State regulators should have taken action to prevent the collapse of a health insurance co-op created under Obamacare, a new report says. The Department of Financial Services failed to take action to address losses at Health Republic Insurance of New York, the report from conservative think tank Empire Center says. Health Republic was shuttered by regulators at the end of November because of financial troubles. The company lost $52.7 million in the first six months of the year and $77.5 million… Reported by bizjournals 10 hours ago.

CHICAGO, Dec. 22, 2015 /PRNewswire/ -- Hinduja Global Solutions Limited (HGS) (Listed on NSE & BSE, India), today announced its inclusion in the "Winner's Circle" in the HfS Blueprint Report: Healthcare Payer Operations. The accolade recognizes HGS as one of the health insurance... Reported by PR Newswire 9 hours ago.

Most people who have explored options or purchased health insurance on the Affordable Care Act's exchanges learned quickly that premiums and deductibles are closely related--the lower the premiums, the higher the deductibles will be. This is the insurance industry's come-on way of attracting enrollees, which may work at first but not in the longer run. Here we examine what this inter-relationship means for many millions of Americans as premiums go up and coverage goes down.

Looking first at premiums, these are the current trends. Although presidential candidate Barack Obama once promised that his health care reform bill would save the typical or average American family about $2,500 a year on their health insurance premiums (1), that promise fell by the wayside long ago. Since many of the ACA's requirements had not kicked in for the first and second enrollment periods in 2013 and 2014, insurers had some latitude in keeping their premiums low to attract enrollees in the early years. But those days are over as these premium projections for 2016 tell us: (2)
· Blue Cross/Blue Shield plans, market leaders in many states, are seeking rate increases of 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee, 37 percent in Kansas, 51 percent in New Mexico, and 54 percent in Minnesota. (2)· The Geisinger Health Plan in Pennsylvania has filed for a 40 percent premium increase, while the Scott & White plan in Texas wants a 32 percent rate increase. · Insurers defend these hikes in various ways, including claims that enrollees were sicker or older than expected, and that some costs were higher than anticipated, such as those for hospitalization, emergency room services, and specialty drugs. Regulation of premium rates falls to the states, where the insurance lobby tends to prevail in avoiding significant regulation of premiums. As one example of industry-friendly regulation, the Oregon insurance commissioner, after a rigorous review of the experience of Health Net, actually approved a 34.8 percent increase in premiums, almost four times what had been requested, over concerns that "inadequate rates could result in companies going out of business in the middle of the plan year, or being unable to pay claims." (3) 
As premiums keep going up, so do deductibles. A 2014 survey by the Kaiser Family Foundation found that average deductibles for bronze plans, which cover just 60 percent of health care costs, were more than $5,000 for individuals and $10,000 for families, while deductibles for silver plans were $2,907 and $6,078, respectively. (4) 

Narrow networks have become endemic under the ACA, which initially permitted insurers to include just 20 percent of "essential community providers" in their plans. A backlash soon broke out among hospitals and physicians on being arbitrarily excluded, forcing disruption of their established relationships with patients and breaking up continuity of care. In response, the Department of Health and Human Services raised its requirement to 30 percent, but this is still a major problem for many patients, especially since out-of-network costs are typically not covered by insurers. Since insurers, hospitals, and physician groups continue to negotiate and re-negotiate their contracts, networks are subject to change at any time, which patients (and physicians) find difficult to keep up with. A recent study found that many health plans sold through the ACA's exchanges in 2015 were so narrow as not to include such specialists as endocrinologists, rheumatologists, and psychiatrists; 15 percent of these plans did not include a single in-network physician in at least one specialty. (5)

What do these well-entrenched trends mean for patients with private health insurance, whether through their employers or ACA plans purchased on the exchanges? These are three major impacts, with no resolution in sight under the ACA:1. Disruption and churning of coverage The Urban Institute estimated that 9 million people would shift between Medicaid and the ACA's exchanges in 2014. (6) We can expect that instability of coverage will continue indefinitely as insurance markets change, requiring a massive bureaucracy trying to mitigate the adverse effects of these shifts. Now, in the ACA's third open enrollment period, the Obama administration is actually encouraging enrollees to switch plans as a way to avoid steep increases in premiums, acknowledging that 86 percent of people who have coverage through the federal exchange can find a better deal (at least for premiums) by switching. (7) Unfortunately, this volatility of coverage is likely to lead to increased costs as new providers become involved in patients' care (often repeating laboratory tests and procedures  that were done in the recent past by former providers), as well as decreased quality of care. 3. Unaffordability of health insuranceMore than 2 million exchange enrollees are not getting subsidies/tax credits because they selected a non-qualifying plan, such as a bronze plan with the lowest premiums and an actuarial value of only 60 percent. (8) Although the median household income in the U. S. is about53,650, Americans are spending an average of more than5,000, just for health insurance, without factoring in all the other costs associated with actual health care. By the fall of 2015, among adults age 19-64 visiting the ACA's exchanges, 57 percent could not afford a health plan. (9) The latest study by the Commonwealth Fund found that 43 percent of privately insured adults say their deductible is difficult or impossible to afford, while one-half of low- and moderate-income adults express difficulty affording their deductibles. (10)5. Inability to afford health care  According to the 2015 Milliman Medical Index (MMI), total health care costs, including insurance, for a family of four with an average employer-sponsored insurance PPO plan in 2015 came to24,671, including payroll deductions and out-of-pocket costs, and is expected to exceed25,000 in 2016. (11) More than one-half of privately insured adults with incomes under 200 percent of the federal poverty level (23,340 for an individual and47,700 for a family of four) had unaffordable health care costs, while 30 percent of adults with moderate incomes (up to46,680 for an individual and95,400 for a family of four) had unaffordable costs, double the rate of higher-income adults. (12) 
As we look at these trends, it seems clear that the health insurance industry needs more and more help from government and taxpayers to stay alive. Though denied by its supporters and lobbyists, it is in a death spiral and would already be in dire straits without these bailouts by the federal government over many years:
· Employers' contributions to employer-sponsored health plans have been tax-deductible for many years· Subsidized markets through the ACA's subsidies/tax credits · The industry continues to seek out healthier enrollees, shifting sicker patients to public programs· The ACA's "risk corridor program" protects insurers from losses in qualified health plans sold in the individual and small group markets; as one example, Blue Cross Blue Shield, the largest insurer in North Carolina, received almost295 million in federal payouts even as it was seeking a 25.7 percent rate increase for its individual policies. (13)
Today, in effect, the Obama administration is being held hostage by the health insurance industry, since it is dependent on it to carry out its signature domestic policy success. No further bailouts are warranted. The public, including patients, families, business and taxpayers, are the patient, not the insurance industry. The industry has had a long run and failed the public interest. It is time to replace it with a more accountable system with universal access, cost containment, lower administrative overhead, and a service-oriented culture--single-payer national health insurance (NHI).

*References:
*
1. Wogan, JB. No cut in premiums for typical family. The Obameter. PolitiFact, August 30, 2012.
2. Pear, R. Health insurance companies seek big rate increases for 2016. New York Times, July 3, 2015.
3. Ibid # 2.
4. Goodnough, A, Pear, R. Unable to meet the deductible. New York Times, October 17, 2014.
5. Dorner, SC, Jacobs, DC, Sommers, BD. Adequacy of outpatient specialty care access in marketplace plans under the Affordable Care Act. JAMA 314 (16): 1749, October 27, 2015.
6. Bergal, J. Churning between Medicaid and exchanges could leave gaps in coverage, experts warn. The Washington Post, January 5, 2014.
7. Goodnough, A. Now, finding a health plan is annual rite for shoppers. New York Times, November 19, 2015.
8. Andrews, M. Study: 2 million exchange enrollees miss out on cost-sharing assistance. Kaiser Health News, August 21, 2015.
9. Collins, SR, Gunja, M, Dotie, MM. To enroll or not to enroll? Why many Americans have gained insurance under the Affordable Care Act while others have not. The Commonwealth Fund, September 25, 2015.
10. Issue Brief. How High Is America's Health Care Cost Burden? Findings from the Commonwealth Fund Health Care Affordability Tracking Survey, July-August 2015. 
11. Milliman. 2015 Milliman Medical Index, May 2015.
12. Ibid # 10.
13. Murawski, J. Blue Cross eligible for $295 million ACA bailout, seeks rate increase. Charlotte Observer, July 7, 2015.

Adapted and excerpted, in part, from my soon-to-be-released book, The Human Face of ObamaCare: Promises vs. Reality and What Comes Next.

(See advance press release at: http://www.johngeymanmd.org)

-- 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 8 hours ago.

Bloomberg TV screenshot

Amid mounting tension over prescription drug costs, the Centers for Medicare & Medicaid Services has posted a new online database to provide information on agency spending for medicines.

And the tool revealed substantial increases in costs for many drugs in the Medicare Part D program, which contributed to an overall increase in health care spending in 2014.

For instance, the database noted at least five drugs where the cost per unit rose more than 100 percent from 2013.

Leading the list was the Vimovo painkiller, which rose in cost more than 500 percent after Horizon Pharma bought the pill from AstraZeneca. And five Medicare Part D drugs each accounted for more than $2 billion in spending, led by the Sovaldi hepatitis C treatment at more than $3 billion.

CMS did not provide a figure for the total drug cost increase in Medicare, but overall, US spending on medicines rose 12 percent last year.

The database, which CMS calls a dashboard, captured data on 80 drugs covered by the Part D and Part B programs. Part D drugs are taken by patients themselves while Part B drugs are those administered in a doctor’s office or clinic. Details are provided on spending per Medicare member, high spending for the program overall, and those drugs with high unit cost increases in recent years.

These 80 medicines represent 33 percent of all Part D spending and 71 percent of Part B drug spending in 2014, or $55 billion of the more than $143 billion in Medicare prescription drug spending in 2014, according to a CMSsummary. For those keeping track, prescription drug spending in Parts D and B was 14 percent of total Medicare spending in 2014, up from 11 percent in 2010.

We should note, however, that the dashboard does not provide the net prices paid to drug makers or the rebates that these companies frequently offer to health insurance plans and prescription benefit managers, which administer drug benefits for employers, government agencies and unions, among others.

The dashboard arrives amid growing controversy over rising pharmaceutical prices. The issue has become the focus of congressional hearings, is a hot topic on the presidential campaign trail, and increasingly has been lamented on social media, especially after Martin Shkreli derided his critics after buying a decades-old, life-saving medicine, and jacking up the price by 5,000 percent.

