In the Illinois exchange, Blue Cross anticipates average rate increases of 29% or more for next year. In Texas, Blue Cross has suffereed huge losses and is asking for a rate increase of 20%. In Pennsylvania, Highmark Health Insurance Co. is asking for 30%. Around the rest of the country, [...] Reported by Forbes.com 17 hours ago.

Dr. Angus Worthing of the Arthritis & Rheumatism Associates, P.C. is fighting for arthritis patients' health, treatment, and medication cost. Authoring the recent article published by The Washington Post "Protecting Access to Medication," Dr. Worthing discusses the rising cost of arthritis medication and the impact on patients financially.

Washington, DC (PRWEB) June 23, 2015

Dr. Angus Worthing of the Arthritis & Rheumatism Associates, P.C. is fighting for arthritis patients' health, treatment, and medication cost. In a recent article published on June 5 by The Washington Post "Protecting Access To Medication," where Dr. Worthing was the contributing author of the piece, he disclosed patients medication cost is exceeding budgets across the Washington, DC district.

Who's to blame and how is the cost impacting patients' health in the long-term? Dr Worthing explains, "Patients are forced to share the high cost of a specialty prescription with their health insurance company — $10 or $20 co-pays for a drug have morphed into co-insurance with the patient paying a percentage of the cost of each prescription. That’s intended to turn people toward generic and other less-expensive medicines, but sometimes a specialty drug is the only one that works". Moreover, this cost can become especially expensive if you suffer with Rheumatoid Arthritis, excelling up to 50 percent, averaging thousands of dollars per month.

Dedicated to his craft of providing outstanding treatment options for arthritis, Dr. Worthing partnered with DC Council member Mary Cheh and Anita Bond to introduce The Specialty Drug Co-payment Limitation Act of 2015. The bill, if passed, would limit the cost of specialty drug co-payments in the Washington, DC District.

The fight for capping cost is spreading in neighboring states, such as Maryland and Delaware, with successful results. Meanwhile the Washington District and Virginia area await their fate. While lawmakers are putting on their thinking caps to pass this over deserving bill, medical officials such as Dr. Angus Worthing continue to stay on the frontline raising a voice for patients and more affordable medication options. Reported by PRWeb 16 hours ago.

New York could become the first state in the nation to classify pregnancy as a "qualifying event" for health insurance enrollment under a new bill awaiting Democratic Gov. Andrew Cuomo's signature.

Both chambers of the state's legislature approved the bill last week. Since pregnancy was not included as a qualifying life event under the Affordable Care Act, the legislation would add it to the list of life events -- birth of a child, marriage, divorce, adoption, leaving incarceration and becoming a U.S. citizen among them -- that qualify a New Yorker to enroll in private, employer-sponsored or state exchange insurance plans at any time outside designated open enrollment periods.

The push to add pregnancy to the list of life events gained momentum earlier this year when New York City Comptroller Scott Stringer issued a report highlighting barriers to health care access for pregnant women. Stringer's report noted that uninsured women may face up to $20,000 in out-of-pocket costs for prenatal and maternity care. New York has the country's second-highest rate of unintended pregnancy, at 61 percent.

"The economic and health benefits of proper healthcare during pregnancy and in the early stages of a child's life are well documented," the report read. "A woman should not have to wait until her baby is born to receive the services she needs from our state's insurance marketplace. Through this action, we will show our commitment to the health and wellbeing of mothers and their children, as well as the principle of access to healthcare for all."

Some businesses and the insurance industry had opposed the bill on the grounds that it could open the door to allowing other conditions to become qualifying events, but reproductive rights groups hailed the bill's passage.

"Pregnancies are quite often unplanned, making limited enrollment periods impractical for many women," Andrea Miller, the president of NARAL Pro-Choice New York, said in a statement. "This legislation is good for the health of all New York families, and NARAL Pro-Choice New York looks forward to working with Gov. Cuomo to ensure its compliance."

"High prenatal costs increase the likelihood that uninsured women without the option to purchase insurance will simply forgo care, jeopardizing their health," Miller added. "This legislation will improve access to care, leading to healthier women and healthier children."

Cuomo's office did not immediately respond to a request for comment from The Huffington Post as to whether he plans to sign the bill.

California may be close to enacting a similar bill, which passed out of the legislature's lower chamber earlier this month.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 14 hours ago.

There were several insights recently noted in the 2015 Employer-Sponsored Health Care: ACA’s Impact study that should draw attention and cause for planning. The average cost increase is 4 percent among employers that know their cost change due to ACA. These are larger self-funded employers that are not responsible for the health insurance tax, which adds over 2 percent more – making the increasing more than 6 percent. ACA-related costs are sadly hitting smaller employers much harder than larger… Reported by bizjournals 13 hours ago.

By Elyssa Kirkham, GOBankingRates.com

If you're in your 50s and have at least something saved for retirement, congratulations: You're in better shape than almost a third of older Americans.

Now stop celebrating. Even if you have a substantial nest egg, your savings could be quickly whittled down by a number of factors -- and one of the biggest is geography.

*Related: 10 Best and Worst Things to Do When Looking for a Place to Retire*

Deciding where to retire shouldn't be something you do based on weather or even proximity to kids -- let them do the driving -- they're more mobile than you anyway. If you want to retire rich, and maintain that wealth, you should be looking at important regional factors, such as taxes, local living expenses, and the affordability and accessibility of health care.

To make the search easier, GOBankingRates investigated all 50 states on those three components. We surveyed:
· *Taxes:* local rates of Social Security income, estate, inheritance, property and sales taxes· *Living expenses:* home values, listing prices, local deposit rates and a cost-of-living index· *Health care:* average individual insurance premiums, average Medicare payment and the health of seniors who take advantage of regional health care

The result: the best and worst states for retiring rich. Read on for the 10 best -- and then the 10 worst -- and see where you should be moving to when you retire.

-1. New Hampshire-New retirees will have a hard time finding as good a tax haven as New Hampshire, and that's largely why it topped our list of the best states to retire rich. The Granite State boasts no sales tax, no Social Security income tax, no estate tax and no inheritance tax.

What doesn't play in the state's favor is its high cost of living, bolstered by higher-than-average home prices and middling deposit account rates -- and the second-highest median property tax in the country.

Still, New Hampshire has one other thing going for it, and it's a big one: excellent health care. Though residents have to face higher-than-average monthly premiums, Medicare payouts are better than average, and seniors in the state are among the healthiest in the country, according to the United Health Foundation.

-2. Delaware-Delaware is another state with low tax rates for retirees, which pushed it to second place on our list. Residents enjoy no sales tax, no Social Security tax and no inheritance tax, though, unlike New Hampshire, Delaware does have an estate tax -- 16 percent. Also unlike New Hampshire, however, property taxes in Delaware remain low: At just 0.43 percent of a home's value, the state has the fourth-lowest median property tax in the nation.

In terms of health care, the average amount of Medicare paid out to Delaware residents is among the highest, though the average premium is on the pricier end. Delaware seniors are on the whole healthy -- the state is ranked 15th in the country for that.

The only category for which Delaware took a hit in our study was living expenses, with higher-than-average home prices and cost-of-living scores.

*Related: 28 Retirement Mistakes People Make*
-3. Idaho-Idaho's extremely low living expenses catapulted it to third in our study, with one of the lowest cost-of-living scores in the nation -- only Mississippi and Tennessee are cheaper. Retirees also have access to higher-than-average local deposit rates to grow their savings and low local tax rates; residents pay no Social Security, estate, or inheritance taxes and fairly low sales and property taxes.

Idaho was bumped out of the top two spots due to less-stellar health care scores: The state is middle of the line (24th place) when it comes to its seniors' health, and its Medicare payouts are only average. Still, the state's average individual insurance premiums are low -- among the 10 cheapest in the nation.
-4. Wisconsin-Retirees in Wisconsin have access to some of the best health care in the country, with the state ranking second in senior health thanks in part to low crime and widespread health care insurance coverage. That, combined with relatively low living expenses, helped it snag fourth place.

