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Health Literacy Missouri receives grant to promote insurance literacy

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The Missouri Foundation for Health (MFH) has awarded Health Literacy Missouri (HLM) a $499,998 grant to help educate people across the state about how to find and choose health insurance. The grant comes at a time when Americans have unprecedented access to health insurance through the online exchanges, a provision of President Barack Obama’s health care law. HLM found that nearly 60 percent of Americans who are eligible for enrollment on the exchanges don’t understand key concepts like co-insurance,… Reported by bizjournals 9 hours ago.

LiveTransfers.com Announces New Informational Video About LiveTransfer Leads for Insurance Agents

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LiveTransfers.com Announces New Informational Video About LiveTransfer Leads for Insurance Agents

(PRWEB) April 29, 2014

LiveTransfers.com, the premier live lead generation platform, is pleased to unveil its latest video: LiveTransfer Leads for Insurance Agents.

Live transfer insurance leads are one of the most effective techniques of reaching highly targeted insurance prospects. It is a powerful marketing program that will bring success to an insurance agency because it is so simple and effective when it comes to closing more sales in this competitive market.

LiveTransfers.com offers a variety of type of insurance live transfer leads:
Life Insurance Leads
Mortgage Insurance Leads
Health Insurance Leads
Auto Insurance Leads
Home Owner Insurance Leads
Annuity Leads

To learn more, insurance agents are encouraged to call 1-800-622-4319, or visit http://www.youtube.com/watch?v=oLSXrNzwHEI.

About LiveTransfers.com
LiveTransfers.com coined the phrase “live transfers” in 2001 by creating an industry and providing live transfer leads. LiveTransfers.com utilizes a multitude of online and offline marketing efforts, such as internet, TV, radio, print, and telemarketing technologies, in order to generate live transfer leads. Reported by PRWeb 9 hours ago.

HUFFPOLLSTER: As Health Exchange Enrollment Surges, ACA Opinions Remain Unchanged

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The Kaiser Family Foundation national poll finds attitudes about Obamacare remaining stable despite the recent surge in enrollment. A new ABC/Post poll has discouraging news for President Obama and his party's Senate majority. But at least most Americans say they'd save him from drowning. This is HuffPollster for Tuesday, April 29, 2014.

*THE BIGGEST REASON NOT TO SIGN UP FOR ACA: THE COSTS* - Jeff Young: "The top reason uninsured people didn't enroll in coverage under Obamacare this year is *they still don't feel like they can afford health insurance*, according to a new survey. The findings in a report published by the Henry J. Kaiser Family Foundation Tuesday highlight the affordability gap facing some U.S. households, especially those with incomes near or above the income cutoff for tax credits that reduce premiums, or those who simply don't believe health insurance is a good value. Thirty-six percent of people without health coverage reported they looked for health insurance during the enrollment period that nominally ended March 31, but found the available plans too expensive, according to the Kaiser Family Found
ation survey." [HuffPost]

*Impressions stable despite enrollment surge...* - Kaiser Family Foundation: "The enrollment surge at the end of March in the health insurance exchanges, created by the Affordable Care Act (ACA), was widely covered in the news, as was the announcement that at least 8 million people have used the new marketplaces to sign up for coverage. The news got a fair amount of attention from the public, with over half saying they followed the enrollment numbers 'very' or 'fairly closely.' But the latest Kaiser Health Tracking Poll finds that *this news did little to change the public’s impressions of the law, with overall opinion remaining exactly where it was last month (46 percent unfavorable, 38 percent favorable)*." [Kaiser]*...yet most oppose repeal* - David Lauter: "*Nearly 3 in 5 Americans said they would prefer to see their representatives in Congress 'work to improve' the healthcare law* rather than 'work to repeal the law and replace it with something else,' according to the latest Kaiser Family Foundation healthcare poll...A survey by Democratic pollster Stanley Greenberg found a similar division on the question of fixing the law versus repealing it. Among likely voters in competitive congressional districts, 52% say the country should 'implement and fix the healthcare reform law' while 42% say they want to 'repeal and replace' it, he found." [LA Times]*'America has convinced itself Obamacare is a disaster'* - Sarah Kliff: "Most Americans don't think Obamacare hit its enrollment target, a new Kaiser Family Foundation poll finds. *Nearly six in 10 Americans (57 percent) said the law fell "short of expectations" on sign-ups*. About a third thought that the law had either met or that it exceeded sign-up expectations. (The second option, by the way, is the right answer: 8 million people signed up for private coverage on the exchanges after budget forecasters had projected 7 million.) This is an especially bizarre finding when you look at another question in the same poll of the same people. a slight majority of Americans either accurately estimate or overestimate enrollment. This means there's some universe of people who think Obamacare hit 8 million enrollees — and also think it fell short of sign-up goals." [Vox]

