "Many qualified and ethical persons are either totally priced out of the election marketplace or will not subject themselves to questionable, or downright illicit, practices that may accompany the current electoral process." McConnell called for dramatic reductions in campaign contribution limits and labeled the idea of a city-run campaign trust fund a "progressive" proposal.

In 1977, he decided to challenge Democrat Todd Hollenbach Sr. for Jefferson County judge-executive, a job that exercises administrative authority over the Louisville suburbs and some city functions like welfare. The job had oversight over the most populous county in the state.

Hollenbach confesses today that he did not consider McConnell a threat. "First time I ever saw him, I must admit I was amused," he said. "I just didn't take him seriously. I can remember thinking to myself, ‘I bet he carried a briefcase in the third grade.' I thought he was just a comical-looking kind of character. ... He had no personality. He was very uncomfortable in a crowd."

But McConnell had a message that was independent enough to gain traction. There were roads that required fixing, cronyism that needed stamping out and a jail whose locks could be broken with a toothbrush. "He was kind of a good-government guy," remembers Meme Sweets Runyon, who worked as McConnell's campaign coordinator and later became his press secretary. "He thought the government could do good and could be a solution."

Charles Musson, a campaign staffer who also later worked in the McConnell administration, agrees: "He wanted to make sure government was effective."

Position papers and campaign strategy were formed in McConnell's basement during brainstorming sessions -- much of it aimed at reaching working-class Democrats. "Mitch would ask questions, and someone would be assigned to do research on that and become the expert on that," Musson remembers. McConnell worked the fried-fish-and-fried-chicken circuit. Some mornings, he served coffee to workers arriving for their shift at the General Electric plant.

McConnell came out in favor of collective bargaining rights for workers and netted the endorsement of the Greater Louisville Central Labor Council. One of his most heavily run ads featured McConnell walking with Cooper, highlighting the young politician's ties to the progressive GOP's old guard.

Dyche reports in his biography that the young politician's message did not include any Republican branding. "Breaking with local tradition," Dyche wrote, "he ran his campaign independently from the Jefferson County GOP apparatus and refused to share a slate with the Republican candidates in other races down the ballot."

While he used negative ads to batter Hollenbach -- most notably one that featured a farmer arguing that Hollenbach's statements on taxes amounted to shoveling manure -- Musson and Dyche recall McConnell showing a soon-to-be-discarded restraint. He chose not to run an ad addressing the court-ordered busing that had caused so much upheaval two years earlier. Hollenbach had no say over the busing but had fought it in court in an embarrassing and losing effort. Another potential ad featuring the young victims of a high-profile traffic accident was similarly deemed insensitive.

McConnell sealed his victory with the surprise endorsement of the editorial board of the Courier-Journal. The young politician told Louisville Today that the daily's nod showed voters that "the community isn't going to go to hell if you have a Democratic mayor and a Republican county judge. It's OK to split your ticket."

Once in office, McConnell governed with bipartisanship in mind. He became "very good" at compromising, Musson says. He hired some of Louisville's leading feminists for his inner circle and began forming coalitions with his Democratic counterparts on the county legislature. "He expected more from me and thought I could do more than I did for myself," Meme Sweets Runyon says. "He demanded a lot from me and insisted that I could do it."

McConnell sought to diversify the county's powerful boards and commissions, which had great sway over planning and development, and had historically been stacked with elites.

He invested in significantly expanding the Jefferson Memorial Forest, adding close to 2,000 acres. His administration also replaced trees uprooted by a tornado. "He was always willing to support green things if you made a good case for it," says Runyon, noting that he also started an office dedicated to environmental issues and had a well-respected liberal run it.

McConnell became known for his insistence on quality personnel. There were no more jailbreaks with toothbrushes. "He believed in things like historic preservation and the environment and functional social services," Runyon adds.

During his second term, McConnell worked closely with the progressive Sloane. If he took a position that might appear hostile to the Louisville mayor, McConnell would give him a warning. "He would call me and explain where he's coming from," Sloane remembers. "There wasn't personal acrimony there. I did the same thing with him." J. Bruce Miller, the Democratic county attorney, says McConnell had the same deal with him.

McConnell joined forces with Sloane to attempt a county-city merger as a way of cutting duplicative services and infusing suburban wealth into the city. It was a fairly liberal idea that proved ahead of its time. The referendum failed twice during their terms, but finally passed in 2000 and went into effect a few years later.

On the merger project, Sloane said the two didn't disagree a lot. "I think he was shrewd, and he did attract some good people," he said. "He wasn't intimidated by progressive people and thinking. [The merger attempt] didn't help either of us. I give him some respect for that. … He was very pragmatic. We were not there to be ideologues."

*'BAD DOGGY'*

On the stump, McConnell likes to tell a story about an encounter with a tobacco farmer during one of his early Senate campaigns. "I'm for you," McConnell recalls the farmer telling him. "And what's more, you're going to win." The tale has multiple iterations -- sometimes it takes place in Western Kentucky in Graves County; at other times, McConnell leaves the location vague. But the story always has the same punch line: McConnell, a Louisville politician, asks the farmer why he's so sure McConnell will be victorious. "That feller," the farmer explains, "he's from Louie-ville."

"I believe you're right," McConnell tells the farmer, and walks on.

McConnell looks like a guy who would foreclose on your farm. The senator has a net worth of somewhere between $9.2 million and $36.4 million, according to his latest financial disclosure filings. Yet he has so much rural authenticity that small-town voters mistake him for one of their own.

McConnell's communion with the working class isn't the result of any intuitive genius. He studied farmers and coal miners for years, cultivating an understanding of the issues and anxieties that dominate rural Kentucky. He learned to hang.

"He can get down on the level with anybody," says Mary Canter, who has worked for a decade at the Graves County Republican Party office. "He can come down to just the average John IQ." Although Canter has met McConnell many times, she can't say where he lives. His credibility is so well established that his background isn't questioned.

Even in his early years campaigning for Cook, McConnell made it a point to respect the local language. Yarmuth remembers getting lost in Appalachia with McConnell. When they finally stopped and asked for directions, "It's right back there," the man told them, down "the road a couple hollers."

Yarmuth, a lifelong Louisvillian, recalls asking the man, "How loud the hollers?"

But McConnell understood, quickly ended the interaction and told Yarmuth to get in the car. In Kentucky, a holler or hollow is an address -- a nook or cranny in a mountain where a family builds a home. In locales without official roads or house numbers, "the next holler over" can be the best way to give directions.

McConnell capitalizes on his country cachet with ads accusing his opponents of being inauthentic creatures of the political machine. The first and most notorious was a cold-blooded ad he ran in his first Senate race in 1984 against Walter "Dee" Huddleston, an ad that became infamous for debasing the tone of national campaigns.

Although Huddleston had one of the strongest attendance records in Congress, he had missed a few votes while giving paid speeches. McConnell's "Hound Dog" ad, produced by future Fox News chief Roger Ailes, featured a man with a pack of dogs searching for Huddleston. It was funny, wry and gently mocking, but the effect was devastating.

Huddleston didn't think anyone would fall for the ad. "I thought the bloodhounds were kind of silly, but as it went on, I thought it was pretty effective," he told HuffPost. "It wasn't true."

The ad was so effective that McConnell spit out a sequel in which the man chases an actor playing Huddleston up a tree.

It was a sign of things to come, and the launch of a long arc in a lengthy and controversial career. Once McConnell won high office and moved to Washington, his embrace of the broad uses of government dwindled, and he came more and more to focus his career on the goal of acquiring power.

By 1990, when Sloane took on McConnell for his Senate seat, the old respect between the two men had gone out the window. On the stump, McConnell called for abolishing campaign donations from political action committees, yet by October he had taken close to $900,000 in PAC money. He deployed class-war tactics, calling Sloane his "millionaire opponent" for holding stock in oil companies, although McConnell and his campaign were highly favored by the industry. "Just remember: Every time the price of gas goes up, rich people like Harvey get richer -- and Kentucky families get poorer. We need to fight back," McConnell argued.

McConnell's campaign even came out and said he was open to raising taxes on the wealthy by eliminating some deductions. In a TV ad, he professed the belief that "everyone should pay their fair share" in taxes, "including the rich."

The central selling point of Sloane's campaign was his long dedication to universal health care. McConnell tried to steal his message with a weak proposal providing meager tax credits and tort reform. He used his own childhood bout with polio to obscure the limitations of his plan. "When I was a child, and my dad was in World War II, I got polio," he said in another ad produced by Ailes. "I recovered, but my family almost went broke. Today, too many families can't get decent, affordable health care. That's why I've introduced a bill to make sure health care is available to all Kentucky families, hold down skyrocketing costs, and provide long-term care."

