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Dictionaries Are Tracking Trumpian Word Usage To Update The English Language Accordingly

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How much power does an American president have?

Enough, apparently, to issue executive orders considered unsound by ethicists. And enough to alter the language we use, as evidenced by dictionary updates centered on heads of state past and present.

The Guardian reported Monday that lexicographers are tracking the use of Donald Trump–related pejoratives, including “Trumpertantrum,” “Trumpkin” and “Trumponomics.”

“We have collected evidence of all of these words and are actively tracking them to see how usage develops,” Katherine Martin, head of U.S. dictionaries at Oxford, told The Huffington Post. “Whether they are eventually added to our dictionaries will depend on the extent to which evidence continues to proliferate.”

Oxford Dictionaries makes a distinction between words added to its digital database, Oxford Online, and words added to the more permanent Oxford English Dictionary. The former is a fluid snapshot of the language at present; the latter is a historical resource that never removes entries. For a word to be added to Oxford Online, its use has to be more than a trendy blip, but it doesn’t need to have been in the lexicon for decades, as is often the case with the OED.

Martin said that “Trumpertanrum,” which spiked in use for a month last February after Sen. Ted Cruz (R-Texas) coined it, “does not appear to be gaining ground as a part of the lexicon.” But “Trumpkin,” as used to describe the president’s supporters, “has been used in a variety of contexts and sources over a longer period of time and continues to amass evidence.”

The word’s other use ― to describe Trump-inspired jack-o’-lanterns ― only saw “significant but ephemeral” use around Halloween last year.

As for “Trumponomics,” Martin says similar words have caught on varyingly. “’Reaganomics’ and ‘Clintonomics’ were widely adopted, but ‘Bushonomics’ and ‘Obamanomics’ far less so,” she said. 

One word Obama’s legacy did leave behind: “Obamacare,” which Oxford Dictionaries defines as “an informal term for a federal law intended to improve access to health insurance for U.S. citizens.” The wording of the definition is intentionally nonpartisan, as are the example sentences listed below it.

“Oxford Dictionaries endeavors to provide factual, unbiased definitions and sample sentences for all words,” Martin said. “This is particularly important when the words are of a political nature.”

-- 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.

Outrage of the Month: Rep. Tom Price: Unfit to Be HHS Secretary

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Read more in Public Citizen's February Health Letter
President Donald Trump would be hard-pressed to find a worse candidate to lead the U.S. Department of Health and Human Services (HHS) than Rep. Tom Price (R-Ga.). Throughout his career in Congress, Price consistently has championed policies that are incompatible with the fundamental mission of HHS, which is “to enhance and protect the health and well-being of all Americans.”

Most troubling have been Price’s relentless efforts to repeal the Affordable Care Act (ACA), legislation that extended health insurance coverage to 20 million more people and reduced the uninsured rate from 16 percent to 9 percent.[1] In 2009, he introduced the misleadingly named Empowering Patients First Act, one of the first bills proposed to replace the ACA. The bill would implement a package of discredited policies, such as high-risk patient pools and individual tax credits for health insurance costs. The legislation also would allow insurers to once again deny coverage to people with pre-existing medical conditions and would eliminate billions of dollars provided to states to expand Medicaid eligibility.[2]

The bill, which Price reintroduced in 2011, 2013 and 2015, would cause millions of people to suddenly lose their health insurance coverage. And the cruel result would be widespread, preventable suffering and deaths among the many people who could no longer afford health care.

In addition to the harming the poorest and most vulnerable patients in this country, Price’s legislation to repeal the ACA also would reward the wealthy physician specialists who have contributed more than $3 million to him since he was elected to Congress in 2004. For example, one section of the bill, titled “Lawsuit Abuse Reform,” would make it more difficult for patients injured by negligent physicians to obtain compensation through malpractice lawsuits.

During his contentious initial confirmation hearing on Jan. 18 before the Senate committee that oversees health issues, Price — himself a physician who should know better than anyone the importance of ensuring health care for all — was pressed by Sen. Bernie Sanders (I-Vt.) regarding whether he believed all Americans, both rich and poor, have a right to health care. Price refused to reply yes or no, but instead said he believed all Americans should have “access to the highest-quality care and coverage that is possible.” Such a statement is a far cry from affirming that people have a right to health care. Indeed, as Sanders quipped, “Has ‘access to’ does not mean that they are guaranteed health care: I have access to buying a $10 million home; I don’t have the money to do that.”

In addition to seeking the dismantling of the ACA, Price also wants to effectively destroy traditional Medicare, a lifesaving program for America’s seniors. He has been a staunch proponent of House Speaker Paul Ryan’s (R-Wis.) plan to privatize Medicare by converting it to a “premium support” voucher program. This change would dramatically increase out-of-pocket health care costs for seniors, making medical care unaffordable for many, while at the same time bolstering the profits of the private insurance corporations.

The Senate must reject the nomination of Price for Secretary of Health and Human Services. His policy prescriptions would be toxic for millions of Americans and would move the nation’s health care system backward.

References

[1] Obama B. United States health care reform. JAMA. 2016;27(6):1718-1727.

[2] Pear R. Tom Price, H.H.S. nominee, drafted remake of health law. New York Times. November 29, 2016. https://www.nytimes.com/2016/11/29/us/tom-price-trump-health-secretary.html. Accessed January 19, 2017.

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

Trump’s Supreme Court Pick: "The Best The Left Could Have Hoped For"

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Trump’s Supreme Court Pick: The Best The Left Could Have Hoped For Submitted by Mike Shedlock via MishTalk.com,

Donald Trump named Neil Gorsuch to succeed Antonin Scalia on the Supreme Court.



The leading candidates for the job all had strong conservative credentials.

 

Gorsuch, 49, joined an opinion in 2013 saying that owners of private companies could object on religious grounds to a provision of the Obamacare health insurance law requiring employers to provide coverage for birth control for women.

 

Hardiman, 51, has embraced a broad interpretation of the constitutional guarantee of the right to bear arms and has backed the right of schools to restrict student speech.

 

Pryor, 54, has been an outspoken critic of the court's 1973 landmark Roe v. Wade ruling legalizing abortion, calling it "the worst abomination of constitutional law in our history."



*Is “Dilbert Persuasion Theory” in play?*

I use that name in reference to Scott Adams the creator of the “Dilbert” comic strip. Adams proposed that* Trump says and does things so extreme, and so many extreme things at once, that all Trump has to do is move a bit the other way to have his critics on the run.*

Let’s put that theory to the test today starting with The Hill article Trump Taps Neil Gorsuch for Supreme Court.



Trump named Gorsuch, a well-respected conservative who sits on the Colorado-based 10th Circuit U.S. Court of Appeals, after a drama-packed day that resembled the president’s former reality show “The Apprentice.”

 

After narrowing his list of 21 picks to Gorsuch and Judge Thomas Hardiman of the Third Circuit U.S. Court of Appeals, both men came to Washington, D.C., giving the appearance that either could be picked.

 

Gorsuch is likely to face a tough confirmation battle, though he was seen as a less provocative choice for the court than Bill Pryor, the circuit judge for the U.S. Court of Appeals for the Eleventh Circuit.

 

*Pryor was a favorite of outside conservative groups, but his controversial views might have made it difficult for Democrats to avoid filibustering him. He has argued that gay people should be prosecuted for having sex, and that abortion should be outlawed including in cases of rape.*



Although Pryor did not make it to the final two, he is in the on deck circle. Pryor’s views on abortion are extreme. Here is an article that came up just today William Pryor & Abortion: 5 Fast Facts You Need to Know.

*Positions of Hardiman and Gorsuch*

Please consider Politico excerpts on Thomas Hardiman.

While Hardiman has backed First Amendment rights in the context of political donations, he took a narrower view in a 2010 suit over an arrest for videotaping a police officer during a traffic stop, holding that there was no clearly established First Amendment right to record such an event.

Hardiman won favor with gun rights advocates for a 2013 dissent that said New Jersey was violating the Second Amendment to the Constitution by requiring those seeking to carry a handgun to demonstrate a “justifiable need” for such a permit.

Wikipedia notes that Neil Gorsuch “has never had the opportunity to write an opinion on Roe v. Wade. However, based on the opinions expressed in his book opposing euthanasia and assisted suicide, some speculate that he may tend to rule in favor of pro-life stances in abortion-related cases.”