Other plusses: Wisconsin has no Social Security, estate, or inheritance taxes, and its sales tax rate is also one of the lowest. The caveat for home-buying retirees: Wisconsin's median property tax is fourth-worst in the nation, though home listing prices in the bottom third will help offset that cost.
-5. Wyoming-The biggest draw for retirees in Wyoming? No taxes -- almost. The state made it to the fifth spot on our list thanks to its favorable tax rates, including no taxes on Social Security, estate and inheritance, and low property and sales taxes. Those perks were tempered by some pretty expensive home prices, however, with the average listing price this month reported by Trulia at $415,000.

Though senior health in Wyoming is middling, the amount of Medicare paid out to retirees is far above average, which is good because the average insurance premium is high -- nearly $300.
-6. Alaska-The Last Frontier is where new retirees can go to escape taxes -- almost all of them. Alaska had the best tax score in our study: no Social Security, estate, or inheritance taxes, and the lowest average sales tax rate of any state that charges one (1.76 percent).

On the other hand, Alaska's lackluster health care dragged the state down in our rankings, even with one of the highest Medicare payouts. On average, residents pay a lot in premiums -- the average, $345, is fifth-highest in the nation. Meanwhile, senior health in the state is in the bottom 40th percentile.

The state is also surprisingly expensive; Alaska ranked fourth-worst on the cost-of-living index, and its home values are higher than average. The one silver lining when it comes to living expenses is Alaskan deposit rates, which are among the highest in the nation.
-7. South Dakota-Like many of the states toward the top of this study, one of South Dakota's biggest draws for retirees is its low tax rates. Unfortunately, these savings are slightly offset by a higher-than-average cost of living and abysmal deposit account rates -- South Dakota is in the bottom 20th percentile for interest.

On the other hand, residents enjoy much higher-than-average Medicare payouts -- in this regard, the state reaches the top 20th percentile. South Dakota seniors also made it (though barely) into the top 50th percentile for their health. The state was hampered by fewer dentists and primary care physicians. The good news, however, is that seniors in this state report have some of the highest frequencies of good physical and mental health days, and the state has little pollution.

*Related: You Don't Really Need a Million Dollars to Retire*
-8. Michigan-Retirees who want to live on less will like Michigan: It's the cheapest state in our top 10, with extremely low home costs and living expenses. Also cheap in Michigan are insurance premiums; The average is just $204, ninth-most-affordable on our list.

Several factors knocked the state down in the rankings, though, including a high median property tax rate and low average Medicare payouts. That's OK though -- Michigan seniors are still ranked relatively well for good health.
-9. Utah-Coming in at No. 9 is Utah, which had the best health care score in our top 10 (second overall). One of the biggest reasons the state ranked so highly is its residents pay the lowest premiums in the country -- $158, on average. Utah seniors are also uncommonly healthy -- they ranked 12th in the nation -- and they enjoy better-than-average Medicare payouts.

On the flip side, Utah's hefty housing expenses hit it hard in our ranking. The state has one of the highest average listing prices -- north of half a million dollars this month -- and an average home value of $208,600.

The good news for retirees is Utah has below-average property taxes and doesn't charge estate or inheritance taxes. It does, however, enforce a 5 percent Social Security income tax and average local sales tax rates of around 6.7 percent.
-10. Arkansas-Retiring in Arkansas will allow you to take advantage of fairly low living expenses and tax rates, but you will have to pay a bit more for your health care.

Arkansas seniors are among the least healthy in the nation, prone to smoking, obesity and cardiovascular disease. There are also fewer dentists per capita. The good news is premiums are pretty inexpensive -- $184 on average -- and residents get decent coverage from Medicare.

The state ranks well for cost of living and has one of the lowest average home listing prices -- $211,000. Residents don't pay Social Security, estate or inheritance taxes but do have to reckon with the second-highest combined sales take rate in the nation, which is upwards of 9 percent.
-10 Worst States for Retiring Rich-How do you keep more of your own money? Well, for starters, don't let it be picked apart by numerous taxes and fees. That was one thing the best states for retirees had almost universally in common; they had great tax rates.

But as important as the small expenses are, it's far more important to plan for the big ones -- like health care. Health care can be one of the biggest -- and least expected -- drains on your budget in retirement, and if you're in an expensive and unfriendly state when it comes to medical costs, you could easily find yourself up the creek without a paddle.

The following 10 states are some of the worst when it comes to expenses like these: big costs that can wreck your savings if you don't plan for them. Read on for the 10 worst states for retiring rich.
-1. New York-The Big Apple might be where you go to strike it rich, but retirees should look out of state if they're hoping to keep their money. New York came in as the No. 1 worst state for retiring wealthy, largely because of its abysmal health care score and high living costs.

Health care first: The average New Yorker pays insurance premiums of $429 a month, third-highest in the nation following New Jersey and Massachusetts. At the same time, average Medicare payouts in the Empire State are among the lowest in the country.

Meanwhile, the state is one of the most expensive in the U.S., ranking third-worst in this factor for having one of the highest costs of living and highest home listing price. Property and sales taxes in the state are also on the more expensive end, though New York doesn't tax Social Security or inheritances.

The good news is New York has an average deposit rate that's in the top 10 -- but that's only good news if you're able to save in the first place.
-2. New Jersey-Coming in second, right behind its neighbor across the Hudson, New Jersey has a lot in common with New York when it comes to retiring rich -- mainly, that it will be pretty hard to do it there.

That's because New Jersey has prohibitively expensive health care costs and high taxes. Residents pay the highest average insurance premiums in the country -- $473 a month -- and receive less-than-average Medicare payouts.

The state's cost of living is slightly more manageable than New York's, but its taxes are extensive, including some of the highest estate and inheritance taxes in our study. Your one reprieve, New Jerseyans, is no Social Security income tax.

Homes are somewhat more affordable in the Garden State than its neighbor, but New Jersey also has the worst median property tax in the nation, which keeps housing costs high. Turns out you're not really dodging a bullet by moving to the suburbs as a retiree.

*Read: 3 Ways to Salvage Your Retirement Plan If You Haven't Saved*
-3. Illinois-Thanks to its poor health care and tax scores, Illinois comes in at No. 3 on our list of the worst states for retirees. Though the state has no Social Security or inheritance taxes, its property and sales tax rates are among the worst in the country. Meanwhile, its average insurance premiums ($247) are on the more expensive end of the spectrum, and its average Medicare payouts are low.

Though Illinois is about average when it comes to cost of living, it's not a good place for savers: The average deposit rates are sixth-worst in the nation.
-4. Connecticut-Despite being one of the more affordable states for health care costs, Connecticut came in fourth on our list of the 10 worst states for retiring rich thanks to its high tax rates and living expenses.

Connecticut residents are taxed on just about everything that matters to retirees -- Social Security and estate, though not inheritance -- and have to pay one of the heftiest property taxes in the nation. Meanwhile, the state is the second-most expensive in the country, according to the cost-of-living index, with high housing prices to boot.

In terms of health care, Connecticut residents pay higher-than-average premiums -- $291 a month -- but also receive bigger Medicare payouts. The main thing the state has going for it? Its residents are healthy, ranked No. 6 in the nation.
-5. California-The Golden State is only golden in one area: tax rates. Residents don't have to pay Social Security, estate or inheritance taxes, though they do have to endure a higher-than-average sales tax rate.

In every other category, however, retirees have it rough. For one, California has one of the highest cost-of-living scores in the country, along with steep home prices -- including the second-most expensive average listing price in the country.

Meanwhile, in the health care arena, Californians receive some of the lowest average Medicare payouts in the U.S. but pay a lower average of $225 a month in insurance premiums. And all that sunshine can only help so much: Senior health in California is a little worse than average.
-6. Vermont-Vermont seniors are quite healthy -- they're ranked ninth in the nation. That's good news because they pay some of the highest insurance premiums out there: $401 a month, on average. The good news is Vermont residents also get the highest average Medicare payouts in the nation.