No attack was too personal for McConnell. Sloane had been caught prescribing himself pain medications with a Drug Enforcement Administration registration number that had expired three years earlier. The Kentucky Board of Medical Licensure eventually cleared him, and Sloane even took a drug test proving he was no addict. Yet McConnell hyped the whole controversy in an ad seemingly inspired by "Reefer Madness." As the camera flashed to pills and vials, a voice-over described Sloane as downing a "powerful depressant" and "mood altering" drugs.

"I got releases by my physicians that this wasn't the case," Sloane, who had a chronic back injury and a bad hip that would need to be replaced immediately following the election, told HuffPost. "What else can you do?"

Sloane went down in defeat.

Miller, the elected county attorney who worked alongside McConnell, says the senator is a formidable opponent in part because he focuses relentlessly on politics. Miller recalls throwing a Valentine's Day party that McConnell attended. After making small talk with McConnell about the Super Bowl, a friend pulled Miller aside in exasperation. The friend, Miller says, couldn't believe McConnell didn't know who had actually played in the game.

McConnell used to invite Miller out for dinner about three times a year. "It always centered around politics," Miller says, of their social interactions. If there was any conversation about their children, Miller says he'd be the one to bring it up. "He had daughters, and I would be the one that would have to initiate a discussion of them. ... He knew I had a son who was a professional golfer at the time. ... If I asked him about his daughters, he wouldn't say, 'Tell me about your son.'"

"He's intense," Miller says. "It's almost single-minded intensity. I'm not being critical of it. That's why everybody got beat by the guy."

McConnell kept producing animal-themed attack ads that made "The Dukes of Hazzard" look like Shakespeare, with messages so over-the-top as to mock the hillbilly humor they were meant to evoke. The G's are dropped, and the mud is thrown. In his 1996 reelection bid against the future governor Steve Beshear, McConnell's ads played off his opponent's last name. One warned voters in a Kentucky drawl not to get "BeSheared." In another, the voiceover declared "Old Beshear's a state fair champion at fleecin' taxpayers" who has taken thousands of dollars "from them foreign agents and lobbyists." The ads all featured sheep being sheared.

McConnell only played dumb on TV. Behind the scenes, he engineered key victories in U.S. House races as he built the Republican Party in Kentucky into a powerhouse. "He is the person primarily responsible for making us a Republican state," says Al Cross, the veteran political reporter and director of the University of Kentucky's Institute for Rural Journalism and Community Issues.

When longtime and popular Democratic Sen. Wendell Ford decided not to seek reelection in 1998, McConnell saw an opportunity to expand his political empire. He'd been Kentucky's first Republican senator in 12 years. Now, as chairman of the National Republican Senatorial Committee (NRSC), he tapped Rep. Jim Bunning, who had won six consecutive House elections, to grab the other Senate seat.

"He was the chairman of the committee, and he was recruiting," says longtime Bunning aide Jon Deuser. "They had a great working relationship."

Bunning's opponent, Rep. Scotty Baesler, cut the profile of a promising Democratic politician. He was known across the state as a college basketball star for the University of Kentucky's iconic coach Adolph Rupp. He'd worked as an attorney providing free services to the poor before being elected mayor of Lexington.

Baesler had used his political capital to implement key support programs for seniors and anti-drug initiatives targeting schoolchildren. During the 1998 campaign, he helped push the Clinton administration into providing more than $19 million to overhaul public housing in Lexington and provide job training programs for the city's poor. He was the pragmatic liberal alternative to McConnell.

Bunning had only one innate advantage over Baesler: He'd had the more distinguished sporting career as a Hall of Fame pitcher for the Philadelphia Phillies and Detroit Tigers. He'd thrown a no-hitter and a perfect game. As a politician, however, Bunning never got out of the minor leagues. He'd been an unremarkable representative in the House, best known on Capitol Hill for his acerbic blather and combative disposition.

McConnell, however, saw someone he could steer to victory. "He was practically the campaign manager for Bunning in that race," says Dave Hansen, a GOP campaign manager who served as political director of the NRSC in the 1990s. The senator sent his top men to aid Bunning. Kyle Simmons, his chief of staff, took a leave of absence to become the Bunning campaign coordinator. Tim Thomas, McConnell's field representative for Western Kentucky, took personal leave to volunteer for the Senate hopeful.

But the senator was more than just a careful stage manager. He was the campaign's pivotal instigator. In August 1998, McConnell took the stage at the annual Fancy Farm Picnic in Western Kentucky and delivered a speech that would define the contentious race between Bunning and Baesler.

The colorful, open-collar campaigning at Fancy Farm, a state-fair-sized festival, is a rarity in contemporary American retail politics. Typically, stump speeches are choreographed for the press, their audiences stacked with enthusiastic supporters. But at Fancy Farm, those running for office are expected to tailor their speech to the setting and let it rip under the ceiling fans. It's as much a comedic roast as it is a political rally.

"It's kind of this throwback," Hansen explains. "Candidates get up there, and they make the most outrageous comments to stir people up."

McConnell gave Bunning a clinic in his ruthless approach to campaigning at the Fancy Farm event. The Republicans coordinated vicious speeches targeting Baesler's status as a founding member of the Blue Dogs -- a caucus of conservative House Democrats. Much to the chagrin of progressives, Blue Dogs have since become a major force in Democratic politics, but the group was still something of a novelty in the late 1990s, a fact that McConnell and Bunning exploited to comic effect. McConnell slammed Baesler as a "blue chihuahua," who had "mistaken Kentucky taxpayers for a fire hydrant" and who would serve as a "lap dog" for President Bill Clinton. Bunning delivered a call-and-response mockery with the festival's GOP audience.

"He would go through all these votes Baesler made and say, 'What do y'all think about that?' And the crowd would shout, 'Bad doggy!'" recalls Trey Grayson, an attorney and party activist who would later be elected Kentucky's secretary of state.

The typically mild-mannered Baesler took the bait and responded with a brutal stemwinder of a speech against Bunning, replete with outsized hand gestures and ugly facial contortions. Although his rant played well with the live audience, an angry man wildly waving his arms and shouting in the August heat left a visual impression that was ripe for McConnell's manipulation. As soon as Baesler's rant ended, McConnell was eager to make sure his staff had caught it on tape.

"We filmed it," says Hansen, who was working for McConnell at the time. "We put it to Wagner music, and it made one hell of an ad."

With Baesler's antics playing out in slow motion over music by Adolf Hitler's favorite composer, McConnell moved the tone of American political ads even lower than his landmark "Hound Dog" spot or the Beshear sheep ads had.

"Mitch saw the video and thought he saw something. He showed it to the Bunning folks," says Grayson. "Baesler looked crazy. He looked kinda like Hitler."

"When I ran, he was the best help Jim ever had," Baesler says of McConnell. "He got that ad running lookin' like I was a crazy man. I thought that thing -- without question, he saw its value."

The race was not called until well after midnight, but Bunning eventually emerged victorious by a little more than 6,000 votes. The barrage of negative ads against Baesler not only worked, they effectively ended his career in national politics. At 57, he was a washout. Two years later, Baesler ran for his old House seat and lost to a Republican by 18 points.

At least in Kentucky, McConnell has proven to be an incredibly effective Democrat-vaporizing machine. He has ended the political careers of everyone he has ever defeated, except Beshear, who was elected governor in 2007, 11 years after losing to McConnell.

"When he took over a long time ago, Republicans weren't alive in Kentucky," Baesler says. "Now everything's competitive. They've even had a Republican governor. That wasn't the case until he got involved a long time ago. He's the backbone of the whole thing. And I wish he wasn't. If he hadn't been with Bunning, I woulda won."

McConnell had moved Kentucky Republicans a long way from Cooper's passionate defense of Medicare. The defeat of the practical, reform-minded Baesler had consequences for the state. In his 12 years as a senator, Bunning's most significant legislative achievement consisted of single-handedly blocking the extension of federal unemployment benefits in 2010. His hardline stance eventually became a standard negotiating position of the Republican Party, cold comfort to the more than 10.7 percent of Kentuckians who were officially out of work at the time.

Bunning's Senate career will be best remembered for his message to those politicians who dared to provide aid to needy citizens: "Tough shit."