The Obama administration took advantage of the uproar last month by holding a day-long forum to discuss pricing concerns. Among those on hand were pharmaceutical and insurance executives, federal and state health officials, and consumer advocates, among others. The dashboard is a bid by CMS to shed more light on pricing, which is a confusing topic for most everyone but industry insiders.

“We realize the dashboard doesn’t provide a complete picture, but still believe that, by sharing this information and allowing people to analyze the data, we can increase the knowledge around drug spending and support efforts that are evaluating whether public dollars are being spent most effectively,” CMS Acting Administrator Andy Slavitt wrote in a blog to introduce the database.

By posting the data, Slavitt added that CMS hopes to prompt other agencies and companies to release complementary data about medicines — such as clinical effectiveness, formulary placement, comparative effectiveness, and discounts and rebates — that would “promote a more complete understanding of value and patient affordability.”

Here are some nuggets from the dashboard:

The highest cost drug per user in Part D last year was Sovaldi, the Gilead Sciences hepatitis C treatment, at $94,056. Rounding out the top five are the antipsychotic Abilify; asthma treatment Advair Diskus; cholesterol lowering pill Crestor; and acid reflux medication Nexium.

For Part B, spending per member was highest for Remodulin, used to treat pulmonary arterial hypertension, at $133,845 in 2014. The five drugs that generated the highest net spending were Eylea and Lucentis for macular degeneration; Neulasta chemotherapy medication; Remicade for rheumatoid arthritis and other ailments; and Rituxan cancer treatment.

There were 540 drugs in Part D where unit cost increases exceeded 25 percent, and the spending totaled $13.7 billion, or 11 percent of total Part D expenditures. There were also 267 Part D drugs where per member spending exceeded $10,000 and that worked out to $26.2 billion, or 22 percent of all program spending, according to the CMS dashboard.

Other Part D drugs that experienced big increases in cost per unit were Captopril for high blood pressure, which rose more than 300 percent, and Digoxin for heart failure, which jumped about 300 percent.

NOW WATCH: Scientifically proven ways to stay healthy this winter Reported by Business Insider 7 hours ago.

WASHINGTON -- More than 8 million people signed up for coverage via the federal HealthCare.gov health insurance exchange marketplace as of Saturday, Health and Human Services Secretary Sylvia Burwell said Tuesday.

On Friday, President Barack Obama announced that enrollment had reached 6 million after this month's deadline for policies that will be in force on New Year's Day. Burwell's revised tally, delivered during a conference call with enrollment workers, includes millions of people whose current plans have been automatically renewed. The final deadline for obtaining 2016 coverage is Jan. 31.

The Department of Health and Human Services predicted modest growth in the health insurance exchanges during this, the third Obamacare open enrollment campaign, but appear to be on track with or even surpassing their own internal projections of 10 million exchange customers in 2016. According to figures from Burwell and the Centers for Medicare and Medicaid Services, sign-ups are outpacing 2015's so far, and more young people are participating.

"Today, we have more sign-ups, more new enrollees and a younger population than we did last year," Burwell said on the conference call.

The Centers for Medicare and Medicaid Services disclosed almost 8.3 million enrollments via the HealthCare.gov system serving more than 30 states, 29 percent of which are new to the exchanges. This total doesn't include sign-ups in states with their own exchanges, such as California and New York, some of which are still accepting enrollments for January coverage.

"Millions more have been signed up or been re-enrolled in state-based marketplaces in addition to that," Burwell said.
As of last year's deadline for Jan. 1 coverage, 6.4 million people had enrolled through the federal exchanges, almost 2 million fewer than during the same period this year. New customers are signing up at a faster pace, with 2.4 million enrollees joining the federal marketplaces so far, one-third more than a year ago. Following Obama's announcement, federal officials said activity on the exchanges ahead of the Dec. 17 deadline for January coverage was unprecedented.

Health insurance companies have reported financial losses on their exchange business and increased premiums at a higher rate for 2016 than for 2015, in part because their customers turned out to be sicker and costlier than expected. According to Burwell, the exchanges may be doing a better job of attracting younger, healthier people this time.

So far, 2.1 million of the enrollees are under age 35, 1 million more than during the 2015 sign-up period, Burwell said. "It's good news. It means a younger risk pool which contributes to a stronger, more stable insurance market," she said.Separately, the Department of Health and Human Services provided updated figures on health insurance exchange enrollment for the current year. Sign-ups peaked at close to 12 million this March, but experienced a net decline during the year. Marketplace consumers cycled out of the exchanges -- either to become uninsured or to seek coverage elsewhere, such as from an employer or government program like Medicare -- and new customers signed up under circumstances making them eligible to get coverage outside the annual open enrollment period -- such as if they married or moved to another state.

As of Sept. 30, about 9.3 million people had health insurance from a federal or state exchange, a net decline of 600,000 people since the end of June, according to the agency. Residents of 37 states using the federal system represented 6.7 million of those consumers, and the remaining 2.6 million were from state-run marketplaces. Eighty-four percent of enrollees received tax credit subsidies to reduce monthly premium costs and 57 percent qualified for extra subsidies to cut costs for cost-sharing, including deductibles and co-payments.

The Centers for Medicare and Medicaid Services partly attributes the decline in enrollment to 920,000 customers seeing their subsidies adjusted over the year. Exchange enrollees report projected annual income when they sign up, but the amount they receive is linked to real income, and discrepancies are reconciled at tax time unless consumers report changes themselves during the year.

This story has been updated with additional enrollment data from the Department of Health and Human Services.
 
*Also on HuffPost:*

-- 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 6 hours ago.

Coauthored by David Squires

When it comes to historic changes in the U.S. health care system, few years could compete with 2014, but 2015 gave it a run for its money. With 2016 knocking at the door, it's time to take a look back and round up the biggest health care events of the year.

*The health spending slowdown ends.*

After five years of historically slow growth, health care spending has picked up again, with growth topping 5 percent in 2014 and early estimates forecasting the same for 2015. What's driving the increase? More Americans with health insurance, and double-digit growth in spending on pharmaceuticals (more on both below). Fortunately, the uptick does not appear to signal a return to the bad old days of 7 percent to 10 percent annual growth that characterized health spending for most of the past half-century. Also encouraging: consumers tended to be partially sheltered from the higher spending, with out-of-pocket health care costs growing only 1.3 percent in 2014.

*Rx pricing lands in the spotlight.*

About that growth in pharmaceutical spending: 2015 may go down as the year drug pricing was forced out of the shadows. First, some very high-priced new specialty drugs hit the market and just about broke the bank for some health care payers, including state Medicaid programs. Then, Turing Pharmaceuticals made national news by acquiring Daraprim--an important medication for HIV/AIDS patients--and jacking up the price 55-fold. The backlash reached all the way to Congress, with ongoing investigations in both the House and Senate. In a turn worthy of Hollywood, the defiant former CEO of Turing, Martin Shkreli, was arrested for unrelated securities fraud. Drug pricing will remain a dominant health care issue in 2016.

*The insurance expansion presses on...*

The number of Americans without health insurance continued to fall in 2015, reaching 28.5 million in the first half of the year, a decline of 7.5 million since 2014 and 16.3 million since 2013. Enrollment in the Affordable Care Act (ACA) marketplaces grew to 9.9 million, and Alaska, Indiana, and Montana agreed to expand their Medicaid programs (and several more states are considering it). Most important, the Supreme Court rejected the plaintiffs' arguments in King v. Burwell, which would have led to 9.6 million fewer people with marketplace or individual market coverage.

*...But the pay-fors take a hit.*

A last-minute deal in Congress delayed or suspended some of the taxes included in the ACA--one on medical devices, one on health insurers, and one on high-cost health plans. Estimated cost: $35.8 billion in lost revenue. To be clear, most of the ACA's funding comes from general revenue, and so isn't directly impacted by these taxes.

*Consolidation reshapes the health care landscape.*

It seemed like every week in 2015 brought news of a mega-merger between two drug companies, hospital systems, or health insurers. This arms race in market size has attracted scrutiny from regulators and calls for greater antitrust enforcement. Such calls are likely to grow louder in light of new evidence linking high regional private health spending to market concentration, and indications that competition in insurance markets lowers premiums.

*Collapse of the CO-OPs.*

Underfunding for risk corridor programs designed to stabilize premiums, unmanageable deadlines, restrictions on marketing, the difficulty of setting up brand new insurance companies--there are many culprits behind the collapse of 12 of the 23 ACA-funded CO-OPs (Consumer Operated and Oriented Plans). But evidence that the folding CO-OPs are a harbinger of a broader collapse of the ACA exchanges remains scant. Rather, the CO-OPs' struggles have highlighted the substantial barriers to injecting competition into insurance markets--and how both economics and politics can get in the way.

*Health care politics mellowing?*

In the next month or two, the Republican-controlled Congress will likely succeed in finally sending a bill repealing the ACA to President Obama's desk, where it will promptly be vetoed. Aside from this gesture, however, the ACA has had a remarkably low profile in a contentious presidential primary season, including in Republican debates. Are the worst of the Obamacare wars behind us? Perhaps. Now that the health system has not collapsed, and so many Americans are newly insured, passions may be damping down.

*Rates of hospital-acquired conditions remain low.*

For far too long, most hospitals have treated hospital-acquired conditions as unavoidable, even where careful research has demonstrated they can be prevented. Finally, though, U.S. hospitals seem to be making progress. Between 2010 and 2013, rates of these conditions fell by 17 percent, and rates in 2014 held at their 2013 low, meaning that an estimated 2.1 million hospital-acquired conditions have been prevented, and nearly 87,000 lives saved, over those four years.

*Mortality is rising for white, middle-aged Americans.*

Finally, new research has uncovered a disturbing trend: white, non-Hispanic Americans between the ages of 45 and 54 are more likely to die today than they were in 1999. The opioid epidemic and rising rates of suicide are two reasons, but are themselves likely only symptoms of profound underlying social and economic issues, such as stagnating wages and incomes, and other pressures on the American middle class.

Despite the year's ups and downs, it's clear that the insurance expansions continued to make a big impact in the lives of Americans in 2015. Here's to a new year in which we continue to make coverage gains--and make inroads on issues such as drugs spending and broader economic inequality.

-- 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 5 hours ago.