That's where the good news ends: Vermont retirees are taxed on almost everything -- estate, inheritance and Social Security income, for which the state has the second-highest tax rate in the nation. Property taxes in Vermont also run high and are matched by higher-than-average home prices, resulting in a headache for Vermont homeowners.

*Related: 10 Immediate Steps to Start Planning for Retirement in Your 40s*
-7. Rhode Island-This small state can cause huge problems for people who retire there, mostly because of its hefty tax rates. Rhode Island has the dubious honor of charging the highest Social Security income tax in the nation at 9.9 percent. Residents also pay taxes on their estates and run into fairly expensive property tax rates.

On the other hand, Rhode Island's health care scores are actually great, thanks to its seniors being among the healthiest in the country -- seventh of all the states -- and the third-highest average Medicare payments in the country. Still, average insurance premiums aren't cheap -- roughly $328 a month -- and neither is the cost of living or home prices. Retirees will have a hard time maintaining their wealth when they're being nickel-and-dimed by taxes and the high costs of living in this state.
-8. Massachusetts-Coming in at No. 8 on our list, Massachusetts is a perfect storm of bad conditions for keeping your money in retirement: It's an expensive state when it comes to day-to-day costs, has higher-than-average tax rates and doesn't offer much relief in health care costs.

Though the state doesn't have a Social Security or inheritance tax, its estate tax is one of the highest, and property and sales taxes are about average. The cost-of-living index puts Massachusetts as one of the more expensive states in the country, and you'll see that reflected in the states's exorbitant home prices.

The one thing Massachusetts seniors have going for them is their health -- they're among the healthiest in the country -- which will come in handy given that the state has the second-highest insurance premiums of all 50 states ($456 on average).
-9. Washington-Dying in Washington will cost you. The state has the worst estate tax rate in the country -- a whopping 20 percent. And though its residents don't have to pay state inheritance or Social Security income taxes, the average sales tax is also one of the worst in the U.S.

The state's health care is middling. Seniors are on the healthier side of the spectrum, but insurance premiums are higher than most, and average Medicare payouts are low. Meanwhile, the cost of living is high, local deposit rates are unimpressive and homes are pricey, making retiring in Washington an expensive endeavor.
-10. Nebraska-Nebraska actually has fairly good health care and cheap living expenses but was dragged into the bottom 10 thanks to its exorbitant tax rate. It received the worst tax score of any state in our study. The state has the highest inheritance tax rate in the nation -- 18 percent -- along with Social Security and property taxes that are among the worst in our study. The one reprieve for Nebraskan seniors: no estate tax.

On the other hand, Nebraska residents are, on the whole, pretty healthy. They pay fairly average insurance premiums and receive a just-below-average amount in Medicare payouts. Life in the Cornhusker State is also cheap; The cost-of-living index is low, as are average home prices. Also low, unfortunately for savers, are average deposit rates. Even so, these positive factors were not enough to offset the enormous tax burden Nebraskan retirees face.

*Related: Why 'Set It and Forget It' Doesn't Work for Retirement Savings*

*Methodology: *These rankings are the result of original research and analysis by GOBankingRates of costs affecting retirees. This cost analysis was based on three types of factors affecting retirees: state taxes, living and financial costs, and healthcare costs. These three factors (determined by 12 data points) were weighted equally to rank the states according to favorable financial conditions for seniors and retirees. Five state and local taxes were considered in these rankings: (1) state sales tax rates, sourced from The Tax Foundation; (2) state tax on Social Security income, sourced from SocialSecurityChoices.com; (3) state estate taxes; (4) state inheritance taxes, sourced from The Tax Foundation; and (5) property taxes, sourced from Tax-Rates.org. Four data points were included among the living and financial costs category: (1) median listing prices, sourced from Trulia; (2) median home values, sourced from Zillow; (3) cost-of-living index, sourced from the Missouri Economic Research and Information Center; and (4) GOBankingRates' own rates for savings accounts and 1- and 2-year CDs, sourced from its database that surveys rates from more than 4,000 U.S. financial institutions. Lastly, the rankings factored health care costs based on three data points: (1) the average health insurance premium, sourced from KFF.org; (2) portion of health costs covered by Medicare, sourced from CMS.gov; and (3) state's rankings on senior health outcomes from AmericasHealthRankings.org.

This article originally appeared on GOBankingRates.com: Best and Worst States to Retire Rich

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 12 hours ago.

Google X, the company’s experimental research arm, has developed a health-tracking band that moves beyond the consumer market and could be utilized in clinical trials or drug tests, Bloomberg reports.

The new band is designed to measure a variety of inputs including heart rhythm, pulse, and skin temperature. It can also track outside factors like noise and light.

The wristband won’t be marketed as a consumer product, Andy Conrad, who heads up Google’s life sciences team, told Bloomberg. Conrad said they intend it to be a "medical device that’s prescribed to patients or used for clinical trials." Most consumer trackers aren’t fit for research, he said. This one will be different. 

This won't be the first wearable to impact the medical community. People with diabetes have been particularly targeted by tech companies, and a variety of apps exist to help monitor things like blood sugar. According to The Washington Post, there are 1,200 apps for people with diabetes in Apple’s app store — some of which work with wearables. Google itself developed a smart contact lens for monitoring glucose levels.  

But Conrad hopes Google’s new wristband will also be used as a preventative measure, to help catch diseases early. "I envision a day, in 20 or 30 years, where physicians give it to all patients," Conrad said to Bloomberg. 

Some health insurance companies, like healthcare startup Oscar, are already experimenting with wearables. Oscar, which raised $145 million dollars in April, was the first health insurance company to give fitness trackers to its members; the company also rewarded them for taking a certain number of steps per day.

But with the idea of constant monitoring by an outside source — be it a doctor or a health insurance company — comes the issue of privacy. For those with chronic health conditions that require this level of medical scrutiny, this is perhaps a non-issue. But in the future Conrad envisions, one where physicians give Google’s band to all patients, the implications for consumers of private health care are unclear. Where will the data go, and how exactly will it be used? These are questions that will have to be sorted out.

Trials for Google’s wristband will start this summer.

*SEE ALSO: Here's how Google's diabetes contacts will work*

Join the conversation about this story »

NOW WATCH: Forget the Apple Watch — here's the new watch everyone on Wall Street wants Reported by Business Insider 12 hours ago.

New insight provided by cutting edge BI software helps clients in government, insurance, life sciences, technology and other industries identify new opportunities, improve processes and cut costs.

Overland Park, KS (PRWEB) June 23, 2015

Spending on Big Data continues to surge, with analyst firm 451 Research projecting that the data market will grow to $115 billion by 2019. With more data comes more need for analysis and strategy, and that’s why an increasing number of organizations across Kansas City and the Midwest have turned to Overland Park, Kansas-based Solomon Consulting Group for business intelligence (BI) consulting.

“Companies are dealing with more data from more sources than ever before, but this isn’t useful if it’s just information,” said Solomon founder and CEO Grant Gordon. “Our BI services help clients make better, faster, more informed decisions that give them a competitive advantage.”

In the past several months, Solomon has added organizations in government, life sciences, health insurance, technology and several other industries to its client list. The first component of Solomon’s BI consulting approach involves capturing, aggregating and interpreting data for customers using the latest BI software. The analytics are then presented in user-friendly reports that help clients find new opportunities, identify and fix bottlenecks and discover new opportunities.

Solomon – one of INC’s 500 Fastest Growing Companies – is also helping client put the insight gained into action with BI roadmaps and strategies that leverage the data analysis. With complete, accurate and up to date reporting at their fingertips, users can create new efficiencies across their organizations.

“You can only move forward when you have data that you understand and leverage, and our BI solutions are delivering new insights into information that was previously useless,” Gordon said. “This helps drive improvements that increase revenue and, for our life sciences and healthcare customers, enhance patient care and service.”