*PADUCAH'S FALLOUT*

On their way to victory, McConnell had shared with Bunning a strategy that he had long preached to his own campaign staffers. The senator had adopted what he called his "west of Interstate 65 strategy," named for the highway that splits the state from Louisville in the north down to the Tennessee border. McConnell believed that his elections were won or lost west of I-65. The far western counties were once a Democratic stronghold, but the territory showed signs that it could be open to a determined Republican.

"He basically told other parts of the state they weren't going to see him as much from, say, the first of August till Election Day," a former McConnell staffer recalls. "He primarily was going to focus west of I-65. That's where he thought more gains could be made."

McCracken County, set along the banks of the Ohio River in Western Kentucky, played a pivotal role in McConnell's expanding power and influence. With its history of strong African-American leaders and outspoken union membership, the county initially opposed him: When he was first elected to the Senate in 1984 by a narrow margin, McConnell lost McCracken by about 4,000 votes. It was a victory to even get that close.

In his critical reelection fight against Sloane, however, McConnell took the county by more than 1,500 votes, and his influence in the region has grown ever since. McConnell now owns the west. Al Cross credits Paducah, the McCracken county seat, and the surrounding area as "the key to his success."

Sen. Mitch McConnell (right) talked with USEC General Manager Howard Pulley during a media tour of the Paducah Gaseous Diffusion Plant in the plant's Central Control Facility on Aug. 12, 1999. (Photo by Billy Suratt)

To capture Paducah, Cross says, McConnell had to court the uranium enrichment plant's workers. "He understood from the get-go, you ... try to take care of the biggest employer in the key town," Cross says. That meant promising job security.

There were good reasons to be concerned about the Paducah plant's survival. With the Cold War arms race giving way to the Three Mile Island disaster in 1979 and new hope for arms treaties between the U.S. and the Soviet Union, the Atomic City began to lose its luster. In 1980, the Paducah plant employed about 1,940 workers in production activities. Within five years, more than 650 of them were gone. In 1987, a similar uranium enrichment facility in Oak Ridge, Tenn., was shuttered, leaving Paducah and a third plant in Ohio as the only such operations left over from the Manhattan Project. The technology was fast becoming obsolete. Among the workers, rumors of the plant closing became an ever-present part of the job.

If the Paducah plant were to close, it would have a devastating effect on the local economy. Production only accounts for a fraction of the plant's economic significance: Hundreds of guards, drivers and other contract workers are employed at the plant, while restaurants, homebuilders, and other establishments are all dependent on the business that the plant's employees provide.

In 1990, McConnell offered an incumbent's solution by playing up his ties to then-President George H.W. Bush and floating the idea of a new state-of-the-art plant in Paducah. According to news accounts at the time, Sloane was far less enthusiastic about nuclear power, citing concerns about safety and hazardous waste. "That killed Sloane in that campaign," the plant union's vice president, Jim Key, told HuffPost.

Paducah never got that new plant, but McConnell discovered a winning strategy and continued to patch together new contracts and make-work jobs, exploiting residents' fears over layoffs. The senator kept the plant's doors open, but he did so at the expense of the workers' own well-being. For decades, the plant's toxins had spread through the air and into the ground, slowly killing its own workers and tainting the surrounding area -- a fact McConnell ignored in Washington and in Paducah.

Workers had breathed in plutonium-dipped dust, sloshed through areas high in harsh chemicals, and got hazardous powders on their food and in their teeth. They'd taken the poisons home with them on their clothes. On site, workers had erected "Drum Mountain," a scrap heap that bled contaminates into the soil. Lawyers and scientists would later deploy "groundwater plume maps" to show how far the toxins had spread.

But the effects of the toxins were plain to see. As early as the 1970s, Fred Buckley's patriotic fervor had begun to dim. He no longer completely trusted management. Although he moved up the plant's ranks, from security guard to running control rooms, he suspected the work was far more dangerous than his bosses had let on. When he welcomed his son Michael at the plant in August 1973, he did so with a warning: Better make sure the equipment isn't contaminated. Don't trust the company. Trust yourself. "I tried to stress -- be sure to not take anybody else's word for it," he recalls.

Buckley had seen his friend Joe Harding waste away to nothing. The two had known each other since childhood, when their families had adjoining corn and soybean farms in Tennessee and they walked to school together along crop-lined roads. Valedictorian of his high school, Harding took in a year of college while Buckley went off to war. But when the two reunited at the plant, Buckley began to notice how the work made Harding sick and the bosses hounded him for speculating about possible radiation contamination. "They didn't give him the respect they should have," Buckley says. "He did his job. Joe came to work after he looked like a ghost."

Sores crept up Harding's legs and wouldn't heal. Fingernail-like protrusions grew out of his elbows, wrists, palms and the soles of his feet. The nails, he said in an audio diary, were "very, very painful." He'd try to trim them, but they'd just grow back. His daughter, Martha Alls, now 71, recalls watching his head shake violently from tremors during Christmas and Thanksgiving dinners.

Harding, who would develop a fatal stomach cancer, knew he had company among his fellow workers. He kept a record of 50 other workers who were either dying or had died of cancer. An internal memo from the plant revealed that management kept its own death list in secret.

In 1971, the plant fired a very sick Harding; he was denied workers' compensation, pension, and health insurance. But Harding continued to speak out against the plant and became a minor celebrity with the anti-nuclear movement. He spent the night of his death in 1980, with his body wasted away to barely more than bones and his skin wrinkled like a walnut shell, giving a last interview to a Swedish media team who had flown in. "I picked them up at the Holiday Inn," Alls says of the foreign reporters. "They stayed with Daddy until midnight. I took them back to the hotel. He died the next morning. I think it just wore him out telling it all."

The year before McConnell was first elected to the Senate in 1984, Clara Harding had her husband's body exhumed and his bones tested, which, according to news accounts, revealed excessively high levels of uranium. A decade later, a co-worker told The Boston Globe that Joe Harding's exhumed body "was hotter than a firecracker."

Clara Harding kept up her husband's crusade, but it took a toll. She had to sell her house and move into a duplex. "I think she wrote to everyone in the government," Alls says. "I just felt like this was a hopeless case. This was the government -- you don't mess with your government." The federal government fought Harding's claim. According to the Courier-Journal, the feds spent $1.5 million in legal fees to deny her the $50,000 she sought in benefits.

McConnell's sole concern about the plant seems to have been protecting it from layoffs and lawsuits. Midway through his first Senate term, he came out in favor of economic sanctions against South Africa's apartheid regime, but fought the ban on importing that country's uranium. McConnell worried about the effect of fewer uranium shipments on jobs back in Paducah. In 1988, he voted against an amendment that would have made Department of Energy nuclear subcontractors liable for accidents caused by intentional negligence or misconduct at plants like Paducah.

McConnell's opposition to trial lawyers became his justification for inaction on worker health. After coming out against another provision aimed at assisting workers in high-risk jobs, he complained that the bill would simply "stimulate personal injury and worker compensation litigation on a scale far beyond our present imagination."

Back in Paducah, however, the litigation was just about to begin.

In the late '80s, wells near the plant were showing signs of possible contamination. Ronald Lamb helped run a mechanic shop on his family's old farmland a few miles from the plant. He and his father and mother all drank from the same well and started getting sick. "We thought we were dying," Lamb told HuffPost. "I lost the hair on my arms. It looked like I had chemo."

On Aug. 12, 1988, government officials contacted 10 households with an ominous directive: Stop drinking and bathing in the water from their wells. The Department of Energy began sealing off wells near the plant and re-routing the water supply for roughly 100 residences.

Lamb says he repeatedly wrote letters to his local elected officials, including McConnell, but didn't get much more than a form letter in response. "They felt your pain but felt like you were being taken care of," Lamb recalls.

Lamb didn't think so and spoke up around the country, including two trips to Washington in the early '90s on his own dime. He and his family also filed a lawsuit. Even though that case was unsuccessful, it led to a January 1997 class-action lawsuit with Lamb and dozens of other area residents that argued the plant had rendered their properties essentially worthless. The complaint alleged that "massive" discharges of radioactive materials and heavy metals had spread to their land, "causing and threatening severe property damage and health problems." The complaint further alleged that the flow of hazardous waste continued unabated. That case was settled in 2010 for an undisclosed amount.

Ruby English, a West Paducah resident whose well was shut off, says her husband Ray had also written to McConnell without success. English had thyroid and colon cancer. Ray worked in the nearby wildlife refuge bordering the plant, she says, and he'd come home with stories about seeing the creek water turn purple and yellow. He'd drink from the well and wash in the creek. He died a few years ago, his immune system a wreck. "The damage is done. I feel sorry for the workers the most," English says. "They're right in the middle of it. ... It's pathetic, it really is."