*Hill Continues*



Sen. Jeff Merkley (D-Ore.) has promised to raise procedural objections to any Supreme Court nominee from Trump, meaning Gorsuch will likely need 60 votes.

 

But it is unclear whether Democrats at large will back a filibuster. Republicans have 52 seats in the Senate, meaning they need eight Democratic votes to break a filibuster. Ten Democrats are up for reelection in 2018 in states won by Trump in the presidential race. It may be difficult for them to filibuster a nominee such as Gorsuch — though they will be under tremendous pressure from liberal groups to do so.



*Neither Gorsuch nor Hardiman will be the lightning rod that Pryor would have been.*

Although Pryor did not make it to the final two, he was in the final 21.

*Silver Lining?*

The Wall Street Journal points out Judge Neil Gorsuch Is Critic of Legal Doctrine That Bolsters Executive Authority.



Judge Neil Gorsuch, President Donald Trump’s nominee to the U.S. Supreme Court, is seen by the right as a credible heir to the late Justice Antonin Scalia. But in one respect, his judicial record could offer Democrats something of a silver lining.

 

As a member of the 10th U.S. Circuit Court of Appeals in Denver, Judge Gorsuch has emerged as a leading critic of a Reagan-era judicial doctrine that has helped to bolster the power of the executive branch.



*Persuasion Theory*

For more on persuasion theory and why it may apply here, please see Trump Ban: Inept Policy or Purposeful Action? WW III?

Persuasion play or not, we can all (except the homophobic radical right nut cases) be thankful that someone who believes that gay people should be prosecuted for having sex, did not make it to the Supreme Court.

We can also be grateful Gorsuch is not in favor of expanding the executive branch.

From the point of view of the Left, Gorsuch may very well be the best they could have hoped for. *The Left would be foolish to block this pick.*

I suspect relatively smooth sailing if Gorsuch handles himself well in senate hearings.

*  *  *

But then again, there's Elizabeth Warren...* The Massachusetts Democrat writes on Facebook that she'll vote against Gorsuch.* Her full post is below:



President Trump had the chance to select a consensus nominee to the Supreme Court. To the surprise of absolutely nobody, he failed that test.

 

Instead, he carried out his public promise to select a nominee from a* list drawn up by far right activist groups that were financed by big business interests.*

 

Judge Neil Gorsuch has been on this list for four months. *His public record, which I have reviewed in detail, paints a clear picture.* Before even joining the bench, he advocated to make it easier for public companies to defraud investors. As a judge, he has twisted himself into a pretzel to make sure the rules favor giant companies over workers and individual Americans. He has sided with employers who deny wages, improperly fire workers, or retaliate against whistleblowers for misconduct. He has ruled against workers in all manner of discrimination cases. And he has demonstrated hostility toward women's access to basic health care.

 

*For years, powerful interests have executed a full-scale assault on the integrity of our federal judiciary, trying to turn the Supreme Court into one more rigged game that works only for the rich and the powerful.* They spent millions to keep this seat open, and Judge Gorsuch is their reward.

 

Every day, our new President finds more ways to demonstrate his hostility for our independent judiciary, our civil society, and the rule of law.

 

*Now more than ever, America needs Supreme Court justices with a proven record of standing up for the rights of all Americans – civil rights, women's rights, LGBT rights, and all other protections guaranteed by our laws. We don't need another justice who spends his time looking out for those with money and influence.*

 

Based on the long and well-established record of Judge Gorsuch, I will oppose his nomination.



And Democratic Senator Jeff Merkley has vowed to pursue a procedural hurdle called a filibuster for Trump's nominee, meaning 60 votes would be needed in the 100-seat Senate unless its long-standing rules are changed. Trump's fellow Republicans hold a 52-48 majority, meaning some Democratic votes would be needed to confirm his pick.



*"We need to fight this Constitution-shredding gambit with everything we've got," Merkley said in a statement.*

Reported by Zero Hedge 3 hours ago.

Neil Gorsuch's Nomination Is Bad News For Planned Parenthood

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WASHINGTON― Neil Gorsuch, President Donald Trump’s Supreme Court nominee, has sided against Planned Parenthood and birth control coverage during his career as a federal appeals court judge. 

In October 2016, Gorsuch backed the state of Utah in its decision to defund Planned Parenthood after anti-abortion activists released a series of heavily edited videos purporting to show the family planning provider negotiating the sale of fetal tissue.

The 10th U.S. Circuit Court of Appeals sided with Planned Parenthood, ruling that Utah Gov. Gary Herbert (R) had likely pulled $275,000 in grants from Planned Parenthood in retaliation for the group’s legal abortion advocacy, an unconstitutional motive.

Gorsuch dissented, arguing that Herbert had lawfully defunded Planned Parenthood because he believed the group was involved in fetal tissue trafficking. “It is undisputed that when the Governor announced his decision to discontinue funding he contemporaneously explained that his decision came in direct response to the videos,” he wrote. “And it is undisputed, too, that the Governor was free as a matter of law to suspend the funding in question for this reason.”

“To be sure,” he continued, “the panel cited the fact that the Governor has long opposed abortion and, from this, inferred that he wanted to punish the group for its lawful abortion advocacy. But it is undisputed that the Governor has held office since 2009 and had taken no action against [Planned Parenthood Advocates of Utah] until shortly after the release of the videos of 2015.” 

Indeed, while Republicans in Congress and state legislatures have been trying to defund Planned Parenthood since 2011, even threatening to shut down the federal government over the issue, the release of the “sting” videos in 2015 gave them political cover to execute the move.

Defunding Planned Parenthood is deeply unpopular with the public ― especially since the family planning provider was cleared of wrongdoing in the wake of the videos. 

The Planned Parenthood dissent was not the first time Gorsuch sided against reproductive rights and birth control access. In 2013, he joined the 10th Circuit Court of Appeals in ruling that the Obama administration could not require closely held, for-profit companies like Hobby Lobby, the Christian-owned craft supply chain, to include contraceptives in their health insurance plans. In his concurring opinion, Gorsuch suggested that it’s reasonable to consider taking birth control “wrongful conduct.” 

“All of us face the problem of complicity,” he wrote. “All of us must answer for ourselves whether and to what degree we are willing to be involved in the wrongdoing of others. For some, religion provides an essential source of guidance both about what constitutes wrongful conduct and the degree to which those who assist others in committing wrongful conduct themselves bear moral culpability.”

If Gorsuch fills the Supreme Court vacancy left open by Justice Antonin Scalia, his opinions on Planned Parenthood, birth control and abortion will be extremely important to the future of reproductive rights in the United States. Republicans control the House and Senate, and Trump opposes abortion rights, so the high court will likely have a chance to weigh in soon on laws that limit women’s health care options. 

Planned Parenthood President Cecile Richards released a statement Tuesday night strongly opposing Gorsuch’s nomination. 

“Nominees to the highest court in the land must make clear that they will protect our fundamental rights ― including the right of a woman to control her body,” Richards said. “There has never been a more important Supreme Court nomination. It has become crystal clear that the courts are going to be the last - and sometimes only - line of defense against dangerous and unconstitutional attacks on basic rights.”  

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-- 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 3 hours ago.

Entrepreneurs: Health law changes may mean finding new jobs

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With Republicans working on legislation to repeal and replace the Affordable Care Act, people who traded a full-time job for entrepreneurship are concerned that new insurance policies may be too expensive or not available at all — and possibly force them to find new jobs that offer cheaper and more comprehensive group plans. "From a safety and stability standpoint, I have to look for a job now," says Michael Duffield, owner of Fruition, a marketing business based in Palm Springs, California, that he started in 2011. [...] while GOP lawmakers and President Donald Trump have said they want a new law to keep the ACA's requirement that insurers cover pre-existing medical conditions, Duffield is anxious about what coverage might look like in the future. For many, leaving a job with a group insurance plan, especially one that their employers contribute to, means they'll have to buy individual policies that are more expensive and may cover less. The ability to buy individual insurance on exchanges in each state helped some of Merredith Branscombe's clients decide to leave their jobs for entrepreneurship. Members of the National Association for the Self-Employed have been calling in recent weeks, asking if the advocacy group will reinstate the health insurance plan it discontinued when the ACA went into effect, says Katie Vlietstra, the organization's vice president for government relations and public affairs. A survey released by the Kaiser Family Foundation in November found that 69 percent or more of participants said they had a favorable opinion of a number of the law's requirements, including coverage for pre-existing medical conditions, the ability of young adults to stay on their parents' plans until age 26 and subsidies to help low-income people buy insurance. Josh Lapp, who co-owns Designing Local in Columbus, Ohio, notes that he and his partners in the community planning and design business can't increase Reported by SeattlePI.com 2 hours ago.