With several weeks yet to go before open enrollment ends for 2016, Oregon has already eclipsed this year's total signups. As of Dec. 19, 128,667 Oregonians had enrolled through HealthCare.gov, exceeding this year’s total of 107,000, according to the U.S. Centers for Medicare & Medicaid Services. The figure includes most “auto enrollments,” or automatic renewals, as well as people choosing new plans. Across the U.S., more than 8.2 million consumers signed up for health coverage through the… Reported by bizjournals 5 hours ago.

Today is the last HuffPost Hill before Christmas, the day when Mary and Joseph did the most Brooklyn thing ever and had their child sleep in a manger. Israel’s U.S. ambassador is distributing holiday gifts crafted by Israeli settlers in disputed areas, a move that will really shake up the War on Christmas. And Donald Trump said Hillary Clinton got “schlonged” in her 2008 presidential campaign. He then fiddled with the ruffles of his powder blue tux and asked that everyone give a big Catskills welcome to Jack Benny. This is HUFFPOST HILL for Tuesday, December 22nd, 2015:

*PROGRAMMING NOTE:* No more HuffPost Hill this week. Schleason's greetings!

*CAMPAIGN TAKES SCHLONG HIT* - A Freudian might suggest that we're all currently being schlonged by Donald Trump. Doina Chiacu: "Republican presidential candidate Donald Trump used a vulgarity to describe Hillary Clinton's loss to Barack Obama for the 2008 Democratic presidential nomination and then poked fun at her taking a bathroom break during a debate. Trump's off-color comments about the Democratic front-runner at a campaign appearance on Monday night came a day after he called Clinton a liar for saying his proposal to ban entry of all foreign Muslims to the United States has aided Islamic State's propaganda efforts. * 'She was going to beat Obama,' Trump said of Clinton in Grand Rapids, Michigan. '... She was going to beat - she was favored to win - and she got schlonged. She lost. She lost.'* 'Schlong' is a Yiddish slang term for a man's genitals." [Reuters]

*Palmieri takes the high road by not responding, but, y'know, actually responding*: "We are not responding to Trump but everyone who understands the humiliation this degrading language inflicts on all women should.” [@jmpalmieri]

For more information on the term "schlonged," including Donald Trump's past use of the word, please click HERE.

*FEWER PEOPLE BEING SENT FROM LAWN* - American Dream upgraded from "dead" to "critical condition," though teeming masses still not welcomed past golden threshold. Roque Planas: "The number of immigrants deported by Immigration and Customs Enforcement dropped for the third consecutive year in 2015, according to figures the Department of Homeland Security released Tuesday. The data also shows a decline in the number of people attempting to cross the border illegally into the United States, even as talk of cracking down on illegal entries from Mexico has played an outsized role in the 2016 Republican presidential debates. ICE deported some 235,413 undocumented immigrants in 2015, down from 315,934 last year." [HuffPost]
(via Americans United)

*Haircuts*: Nick Baumann, Sara Bondioli (h/ts Arthur Delaney)

*DELANEY DOWNER* - Michigan state officials insisted that the water supply in Flint was safe even though they knew an unusual number of children had suffered lead poisoning, according to a scientist who helped blow the whistle on Flint's water crisis. Through a public records request, Marc Edwards, a civil engineering professor at Virginia Tech, uncovered a July 2015 memo warning of elevated lead levels in Flint kids' blood. *An internal report from the Michigan Department of Health and Human Services warned that lead poisoning rates "were higher than usua*l for children under age 16 living in the City of Flint during the months of July, August and September, 2014." They did nothing until they got called out by an outside pediatrician who'd independently discovered the poisoning. [HuffPost]

Does somebody keep forwarding you this newsletter? Get your own copy. It's free! Sign up here. Send tips/stories/photos/events/fundraisers/job movement/juicy miscellanea to huffposthill@huffingtonpost.com. Follow us on Twitter - @HuffPostHill

*JEB BUSH NOT RESONATING* - He makes Mitt Romney come off like Billy Mays (RIP). Ed O'Keefe: "For nearly a month, Jeb Bush has established himself as the leading Donald Trump attacker, convinced that relentlessly criticizing the Republican front-
runner’s temperament and rhetoric will draw fresh support. So far, it hasn’t worked very well. Bush remains stranded at the back of the GOP pack, polling at around 4 percent nationally and little better in the early states of Iowa and New Hampshire. Trump, meanwhile, has actually gained ground over that time -- and has only intensified the barrage of insults he routinely lobs at Bush. In the past week, Bush has called Trump a “jerk” who is “not serious” and is running a “chaos campaign.” The former Florida governor has also run ads calling Trump “unhinged” and also torn into the front-runner for praising the leadership qualities of Russian President Vladi­mir Putin and for talking about deporting Latinos and barring Muslims." [WaPot]

Today's Big Question: Why isn't Marco Rubio winning? He is the handsomest candidate, after all.

*OBAMACARE SIGN UPS REACH EIGHT MILLION* - Jeff Young: "More than 8 million people signed up for coverage via the federal HealthCare.gov health insurance exchange marketplace as of Saturday, Health and Human Services Secretary Sylvia Burwell said Tuesday. On Friday, President Barack Obama announced that enrollment had reached 6 million after this month's deadline for policies that will be in force on New Year's Day. Burwell's revised tally, delivered during a conference call with enrollment workers, includes millions of people whose current plans have been automatically renewed. The final deadline for obtaining 2016 coverage is Jan. 31. The Department of Health and Human Services predicted modest growth in the health insurance exchanges during this, the third Obamacare open enrollment campaign, but appear to be on track with or even surpassing their own internalprojections of 10 million exchange customers in 2016. According to figures from Burwell and the Centers for Medicare and Medicaid Services, sign-ups are outpacing 2015's so far, and more young people are participating." [HuffPost]
Could anything be more Dianne Feinstein-y than Dianne Feinstein's holiday card? (via NYT)

*CHUCKLEHEAD UPDATE* - The lawn is mowed, the merlot is poured, the presentation bowl in the finished basement is filled with mixed nuts, but the Chuckleheads keep on Chuckleheading. Warren Rojas: "Butler County Auditor Roger Reynolds’ abrupt withdrawal last week from the 16-way contest to fill the vacancy created by Speaker John A. Boehner’s retirement is another sign of how little conservatives think of the former speaker. Reynolds was seen as a favorite among the 14 Republicans in the race and was believed to have Boehner’s backing. But that didn’t work in Reynolds’ favor among some conservatives. 'It is pretty clear that Boehner is behind Roger Reynolds,' Lori Viars, a board member of the Conservative Republican Leadership Committee, told Cincinnati.com in October. And that, she hinted, might not be such a good thing. 'While Boehner is a big fish in Butler County, a lot of conservatives who vote in primaries have not been happy with him,' she warned." [Roll Call]

*DISPATCHES FROM OUR HIGHLY FUNCTIONAL FOREIGN POLICY* - Call in the Dyson repairman because the whole Middle East is one big power vacuum. Josh Rogin: "There have been at least two camps inside the top levels of the Obama administration who vigorously disagree on the goals of U.S. Syria policy. [Former National Security Council senior director for Middle Eastern and North African affairs Steven] Simon, along with his two successors, Philip Gordon and now Robert Malley, *have argued internally that the U.S. should make the fight against the Islamic State its first priority and delay the drive to oust Assad*. The fear is that pushing Assad out too soon would create a power vacuum that the terrorists would fill, gaining territory. The other camp, led by UN Ambassador Samantha Power, insists that Assad’s removal is a necessary step toward ending the war. The thinking is that unless he steps down or is removed, there is no way to defeat the Islamic State. By this logic, the best policy is to work with the opposition and ramp up U.S. support for the rebels fighting the regime. This camp is losing ground as the Islamic State appears to be a bigger threat and as the war drags on." [Bloomberg ]

*How's that relationship repair going?* "This year’s holiday gifts from the Israeli embassy come with a politically charged message: the occupied Palestinian territories are part of Israel. Israel's ambassador to the U.S., Ron Dermer, tweeted on Monday that all of the presents he is sending this holiday season will be products produced in the occupied West Bank and Golan Heights. The gifts will include wine, olive oil, body cream, and halva, the Israeli embassy told The Huffington Post." [HuffPost's Jessica Schulberg ]

*BECAUSE YOU'VE READ THIS FAR* - Here's a child who is bewildered by automatic doors

*THE FIRST STEP IS ACCEPTANCE* - Almost as sad as the LC who got addicted to oil industry informational briefing hors d'oeuvres quiches. Cady Zuvich: "A Florida man has so far this month created more than 350 political groups -- including hundreds of federal super PACs that claim to represent interests ranging from racquetball to the petroleum industry. And no, the super PACs’ creator is not a seasoned campaign fundraiser. Nor is he a billionaire primed to dole out cash to his favored presidential candidates. He’s “Josh Larose,” usually known to exasperated election regulators as Josue Larose, and by any name, a political fetishist quite unlike any other. His obsession: super PACs. Since 2010, Larose has registered hundreds upon hundreds of these and other political groups under his name. Although super PACs may legally raise and spend unlimited money, almost none of Larose’s groups ever generate a dime." [CPI]

*COMFORT FOOD*

- Donut and ice cream sushi.

- The Onion reviews "The Force Awakens."

- A brief explanation of … um … waddya call 'em … ellipses!

*TWITTERAMA*

@SenileDonDraper: Ford: Tough enough for a schlong. Delicate handling for a hoo-hah.

@mileskahn: Positive political ad voice: "Vote for a leader who DOESN'T need to pee - because he's all smooth like a genital-less Ken doll. Trump 2016."

@mollyesque: PSA: It’s “cojones,” not “cajones.” The latter means “drawers,” like a dresser, which is almost certainly not what you mean.

*Got something to add? Send tips/quotes/stories/photos/events/fundraisers/job movement/juicy miscellanea to Eliot Nelson (eliot@huffingtonpost.com) or Arthur Delaney (arthur@huffingtonpost.com). Follow us on Twitter @HuffPostHill (twitter.com/HuffPostHill). Sign up here: http://huff.to/an2k2e*-- 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 5 hours ago.

San Diego, Calif., Dec 22, 2015 / 04:59 pm (CNA).- Maura Byrne was terrified to go to therapy for the first time.

She knew something was wrong, and she knew she needed help. But she didn’t know if she wanted to revisit the ghosts of her past, particularly with a therapist.

“I was very reluctant to do it, there’s just such a stigma associated with therapy, and I didn’t know if I wanted to open up to someone,” she told CNA.