"Once full of aquatic life," the court complaint filed on behalf of residents stated, "the Little Bayou Creek is now void of any meaningful plant or animal life." A pair of deer were found near the plant in the early '90s with trace amounts of plutonium in their systems, according to the Associated Press. A 1990 Department of Energy inspection report noted that hazardous contamination had spread to rabbits, squirrels and apple trees.

The inspection highlighted management deficiencies and evidence of contamination at the Paducah plant. In multiple areas, management acknowledged the plant lacked the tools to measure such contamination or had not put adequate safeguards in place. Four years later, the Environmental Protection Agency declared the facility a Superfund site, adding it to the agency's official list of ecological cleanup priorities.

The Paducah plant's hazardous "Drum Mountain." (Photo from a GAO report)

Michael Buckley remembers the very room where they had held worker meetings had to be cordoned off; the room was found to be full of contaminants. Drum Mountain, he says, was no secret. "I didn't consider it a joke," he remembers. "Everybody knew the residue in the barrels was contaminated. You know that runoff's gonna get into the underground water."

The workers had little control over the mess and lacked suitable protections. "The essential problems were created in the haste to build nuclear weapons," says Terry Lash, director of the Department of Energy's Office of Nuclear Energy during the 1990s. "Because of the threat to the existence of the country, they just didn't worry about the long term."

McConnell and other Kentucky officials were intimately familiar with the plant's problems. Tim Thomas, who worked on McConnell's staff as a field representative for Western Kentucky starting in 1997, told HuffPost that the senator's office and the Department of Energy had discussions "on a regular basis."

McConnell and his staff toured the facility every few years and knew about the contaminated water supply and the mountain of leaking storage containers. McConnell also knew the name of Joe Harding. "I had heard of the widow," Thomas says. "We had heard of Joe Harding. We didn't know if this was an isolated incident or what. We were not in an investigative position."

Mark Donham, 60, served as chairman of the Paducah Citizens Advisory Board, which was tasked with watchdogging safety issues and making recommendations to the Department of Energy about the cleanup. He doesn't recall Thomas or any other representatives from McConnell's office taking a big interest or even attending the board's public meetings detailing the contamination spread.

Meanwhile, the plant's own community relations plan in January 1998 noted that the number of possible hazardous waste zones had soared to 208. Despite all the concerns, Donham says, "McConnell never stood up and lobbied for an investigation."

When The Huffington Post asked McConnell at his weekly Senate press conference on the Hill in June about his handling of the hazardous waste issue, the senator brushed it aside. "That's of course a parochial question," he said. "I'll be happy to address it if you'll check with the office." His office did not respond to follow-up questions or multiple requests for an interview with the senator.

It was not until The Washington Post reported in August 1999 -- 19 years after Harding's death and five years after the Superfund listing -- that thousands of plant workers "were unwittingly exposed to plutonium and other highly radioactive metals," turning the plant's problems into a national scandal, that McConnell finally sprang into action. He called for hearings into the contamination outside the plant and rushed to Paducah for a tour of the facility.

McConnell and Bunning requested a Government Accountability Office report on the situation at the plant, but the agency returned a scathing indictment of the senators' own inaction. Since 1993, McConnell had served on the Senate Appropriations Committee -- the panel responsible for the government's final funding decisions -- but according to the GAO, the Department of Energy hadn't been given the money it had requested to clean up the Paducah site.

"The funding available for cleanup had been much less than requested [by DOE]," the April 2000 report reads. "Cleanup at the site, including the removal of contaminated scrap metal and low-level waste disposal, was delayed because of funding limitations."

All told, there were roughly 496,000 tons of depleted uranium in storage, according to the GAO, along with 1 million cubic feet of "uncharacterized waste." Drum Mountain had swollen to 8,000 tons of life-endangering scrap and stood nearly 40 feet tall. The feds suggested that the plant, so utterly compromised, could become its own spontaneous threat. "Some of this waste and scrap material poses a risk of an uncontrolled nuclear reaction that could threaten worker safety," the report reads.

With a wave of press coverage focused on the Paducah plant, McConnell did something that few in Washington would expect from the fierce Obamacare opponent: He worked to pass what amounted to a new entitlement that allowed plant workers over age 50 access to free body scans and free health care. The program also provided $150,000 lump sum payments to workers who developed cancers or other illnesses from radiation exposures, and up to $250,000 in compensation for medical problems caused by other toxins. Spouses and children were also eligible for the program, which cost the federal government more than $9.5 billion.

But the legislation was not a high priority on Capitol Hill. When the bill stalled, Bill Richardson, then President Clinton's energy secretary, credits McConnell with pushing it through. "I remember the bill was in trouble," Richardson told HuffPost. "There was some last-minute shenanigans, and McConnell got it done."

At least to Richardson, McConnell claimed to have worried about safety at the plant. "McConnell talked to me about this issue," Richardson says. "He was pretty outraged, but he basically said that he had been trying to work [on this] and I was the first secretary to listen."

After the bill became law and the entitlement was put in place in 2001, McConnell and his wife, Elaine Chao, who was President George W. Bush's labor secretary at the time, flew to Paducah and awarded the first $150,000 check and a folded American flag to Harding's widow. The money was nowhere near enough to cover the extent of his medical bills. "He didn't get anything compared to what he was supposed to," his daughter Alls, who says she's a McConnell supporter, told HuffPost. She added that the ceremony "meant everything to Mother. ... It was recognition that Daddy had done good." Residents who drank from the poisoned wells, like Lamb and English, weren't covered by the entitlement.

But the program was enormously popular in Kentucky, and with good reason. Workers who had seen nothing for decades were suddenly receiving payments. Thousands of others were being screened, and many lives were saved. The free checkups caught cancers and heart conditions.

The exams identified a few suspicious nodules in Michael Buckley's lungs. "I want to definitely keep track of the problems and make sure they don't get any larger," he says.

Years later, during his 2008 reelection campaign, McConnell was still championing the compensation bill in a TV ad that featured Michael's father, Fred, praising the senator for helping out Paducah's workers. "Without a doubt, Senator McConnell has saved people's lives," Fred Buckley told viewers. The ad ended with another worker declaring that the senator "cares for the working man."

McConnell had spun a political liability into gold, going from potential goat to savior. He flooded the media market in Western Kentucky with that ad. "They ran that thing every night it seemed like to me for two years," Fred Buckley recalls.

Cleanup is still slow in coming. Outside Big Bayou Creek, which flows into the Ohio River, the Department of Energy has posted a sign that warns of toxic sediment. "Use of this waterway for drinking, swimming or other forms of recreation may expose you to contamination," it states.

In 2008, the senator thumped his Democratic opponent by more than 4,000 votes in McCracken County.

*MCCONNELL'S SAFETY NET*

In Paducah, old men waited years with cancerous growths before they were treated. In Appalachia, men with rotting teeth give up waiting and yank them out with pliers. In the southwest part of the state, prenatal care for some expectant mothers is an emergency room visit after their water breaks. In central Kentucky, a woman must live five months with a numb arm before seeing a nurse at a free clinic 45 miles from home.

Kentucky doesn't have so much a safety net as a painful waiting list -- a very, very long one. More than 17 percent of its citizens go without health insurance of any kind, even as the state's high poverty rate results in more than 880,000 Medicaid patients. Only about 43 percent of the state buys health insurance from the private sector.

The public health results are what you might expect: terrible. The state has the seventh-highest obesity rate in the nation and, predictably, the eighth-shortest life expectancy. Kentucky babies start with disadvantages from their first cry: The number of premature births in the state has increased over the past decade, while the number of babies born addicted to drugs jumped by nearly 1,100 percent between 2001 and 2011. Certain counties have infant mortality rates higher than those of "third world countries," according to a March 2013 report from the Kentucky Department of Public Health.

To try to address the needs of Kentucky residents, health care providers in the state have been forced to get creative. In Elkton, the Helping Hands Health Clinic is supported by twice-a-week bingo games put on by the staff, while in Danville, the Hope Clinic operates out of an old bank and serves six counties. Last July, a mobile clinic set up a triage on fairgrounds in Wise County, Virginia, which served many Kentucky residents who crossed over the state line. Stan Brock, the clinic's founder, says that in a little more than two days, they saw 1,453 dental patients and pulled 3,467 teeth. "It filled several buckets," he recalls.