*OBAMA'S APPROVAL REMAINS IN A SLUMP* - Dan Balz and Peyton M. Craighill: "Democrats face serious obstacles as they look to the November elections, with President Obama’s approval rating at a new low and *a majority of voters saying they prefer a Congress in Republican hands to check the president’s agenda*, according to a new Washington Post-ABC News poll….Obama’s low rating could be a significant drag on Democratic candidates this fall — past elections suggest that when approval ratings are as low as Obama’s, the president’s party is almost certain to suffer at the ballot box in November." [WashPost, ABC]

*Lowest ever?* - Not quite. HuffPollster: "HuffPost Pollster's average, which incorporates all public polling, shows Obama's approval barely ticking up this year, rising about a point since January. The Pollster average currently puts him just under 44 percent, barely a percentage point better than his all-time low of 42.5 in December." [HuffPost]*Economics plays a role* - Regression analyses find that views of the economy are second only to partisanship in predicting House vote preference. [ABC

*2014 'starting to look a lot like' 2010* - Scott Clement: "A new Washington Post-ABC News poll offers fresh evidence that *Democrats are facing major enthusiasm problems within their base* that make it difficult -- if not impossible -- for them to rebuild the winning coalition put together by President Obama in 2012. While nearly seven in 10 of all registered voters say they are "absolutely certain" to vote in November, several key Democratic constituencies are much less committed to voting. Barely half of voters ages 18 to 39 are certain about voting (53 percent) and 55 percent of non-whites describe themselves as certain to cast a ballot. By contrast, more than seven in 10 whites and voters older than 40 say they will definitely cast ballots -- both groups that have favored Republicans in the past two elections." [WashPost]

*Twitter counterpoints*

-*Steve Koczela*: "How many more times can someone write a poll story that says '2014 turnout isn't 2012 turnout' and call it news? [@skoczela]

-*Amy Walter:* "Two observations about polling: 1) likely voter in April not same as one in Nov; 2) nat'l polls are pretty worthless" [@amyewalter]

*POLL FINDS YOUNG AMERICANS UNENTHUSIASTIC ABOUT MIDTERMS* - HuffPollster: "*Fewer than a quarter of adults under 30 are sure they'll vote this November*, according to a new poll from the Harvard Institute of Politics. The low number isn't in itself surprising: Turnout among young voters regularly drops in midterm elections. The latest numbers suggest, however, youth turnout could dip below the level of 2010, when 31 percent said in February of that year they'd definitely vote, and about 23 percent actually made it to the polls….The new poll found young Democrats to be especially unmotivated: Those who voted for Barack Obama in 2012 were 9 percentage points less likely than those who voted for Mitt Romney to say they're definitely voting this time….Americans are not particularly good at predicting whether they will vote. The survey's results on possible turnout, however, point to a sense of disaffection among young adults that's borne out elsewhere in the poll. " [HuffPost]

-Turnout scholar *Michael McDonald*: "This is overblown projection from one poll. Census reports youth midterm turnout steady 1972--2010. Why sudden change now?" [@ElectProject]

-*Sasha Issenberg*: "Your regular reminder: asking people how likely they are to vote is worthless. From the @Slate archives: [Slate]" [@victorylab]

*AMERICANS DIVIDED OVER MIDDLE EAST PEACE PROSPECTS* - Pew Research: "Amid the breakdown of peace talks between Israeli and Palestinian negotiators, the public is divided over whether a way can be found for a peaceful two-state solution in the Middle East. Overall, *46% say an independent Palestinian state can coexist peacefully with Israel, 44% do not think this can happen*. A year ago, 50% thought it was possible for an independent Palestinian state to exist peacefully alongside Israel, 41% did not. The new national survey by the Pew Research Center, conducted April 23--27 among 1,501 adults, finds that Republicans are particularly skeptical about the prospects for a peaceful two-state solution: just 34% think a way can be found for this to happen. Independents (50%) and Democrats (52%) are more optimistic that a solution can be found." [Pew]

*AMERICANS THINK PUTIN WOULD LET OBAMA DROWN* - Emily Swanson: "Last week, the world learned that Barack Obama would, in fact, save Vladimir Putin from drowning. But according to a HuffPost/YouGov poll, Americans don't think Putin would return the favor. Responding to a question at a news conference in South Korea last week, Obama said, 'I absolutely would save Mr. Putin if he were drowning.' He noted, 'I used to be a pretty good swimmer. I grew up in Hawaii.' Most Americans think that's true. In the new poll, they said *by a 53 percent to 29 percent margin that they think the U.S. president would save his Russian counterpart from a watery death*….Neither Obama nor Putin, though, addressed what they think would happen in the opposite scenario. But the HuffPost poll asked the question about Obama in watery trouble, too. It found that the 25 percent of Americans who think Putin would save him were far outnumbered by the 51 percent who think he would not….[M]ost Americans say that they themselves would save either world leader. Seventy-one percent said they would save Obama, while 57 percent said they would save Putin." [HuffPost]

*HUFFPOLLSTER VIA EMAIL!* - You can receive this daily update every weekday via email! Just click here, enter your email address, and and click "sign up." That's all there is to it (and you can unsubscribe anytime).

