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Last Day For “Obamacare” Sign Up

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Time is running out to sign up for health insurance and have that coverage take effect starting January 1st. Monday, December 15th, is the final day to sign up to meet the deadline. Reported by cbs4.com 16 hours ago.

Small Businesses Drop Coverage As Health Law Offers Alternatives

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Subsidies created by the health law to help workers buy their own coverage and steady increases in companies' insurance costs have made it easier for them to decide to discontinue health insurance. Reported by NPR 14 hours ago.

Two Years After Newtown, Some States Are Retreating On Mental Health Funding

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This piece comes to us courtesy of Stateline. Stateline is a nonpartisan, nonprofit news service of the Pew Charitable Trusts that provides daily reporting and analysis on trends in state policy.
Fewer states increased their spending on mental health programs this year compared to last year, when a spate of horrific shootings by assailants with histories of mental illness prompted a greater focus on the shortcomings of the country’s mental health system.

Some states slashed their mental health budgets significantly this year. At the same time, however, a number of states adopted mental health measures in 2014 that won plaudits from behavioral health advocates.

A survey of state spending published last week by the National Alliance on Mental Illness (NAMI) found that 29 states plus the District of Columbia increased their spending on mental health in fiscal year 2015. A year earlier, 37 states plus D.C. increased their mental health budgets.

NAMI warned that the momentum to improve state mental health services, which was especially powerful after the December 2012 Sandy Hook massacre in Connecticut, has slowed.

The group is concerned that last year’s increases were just a blip, and that states are returning to the pattern of the period between 2009 and 2012, when total state spending on mental health fell by $4.35 billion. In fiscal year 2009, total mental health spending by all states was $1.55 trillion.

In many states, spending on mental health still hasn’t returned to prerecession levels.

Medicaid Expansion

But state budgets don’t paint a complete picture of mental health spending. In January, 27 states plus D.C. expanded Medicaid eligibility under the Affordable Care Act (ACA) to include single people without children who earn 138 percent or less than the federal poverty level, which for an individual is $11,670. That change ushered 7.5 million new enrollees into Medicaid, which provides access to a wide range of mental health services. The federal government is paying 100 percent of the costs associated with those expansion enrollees.

“That is the single most important thing that has happened in mental health this past year,” said Debbie Plotnick, senior director of state policy of Mental Health America (MHA), formerly the National Mental Health Association.

But the expansion may also have persuaded some states to pull back funding for community mental health centers and other mental health initiatives, including school and substance abuse programs.  

Rhode Island, for example, citing “a continuingly constrained budgetary environment,” cut its mental health funding by $33.6 million this year, according to NAMI, a 20 percent reduction. Michigan, Arkansas, Hawaii, Kentucky and Massachusetts also expanded Medicaid but reduced mental health funding this year.

A number of states that declined to expand Medicaid also reduced mental health spending, according to NAMI. Alaska, which cut mental health spending by 37 percent between 2009 and 2012, made further cuts in the last two years as it weathered falling revenue from declining oil prices. Nebraska, Louisiana and North Carolina, also followed mental health cuts made during the recession with additional reductions in fiscal years 2014 and 2015.

Still, 29 states plus D.C. did increase mental health spending. Virginia spent an additional $54.9 million to increase the number of psychiatric beds and strengthen community mental health programs and telepsychiatry. Missouri approved an initial $14 million for the construction of a new maximum security psychiatric hospital projected to cost a total of $211 million. New Hampshire and New Jersey put more money into community mental health. Florida increased community mental health spending as well, restoring $15.2 million in cuts it had made since 2012.

State Mental Health Rankings

Coincident with the NAMI survey, MHA released its rankings on the mental health status of all 50 states and the District of Columbia based on the prevalence of mental illness and access to mental health services in each state. Access is measured by such indicators as the presence of barriers to treatment, such as lack of insurance, copays, coinsurance, denials of coverage and insufficient numbers of mental health providers. The survey was conducted before the full effects of health insurance expansion under Obamacare had taken effect.

Massachusetts, Vermont, Maine, North Dakota and Delaware topped the list while the bottom five were Arizona, Mississippi, Nevada, Washington and Louisiana.

There is a high, but not perfect, correlation between states’ rankings and whether they are Medicaid expansion states. Maine, third on the list, is not an expansion state. Conversely, Washington (48th), Nevada (49th) and Arizona (51st), all expanded Medicaid under ACA.