For years, McConnell responded to Kentucky's poverty and health care crises by directing millions of dollars in federal earmarks to various projects in the state, constructing what has amounted to a lottery system. To get help, the plight of Kentuckians did not have to rise to a national scandal like the Paducah plant's contaminated workers. Nor did it require the tint of a conservative cause. They just had to be very lucky. (Nobody has emphasized just how lucky more than the senator himself. McConnell has greeted the recipients of his earmarked funds like winners of the Powerball jackpot, complete with giant novelty checks.)

Earmarks have political benefits, and McConnell made a point of visiting remote counties to tout the federal money he had secured for his constituents.

"I hate to call it passing out checks, but you know that's kind of what it amounts to," says David Cross, who served as chairman of the Clinton County Republican Party until 2012. Cross remains a McConnell-supporting Republican, and still lives in Clinton County, which has a population of about 10,000 on the state's southern border. Cross says McConnell would visit Clinton "when there was some aspect of the federal government involved locally and Senator McConnell was involved and he wanted the local community to know he was involved."

McConnell was one of hundreds of politicians who benefited from making this kind of selective disclosure, since earmarks were essentially anonymous under congressional procedures for decades. New rules in 2008 required members of Congress to disclose their funding requests, and the practice was banned outright in 2011. A Huffington Post review of three years' worth of public earmarks, from 2008 through 2010, shows that McConnell orchestrated the delivery of nearly half a billion dollars in federal funds, with a pronounced emphasis on projects in his home state. If earmarks coordinated with presidential budgets are included, the figure swells to $1.5 billion.

Earmarks are no longer part of McConnell's political toolkit, but the senator is still campaigning on his pork-barrel legacy. Just days after Alison Lundergan Grimes formally jumped into the Senate race, he was already reminding voters of the federal benefits he has steered to Kentucky, and ridiculing Grimes' ability to bring home the bacon as a backbencher.

"Kentucky would lose dramatically by trading in a leader of one of the two parties in the Senate for a rookie," McConnell told reporters on July 3. "Kentucky is in an extraordinary position of influence as a result of their confidence in me over the years. ... Do we really want to lose the influence?"

The biggest chunk of McConnell's earmarks were devoted to defense spending, but they financed an astonishing variety of projects, including at least $21.9 million on civilian health efforts and $24 million for a "medical/dental clinic" at the Army's Fort Campbell.

McConnell directed money to everything from mobile health screenings to lab upgrades for stem cell research into heart failure. One earmark funneled money to a University of Louisville scientist for groundbreaking research into aging, with treatment implications for Alzheimer's and even space travel.

Indeed, the state's public universities have been big benefactors of the senator's earmarks. In the decade before the earmark ban, McConnell bestowed approximately $140 million on the University of Kentucky, according to Bill Schweri, the university's director of federal relations. Much of the McConnell largess went to new building construction and steady research support.

Schweri met regularly with McConnell's staff, becoming intimately familiar with what the senator would approve. McConnell's staff had the same basic questions for every pitch: How will this help Kentucky? How will this keep University of Kentucky alums from fleeing the state? "He wanted to see the university be an economic driver in the state," Schweri explains.

Using a public university to drive the state's economy, much less providing public health care, would be anathema to members of the tea party. At least nationally, the Senate minority leader isn't so generous or noble. McConnell has, almost as a matter of routine, favored corporate subsidies and tax cuts for the wealthy over safety net support for Americans living in poverty. Nearly every social support program can count on McConnell's opposition, from home heating assistance to allowing states to access cheaper medications.

Children receive no special exemption from McConnell's tough love at the federal level. He has sought to prevent disabled children of legal immigrants from receiving benefits and has been a fierce opponent of the Children's Health Insurance Program, which provides medical coverage for families who make too much to qualify for Medicaid but can't afford private insurance. It is no shock that his opposition to Obamacare has been unwavering, all the way down to Medicaid expansion in his own state, which will give more than 350,000 Kentuckians access to the program.

But at least in Kentucky, there is what might be called the McConnell option. Some of his federal appropriations went to health care services for the state's most vulnerable citizens. And unlike Obamacare, his earmarks frequently provided direct government services without a private-sector intermediary.

In the 2005 and 2008 federal budgets, McConnell and his staff recognized the rotting teeth and premature pregnancy problems in their state, and funded a program whose research saw a linkage between the two. The University of Kentucky received a total of $1.78 million for the program -- a drop in the bucket, but, Schweri says, an easy sell.

"Staff picked up on it right away," he recalls. "Senator McConnell has really, really good staffers. They are very knowledgeable. It never ceases to amaze me how clued in they are to the state of Kentucky."

The earmark funding trickled down to the Baptist Women's Clinic's pilot prenatal care program, known as "CenteringPregnancy," which targeted at-risk, soon-to-be moms. Along with providing sonograms and routine care, nurses and midwives moderated group sessions that went beyond breathing exercises and swaddling techniques. They found room to address what so much of Kentucky's social services could not.

A couple attending a group session at CenteringPregnancy in late February.

The expectant moms talked about not having a place to live, worries about completing high school, and living under the boot of abusive men. Some women confessed they couldn't afford transportation and had to walk to the sessions.

"It will be the heat of the summer, and you will have moms that are walking," says LeAnn Langston, a registered nurse and a nurse manager with the clinic. "We've had women pushing strollers in the heat of the summer." After bonding with each other at the sessions, groups formed carpools.

In 2006, CenteringPregnancy's first year, 370 women participated, almost all of them young and on Medicaid. The program's popularity ensured a significant impact locally, but like many of McConnell's other health solutions, it was all but irrelevant statewide.

The earmark provided for an examination room as well as a dentist and a hygienist on site to offer screenings and cleanings at no charge to the mothers. Oral infections can complicate a pregnancy and have an impact on birth weight. Some of the women, Langston recalls, had never been taught how to use a toothbrush. "A lot of it was the culture -- ‘Everyone in my family has false teeth,'" Langston explains. "They would show up in the ER if they had a toothache. They really didn't acknowledge their mouth unless there was pain."

The clinic dentist flushed diseased gums, excavated years of calcified plaque and uprooted necklaces of dead teeth. Full-mouth extractions, Langston says, were not rare. Neither was evidence of drug use. After the clinic put in place random drug testing and ramped up counseling, Langston says, nearly 90 percent of the women who tested positive on the initial visit were drug-free by the time they were ready to deliver their babies.

The women needed all the help they could get. For many low-income mothers in Kentucky, Medicaid covers at most the first two months after they give birth. If they have drug problems, bed space at rehab facilities is limited across the state. Just traveling to these places can be a barrier, says Dr. Ruth Ann Shepherd, the director of the Division of Maternal and Child Health in the state's Department for Public Health. "I don't know that there is ever going to be enough treatment facilities," she adds.

Lack of space isn't the only problem. After weeks of effort, Langston and her team re Reported by Huffington Post 2 days ago.

The Following post first appeared on FactCheck.org.

An ad from a conservative advocacy group attacks the federal health care law by asking misleading and loaded questions about its impact. The ad features a mother named Julie, who asks, “If we can’t pick our own doctor, how do I know my family’s going to get the care they need?” The law doesn’t prohibit Julie from picking her own doctor.

She further assumes the government is going to be intimately involved in her family’s health decisions in asking, “Can I really trust the folks in Washington with my family’s health care?” Unless Julie’s family becomes eligible for Medicaid under the law, she’ll be getting private insurance, just as she is now (as best we can infer from the ad).

The TV spot, which Americans for Prosperity began airing in Ohio and Virginia July 9, directs viewers to the website ObamacareRiskFactors.com, which is more misleading than the ad itself. The site warns of reduced wages and hours for those who work for small employers that aren’t even subject to the law, for instance.

*Ad Wars Resume*

Over the past four years, the Affordable Care Act has been the focus of a hefty share of ad dollars. But those for and against aren’t done arguing about it yet — in fact, the war is heating up as major provisions of the law are about to take effect. In October, the health insurance exchanges will start accepting customers, and in 2014, the individual mandate, requiring most Americans to have insurance or pay a fine, kicks in.

So while Julie, a mother of two, prods viewers to feed their doubts about the law, another mom praises the benefits of the legislation in a TV ad from Organizing for Action, a nonprofit group that advocates for the president’s policies. In that spot, airing on cable channels CNN, MSNBC, Bravo and Lifetime, Stacey Lihn says the law eliminated lifetime caps on coverage. True, lifetime limits were prohibited early on, in 2010, and annual limits completely phase out on Jan. 1, 2014. Lihn, who spoke at the Democratic National Convention and has documented her family’s story on her personal blog, says that her daughter, Zoe, who was born with a congenital heart defect, “was halfway to her cap before her first birthday. Thanks to Obamacare, we can now afford the care that Zoe needs.”