*TUESDAY'S 'OUTLIERS'* - Links to the best of news at the intersection of polling, politics and political data:

-David Perdue and Jack Kingston lead the Georgia GOP Senate primary. [Survey USA]

-PPP (D) shows Thom Tillis "breaking away from the pack" in North Carolina's Republican primary for Senate, as does Civitas (R). [PPP, Civitas]

-Rasmussen finds Mike Michaud and Paul LePage tied in the Maine gubernatorial race. [Rasmussen]

-Chris Christie's horse race numbers against Hillary Clinton aren't much different from those of other potential Republican candidates. [FDU Public Mind]

-Suffolk University finds Al Franken polling in the mid-40s against GOP rivals. [Suffolk]

-It's Mike Huckabee's turn for a YouGov public opinion "reputation audit." [YouGov]

-Few Americans report being contacted by campaigns through mobile technology. [Gallup]

-Kaiser Fung is unhappy with the charts produced by the WSJ's Numbers Guy feature since Carl Bialik left. [Junk Charts]

-Carl Bialik finds that U.S. polls that interview in English only (offering no option for Spanish) understate interest in the World Cup. [538]

-Nate Silver estimates that most Clippers fans are minorities. [538] Reported by Huffington Post 8 hours ago.

Poll: Americans think Obamacare missed its goals, support birth control

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Almost half of Americans know how many people signed up for health insurance through government exchanges – some 8 million people nationwide – but 57 percent believe the government failed to meet its enrollment goals. They would be wrong. Reported by Seattle Times 8 hours ago.

Obamacare Enrollees Emboldened To Leave Jobs, Start Businesses

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Some people who felt stuck in certain jobs just because they needed the employment-based health insurance say they are finding the Affordable Care Act liberating. Reported by NPR 8 hours ago.

City Council Initiative Shows Promise in Cancer Prevention

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The post City Council Initiative Shows Promise in Cancer Prevention by Petr Svab, Epoch Times appeared first on The Epoch Times.

NEW YORK—Michael Caffes owes one to City Council. When he lost his job in 2010, he was left with no health insurance, but he was still able to get his potentially cancerous condition fixed for free, all thanks to a …

The post City Council Initiative Shows Promise in Cancer Prevention by Petr Svab, Epoch Times appeared first on The Epoch Times. Reported by Epoch Times 6 hours ago.

When It Comes To Health Care, There Are 2 Americas, And These Maps Are Proof

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When it comes to the quality of health care, there are two Americas.

In one America, infant mortality, avoidable deaths, health-care costs and other measures are far worse than in the other America, according to a new study by the Commonwealth Fund, a health policy research firm. And thanks to Republican lawmakers and the Supreme Court, the gulf between them may only get wider.

The map below from the Commonwealth Fund shows the stark divide. States with the worst overall health care systems -- as measured by factors like the number of insured adults and children, avoidable emergency room visits and access to affordable care -- are dark blue. States with better health-care systems are white.

When it comes to things like health care access, quality and cost, certain states can be as much as eight times better than others, the report found.

“We continue to see this very wide geographic spread,” said Commonwealth Fund senior vice president Cathy Schoen, a coauthor of the report. Millions of lives could be saved if the low-performing states could close just half the gap with the top states, Schoen said. "We really need to stay focused on aiming higher.”

Many of the lower-performing states have higher rates of early deaths that could have been prevented by access to quality health care. The Commonwealth map below shows the number of avoidable deaths per 100,000 in each state.

Many of the worst states for health care have several things in common. They’re mostly in the South and are more likely to be among the poorest in the nation. Many of them have long had unusually tight standards for applicants to qualify for Medicaid, said Schoen, and many have been slow to expand children’s health insurance.

What's more, 16 of the 26 states at the bottom of the Commonwealth Fund’s scorecard aren’t expanding Medicaid under the Affordable Care Act, also known as Obamacare.
The states in lighter grey aren't expanding Medicaid. Many of these are also states in which overall health systems are worse.
One of Obamacare’s major tools for giving the poor better access to health care is expanding Medicaid to those making 133 percent of the federal poverty limit -- about $15,521 for a single person -- or less.

But the Supreme Court ruled in 2012 that states could opt out of joining the Medicaid expansion and the extra federal money that came with it. Many states with Republican governors or majority Republican legislators have done just that, leaving millions of their residents out of the national effort to cover the uninsured.

Increasing access to Medicaid isn't a cure-all for low-performing states, and improving health care outcomes overall will require more than just expanding Medicaid. But it could help, Schoen said. For one, it will extend health coverage to more people, making it less likely that poor patients will head to the emergency room for things other than emergencies. And if more low-income residents can pay for health care, more doctors might be convinced to move to poor or rural areas.

"The states that stay out could fail to improve, or fail to improve as fast as other states that choose to participate,” Schoen said. “In some of these states, staying where you are is not very good performance.”

Black Americans are likely to suffer disproportionately from these policies. More than two-thirds of poor, uninsured blacks live in states not expanding Medicaid, according to a December 2013 New York Times report. Already, the rate of avoidable early deaths among blacks is twice as high as among whites in many states, Commonwealth found. That gap is even wider in states with higher early death rates overall.