About Solomon Consulting Group

Solomon Consulting Group is a specialist provider of Business Intelligence (BI) solutions, Business Process Improvement (BPI) consultancy, technical staffing solutions and strategic consulting. Solomon's goal is simply to make their client's information technology departments better with their comprehensive solutions in staffing, reporting, analytics, process and software development. Solomon, named to the 2013 and 2014 Inc. 500 list of fastest growing companies, also provides staffing services and consulting for professionals making a career change. For more information, visit http://www.solomonbi.com. Reported by PRWeb 12 hours ago.

Winning can be more complicated than losing when it comes to the law known as “Obamacare.” That’s a reality Republican lawmakers are beginning to mull as the Supreme Court’s term draws to a close.Within a week, the justices are due to rule in King v. Burwell whether federal subsidies can flow through state health insurance exchanges created by the federal government. Reported by Washington Post 6 hours ago.

Bronx Community College was proud of Kalief Browder.

At the end of the 2014-15 school year, the 22-year-old had an impressive 3.55 grade point average. He led study groups. He tutored other students. And on June 5 -- just one day before Browder died by suicide in his mother's Bronx home -- he volunteered at a graduation rehearsal for other students.

"He was so happy," Elizabeth Payamps, a Bronx Community College faculty member who worked closely with Browder, remembers of his last day at the school. "He was acting completely normal."

Years earlier, Browder had been robbed of an education. When he was just 16, he was arrested on a burglary charge that would ultimately be dismissed. While his high school classmates went to prom and graduation, Browder languished for three years in New York City's notorious Rikers Island jail.

There, he suffered appalling violence at the hands of guards and fellow inmates, and spent an accumulated and torturous two years in solitary confinement -- where the teen was locked alone in a tiny cell for 23 hours a day.

Browder reflected on the use of solitary confinement in the United States in a research paper for his community college English class this spring.

"Instead of solitary confinement rehabilitating inmates there is evidence of it actually causing severe mental problems for inmates and in the long run leaving the mental disorders for their families to deal with," Browder writes in the paper, a copy of which was obtained by The Huffington Post.

*[SCROLL DOWN TO READ BROWDER'S FULL RESEARCH PAPER]*

Browder, of course, knew firsthand the horrific mental health consequences of solitary confinement. After being released from Rikers, he struggled to adjust to the outside world. He suffered deep bouts of depression, became increasingly paranoid, spent time in a psychiatric hospital, and made multiple attempts to end his own life.

"Ma, I can't take it anymore," Browder reportedly told his mother shortly before his death. According to his family, it was the demons Browder developed while in solitary confinement that would eventually lead to his suicide.

But in his paper, "A Closer Look At Solitary Confinement In The United States," which he turned in to his professor on May 11, Browder makes no mention of this personal anguish. Like any good academic, he keeps to the third person.

Citing a study from University of Toronto professor Brett Story, Browder's paper traces the history of solitary confinement in America to the early 19th century, when the Quaker church in Philadelphia implemented it as a means of rehabilitating inmates instead of punishing them.

The practice was meant, Browder writes, as a way for inmates to "reflect on the misbehaviors they conducted in the jail or prison and change their behavior."

Solitary confinement then spread throughout American prisons. "However," Browder adds, "many health defects were beginning to present themselves within inmates. According to Story, 'As early as the 1830s, reports had started to materialize about the various mental disorders isolated prisoners were exhibiting. These included hallucinations, dementia, and monomania.'"

"By the late 1800's," Browder continues, "solitary confinement began to be frowned upon because of the adverse mental health issues it continued to cause to inmates and by the early 1900's it was abolished."

Browder's attorney, Paul Prestia, read a copy of the research paper before going to Browder's funeral, at which he delivered the eulogy.

"I learned something from [the research paper] and I'm an expert of sorts on solitary confinement," Prestia told HuffPost.

"I don't believe there's any place for solitary in our society," he added. "It's inhumane and I wasn't aware of its history, and now I am, and I learned it from Kalief Browder, who was the face of [solitary confinement] in this city."

Browder's paper goes on to detail the aggressive resurgence of solitary confinement in the 1980s, and its overuse in the ensuing decades.

"Many inmates who go through these problems of being in solitary confinement are now stuck with mental health issues and some don't even have health insurance to even tend to their care," Browder writes.

He cites a 2013 article in the Law and Psychology Review, in which John Cockrell lists the physical effects of solitary confinement ("chest pains, weight loss, diarrhea, dizziness, and fainting") and its psychological effects ("decreased ability to concentrate, confusion, memory loss, visual as well as auditory hallucinations, paranoia, overt psychosis, violent fantasies, anxiety, depression in huge numbers, lethargy, and trouble sleeping").

And then, in a sentence that today carries an awful poignancy, Browder writes: "Attempts to commit suicide are not uncommon."

Prestia said he hopes New York City Mayor Bill de Blasio will read Browder's paper.

Since Browder's story gained national attention last year, de Blasio has implemented a series of major reforms to Rikers. Perhaps most notably, he and Department of Correction Commissioner Joseph Ponte ended the use of solitary confinement for 16- and 17-year-old inmates.

And in April, the mayor announced "Justice Reboot," a program to clear backlogs in the city's courts in hopes of preventing people from staying on Rikers for long periods of time without a trial.

"I'd like the mayor to continue the reforms, continue them in the direction he's made them," Prestia said. "Kalief was the impetus behind the move to abolish solitary for juveniles, but the city could go further, consider abolishing it for anyone under 21, and maybe go beyond that."

Although Browder became a national symbol of the problems with solitary confinement, Payamps, the Bronx Community College faculty member, said Browder didn't want to be known for his time at Rikers while on campus.

Once, when other students were watching Browder's appearance on the television program "The View," he "politely asked them to turn it off," Payamps said.

"He kept himself anonymous," she added.

Recently, Payamps met with Browder's mother, Venida, and showed her photos of her son's happy times on campus. Payamps also told her that she is currently lobbying the City University of New York -- which operates Bronx Community College -- to bestow her son with a posthumous associate's degree in business. Upon hearing this, Venida broke down in tears:
[CITE: https://www.facebook.com/bronxcc/posts/10153054056603871]

Browder, who spent 3 years without a trial on Rikers Island, had just finished a semester at Bronx Community College. 1:40 06/15/15

Posted by Bronx Community College on Tuesday, June 16, 2015
"I think Kalief would've graduated with honors had he continued," Payamps said. "He was a really good student."

For his paper on solitary confinement, she added, Browder received an "A."

Need help? In the U.S., call 1-800-273-8255 for the National Suicide Prevention Lifeline.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 10 hours ago.

It's impossible to predict how the famously leak-proof Supreme Court will rule on any case, but that doesn't stop court-watchers from speculating on the biggest cases of the day.

With less than a week left in its current session, the Supreme Court still has to rule on two major cases. One will determine whether same-sex marriage bans are constitutional, and the other will determine the fate of a key provision of the Affordable Care Act, colloquially known as Obamacare.

We reached out to Carter Phillips, a partner at Sidley Austin, to get his insights on how the court might rule. Carter has argued 80 cases before the high court — more than any other lawyer in private practice, according to his firm bio. 

"If my experience could help me predict accurately where the Court will come down, then I would get out of practice and go make some real money," Phillips joked in an email. "But I will tell you what I think will happen."

Phillips predicted a win for gay marriage supporters and a toss-up on Obamacare.

The first case he commented on centers on the constitutionality of same-sex marriage bans in Kentucky, Michigan, Ohio, and Tennessee, and it will consider these two questions:

1) Does the Fourteenth Amendment require a state to license a marriage between two people of the same sex?

2) Does the Fourteenth Amendment require a state to recognize a marriage between two people of the same sex when their marriage was lawfully licensed and performed out of state?

Phillips said he thinks the court will strike down same-sex marriage bans, and he believes conservative justices may end up joining that majority decision.