The conservative ad is more general, and we don’t know much about the circumstances of the family in it. The mother, Julie, says her son had seizures two years ago and she has questions about Obamacare. Julie asks, “If we can’t pick our own doctor, how do I know my family’s going to get the care they need?”

But Julie doesn’t mean that she won’t be able to actually select a physician on her own, as the question implies. Instead, the worry is that she won’t be able to keep her current doctor.

AFP spokesman Levi Russell told us that the law will limit provider networks and the choice of doctors for “millions” of Americans. But the support for that claim mainly pertains to those who would be buying their own insurance on new insurance exchanges or new Medicaid enrollees who will qualify for the program under the law’s Medicaid expansion. And most of those individuals will be newly insured.

We can infer from the ad that Julie’s family has insurance and wouldn’t be seeking it on the exchanges or Medicaid. But we don’t know for sure. Russell would not provide more information on Julie’s circumstances other than to say she and her family are real, not actors. He said the group didn’t want to make Julie’s family the “centerpiece” of the ad campaign. “Instead, their experience should point others to go learn more for themselves and how they personally will be impacted,” he said.

Let’s assume Julie’s family has employer-sponsored insurance, as 57 percent of non-elderly Americans do. AFP points out that the nonpartisan Congressional Budget Office has estimated that those with work-based coverage will decline by 7 million, on net, because of the law by 2023.

That figure is a combination of workers losing coverage, others gaining it and others buying insurance elsewhere. The CBO estimated that for 2019 — when the net figure is 8 million — those losing an offer of employer-based insurance, which they would have received had the law not been enacted, would be 12 million, with 7 million others gaining work-based coverage because of the law, and 3 million more declining their employers’ offer and getting insurance elsewhere. CBO has explained in its previous estimates that businesses dropping coverage are likely to be smaller companies with low-income workers who would be able to get subsidies to buy insurance on the exchanges.

It’s possible Julie will find herself among the employees who lose coverage, buy a new plan elsewhere and not have her same doctor in the provider network. But her chances are small: 160 million Americans are expected to have work-based coverage in 2023 under the law, up from 155 million in 2013.

AFP provided two other pieces of support for this claim. A March 1, 2013, Wall Street Journal article said that some insurance plans sold on exchanges will likely have small networks of providers in order to keep premium costs down: The insurers were asking for a discount from hospital groups in exchange for the hospitals getting new customers as part of a small network. And a Health Affairs study found 31 percent of doctors didn’t accept new Medicaid patients in 2011. That’s not due to the health care law, but it’s a concern since the law will expand Medicaid eligibility by about 12 million in the coming decade. That study also said an increase in fees to primary care physicians under the law — for 2013 and 2014 — could boost the acceptance rate, at least temporarily. But doctors not being open to new patients is a problem generally: Eighteen percent weren’t accepting new privately insured patients.

Perhaps more germane to this losing-your-doctor worry is the fact that the Affordable Care Act doesn’t guarantee — and simply can’t — that everyone who likes their doctor and their current health plan can keep them, as President Obama has often claimed. As we’ve said before, employers are free to switch or drop insurance plans under the law — just as they were before it was enacted. And workers who change jobs have no guarantee — before or after the law — that their new health plan will include their doctors in provider networks.

*Premiums, Pay Checks and Big Government*

Julie goes on to ask, “What am I getting in exchange for higher premiums and a smaller paycheck?” Again, we don’t know Julie’s circumstances and why she assumes her paycheck is going to get smaller and her premiums are going up. But it’s true that expanded benefits required by the law have caused premiums for work-based plans to go up, on average.

When family premiums for employer plans jumped 9 percent from 2010 to 2011, experts told us the Affordable Care Act was responsible for a 1 percent to 3 percent hike, with the remainder due to higher medical costs, the usual culprit for increasing premiums. The law’s provisions that caused the bump were the elimination of preexisting condition exclusions for children, the requirement that dependents be covered on their parents’ plan to age 26, free coverage of preventive care, and the increase in caps on annual coverage.

So those are some of the increased benefits that Julie is already getting in exchange for slightly higher premiums.

For 2012, employer-based insurance went up a much smaller 4 percent on average. The growth in national health spending from 2009 to 2011 has been at historic lows, around 4 percent, and that trend is expected to continue for 2012 and 2013. Experts mainly say the down economy is the reason for reduced growth in spending, though it’s possible the Affordable Care Act’s emphasis on new payment models may be leading to more efficient care by health care providers.

If Julie purchases her own insurance, it’s unknown what exactly would happen to her premium, as we’ve explained before. Some individuals will pay more, and some will pay less. Some will get significantly more generous benefits for higher premiums; others may not even want a more generous plan. Benefits and premiums vary widely on that market, and the change in premiums for individuals will likely also vary widely — depending on what benefits they have now, health status, the protections of the state they live in and more. The Affordable Care Act does prevent discrimination based on preexisting conditions, limit variation in premium rates (to age, where you live, family size and tobacco use), and require a minimum benefit standard for these plans.

Most of those purchasing plans on the exchanges — about 80 percent — will qualify for government subsidies to offset the premium cost, according to the Congressional Budget Office. If Julie’s family earns up to 400 percent of the federal poverty level — $94,200 for a family of four — the family will qualify for a subsidy.

Finally, Julie wonders how well the government can manage her health care, asking, “Can I really trust the folks in Washington with my family’s health care?” But the law doesn’t put the government in charge of health care decisions — despite the many claims we’ve seen over the years to the contrary. This isn’t a “government-run” plan or “takeover,” as so many have tried to claim. There’s no board deciding who gets brain surgery or picking anybody’s doctor for them.

The law greatly expands private insurance, bringing millions of new customers to insurance companies. It’s true there are new insurance regulations as we’ve mentioned — no annual or lifetime limits on coverage, no preexisting condition exclusions, a standard set of minimum benefit requirements for plans on the exchanges. But those are consumer protections, not rules that put Washington in charge of managing families’ health care.

*More Questions than Answers*

The AFP ad encourages viewers to visit ObamacareRiskFactors.com, where they can input some basic information about themselves and answer the question, “Are you at risk under the new healthcare law?” But don’t expect an unbiased answer.

When we said we worked for an employer with 0 to 50 employees, our first risk factor was a warning that our hours or pay could be cut because of “requirements to provide insurance to all employees.”

The warning said that “government forces employers to make a difficult choice: reduce employee’s hours or wages or go out of business.” But employers with less than 50 full-time workers aren’t subject to any requirement to provide insurance to their employees. There was no mention of that, despite the fact that we had said we worked for a small employer. (The administration recently announced that it was delaying the requirement for employers with 50 or more workers for one year, until 2015.)

The risk factors we received also warned of “longer lines and delayed care,” citing a doctor shortage of 45,000 primary care physicians by 2020, estimated by the Association of American Medical Colleges. The warning doesn’t make clear that the AAMC said a shortage was predicted before the law was passed, but the shortage coupled with adding tens of millions to the rolls of the insured is certainly a legitimate concern. AAMC said the coverage expansion will “exacerbate a physician shortage driven by the rapid expansion of the number of Americans over age 65.” It called for Medicare-funded residency training to help alleviate the problem.

AFP exaggerates by saying that “[t]hese problems will continue to get worse as one-third of doctors will retire over the next decade — many fueled by ObamaCare’s rules and regulations.” AAMC says simply that one-third will retire because “[o]ur doctors are getting older, too.”

Americans for Prosperity almost gets it right when it says that “ObamaCare mandates that employers provide insurance coverage to all full-time employees, but it doesn’t mandate that coverage be provided for spouses or children.” The law does mandate that insurance policies cover children up to age 26. But it’s true there’s no mandate for coverage of spouses.

Of course, there was no mandate for employers to cover spouses before the law, and some firms have charged more for spouses or, for a small percentage of large firms, excluded them from coverage. The human resources consulting firm Mercer has said that its 2012 health benefits survey found 4 percent of employers with 5,000 or more employees denied coverage for spouses. MarketWatch reported in a February 2013 article that the practice, primarily used for spouses who could get insurance through their own jobs, could increase as health care expenses continue to rise (with or without the Affordable Care Act) and as the state-based exchanges created under the law give spouses another option for coverage. MarketWatch quoted Joan Smyth, a benefits consultant at Mercer as saying, “When there’s a place for people to go, employers won’t feel as beholden or compelled to cover the spouse.”

It remains to be seen whether the lack of a spouse mandate will have an impact.