A young woman from northern New Jersey, Byrne experienced her share of trauma in the past, including abuse, an eating disorder and a diagnosis of depression in college. After visiting the Institute of the Psychological Sciences in Arlington, Virginia, she was further diagnosed with borderline personality disorder and chronic post-traumatic stress disorder.

“Them diagnosing me with those things was both hurtful but very helpful, because I knew something was wrong with me, but I didn’t know what it was, and I didn’t know how to fix it,” Byrne said.

Once she reached out for help, Byrne realized she needed to continue with therapy, which she did for the next two years. And that was when the hard work, healing – and inspiration – began.

She found a Catholic psychologist in Nashville, Tennessee, and within a matter of weeks transplanted her entire life from her home on the East Coast to the southern state in order to continue with counseling.

It wasn’t easy.

“I worked really hard, because therapy was really expensive and I was working as a baker and so I didn’t have health insurance, and so at times I worked up to three jobs to pay for the care that I needed,” she said.

But the healing she experienced from her Catholic doctor was unlike any other doctor she had encountered.  

“He really challenged me to see beauty in my suffering, and therapy was very, very difficult, but at the same time very beautiful,” she said.

“And when I was done with therapy, he said to me: ‘Everyone suffers, but it’s what someone does with that suffering that makes them a saint.’”

That’s when the idea for Made in His Image was born.

“He inspired me to start a ministry for women who have suffered the way I have, and to teach them about their dignity as daughters of God,” Byrne said.

That was in September 2011. Byrne started travelling and speaking to high school and college aged women about their inherent beauty and dignity and daughters of God, and she started reaching out to them through a blog and social media, writing about how much God loves them as Father despite anything they’ve been through.

Currently, the Made in His Image Facebook page has over 36,000 likes. The website includes testimonials from women who have experienced healing through the ministry, as well as blog posts from various contributors on topics such as forgiveness, modesty, chastity, and recovery from various traumas like abortion and abuse.

Byrne has even taken her testimony overseas, to Belize and Uganda, to help women there learn of God as a loving Father.

“That’s three years of really hard work in the making,” she reflected at the end of 2014. Getting started, she had no background in social media, and picked the brains of various friends who had wisdom to share.

“The ultimate goal for Made in His Image is to be the first Catholic medical center in the world for girls suffering from eating disorders and abuse,” Byrne said. “There are Christian centers, but none that are Catholic, that’s the ultimate goal.”

It’s a tall order, but Byrne sees a need in the thousands of e-mails she gets from women who have found Made in His Image.

Those e-mails of women reaching out for help are also why Byrne quit her job as a baker to pursue this ministry full-time.

One e-mail in particular made her realize she had a full-time task on her hands.

“I received an e-mail from a young woman who… had planned on taking her life that night, but for some reason – she didn’t say the reason – she was just Googling around online and she found Made in His Image,” Byrne said.

“She read all of our blog posts, and she said the reason she didn’t take her life was because of all the posts that she read, and she was told that she was loved on the blog posts.”

In order to make the ministry sustainable after quitting her job, and to help Made in His Image reach its ultimate goal, Byrne launched a Go Fund Me campaign in late 2014.

“It was definitely a leap of faith,” Byrne said at the time, “and I just live like month-to-month with my finances, which is not ideal at all, and to just to make this sustainable is really important.”

Byrne said one of the biggest lies she wants to bust for women and girls is that they are not enough – not enough to seek the help they truly need, not enough to experience healing, not enough to believe they are beautiful and loved.

“I want them to know about God the Father’s love, and how incredibly worthy they are, how incredibly enough that they are, and how God delights in them,” Byrne said. “Ultimately I want them to develop a personal relationship with God as Father, and to learn about their dignity as daughters of God.”

Nearly every post on the website ends with a simple but loving: P.S. You’re enough.

Byrne also tries to help young women get over the stigma of seeking out therapy and counseling.

“I tell them, you know I think everyone should be in therapy at some point in their life, it’s so helpful,” she said. “If you were sick, you would go to the doctor, and you know, when we have things that we need to deal with, it’s so helpful to go and talk to someone who has that knowledge just like a medical doctor.”

She also tells them that if they don’t like therapy the first time, they don’t have to go back. But almost always, once a woman starts counseling, she recognizes its value.

“They know it’s really, really hard, but they really actually do like it.”

Another thing she tries to help women and girls with is forgiveness and freedom from their past. Often, abuse comes from a family member, which can be very difficult to process.

“Something that was really helpful to me to recognize and learn about was how we all have free will,” Byrne said. “I think it’s really easy when something traumatic or horrible happens, we think ‘If God loved us, he wouldn’t allow this to happen.’”

“But if we know that person had free will, and God gives each of us free will, and we can either sin or do good with our free will, and the person who hurt them chose to do evil with their free will - it’s just really helpful to work through that process.”  

In situations of abuse, Byrne stressed that it is important for women to seek separation from the situation and holistic healing for themselves before considering reaching out to a family member who has been abusive. When the time comes, Byrne says it is essential to pray for the grace to forgive.

“When you fail to forgive, you’re holding yourself hostage, and when you forgive them, you’re really setting yourself free, and it really comes down to that,” she said. “Ultimately, we are called to love like Christ, and when Christ hung on the cross, he loved those who were persecuting him.”

The testimonials on Made in His Image’s website speak volumes for what the ministry has done for girls and women already:

“I hadn't eaten in weeks. Then I read your blog and it gave me the resolve to fight again. Thank you.”

“I listened to one of your live talks and it changed my life. Your passion is inspiring. I never knew going to therapy was okay, before you told me. Thank you for what you’ve done for me. Made in His Image is an amazing ministry, it saved my life.”

“You are so honest and real and there’s so much hope in the way you write. I’m so happy to have found it. I’m amazed at what you’re doing. Your posts bring me a lot of comfort and hope. I’ve been struggling lately with so much … but today is the Triumph of the Cross…and it’s so perfect that I found your blog today. I’ll pray for you today. Thanks for everything you’re doing!”

Byrne said that through the Holy Spirit, she hopes her ministry will continue to change hearts and save lives.

“I just want to expose them to genuine, authentic love, and that is the love of God as Father,” she said, “and I really think the Holy Spirit will take over from there, and I really think their lives will be transformed.”

This article was originally published on CNA Jan. 4, 2015.

  Reported by CNA 2 hours ago.

AP Photo/Carlos Osorio

Washington may not have produced a whole lot of useful legislation this year – evidenced by the round of hearty backslapping that took place last week after Congress simply did its job and funded the federal government – but there was something the nation’s capital churned out in abundance: falsehood.

Yes, yes. Dog bites man. We know. But in a democracy, it still feels necessary to point out some of the political class’s most egregious whoppers, particularly heading into an election year.

This year’s crop of mendacity is, as usual, a mixed bag. Some examples have at least the patina of plausible deniability. Maybe a candidate really believed a wildly incorrect statistic. Others, if the listener were feeling particularly sympathetic, might be written off as unintentional exaggeration. And some are no-doubt-about-it, flat-out lies – claims that have been publicly debunked so thoroughly and so widely that no sentient person in public life could credibly claim not to know they are false.

One note before digging in. The fact that Donald Trump was the leading Republican candidate for president complicated the selection process enormously. The former reality television star single-handedly pumped so much falsehood into the public discourse in 2015 that we briefly considered giving him a list all to himself. Or maybe retiring him into some sort of Masters Division to give up-and-coming liars a chance to step out of his shadow. In the end, Trump was granted two entries on the top 10 list, a courtesy extended only to him, to Sen. Ted Cruz and to President Obama.

Herewith, in no particular order, the top 10 political lies of 2015.

-Donald Trump: When the World Trade Center collapsed after the 9/11 attack, the mogul said repeatedly, “I watched in Jersey City, N.J., where thousands and thousands of people were cheering.”-

This is, to use a technical fact-checking term, a crock. Trump never saw this because it didn’t happen. The idea that thousands of people – whom Trump identified as “Arabs” in some of his comments – were cheering or, as he also said, “dancing in the streets” is such nonsense that his defenders have had to fall back on the “you can’t prove it didn’t happen” argument, which if not the last refuge of scoundrels is at least the last refuge of liars

-President Barack Obama: The Keystone XL pipeline “bypasses the United States.”-

For the Obama administration, it has become increasingly difficult over the years to pretend that the failure to make a decision on whether or not to allow the construction of the controversial Keystone XL pipeline was anything other than political. In 2015, one of the president’s go-to lines was this one.

It suggested that the pipeline would carry dirty and environmentally dangerous tar sands oil through the heart of the U.S., only to see it put on tankers and hauled away. Love the pipeline or hate it, there is no denying that as much as 15 percent of that oil would be processed in the upper Midwestern United States, and that a large portion would be processed in Gulf Coast refineries that employ a lot of American workers.

-Texas Sen. Cruz: The reason “Obama has not bombed ISIS' oil fields is they're concerned about global warming.”-

*
AP Photo/Carlos Osorio*

Maybe you don’t admire the Texas senator and Republican presidential candidate’s decision to misquote a CIA official, which he did with that statement. Maybe you aren’t a fan of his willingness to misrepresent his country’s strategy in a foreign war against a terrorist organization. Given all that, though, you still have to grant that for a GOP presidential candidate, the temptation to skewer the president for failing to harm ISIS while simultaneously ridiculing those concerned about global warming was probably too much to resist. Too bad it was wrong, wrong, wrong.

-Sen. Bernie Sanders (D-VT): “Climate change is directly related to the growth of terrorism.”-

Misrepresenting the history and status of the battle against terrorism in order to press an unrelated agenda is not limited to Republicans or to climate change denialists. Witness Vermont Sen. Bernie Sanders, Hillary Clinton’s top rival for the party’s nomination, discussing terror.

Is climate change actually directly related to terrorism? No, not so much. There is a theoretical argument that the environmental stresses on some populations associated with climate change might drive certain elements of the population into cities, where with their lower educational attainment the members of the displaced group might find themselves more receptive to radicalization … asleep yet?

No, there is no straight-line relationship between climate change and terrorism.

-*Hillary Clinton: Ninety percent of my emails as Secretary of State were, according to the State Department, “already in the system.”*-

*
AP Photo/Carlos Osorio*

Clinton, under fire for her highly questionable decision to endanger national security by using a personal email address for work correspondence while serving as Secretary of State, tried to convince a congressional panel that the vast majority of emails that moved through her account were also archived by the State Department.