"I think it could be more than 5-4 because I think the justices will figure out the way the winds of history are blowing and will not be keen on seeing their individual legacies tarnished by having hopelessly attempted to block the protection of rights," Phillips wrote, "and I think the conservatives who go that way will say there is something unique about marriage and the need to protect an individual's legitimate desire to have the stability and benefit of those bonds." 

The other case he commented on, King v. Burwell, centers on whether the US government can keep subsidizing insurance in the roughly three dozen states that have not set up their own insurance marketplaces.

The health law laid out a plan in which states set up their own exchanges but said the federal government could step in and set up the exchanges for the states if they could not do it on their own.

Opponents of the law point to a part of the statute that they say suggests people can't receive subsidies unless the state set up their insurance marketplace. That part of the law says that subsidies should be issued to plans through an exchange "established by the state."

If the Supreme Court sides with the law's challengers, millions of people will lose their health insurance because the federal government will no longer be able to subsidize it.

In his email to Business Insider, Phillips said he seemed troubled by the fact that President Barack Obama has publicly defended his signature healthcare law while the decision on its fate is still pending.

"If I thought I were about to win an important case, I would say nothing for fear of tipping the scales. But if someone at the Court leaked the outcome to the White House, then I might very well do whatever I could to create as much political pressure as I could to convince a fifth vote to take the pragmatic approach rather than the ideological one," Phillips wrote. "But that assumes the President is being calculating based on inside information here rather than merely speaking off the cuff."

Carter added, "I don't like conspiracy theories."

Despite Obama's comments, Phillips said the oral arguments suggested one of the court's conservative justices — Chief Justice John Roberts or Justice Anthony Kennedy — might be swayed to save Obamacare.

"The four liberals were very aggressive at the oral argument and only three of the conservatives were," Phillips said. "So if Obama could pick off either the Chief or Kennedy, he would win." 

*SEE ALSO: This comment from Justice Kennedy could signal the fate of Obamacare *

Join the conversation about this story »

NOW WATCH: 11 mindblowing facts about North Korea Reported by Business Insider 10 hours ago.

When a job loss impacts your ability to pay health insurance premiums, losing your coverage and gaining significant medical bills is a real possibility. Fortunately, in most cases, your policy won’t be canceled immediately, giving you some time to catch up. Reported by Forbes.com 9 hours ago.

The nation's largest health insurer will leave the nation's largest health insurance trade group by June 30. Minnetonka-based UnitedHealth Group Inc. is dropping out of America's Health Insurance Plans (AHIP), citing strategic differences, The Wall Street Journal reports. Politico first reported the story. A UnitedHealth spokesman told WSJ that "AHIP has set forth a strategy and direction it feels best serves a membership profile and need that does not fit UnitedHealth Group and our diversified… Reported by bizjournals 8 hours ago.

By Susan Cornwell
WASHINGTON, June 23 (Reuters) - Democrats were prepared to quickly come up with a legislative solution should the U.S. Supreme Court rule in the next few days to invalidate a central part of President Barack Obama's signature healthcare law, party leaders in the Senate said on Tuesday.
The high court is expected to rule by the end of June in a case that challenges tax subsidies that are helping millions of Americans afford health insurance premiums under the 2010 Affordable Care Act, known as Obamacare.
The plaintiffs in the case argue that the law's language restricts these subsidies to states that have established their own health insurance exchanges under the law.
A ruling in the plaintiffs' favor could mean that 6.4 million low- and middle-income Americans in the 34 states that use the federal health insurance exchange will lose their tax subsidies and possibly their insurance.
"The Supreme Court, I'm hopeful and confident, will rule the right way. If they don't, we're ready to move on it quickly," Senate Democratic Leader Harry Reid told reporters.
Reid did not elaborate. But No. 2 Senate Democrat Dick Durbin said that if the administration loses the case, Democrats would offer a short piece of legislation clearly saying the tax subsidies are also available to people on the federal exchange.
"It's one sentence and it's already been written," Durbin said in a Capitol hallway. "I hope we don't need it," Durbin added.
Democrats generally have been reluctant to talk about the possibility that the administration might lose the case.
"Leader Pelosi is confident that the court will not act to kick more than six million Americans off their health insurance," Drew Hamill, spokesman for House Democratic Leader Nancy Pelosi, said Tuesday.
Leading Republicans, who have opposed Obamacare from its inception, say they will have a legislative plan of action if the court throws out the subsidies. But they have not provided many specifics, saying they will do so after the court rules.
In both the House and Senate, some Republicans say they would favor extending the subsidies for up to two years while working on other changes to the law. Those changes could include letting states opt out of Obamacare to set up their own insurance systems. (Reporting by Susan Cornwell; Editing by Kevin Drawbaugh and Grant McCool)

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 7 hours ago.

Should we allow each state to decide whether black Americans can marry white Americans? Today, that idea seems absurd. Most Americans believe that states shouldn't be permitted to trample the basic right of interracial couples to marry -- even if a majority of people in a state want to do so. It would be unfair -- a clear violation of our belief in equal rights.

That's exactly what the U.S. Supreme Court will decide in the next week when it addresses the question of whether there's a constitutional right to same-sex marriage. In its two rulings in 2013 -- overturning the federal Defense of Marriage Act (DOMA) and invalidating California's Proposition 8 (which banned same-sex marriage) on technical grounds -- the justices stopped short of proclaiming that same-sex marriage is a basic right. They left it to the states to determine whether gay Americans have the same right to marry as their straight counterparts.

Now the issue is before them again. The justices have to decide between conflicting lower federal court rulings that both overturned and upheld state bans on gay marriage. What will they decide? States' rights or equal rights? It is that simple.

In 1967, in Loving v. Virginia, the Supreme Court knocked down state anti-miscegenation laws, saying that states did not have the right to ban marriages between black people and white people. At the time, "states' rights" was the justification used by Southern racists to defend Jim Crow laws, including school segregation, racial discrimination in restaurants and buses, severe limits on voting by African Americans, and bans on interracial marriage.

Public support for gay marriage has hit a new high, according to surveys by the Pew Research Center and the Gallup Poll. In 1996, only 27 percent of Americans believed it should be legal for gay and lesbian couples to marry, Gallup found. Today, that number has increased to 60 percent.

Moreover, support for gay marriage is much higher among younger Americans, indicating that the future belongs to the advocates, not the opponents, of same-sex marriage. Pew found that among Millennials (Americans between 18 and 39), 73 percent endorse gay marriage. Support has also been increasing among older Americans. Among baby-boomers (those who are now between 51 and 69), support for same-sex marriage has increased from 32 to 45 percent since 2001.

Homophobia has not disappeared, but the gay rights movement has clearly won most Americans' hearts and minds. The tide has turned. Opponents can try, but they can't push it back. Soon, conservative politicians and groups will no longer be able to use gay marriage as a "wedge" issue to stir controversy and win elections. The days of gay-bashing as a political strategy are numbered.

Because the Supreme Court has so far refused to rule that same-sex marriage is a constitutional right, gay activists and their straight allies have had to pursue marriage equality on a state-by-state basis through ballot measures, state legislatures, and the courts. The number of states allowing same-sex marriage has grown rapidly. Gay couples can now marry in 36 states and the District of Columbia.

Fourteen states -- Alabama, Arkansas, Georgia, Kentucky, Louisiana, Michigan, Mississippi, most of Missouri, Nebraska, North Dakota, Ohio, South Dakota, Tennessee and Texas -- still ban gay couples from tying the knot.

The battle for gay marriage is often compared with the struggle to end the prohibition against marriage between blacks and whites. In fact, Americans' attitudes about same-sex marriage has changed much more quickly. But it is hard to see how the legal case for gay marriage is any different from the arguments against state bans on inter-racial weddings.

In 1948, when California's Supreme Court legalized interracial marriage (the first state to do so) in Perez v. Sharp, most Americans opposed it. In the 1950s, when half the states still had laws prohibiting interracial marriage, over 90 percent of Americans still considered it wrong. By 1967, when the Supreme Court knocked down state anti-miscegenation laws everywhere, 16 states still had such laws on the books and 72 percent of the public still opposed interracial marriages.