The risk factors also warned that “[f]ailing to purchase insurance will result in a tax penalty of $695.” True, when the law is fully implemented in 2016. But the AFP site only tells half the story. It doesn’t ask whether individuals already have insurance or not, and it says nothing about opportunities for federal subsidies to help the uninsured buy coverage or expansion of Medicaid eligibility.

We’re not suggesting that the Affordable Care Act shouldn’t prompt questions and concern from Americans. There are many unknowns about how exactly a law of this magnitude will play out, particularly its impact on those who buy their own insurance. But don’t expect honest answers from a partisan anti-Obamacare campaign.

– Lori Robertson Reported by Huffington Post 2 days ago.

For associations and those working as consultants in the insurance and HR benefits industries, the DentalInsurance.com Affiliate Program provides an easy way to add potential revenue streams to existing web sites.

Los Angeles, CA (PRWEB) July 11, 2013

DentalInsurance.com, which provides quality dental insurance coverage to individuals, families, and businesses, announces the opportunity for trade or professional associations and those in the insurance, HR benefits, and related industries to gain potential new revenue through their existing online properties.

“With the implementation of the Patient Protection and Affordable Care Act of 2010 (PPACA), which mandates that individuals obtain health insurance beginning in 2014, sales of standalone dental and vision insurance plans are expected to rise,” Avery Smith, Director of Business Development for DentalInsurance.com said. “As employers increasingly look for opportunities to move benefits administration into the hands of third-party providers, the DentalInsurance.com Affiliate Program is an outstanding prospect for providing agency clients and association members with online access to dental insurance.”

DentalInsurance.com Affiliates - which may be trade or professional associations, licensed agents or brokers, health content websites, financial institutions, affinity groups or other online sites that offer access to the small-business marketplace - can earn marketing fees each time interested site visitors complete and submit an application directly on DentalInsurance.com via a unique link that is placed on the Affiliate’s own site.

Associations and licensed agents or brokers also have the opportunity to participate in an expanded partnership with further benefits. In addition to a non-dues revenue stream that is easy to administer and free to set up, these types of partners also have the opportunity to co-brand or private-label the DentalInsurance.com services.

“For associations and licensed agents or brokers who wish to partner with DentalInsurance.com, we provide a tailored web site where their members can easily compare dental insurance options,” Smith said. “With the DentalInsurance.com Affiliate Program, associations can help their members save time and money, and licensed agents or brokers can empower their clients with more control over dental insurance benefits.”

For more information about the DentalInsurance.com Affiliate Program, please visit http://www.dentalinsurance.com/di/web/affiliate/ or email affiliates(at)dentalinsurance(dot)com.

About DentalInsurance.com

Based in Los Angeles, CA, DentalInsurance.com has been the preeminent online exchange platform for dental insurance and discount dental plan comparison shopping since 2001. A leading innovator and provider of dental insurance and discount protection to individuals and employers, DentalInsurance.com was the first company to enable consumers to compare, apply for, and purchase dental insurance and discount protection from top-rated insurance carriers online via the company’s website at http://www.dentalinsurance.com. Working diligently to deliver the most competitive carriers and plans nationwide, DentalInsurance.com provides individuals, families, and businesses quality dental coverage to fit every budget and lifestyle. Reported by PRWeb 2 days ago.

Obama administration awards $3.4 million to New Jersey health centers to provide enrollment assistance


Health and Human Services (HHS) Secretary Kathleen Sebelius today announced $3,387,083 in grant awards to New Jersey health centers to enroll the uninsured in new health coverage options made available by the Affordable Care Act. In New Jersey, 20 health centers operating 125 sites served 467,913 patients last year, 43 percent of whom were uninsured. With these funds, the awardees expect to hire 69 additional workers, who will assist 73,201 New Jerseyans with enrollment into affordable health insurance coverage. Across the nation, 1,159 health centers will receive $150 million in grant awards.

“This investment will give New Jersey neighborhoods and towns one more resource to help people understand their insurance options and enroll in affordable coverage,” HHS Secretary Sebelius said.

Health centers have a long history of providing eligibility assistance to patients along with delivering high-quality, primary health care services in communities across the nation.

With these awards, health centers will help consumers understand their coverage options in the new Health Insurance Marketplace. They will also help determine an individual’s eligibility for Medicaid and the Children’s Health Insurance Program; any financial help they can get; and enroll them in new affordable health coverage options.

The awards, issued by the Health Resources and Services Administration (HRSA), complement and align with other federal efforts, such as the Centers for Medicare & Medicaid Services-funded Navigator program.

Today’s announcement is part of the administration's larger effort to make applying for health coverage as easy as possible. The new, consumer-focused HealthCare.gov website and the 24-hour-a-day consumer call center are available to help New Jerseyans prepare for open enrollment and ultimately sign up for health coverage. These new tools will help New Jerseyans understand their coverage options and select the plan that best suits their needs when open enrollment in the new Health Insurance Marketplace begins October 1, 2013.

“New Jersey health centers are excited to help individuals in their communities take advantage of the benefits of new health insurance coverage options that start in January, 2014,” said HRSA Administrator Mary Wakefield, Ph.D, R.N. “Having trained, face-to-face assistance in enrollment from trusted resources at local health centers means that more New Jerseyans will get the help they need.”

For a list of health centers receiving this funding in all 50 states, visit: http://www.hrsa.gov/about/news/2013tables/outreachandenrollment/

To learn more about the Affordable Care Act, visit www.HealthCare.gov. To learn more about HRSA’s Health Center Program, visit http://bphc.hrsa.gov/about/index.html.

Like HHS on Facebook, follow HHS on Twitter @HHSgov, and sign up for HHS Email Updates
Follow HHS Secretary Kathleen Sebelius on Twitter @Sebelius

Company Contact Information
New Jersey Primary Care Association
Olena Fedorchuk
3836 Quakerbridge Rd. Suite 201
Hamilton, NJ
08619
6096899930

News and Press Release Distribution From I-Newswire.com Reported by i-Newswire.com 2 days ago.

One of the foundational lies told by President Obama during the debate over his health care law was that "if you like the plan you have, you can keep it." Of course, that's only true if the plan is still offered. Thousands of part-time employees at Wegman's grocery store chain learned this week that the company would no longer provide health benefits to its part-time workforce. 

Currently, Wegman's offers health benefits to all employees working more than 20 hours a week. The new ObamaCare law requires employers to offer benefits to all employees working more than 30 hours a week. The law goes further, however, and dictates the kind and level of coverage employers have to provide. These costs will likely be higher than current benefits, so the company is adjusting by eliminating benefits for part-time workers. 

As evidence of the perverse incentives that arise with government mandates, one insurance broker told the Buffalo News that the part-time workers may actually be better off losing coverage. If their employer offered coverage, the workers wouldn't be eligible for subsidies on the health exchanges. If the employer drops coverage, however, the workers are eligible for any federal subsidies to purchase insurance. 

The taxpayer, of course, is decidedly not better off. 

The calculations behind Wegman's decision are going on in companies across the country. Late last week, the Obama Administration announced it was delaying for one year the mandate that employers provide health coverage for its full-time employees. The delay is due to Democrat fears of wholesale changes to the labor force being made ahead of the 2014 mid-term elections. Wegman's announcement shows, however, that those changes are coming anyway. 

If ObamaCare were intended to eliminate employer-provided health insurance, it wouldn't be designed much differently. The delay of the employer mandate actually incentivizes this. Employer may not be required to provide health insurance next year, but individuals will be required to have it. This will push millions of workers into the exchanges to purchase their own health care or face escalating penalties. 

Since so many will be eligible for subsidies, costs to the federal government will skyrocket. Most of the fiscal estimates of the bill's impact were predicated on the idea that employers who currently offer insurance would continue to do so. 

As the Wegman's example shows, that clearly isn't the case. 




 
 
 
  Reported by Breitbart 2 days ago.

If you want to find criticism of the Affordable Care Act, colloquially known as Obamacare, just log onto any American news website and look at the front page. If you want to find criticism about the way health insurance fundamentally works, just listen to Virginia attorney general and republican gubernatorial hopeful Ken Cuccinelli, who claims it was never intended to cover routine doctors visits.

In a joint presentation with democratic state delegate Patrick Hope in which the two politicians offered their opposing views on the ACA’s impact in Virginia, Cuccinelli argued that health insurance was initially intended only for major medical expenditures and catastrophic incidents. He supported his claim that if car insurance doesn’t cover oil changes, medical insurance shouldn’t cover check-ups, according to Ashburn Patch.