10 Little-Known Tips For Saving Money On Health Care

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Sometimes, the devil is in the details. That’s a rule that applies to health care as well; the more you know, the better off you will be. Here are 10 ways you might be surprised to know you can save money on the one truly priceless thing you have: your health.

*1. Prescriptions may cost you less if you don’t use your insurance.*

As difficult a pill as this is to swallow, your best deal on some commonly prescribed drugs may be found by ignoring the drug coverage you pay for and instead just reaching for your wallet. Often, your insurance drug plan requires a copay that is higher than the cost of paying cash at the register. 

Several pharmacies, including Walmart, charge as little as $4 for a 30-day supply of some generic drugs, or $10 for a 90-day supply. Costco has an even longer list of low-cost generics and doesn’t require a membership to use its pharmacy. Costco also offers a home delivery service and will also fill prescriptions for your pets. 

David Belk, a physician in the San Francisco Bay Area, who runs the website, TrueCostofHealthcare.org, suggests that before you hand your insurance card to the pharmacist, use your insurer’s or employer’s tools to check your out-of-pocket costs for your medications. Compare that with the pharmacy’s cash price. This strategy often saves money on generics, but might not bode as well with brand-name drugs, Belk says. With more expensive drugs, the insurance company may have negotiated a lower rate. 

2. Ask your doctor for both samples and coupons.

When your doctor prescribes you something you haven’t taken before, neither of you know whether you will have an adverse reaction. It is a perfectly legitimate to ask for a sample that you can try before you spend money on filling a prescription. 

But also ask for a coupon! Yes, drug manufacturers frequently give the doctor a pad of discount coupons to dispense along with the prescriptions. The last thing the drug manufacturer wants is for you to get to the pharmacy, hear the price and walk out. The coupon strategy, while a bit like buying cereal in the supermarket, makes the customer feel good about a break. But a good many physicians simply ignore or forget about the coupons; you, on the other hand, shouldn’t. 

3. Hit up the drug manufacturers for discounts.

Many drug companies have assistance programs for their medications. In some cases, they are need-based ― but not always. Sometimes you just need to know to ask. You can check what’s available here based on drug name. Or google the name of your medication and the word “coupon” and see if the drug manufacturer’s website has details. Prozac is covered by the Lilly Cares program. The high price of Renvela, a phosphate binder frequently prescribed for kidney dialysis patients, drops to $5 a month with a simple one-page form asking for the patient’s name, date of birth, address, and the location where dialysis was being given. Renvela costs several hundred dollars otherwise.

4. Consider an HMO.

In an HMO, you are restricted to treatment by providers who work for the HMO. Visits to doctors and hospitals outside of that HMO typically aren’t covered, except in emergencies. Doctors work for the HMO, not the patient although they are professionally bound to deliver the best care possible. The long-ago days of HMOs having a bad rap have passed.

HMOs restrict your choices, but greater freedom has a heftier price. 

5. If you don’t need a Cadillac, why not just buy a Ford?

 In general, you will pay higher premiums if you want to retain the flexibility of seeing any doctor of your choosing.

Why do people care about doing that? In some cases, they have a long-standing relationship with a particular doctor who doesn’t happen to be in their company’s insurance network. They want to keep seeing him, so they choose a PPO that allows them to do so even if it means they will pay more.

Why else? Some people feel that if they should get seriously ill, they will want to see the top specialists in that field. It’s the old joke: What do you call that guy who graduated dead last in his medical school class? You call him “Doctor.” If you’ve just been told you are terminally ill, you may not want that guy. 

It seems obvious but bears repeating: If choice isn’t important to you, why pay for it.

6. Practice asking: “Are you in-network?”

Whenever it is in your power to do so, book appointments with practitioners who are in-network for your plan. This means they have agreed to accept a certain amount for their services and you will only have to pay your copay and deductible. At least in theory.

Alas, if it were only this simple.

Your doctor may be in-network, but is the lab he sends your blood to also in-network? If not, you may get a bill and be expected to pay it. What about the specialist he sends you to for that rash? Before you make an appointment, find out if she is in-network. 

Things get really dicey when your in-network doctor sends you to an in-network hospital, but the emergency room doctor, the hospitalists, the surgeon or anesthesiologist are all out-of-network. Yes, what you are supposed to presumably do is stop the doctor with the chest paddles and ask if he takes your insurance in-network. Absurd, right?

The situation has gotten so out of hand that a Kaiser Family Foundation study reported that nearly 7 in 10 people with unaffordable out-of-network medical bills did not know that the health care provider was not in their plan’s network at the time they received care.

7. Ask if your doctor plans to “balance bill” you, and if he does, go elsewhere.

Balance billing is when a provider takes the money from your insurance plan, decides he’s entitled to more, and then sends you a bill for the rest of their desired fee, aka the “balance.” Mind you, they likely never told you upfront that they intended to do this. Nor do they tell you just how much they will bill you for.

Balance billing has been deemed illegal in some states under certain circumstances. Just last year, New York set limits on these bills from out-of-network providers in emergency situations and in non-emergency situations when patients receive treatment at an in-network hospital or facility. 

Talk about a situation begging for a federal solution.
8. Ask to see the itemized charges sent to your insurer.

You may be amazed to see how often your doctor’s office messes up. A wrong billing code can cost thousands of dollars more. There is plenty you can learn from seeing an itemized bill, and a lot of it may raise your blood pressure. You might even discover that you were billed for procedures and things that didn’t actually occur. 

NerdWallet found that 49 percent of Medicare medical claims contain medical billing errors ― resulting in a 26.4 percent overpayment for the care provided. Stephen Parente, a professor of health finance at the University of Minnesota who has studied medical billing extensively, estimates that 30 percent to 40 percent of medical bills contain errors. The Access Project, a Boston-based health-care advocacy group, says it’s closer to 80 percent. And these mistakes are adversely impacting our credit.  An estimated 9 million people in 2016 were contacted by a collection agency because of a billing mistake, according to the 2016 Biennial Health Insurance survey by the Commonwealth Fund, a Washington-based nonprofit focused on health-care research. Medical bills account for more than half of all debts in collection, said a Consumer Financial Protection Bureau study.

So it behooves you to ask exactly what you are being billed for.

“Sometimes, just requesting this information [an itemized bill] is enough to rattle a billing employee into action,” notes the Medical Billing Advocates of America.

Let’s rattle, shall we?

9. Take advantage of free screenings and flu shots.

Nothing beats free. Drugstores, employers and even shopping centers are getting in on the free game. Blood pressure tests, health screenings and flu shots can generally be found in your local community. If you are a senior, try your local senior center. If you can’t find free, Costco and Sam’s Club offer them for about $15, which may even beat your copay for an office visit to your doctor.

10. Try Living Social for dental cleanings.

Dental insurance is often capped and won’t pay for cosmetic work. If you get it from your employer, good on you. But the idea of buying it on the open market gets mixed opinions.

Instead, consider this: Negotiate a cash price with your dentist for any major dental work and use Living Social vouchers for routine cleanings and exams with X-rays. The prices range from $19 to $50 and are generally offered by dentists hoping to grow their practices. 

-- 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.

Insurers shrink from exchanges as lawmakers mull changes

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The Affordable Care Act's insurance exchanges have become too risky for major health insurers, and that's creating further doubt about coverage options consumers might have next year. Swedish told Wall Street analysts during a conference call that if Anthem doesn't see stability in the exchanges heading into next year, "then we will begin making some very conscious decisions with respect to extracting ourselves." The losses that insurers have taken on coverage sold on these state-based exchanges in recent years have already prompted some to scale back their participation or raise rates, in some cases dramatically. Separately, Tennessee insurance commissioner Julie McPeak told a US Senate panel Wednesday that Congress needs to send the industry a clear signal by March to avoid disrupting the individual health insurance market for 2018. Reported by SeattlePI.com 4 hours ago.

People Are Rushing To Get Critical Prescriptions Out Of Fear Over Obamacare Repeal

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Vicki Murphy can’t afford to pay for her blood pressure medication if she loses the health insurance she obtained through the Affordable Care Act. That’s why the 55-year-old is planning to stock up on her medications now.