The path-breaking case was filed by an interracial couple -- Mildred Jeter Loving, a black woman, and Richard Loving, a white man -- who lived in Central Point in rural Virginia. The Lovings were a humble working-class couple who simply wanted to live as husband and wife and raise their three children in Virginia, where they were born and where they and their extended families lived.

In June 1958, they drove 90 miles and got married in Washington, D.C., to circumvent Virginia's Racial Integrity Act of 1924, which made interracial marriage a crime. The local police raided their home at night, hoping to find them having sex, which was also a crime in Virginia. The cops found the couple in bed. Mrs. Loving showed them their marriage certificate on the bedroom wall. That was used as evidence that they had violated Virginia's law. The Lovings were charged with "cohabiting as man and wife, against the peace and dignity of the Commonwealth."

In his ruling, Leon M. Bazile, the Virginia trial judge wrote:
Almighty God created the races white, black, yellow, malay and red, and he placed them on separate continents. And but for the interference with his arrangement there would be no cause for such marriages. The fact that he separated the races shows that he did not intend for the races to mix.
On January 6, 1959, the Lovings pled guilty and Bazile sentenced them to one year in prison. The judge said he'd suspend their sentence if they agreed to leave the state for 25 years. They agreed and moved to Washington, D.C.

In November 1963, the Lovings filed a motion in the state trial court to reverse the sentence on the grounds that it violated the Constitution's 14th Amendment. It took four years to reach the U.S. Supreme Court. In the interim years, the civil rights movement galvanized America and stirred its conscience about racial injustice. Congress passed the Civil Rights Act and the Voting Rights Act. Change was in the air.

The Supreme Court at the time included two conservative Republicans (John Harlan and Potter Stewart), a moderate Democrat (Byron White), and two Southerners (former KKK member Hugo Black of Alabama and Tom Clark of Texas, both Democrats), as well as three solid liberal Democrats (William Douglas, William Brennan and Abe Fortas). Chief Justice Earl Warren, a moderate Republican as California governor who became a liberal on the court, used his persuasive skills to engineer a unanimous decision.

In deciding the Loving case, the justices no doubt recognized that, despite the fact that many Americans still opposed interracial marriage, the tide of history was turning, and they wanted to be on the right side.

Warren penned the opinion for the court, noting that the Virginia law endorsed the doctrine of white supremacy. He wrote:
Marriage is one of the 'basic civil rights of man,' fundamental to our very existence and survival... To deny this fundamental freedom on so unsupportable a basis as the racial classifications embodied in these statutes, classifications so directly subversive of the principle of equality at the heart of the Fourteenth Amendment, is surely to deprive all the State's citizens of liberty without due process of law. The Fourteenth Amendment requires that the freedom of choice to marry not be restricted by invidious racial discrimination. Under our Constitution, the freedom to marry, or not marry, a person of another race resides with the individual and cannot be infringed by the State.
Reread Chief Justice Warren's words. Then substitute same-sex marriage for interracial marriage and see if his views are any less compelling. Most Americans would now agree that to deny gays and lesbians the right to marry is, as Warren put it, "directly subversive of the principle of equality at the heart of the Fourteenth Amendment."

Back then, the Supreme Court was way ahead of public opinion regarding interracial marriage. Many white Americans believe that African Americans were inferior people. In fact, it wasn't until the 1990s that even half of Americans said they approved of marriage between blacks and whites. In 2011, the most recent poll on the topic, 86 percent of Americans -- including 84 percent of whites and 96 percent of blacks -- supported interracial marriage.

It may be shocking to some that 16 percent of Americans still disapprove of black-white marriages, but the shift in public opinion over five decades has been steady and irreversible. Equally important, 97 percent of Americans younger than 30, and 79 percent of those who live in the South, support interracial marriage.

Some Americans today have similarly bigoted views about gay people, also justified on religious grounds and with reference to what they believe the Bible says and what God wants. You can still hear them on conservative talk radio shows and among the protesters in front of the Supreme Court building, claiming to be "defending" the institution of marriage. But the number of Americans who hold anti-gay views is rapidly shrinking.

The civil rights movement laid the foundation for the gay rights crusade, which adopted many of its strategies and tactics, including grassroots organizing, protest and civil disobedience, fighting for justice in the courts, lobbying for legislation, and campaigning to elect sympathetic candidates.

After the gay rights movement burgeoned in the 1970s more and more public figures -- politicians, entertainers, teachers, judges, journalists, businesspersons, athletes and clergy -- acknowledged their homosexuality. TV sit-coms began to have openly gay characters. Businesses began to appeal to gay consumers. When Gerry Studds came out of the closet in 1983, he was the first member of Congress to do this. Now there are six openly gay and lesbian members in the House. Tammy Baldwin of Wisconsin, elected in 2012, is the first openly gay politician in the U.S. Senate. All 50 states now have at least one openly gay elected official, according to the Gay and Lesbian Victory Fund. In 2013, NBA player Jason Collins became the first pro athlete in a major American team sport to come out of the closet. Last year, Apple's Tim Cook became the first gay CEO of a Fortune 500 corporation to do so.

As gay activism accelerated, and as more and more people (including public figures) came out of the closet, attitudes changed, reflecting a profound transformation in public opinion. In 1994, 40 percent of Americans believed that people choose to be gay, and in 2004, 33 percent thought so. In a national survey conducted last year, 65 percent agreed that "being homosexual is just the way they are," while only 25 percent believed that "being homosexual is something that people choose to be."

As advocates began to put specific issues on the agenda, public support increased for such questions as allowing open gays and lesbians to teach in public schools, providing health benefits for gay partners, permitting gay couples to adopt children, ending anti-sodomy laws, outlawing job and housing discrimination against gays, funding research to combat AIDS, and imposing penalties for people who commit hate crimes against gays. In 1993, for example, only 44 percent of Americans believed that gays should be allowed to openly serve in the military, according to a Washington Post/ABC News poll. By 2008, more than 75 percent thought so. In 2010, President Obama signed legislation ending the 17-year "don't ask, don't tell" policy.

More and more people have confronted their own values and views about a subject that was once taboo in their own lifetimes. In the past decade, a growing number of Americans began realizing that they knew gay people. In 1992, only 52 percent of Americans said that they knew someone who is gay or lesbian. By 2010, that figure had increased to 76 percent. People under 30 were more likely to stay they knew a gay individual (84 percent) than those between 30 and 64 (77 percent), and those 65 and older (66 percent). Not surprisingly, people who know someone who is gay or lesbian are less likely to disapprove, and more likely to feel comfortable around, homosexuals, and to support same-sex marriage, polls have found.

Until the late 1990s, gay marriage wasn't even an issue, and most pollsters didn't bother asking the public how they felt about it. (One exception was the Field Poll, which first asked Californians in 1977 if they approved of extending marriage laws to same-sex couples. By a 59 percent to 28 percent margin, they said no).

But eventually the question of gay partnerships -- civil unions and then marriage -- emerged as a topic of public debate and private conversations in every corner of the country. Initially, the idea of civil unions broke the comfort zone barrier.

In 2002, the New York Times began to publish announcements of same-sex civil unions and weddings. The following year, a Washington Post/ABC News poll asked Americans if gay and lesbian couples should be allowed to form "legally recognized civil unions, giving them the legal rights of married couples in areas such as health insurance, inheritance and pension coverage." Only 40 percent agreed. When they asked the same question in 2010, 66 percent agreed.

Not surprisingly, in the past decade, support for legalizing gay partnerships has skyrocketed. A growing number of politicians, including President Obama and even some Republicans, have voiced their endorsement. President Obama has urged the Supreme Court to overturn the same-sex marriage ban.

There is, of course, a hard core of anti-gay Americans who generate headlines, including some politicians and clergy, but their followers are shrinking.