However, this logic isn’t as uncommon as you might think. Senator Rand Paul (R-Ken.) is a physician, and the Tea Party icon claims that more capitalism should be applied health care to lower prices in a free market manner.

“Capitalism has not been tried yet in health care,” said Sen. Paul on a September 2012 episode of MSNBC’s “Morning Joe.” “Most of health care is government-fixed prices and there’s very little capitalism. In fact, I’m a physician. In my practice, about 3% of my practice was capitalism. Those are people who came in with high deductibles or paid cash. That marketplace worked because we did bid down prices on things that people came in and paid for.”

With apologies to the senator, this plan might not work as well as Paul thinks it could. ThinkProgress countered:

“Proponents of high-deductible health plans claim that they curb health care costs by providing consumers a market incentive to lead healthier lifestyles. But this “market-based” approach involves massive cost-shifting from hospitals and providers onto consumers, forcing sick Americans to choose between exorbitant out-of-pocket costs and forgoing treatment. Such plans also disproportionately affect those who require ongoing care or have chronic illnesses”

 

Sources: Ashburn Patch, ThinkProgress, YouTube Reported by Opposing Views 2 days ago.

Most agree that big changes are coming to your health care as a result of the Affordable Care Act (ACA), otherwise known as "Obamacare." But the best, unintended consequence of the ACA is quietly brewing right now: over the next ten years, a robust, competitive, cash-based marketplace for all health care services - from the simple flu shot to the complicated heart transplant - will be introduced.

In a country that spends $2.6 trillion on health care, this will dramatically bend the cost curve down for consumers. There's an ecosystem of innovation emerging that will dismantle the pricing game that is crippling the U.S. health care system. This ecosystem will make patients more engaged in their health care decisions and give respected providers a more direct avenue to treat their patients.

The ACA introduces some common-sense insurance reforms, that will let kids stay on parent's policies through the age of 26, that will eliminate lifetime dollar limits on coverage payments, and that will restrict an insurer's ability to deny coverage based on pre-existing conditions. More than 30 million Americans that don't have health insurance will have access to coverage, and both States and the Federal Government are rapidly standing up new health insurance "exchanges" which create a marketplace where you can buy insurance.

Simultaneously, employer-provided health care is about to go the way of employer-provided pensions. In other words, it is disappearing. Soon, your employer will offer you, say, a $6,000 health care allowance, or perhaps a $12,000 allowance for you, your spouse and your spouse and your family. Along with that health care allowance, your employer might offer 2-3 employer-sponsored plans, while also pointing out the options available on the public exchanges. No longer will your employer offer comprehensive health care as a benefit. It is too expensive. They are already pursuing pricing transparency for prescription claims through companies like Truveris, which we invested in, to get their arms around health care expenses and contain them. Whatever health option they choose, employees will start spending money on health care carefully and wisely, much like they shop for most high-priced items. First they will select the plan that is right for them. Younger employees are likely to seek the least expensive policies with the highest available deductibles. Employees with families will quickly realize that the new health care allowance won't pay for 100 percent of comprehensive insurance. They, too, will move to higher deductible plans to not have to incur much up front in out-of-pocket insurance costs. America's Health Insurance Plans (AHIP) estimates enrollment in high deductible plans tripled over the last six years and I believe that number will only grow more exponentially.

Soon, a large group of Americans will be spending a lot more of their own money, in the form of higher deductibles, before their insurance kicks in. And incidentally, those consumers, spending their own money, will demand pricing transparency from providers and begin to create a cash marketplace for health care services.

At the moment, dissecting Explanation of Benefits from insurance companies is an impossible task for most consumers -- trying to understand what the doctor charged, the price the insurance company is willing to pay, how much you have to pay, why certain charges were denied, how to appeal those denials, how all of this relates to your individual deductible, your family deductible and your out-of-pocket maximum. I'm literally willing to bet that Web marketplaces like PokitDok for example, that make cash pricing available directly from medical practices, will lead the way, which is why we decided to invest in this space.

Consumers aside and employers aside, health care providers will seek steady, more predictable revenue streams. It is estimated that by 2016, 25 percent of independent practices are shifting away from the insurance reimbursement system and requiring patients to pay for treatment directly. They are sick and tired of insurance companies and the government (via Medicare and Medicaid) trying to "save money" by driving down how much they pay doctors per visit or per procedure. They are looking for cash-paying customers who will pay the same amount (or even a lower amount) without the high transactional costs of the claims-based insurance system. And they're adopting simple tools like ZocDoc and PokitDok to market what they offer and let patients find convenient appointment times with doctors online.

Cash pricing is hitting retail too. CVS bought MinuteClinic, and posts cash prices for services at every store. Other medical services, like Qliance, which we got behind alongside Bezos Expeditions and others, are pioneering "Direct Primary Care" offering you unlimited access to and service from your primary care doctor for less than $100 a month, whether you have insurance or just want to pay directly, in cash, like you would a gym membership.

The cash marketplace -- all unintended benefits of the ACA.

So be prepared for the big changes coming -- new, simpler, more direct, economical access to doctors.

It will be the best thing that has happened to health care in 75 years. Reported by Huffington Post 2 days ago.

Insurance provider WellPoint has agreed to pay a $1.7 million fine for exposing more than 600,000 personal records online due to weak database security, the U.S. Department of Health & Human Services (HHS) said Thursday.

WellPoint, based in Indianapolis, is one the largest health insurers in the U.S., with more than 100 million customers covered by it and its subsidiaries.

In 2009, WellPoint reported to the federal agency that an online database holding personal and health information for 612,402 individuals was left accessible over the Internet between October 2009 and March 2010. The data included names, addresses, birth dates, Social Security numbers, phone numbers and health information.

The Health Information Technology for Economic and Clinical Health Act requires that organizations which fall under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules must report health-related data breaches, according to HHS.

To read this article in full or to leave a comment, please click here Reported by PC World 2 days ago.

Paramount Rx Provides Cost-Effective Solutions during Health Care Reform

Cary, NC (PRWEB) July 12, 2013

The delay of the Affordable Care Act employer mandate accentuates the important role that PBMs will continue to play as Health Care Reform is enacted on both a national and state level.

PBMs that bridge the relationships among employers, consumers and the pharmacy industry will always have an essential place in the health care system. With drug costs escalating drastically, the entire industry is monitoring the evolution of the Affordable Care Act, anticipating both opportunities and challenges to help individuals who are uninsured or under-insured.

The employer mandate, which would penalize those with more than 50 employees if they do not provide minimum standards of affordable health insurance, is now slated to come into effect in 2015. The delay gives companies more time to address rules and implementation procedures, but still leaves questions for the large number of workers who are without insurance and dealing with the high costs of health care. According to the Commonwealth Fund 2012 Biennial Health Insurance Survey, approximately 84 million Americans went uninsured or under-insured last year, simply because they couldn’t afford it. The number represents almost half of all working-age adults in this country.

To deal with the rising price of health care, while also showing support for their employees and community, a number of companies are adopting a consumer-driven health care model that utilizes a discount prescription card benefit. These programs give consumers wider access to affordable prescription drugs and provide more flexibility to manage their own health care expenses.

IBC Bank, one of the largest banks in Texas serving more than 85 communities, has utilized one such program with the help of Paramount Rx. Through the program, thousands of area residents and employees at businesses served by IBC Bank across Texas and Oklahoma receive a prescription discount card at no cost. To date, they have saved nearly $1 million off the retail price of their prescriptions.

Bank customers and family members simply present the We Do More Rx discount card to the pharmacist each time they fill a prescription, and they receive an average savings of 36 percent off retail prices. There are no deductibles or maximum benefit levels, and no exclusions for pre-existing health conditions.

“We’ve received very positive responses from customers about the money they are saving,” said Dale Randol, IBC Insurance Agency executive vice president and chief operating officer. “We had more than a hundred calls during the first month of the program from customers who said they appreciate what we’re doing. Businesses are also interested in participating in the program for their employees.”

In uncertain times, every little bit helps. As the Affordable Care Act continues to develop and unfold, the Paramount Rx Prescription Discount Program is doing its part by providing cost-effective solutions, and a breath of fresh air, for the millions of people struggling with escalating medical expenses.

About Paramount Rx
Paramount Rx is a full-service prescription benefits manager (PBM) focused on consumer-driven health care to help clients provide services for consumers to save money on prescription drugs. The company has tailored programs to help their customers and consumers achieve significant savings with discount prescriptions through a national network of over 54,000 participating pharmacies. For more information, visit http://www.paramountrx.com.

### Reported by PRWeb 1 day ago.