In the first wave of health-related worry after the election of President Donald Trump, women rushed to get IUDs and other long-acting forms of birth control out of fear that the new administration would eliminate Obamacare’s birth control coverage.

But an ACA repeal threatens more than reproductive care. 

Women around the country are trying to stockpile a range of medications and find substitutes for other treatments that allow them to function in their daily lives ― just in case the entire law is shelved and an adequate replacement isn’t enacted. 

People who enrolled for Obamacare coverage in 2017 should have insurance through the end of the year. But no one is sure what actions the Trump administration may take to undermine the program in the coming months. The president has already issued an executive order that could potentially weaken the ACA before repeal, leaving people worried and searching for alternatives. 

While some people stand to benefit from ACA repeal ― either because their premiums would decrease or they’re among the well-off who would get large tax cuts ― Murphy and other women who spoke with The Huffington Post won’t.

A three-month supply of the blood pressure medication Murphy needs to reduce severe swelling in her legs has a market price of $157.99.

She can’t afford that. “I live on just about $600 a month. That’s for rent, utilities and food,” said the Long Beach, California, resident.

Without Obamacare, Murphy said she also can’t afford the physical therapy sessions she needs to alleviate back pain from a severe spinal injury. Her surgeon has even ordered her a back brace, she said, just in case.

“When the ACA passed, I qualified for free Medi-Cal [Medicaid],” Murphy said. “It covers my medicine for blood pressure, cholesterol, physical therapy and my overall medical needs. If I lose my coverage, I will not be able to afford any of my medications. None of my doctors will say that I’m disabled [but] I’m only able to handle working for my parents for three to four hours, four or five days a week.”

Medical decisions should be driven by current medical needs and conversations with health care providers instead of potential policy changes, said Dania Palanker, a health policy expert at Georgetown University.

One risk in stockpiling medications, Palanker noted, is that the drugs that are the right choice for a patient today may not be tomorrow.Murphy was uninsured for more than five years before the ACA expanded Medicaid. The law has been critical to better health care for her and for many others. Researchers studying the impact of Obamacare have consistently found that people who obtained insurance under the ACA gained better access to care as well.

Those gains haven’t always been huge, but they have been real ― as Megan Rodriguez can attest. On election night, Rodriguez started making plans to get some key medical needs addressed before Republicans could finalize a repeal.

The 29-year-old Chicago medical student said she won’t be able to afford the prescription glasses she needs to see without insurance. She is also hoping to obtain a long-term form of birth control. 

“I’m really nervous and worried that they’re going to be able to take all of this away, so I’m trying to get as much done as quick as possible,” she said.

“I don’t know when the next news update is gonna come that they’ve repealed some provision that I’m counting on or they’ve repealed the whole thing,” Rodriguez added. “It’s adding to my anxiety.”  

Rachel, a 37-year-old mother who lives outside Baltimore, said she is ordering an emergency 90-day supply of her medications, including anti-depressants. Her primary concern is that she won’t be able to afford the Adderall she needs to alleviate chronic fatigue.

“When I didn’t have health insurance, [Adderall] costs me about $400 a month. And with my daughter — luckily she’s not on it now — but she had to be on a special formula that was $600 a month,” Rachel said.

That’s a financial burden Rachel can’t handle herself. After her divorce, she said, she went without insurance that covered mental health costs for a year. The cost of her medical bills exceeded what she made that year, leading her to file for bankruptcy. She has never quite bounced back.

“The times when I haven’t had the care I needed, I’ve gone into a lot of suicidal thoughts and making attempts even,” she said. “Obamacare saved people’s lives.”
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As a Mother, I Can't "Move On" After the Election

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Recently, my office was mostly empty, except for a friend who works across the hall from me. When everyone is gone, I listen to public radio. She hears it from her office.

We both work and live in a predominantly white, suburban area. Our children go to school with predominantly white populations. We live in Trump Country.

I’ve heard stories of Trump supporters in urban areas keeping quiet about their choice of candidate for fear of admonishment from their liberal, urban peers. Well, it’s the opposite in white suburbia. You don’t want to talk too loudly about your liberal views, lest someone draw you into a debate which often can turn mean.

That’s the thing about identifying with a political candidate, or celebrity or anyone, really. You see something of yourself reflected. And Trump is mean. And I’ve heard his supporters say some really mean things…mostly racist, classist things. They feel safe around me because I am white in an affluent area. No need to look around first.

Anyway, we were listening to the radio and a Trump soundbite came on and my office-mate said something about not being able to listen to him anymore. We started talking about it.

We have something in common. We feel that our families are directly threatened by Trump’s presidency.

We shared with each other the moments we absolutely knew that we could never support him as a president. Or a human being.

For me, that moment was when he mocked a disabled reporter. It was a moment of absolute horror. I am the mother of a child with multiple disabilities. She looks different than her peers. She sounds different than her peers. She is cognitively different than her peers. Trump is exactly the kind of person I am afraid for her to meet out in the world. A person who is deliberately cruel.

My office-mate is a white woman. She is married to a black man. They have children. For her, it was when Trump was endorsed by white nationalists. And didn’t reject that immediately. When he became the party of the KKK.

For both of us, it’s when suddenly, we had an overwhelming feeling of fear for our children’s safety and well-being.

The day after the election was a day of shock and grief for us. And much of the nation. But for some, it was a day of victory and celebration. Then the after-dialogue started, on social media and in the general public.

On one side, there was a lot of grief and disbelief. And on the other, a lot of “get over it”. It was said in various ways. “It’s over now…move on.” “It is what it is…accept it.” Or, “We didn’t throw a big fit when your side won last time. Grow up.”

Hearing those things after a devastating loss, which was personal to so many of us, felt like getting kicked when we were down. And ultimately, it felt like a betrayal.

Knowing some of my friends voted for Trump, and so many strangers voted for him, felt like a betrayal both intimate and impersonal. It felt hopeless and dark, knowing so many people voted for a racist, misogynist, intolerant able-ist. The list is incomplete.

It’s been almost 3 months since the election. The wound hasn’t healed at all. And to those who say it’s time to move on, I say, “f**k off.”

I can’t look at my beautiful daughters and forgive. My friend with the interracial family can’t look at her beautiful children and forgive. Those votes made the world an uglier, less-safe place for our children, and for that, we can’t forgive.

Some Trumpers are having buyer’s remorse. Especially now that we have collectively experienced a week of Trump’s presidential moves.

In one week we’ve lost decades of work and diplomacy and expanding liberties for our citizens. In one week we’ve come much closer to destabilizing the world at large.

In one week, we have seen steps taken to deprive millions of people of their health-insurance, to de-fund programs for women and children, to de-legitimize the citizenship of a portion of our population due to their religious beliefs, to silence the free press, to tear apart families based on legal status, to ruin one of our best trade relationships and goodwill towards a neighboring nation. It is breath-taking. What it is not, is astonishing. Because he told us he wanted to do these things. And now he is.

And Trump voters heard all of it and chose it. They heard him say these things and mock people and objectify them and be a really horrible human. And still, they chose him. They chose a fascist nightmare with the ability to literally ruin the world.

Therefore, we can’t move on. Because those votes broke America. It wasn’t perfect, especially for people of color, women, non-Christians, the LGBTQ community, for people living in poverty and people struggling in rural communities. It wasn’t perfect but we were doing the hard work to try to improve those things. And hard work can take a long time. Trump was a desperate grab at a quick fix.

I cried over my daughter while she slept last night. What changes to the public education system might take away her much-needed services? What public cruelty will she be exposed to because permission has been granted by the actions of the highest office in the land?

No, I don’t think there will come a time when I will “move on.” What is far more likely, and I’m already scrambling for purchase, is that I will be dragged violently backward. And so will you, Trump voter or not.

I hope I’m wrong, and that one day I can make peace with what has been done. With the will of, not the popular majority, but of far too many citizens, regardless. I hope I reach that day and don’t feel the sting of betrayal. Sadly, today is not that day.

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

Several Elements Behavioral Health Facilities Now Contracted With MHN Insurance

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Clients at four Elements Behavioral Health addiction treatment centers may now be able to apply their MHN health insurance benefits to the cost of treatment.