Except no, they weren’t. Or at least there is no way that the State Department could possibly have known what percentage of the emails Clinton sent and received from a private email server during her tenure at State were captured by State Department servers, because unless they went to State Department addresses, the Department would never have known about them at all.

-Jeb Bush: Planned Parenthood is “not actually doing women’s health issues. They are involved in something way different than that.”-

You don’t have to like Planned Parenthood. You don’t have to vote to spend government money to fund Planned Parenthood. There are plenty of arguments you can make to support either side.

But over the summer, in response to a set of controversial (and controversially edited) hidden-camera recordings of Planned Parenthood staff discussing what they would charge to cover expenses associated with retrieving fetal tissue for researchers after an abortion, attacking the non-profit for “selling baby parts” became a standard tactic on the far right.

Bush didn’t go that far, but to suggest that an organization that does little except provide health care services to women does nothing of the sort was a clear political pander.

-Senate Minority Leader Harry Reid (D-NV): Planned Parenthood “is the health care backbone for American women during their lives. In fact, it is the only health care that a significant number of women get. About 30 percent of women, that’s their health care.”-

*
AP Photo/Carlos Osorio*

Sigh. No. This is just not true. Throughout 2015, Planned Parenthood was plainly the subject of a coordinated campaign of disinformation from abortion opponents. The response from the political left was to fall in line and defend the organization, often by pointing out factual problems with some of the accusations.

But here, Reid was pretty plainly making up statistics. Even Planned Parenthood itself only claims that one in five women – 20 percent – visit one of their clinics during their lifetimes.

-Donald Trump: “Our president wants to take in 250,000 [refugees] from Syria.”-

In the aftermath of the Paris attack of November 13 that left over 120 people dead and scores more wounded, there was a strong movement, particularly among Republican presidential candidates, to promise to keep Americans safe. One of the most common promises was that they would bar refugees fleeing the brutal civil war in Syria from entering the country.

The fear-mongering was widespread and virulent – Trump would eventually graduate to proposing a total ban on all Muslims – but in the early days, most candidates satisfied themselves with attacking Syrian refugees. He made it worse by repeatedly claiming that the administration was planning to admit far more of them, by a factor of 25, than the White House had ever suggested.

-Rep. Pete Sessions (R-Texas): “Every day, all along border states, maybe other places, there are murders by people who have been arrested coming into this country, who have been released by the Obama administration.”-

In a year remarkable for its anti-immigrant rhetoric, it’s difficult to identify the worst examples. But this comment from the Texas congressman gets to the heart of the strategy behind many of the political attacks on undocumented immigrants, which are plainly aimed at creating a climate of fear.

Are there violent criminals among the undocumented population? Sure there are. Just like there are violent criminals among native-born Americans. Is the Obama administration releasing violent offenders who go on to kill one American every day? No. Seriously. No. Not even close.

-President Barack Obama: After the implementation of the Affordable Care Act, “129 million people who could have otherwise been denied or faced discrimination now have access to coverage.”-

*
AP Photo/Carlos Osorio*

Really, in this day and age, what collection of untruths could be complete without at least one reference to Obamacare? The controversial health law has generated an extraordinary amount of nonsense from partisans on both sides of the aisle.

This particular statement from the president makes the cut based on its sheer gratuity. Are there people currently insured who would not be without the provisions of the Affordable Care Act? Yes, without question.

But 129 million? That’s almost 40 percent of the country’s population. It’s true that health insurance was unavailable to tens of millions before Obamacare became law, but it takes a very generous definition of victims of denial and discrimination to get to 40 percent of the U.S. population.

NOW WATCH: Why '5+5+5=15' is wrong under Common Core Reported by Business Insider 2 hours ago.

ez1095 software is now available for California business owners to file Affordable Care Act Forms 1095 C, 1094 C, 1095 B & 1094 B. The application comes as a 30 day no cost or obligation trial at http://www.halfpricesoft.com.

San Diego, CA (PRWEB) December 23, 2015

The Affordable Care Act (ACA), or health care law requires all employers that have 50 or more full-time employees or equivalents to file an annual return in 2016 reporting health insurance they offered employees. Many business owners contacted halfpricesoft.com for a simple solution. Because of this, Halfpricesoft.com has just developed a new software application called ez1095. This will allow business owners to file ACA form 1095 and 1094 with ez1095 software. Ez1095 software can prepare and print form 1095 B, 1094 B, 1095 C and 1095 B

“California businesses are accommodated with new ez1095 software for printing ACA forms 1095 and 1094 .” said Dr. Ge, the founder of Halfpricesoft.com.

New ez1095 ACA form software is easy-to-use and flexible. Developer’s created this software in anticipation of the requirements by the government to file forms 1094 and 1095 starting in 2016. ez1095 software’s graphical interface leads customers step-by-step through setting up company, adding employees, add forms and print forms. Customers can also click form level help links to get more details regarding the software.

ez1095 software is compatible Windows 10, 8.1, 8, 7, Vista, XP and other Windows systems. Potential customers can download and try this software at no obligation by visiting http://www.halfpricesoft.com/aca-1095/form-1095-software-free-download.asp

The main features include but are not limited to :· Support unlimited companies.
· Support unlimited number of recipients.
· Print unlimited number of 1095 and 1094 forms.
· Fast data import feature
· Print ACA forms 1095 and 1094 on blank paper with inkjet or laser printer.
· Print Form 1095 C: Employer-Provided Health Insurance Offer and Coverage Insurance
· Print Form 1094 C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
· Print Form 1095-B: Health Coverage
· Print Form 1094-B: Transmittal of Health Coverage Information Return
· Print recipient copies in PDF format.

Priced at just $195, this ACA forms filing software saves employers time and money. To learn more about ezCheckDraft check writing software, customers can visit http://www.halfpricesoft.com/aca-1095/aca-1095-software.asp

About halfpricesoft.com
Founded in 2003, Halfpricesoft.com has established itself as a leader in meeting the software needs of small businesses around the world with its payroll software, employee attendance tracking software, check printing software, W2 software, 1099 software and barcode generating software. It continues to grow with its philosophy that small business owners need affordable, user friendly, super simple, and totally risk-free software. Reported by PRWeb 17 hours ago.

*TOP STORIES*

*AND THEN THERE WERE SIX* The next GOP primary debate will feature only six candidates, likely bumping Carly Fiorina, Rand Paul and John Kasich to the undercard debate. [Jason Linkins, HuffPost]

*OBAMACARE ENROLLEES OVER 8 MILLION* "The Department of Health and Human Services predicted modest growth in the health insurance exchanges during this, the third Obamacare open enrollment campaign, but appear to be on track with or even surpassing their own internal projections of 10 million exchange customers in 2016." [Jeffrey Young, HuffPost]

*SOMEONE STOLE A SECRET SERVICE AGENT'S GUN AND BADGE* Makes you feel very confident in the president's security. [WaPo]

*IRAQI FORCES STORM RAMADI* At least 250 ISIS fighters remain entrenched in the city. [Reuters]

*THE GROWING THREAT OF RISING DRUG PRICES* A look at the devastating repercussions of massive drug price upticks. [NYT]

*BOKO HARAM HAS DEPRIVED OVER A MILLION CHILDREN OF SCHOOL THIS YEAR* Fear of violence at the hands of the terror group keeps the kids at home, where they are more likely to be "abused, abducted, or recruited." [AP]

*THE WHITE HOUSE RELEASES PLAN TO COMBAT MULTIDRUG-RESISTANT TUBERCULOSIS* "While tuberculosis advocates are thrilled with the ambitious scope and potential unifying force of the National Action Plan, many worry whether the funds will be made available to implement it." [Lauren Weber, HuffPost]

*To get The Morning Email, HuffPost's daily roundup of the news, in your inbox, sign up here. And listen to the news in under two minutes here.**WHAT’S BREWING*

*'AMERICANS ARE DRINKING THEMSELVES TO DEATH'* "Alcohol is killing Americans at a rate not seen in at least 35 years, according to new federal data. Last year, more than 30,700 Americans died from alcohol-induced causes, including alcohol poisoning and cirrhosis, which is primarily caused by alcohol use." [WaPo]

*THE MOST GOOGLED PEOPLE FROM EACH COUNTRY* Lionel Messi and Rihanna clean up. [Time]

*REMEMBER THE PEOPLE THE INTERNET HATED?* Where the most reviled folks of 2015 are now. [WaPo]

*A LOT OF WOMEN'S BLADDERS ARE FALLING OUT* And no one wants to talk about it. [WaPo]

*WHAT MAKES THE WORLD GO ROUND* The best foreign affairs stories from 2015 help make it clear. [HuffPost]

*THE EVOLUTION OF MALE NUDITY ON TV IN 2015* "The small uptick is hardly a corrective to exploitative female nudity. There’s still a crucial distinction in this recent crop of shows: When men undress, it’s for artistic reasons, not salacious ones." [Vulture]

*For more from The Huffington Post, download our app for iOS or Android.*

*WHAT'S WORKING*

*'NESTLE JUST SET THE STANDARD FOR CAGE-FREE EGGS'* "In five years, Nestle will use cage-free farms to provide the 20 million pounds of eggs used in items sold in the U.S., like Häagen-Daz ice cream, Toll House cookie dough and Lean Cuisine breakfast items. The company, which made the announcement on Tuesday, doesn't currently use any cage-free eggs, meaning it will need to completely overhaul its U.S. supply chain." [HuffPost]

*For more, sign up for the What's Working newsletter.*

*ON THE BLOG*

*HOW TO GET LOWER AIRFARE* Changing your point of origin does wonders. [HuffPost]

*BEFORE YOU GO*

~ Amazon and UPS are best buds no more.

~ Everybody is flipping out about a bright streak of light in Nevada -- anyone hear the "X-Files" theme song?

~ All the adorable winter engagement photo ideas for your newly engaged friends (although someone please tell us how it's not a fire hazard to wrap yourself in Christmas lights).

~ The "Here To Make Friends" podcast is back, and we are so very excited for the return of Bachelor nation.

~ What flight attendants think of you when you walk onto the plane.

~ Robert Durst will be extradited to Los Angeles on a murder charge.

~ What it's like to live in a city coated in smog.

~ For 55 officers involved in fatal shootings this year, "it wasn't their first time."

~ The Internet is going bananas over this snowman drawing where you look for the panda.

~ Yeah, Prince Harry's Christmas card is divine.

~ You're using your toaster wrong.

~ Inside the world's most expensive SUV.