The difference in avoidable death rates in white and black populations in different states.
Still, there is some hope: Kentucky, Arkansas and Nevada, which all rank in the bottom quarter of the Commonwealth Fund's scorecard, are expanding Medicaid. That could help them catch up."You could see a few states start to improve quickly," Schoen said. Reported by Huffington Post 2 hours ago.

Poll: Slight Improvements But Tough Terrain Ahead for Democrats

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Support for President Barack Obama and his health care law has increased in the weeks since the White House announced that eight million Americans have enrolled in the law’s health-insurance exchanges, according to a new NBC News/Wall Street Journal poll. Reported by msnbc.com 2 hours ago.

HUFFPOLLSTER: Obama's Numbers Look Bleak -- But Are They Improving?

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Another day, another national poll showing a bleak political environment for Democrats, yet with a different story about Obama's approval rating. The Upshot and FiveThirtyEight both tackle measurements of racial stereotypies. And when it comes to click bait, it's hard to top 'I Don't Agree With Nate Silver.' This is HuffPollster for Wednesday, April 30, 2014.

*POLL FINDS OBAMA'S NUMBERS RETURNING TO STATUS QUO* - Chuck Todd, Mark Murray and Carrie Dann: "Bill McInturff, the Republican half of our NBC/WSJ poll, perhaps summed up our latest survey the best: The poll shows that things are better for President Obama and the Democrats after eight million Americans enrolled on the health-care exchanges. But they are still far from good. Obama’s job-approval rating now stands at 44%, a three-point increase from last month, though that movement falls within the poll’s margin of error. For the first time since early October (before the federal health-care website’s disastrous launch became a months-long national story) the president’s personal favorable/unfavorable rating is right-side up, at 44% positive and 41% negative. And 36% see the health-care law as a good idea, versus 46% who view it as a bad idea -- a slight uptick from 35% good idea and 49% bad idea back in March. *Bottom line: Obama’s standing is pretty much back to where it was BEFORE the website woes.* But remember, that same standing was already difficult terrain for the president and Democrats. "
[NBC]

*Better isn't the same as good* - John Harwood: "'The president has moved from a wipeout position to a competitively negative position,' said Democratic pollster Peter Hart, who helps conduct the NBC/WSJ poll. But as his Republican counterpart Bill McInturff added, 'better' is not the same as 'good.'" [CNBC]

*Agreement with Obama's economic message* - Reid Epstein: "Yet, those polled agree with Obama’s overarching economic message that it has become harder for lower- and middle-class people to get a fair deal. *More than half, 55%, said the country’s economic and political systems are stacked against them*, the most that have said so in WSJ/NBC surveys since 1992. Dissatisfaction ranges over many political and economic institutions. Some 54% said the gap between rich and poor means not everyone has an opportunity to improve his or her standard of living. Confidence in the federal government is anemic (with only 16% saying they have confidence). The same goes for large corporations (13%), big banks (13%), the news media (19%) and health insurance companies (13%)." [WSJ]

*Little appetite for foreign intervention* - HuffPollster: "Forty-seven percent of Americans say the U.S. should be less active in world affairs, while 30 percent think it should remain at its current level. Just 19 percent want to see the country become more involved. hose opinions represent a stark change from just after the 9/11 attacks. In September 2001, 37 percent of Americans thought the country should be more active, and only 14 percent wanted it to take a less active role. While the NBC/WSJ poll hasn't asked the same question in the intervening years,other questions show similar support for an isolationist approach. **From 2005 to 2012, the percentage of of Americans saying the country should 'focus more on our own problems here at home' jumped 20 percentage points**, from 54 percent to 74 percent. CBS polls in the past two years found that a majority of Americans don't want the U.S. to take a leading role in solving conflicts." [HuffPost]

*Remember yesterday's 'new low?'* - Mark Mellman (D) does: "#overreadingpolls: yesterday ABC/WashPo Obama at approval low. WSJ/NBC today Obama gets bump. Can't be both true. Best bet: neither are" [@MarkMellman]

*'WHY I DON'T AGREE WITH NATE SILVER'* - Josh Kraushaar: "[C]ount me underwhelmed by the new wave of Senate prediction models assessing the probability of Republicans winning the upper chamber by one-tenth of a percentage point. It's not that the models aren't effective at what they're designed to do. It's that the methodology behind them is flawed. Unlike baseball, where the sample size runs in the thousands of at-bats or innings pitched, these models overemphasize a handful of early polls at the expense of on-the-ground intelligence on candidate quality. As Silver might put it, there's a lot of noise to the signal. *The models also undervalue the big-picture indicators suggesting that 2014 is shaping up to be a wave election for Republicans*, the type of environment where even seemingly safe incumbents can become endangered. Nearly every national poll, including Tuesday's ABC News/Washington Post survey, contains ominous news for Senate Democrats. President Obama's job approval is at an all-time low of 41 percent...Democrats hold only a 1-point lead on the generic ballot in the ABC/WaPo survey—worse positioning than before the GOP's 2010 landslide." [National Journal]

