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Wonkblog: Why it would be hard for Obamacare to recover from a Supreme Court loss

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The Supreme Court on Wednesday will hear about the potential disruption in health insurance coverage for millions of people if Obamacare subsidies are struck down in the nearly three dozen states that didn't set up their own exchanges. Behind the scenes in these states, insurers are scrambling to keep the subsidies in place, as I and my colleagues wrote over the weekend. Reported by Washington Post 56 minutes ago.

Courting Disaster: Obamacare Is Back At The Supreme Court, And These 6 Lives Hang In The Balance

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Obamacare is back before the Supreme Court in a case that could gut the health care law and leave millions of Americans facing severe consequences.King v. Burwell, a lawsuit that originated in conservative and libertarian think tanks, alleges that a stray phrase in the Affordable Care Act -- “an exchange established by the state” -- means the federal government isn’t allowed to provide subsidies to the residents of states that refused to establish health insurance exchanges under the law.

Only 13 states and the District of Columbia have their own exchanges. If this bid to derail the Affordable Care Act succeeds, the subsidies would disappear -- maybe immediately, maybe a little later -- for Obamacare enrollees everywhere else.

Behind the numbers, however, is a very human story. Without the subsidies, health insurance costs would spike beyond the means of low- and moderate-income recipients. As a result, close to 10 million people would lose their health coverage. Many others would face major increases in the premiums they pay for insurance.

The Huffington Post interviewed six Americans at risk of the worst effects of a high court ruling against Obamacare. We wanted to know how the law has affected their lives already, and how the absence of subsidies might affect them in the future. They told stories of life and death, financial ruin, lifelong plans in jeopardy and families disrupted. Here are those stories, as told by the people who would be living them.
Karen Hines
VirginiaJoe Lucas
PennsylvaniaJay Joshi
TexasDave Price
IllinoisSheila Tyson
AlabamaJared Blitz
Arizona Reported by Huffington Post 9 hours ago.

Courting Disaster: Going Without Health Insurance Could 'Bankrupt Me,' Chicago Man With Skin Cancer Says

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Press play to hear Dave Price tell his story.

Over the last eight years, Dave Price has beaten skin cancer, struggled with the transition into a new career in his 50s and eaten away at the savings he worked decades to build. What happens next is in the hands of the nine justices on the Supreme Court.

Price, 59, is covered by a health insurance plan he bought from an Obamacare exchange. Under the Affordable Care Act, he couldn’t be turned down because of his pre-existing condition. His family income of less than $30,000 a year means he and his wife, who live in Chicago, qualify for tax credits that make the coverage affordable. If the Supreme Court invalidates those subsidies in Illinois and more than 30 other states, Price faces a decision: tap even deeper into his retirement fund to pay for health insurance, or leave the cancer unchecked. It’s not much of a choice, he said.

“If they pull the subsidy, we’re going to have to stay in ACA and pay the full cost,” Price said. That would mean more than $13,000 a year in health insurance premiums and out-of-pocket costs. Price said his twice-yearly cancer checkups cost $2,000 each, and having new melanomas removed costs up to $5,000. “I joke around with my kids that with the cancer, they’re burying me a piece at a time,” he said.

Price was diagnosed with melanoma in 2007. At the time, he had health insurance from his job, where he worked as an operations director for a manufacturing company. That coverage paid for $85,000 worth of cancer treatments. Price left his job in 2010 to go to graduate school to become an adult educator. He currently works part-time as a job trainer at a community college.

Before Obamacare, health insurance and out-of-pocket costs came to about $10,000 a year, and Price spent down his savings and tapped his retirement fund to get by. When he signed up for insurance on the exchange, his costs went way down.

“The difference was, my premiums went from $5,600 a year to $1,800 -- basically saving $3,800 a year,” Price said. “Most of that savings is from the ACA subsidy.” Price and his wife receive a tax credit worth a little under $300 a month. Their insurance plan is comparable, and in some ways better, than what he had prior to Obamacare, he said.

“I have to keep insurance,” Price said. “The melanomas, if I catch them early, are three to five grand apiece. If I were to have anything like the one I had before, it would bankrupt me.”

*For more personal stories about the real-life effects of the Supreme Court case, go to Courting Disaster: Obamacare Is Back At The Supreme Court, And These Six Lives Hang In The Balance.*

The audio interviews in this feature were produced and edited by Ibrahim Balkhy and Brad Shannon. Reported by Huffington Post 9 hours ago.

Courting Disaster: 'There's No Humanity In What's Going On'

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Press play to hear Jared Blitz tell his story.

If the Supreme Court rules that Obamacare subsidies in more than 30 states are illegal, millions will lose their health insurance because they won’t be able to afford it. Others will keep their plans in spite of the subsidies disappearing -- and that’s a problem, too.

Jared Blitz, 33, knows he needs medical care and has a costly surgery on the horizon. Because his subsidy is small, he plans to keep his insurance even if the high court rules against the law.

“For somebody like me, I can handle it,” said Blitz, who lives in Mesa, Arizona. “I also think of health care as being one of the major priorities because I have a heart condition, so if I have to pay a higher premium, that’s something I don’t have an issue with. So the subsidies would be nice, but I can make due if I don’t have it, just because I’ll sacrifice elsewhere.”

Eliminating the subsidies will drive people out of the insurance market, and those who remain will mainly be people with costly medical conditions who need the coverage most, like Blitz. This will drive up costs for insurers and lead to rate hikes for everyone left in an increasingly volatile market.

Blitz was born with a heart condition called aortic valve stenosis, meaning one of his heart valves is too narrow. Soon, perhaps later this year, he will need another surgery to stay alive. The operation cost $200,000 when he was 17, and his next will cost about $50,000. Blitz also needs tests on his heart every year that cost up to $3,000.

Blitz went uninsured for a time after finishing graduate school as he endured rejections by health insurers. One company offered to insure everything but his heart, essentially providing useless coverage for someone with his condition. He finally settled for a plan that exposed him to unlimited out-of-pocket costs and would have left big expenses uncovered if he’d needed surgery or had a medical emergency.