We've seen dramatic changes in public opinion before -- on such issues as women's suffrage, sexual harassment, interracial marriages, racial and sexual discrimination in jobs and housing, women's roles at home and work, government's role in protecting the environment, fuel efficiency in cars, and disability rights. In each case, grassroots movements made a big difference. Their role is to put new issues on the public agenda -- to make people think about things they hadn't thought about before.

Initially, this makes people feel uncomfortable. It sometimes even triggers a backlash among some people who resist change. But eventually most people come to accept the reality -- and fairness -- of new ideas and behaviors. The radical ideas of one generation become the common sense of the next.

The nine Supreme Court justices will soon decide how they want history books to remember them. On the civil rights issue of same-sex marriage, do they want to be on the side of equal rights, or do they want to force LGBT activists and allies to pursue equality on a state-by-state basis?

When children born this year reach voting age 18 years from now, they will surely wonder how it was even possible that America once deprived gays and lesbians the right to marry. They will take same-sex marriage for granted.

*Peter Dreier is professor of politics and chair of the Urban & Environmental Policy Department at Occidental College. His most recent book is The 100 Greatest Americans of the 20th Century: A Social Justice Hall of Fame (Nation Books, 2012). *

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 7 hours ago.

Covered California faces significant challenges, from trying to build up its enrollment numbers, to the end of federal revenue guarantees for health insurance companies that agree to participate in the exchange -- something observers say could cause premiums to spike. Reported by San Jose Mercury News 5 hours ago.

Minnesota's health insurance exchange is looking for a permanent leader. Reported by TwinCities.com 3 hours ago.

Apple Vacations To Offer Five and Seven-Night Travel Options to Cuba

NEWTOWN SQUARE, PA (PRWEB) June 24, 2015

As a result of eased U.S. travel restrictions to Cuba, Apple Vacations (http://www.AppleVacations.com) will sell tour programs under the 12 pre-approved travel categories licensed by the Office of Foreign Assets Control (OFAC) of the U.S. Department of Treasury. Apple Vacations’ tours are classified as “Educational Activities” known as “People-to-People”. These pre-arranged itineraries are designed to give vacationers the opportunity to immerse themselves in Cuban culture, and to interact and engage with its people. In the initial launch, the first departures are in Sept. and Oct. 2015.

The leading vacation wholesaler is working with US-based Cuba Travel Services, a Cuba-licensed operator that charters flights from Miami to Cuba with Sun Country Airlines and American Airlines. Connections to Miami can be arranged from all major U.S. gateways.

“We are very excited to launch tours to Cuba to a wider U.S. travel audience, offering affordable prices and a length of stay conducive to most Americans’ schedules,” said Tim Mullen, president of Apple Vacations. “We are working with Cuba Travel Services to create a seamless and enjoyable experience, from ensuring that the required entry documentation is submitted to the fulfillment of the itineraries while in the destination”.

The five-night Havana Getaway provides a cultural overview of Cuba’s historic and rhythm-infused capital, ideal for U.S. visitors who cannot allot the 10+ days required by other Cuba travel programs available to Americans. Highlights include comprehensive sightseeing tours, musical performances, antique American cars, a cigar rolling demonstration and plenty of authentic Cuban cuisine. The Havana Getaway is priced from $2,233 per person, based on double occupancy, with departure dates on Sept. 5 and Oct. 17, 2015.

Apple Vacations is also launching a seven-night Colors of Cuba program. In addition to the features of the Havana Getaway, this itinerary includes two nights in the well-preserved colonial town of Trinidad – a UNESCO World Heritage Site in the central Cuban province of Sancti Spiritus, known for its pastel-colored buildings and cobblestone streets. The Colors of Cuba itinerary is priced from $2,733 per person, based on double occupancy, with departure dates on Sept. 11, Sept. 25 and Oct. 8.

Prices include Cuban health insurance, charter flights departing from Miami (connecting flights from other US cities available), Cuban tourist visa processing, U.S. taxes and fees. A Cuban departure tax of $25USD per passenger will be collected upon check in at Miami International Airport.

Travel to Cuba must be booked a minimum of 40 days in advance of departure date to allow ample time for the processing of required documentation.

Travelers will receive an orientation in Miami to ensure familiarity with Cuban laws, policies and traditions prior to arrival in Cuba.

Visit http://www.AppleVacations.com/Cuba for more information.

APPLE VACATIONS
For more than 45 years, Apple Vacations, America's Favorite Vacation Company, has provided affordable, top quality vacation packages from U.S. departure cities nationwide to vacation destinations throughout Mexico, the Caribbean, Central America, Hawaii and Europe, as well top North and South American ski resorts. With the support of travel agents, Apple Vacations has delivered more passengers to Mexico and the Dominican Republic than any other tour operator worldwide. Apple Vacations is consistently voted "Best Tour Operator to Mexico and Latin America" by readers of the leading travel trade magazines.

CUBA TRAVEL SERVICES, INC.
Cuba Travel Services Inc., with offices in California and Florida, arranges daily, non-stop, direct
public charter flights between the United States and Cuba. Cuba Travel Services, Inc. is licensed by the U.S. Treasury Department's Office of Foreign Assets Control (OFAC) as both an authorized Carrier Service Provider (CSP) and Travel Service Provider (TSP) in travel related services to Cuba. As a full service charter and tour operator, Cuba Travel Services provides the highest level of professional services to individuals, groups, families, educators, students, professionals and organizations, under Specific or General Licenses issued by the U.S. Treasury Department. Its mission is to facilitate a safe and rewarding travel experience that only Cuba can offer through its rich diverse culture, history and natural beauty. CTS’s unmatched knowledge and expertise of each individual Cuban province make it the most preferred air charter and tour operator in the market.

### Reported by PRWeb 19 hours ago.

Fewer North Carolinians went without health insurance in 2014 than at any point since the implementation of Obamacare, according to figures released Tuesday by the U.S. Centers for Disease Control and Prevention. Still, the rate of uninsured people was higher in North Carolina than in many other states. In North Carolina, the uninsured rate fell to below 15 percent for all ages and to close to 17 percent for those under age 65. Nationwide, 11.5 percent of all Americans were uninsured, according… Reported by bizjournals 19 hours ago.

Arizona seniors seeking a long-term nursing home stay in their state will pay roughly $77,500 a year, the average annual cost based on the daily private and semi-private rates of over 150 nursing homes in Arizona. Medicare does not pay for long-term care, while Medicaid does pay for an ongoing stay in a nursing home for low-income seniors.

Chicago, Illinois (PRWEB) June 24, 2015

The Caregiverlist® Nursing Home Index reports the updated costs and ratings for nursing homes in the state of Arizona in order to assist seniors looking to plan ahead for their senior care options. Because Medicare does not pay for long-term care, but does pay for short-term stays in a nursing home, the costs and ratings of a local nursing home can assist a senior and their family to plan ahead for the right senior care option. Medicaid for low-income seniors may pay for an ongoing stay in a nursing home, but does have a financial requirement in order to qualify. The June 2015 Caregiverlist® Index reports the average annual cost for an Arizona nursing home is $77,526.00.

Seniors in Arizona looking to plan ahead for senior care options should first understand the daily costs of nursing homes in their area and review the most important factors indicating quality of care. This is because Medicare does not pay for long-term care but does pay for short-term stays in a nursing home, usually as post-hospital stay rehabilitation.

Seniors in the Grand Canyon State needing nursing home care can now view the most recent ratings and costs of nursing homes in their area by using the interactive Caregiverlist® Nursing Home Directory. This month’s update of the Arizona's Caregiverlist® Index indicates that the average cost of a nursing home in Arizona is $212.40 per day, or about $6460.00 per month. Of the 151 total Arizona nursing homes, the majority, 124, receive a Caregiverlist® Nursing Home Rating of 3- and 4-stars, with 5-stars being the highest score. Just 8 of the nursing homes rank 1-star, the lowest quality rating. However, keep in mind that new nursing homes also will receive only a 1 star until they have had a chance to be rated. Only 7 of the 151 nursing homes in Arizona receive a 5-star Caregiverlist® Nursing Home Rating.