(PRWEB) February 02, 2017

The Elements Behavioral Health® family of addiction and mental health treatment centers recently contracted with MHN, an insurance provider and behavioral health subsidiary of Health Net, Inc. The new partnership allows Elements Behavioral Health clients to apply MHN insurance benefits to the cost of treatment at four facilities in the company’s national network of mental health and drug rehabs.

The contract with MHN includes insurance benefits for:

1) Residential, partial hospitalization and intensive outpatient treatment for substance abuse, mental health conditions and eating disorders at Promises Scottsdale in Arizona
2) Trauma-related substance abuse and mental health disorders treatment for clients in the trauma program at Journey Healing Centers in Utah
3) Treatment services for drug and alcohol addiction at Promises Young Adult program in West L.A. and Promises Professionals Treatment Program in Santa Monica, California

“Contracting with MHN will give more people battling addictions, eating disorders, trauma and other mental health issues access to the life-changing, evidence-based treatment that our programs provide,” said Chris Karkenny, Chief Executive Officer of Elements Behavioral Health. “We are committed to removing as many barriers to treatment as possible, and our contract with MHN makes it possible to help many more people get expert behavioral health care.”

MHN, a subsidiary of Health Net, Inc., provides managed behavioral health care services and employee assistance programs (EAPs) and is one of the oldest and largest providers of its kind in the United States. A trusted name in behavioral health care insurance for more than 30 years, MHN’s provider network includes over 1,400 medical facilities and 55,000 health care practitioners. Clients include organizations such as Taft-Hartley Trust Funds, Fortune 500 companies, health plans and government agencies.

“Our dedicated admissions teams work diligently to help make sure we maximize insurance benefits for each client who walks through our doors,” said Cassandra Loch, LCSW, President of Program Operations for Elements Behavioral Health. “Our contract with MHN provides another avenue to do this, and get people the help they need.”

About Elements Behavioral Health

Elements Behavioral Health is the owner of a nationwide platform of behavioral health programs with over 750 licensed beds throughout nine states. The Elements Behavioral Health® family of programs offers comprehensive, innovative treatment for substance abuse, depression and anxiety disorders, eating disorders, trauma, sexual addiction, and other mental health disorders. Through its programs, the company is committed to delivering evidence-based, clinically sophisticated treatment that promotes permanent lifestyle change, not only for the patient but for the entire family network. For more information, visit elementsbehavioralhealth.com. Reported by PRWeb 8 hours ago.

What the pro-life movement can learn from Planned Parenthood

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Washington D.C., Feb 2, 2017 / 03:24 am (CNA).- Planned Parenthood is the nation’s largest abortion chain – but rather than dismissing it, pregnancy help centers may be able to learn from its strengths as a brand, said one research analyst.

“The brand of Planned Parenthood is, unfortunately, pretty solid in the minds of these women,” said Dr. Jeff Pauls of the Vitae Foundation. Yet many women admitted that they “still weren’t totally comfortable with the experience of having to go there.”

Planned Parenthood may have a “solid” reputation in the minds of its customers, yet pro-life pregnancy centers could serve more of these women if they emulated its strengths, he told CNA.

The Vitae Foundation partnered with Dr. Charles Kenny, an industry leader in “right-brain research” on customers’ loyalty to brands like Coca-Cola and American Express, to investigate what Planned Parenthood’s clients thought of the organization and discover what pro-life pregnancy centers could learn from the abortion giant.

They conducted in-depth interviews of over 70 women, many of them from metropolitan areas like New York, Chicago, Miami, and Los Angeles and who “had no idea who did the interview,” Pauls noted.

Questions asked included when and how women had first heard about Planned Parenthood, why they decided to go there, what they thought about the organization’s brand and health care, and if they had ever heard of a “pregnancy help center.”

The questions were meant to “have them go into their mind’s eye and really relive their experience at Planned Parenthood,” Pauls said. There were two types of customers they found, “active” women who were currently customers of Planned Parenthood, and “legacy customers,” or women who used to go to Planned Parenthood and had stopped going, but had referred someone else there in the last year.

They found that Planned Parenthood has a “solid” reputation with these women, but along their brand’s strengths there were significant weaknesses, as the women interviewed acknowledged negative experiences at clinics.

The “strengths” of the Planned Parenthood brand are a “non-judgmental” appearance of staff workers who help women think they are in “control,” providing them feelings of “acceptance” and “freedom,” Pauls explained.

They also promote an atmosphere of “confidentiality” which is really “secrecy,” Pauls said, “the way that Planned Parenthood helps them engage in risky sexual activity without their parents knowing.”

However, women also complained of “long waits” at clinics as well as an “unpleasant gauntlet of fear, anxiety, nervousness, and anger that they had to deal with in the waiting room,” he continued.

“Try as they might to develop this kind of warm, comfortable waiting room experience, it’s nearly impossible, according to the women, because of what’s going on there,” he explained, noting that women recalled thinking, “I just don’t feel like I belong here with these people.”

And there were violations of HIPAA – of the privacy of one’s confidential medical information – at clinics.

“We did hear some women talking about Planned Parenthood staff talking about procedures out in the waiting room, in front of everybody,” Pauls noted. These public conversations included “what their health history was.”

While such instances were not frequent, “we did hear that from enough women that that’s not rare,” he said.

Another brand “weakness” was that women who frequented Planned Parenthood clinics when they were younger had moved on to other health care providers as they grew older, even though they still referred younger clients to clinics.

There might be several reasons for this, Pauls explained. Older women may have stopped the “risky sexual activity” of their former years, or they might have better health insurance and be “in a position to afford and get good health care at a doctor or an OBGYN,” he said.

“They say that they still believe that Planned Parenthood is as good or better than” other providers, Pauls said. Women appreciated what Planned Parenthood did for them – providing them with birth control and performing abortions – but they “still weren’t totally comfortable with the experience of having to go there.”

Planned Parenthood has recently insisted that it is an important provider of women’s health care. Yet it is not holistic health care, Pauls insisted.

“It’s a place to get, in their words, to ‘fix a mistake’” and “solve a problem.”

For instance, clinics did not offer “real counseling” for women considering abortion, “because if they did, it would be an admission that abortion harms women,” Pauls said.

Rather, clinics focused on “helping women feel alright about abortion, and giving them these defense and coping mechanisms for the inevitable pain and difficulty they go through,” he said.

For instance, clinic workers told women of their abortion “you won’t even think about it later on” and “it’s no big deal, women do this all the time.”

They would encourage them that “it’s actually a good thing that you’re doing for your family or your future family or your education or your career.”

“A lot of times they’ll even refer to abortion and their need to go to Planned Parenthood as a necessary evil,” Pauls said.

“She feels like she really has no real choice, so Planned Parenthood is the only way really to move forward without kind of experiencing this death of her current self or her future self.”

In contrast, pregnancy centers can step in and offer “holistic” health care that Planned Parenthood doesn’t, Pauls insisted.

One significant “surprise” from his research was that “none” of the women “knew what a pregnancy help center was” or had “much knowledge or interest in it.” This was despite the fact that 2,400 pregnancy help centers outnumber Planned Parenthood clinics almost four to one.

These pregnancy clinics don’t perform abortions but instead provide women financial, material and emotional support to have their baby and can even offer medical care and psychological counseling.

“Women are interested in this holistic approach to health,” of “being healthy in mind, body, spirit, soul, vocation,” Pauls said.

The care in pregnancy help centers is “not just physical, which is what Planned Parenthood does. Make them unpregnant and send them back out into a risky lifestyle, to have them come back and do it all over again.”

Many pregnancy centers are “connected with a medical model or a medical referral system where they can address the physical, psychological, emotional, social, intellectual, and vocational health needs of the woman,” he said.

 

  Reported by CNA 7 hours ago.

MAP Announces Partnership with Intent Solutions to Assess Medication Compliance in Patients with Addiction

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MAP Health Management is partnering with Intent Solutions to track patient adherence to medication protocols with the use of the TAD™ biometric pill device

Austin, Tx (PRWEB) February 02, 2017

MAP Health Management, LLC., announced today a partnership with Intent Solutions designed to track adherence to medication protocols for patients with a Substance Use Disorder diagnosis who are served by MAP’s patient engagement technology. Intent Solutions is the creator of the TAD™, a biometric pill dispensation device that can track in real-time who has or has not taken their medication.