When Affordable Care Act enrollment started, Blitz signed up for a plan with better coverage than his old insurance at a slightly lower cost. He gets a small subsidy that was $50 a month last year and $20 a month this year. Blitz earns about $25,000 a year as a part-time college professor. Arizona’s health insurance exchange is run by the federal government because the state declined to establish its own.The lawsuit before the Supreme Court claims subsidies are only legal in state-run exchanges, not federal ones.

What really concerns Blitz is the possibility that the Affordable Care Act’s rule that insurance companies have to cover people with pre-existing conditions will go away, something congressional Republicans favor as part of repealing Obamacare.

“They may as well line me up and kick me in the balls,” Blitz said. “That’s just brutal to do to people. I don’t get it. There’s no humanity in what’s going on.”

*For more personal stories about the real-life effects of the Supreme Court case, go to Courting Disaster: Obamacare Is Back At The Supreme Court, And These Six Lives Hang In The Balance.*

The audio interviews in this feature were produced and edited by Ibrahim Balkhy and Brad Shannon. Reported by Huffington Post 8 hours ago.

Courting Disaster: After Liver Transplant, Anxiety About Health Care Costs Without Obamacare

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Press play to hear Sheila Tyson tell her story.

A sudden illness nearly killed Sheila Tyson two years ago, throwing her life into disarray. She lost her job and burned through every penny she had -- and then some. Affordable health insurance is keeping her alive and afloat today, but that could soon change just as suddenly.

Tyson, 59, needed a liver transplant in 2013 after the Hepatitis C she’d had for years rapidly worsened. Luckily, her doctors found a donor within three weeks and the surgery went well, but her recovery was complicated when her Hepatitis returned. A new drug called Sovaldi, which costs more than $80,000, cured her, but Tyson couldn’t go back to work and her employer cut her off.

With that job went the health benefits, forcing Tyson to pay $600 a month for COBRA coverage, plus another $200 for medications, at a time when she wasn’t bringing home a paycheck.

“I was faced with no insurance, faced with no income and I want to live,” Tyson said. “I was about to lose everything -- my house, my car, my dignity. I mean, my life.”

When enrollment under the Affordable Care Act started in the fall of 2013, Tyson, who lives in Birmingham, Alabama, signed up for a subsidized plan that cost $19 a month. Alabama relies on a federally run health insurance exchange, which makes Tyson vulnerable to losing her coverage if the Supreme Court rules against the law later this year after hearing oral arguments Wednesday.

Tyson still hasn’t been able to find work, despite a full recovery. Without a job, she tries to get by on $900 a month in disability benefits and $90 in food assistance. Subsidized health insurance has helped her maintain her health and manage her expenses, but her situation is precarious.

“I have nothing left. I’m struggling today,” Tyson said.

Without the subsidies, Tyson simply wouldn’t be able to afford the insurance. “No way. If I did keep it, I would be choosing between having a roof over my head and my life,” she said. “Where would I cut corners? It would be food -- I would be trying to go to food banks.”

So after narrowly avoiding a medical and financial disaster two years ago, Tyson could end up facing a life-or-death threat again: unable to afford doctor visits or drugs she needs to keep taking to prevent her body from rejecting her new liver.

“It would be a waste of me even getting a transplant, basically,” she said.

*For more personal stories about the real-life effects of the Supreme Court case, go to Courting Disaster: Obamacare Is Back At The Supreme Court, And These Six Lives Hang In The Balance.*

The audio interviews in this feature were produced and edited by Ibrahim Balkhy and Brad Shannon. Reported by Huffington Post 8 hours ago.

Courting Disaster: 'Obamacare Came Just In Time For Us'

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Press play to hear Jay Joshi tell her story.

When Jay Joshi first heard about the Supreme Court case that could take away the health insurance subsidies that enabled her family to get covered, “it came as a total shock,” she said.

Joshi’s husband, Kaye, has diabetes and was uninsured before the Affordable Care Act went into effect. The family was paying full price for his insulin at the pharmacy or stocking up on cheaper medicines during their visits every two years to India, the country they left more than three decades ago for life in the United States.

“He’s 62 and I’m 60, so this is the age when I think health issues start cropping up. So we really needed some health insurance, and Obamacare came just in time for us,” said Joshi, who lives in Richardson, Texas, outside Dallas. The couple and their two sons got subsidized coverage for less than $300 a month on the state’s insurance exchange, which is run by the federal government. The lawsuit before the Supreme Court alleges only exchanges created by states themselves are permitted to provide these tax credits.

Things have been tougher since Jay Joshi’s career as a travel agent dried up and the family’s laundromat went out of business during the economic downturn. Kaye Joshi has only ever run small businesses and has no experience doing anything else, but the family doesn’t have the money to open a new one. Jay Joshi has been working part-time as an after-school teacher, but they’ve had to spend down their savings.

Having a pre-existing condition kept her husband without health coverage even when things were going better, Joshi said. “It was very, very difficult -- almost impossible -- to get him insurance, and my greatest fear was if something was to happen to him and he had to be hospitalized, that would be a big expense for us,” she said. Health care already ate up a quarter of the family’s budget even without a catastrophe, she said.

When they got Obamacare, it was "a sigh of relief for us,” Joshi said. The "nervous edge" she felt about the financial toll of an unseen health emergency dissipated. Losing their health insurance subsidies now, however, would put the Joshi family back at square one.

“I’ve just been keeping my fingers crossed that Obamacare is not taken away, the subsidy is not taken away," Joshi said. "Because I believe, looking at my invoice that I have, it’s something that I don’t think I can afford without the subsidy.”

*For more personal stories about the real-life effects of the Supreme Court case, go to Courting Disaster: Obamacare Is Back At The Supreme Court, And These Six Lives Hang In The Balance.*

The audio interviews in this feature were produced and edited by Ibrahim Balkhy and Brad Shannon. Reported by Huffington Post 9 hours ago.