June 2015, National Averages Weighting for Rating

2 hours, 28 minutes: C.N.A. Hours per Resident per Day 40%
15.7%: Long-stay Residents with Increasing Activities of Daily Living Needs 20%
1.0% Short-term Residents with Pressure Sores (Bed Sores) 20%
Overall Medicare Star-Rating Score 20%

Caregiverlist® Arizona Nursing Home Rating and Cost Index

Total Number of Nursing Homes: 151

Average Cost Varies by Region
Average Cost of Private Room for Arizona: $239.91
Average Cost of Shared Room for Arizona: $184.88
Average Star-Rating: 2.9

Arizona Nursing Home Star-Rating Results
5-Star: 7
4-Star: 61
3-Star: 63
2-Star: 12
1-Star: 8

The Caregiverlist® rating combines 4 criteria to calculate an overall star-rating with a 5-star rating as the highest and a 1-star rating as the lowest score, as rated against the results for the total number of nursing homes.

Arizona seniors and their families must remember that nursing homes have become an extension of a hospital stay and many times Medicare health insurance will authorize a hospital discharge directly to a nursing home for rehabilitation after a major medical event has happened. This means researching the right nursing home ahead of time will ease the transition should a medical emergency occur.

Senior care costs are always a factor when choosing the right senior care option, as many elderly live on a fixed income. The average annual cost of a nursing home in Arizona is $77,526. Low-income seniors in Arizona may qualify for Medicaid, with the financial qualification of no more than $2,000 in assets for individuals and a $3,000 limit for couples. Medicaid will pay for long-term care in a nursing home for as long as the senior qualifies for needing care, even if this means multiple years of care until death. Visit the Caregiverlist® Arizona Medicaid Eligibility Requirements for for more information. Because seniors must private pay for a nursing home if needing care beyond the number of days Medicare will reimburse (usually only up to 100 days), many seniors also explore senior home care and assisted living options. Some assisted living centers also provide nursing home care.

Seniors should review the ratings and costs of nursing homes in their area and then visit the nursing homes which meet their budget availability. Ratings for nursing homes are only a starting point and while the Caregiverlist® Index calculates a custom rating based on the most important criteria for quality, Medicare will only begin auditing the nursing home’s submitted information for C.N.A. staffing next year. Right now all of the information for the nursing home ratings is self-reported.

About Caregiverlist®
Caregiverlist.com® is the premier service connecting seniors and professional caregivers with the most reliable senior care options, highest quality ratings and outstanding careers nationwide. Founded by senior care professionals, Caregiverlist® delivers the efficiencies of the internet to senior care companies by providing online job applications, caregiver training, background checks and industry news. Seniors and caregivers can access senior service information “by state,” view nursing home costs and star-ratings and learn about all senior care options and quality standards. For more information, please visit http://www.caregiverlist.com. Reported by PRWeb 18 hours ago.

In the pursuit of an investment adviser or investment manager one of the most important (and unfortunately complicated) pieces of information to obtain is their complete fee structure. As many see future investment returns more muted the level of total fees will become more important. After all, in a well-diversified balanced portfolio in the past century an 8% gross return was not unreasonable. Going forward a 5-6% gross return seems more likely. This being the case, a 2% total fee on an 8% gross return might be palatable (fee represents ~25% of gross return), but the 2% total fee on a 5% return is not (fee is 40% of return).Before we get into the fee discussion it is also *important to distinguish between the two types of investment advisers; as their fees, incentives, and duties to the client can differ significantly*.
1. Fee-only (independent) advisers make no compensation from fund or other investment companies with their only compensation coming via a flat fee charged to the client.3. Other advisers (brokers or wire-house advisers) can make money in many ways (management fees, compensation from fund/investment companies, commissions, etc.).
Here are all the investment adviser management fees you need to understand.

*Adviser 'Investment Management' Fee (Flat-Fee)*

This is the most straight-forward fee charged by most investment advisers. This is charged by all 'fee-only' advisers and some brokers. This type of investment management charge makes logical/ethical sense for the following reasons:
· Straight-forward and transparent; usually quoted as an annual flat percentage fee based on *assets under management (AUM)* and charged quarterly.· Aligns the interest of the client and the adviser; if value of portfolio decreases adviser earns less in fees and vice versa· Eliminates all potential conflicts of interests; adviser is paid no compensation by outside interests (commissions, funds, investment products, etc.)· The larger the value of assets under management the less the yearly percentage fee will be; typical yearly percentage charges will run from 1.5% to 0.5%.
*'Underlying Mutual Fund/Investment Product' Fee*

This is the fee that the underlying mutual funds, ETFs, annuities, and products within a portfolio charge for their specific management. These fees are not easily found and the investor never sees these explicitly come out of their account; but make no mistake they are there and very meaningful! The fees are reflected in the prices of the investment securities themselves. For example, if you invest in both an 'actively managed' US stock mutual fund that charges a 1% yearly fee and a passive index US stock mutual fund that only charges 0.1%, assuming their investments performed the same the actual performance to the client will be very different. In this case if the stock market was up 10%, the active fund would show a 9.0% return, and the index fund would show a 9.9% return. This simple fact is why *more and more advisers are moving towards a core of low cost passive investments*. A typical portfolio 'underlying investment' fee would be between 0.2% (all index funds) and upwards of 1.5% in an 'active' portfolio.

*Commissions*

These are the investment adviser fees charged by a broker to buy/sell stocks, bonds and some ETFs/ mutual funds. Normally, especially for larger clients, this can be one of the smaller components of the total portfolio fee. Typical commission charges will range from $7 to $15 per transaction. On a $1M portfolio assuming in a year there are ~ 30 fee transactions, total commissions could be in the $200-$450 range. In this example the percentage of the portfolio consumed by commission fees would only be 0.02%-0.04%. It is important to note however the smaller your portfolio the more important these fees become.

*Mutual Fund 'Load' Fees*

These are investment adviser fees which only certain types of advisers charge/receive. 'Loads' are charged by certain types of mutual funds and brokers and can be very meaningful. Loads can range anywhere from 1-5%. Some loads are charged up front (if you invest $10,000, only $9,500 would actually get into the investment) as $500 would be the immediate load charge. Other loads are back-end, where if you keep your investment in the fund for a period of 1-5 years the load is 'waived'. This arrangement does have a cost however, as it severely limits the liquidity of your money. Since these fees also open up the possibility for conflicts of interests with the investment adviser, in most cases it makes sense for clients to avoid advisers who utilize these funds.

*In summary*

All the above fees can reduce the 'real' total return of a portfolio for an investor. Being that investment fees are nearly 100% predictable, reducing costs is the easiest way to improve future investment performance. Generally if an investor avoids advisers who deal in 'load funds', are not compensated from commissions, and keeps higher cost 'active' mutual funds to a minimum are already ahead of the game. A quality independent adviser managing a $1M portfolio who utilizes mostly index funds/ETFs should have a management fee of 1% or less, an underlying investment expense of 0.4% or less, and minimal commission charges.

Therefore if your current investment expense is greater than 1.5% or so (in all) or you are holding 'load' funds, I would start questioning your investment adviser or look for a second opinion.

To learn more about Eric Mancini, view his *Paladin Registry profile*.

Previously posted on *Paladin Registry*.

*About the Author:* Eric D. Mancini is a Certified Financial Planner (CFP®) and the director of investment research at Traphagen. Eric graduated Penn State University with a BS in Economics and specializes in portfolio management, investment analysis, and personal financial planning. He also works with clients on insurance planning, tax planning, and personal income tax preparation. Eric has obtained the Certified Financial Planner (CFP®) designation, the NASD (National Association of Securities Dealers) Series 65 license, the NJ Life and Health Insurance license, and is currently pursuing his CFA® (Chartered Financial Analyst) designation.

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