Overall, the report says that 42.5 million Americans suffer from some sort of mental illness, 19.7 million have a substance abuse problem and 8.8 million report that they have seriously considered suicide.

The MHA report also ranks the mental health of young people across the states. Vermont, North Dakota and Wisconsin top the list. Nevada, New Mexico and Montana rank last.

New Mental Health Measures

Although NAMI pointed to the retreat from state mental health spending this year, its report did note a number of new laws that it hailed as possible models for other states. Among them:

Virginia established a registry of available beds in public and private psychiatric facilities to help place individuals who meet the criteria for temporary detention as a result of mental illness. The bill arose after the mentally ill son of Virginia state Sen. Creigh Deeds stabbed his father and then killed himself with a rifle a year ago. Only hours before the incident, the young man had been released from emergency detention when officials were unable to find a hospital with an available bed where he could receive a psychiatric evaluation before being released, as required under law.

Minnesota passed a measure that would base community mental health workers in schools to handle acute mental health cases. Sita Diehl, NAMI’s director of state policy and advocacy, said, “School counselors are focused on general mental health issues. They may not be equipped to handle serious mental health in children.”

Massachusetts enacted a comprehensive “safe and supportive school” measure, which, among other provisions, encourages schools to explore mental health issues when they assess the poor performance or poor behavior of students. “Schools think in terms of academics,” said state Rep. Ruth Balser, a Democrat, who sponsored the bill. “It’s a matter of us educating the educators to think of the whole child.”

For people in the throes of psychosis or another mental illness crisis, Minnesota now provides transportation to a hospital in unmarked cars driven by mental health professionals rather than in police cars with flashing lights and sirens. “When law enforcement is called for medical situations it’s really embarrassing and humiliating for people who didn’t break any law,” said NAMI’s Diehl.

Illinois passed a law aimed at preventing parents with limited or no health insurance from having to relinquish custody of their severely mentally ill children to foster care to get those children intensive mental health treatment. The law requires the state to identify children at risk of state custody and work with their families to get the needed services. In the past, children were taken away from parents to get them treatment. “It was a dirty, dirty secret,” said Sara Feigenholtz, the Democratic state representative from Chicago who sponsored the legislation.

Kentucky allows trained nurse practitioners to prescribe psychiatric medications, a measure intended to help patients without easy access to psychiatrists. Illinois passed a similar measure pertaining to psychologists.

At the other end of the spectrum, North Carolina approved a law requiring Medicaid patients to get authorization from Medicaid before obtaining psychiatric drugs. While supporters cited cost-savings as a rationale for the measure, NAMI’s Diehl predicted it will lead to otherwise avoidable hospitalizations or arrests that will cost the state far more than the medications.

Idaho’s legislature voted to allow the use of restraints with mentally ill patients without a physician’s permission. Georgia terminated the University of Georgia’s “navigator” program, which provided trained helpers to assist people trying to obtain insurance on the federal health exchange.

And Georgia, Arkansas and Tennessee all enacted measures barring promotion of ACA’s provisions or preventing those states from expanding Medicaid eligibility and improving access to mental health care. Reported by Huffington Post 13 hours ago.

Midnight Monday is the deadline for Jan. 1 health coverage through Virginia's health marketplace

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Monday, Dec. 15, is the deadline for consumers to sign up for health insurance through the Affordable Care Act’s insurance marketplace, www.healthcare.gov, for coverage effective Jan. 1, 2015. Reported by dailypress.com 12 hours ago.

Critical Months Ahead for Single-Payer Advocates

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Two weeks from now, Vermont Gov. Peter Shumlin will describe how he thinks the country's first state-based single payer system will be financed. Whether the Green Mountain State keeps moving forward with its goal of achieving universal coverage while also reducing the growth of health care spending depends largely on how the state's residents and businesses react to what Shumlin has in mind.

Vermont lawmakers passed a bill in May 2011 that set the state on the path toward single payer, but the bill left it up to Shumlin to figure out the financing. Although everyone has known from the beginning that the cash needed to operate the new system--estimated at $2 billion in its first year-- will have to come from tax revenues, no one knows exactly what combination of taxes the administration favors.

Earlier this month, vtdigger.org reported that Shumlin would propose both an employer payroll tax and an increase in the state income tax. The money generated would then replace the premiums that employers and residents currently pay health insurance companies.