Courting Disaster: To Keep Health Coverage, House Painter Would Work Himself Sick

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Press play to hear Joe Lucas tell his story.

Joe Lucas paints houses, and he’s worked for decades to set himself up for retirement. He paid off his house early, and now that he’s in his 50s, he hopes to start winding down his career and getting ready for the next phase of his life. But thanks to the looming Supreme Court decision, he might have to scrap those plans.

Health care costs were the big wild card, a fact driven home in 2010 when Lucas, who had no insurance, suffered an aortic aneurysm. The $69,000 hospital bill got paid in the end when Lucas learned he’d become eligible for Medicaid, but the episode was a wake-up call. That’s when he ran into the pre-Affordable Care Act health insurance market.

“I can’t let this happen again, so I was looking to purchase insurance,” said Lucas, 52. But his history of heart problems made him too much of a risk for the insurance companies serving his home city of Pittsburgh. “I was finding out that nobody wanted to sell me insurance.”

Lucas later signed up for a temporary Obamacare program for people with pre-existing conditions, at a cost of $279 a month. He enrolled in a private insurance policy last year through the Affordable Care Act’s exchanges that costs him about $150 a month, after a $220 tax credit.

The subsidies have made it possible “to take it just slightly easier and not have to kill myself,” said Lucas, who uses four medications daily to control his blood pressure and needs $11,000 worth of tests on his heart every year.

If the Supreme Court rules that subsidies on federally run exchanges, like the one Lucas used in Pennsylvania, are illegal, he is determined not to lose his coverage. “If I don’t have the insurance, I can’t see my cardiologist, that means I don’t get prescriptions for my blood pressure -- which is what’s basically keeping me in good health,” he said.

Lucas said he’d have to try to pile on more work, if he can find it, to keep his insurance.

“I worked 40 to 60 hours for almost 30 years. So I kind of figured that between 50 and 70, I was hoping to slow down,” he said. “It definitely would erode time off my lifespan.”

*For more personal stories about the real-life effects of the Supreme Court case, go to Courting Disaster: Obamacare Is Back At The Supreme Court, And These Six Lives Hang In The Balance.*

The audio interviews in this feature were produced and edited by Ibrahim Balkhy and Brad Shannon. Reported by Huffington Post 9 hours ago.

Courting Disaster: How Losing Health Insurance Would Change The Lives Of One Breast Cancer Survivor And Her Mother

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Press play to hear Karen Hines tell her story.

Obamacare allowed Karen Hines, a three-time breast cancer survivor, to get health insurance she was denied before because of her medical history. It also gave her the financial help she needed to buy it. But if those subsidies disappear after a Supreme Court ruling in June, Hines is mostly worried about what will happen to her ailing mother.

Hines spends her days caring for her 84-year-old mother, who suffered a stroke in 2010 and has dementia, in their Virginia Beach home. Hines, 59, is able to do so because she has her own health care needs covered, but if she lost the subsidies she’d have to return to full-time work that provides health benefits. That would mean her mother would have to spend more time away at elder care and less time at home with her daughter.

“It would be tough on my mother,” Hines said. “It would be harder on her to go to day care more for a longer period of time, because she needs a break and she needs some rest.”

Finding a job that provides health care wouldn’t be easy for Hines. She left behind her career in public relations more than a decade ago to pursue graduate studies in American history, aiming to become an educator. Her third breast cancer diagnosis in 2009 and the side effects of chemotherapy interrupted her studies and teaching work, and she took medical leave in 2013. She hasn’t worked since, and subsists on the “pittance” she receives from Medicaid for looking after her mother.

“Look, life’s not really hopeful out there for a 59-year-old to go into the workforce again,” Hines said. “Considering that I was in graduate school and so away from my longest type of employment, my skills are not current.”

Hines pays about $250 a month for her health insurance, after a subsidy of more than $200. She got the insurance on a federal health insurance exchange because Virginia didn't set up one. The lawsuit before the Supreme Court claims only state-run exchanges can distribute subsidies. She figures she could dig deeper into her retirement savings to pay the full price for about a year, but doesn’t know how she’d cope after that.

Even during that first year, Hines would have to cut back on her coverage and her medical care, a dicey proposition for someone still at risk for cancer even after having both her breasts and her ovaries removed.

“I’ll scrimp back as far as I can to make sure that I can cover catastrophic care,” Hines said. “Everything else goes.”

*For more personal stories about the real-life effects of the Supreme Court case, go to Courting Disaster: Obamacare Is Back At The Supreme Court, And These Six Lives Hang In The Balance.*

The audio interviews in this feature were produced and edited by Ibrahim Balkhy and Brad Shannon. Reported by Huffington Post 8 hours ago.

Population Health, Accountable Care Payment Reform, and Analytics Lift the Mired Payer BPO Market towards $8.0B, Black Book Survey

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The health payer outsourcing industry anticipated whopping gains from the expansion of health insurance access to more than 30 million Americans but post-ACA deals ran lackluster in contrast to the stakeholder expectations revealed in a 2013 Black Book poll. However, a new health plan BPO marketplace is emerging, driven by the urgencies for claims processing modernization, big data aggregation, member information security, population health and business intelligence, rebooting the industry and signifying a 22% year-to-year increase, the majority of new contracts being linked to these revolutionary business process outsourcing services.

New York, NY (PRWEB) March 03, 2015

The US healthcare payer industry, facing a number of challenges due to regulatory reform and market disruption is motivated by the potential of implementing unconventional business process outsourcing and innovative software-as-a-service. Increasingly, health plans, particularly newly established plans and provider-based payer organizations, are flocking to BPO to help them operate smarter by reducing the cost of front, middle and back office processing.

Black Book’s survey 5,400 health plan BPO user were collected from Q3 2014 to Q1 2015. Top ranking vendor results can be accessed at http://blackbookmarketresearch.com/health-plans-payers/

“At a time of great change in health care, BPO vendors are helping public and private payers achieve great efficiency and cost savings, improve transparency and member services, and enhance the health plans’ ability to participate in the reforming health care business models,” said Doug Brown, Managing Partner of Black Book.