The partnership will launch with a pilot program as early as March of this year wherein a number of patients whose risk for relapse is continuously measured by MAP’s technology will be provided a TAD™ device. The device will send real-time data to MAP’s platform when a patient takes their medication, or fails to do so. With this information, MAP can inform the appropriate members of collaborative care networks if a patient is overusing their medication, or failing to take their medication at all. This information is then leveraged to improve clinical outcomes and manage financial risk through facilitating early interventions and other modes of mitigating recidivism and costly treatment episodes.

86% of patients served by MAP’s technology have a co-occurring mental or behavioral health disorder in addition to Substance Use Disorder and 94% are prescribed at least one medication. Capturing actionable data regarding medication compliance is an essential component of improving clinical and financial outcomes for this demographic.

“The number one factor in improving outcomes is early intervention. Putting the TAD™ into the hands of people recovering from addiction who are prescribed medication will greatly enable MAP to better inform treatment providers, family members, and insurance carriers who are at high risk for relapse and readmission resulting from the lack of medication compliance”, said Jacob Levenson, CEO of MAP Health Management, LLC.

Currently, identifying who is properly taking their medication after acute addiction treatment episodes has been elusive. “We are excited to partner with MAP and empower their ecosystem with our TAD™ device. We know that our product has great efficacy for those with Substance Use Disorder and MAP knows how to leverage our device to improve outcomes for all of the stakeholders,” said Sam Zamarripa, President and Director of Intent Solutions.

MAP continues to add to its robust ecosystem of patients, providers, insurance companies, and technology products, all of which are integrated into MAP’s population health platform. MAP is generally recognized as possessing the most robust risk identification and reporting environment for insurance companies related to the addiction treatment space.

About MAP Health Management, LLC

MAP develops technology-enabled solutions that improve clinical and financial outcomes for chronic behavioral health illnesses such as Substance Use Disorder. MAP empowers treatment providers, health insurance companies, health systems, and patients with the right data at the right time in order to improve clinical and financial outcomes. For more information, visit https://www.thisismap.com. To download the recently released white paper, ‘The 5 Key Factors to Successful Behavioral Health Population Management,’ visit: https://thisismap.com/insights/white-papers/5-key-factors-successful-behavioral-health-population-management.

About Intent Solutions

Headquartered in Atlanta, Georgia, Intent Solutions is a technology, software, and data service company focused on developing solutions, for clinical research, pain management and specialized pharmacy, designed to markedly improve the monitoring and management of medication adherence and provide real-time behavioral data to more accurately measure compliance and efficacy

It is estimated that up to one-half of all prescriptions are not taken which results in deaths of over 125,000 from adherence related causes and a staggering economic burden in health care of $300B, and a global revenue loss of $564B to pharmaceutical companies. The adherence problem may include taking more or less than prescribed, skipping doses, and also the abuse, misuse, and diversion of medications.

For more information about Intent Solutions, please visit: http://www.intentsolutions.com/. Reported by PRWeb 5 hours ago.

Marching In Topeka: Grief, Disbelief And Action In A Red State

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I went to bed past midnight on election night, after witnessing the shocking development that Donald Trump would win the electoral vote. Our college sophomore son texted us at 1:30 a.m. that Trump had indeed bagged the Electoral College.

Sometime in the wee hours I dreamt I was comforting Hillary Clinton, who was, naturally, dressed in a pantsuit. I hugged her and told her how sorry I was that she had lost the election. Then I said, “I love your hair color. Can you tell me who your hair colorist is?”

Maybe my hair colorist question expressed my unconscious wish to normalize the life ahead of us, to convince myself that even in the face of devastating election results, we could all return to life as usual. But I awoke to a grimmer reality. Like many others, I didn’t shower that day or leave the house. I cried when Tim Kaine spoke. I cried when Hillary finally conceded to Trump. I skipped the panel I was planning to attend that evening at a public library. And for many days after, I burst into tears unexpectedly, still in shock at the death of my dream that we would have our first female president, a woman vastly qualified and prepared for the office.

In fact, I’ve remained in shock, dismay and disbelief until the recent Women’s March. I knew I didn’t want to board a bus for D.C., but when my 34-year-old dancer daughter said she was attending the Topeka march, and that she and her partner and another friend were making signs, I committed to going with them.

In the past, I have preferred to air my political beliefs through writing, not marching. In fact, this women’s march was my first march ever. In college, as a student journalist, I covered protests, but did not participate in them. I once did a half-marathon walk/run for the ERA, but I have preferred the pen to the pavement.

The goddesses smiled on the Topeka Women’s March, which drew 4,000 participants, young and old, male, female and in-between, to the south side of the State Capitol on a sunny day in the 50s. Against the bluest sky, the crowd was uplifted by a wonderful all-female musical group, The Skirts. My daughter recognized the mandolin player as a kindergarten teacher whose class she visits once a week to teach creative dance. They led us in “Teach Your Children Well,” with telling lyrics given the antics of our renegade president. A child in the crowd held a sign: “I’m Listening.”

Beryl New, African American principal of Topeka’s east-side Highland Park High, who had children in day care with my daughter, served as a dynamic emcee. “We have been blessed so that 4,000 people can come together to celebrate the banner over all of us, the banner of love,” she said. Interestingly, the organizers of the march in Topeka were a young University of Kansas professor, who lived down the street from us as a girl, and a History and Spanish teacher at a local private school, the younger sister of a classmate and friend of my daughter from a big Mormon family.

A female Unitarian minister led a prayer that ended with the wish that we come together in “a movement, not a moment.”

As we listened to the speakers, a mother tapped me on my shoulder and told me her daughter wanted to give me a sunflower. At the end of two and a half hours of a baker’s dozen women speakers, including a construction worker, a transgender woman, an African American legislator, an indigenous speaker, a disabled activist, and more, we marched around the Capitol Building. For the first time since Trump’s election, I felt exhilarated. I was joined by my husband and my son, our daughter and several of her friends. I carried my Kansas sunflower proudly.

Fatima Mohammadi, of Iranian/Danish parents, mother of three and an attorney, had ended her remarks by asking the crowd, “What if this darkness is not the darkness of a tomb, but of a womb?”

Across the nation, Gloria Steinem, veteran activist, echoed these sentiments at the Women’s March on Washington when she said, surveying the crowd of one million gathered there: “This is the upside of the downside.” Her rousing, stirring keynote referenced the 370 marches occurring in all states and on seven continents, marches that in the days after were reported to have drawn 3 to 4 million.

In closing, Steinem observed that often after electing a “possible president, we too often go home.” But as she said, since “We’ve elected an impossible president, we’re never going home.”

The National Women’s March organizers have recommended 10 actions in 100 days. This week I was invited to three postcard-writing parties. At the one I attended I asked my Congressional representatives to not tamper with the Affordable Care Act, telling the story of my daughter’s duet partner who broke her wrist during a performance, but had insured herself thanks to the ACA two weeks before. I wrote my state legislators asking that they support a bill granting permanent exemption from the Kansas concealed carry laws for public buildings, including universities, saying had I known there would be weapons on campus at the University of Kansas after July, I would have encouraged my son to go out of state to college.

The many airport rallies in opposition to Trump’s travel restrictions for those from seven Muslim-majority countries shows public protests will continue.

We Kansans may live in a red state, but sizable numbers of us intend to resist the Trump administration when it steps on the rights of those perceived as Other. During the first week alone, those others were non-Christians, Muslims, and people with little means to purchase health insurance.

We are not going home, as Steinem, 82, and still splendid in her galvanizing energy, said. We will keep up the pressure. We will move through loss and grief, toward hopeful and positive action.

-- 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 2 hours ago.

Mental Health, the Internet of Wellbeing and Age-Proofing America on the Menu at the 2017 Lake Nona Impact Forum

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More than 250 of the nation’s top health care entrepreneurs and innovators, academics, government officials and other thought leaders will discuss and develop solutions to improve health, wellbeing and sustainable living throughout the world at the 2017 Lake Nona Impact Forum held Feb. 15-17 in Lake Nona, Orlando, Fla.

Orlando, Florida (PRWEB) February 02, 2017

More than 250 of the nation’s top health care entrepreneurs and innovators, academics, government officials and other thought leaders will discuss and develop solutions to improve health, wellbeing and sustainable living throughout the world at the 2017 Lake Nona Impact Forum held Feb. 15-17 in Lake Nona, Orlando, Fla. The 5th annual Impact Forum will feature a series of collaborative, action-oriented discussions about the impact of healthy community innovation; sports health and performance; progress and challenges in advancing mental health care; and promising health care technologies and start-ups, among other topics.