Even though Shumlin signed the single payer bill into law almost four years ago, Vermont can't implement its plan until 2017 because the Affordable Care Act prohibits states from making significant changes to their health care systems until then. The ACA also stipulates that states will have to persuade the feds that any structural changes they want to make will not reduce the number of people with health insurance or increase costs.

The release of the Shumlin administration's tax proposal will represent the insurance industry's biggest opportunity to derail the state's plans. Health insurers have reason to be concerned. Even though Vermont has just 627,000 residents, successful implementation of a single payer system there would show the rest of the country that health insurance companies are unnecessary middlemen that add costs rather than value.

The goal of the insurance industry will be to generate fear, uncertainty and doubt among the state's residents and business owners. While polls continue to show that the proposed new system enjoys wide support, that support will erode if the industry and its allies win the messaging war.

It's not likely, though, that the industry's involvement in that war will be evident. I know from experience that insurers use organizations like the U.S. Chamber of Commerce and the Federation of Independent Business to carry out their PR campaigns. And they go to great lengths to hide their involvement. We probably would never have known that America's Health Insurance Plans, the industry's main trade group, funneled more than $100 million to the Chamber to pay for TV ads designed to derail federal health care reform had it not been for diligent investigative reporters at the National Journal.

In anticipation of the unveiling of Shumlin's plan, some of the state's biggest employers are already expressing concerns. It gets complicated because large employers provide subsidized coverage to about 20 percent of the state's population. The PR guy for National Life, a life insurance and financial services company, told Vermont Public Radio last week that "it's difficult for us to imagine how this (single payer) works to the benefit of our employees."

Knowing that insurers could easily derail his blueprint unless he had a strategy to counter their strategy, Shumlin last year formed a Business Advisory Council on Health Care Financing. The 21-member council "provides the governor with advice and information on health care financing based on the business experience of its members," according to its website.

But Shumlin also has to make sure his plan meets the approval of the many single payer supporters who helped elect him. Soon after vtdigger.org broke the story about the governor's financing plan, James Haslam, executive director of the Vermont Workers Center, a nonprofit that advocates for "an economically just and democratic Vermont," said his group is concerned about how the proposed payroll tax will be levied.

Still, the advocates understand that implementing a single payer system is complicated, far more so than any of them ever imagined.

"We are finding out just how hard it is to disentangle ourselves from the grip of all the payers and special interests that have infested our health care system," Dr. Deborah Richter, president of the nonprofit single-payer advocacy group Vermont Health Care for All, told me. "People need to be reminded that we will pay for health care with or without reform, but that we'll in fact pay more without reform.

"This is our one chance to get this done," she added. "This is our health care Halley's Comet. The stars are aligned, and we won't get another chance to fix health care in Vermont for a very long time."

Sounds like something worth watching. Reported by Huffington Post 11 hours ago.

NY State of Health extends insurance exchange enrollment deadline until Saturday

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Consumers now have until Saturday to enroll or renew their health insurance on the state's health insurance exchange for coverage that will begin Jan. 1. Reported by Newsday 11 hours ago.

Health Insurance: Prescriptions for Populations

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How will we use data to improve the health of every person an insurer covers? That will be the key to success in the future. Reported by Forbes.com 10 hours ago.

Obamacare, the Game, Part II: We're on the Road to Health Care

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The mechanics of getting health care under the ACA are improving. The snake-oil salesmen to whom our life and health are handed after leaving Healthcare.gov, however, remain their slithering, slimy, selves. It begs the question: When do we remove the few hundred fiefdoms hijacking our most basic right to life, our health, and join the rest of the world's top industrial nations with real, affordable, universal, national health care for all of our citizens?

Last year, Republicans went volcanic over letters to constituents that told them that their non-ACA compliant plans would end. Republicans kind of, sort of well, neglected to mention that these insured would automatically, because of the ACA, be rolled over by their current insurer to the next closest plan that was ACA-compliant if they did not pick one of their own. They weren't being "dumped."

The Obama administration blinked, and let people keep bad plans that ripped them off, most of which you'd have to have a law degree to understand, in the fine print, how badly you were getting hosed.

You could hear a GOP pinhead drop this year. There was utter silence as my letter from Cigna arrived. My rate had jumped 78 percent in one year! My blood pressure spiked about the same level as my stomach dropped to the floor. I felt like the Grinch on Christmas Day: How could it be so?! I vented on Twitter, including @Cigna in my rage. Within a few hours I had a representative calling me to explain.