The payer market place for traditional BPO services rose only 13% in contrast to the 7.2 million new paying members enrolled in plans as a result of the Affordable Care Act. “The routine BPO functions of claims adjudication, call centers, and member processing produced only modest gains for outsourcing vendors compared to projections which could have emerged had the 30 million possible new Obamacare members been realized,” said Brown.

However, inventive and unchartered administrative services in the industry, which include government payers, private health plans, commercial insurers, hospital and physician/provider sponsored plans, third party payers, managed care organizations, accountable care organizations and care management groups stand are pushing the $5.2B 2014 BPO marketplace to a predicted $8.0B in 2016.

“Payer contracting in these evolving areas has nearly doubled in just the past twelve months,” said Brown. From Q1 2013 to Q1 2015, Traditional payer BPO services including call centers, member enrollment and claims processing barely pushed a 9% CAGR as reported to Black Book.

The most popular BPO functions now span outsourcing analytics, new plan set up, claims modernization, alternative payment services, utilization management, security, value-based solutions development, sales and marketing, population health and big data initiatives, and multi-channel contact center management.

“The most significant opportunities for outsourcing service providers to support both public and private insurers lies within member analytics, population health and claims processing modernization.”

87% of health plan managers polled collectively indicated population health, software-as-a-service, accountable care/chronic care management assistance, big data aggregation, health information exchange, data security, and analytics are their top priorities in 2015-2016. 74% indicated they would likely outsource the development and management of new value-based payment models because of inadequate technology, staffing, resources or competing IT ventures currently underway.

83% of payers participating in the survey confirmed improved claims processing and modernized claims system capabilities top organizational strategies with project start dates before Q2 2016. 68% indicated they are considering outsourcing among the best solutions for claims modernization at this time.

61% of health plans are contemplating outsourcing utilization management by 2016, and 27% of payers are currently reviewing the potential for plan effectiveness by outsourcing care coordination and case management.

“Recent outsourcing adoption advances are being fueled by service and start up urgencies of newly developed health plans, expanding provider-based plans, and insurers experiencing higher membership demands driven by Obamacare,” said Brown. “But 92% of current and prospective users source the big gains for payer BPO vendors to the need for swift solutions to address increased regulatory governance, controlling fraud/waste/abuse, and the lack of capabilities in the current mix of in-house technologies.”

Black Book determined the major upturns in outsourcing implementations were in large part due to the 39% of small to medium sized plans now contracting for some processes, up from 20% in 2012. Eight of ten of the largest US health plans are outsourcing significant portions of their operations, including offshored services to India and the Philippines.

Top vendors were honored by clients in nine payer BPO service and software categories for outstanding health plan performances across eighteen key performance indicators through Q1 2015. These top rated vendors include:

Population Health Services: Cost Optimization, Value Based Solutions, Accountable Care & Care Management – Lumeris

Population Health: Utilization Management - HCCA

Population Health: Analytics & Big Data Management – IBM Global

Claims Processing & Modernization – Xerox

Member Services & Contact Centers – Hexaware

Provider & Network Management Services– Trizetto

Payer Marketing & Sales Outsourcing – IMS Health

Revenue Cycle & Coding Support Outsourcing - DST Health Solutions

Health Insurance Exchange Support - Dell

About Black Book ™

Black Book Rankings, a division of Black Book Market Research LLC, provides healthcare IT users, media, investors, analysts, quality minded vendors, and prospective software system buyers, pharmaceutical manufacturers, and other interested sectors of the clinical technology industry with comprehensive comparison data of the industry's top respected and competitively performing technology vendors. The largest user opinion poll of its kind in healthcare IT, Black Book™ collects over 450,000 viewpoints on information technology and outsourced services vendor performance annually. Black Book was founded in 2000, is internationally recognized for over 15 years of customer satisfaction polling, particularly in technology, services, outsourcing and offshoring industries.

Black Book™, its founders, management and/or staff do not own or hold any financial interest in any of the vendors covered and encompassed in this survey, and Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results.

Follow Black Book on Twitter at http://www.twitter.com/blackbookpolls For methodology, auditing, resources, comprehensive research and ranking data, see http://blackbookmarketresearch.com Reported by PRWeb 8 hours ago.

Maryland bill could change the way your company buys health insurance

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Maryland legislators are considering a change to health insurance rules that would make it harder for small businesses to self fund, a cheaper alternative to buying a traditional health plan that is increasingly popular. Self-funding is a type of health insurance in which businesses use a pool of money to cover the cost of employees health costs, instead of buying a health plan through an insurance company. These companies buy what's called stop-loss insurance, which kicks in should an individual… Reported by bizjournals 8 hours ago.

WellCare Partners with The Results Companies to Bring More than 150 Jobs to Paris, TX

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WellCare Health Plans, Inc. (NYSE: WCG), and The Results Companies today announced a partnership that expands WellCare’s call center operations and brings more than 150 jobs to Paris, Texas.

TAMPA and FORT LAUDERDALE, Fla. (PRWEB) March 03, 2015

WellCare Health Plans, Inc. (NYSE: WCG), and The Results Companies (Results), a premier global customer experience provider for Fortune 500 companies, today announced a partnership that expands WellCare’s call center operations and brings more than 150 jobs to Paris, Texas. As a result of the expansion, a new call center, The Results Companies’ Customer Experience Center, has been established in Paris. The facility provides customer service support for WellCare’s Medicaid, Medicare and Prescription Drug Plan businesses.

WellCare and Results celebrated the grand opening of the facility with a ribbon cutting ceremony. Local community leaders, including State Rep. Gary VanDeaver (D-1) and members of the Lamar County Chamber of Commerce participated in the event.

"I would like to thank WellCare and The Results Companies for their long-term commitment to providing jobs that will help to boost and support our local economy,” said State Rep. Gary VanDeaver (HD-1). “The creation of more than 150 jobs is confirmation that Paris has much to offer employers and employees."