*What's his beef?* - Via Twitter conversation with HuffPollster, Kraushaar says his problem has less to do with the odds that Silver and the other modelers give of a Republican takeover, and more with the models themselves: "[I] think the model slow to capture a lot of on-ground developments, very reactive. dependent on flawed polling." He *also argues that the models are too certain about the outcomes in the Senate races in Michigan, New Hampshire, Virginia and Oregon*. How would he rate the probability of Democratic victories these states? "probably around 70% in MI; 55% in NH; 75% in VA, OR. Ballpark figures." Nate Silver's most recent update of his model rates the probability of victories as 55 percent in Michigan, 75 percent in New Hampshire, 90 percent in Oregon and 95 percent in Virginia. [@HotlineJosh via Storify, 538]

*A Senate modeler reacts* - John Sides, via Twitter: "Contra @HotlineJosh...*@UpshotNYT's Senate model weights big picture more than early polls*...Moreover, like our model [for the Washington Post], @UpshotNYT's model builds in information about 'candidate quality,' which @HotlineJosh cites as important. " [@monkeycageblog here and here, citing UpshotNYT]

*Silver has no comment* - Tom Kludt: "[Nate] Silver told TPM in an email that 'the results speak for themselves' and opted not to comment further." [TPM]

*MEASURING RACIAL STEREOTYPES* - Amanda Cox: "The condemnation of remarks by the Los Angeles Clippers owner Donald Sterling is almost unanimous. But racism is still more common than you may realize. In surveys, *more than one-fifth of whites volunteer views consistent with negative racial stereotypes*. While many fewer Americans express animosity toward blacks than they did 40 years ago, a CBS News poll from March showed that 46 percent of Americans thought racial discrimination would always exist." Cox produced a set of charts plotting responses to a of questions asked regularly over at least a dozen years by the General Social Survey. [NYTimes]

*'Are White Republicans More Racist Than White Democrats?'* - Nate Silver and Allison McCann combined eight GSS measures, including those captured by the NY Times graphic, into a combined index of negative racial attitudes: "We accomplished this by averaging the number of white Americans who provided the arguably racist response to each survey item, extrapolating the value for years in which the General Social Survey didn’t ask a particular question based on the long-term trend in responses to it. As of 2012, *this index stood at 27 percent for white Republicans and 19 percent for white Democrats*. So there’s a partisan gap, although not as large of one as some political commentators might assert. There are white racists in both parties. By most questions, they represent a minority of white voters in both parties. They probably represent a slightly larger minority of white Republicans than white Democrats. [538]

*Measuring 'racism' isn't easy* - David Hill (R) "From a pollster’s perspective, racism is a tough nut to crack. Is there any proven and tested battery of questions that will measure racism? For that matter, is racism a single construct, or is it a multidimensional phenomenon that renders measurement nigh impossible?...When race is an issue in campaigns, pollsters need to get their hands around its measurement. In races where I have needed to consider the role that racism plays in voter choice, I have struggled to get it right, usually settling on an indirect strategy of asking voters whether they knew other voters who were being influenced by race. *My assumption, then as now, has been that voters will not fess up to direct questions about their own racism*. They may not even be self-aware of their true feelings about race and how it might affect their electoral behavior." [The Hill]

*RANKING SENATE RACES BY VOTER MOBILIZATION* - The New Republic: "While pundits cite polls, the political pros who steer campaigns keep their eyes on different figures: how many actual votes their candidate needs to prevail, and where those votes will come from. Proprietary formulas reveal the number of votes that a contender can count on going in, which leaves a shortfall that can be closed through mobilization. *With field studies having determined a price for each additional vote yielded by the most effective turnout tactics, we were able to compare the relative difficulty and costliness of this year’s most competitive Senate races*….Of course, no campaign would ever rely solely on volunteer outreach or paid get-out-the-vote communications. But by calculating absolutes for both methods, we were able to compare the work ahead for Democrats in these races, and what it will take the party to hang onto or pick up the seat by transforming the midterm electorate through turnout." The top three races? *West Virginia, Alaska and Montana.* [TNR]

*HUFFPOLLSTER VIA EMAIL!* - You can receive this daily update every weekday via email! Just click here, enter your email address, and and click "sign up." That's all there is to it (and you can unsubscribe anytime).

*WEDNESDAY'S 'OUTLIERS'* - Links to the best of news at the intersection of polling, politics and political data:

-PPP (D) finds Tom Cotton and Mark Pryor tied in Arkansas. [PPP]

-ABC/Washington Post is the latest national poll to show a wide open Republican primary while Hillary Clinton dominates the Democrats. [WashPost]

-Presidential polls taken two years out almost never predict the winner. [NYT]

-Republicans may not think their candidates deserve reelection, but they plan to vote for them. [WashPost]

-The Harvard IOP survey provides another measurement showing college age Millennials to be less Democratic than their older counterparts, argues John Sides. [WashPost]

-Dante Chinni uses college towns to illustrate how turnout declines among younger voters in off-year elections. [WSJ]