More on that in a moment...

*Previously, on "Obamacare, the Game:"*

In my first HuffPost Affordable Care Act (ACA) post, "Obamacare, the Game," I saved a little on the monthly premium, but a huge amount on a Gold plan for my blended family of seven.

In 2013, before the ACA fully kicked in, Blue Cross of Florida took my $2000 per person deductibles, lumped them all together, and hit me square between the eyes with a sky-high $14,000 deductible and $25,000 out of pocket for my family per year. The only good news was that Stephen King took an interest in the rights to my health care horror story.

My ACA-backed Cigna plan was a PPO, the plans with the most flexibility of seeing your doctor. It had a $0 deductible with $10,000 out of pocket, reasonable office visit, hospital and pharmacy costs, with a nice caveat that any one member of the family hitting $5,000 covered for out-of-pocket for the year was now "at cap." Given the other 63 plans that I waded through, this was the best balance of paying up front and paying out over the course of the year. I did not qualify for a government subsidy.

*The ACA Works (Sort of)*

How did I do under demon "Obamacare?" My health bills dropped by well over $6,000 last year, between slightly reduced monthly rates, and leaving the pre-ACA "you-pay" co-pay system with a deductible that could not be met unless there was a catastrophic health problem in the family.

2012's $2,200 urgent care trip for kid with the basketball court face-plant became the $70.00 urgent care trip for a same-sport, different kid in 2013. The pre-ACA $1,800 medicine bill at the allergist? $0 under the ACA.

I found out that I saved even more though. Roughly another $2,600.

*The Osmond Family Plan & Shaking the 21+ Off the Family Tree*

The very nice Cigna agent informed me that I saved more with the ACA than I thought. With seven in my family, Obamacare does not allow insurance companies to charge for more than the first three children in a household as long as they're under 21 years of age and living with you full time. My two younger children were receiving healthcare then, essentially, for free.

One of the most unpopular portions of the ACA, if you're an insurance company, has been the law's right to keep family members on the plan until they are 26 years old. Group pricing depresses what they can charge individual eighteen to twenty-somethings and nicks profits on plans that big insurers sell to colleges, most of which required health insurance even before the law passed.

At midnight of three 21st birthdays in our blended family, you could hear my insurance bill fattening up 76.4%. My two "free" kids became paid, and my three new young adults moved up a rate tier.

The barrel of the insurance company "gun" was pointed square at my head: Take the college plans and keep my good insurance, or move down in care and up in potential expenses to get a better price and keep everyone on the plan. Ultimately separating the twenty-somethings was the only sensible way to go.

I now pay for four plans, even though all of them are with the same insurance carrier, both at home and at school, for less than the one plan at the new, higher rate. It dropped my 78 percent rate spike to just 9.1 percent.

Just.

I share with you my story because it is emblematic of the level of complexity of the bloated private insurance-based ACA that is both inefficient and costly. It is a system whose "bottom line" focuses on corporate profits and executive compensation, not patient care, cost control, and improved outcomes.

*You Betta Shop Around*

I was told by a Healthcare.gov email to shop around for 2015, and not assume my plan was okay. There were HMOs, PPOs, and EPOs, all well explained by the Washington Post.

48 percent of the plans offered in Florida were Health Maintenance Organizations (HMOs), a bit ahead of the national average. Millions of Americans have to take these plans because they're often the most affordable. None of my doctors participate in them though.

21 percent were the sneaky Exclusive Provider Organization, an HMO/PPO hybrid which flat-out does not allow you to see a doctor outside of your provider network AT ALL other than in an often narrowly defined "emergency."

How's that a fail? Say someone goes to an EPO provider doctor and clinic for a routine colonoscopy which is "free" in the EPO plan. Well, sort of. The anesthesiologist doesn't happen to be in the EPO. You get their full $700.00 bill, and not even a negotiated discount from the insurer. It also doesn't count towards your deductibles or out of pocket.

Rates, terms, and conditions remain the achilles heel of the ACA. The private market has created, intentionally, a hodgepodge of rates, with hidden cost trap doors. You might save $1800 on the cost of a slightly different plan, but one trip in an ambulance, or even a few expensive medicines to take care of an eye problem or healing a broken bone could evaporate that discount and leave you $11,000 or more on the hook under deductibles and the out of pocket "cap."