“I am pleased that WellCare and Results have chosen Paris for their expansion,” said State Sen. Kevin Eltife (SD-1). “Paris offers a skilled workforce and pro-business climate that will contribute to their long-term success.”

“This new call center supports WellCare’s mission to assist our 4.1 million members in accessing the care and services they need to be healthier and to enjoy better quality lives,” said Scott Black, WellCare’s vice president, channel communication services. “We look forward to working with Results to become a valuable business partner in this community.”

“As The Results Companies continues to grow, we are excited about expanding in Paris, Texas with WellCare, one of our most tenured clients,” said Robert Rapp, Results’ Chairman and Founder. “Results understands that the success of this opportunity is based on a strong partnership - a partnership between Results, WellCare and the community of Paris. Partnerships only succeed when all parties are invested in the outcome. We look forward to the community of Paris helping Results support WellCare and its other clients.”

The new facility is expected to be fully operational by the end of March and still has approximately 25 open positions. For more information about the positions or to apply, visit the companies’ websites at http://www.wellcare.com and http://www.theresultscompanies.com.

As of Dec. 31, 2014, WellCare serves approximately 29,000 Medicare Advantage and 127,000 Medicare Prescription Drug Plan members in Texas.

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 4.1 million members nationwide as of Dec. 31, 2014. For more information about WellCare, please visit the company's website at http://www.wellcare.com or view the company’s videos at https://www.youtube.com/user/WellCareHealthPlan.

About The Results Companies
For more than 20 years, The Results Companies has served as a premier global customer experience provider for Fortune 500 companies and uniquely designed, built and operated award-winning call centers that have set the standard for innovative customer-focused contact solutions. We offer a full range of services that include customer service, acquisition, enrollment, retention, membership support services and transaction processing to outbound sales and retention campaigns. Entrusted with over 45,000,000 relationships a year, our success and proven ability to respond to our Partner’s growth has enabled us to expand our global footprint. With over 9,300 employees in 18 locations in the United States, Philippines, and Latin America, The Results Companies’ expertise extends beyond call centers. We’re experts in representatives, analytical technologies, brand fulfillment and creating strategic advantages for our Partners. Visit TheResultsCompanies.com to learn more. Reported by PRWeb 7 hours ago.

Janet Yellen Gets the Need for Rising Wages. That's Why Republicans Are Out to Get Her.

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First, let's start with the good news, developments that are both important and a long time coming. Thursday's reports from the Bureau of Labor Statistics showed:
1) For all employees, real hourly wage growth (i.e., growth above the rate of inflation) came in at 1.2% in January, 0.5% of which came from increased wages and 0.7% of which came from a drop in inflation (mostly from a reduction in energy costs).

2) For all private, nonfarm employees, real hourly wages increased 2.4% from January 2014 to January 2015, and--thanks to an increase of 0.6% in the average workweek--real weekly wages increased by 3.0%.

3) Within private, nonfarm employees, for nonsupervisory and production employees (i.e., workers as opposed to management) real weekly wage growth was *3.8%* from January 2014 to January 2015.

This increase in weekly real wages is worth applauding, particularly because it is *higher* for regular workers than for management. I don't usually use bold fonts, but sometimes data can make a person's eyes glaze over. This stuff is too exciting to miss.

Not that many years ago, annual raises of 4 percent or more were common. However, inflation in those years was much higher than it is right now. If inflation increased by 4 percent, and you got a 4 percent raise, then you really got no raise at all. Over the past 12 months, inflation actually decreased by 0.1 percent, which helps workers' purchasing power significantly.

So now to Janet Yellen. She was nominated by Barack Obama, and became the chair of the Federal Reserve just over one year ago. She is not only the first woman chair, she's also the first Democratic nominee to serve as chair since Paul Volcker ascended to the position in 1979. That's because Bill Clinton decided in 1995 to reappoint Alan Greenspan, a conservative Ayn Rand acolyte initially nominated by Ronald Reagan. In January 2001, Greenspan provided crucial cover to George W. Bush's plan to cut taxes (mostly on the rich) by predicting that the projected federal surplus was so substantial that we could both have a big tax cut and still completely (cough) pay down our national debt.

Congress charged the Federal Reserve with a mandate to seek "maximum employment, stable prices, and moderate long-term interest rates." However, Fed chairs have typically focused more on fighting inflation (i.e., keeping prices stable) than on seeking maximum employment. At least until Yellen arrived, that is. To a degree that separates her from previous Fed chairs, Yellen has expressed strong concerns about economic inequality, notably in an October speech:
It is no secret that the past few decades of widening inequality can be summed up as significant income and wealth gains for those at the very top and stagnant living standards for the majority. I think it is appropriate to ask whether this trend is compatible with values rooted in our nation's history, among them the high value Americans have traditionally placed on equality of opportunity.
In Yellen's testimony before Congress earlier in the week, she addressed this issue as it relates to Fed policy. Perhaps the most important decision the Federal Reserve makes is where to set interest rates. Keeping interest rates low has a stimulative effect, while raising them slows or even halts economic growth. William McChesney Martin, the longest-serving Fed Chair, famously said that the primary job of the Fed was "to take away the punch bowl just as the party gets going," i.e., to make sure that economic growth doesn't get so strong as to set off an inflationary spiral.

The problem comes when Fed chairs see that as their only job, and forget that he or she also must seek maximum employment. Typically, the only time when wages can grow enough to really improve workers' lives is when unemployment is low and the labor market gets tight--giving employees the leverage they lack when they feel lucky just to have any job at all. The Great Recession gave us years when that was the case, although now, finally, things are improving. 2014 was the best year for job growth since 1999. For example, the raises announced recently by Walmart, TJ Maxx, and Marshalls resulted from the tightness of the labor market, as well the organizing work done by employees, not a sudden commitment to a living wage on the part of corporate headquarters.