“The health care environment is changing at an unprecedented speed. By convening some of the world’s most brilliant minds at the Lake Nona Impact Forum, we are able to put innovative thought into action that improves health, wellbeing and sustainable living at home and around the globe,” said Gloria Caulfield, Executive Director of the Lake Nona Institute.

This year’s presentations and conversations will be led by some of the nation’s foremost health and wellness leaders, including keynote speaker Sandi Peterson, Group Worldwide Chairman of Johnson & Johnson. In addition, the Impact Forum will feature discussions about some of the most pressing health care issues today: the Affordable Care Act and universal health insurance, health care innovations for an aging population, America’s most costly chronic disease – diabetes, mental health care, technological advances impacting personal wellbeing and health, and the crisis in youth sports. A special panel will convene four of the most recent U.S. Surgeons General who will discuss public health for the 21st century.

Speakers and panelists include:·     Ezekiel Emanuel, MD, Joint Appointment, Wharton School and School of Medicine, University of Pennsylvania; Founding Chair, Clinical Center of the NIH; Former Special Advisor on health policy, Office of Management and Budget
·     Ray Kurzweil, Inventor, Author and Futurist; A Director of Engineering, Google
·     Vice Admiral (VADM) Vivek H. Murthy, M.D., M.B.A., U.S. Surgeon General
·     Drs. David Satcher, Antonia Novello, Richard Carmona and Joycelyn Elders, former U.S. Surgeons General
·     Margaret Trudeau, former First Lady of Canada and mental health advocate
·     Deepak Chopra, MD, FACP, Founder, The Chopra Foundation; Co-Founder, Center for Wellbeing
·     Jeff Arnold, Founder and CEO of Sharecare
·     Michael Johnson, American sprinter, Olympic gold medalist, eight-time World Champion
·     Katrina Adams, Chairman of the Board, CEO and President of the USTA
·     Annika Sorenstam, professional golfer
·     Charles Woodson, ESPN analyst and NFL Hall of Famer
·     Steven Krein, Co-founder and CEO of StartUp Health
·     Kevin Hagan, CEO of the American Diabetes Association
·     Frans Johannson, Founder and CEO, The Medici Group
·     Sean Nolan, President and CEO of AveXis

The three-day symposium, developed by the Lake Nona Institute, is an invitation-only event inspired by the Aspen Institute, TED Conferences and the Clinton Global Initiative platforms. The event is set in Lake Nona, a 17-square-mile integrated, master-designed community in Orlando, home to one of the fastest-growing health and life sciences clusters in the nation and a model for the design of a comprehensive, healthy community that is the current focus of a longitudinal study by Johnson & Johnson Health & Wellness known as the Lake Nona Life Project.

To help develop innovative solutions to challenges in achieving optimum health and related technology, the 2017 Lake Nona Impact Forum is hosted at the health and life sciences cluster of Lake Nona Medical City; host venues include the Orlando VA Medical Center, University of Central Florida College of Medicine, the University of Florida Research & Academic Center, and the GuideWell Innovation Center.

The 2017 Lake Nona Impact Forum is presented by Johnson & Johnson, along with Founding Sponsors: Cisco, Edyth Bush Charitable Foundation, GuideWell Innovation, Sharecare, and Tavistock Foundation; Impact Sponsors: KPMG, Integrated Wellness Partners, Technogym, Florida Hospital, and Citibank; Medical City Partners: Nemours Children’s Health System, University of Central Florida College of Medicine, UF Health; and Contributing Sponsors: Dr. Phillips Charities, PepsiCo, Roche, the United States Tennis Association, Tavistock Life Sciences and the Mayo Clinic.

To learn more about the Lake Nona Impact Forum and the Lake Nona Institute, visit http://www.LakeNonaImpactForum.org and http://www.LakeNonaInstitute.org. Follow us on Twitter at @LN_ Institute and at Facebook.com/LakeNonaInstitute. You can also join the conversation online using the hashtag #LNIF17.

About the Lake Nona Institute:
The Lake Nona Institute is a nonprofit, community-focused organization that incubates, activates and measures the impact of innovative technologies and programs that can become global models for building healthy, sustainable and inspired communities. The Institute focuses on programs based on: Health & Wellness, Education and Sustainability. At its core, Lake Nona Institute believes that individuals in the social context of a community can and do have a profound impact on wellness, education and sustainability.

About Lake Nona:
Orlando’s Lake Nona is one of the fastest-growing communities in America with more than 10 million square feet of world-class residential and commercial facilities – and it’s just getting started.  The 17-square-mile, master-designed community is home to thoughtfully designed neighborhoods, world-class education facilities, a Health & Life Sciences Cluster, a Sports & Performance District highlighted by USTA’s New Home of American Tennis – the largest tennis facility in the country, diverse work spaces, recreational facilities, retail centers, and entertainment venues encompassing the best Orlando has to offer with all the conveniences of a dynamic, vibrant community. Driven by a long-term vision, Lake Nona is committed to building an innovative community that inspires human potential whilst being focused on sustainable design, healthy living, and groundbreaking gigabit fiber optic technology. Adjacent to Orlando International Airport, Lake Nona will feature millions of square feet of commercial space, thousands of hotel rooms, 25,000+ residents and hundreds of shops and restaurants. Reported by PRWeb 5 hours ago.

The Building Trades’ Faustian Bargain

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(Photo: AP/Christian Torres)

Workers continue building a taller fence on the Mexico-U.S. border separating the towns of Anapra, Mexico, and Sunland Park, New Mexico, on January 25, 2017.

The first time I ever saw Terry O’Sullivan, he was sporting a T-shirt on a sunny Los Angeles day more than 15 years ago. I remember him shouting to a crowd of workers and activists, making an impassioned case for immigrant rights. Newly installed as the international president of the Laborers Union, O’Sullivan told his listeners in no uncertain terms that the nation needed to give its undocumented immigrants the right to become citizens, to let them live their lives out of the shadows, to stop raiding the places where they worked.

O’Sullivan came by these positions honestly. Of all of America’s current labor leaders, he is the most Irish—he’s a longtime supporter of Sinn Fein, and the chairman of D.C. Friends of Ireland—and knows just how reviled and despised the Irish immigrants who came to this country in the 19th and early 20th century were. He can reel off the indignities that were heaped upon them by the Protestants who’d gotten here first: the exploitation they endured while building railroads, digging ditches and cooking for the gentry; the violence they suffered from crazed nativists.

If all that weren’t enough to instill in him an empathy for immigrants, O’Sullivan also headed a union that had hundreds of thousands of Latino members, some of them immigrants, some of them undocumented, many of them with immigrant and undocumented family members. Unions don’t take a racial census of their members, but Laborers officials have told me they think that their union—which has approximately 500,000 dues-paying members—is roughly 40 percent Latino, and less than 50 percent white. In places like Southern California, Laborers’ locals are well over 80 percent Latino, and in many cities, even those far removed from the Sun Belt, Laborers locals are heavily Latino as well.

At a time when labor rallies for immigrant rights and the undocumented invariably featured the leaders of overwhelmingly Latino unions like the hotel workers and the janitors, O’Sullivan was the stand-up guy from the building trades unions, a number of which—quite unlike the Laborers—still endeavored to keep their memberships as white as they possibly could.

That, however, was then. Fast-forward to Donald Trump’s fourth day as president, and to the meeting he held with five building trades leaders. Trump told them he would build like no one’s built before, and intimated he’d reverse President Obama’s orders that had blocked the construction of the Keystone XL Pipeline and the Dakota Access Pipeline (which he did the following day). The labor leaders greeted the announcement rapturously—and then some. “It was an honor that on his first full [week]day in office, President Donald J. Trump called upon leaders and rank and file members of North American Building Trades Unions to solicit our views with regard to his promises to create jobs, rebuild America’s infrastructure, [and] further develop and harness America’s abundant energy resources,” said Sean McGarvey, who heads the Building and Construction Trades Department of the AFL-CIO.   

O’Sullivan’s statement on Trump’s pipeline announcement was no less effusive. Headlined “It is Finally Beginning to Feel Like a New Day for America’s Working Class,” it celebrated Trump’s pipeline announcement, and said that the new president “has shown that he respects laborers who build our great nation, and that they will be abandoned no more.”