*Silver and Gold*

The tiers "Platinum,""Gold""Silver" and "Bronze" are virtually useless designations, at least on the federal exchange. There are Bronze plans that cost as much, if not more, than Gold ones, and Silver plans priced under Bronze. Offerings too, are the wild west. An PPO or EPO plan can offer better features on the Silver tier for less than a comparable HMO bronze plan.

*New Year. Old Healthcare.gov Problems*

The national exchange generally works. It remembered my 2014 contract, let me remove family members, and only failed once on showing me plans. A thirty minute hold for a specialist at Healthcare.gov, and I was told to delete the application and try again on Saturday morning, as the system was being swamped again with new applicants and it was overwhelming it.

It was my third call of the day, including two to Cigna, my current provider, to ask questions about plans and how to deal with minor problems in the ACA system, the Cigna system and between systems. I spent about four hours reading plans, and sorting things out, including the two-and-a-half hours to wait for advice over different phone calls to a local advisor, Cigna, and Healthcare.gov. Some of the personnel were well educated to the information and very helpful. Others, particularly at the government help line, were pretty clueless.

The private insurers are no more apt at dealing with insuring a lot of people either. Last year it took nearly eight weeks for Cigna in Florida to digest all of the new business coming from Healthcare.gov, issue account numbers and send out insurance cards. When I called this year to ask if I needed to pay the "deposit" of the first month on Healthcare.gov if I already had a Cigna account and wasn't changing plans, the operator really didn't know. They told me to pay the first month in the ACA system, and have the insurance company credit me if they double-bill me for it. Such efficiency and clarity!

*Medicare for All*

Single payer would make both the patient's and doctor's lives much simpler, improve care and reduce costs in the system. The Physicians for a National Health Program put it best:
"Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. As a result, administration consumes one-third (31 percent) of Americans' health dollars, most of which is waste."
Listening to endless background music at the different bureaucracies and help centers, I got one whose radio background was playing the appropriate Talking Heads tune "Road to Nowhere" which my bored brain gave a little health care-related spin...

"Well we know that we're growin'
And we know that we're agen'
And Healthcare.gov ain't goin'
So we can't see what what's the pla-an,

Yes we're not little children
And we want our good health,
But without single payer,
We just transfer dwind'ling wealth

We're on a road to health care
Come on sign-up
Takin' that ride to health care
Don't just give up.

I'm feelin' okay this mornin'
And you know,
Get hit by a bus and pay the price,
Down we go, down we go...

Getting everyone into the pool was a good first step. Costs are high and services on any plan are mediocre to poor at best unless spend huge amounts of your annual income for a "cadillac" plan. That was the case before Obamacare, and, while it has forced insurers, most of whose logos should be a skull-and-crossbones, to play a bit more "fairly" with consumers, we have a long way to go just to climb up to a standard of cost effective care enjoyed over much of the world today that is a bit wiser than we are.

My shiny two. Reported by Huffington Post 8 hours ago.

Crunch time again for health insurance sign-ups

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President Barack Obama's push to cover America's uninsured faces another big test Monday. Reported by Deseret News 8 hours ago.

Obamacare Enrollment Off to Healthier Start This Year

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Obamacare Enrollment Off to Healthier Start This Year Filed under: Health Care, Personal Finance, Internet, Barack Obama, Health Insurance

*HealthCare.gov/AP*

By RICARDO ALONSO-ZALDIVAR

WASHINGTON -- Sign-up season for President Barack Obama's health care law is off to a stronger start this year, even as Americans remain skeptical that the government's newest social program is right for the country.

As one major enrollment deadline was passing Monday, other second-year milestones quickly approached. The administration seems well on the way to its goal of 9.1 million customers enrolled for private coverage through government-sponsored online markets. But it's not there yet.

Public attitudes toward Obama's signature law are only slightly less chilly than before the congressional midterm elections that saw Republicans, still clamoring for its repeal, win both chambers of Congress.

An Associated Press-GfK poll earlier this month found an uptick for the Affordable Care Act, with 29 percent saying they support it, compared with 25 percent in October. Opposition to "Obamacare" was stable at 41 percent, while the rest were on the fence.
In nearly every state, Monday was the deadline for new customers to pick a health plan to take effect Jan. 1, and for current enrollees to make changes that could reduce premium increases before the new year. Open enrollment season doesn't end until Feb. 15, for coverage that takes effect March 1. Current customers can still make plan changes through that date.