The stage is now set for decent wage growth going forward, unless the Fed decides to take the punch bowl away and raise interest rates off the historic lows--just above zero percent--at which they've been since December 2008. Yellen has made clear, however, that she is not going to raise rates until and unless labor market conditions continue to improve. At this point, as she testified, "too many Americans remain unemployed or underemployed" and "wage growth is still sluggish."

In response to Yellen's testimony, Republicans expressed what we might call a degree of displeasure. Rep. Mick Mulvaney (R-SC) told her: "You're sticking your nose in places that you have no business to be" by considering issues such as wage growth, long-term unemployment, and income inequality. Rep. Sean Duffy (R-WI)--the guy who complained that he "struggle[d]" on his congressional salary of $174,000 per year--attacked Yellen for talking about income inequality last October and offering a "political backup" (whatever that is) to Democratic candidates who made it an issue on the campaign trail.

Yellen pointed out that she had only been discussing economic trends that are "a problem that everyone in this room should be concerned about," and added, "I am not making political statements. I am discussing a significant problem that faces America .... I didn't offer any policy recommendations whatsoever in that speech." To Republicans, it seems even just talking about data is partisan and political. Imagine what they'd think of actually doing something to counter poverty, wage stagnation, and income inequality. Instead, what they want to do is bring Yellen under their control and stop her from sticking her nose in places they don't think it should be.

On the one hand, government programs have played a major role in alleviating poverty, as Josh Barro at the New York Times explained. Based solely on pre-tax income, the percentage of Americans living in poverty would have jumped by 5 percentage points from 2007 to 2012, i.e., the period following the Great Recession of 2008. Thanks to Medicaid, food stamps, unemployment insurance, and other government programs that automatically aid people earning less than a certain amount--along with measures President Obama and congressional Democrats enacted as specific reactions to the crash, such as the stimulus and extensions of unemployment insurance--the percentage of Americans living in poverty increased by 1 percentage point instead of the aforementioned 5. No small feat.

Additional changes Democrats enacted, including Obamacare--which taxed the rich to provide health insurance premium subsidies to middle- and lower-income Americans and expanded Medicaid--as well income tax hikes on high earners, will further help combat income inequality going forward. Raising the minimum wage is also an important step, albeit one that only some states and localities have taken. But those measures, many of which took effect in 2013 or later, are just now starting to have a real impact. In reality, they can only do so much when it comes to broader income inequality and helping those who are neither rich nor poor. The biggest, most broad-based development that would help both those toward the bottom and those in the middle is rising real wages for American workers. Yellen's approach to setting interest rates reflects her understanding of that fact.

As long as inflation remains low--the Fed considers an annual inflation rate at or below 2 percent to be consistent with price stability--Yellen can keep interest rates low. If she does so, we can start to really reverse the trend of no real wage growth over the past four decades. It is absurd that real hourly wages in late 2014 were at the same level they were in 1979. The high point for average inflation-adjusted wages was actually January 1973.

To get back to that level and--here's a radical notion--maybe even surpass it, we need someone in charge at the Federal Reserve who understands that creating conditions that increase the purchasing power of American workers' paychecks is a part of her mandate. From what she's said and done so far, it appears Janet Yellen is exactly that kind of Fed chair. Reported by Huffington Post 6 hours ago.

Here Are The States Where Obamacare Subsidies Could Disappear

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A new Supreme Court case could strip affordable health care from as many as 10 million people.

At issue in the case King v. Burwell is the Affordable Care Act's health insurance subsidies, which help millions of Americans afford health coverage. If the Supreme Court rules against the government, thereby gutting one of the most fundamental aspects of the law, it'll mean that the federal government can't subsidize health care in states that declined to establish their own marketplaces under Obamacare. That'll make health insurance unaffordable for many of the poorest, sickest Americans.

Here's a map that shows how dire things are. For the 13 states and Washington D.C. that have established their own state-run marketplaces, nothing will change as a result of the ruling. Residents of the 37 remaining states stand to lose their health insurance.

Map by Alissa Scheller. Reported by Huffington Post 4 hours ago.

The Man Who Didn't Want Health Insurance

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King is the face of, but not the driving force behind, this latest major challenge to the Affordable Care Act. Reported by IBTimes 4 hours ago.

U.S. Doctor Shortage Could Hit 90,000 By 2025

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The nation’s shortage of doctors will rise to between 46,000 and 90,000 by 2025 as the U.S. population grows, more Americans gain health insurance and new alternative primary care sites proliferate. Reported by Forbes.com 4 hours ago.

PreferredOne lost $139M on its individual plan bet

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PreferredOne's big bet on the individual health insurance market in MNsure's first year didn't pay off. The Golden Valley-based company's individual-plan business lost $139 million last year, the Star Tribune reports, citing financial filings released Monday. Its broader insurance business posted a much smaller loss of about $21 million for the year. PreferredOne dominated MNsure in the state-run health insurance exchange's first year by offering some of the cheapest premiums nationwide. That success… Reported by bizjournals 3 hours ago.

Apple Shifting Security Team From Contractors to Full-Time Employees

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Apple has decided to hire the majority of its day-to-day security staff in Silicon valley as full-time employees, a company spokeswoman confirmed to the San Jose Mercury News. Many of the security guards that Apple has hired in the past as contractors will become part of the company's expanded in-house security team and receive the same benefits as other employees, including full health insurance, retirement contributions and a leave of absence for new parents.
Apple security guard in dispute with photographer at iPad event (via The Australian)

Apple will continue using contractors as security guards for special events, such as the upcoming "Spring Forward" media event at the Yerba Buena Center for the Arts on March 9th. Apple is believed to have begun constructing an extension on the Yerba Buena Center over the weekend, possibly as an Apple Watch demo area, and security guards wearing "Apple Security" shirts were spotted monitoring the premises.

"We will be hiring a large number of full-time people to handle our day-to-day security needs," the spokeswoman told the San Jose Mercury News. "We hope that virtually all of these positions will be filled by employees from our current security vendor and we're working closely with them on this process."