-Jamelle Bouie cautions Republicans from reading too much into the gains they are likely to make in 2014. [Slate]

-Mark Mellman (D) reviews the "sound and fury" of criticism directed at last week's New York Times/Kaiser polls of four southern states and finds "no real evidence these polls are flawed." [The Hill]

-Andrew Kohut cautions Republicans about a strategy of attacking Obama's foreign policy. [Politico]

-An Edison Research exit poll in Iraq projects Nouri al-Maliki's State of Law Party to be the largest in the Parliament. [Edison Research]

-Harry Enten notes that "establishment Republicans" are poised to defeat "Conservative outsiders" in this years Senate primaries. [538]

-The former senior Facebook engineer who was hired to oversee the RNC's data and tech overhaul will be taking a diminished role at the committee. [HuffPost]

-Self-funding donors accounted for 27 percent of the money raised in 16 high dollar primary races this year. [WashPost]

-Global Strategy Group (D) advises Democrats to focus on a message of economic growth rather than income inequality. [GSG]

-39 percent of Internet users have changed passwords or canceled accounts due to the Heartbleed security flaw. [Pew Internet

-With a big assist from Jimmy Fallon and Robinson Cano, Larry Rosin explains the value of anonymity in opinion research. [Edison Research] Reported by Huffington Post 19 hours ago.

Sen. Vitter is back with his proposal to strip health subsidies for Congress/White House

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WASHINGTON -- To the great annoyance of some of his Senate colleagues, Sen. David Vitter, R-La., announced Wednesday that he still wants a vote on his proposal to bar continued federal subsidies for member and staff health insurance bought under... Reported by nola.com 19 hours ago.

MNsure board drops 'interim' tag from CEO's title

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Associated Press The man who runs Minnesota's online health insurance marketplace says there is plenty of work ahead as it prepares for a new Reported by TwinCities.com 18 hours ago.

Health Care Reform and the Futures of Primary Care and Psychiatry

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What does health care reform have to do with the futures of primary care and psychiatry? A lot, and most of it is still under our collective radar screen.

Both fields are essential to our health care system, and both face critical shortages even as the demands for their services are increasing. Demands are accelerating as the Affordable Care Act (ACA) starts to provide greater access to care for millions of previously uninsured patients. And in both cases, the ACA will not do much to relieve these shortages.

How serious are these shortages? Hospital systems seeking to link up with accountable care organizations and patient-centered medical homes are finding it difficult to recruit primary care physicians -- their highest priority. Almost 20 percent of positions are unfilled. (1) The supply lines for primary care and psychiatry are meager compared with present and future needs. Just 12 percent of all practicing physicians are in primary care today. Only 8.4 percent of graduates of U.S. medical schools opted for graduate training in family medicine in 2013 (2); for psychiatry, that number was 4.2 percent. (3)

Primary care and psychiatry have much in common. Both are undervalued and under-reimbursed. Both involve face-to-face time with patients to evaluate and manage their problems with continuity over long periods of time. As health care has become a largely for-profit industry, procedures (such as surgical or imaging procedures) have been much more highly reimbursed than the cognitive care that is the backbone of primary care and psychiatric practice. As a result, primary care specialties and psychiatry are near the bottom of incomes among clinical specialties. We have a continued mismatch between system needs and the supply of physicians to meet them.

These are some of the trends over recent years that exacerbate shortages in both fields (4):

*Primary care: *
· Inadequate reimbursement that often fails to cover physician costs (e.g. Medicaid patients).· Increased office overhead to keep up with paperwork and billing, driving many primary care physicians into hospital-affiliated groups.· Shift from self-employed practice to employment by hospital systems that drive physicians to see more patients per hour and be more "productive" through shortened office visits.· Increasing dissatisfaction with primary care practice. (5)
*Psychiatry: *
· Shift of practice from mental illness to mental health, leaving a vacuum in the care of serious mental illness (e.g. schizophrenia, other psychoses).· Deinstitutionalization of mental illness care, with contraction or closure of many public mental hospitals.· Inadequate reimbursement for "talk" therapy.· Lack of insurance coverage for many psychiatric services.· The practices of some 90 percent of psychiatrists are now involved with "med checks," short visits without time to listen and understand patients' problems; most psychiatrists avoid care of the seriously mentally ill in favor of those with much less serious mental health problems such as anxiety disorders.
We are left today with well-entrenched specialty maldistribution in our physician workforce. As a result, as the ACA brings higher demand for care with more newly insured patients, we have:
· Restricted access to care -- it is hard to find a primary care physician, especially in rural areas; among psychiatrists, 55 percent accept Medicare patients while only 43 percent will see Medicaid patients; (6) 55 percent of the country's 3,100 counties have no practicing psychiatrists, psychologists or social workers, as a result of attrition and budget cuts. (7)· Increased use of emergency rooms, increased fragmentation and costs of care; loss of continuity and depersonalization of the doctor-patient relationship.· Five percent of the adult U.S. population suffers from serious mental illness; over the last 20 years, the number of patients qualifying for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) has gone up by 250 percent for adults, and by 35-fold for children. (8)· Our jails are filled with the seriously mentally ill (e.g. the biggest jail systems -- Cook County in Chicago, Los Angeles County and New York City -- have more than 11,000 prisoners under treatment compared with a combined total of 4,000 in the three largest state-run mental hospitals. (9)
While the ACA does make some efforts to address these problems -- such as providing limited and temporary boosts to primary care physician reimbursement, requiring parity of mental health care with that of physical illness, and enabling states to establish "health homes" for the mentally ill -- these are far too limited to make a dent in the above problems. We need to make fundamental reforms that will, over a generation or two, rebuild the primary care and psychiatry workforce. Even with the ACA, many holes in insurance coverage will remain, reimbursement through a flawed fee-for-system (FFS) will be inadequate, and much of the demand for primary care and mental illness care will go unmet.