Based on early numbers from the administration, it's looking like the majority of the 6.7 million current customers have opted to stay in their current plans and be automatically renewed on Jan. 1. Making sure that happens as smoothly as it's been advertised is the administration's next major challenge.

In Des Moines, Iowa, Cheryl James said she and two of her adult nieces helped each other and managed to sign up without too much trouble. James, who is studying early childhood education, found out she qualified for almost no-cost insurance under Iowa's Medicaid expansion, financed through the health care law.

"We are pretty satisfied with the coverage," said James, who's in her late 40s. "It took a couple of tries, but we weren't frustrated. It wasn't difficult."

Like Iowa, Tennessee has a Republican governor. On Monday it became the 28th state to accept the health care law's Medicaid expansion. Even as congressional Republicans are still vowing to overturn the law, 10 GOP governors have initiated expansions in their states.

As Monday's deadline for Jan. 1 coverage approached, HealthCare.gov and state health insurance websites saw a jump in traffic. Wait times at the federal call center stretched to 20 minutes and longer. The federal government is running the insurance markets in 37 states. Also known as exchanges, the markets offer subsidized private plans to people who don't have coverage on the job.

Consumers have different motivations for signing up. Enrollment counselors say they are starting to see more people worried about incurring fines for remaining uninsured. The fines are going up substantially in 2015, to a minimum of $325, from $95 this year.

"We are seeing a surge of folks coming back with questions," said Nita Carter of UHCAN Ohio, an advocacy group promoting sign-ups. "We are also seeing a surge of uninsured people who understand they will have to pay a penalty, and they want to get insurance."

*Too Many Plans?*

Health insurance companies can no longer turn people away because of health problems, but picking a plan still is daunting for many. Consumers also have to navigate the process of applying for or updating federal subsidies, which can be complex. Many returning customers are contending with premium increases generally in the mid-to-high single digits, but much more in some cases.

Last year's open enrollment season turned into a race to salvage the reputation of the White House by fixing numerous technical bugs that crippled HealthCare.gov from its first day. With the website now working fairly well, sign-up season this year is a test of whether the program itself is practical for the people it is intended to serve.

The administration's next big logistical challenge is making sure that millions of current customers will have a smooth transition to 2015. The plan is for their existing coverage to renew seamlessly, but it's the first time the government has attempted to coordinate that transition.

Most current customers who do nothing will be automatically renewed Jan. 1 in the plan they now are in, and that still may be a good idea for many consumers who missed Monday's deadline for Jan. 1 changes.

But staying in their current plans also may mean getting locked into a premium increase and missing out on lower-priced plans for 2015. It also means keeping the 2014 tax credit, which may be less than what enrollees legally would be entitled to for next year.

-Associated Press Director of Polling Jennifer Agiesta contributed to this report.
 

Permalink | Email this | Linking Blogs | Comments Reported by DailyFinance 8 hours ago.

Can My Husband Buy His Own Plan on the Health Insurance Marketplace?

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Can My Husband Buy His Own Plan on the Health Insurance Marketplace? Reported by ajc.com 8 hours ago.

Wonkblog: Most Obamacare enrollees are ignoring tonight’s deadline, and it will cost them

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Monday night marks a pretty important deadline for Obamacare — the last chance for most existing customers to sign up for new coverage starting Jan. 1 that would potentially save them hundreds, if not thousands, of dollars on health insurance next year. And it looks like a deadline that most are going to let slip by. Reported by Washington Post 8 hours ago.

New Obamacare Tax This Filing Season: Your Shared Responsibility

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It’s the first season you have to report your health insurance status on your tax return. Are you ready? Reported by Forbes.com 7 hours ago.