Apple has faced increasing pressure to provide individuals who cook, clean and monitor security for the company with the same benefits as other employees. Local union United Service Workers West staged a protest on Apple's headquarters in Cupertino, California in December over complaints that its security contractor Security Industry Specialists treated workers poorly and that many positions were part-time.

Other service workers in Silicon Valley are also fighting for better wages and benefits. The Wall Street Journal reported that a group of 158 bus drivers working for Compass Transportation, which provides shuttle service for Apple, eBay, Genentech, Yahoo and Zynga, voted on Friday to be represented by local union Teamsters Local 853 in negotiations with Compass over fair working conditions.*Recent Mac and iOS Blog Stories*
• AT&T Modio LTE Case for Wi-Fi iPad Mini Launches March 20 for $49.99 with Contract
• Pebble Introduces 'Pebble Time Steel' Following Successful Kickstarter Campaign
• iCloud Photo Library: What You Need to Know
• Google's New Take on Mobile Payments Puts Focus on Developers With Android Pay
• IBM Expands MobileFirst for iOS Portfolio With Three New Apps
• Next-Generation iPhones Said to Feature Force Touch, Lack Dual-Lens Camera System
• SanDisk Announces 128GB iXpand Flash Drive and Updated Sync App With Touch ID
• Apple Watch Debut in 'Style' Suggests Space Gray Pricing May Start at $349 Reported by MacRumours.com 3 hours ago.

This dire prediction shows what's at stake in the new Supreme Court fight over Obamacare

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This dire prediction shows what's at stake in the new Supreme Court fight over Obamacare The Supreme Court will hear arguments Wednesday in a new Obamacare fight over whether the federal government can keep subsidizing insurance in the roughly three dozen states that refused to set up healthcare marketplaces. 

The justices' decision could gut Obama's health reform law and determine whether thousands of Americans live or die, according to a brief filed by public health professionals in that case.

The dispute revolves around the interpretation of four words in the law. Obamacare opponents argue the law limits health insurance subsidies to people living where a healthcare exchange had been "established by a state" because that is what the Affordable Care Act (ACA) technically says. If the Supreme Court agrees with that literal reading of those four words, 8.2 million people in America will lose their health insurance, according to the amicus brief filed by the American Public Health Association.

That brief went on to say that the "interrelationship between insurance coverage, healthcare access, and population health" means that a loss of insurance of that magnitude translates to 9,800 additional deaths every single year.

"Nothing in the ACA requires these terrible health outcomes," the brief stated.

This is the second time the high court has heard a challenge to Obamacare. In 2012 the Supreme Court upheld another key part of Obamacare — the requirement that most people buy health insurance or pay a penalty. To make insurance affordable, the law stipulated that states would set up subsidized exchanges. If the states could not set up exchanges, the law said the federal government would create one for the state.

In fact, the majority of states failed to establish their own exchanges, forcing the federal government to step in. Now, opponents of the law — four Virginia residents who don't want to buy health insurance — claim the law doesn't authorize subsidies for people buying insurance from exchanges set up by the federal government.

They point to text of the law specifying that subsidized insurance is available through "exchanges established by the state." Read literally, that would exclude exchanges the federal government established on behalf of states.

But the federal government says those four words must be read in the context of the law. In a brief to the Supreme Court, the US Secretary of Health and Human Services points out that subsidized insurance is the key to making the entire law work. Those four words shouldn't be read in a vacuum, the brief said.

While the Supreme Court hears the case Wednesday, it could be months before a decision is reached. Chief Justice John Roberts, a conservative, was the surprise swing vote the last time the court ruled on Obamacare and could play a decisive role in the case again.

Join the conversation about this story »

NOW WATCH: A lawyer in Florida has come up with an ingenious way for drivers to evade drunken-driving checkpoints Reported by Business Insider 32 minutes ago.

Right to Work? Right-Wing Origin

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Mark Twain famously noted, "History doesn't repeat itself, but it does rhyme." The current efforts to roll back the ability of working people to counterbalance the corporate domination of American politics is firmly rooted in the initial corporate opposition to the Wagner Act of 1935 that finally assured American workers the right to organize and bargain for wages and working conditions. Among those early efforts to reduce the strength of unions was an effort led by Vance Muse.

Muse, a Texas oil man, didn't like unions and he really didn't like the shape the union movement was taking in the 1930s. Large industrial unions like the United Auto Workers and the United Steelworkers were growing with white and black workers. Turns out Muse represented the old-line plutocrats' views on economics and race. His view of this new-found economic "brotherhood" was: "From now on, white women and white men will be forced into organizations with black African apes whom they will have to call 'brother' or lose their jobs."

In 1946, his extremism led to an expose by journalist Stetson Kennedy. He reported in Southern Exposure that Mrs. Muse drove home the couples' views on race when she addressed "Eleanor Clubs." Rumors had circulated throughout the South of Eleanor Clubs -- supposed organizations of black domestic servants seeking better wages and working conditions, named after Eleanor Roosevelt for her leadership on race and worker justice. The clubs never existed -- they were just figments of racist imaginations like Mrs. Muse's. She said:

"$15 a week salary for all n----- house help, Sundays off, no washing and no cleaning upstairs." As an afterthought she added, "My n----- maid wouldn't dare sit down in the same room with me unless she sat on the floor at my feet!"

Muse led the efforts of the "Christian Americans" to pass state-level legislation to limit the growth and strength of unions, first in his native Texas, and then throughout the South.

To make it sound more modern and familiar, the movement went to Kansas in the 1950s, where the "right to work" movement was led by Fred Koch, a co-founder of the John Birch Society, and precursor of the Koch brothers. Kansas passed its right to work law in 1958.

The result has been two America's when it comes to the right of workers to organize and have an organized voice in the political process: one free, the other fettered and chained to one-sided politics. But for African Americans it has been another hurdle to decent pay and work conditions.

The America that is hemmed in by right to work laws is home to more than half the African American workforce. Those states have the lowest share of workers in unions, much lower than the national average. Yet because African Americans are the group most likely to belong to unions, it is clear the lower union density for African Americans in right to work states reflects legal barriers, not workers' wishes.