All this can be fixed, over time, with an intertwined strategy that includes universal access through a single-payer system of national health insurance (H.R. 676 in the House of Representatives), together with physician payment reform (two possible approaches have been suggested in earlier Health Care Disconnects blogs) (10, 11), and changes in medical education that would be enabled by predictable reimbursement aligned to national needs.

A single-payer financing system would simplify billing and health care administration, thereby reducing physicians' "hassle factor" and restoring needed time for direct patient care. It would also enable reform of our present payment distortions between primary care and other time-intensive specialties (such as psychiatry and geriatrics) and the procedure-oriented non-primary care specialties. These steps could begin to correct shortages in time-intensive specialties and rebalance a physician workforce that will better meet growing needs for care.

*Suggested Reading: *
1. Japsen, B. Doctor, nurse vacancies soar amid Obamacare rollout. Forbes, December 8, 2013.
2. Biggs, WS, Crosley, PW, Kozakowski, SM. Results of the 2013 National Resident Matching Program: Family medicine. Family Medicine 45 (9): 647-651, 2013.
3. Moran, M. More graduates choose psychiatry in 2013 Match. Psychiatric News Update, April 19, 2013.
4. Geyman, JP. Challenges to the future of psychiatry: Parallels with primary care. Psychiatric Annals 44 (1): 69-72, 2014.
5. Hoff, T. Practice Under Pressure. Piscataway, NJ. Rutgers University Press, 2010: 43-48.
6. Pear, R. Fewer psychiatrists seen taking health insurance. New York Times, December 11, 2013.
7. Fields, G, Dooren, JC. For the mentally ill, finding treatment grows harder. Wall Street Journal, December 21, 2013.
8. Angell, M. The crazy state of psychiatry. In Brooks, D. (ed) The Best American Essays 2012. New York, 2012.
9. Fields, G, Phillips, EE. The new asylums: Jails swell with mentally ill. Wall Street Journal, September 26, 2013.
10. Gimlett, DM. Primary care payment quick fix. Health Care Disconnects, posted September 12, 2013.
11. Kemble, S. Is fee-for-service really the problem? Health Care Disconnects, posted October 19, 2013.

This post originally appeared on the blog of the Health Care Disconnects Online Journal. Reported by Huffington Post 18 hours ago.

House Report: Just 2.5 Million Have Paid Obamacare Premium

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Only two-thirds of those enrolled in Obamacare health insurance programs through HealthCare.gov had paid their first month's premium by April 15 — and only 25 percent of those were in the desperately needed 18-34 age group, according to figures House Republicans released on Wednesday. Reported by Newsmax 16 hours ago.

Hawaii Health Connector's enrollment count nears 9,000 on day of deadline to sign up

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Individuals who could not complete an application for health insurance coverage during the open enrollment period that ended March 31 had until Wednesday to finish the enrollment process thanks to an extension enacted by the Hawaii Health Connector. The initial extension was to end April 15, but a  second and final extension pushed it to April 30. Individuals and families without insurance beyond April 30 will be subject to financial penalties as part of the federal Affordable Care Act’s individual… Reported by bizjournals 16 hours ago.

Cancer Diagnosis in Pets is a Growing Health Concern

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PetFirst shares information on the diagnosis and treatment of cancer in dogs and cat, plus how pet insurance can help in your pet’s care.

Jeffersonville, Ind. (PRWEB) April 30, 2014

The diagnosis of cancer in pets has become as common as it is for humans. Cancer accounts for almost half of the deaths of pets over the age of 10, primarily in dogs, while cats see fewer diagnosis. PetFirst offers pet owners more information on the different stages of cancer and the treatment options to keep in mind when faced with the illness.

According to the American Humane Association, cancer is the leading cause of death in dogs with one in every two dogs developing the disease. Of those, one in four will die as a result of the cancer. The numbers for cats diagnosed with cancer are not as extreme; however, the reasons vary based on less cats being seen by a veterinarian on a regular basis.