Lyft plays Whac-a-Mole with regulators nationwide

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David Estrada persuaded California, Florida and Nevada to legalize self-driving cars two years ago as Google legal director. [...] as Lyft’s vice president of government relations, he needs to work with regulators nationwide — and worldwide starting in 2015 — to create frameworks for Lyft’s on-demand rides by regular people driving their own cars. Estrada, who’s been at Lyft since January, played a key role in the company’s agreement last week to settle allegations by the district attorneys of San Francisco and Los Angeles that it misled customers and violated state laws. The prosecutors sued rival Uber, while Lyft agreed to share more information about its background checks, allow regulators to check how its app calculates fares, and not operate at California airports without permits (it has an OK to work at SFO). Is your job like a game of Whac-a-Mole as Lyft opens in new cities and encounters fresh backlashes from lawmakers and others? Most people would sign up for Lyft if they could do it standing at line in the grocery store and spend five minutes and then have Lyft do all the work of background checks, and a driver mentor to meet you and inspect your vehicle and take a ride. People can prepare for the test, get a clean result and get back on the road; it does nothing to deter drug/alcohol use. Privacy for ride passengers has been in the news. Only a very limited group of people at Lyft have access to personally identifiable information on trips. Just people on the customer service team who need to respond to queries, and key executives. Anyone else who needs access goes through a protocol creates by the legal department to demonstrate why they need it. What are Lyft’s long-term goals about reducing car usage? France wants to be a leader in the sharing economy, for instance, but the taxi drivers don’t feel the same way, and it just banned UberPop (Uber’s nonprofessional service, similar to UberX). Do you see changes coming to provide more protections for people who don’t have the benefits and security of a full-time job? The sharing economy frees workers from being dependent on an employer providing all their benefits. With the Affordable Care Act they can purchase health insurance on their own. Many are students, firefighters, musicians, teachers — they don’t want us to be their employer, they have an employer already or they don’t want one. Carolyn Said is a San Francisco Chronicle staff writer. Reported by SFGate 6 hours ago.

WellCare Appoints Kenneth A. Burdick CEO and Board Member

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WellCare Health Plans, Inc. (NYSE: WCG) announced that its board of directors has appointed the company’s president and chief operating officer, Kenneth A. Burdick, as CEO, replacing David J. Gallitano, effective Jan. 1.

Tampa, Fla. (PRWEB) December 15, 2014

WellCare Health Plans, Inc. (NYSE: WCG) announced that its board of directors has appointed the company’s president and chief operating officer, Kenneth A. Burdick, as CEO, replacing David J. Gallitano, effective Jan. 1. Burdick is also now a member of WellCare’s board. Gallitano has served on an interim basis as the company’s CEO since November 2013, and will remain as WellCare’s non-executive chairman of the board.

“Ken demonstrates the kind of leadership that the board believes is necessary to lead WellCare into the future,” said Gallitano. “Over the past year, Ken has been instrumental in developing our strategy, building the infrastructure we need for the future and transforming our company's culture. Further, his extensive health care background will enable him to continue to effectively implement the company's long-term plans.”

"I'm very optimistic about WellCare’s mission and direction,” said Burdick. “We are making great progress on our strategic plan, and I’m honored to have the opportunity to lead this company into what is an exciting and promising future.”

Burdick joined WellCare in January 2014 as president, national health plans, and was promoted to president and chief operating officer in June 2014. Prior to joining the company, Burdick was CEO of Blue Cross and Blue Shield of Minnesota. From 2010 to 2012, Burdick was with Coventry Health Care as CEO of the Medicaid Division and also served as CEO of MHNet, Coventry’s behavioral health subsidiary. Before that, Burdick spent 14 years as an executive with UnitedHealth Group, rising through positions of increasing responsibility, including CEO of UnitedHealthcare Group’s commercial business where he held P&L responsibility for $26 billion in revenue, and CEO of UnitedHealthcare’s Medicare business. Burdick has served on a number of boards in the health care industry. He holds a bachelor’s degree in American Studies from Amherst College and a law degree from University of Connecticut School of Law.

About WellCare Health Plans, Inc.
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members nationwide as of Sept. 30, 2014. For more information about WellCare, please visit the company's website at http://www.wellcare.com or view the company’s videos at http://youtu.be/tWeMyxFaxgE. Reported by PRWeb 6 hours ago.

Coloradans stymied by tech errors when enrolling for health insurance

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Consumer complaints over technical difficulties with the state health insurance exchange, Connect for Health Colorado, increased as an enrollment deadline came and went on Monday. Reported by Denver Post 6 hours ago.

With Hospitals Under Stress, Tennessee’s Governor Pursues Medicaid Expansion

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Gov. Bill Haslam proposed using federal funds to cover 200,000 low-income residents through their employer’s health insurance plan or the state’s Medicaid program. Reported by NYTimes.com 3 hours ago.

A long vacancy: Controversial religious freedom diplomat takes helm

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Washington D.C., Dec 15, 2014 / 07:19 pm (CNA/EWTN News).- The U.S. Senate voted 61-36 on Friday to confirm Rabbi David Saperstein as the next U.S. Ambassador at-large for International Religious Freedom.