~ This visual of the "Rugrats" crew all grown up is scarring.

~ Looks like Shonda Rhimes and Patrick Dempsey still have beef.

~ Are you a woman? Looks like you're paying a surcharge on a lot of basic goods because of it.

~ The companies that will make a fortune from climate change.

*The Morning Email will return December 28th! Have a wonderful holiday weekend.*

*Send tips/quips/quotes/stories/photos/events/scoops to Lauren Weber at lauren.weber@huffingtonpost.com. Follow us on Twitter @LaurenWeberHP. And like what you're reading? Sign up here to get The Morning Email delivered to you.*

-- 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 15 hours ago.

Zane Benefits announces the release of a new, small business-focused eBook

Salt Lake City, UT (PRWEB) December 23, 2015

In today’s consumer-driven economy, lack of choice and flexibility have come to be seen as major deficiencies of traditional, employer-provided group health plans.This is the focus of a new eBook published by Zane Benefits titled "Choose Freedom—How Choice Creates Benefit Value"

This small business resource gives historical context to the rise of employer-sponsored health benefits, and the dynamics of the current health insurance market. As the cost of employer-sponsored plans have increased incrementally over the past two decades, many new challenges have been introduced. Most notably, the increasing difficulty small business administrators face as they struggle to afford health benefits and compete for top talent.

According to Zane Benefits, small businesses can create a competitive advantage by offering health insurance choice. In other words, stringent group plans aren't the only option, and often they fail to meet the individual needs of employees. Small businesses should consider a choice-based plan that is employer funded, but employee owned. This type of plan allows employees to choose and purchase their own individual health insurance plan, then get reimbursed for their premium.

"It's all about the power of choice," says Zane Benefits VP of Marketing, Mark Farr. "When we treat health insurance like a consumer product, the value of that product increases. More valuable benefits translate into satisfaction and productivity—which are the reasons we offer benefits in the first place."

The new 12-page eBook serves as an informational resource for any business considering a modern solution to their health benefits needs. Reported by PRWeb 15 hours ago.

MN

Mike Nudelman / Business Insider

Oscar-winning documentary filmmaker Michael Moore is in a good mood. And it's not because he thinks the country is in good shape. But as he gets on the phone with Business Insider, he can't contain himself, as he's just left Trump Tower in Manhattan, where he stood with a sign that read "We Are All Muslim" until the police asked him to leave.

"We've just left the grounds," Moore said with a fiendish giggle. He would later post an open letter online telling Trump that if he wants to ban Muslims from entering the US, "you are first going to have to ban me. And everyone else."

It's the kind of headline-grabbing move for which Moore is known, going all the way back to his 1989 debut film "Roger & Me," which looked at laid-off autoworkers in his hometown of Flint, Michigan. 

The Trump stunt also comes as Moore's first movie in six years hits theaters, "Where to Invade Next" (opening in New York and LA on December 23 and wider February 12). In it, he travels around the world, showcasing what he says they are doing better than the US, from healthcare and school lunches to treatment of prisoners.

We talked to Moore about what led him to make the movie, why Trump is so popular, and what it will take for America to have strict gun laws. 

This interview has been edited for length and clarity.

*Jason Guerrasio:* You've said on numerous occasions that you were intentionally secretive about making this film. Why was that?

*Michael Moore:* It was more, I would say, personal and artistic reasons than really to hide. Because, first of all, it's really hard for me to hide. But myself and the crew, I said, "Why don't we make a film and unplug ourselves from the machine?" We stayed off social media. We didn't have a publicist and anyone issuing press releases. What if we just focused on our art and the film we wanted to make? And why don't we make this as if this is the last film we're ever going to make? What would that film look like? So we unplugged ourselves and went about our work. It had more to do with that than anything else.

*Guerrasio:* And how liberating was that?

*Moore:* It was incredible. It felt like I was back making "Roger & Me." It was a small crew. We hopped in the van after we got off the plane, and we were very lean about it. We wanted to make it for a little bit of money. The budget was two-thirds less than my last two movies [which were budgeted around $10 million]. I work for union scale. The crew and I are all friends and some of us have been doing this since "Roger & Me" for 25 years. So it had a great feeling to it. And we didn't get production offices. We did all of the preproduction in my living room, and then we went and shot for 35 continuous days. 

*Guerrasio:* And is it true the idea for this movie has been with you for many years?

*Moore:* Yeah, when I was 19 years old I got a youth hostel card, got a year-round pass, and went back-packing around Europe for two months. Over and over I would see things and I would go, "How come we don't do that in the US? Why don't we have that?"

"How come we don't do that in the US? Why don't we have that?"

And every time I have traveled since in my life, you've done this I'm sure, you run into things and you go "That's a great idea, why don't we do that?"

*Guerrasio:* So what took so long for you to get this project off the ground?

*Moore:* I would just come up with another idea. And this would move to the back burner. It moved to the front burner in the beginning of this year when all the negotiations were going on over the Iran deal and conservatives in this country were talking about [how] we shouldn't be signing a deal with Iran, we should be bombing them. And I'm like, "Are you serious?" [Laughs] For the last decade and a half, we've been bombing and invading countries and I just thought I have to do [this film] now and I'm going to make it as an invasion film, in fact. The kind of invasions I would like us to participate in from now on. Invasions of ideas with non-violence. 

*
Mike Nudelman / Business InsiderGuerrasio:* It seems like since you premiered the film at the Toronto International Film Festival, it's gotten a very positive response, more so than your other recent ones. Do you feel that?

*Moore:* Absolutely.

*Guerrasio:* Why do you think that is?

*Moore:* [Laughs] That's a very good question because it's one I've been asking myself. I've been trying to analyze it and figure it out. I don't know what the exact answer is — I can give you a bunch of answers. It's my first movie in six years. The last six years, I got a lot of fan mail from people asking, "When is the next film coming out?" I think that's part of it. I purposely stayed off television for the last two years. Last time I appeared as a guest on a TV show was October of 2013. That was part of the unplugging. And then in the beginning of 2014, my father passed away and I went through a divorce. There were a lot of things going on.

Also, I think people are feeling more and more that we've moved back into a darker time. Donald Trump is absolutely going to be the Republican candidate for president of the United States. It's going from being a joke to being a serious reality.

Donald Trump is absolutely going to be the Republican candidate for president of the United States. It's going from being a joke to being a serious reality.

And I think the enthusiasm for this film and people wanting to see it is partly based on this election year we're in now and the various tragedies that have occurred recently and what do we do? Are we going to get dragged down the rabbit hole again? Are we going to lose another decade of making our country a better place and the world a better place because we're so caught up in violence and war? I think those are all probably part of why people are exited to see this movie.

*Guerrasio:* You have stated numerous times while doing Q&As at screenings recently that a majority of Americans are in a demographic that should not support Donald Trump, then why are his poll numbers so big?

*Moore: *Yes, 81% of the country is either women, people of color, or youth between the ages 18-31. 

His numbers are high because they are polling Republican voters, or likely Republican voters in the primary. But when they poll him against [Democratic primary candidates] Hillary [Clinton] or Bernie [Sanders], he still does quite well. I think that's in part because my side of of the political fence is the slacker side of the fence. That even though statistically there's no way Trump can win, because he's alienated those three main groups that make up 81 percent of the country, the difference is his side always shows up to vote. My side, not so much. Then it becomes incumbent upon picking the candidate who will mostly inspire women, people of color, and young people to come out and vote. I think obviously Hillary is going to inspire a lot of women to come out and vote. I think Bernie has inspired a lot of young people to come out and vote. And the African-Americans and Hispanics, probably a split between the two is my guess. When people ask me, "Who should we vote in the primaries?" I say, "You should vote for who you think should be president." Don't vote for who has a better chance, because whoever has a "D" by their name on the ballot is going to win, assuming we get the vote out.

My biggest concern about Hillary right now is her lack of inspiration. She doesn't get big crowds. There's not a lot of excitement about her. Too many young people see her as the same-old, same-old politics. So she is going to have to have a bit of what Obama had and a bit of what Bernie has if she's going to be the candidate. I honestly believe that Bernie Sanders could be elected president of the United States. I think people will pour out in droves to elect him and there's just not enough angry white guys anymore over the age of 35 to put Trump in office. 

*Guerrasio:* You mention Bernie Sanders — I remember in the first Democratic debate, he brought up Denmark, and it reminded me of your film. What are your thoughts on how he uses Denmark as an example of how we should live our lives in the US?

*Moore:* I say it differently than the way he said it. Also, when Bernie said that, Hillary ridiculed him and I thought, wow, Hillary, first of all, by making that statement she's relying on the ignorance of the American public not knowing how well off their lives would be if they lived in Denmark. There's nobody in Denmark that needs to work a second job. There's nobody in Germany that needs to work a second job. Pencil makers make enough money to have a great life. And I asked them all there if they had a second job and they all laughed at me. They laughed at that question. The way I put it in the film, and the way Bernie didn't, it's not that Denmark has these good ideas; it's that Denmark and Norway and Germany and France, they took a lot of our great ideas and made them a reality.

It's that Denmark and Norway and Germany and France, they took a lot of our great ideas and made them a reality.

I mean every country we went to, they kept saying to me, why don't you do this or do that, because you were the ones that came up with this idea. 

Look, everybody my age or older knows that the world was envious of our public education system. We were the top in the world. We had the best schools in the world for public schools and anybody, regardless of their economic status, got a good education in the United States of America. And they would say to me over there, "Why did you guys give up on that? You just flushed your great education system down the toilet and we just picked up what you were doing." And they did it better. The sense that we started to have is that the whole thing about the American Dream was alive and well over there and here it is exactly what the term implies — a dream. Over there it's an American reality. But they have made it a Danish reality, a German reality, an Italian reality.

There are more laughs in this movie than any of my other movies since "Roger & Me," but you also feel, and I have seen the movie now with various regular audiences, there's a slow burn that rises throughout the movie of people sitting in the audience going, "How come we don't have that?""Why don't I have any time off?" Why is it that there's no French word for co-pay or deductible? They don't even know what those words mean when you ask a French person who has been to a doctor. [Laughs]

*Guerrasio:* With all the examples you show in the movie, is there one that you believe could be established in this country right now?

*Moore: *In terms of what can happen the soonest, parents and local school districts can stop poisoning their children at lunch now. They can literally get the PTA and the school board together and say we are going to do lunch differently from now on. I think [universal] paid maternity leave, that's within a year or two of happening. Certainly in the next administration. The decriminalizing of drugs, already happening. Obama's new drug czar on "60 Minutes" declared the war on drugs over. So these things are happening.