The first step in the fight against cancer for pets is prevention and awareness. Prevention can be as simple as routine visits to the veterinarian to have your pet examined. Blood and fecal tests, as well as a physical exam can show changes from visit-to-visit, allowing your veterinarian to monitor your pet’s overall health. As a pet parent, also be aware of the signs and symptoms of cancer, paying close attention to changes in your pet’s behaviors. A few specific items to watch include:·     Not eating or eating infrequently
·     Vomiting
·     Blood in their urine
·     Losing weight
·     Lethargic
·     Inability to be comfortable when resting, restlessness

Once your pet has been diagnosed with cancer, there are several treatment options that can prolong your pet’s life. One treatment option is the removal of the mass through surgery. In some cases, removing the mass resolves the problem and the pet is considered cured. In other instances, chemotherapy may be required, even radiation therapy is an option. The bottom line in the care of your pet is maintaining the highest quality of life for the longest time possible.

Maintaining that quality of life for your pet can become expensive, even cost prohibitive for some families. A pet health insurance plan can assist with those expenses. It is important to establish a pet insurance policy early, prior to any cancer diagnosis or symptoms.

The Lifetime Accident and Illness policy options with PetFirst cover chronic and hereditary conditions, including various treatments for cancer. Policy options range from $5,000 to $20,000 in coverage with no per-incident limit and most claims are reimbursed within 10 days of being submitted.

Securing a pet insurance policy is easy and can be done either online or by phone. To find PetFirst, visit http://www.petfirst.com or call 1-877-894-7387 and a representative will customize a personal insurance plan for you and your pet.

For more information on the most common cancer diagnosis specific to purebreed dogs, visit PetFirst at http://www.petfirst.com.

About PetFirst

PetFirst is the fastest growing pet insurer in North America offering easy-to-understand lifelong coverage for dogs and cats. PetFirst’s comprehensive coverage is unique in the industry providing simplified policies with coverage for hereditary, chronic and breed-specific conditions with no per diagnosis limits. PetFirst offers pet insurance in all 50 states and the District of Columbia through animal welfare agencies, retailers, employers as well as other partners. PetFirst polices are underwritten by American Alternative Insurance Corporation (Munich Re) which is rated by A.M. Best as A+. Additional services are underwritten by Lloyd’s. For more information about PetFirst pet insurance, visit http://www.petfirst.com or call 877-894-7387.

-30- Reported by PRWeb 16 hours ago.

Not All Health Care Premiums Are Paid Up, House Panel Says

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The House Committee on Energy and Commerce said Wednesday that only two-thirds of people signing up for private health insurance in the federal exchange had paid by April 15. Reported by NYTimes.com 15 hours ago.

Your Money Adviser: Few Options for Those Who Missed Health Insurance Deadlines

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Only Nevada has extended its deadline to sign up for insurance past April 30, and the next open enrollment period does not start until Nov. 15. Reported by NYTimes.com 15 hours ago.

City to collect $12.5M from Divvy sponsorship

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Chicago's Divvy bikes will become moving advertisements for the state's largest health insurance company under a corporate sponsorship of the bike-sharing program that provides the city with $12.5 million to improve and expand cycling, officials will announce Thursday. Reported by ChicagoTribune 13 hours ago.

City to collect $12.5M from Divvy sponsor

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Chicago's Divvy bikes will become moving advertisements for the state's largest health insurance company under a corporate sponsorship of the bike-sharing program that provides the city with $12.5 million to improve and expand cycling, officials will announce Thursday. Reported by ChicagoTribune 5 hours ago.

Aon Hewitt, Alston & Bird Executives to Analyze Post-ACA Regulatory Issues of Private Exchanges

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In an upcoming webinar from Atlantic Information Services, participants will learn about regulatory and compliance hurdles facing private insurance exchanges.

Washington, DC (PRWEB) May 01, 2014

As employers look for ways to limit their contribution obligations while continuing to offer valuable health insurance coverage, insurance carriers are meeting that need by launching their own single-carrier exchanges, participating in multi-carrier exchanges, or both. But what are the key tax and ERISA compliance issues employers and insurers need to understand? On May 15, the Atlantic Information Services, Inc. (AIS) webinar, “Private Exchanges: Avoiding Regulatory Pitfalls in the Post-ACA World,” will address what compliance issues employers, health insurers and private exchange operators should expect in the future.

During the May 15 webinar, participants will hear expert presentations from John Hickman, Esq., head of the Alston & Bird, LLP Health Benefits Practice, and Ken Sperling, national health exchange strategy leader at Aon Hewitt. Participants will get detailed answers to these and other complex questions:· What compliance issues arise when an employer provides defined-contribution dollars for individual policies sold on private or public exchanges? How does the IRS guidance in Notice 2013-54 affect such arrangements?
· From a regulatory perspective, what is the difference between fully insured and self-insured exchanges?
· What needs to be considered when determining the employer subsidy?
· Can employees pay for any excess cost of coverage through a pre-tax salary reduction?
· What are the benefits of group versus individual coverage? What are the compliance hurdles?
· Will employer-subsidized coverage through individual policies make employees ineligible for federal subsidies through the federal exchange?

Visit http://aishealth.com/marketplace/c4r20_051514 for more details and registration information.

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://www.AISHealth.com. Reported by PRWeb 9 hours ago.
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