“Those of us who have followed religious freedom issues at home and abroad over the years know how dire the situation is today for many religious communities around the world,” said Rev. Dr. C. Welton Gaddy, president of Interfaith Alliance, in response to the confirmation. “David’s leadership has never been more needed, may he go from strength to strength.”  

The position, as an official part of the U.S. State Department, is charged with promoting and protecting religious freedom abroad.

The ambassador position has been vacant for much of President Obama’s time in office. It was empty for the first two years of his presidency, until Rev. Suzan Johnson Cook was sworn in to the office in May 2011.

Cook resigned in October 2013, and the administration did not nominate Saperstein until July 2014. Dr. Tom Farr of Georgetown University, a prominent advocate for global religious freedom, called the extended vacancy “bizarre.”

Rabbi Saperstein will be the first non-Christian to hold the position. Nominated by Secretary of State John Kerry on July 28, he is the head of the Religious Action Center for Reform Judaism and was the first chair of the U.S. Commission on International Religious Freedom when it was created by Congress in 1999. He was named the most influential rabbi in the country by Newsweek in 2009.

Saperstein has also chaired the Coalition to Protect Religious Liberty and served on the board of the NAACP and as a member of the White House Council on Faith-Based and Neighborhood Partnerships.

His nomination drew praise from many, including Dr. Farr, for his previous work to promote religious liberty abroad. However, it was met by criticism in other circles for his opposition to the Supreme Court’s Hobby Lobby decision.

That decision, issued June 2014, protected Hobby Lobby and its Christian owners from the demands of the federal contraception mandate, which requires employers to offer health insurance covering contraception, sterilization and some drugs that can cause early abortions. The owners of Hobby Lobby said that the mandate forced them to violate their religious convictions; the Supreme Court agreed.

Saperstein was a supporter of the 1993 Religious Freedom Restoration Act, the law under which Hobby Lobby found protection from the mandate. However, the rabbi argued against an “overbroad interpretation” of the act. He thought that Hobby Lobby was not protected under the law in claiming a religious exemption to the contraception mandate.

The rabbi insisted that “all women must have the right to make their own health care choices according to their faith and conscience – including when it comes to reproductive health.”

He also supported a Senate bill that would have overturned the Hobby Lobby decision and required religious employers with group health plans to cover birth control, regardless of their religious beliefs. The U.S. bishops and religious freedom advocates throughout the country staunchly opposed the bill, saying it would do away with conscience protections for business owners.

Saperstein drew support in the confirmation vote from all the Senate Democrats except for Sen. Joe Manchin (D-W.Va.). Republicans opposed the confirmation by a nearly four-to-one ratio.

Sen. Tom Coburn (R-Okla.) acknowledged that Saperstein’s views on the Hobby Lobby case contributed to his “no” vote.

“I don’t agree with his philosophy, especially how he opposed the Green family from Oklahoma,” he told CNA.
  Reported by CNA 3 hours ago.

Covered California extends deadline to sign up for Obamacare

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California's health insurance exchange extended its deadline for consumers who want Obamacare coverage in effect beginning Jan. 1. Reported by L.A. Times 2 hours ago.

Gov. Cuomo Orders NY Health Insurers to Cover Sex-Change Operations

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Gov. Andrew Cuomo (D) has told New York health insurance companies they must cover sex-change operations and other treatments considered to be “medically necessary” to attempt to change a man or woman's sex.

The New York Times reports that Cuomo sent a letter to insurance companies indicating that the coverage for such treatments and surgeries stems from state law’s requirement that health insurers provide coverage for psychological disorders.

“An issuer of a policy that includes coverage for mental health conditions may not exclude coverage for the diagnosis and treatment of gender dysphoria,” said the Governor in his letter:



The current, fifth edition of the DSM recognizes a diagnosis of gender dysphoria2 for people whose gender at birth is contrary to the one with which they identify. Since the DSM classifies gender dysphoria as a mental disorder, and it is thus covered under the Empire Plan, Timothy’s Law requires an issuer delivering or issuing a group or school blanket policy in New York that provides coverage for inpatient hospital care or for physician services to provide coverage for the diagnosis and treatment of gender dysphoria.



According to the Transgender Legal Defense & Education Fund, New York is now the ninth state to require insurance coverage for sex-change treatments and surgery. The state is also in the midst of settling a lawsuit that seeks Medicaid coverage for sex-change surgeries. Reported by Breitbart 1 day ago.
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