African Americans are strong supporters of unions because of the gains they enjoy through union membership. Work by Janelle Jones and John Schmidt at the Center for Economic and Policy Research highlights that compared with similarly educated workers in the same industry and state, black union members receive 15.6 percent higher pay than nonunion black workers; they are also 36.7 percent more likely to have employer-provided health insurance and 49.1 percent more likely to have an employer-provided pension plan.

The weaker position of unions in right to work states means generally lower labor standards. All eight of the states with state minimum wages lower than the federal minimum wage are right to work states. Less voice for workers, more voice for corporations means an economic playing field tilted to corporate greed. The Economic Policy Institute calculates that the wages of otherwise similar workers are 3.2 percent less in right to work states.

The nefarious nexus of racism and right to work laws cannot be easily dismissed. Researchers David Jacobs and Marc Dixon find a strong link between racial divisions among workers and politicians feasting on this to pass right to work laws. Researcher Gilbert Gall analyzed the voting patterns in Missouri's 1978 attempt at right to work and found a strong opposition vote in urban, black districts. So the division is not necessarily a divide on how black workers see unions, as much as it is whether votes are driven by the same plutocratic ploys of subliminal racism linking conservative plutocrat "values" to right to work.

In its modern form, this is often an appeal to Libertarian individualism, unions being the antithesis, while corporations (organized capital) somehow embody individualism. It's an old trick. And falling for it only dooms one to ignore history. Reported by Huffington Post 50 minutes ago.

SCOTUS vs. The ACA

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This post originally appeared in The Washington Spectator.

By Lou Dubose

The amicus briefs filed in the challenge to the Affordable Care Act (ACA) to be argued before the Supreme Court on March 4 illuminate the Great American Political-Cultural Divide.

Those who filed briefs in defense of Obama's legislation are recognizable: the American Cancer Society, the American Academy of Pediatrics, et al. There is a different anthropology among those who filed briefs supporting the plaintiffs who are challenging tax subsidies for low-income buyers of health-care insurance policies.

Texas's Black Americans for Life considers abortion and contraception "a tool by some who wish to target the African-American community."The amicus briefs filed in the challenge to the Affordable Care Act (ACA) to be argued before the Supreme Court on March 4 illuminate the Great American Political-Cultural Divide.Colorado's Mountain State Legal Foundation is "dedicated to bringing before the courts those issues vital to the defense and preservation of individual liberties, the right to own and use property, and the free enterprise system."

The American Civil Rights Union is "dedicated to defending all of our constitutional rights, not just those that might be politically correct."

Senator John Cornyn of Texas is named on the amicus brief filed by 16 Congressional Republicans, an unlikely choice to lead any health-care pleading.

At 26.8 percent (24.81 percent after ACA enrollment), Texas leads the nation in the percentage of residents lacking health-care coverage. It also leads the nation in the number of eligible residents, 1,046,430, who are shut out of Medicaid. Texas, like 25 other Republican-led states, has rejected the Medicaid expansion provided through the ACA.

 
*A Fight over Five Words*

King v. Burwell is a fight over five words in the statute: "Exchange established by the State."The ACA creates insurance-market exchanges through which anyone can purchase private health-insurance policies. In an attempt to subvert the law, most states governed by Republicans refused to establish exchanges. But the law also created a federal exchange, where residents who are denied access to state exchanges can purchase insurance. Currently, state and federal exchanges provide subsidies for low-income purchasers of insurance.

According to the plaintiffs, one phrase in a section of the statute describing the subsidies -- "Exchanges set up by the State" -- restricts the subsidy program to state insurance exchanges, although other language indicates that Congress intended to extend subsidies to all insurance buyers who meet the law's income qualification.

This lawsuit isn't what it claims to be.

Contradictions and hypocrisy underlie the intent of the plaintiffs and the politicians supporting them.

Consider the plaintiffs.

David King and three other residents of Virginia, which has no exchange, qualify for subsidies provided through the federal exchange. They are asking the Court to overturn the subsidies, because, on ideological grounds, they object to the ACA's mandate requiring individual health-care coverage.

Consider the elected officials.

John Cornyn, for example. Or Florida's Marco Rubio, or Utah's Jake Garn, or Tennessee Rep. Marsha Blackburn. All signed the anti-subsidy amicus brief filed with the Court, and all represent states whose Republican governments refused to create exchanges. They are petitioning the Supreme Court to hand down a decision that will strip subsidies from low-income residents in the states they represent.

It requires at least four justices to decide to hear a case. The activist and Republican majority on the Roberts Court has decided to hear the appeal of a lawsuit filed and financed by ideologues determined to destroy the Affordable Care Act.

To decide on behalf of the plaintiffs, the justices will have to ignore principles by which they have decided cases requiring them to interpret the meaning of statutes. Yale Law School Professor Abbe Gluck explains in an article published by Scotusblog. --------------------Professor Abbe Gluck on King v. Burwell from Yale Law School on Vimeo. --------------------Republican justices, he writes, in particular Antonin Scalia, are "textualists" who have "repeatedly emphasized that textual interpretation is to be sophisticated, 'holistic' and 'contextual,' not 'wooden' or 'literal,' to use Justice Scalia's words."

Gluck quotes Scalia's explaining textualism in an opinion handed down in June 2014, in which the justice describes "the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme."

Gluck also quotes four of the five Republican justices who published a joint dissent in the 2012 case that upheld critical provisions of the ACA. They address the very subsidies that are now before the Court: "Congress provided a backup scheme; if a State declines to participate in the operation of an exchange, the Federal Government will step in and operate an exchange in that State. That system collapses if the federal subsidies are invalidated."

The preceding sentence is critically important. The Republican justices know "the system collapses if the federal subsidies are invalidated." --------------------Lou Dubose is the editor of The Washington Spectator.

See also: "Kill the Bastard: The Money Backing the Obamacare Supreme Court Case." Reported by Huffington Post 5 minutes ago.
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