The things that are going to take a little longer will be returning our schools to the progressive liberal education that they used to have 50, 60 years ago. Post-World War II America. I think the thing that would make people the happiest, if you were polling people — guaranteeing at least a four-week paid vacation every year would go well with everybody.

*Guerrasio: *Looking at the other side of the coin, the big criticism of your movie is, to take the example of Italy, yes, the country has this amazing universal vacation package for its workers, but look at their economy. How do you respond to that?

*
Mike Nudelman / Business InsiderMoore:* I wouldn't want to live there. I don't consider it a criticism; they are talking about a film that I didn't make. I'm making a film about the United States, not a film about Italy. I'm just using Italy to show Americans the way things could be and how our dream has been deferred to other countries. As I say in the beginning of the film, I went there to pick the flowers, not the weeds. Every country has problems. But to dismiss the good things that they do because they don't do other things well, it would be — let's say, an Italian documentary filmmaker went to Silicon Valley to make a documentary on the genius of the iPhone and then an Italian said to him, "You made this whole film about the iPhone and the genius of it and Silicon Valley and you failed to mention that in the US, they have had 315 mass shootings in the US this year." Well, yes, but it's apples and oranges. I wouldn't want other countries to dismiss our good ideas because we have so many messed-up things going on and I'm not going to dismiss their good ideas because they have messed-up things going on. 

*Guerrasio:* Well, speaking of the bad things going on here: The number of mass shootings in this country has been staggering this year. You won an Academy Award for your movie "Bowling for Columbine," which showed why the current gun laws in the US aren't working, yet things haven't improved. How does that make you feel?

*Moore:* Well, I feel pretty bad. Because I made that movie to try and stop it. I was appealing the "R" rating for "Where to Invade Next" to the MPAA a couple of weeks ago and I said, "I was here 13 years ago with 'Bowling for Columbine' and you gave me an R rating and back then there was a school shooting a year. You said you didn't want to upset teenagers who watch a movie, that it would make them think about school shootings." Well, how has that worked out? We're never better off as a society when you try to limit information. Or limit discussion. So the limiting and censoring at that time didn't help the problem, it didn't go away, it only got worse.

I'm not going to dismiss their good ideas because they have messed-up things going on. 

 

*Guerrasio:* Are you concerned that "Where to Invade Next" will have the same fate as "Bowling for Columbine" where no change happens?

*Moore:* No, because sometimes you have to play the long game. I made a film in the '90s called "The Big One." I go to see [Nike co-founder] Phil Knight and I said, "You got 12-year-olds working in your factories in Indonesia," and he said, "They aren't 12; they are 14." Oh, I feel so much better, thank you. But within a week of that movie coming out, he raised the age limit of his workers to 18. He just immediately decided not to use child labor. And I've had little things happen in other films once I put it out there. But obviously, yes, the gun problem has gotten much worse.

Mike Nudelman / Business InsiderWhat I had to say about General Motors and industrial America in "Roger & Me," I don't think anyone disagrees with anymore, but that film was too far ahead of the curve, like 20 years ahead of General Motors going bankrupt when I was trying to warn people about it. I think the reason why I'm more optimistic with this film having an impact is that I'm not 20 years ahead of the curve on these issues I'm raising in the film. I'm on the curve. It's already happening, some of it. And what isn't happening is boiling just beneath the surface and it's ready to come up. 

*Guerrasio:* So what will we see first in this country: one of the ideas in your movie that are boiling to the surface, or a strict gun law?

*Moore:* You'll see a strict gun law passed when someone releases the crime scene photos of the next school where 20 young people's children's faces have been blown away.

You'll see a strict gun law passed when someone releases the crime scene photos of the next school where 20 young people's children's faces have been blown away.

During the Vietnam War, you saw what was happening over there on the 6:30 news — that did more to turn people against the war than anything else. A three-year-old washes ashore in Turkey three months ago, and it galvanized all of Europe and they opened their doors to the Syrian refugees. One photo of the three-year-old dead. I don't want the parents to suffer through it, but if the crime scene photos from the next mass shooting were ever released, that night the NRA, they might as well shutter their doors and windows, because they are done. That's what it will probably take.

*Guerrasio:* That's a horrific thought, to think that's how far we need to go.

*Moore:* Well, that's who we are. In the end we're human beings, we have a conscience, we have a heart, and you think of Sandy Hook and those 20 six-year-olds all shot at point blank range by this lunatic. Who, by the way, the NRA says, "This is a mental health issue." Yeah, the issue was that his mom bought him guns that neither he nor anyone else should have access to. That guy was seeing two shrinks, first of all, I just want to make this point. His father is vice president of General Electric. Okay. This wasn't just some crazy guy out in the woods. This was a guy who had means, who had help, who had a great health insurance policy. But he also had easy access to guns. 

*Guerrasio:* Are you surprised by how people have reacted to the optimism of "Where to Invade Next"? This is a lighter side of you that you're showing.

*Moore:* [Laughs] I hear people say that and I notice it, too. I watch the movie and think maybe I don't let that side out enough. So maybe this movie is closer to the real me as I'm experiencing these things in these countries. Maybe I'm just happy to see that there is a solution to a lot of these problems. You would feel good if you're sitting there and this German guy on the board of Lufthansa is telling you that they now have a law in Germany where it's against the law for the boss to bother you while you're on vacation. And now companies have expanded that and they are getting ready to pass new laws that would make it illegal for the boss to contact you after you go home for the day, unless it's an emergency. You can turn your phone off and have a life. You see happy Germans — when have you seen a happy German? It's a population of very happy people.

*Guerrasio:* Why is the theatrical experience still vital to you? In a world where audiences want more content to stream, why are you steadfast about going the traditional route?

*Moore:* I love Netflix. When you get a cold, that's everyone's go-to, you just binge watch the latest things. I'm in the middle of "Master of None" right now. This is a much longer conversation, but I'll say this: It is critical that documentaries that are made for a theatrical audience have theatrical distribution. I think for the audience it's much better to see some of these films with 200 other people in the dark than home alone. It's a whole different experience.

I think for the audience it's much better to see some of these films with 200 other people in the dark than home alone.

I have to be honest, when I'm watching a movie on television or my computer, I don't really in my head think that I'm watching a movie. I don't know what the name of it should be, but in the same way that they issue the "Mona Lisa" postage stamp, that wasn't the "Mona Lisa," that was a stamp with a picture of the "Mona Lisa" on it. "Mona Lisa" is over in the Louvre. I and the others that make these movies for theaters, we make them for a 50-foot screen. We make them to be experienced with others, because you're going to have a different emotional response. The laughter, the crying, the anger, whatever it is. And I think there's something very valuable about that.

Do I like the accessibility that there are computers and iPhones and Netflix and all of that? Absolutely. Because I'm for reaching people whatever way they want to be reached, but I want to encourage people, when they can, to see these movies in theaters. And I think to go to the movies is an active thing, it's not a passive activity. You have to actually commit. You have to get a babysitter; you have to leave the house; you have to spend money. When it's just noise on in the background when you're working at home or cleaning the house or making dinner, it's something else. It's not really a movie.

NOW WATCH: One of the most incredible stunts in history has inspired a generation of daredevils and outlaws on Instagram and YouTube Reported by Business Insider 11 hours ago.

As New Year's Eve approaches, I hear more people making resolutions about their gym memberships and careers than about handling their money in the coming year. Maybe that's because people don't know where to start.

The Allianz Life Insurance Company of North America's annual New Year's resolutions survey for 2014 reported that 49 percent of respondents said that health and wellness were their first priorities for the coming year, up from 43 percent in 2013. Only 30 percent ranked financial stability as their top goal for the year.

In 2016, make realistic goals and consider creating an annual financial calendar that helps you stick to them. Here are some key calendar items to set and execute:

*Set three important money goals for the year.* Three money goals may not sound like a lot, but if you've never thought about money goals before, establishing these targets can make a major difference in your financial life. Set goals that address key money concerns or serve as a springboard for a solid financial future. Choose what makes sense for you, but if you need suggestions, here are three of the most important basic financial goals:
*• Create or reset your budget.* If you've never made a budget before, spend a month or two tracking everything you spend. Review your findings closely and determine whether you're spending less than you're earning and using those funds to meet key goals. If not, see if there are any spending areas you can cut. Write down those limits and stick to them.
*• Build an emergency fund.* An emergency fund contains between three to six months of living expenses you can draw upon only in a real financial emergency - unemployment, illness or a major unplanned expense.
*• Save for a reward.* Make one of your three goals a fun goal - a vacation, a new bike, a wardrobe upgrade - something that feels like a treat.

Total up the money needed to achieve goals with a dollar amount and schedule days on your calendar that you will either deposit money or make payments to reach those goals.

*Mark the dates for your three free credit reports.* It is best to schedule receipt of your three free credit reports from Experian, TransUnion and Equifax at different points in the year so you can keep a steady eye on your credit and spot irregularities if they happen.

*Set and schedule major home projects.* Is your car, a furnace, a roof or some other major household structure or appliance getting close to a replacement date? Start planning for your new acquisition by marking a reasonable replacement date on your calendar. Then evaluate both cost and applicable labor for that goal and determine the best way to set aside funds in advance. You may want to consider adding a little money over time to your emergency fund to handle such goals so you'll have cash available.

*Review your investment allocations for retirement and other financial goals.* Consider reviewing your holdings in retirement or investment accounts once a year to make sure they're still performing as you've planned. If you work with a qualified financial planner or tax professional, talk to them about the right date or dates to check in and discuss your choices. Regular discussions help you keep an eye on such goals and make sure you're still on target.

*Mark key dates for raises and open enrollment.* If you're getting a raise this year, mark the date it kicks in so you can adjust your budget. Also, many employers schedule open enrollment for health insurance and other benefits in the fall, so give yourself enough time to evaluate your current options and see if you need to make changes for the coming year.

*Note insurance renewal dates.* If you're not comparison-shopping for the auto, homeowners or health insurance coverage you buy on your own, there's a good possibility you're losing out on money, service or coverage. Review all your renewal dates, count back two months and put a date on the calendar to start contacting agents to review your current policies so you can make sure you're getting the most coverage for your money.

*Schedule midyear and year-end financial reviews.* Schedule time in June and November to see how you're doing with budget, savings, spending, investment and tax issues. The June date is for corrective actions; the November date is to determine the spending, savings or tax moves you want to make before December 31 and to set financial goals for the New Year. If you work with a qualified financial or tax expert, consider involving him or her in the conversation.

*Set the date...and then automate.* If you know you need to deposit certain amounts to various savings, investment and checking accounts every Friday, why not make that process as easy as possible? Sign up for automatic withdrawal to all key retirement accounts at work and automatic deposits to personal accounts every payday. It's hard to spend money you don't see.

*Bottom line:* The key to a better financial life may be as close as the calendar you keep on your wall, your computer or smartphone. Assigning actual dates to your spending, savings, investing and planning decisions will make sure important money decisions are always on your "to-do" list.

Nathaniel Sillin directs Visa's financial education programs. To follow Practical Money Skills on Twitter: www.twitter.com/PracticalMoney

This article is intended to provide general information and should not be considered legal, tax or financial advice. It's always a good idea to consult a legal, tax or financial advisor for specific information on how certain laws apply to you and about your individual financial situation.

-- 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 11 hours ago.

In North Carolina, 544,950 signed up for health insurance through the Affordable Care Act this year, already eclipsing last year’s total and more than doubling the number that had signed up by Christmas 2014. This snapshot, for the first time, reflects consumers who were automatically re-enrolled into 2016 coverage. Many of these consumers will see a premium rate increase, largely because health insurers underestimated the costs they would pay in health care claims for those enrolled in these… Reported by bizjournals 11 hours ago.

Making predictions on what will happen in politics is a risky business, especially for an entire year. Just ask those who thought at the beginning of 2015 they knew how the GOP presidential nomination process was going to play out.

With that caveat in mind, here are a few thoughts on what might happen in health care in 2016.

*The Affordable Care Act*

Since the moment it was passed and signed into law, the GOP has trained its sights on the ACA and made repeal a central policy goal of the party. The problem was -- and remains -- the GOP does not have the 60 votes in the Senate to overcome a filibuster by Democrats, and even if it could (and they found a way to overcome that hurdle, more on that later), they still faced the reality of a presidential veto. Despite this, the House passed upwards of 50 pieces of legislation to repeal all, or parts, of the ACA with no success as the bills died in the Senate.

They have had some success over the years going at the law indirectly but only around the edges. However, in the must-pass 2016 spending bill the GOP succeeded in including several changes to the law that while not altering its core, will have an impact. Changes include delays in the Cadillac tax on high-cost health plans (two years), the Health Insurance Tax (one year) and the medical device tax (two years) as well as a continuation of a requirement that makes the 3Rs (risk corridors, reinsurance and risk adjustment, which together are designed to protect health plans against unforeseen losses) program budget neutral.

The impact of these changes will be less revenue for the government to pay for the law, though insurers and medical device manufacturers say the delays will help keep the cost of their products from going up as much if the taxes were in place. The 3Rs change, while portrayed as "corporate welfare" by Republicans, could lead to the demise of more co-ops and lead some health plans to leave the marketplace in 2017.

The big news for the GOP is that they appear poised in early 2016 to send a Budget Reconciliation bill to the president's desk that in essence repeals nearly all of the ACA -- a goal they have had since the bill first became law. The president has already indicated he will veto the bill, and it is not expected either chamber will muster the two-thirds votes necessary to override a veto. However, politically this will fulfill a major goal for the GOP in that they will have sent for the first time a bill to the president's desk that repeals the law. This will allow them to make the case to the electorate that all they need now is for the voters to send a Republican president to the White House in November 2016.

*ACA: 2016*

With the achievement of sending a bill to the president that repeals the law, in 2016 Republicans will switch from trying to repeal the ACA to oversight of the law led by an investigation into co-ops. Various committees in the House and Senate will conduct more investigations and oversight of key components including the collapse of the co-op program and various other aspects of the bill including how states spent federal funds on creating the state marketplaces and other provisions involving the spending of federal dollars in support of the program. They will use the results and hearings to help shape the health care debate in the presidential and House and Senate races and put pressure on Democratic candidates.

*Co-Ops*

Co-ops, created by the ACA as an alternative to the public option proposal, which was floated by some Democrats when the bill was being written, were seen by many as a solid competitor to private plans. And while co-ops exist and do quite well in the non-ACA marketplace world, the circumstances they were created under and the regulatory scheme that governs them made their success highly problematic. Under any circumstance, running a health plan of any kind is difficult, requiring expertise and experience. The co-ops faced even more challenges as the law limited who could sit on their boards of directors effectively robbing them of needed expertise. This combined with a strategy of going to market with often market-leading low premium prices that did not match up with expected utilization led to shaky finances. The end came for many when the government was unable to share its promised payments under the 3Rs program due to the deal they struck with Congress earlier that made the program budget neutral and limited the amount of funds they had available to payout to participants. As a result, 13 of the original 25 co-ops went out of business in 2015. The finances of the remaining 12 are clearly in jeopardy.

By the time of the November election, it is likely that only two to four co-ops will exist giving the GOP and their presidential nominee a great sound bite for the November election. Democrats will try and prop up the program without success. Despite the claims from both sides about why the program failed (GOP will say it was poorly managed/regulated and expand that claim to the ACA; Democrats will say GOP pulled the rug out from under the program by limiting payments from the 3Rs and as a result harmed persons and the taxpayer), the bigger reality is that running a health plan under even the best of circumstances is a very difficult endeavor.

Whatever happens, it is the consumer who will feel the result.

*Drug Prices*

The focus of the political pendulum swung from the health insurance industry to the pharmaceutical industry in 2014 and 2015 starting with the revelations about the price of Gilead's new Hepatitis C drug Sovaldi (and how much revenue this generated for the company) through the price increase that Turing Pharmaceuticals made for Daraprim, a drug used to treat toxoplasmosis, which is a parasitic disease that afflicts people with weakened immune systems such as individuals suffering from AIDS and pregnant women. Turing increased the drug's price by 5000 percent -- from $13.50 a pill to $750.

In 2015, through its monthly tracking poll, the Kaiser Family Foundation reported that the cost of pharmaceuticals were high on the public's mind as an issue of great importance.

Given this, the debate over health care costs will heat up in 2016 particularly regarding drug costs. This is important because the GOP, long a defender of the pharmaceutical industry, is beginning to show cracks in their normal blanket defense as witnessed by recent hearings by the Senate Special Committee on Aging and Senator McCain's revival of the old chestnut "Drug Importation." While no significant legislation will pass because it is a presidential election year, a feel-good bill or two might (i.e., drug importation, which will do nothing to reduce drugs costs though Republicans will claim it will, thus risking the continued anger of voters who already feel let down by unfulfilled promises). However, the debate in 2016 is important as it will shape what happens in 2017 where the real action will happen.

And that's the way it might be in 2016 - or not.

-- 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 11 hours ago.

Reported by syracuse.com 8 hours ago.

As telemedicine continues changing the way we experience healthcare, more Americans see smart phone doctor appointments as a standard commodity that can be given away as a gift. Some see it as the perfect gift for busy friends and relatives worried about their health, but never have the time to see a doctor.

New York, NY (PRWEB) December 23, 2015

It was bound to happen. As 15-minute, $50 smart phone doctor visits become an increasingly familiar way to see a doctor, at least one telecare provider, New York based DocChat, sees virtual doctor appointments as a great holiday or birthday gift idea; and patients agree.

“We want to do more than make healthcare convenient and affordable,” said DocChat founder Dr. Steve Okhravi, a former hospital ER physician. “We want to make it a commodity, a product people can purchase in different packages and give to friends or relatives who are too busy to visit a local doctor but not too busy to see one through their smart phone.”

Last week, DocChat began offering “Digital Doctor Gift Certificates” - the first telemedicine gift certificate offered by any provider in the fast-growing mobile healthcare market. By visiting the DocChat Gift Certificate Ordering Page on the company's Website - https://docchat.io/giftcardsCheckout - a health-conscious friend can purchase a discounted virtual doctor consultation for $40. The certificate can be purchased by anyone and sent by email to a friend relative anywhere in the US. According to DocChat, it makes no difference whether the certificate recipient is located in the same city or across the country and it makes no difference whether they have health insurance. As long as telemedicine services have been approved in the patient's state, the gift certificate can be redeemed and the recipient will have access to board-certified medical care through their Smart phone, laptop, or desktop whenever they wish. The company's slogan launched along with the service: "Give the Gift of Health!"

“I think it’s a great idea,” said 76-year old Margarita Benson, an Oakland, CA resident and regular DocChat patient. “I’m diabetic and use DocChat when I get worried about my sugar levels being too high or too low. Having instant access to a physician through my smart phone who’s also an expert in diabetes helps me manage my panic attacks.” Thanks to timely advice from her DocChat doctor, Benson has avoided the expense and inconvenience of frequent trips to the ER. She thanks DocChat for saving her money and keeping her out of the hospital. “When I read about DocChat gift certificates, I immediately thought of my daughter and signed up,” said Benson. Her daughter, Sabrina Shane 48-years-old resident of Oakland, CA and the mother of three underage children, maintains a full-time job as a single mother. Because her children always seem to be skinning their knees, breaking bones, of catching colds, the DocChat gift certificate is likely to be used within a few weeks or within a few days after the holiday season. “My daughter has no time. Giving her a digital doctor is the only way she's going to see a doctor," said Benson. DocChat guarantees that a board-certified physician will be available for a video call within 15 minutes.

DocChat offers "Digital Doctor Gift Certificates" in four discounted packages:
1) 1 Call/Consultation = $40 ($10 savings)
2) 3 Calls/Consultations = $110 ($40 savings)
3) 5 Calls/Consultations = $180 ($70 savings)
4) 12 mo. annual subscription = $500 ($100 savings)

Will gift certificate recipients appreciate the convenience of a free virtual doctor’s appointment? A recent study suggests the answer is “yes”. The study of 8,000 patients who used telemedicine services found no difference between the virtual appointment and an in-person office visit. Reported by PRWeb 8 hours ago.

The state may have to return to about $830,000 in Cover Oregon federal grant funding it used for operational expenditures, rather than for building the health insurance marketplace website. The items in dispute are $448,080 for construction activities at one of Cover Oregon’s leased buildings and $382,179 in retention bonuses paid to Cover Oregon employees, said Jake Sunderland, spokesman for the Department of Consumer and Business Services. What were the biggest Oregon health care stories… Reported by bizjournals 7 hours ago.