I don’t doubt that O’Sullivan knows that last sentence is a more an expression of hope than of fact. (That’s my inference—the Laborers’ president declined to speak with me for this article.) In the meeting with Trump, he heard the president refuse to commit himself to preserving the Davis-Bacon Act, which, since its passage in 1931, has guaranteed decent pay to workers on federally funded construction projects. O’Sullivan has condemned every assault the Republicans have hurled at labor: the right-to-work laws, the court cases endangering public-sector unions. He was a voluble supporter of Hillary Clinton in the last election and didn’t hedge his opposition to candidate Trump.

And he hasn’t said a word indicating he’s backed off on his support for immigrants, documented or not. Nonetheless, his meeting with Trump roused the ire not only of pipeline opponents, but also of many of his own members. And rightly so.

“Our Latino and black members—you can’t even mention the word ‘Trump’ to them; they think he’s the devil,” says one leader of a Laborers local. “They really didn’t like that Terry was in that meeting.”

For a guy who’s been more committed to the cause of labor, broadly defined, than many of his building trades peers, O’Sullivan’s meeting with Trump and the praise he accorded him fell several light years short of the solidarity with all working-class Americans to which O’Sullivan has often given voice. It may be that in his meeting with Trump, the president showed, as O’Sullivan said, “that he respects laborers,” but the president has also vowed to deport immigrants who almost surely include some of those same laborers and their families. The new administration’s “respect” is subordinate to its white nationalist rage, and O’Sullivan must know that.

Just by attending the White House meeting, the building trades leaders fell into a Trump-Steve Bannon trap. By calling the meeting, the new administration’s goal, clearly, was to replicate the split in the labor movement that Richard Nixon endeavored to engineer by cheering on the hard hats who reviled (and now and then physically attacked) the longhaired Vietnam War protesters during his presidency. At the core of their base, Trump and Bannon believe, are white male working-class voters who make things with their hands in factories or on construction sites. As November’s election made clear, Trump and Bannon had already made considerable progress toward solidifying that support. The network exit poll showed that whites with no college degree favored Trump over Clinton by a 66 percent to 29 percent margin. On the other hand, Clinton prevailed in union households by a 51 percent to 42 percent margin.

However—when you break down the union household vote by race, it’s clear Trump had already made major inroads into labor solidarity. Whites from union households preferred Trump over Clinton, 52 percent to 40 percent. Whites from union households with no college degree favored Trump by a 58 percent to 32 percent margin. (To my knowledge, these cross-tabulations have not been previously published.) The eight-point difference between white working-class union households and all white working-class households is a significantly smaller bump than unions have been accustomed to producing for Democratic presidential candidates.

Splitting the union vote won’t do for Trump what it did for Richard Nixon in his 1972 blowout victory over George McGovern, since the white working-class union household vote is many times smaller than it was in 1972. (In November’s exit polls, such voters constituted just 7 percent of the electorate.) But it can nonetheless weaken a labor movement that is barely a shell of what it used to be. (In the Labor Department’s annual survey of union membership released last week, the rate of private-sector unionization was down to 6.4 percent.) And weakening the labor movement has become a central political objective for the entire Republican Party, which sees labor as its chief institutional enemy at election time. Even those building trades leaders who met with Trump understand that.

So why did they go? I’m told they were invited with barely a day’s notice and had no clear idea of what was going to happen. As well, they brought to the meeting a sense that the Democratic Party, at least under Obama, had all but abandoned them. Obama had sided with environmentalists and tribal leaders on the pipeline questions. He had refused to exempt the kind of union health insurance plans that building trades members enjoy from his health-care law’s “Cadillac tax” on generous plans. On this latter issue, progressive Democrats should have taken up the workers’ cause more than they did. The idea that middle-wage workers whose unions have been able to negotiate decent health insurance should be penalized was one of the few moral issues and many political issues on which the Obama administration was tone deaf.

If anything, O’Sullivan found himself in more of a box than his building trades peers. Precisely because the opposition of most contractors to unions is so vehement and pervasive, and because the laws ensuring workers’ right to organize are so weak, most unionized construction has been winnowed down to publicly funded infrastructure projects. For the Laborers, the dilemma is even more acute. “Half of the union’s work is in pipelines,” says one local leader. “Not Keystone, but smaller stuff, laying natural gas distribution lines to new housing developments, projects for local utilities, that sort of thing.”

Keystone itself was never going to generate all that many jobs. The reason the trades adamantly pushed the Obama administration to approve the project, according to one labor official, is that it was “a test of their ability to deliver in a Democratic administration for the groups behind such projects—like the oil industry—who in turn would ensure that future mega-projects would be done by union labor.” (It’s worth noting that among the very few groups in the Democrats’ political universe that endorsed former ExxonMobil CEO Rex Tillerson’s nomination for Secretary of State were the Building Trades Council and the Laborers.)

It’s easy for progressives to condemn the trades for their support for the fossil fuel industry. Until the alternative energy industry produces a comparable number of comparable paying jobs, however, that criticism should come (as indeed it should) with an understanding that the economy has not yet created those kind of jobs in those kind of numbers, and that progressive business, economic, and political leaders (like business, economic, and political leaders at all points on the political spectrum) have yet to devise plausible ideas on how to create large numbers of middle-income jobs for workers who build things or make things. A massive (and long overdue) increase in infrastructure construction and repair—provided those jobs are union—is one of the few ways to significantly increase the number of middle-income Americans, as both Bernie Sanders and Hillary Clinton recognized.

“If there’s a massive infrastructure boost, we stand to gain jobs,” says one Laborers official. “But if Trump and the Republicans cut our wages in half, that would kill us.”   

What Terry O’Sullivan has struck is a Faustian bargain—Faustian because there’s no guarantee his members won’t have their wages cut in half, Faustian because Trump’s infrastructure plan relies on financing so cock-eyed it may not amount to much, Faustian because it’s a deal with a devil who may well deport some Laborers and their families, Faustian because the devil may want nothing so much as to split the labor movement on racial lines and thereby kill it, and Faustian, finally, in the same sense that building the autobahns despite all else that was going on in Germany from 1933 through 1939 was Faustian, too.  

And the bargain could quickly get worse. Trump, after all, has committed himself to build not just the two pipelines, but a third massive project as well: the wall on the border. Can a union that is 40 percent Latino and that is committed to the dignity and rights of immigrants support that idea? Can its members actually work on the wall? Will its members who live near the border—in that part of the nation, the clear majority of them Latino—even want to work on the wall?

Earlier this week, AFL-CIO President Richard Trumka (who was not in that meeting with Trump; indeed, it was to split the building trades off from Trumka and the bulk of the labor movement that Trump and Bannon convened the meeting in the first place) released a statement condemning three Trump executive orders—the one against Muslims, the one against immigrants, and the one calling for a wall on the border. “The labor movement,” Trumka said, “will adhere to our core principles of solidarity, dignity, and respect for working people of all races, faith traditions and immigration status.”

I don’t doubt that O’Sullivan would dearly love to release such a statement (at least, about Muslims and immigrants), too, if only he didn’t fear the consequences of offending a president who has dangled the lure of massive projects before his members—a president, worse yet, who takes every policy difference personally. After Trumka released his statement, I asked the Laborers if they had a position on the wall. They have yet to get back to me.  Reported by The American Prospect 3 hours ago.

A.M. Best Briefing: Affordable Care Act Exchange Marketplaces Continue to Challenge Insurers

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A.M. Best Briefing: Affordable Care Act Exchange Marketplaces Continue to Challenge Insurers OLDWICK, N.J.--(BUSINESS WIRE)--The individual health exchange membership, as part of the Patient Protection and Affordable Care Act (ACA), continues to be impacted by high-risk individuals who are greater utilizers of services, according to a new A.M. Best briefing. As a result, many participating health insurance carriers have experienced larger operating losses in that line of business and some insurers have scaled back operations for 2017 or exited the marketplace. The Best’s Briefing, titl Reported by Business Wire 3 hours ago.

The biggest health insurers are freaking out about the uncertainty surrounding Obamacare's repeal

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The biggest health insurers are freaking out about the uncertainty surrounding Obamacare's repeal· *Republicans' plan to repeal and replace Obamacare has created uncertainty around the law's individual heathcare exchanges.*
· *Insurers are considering not offering plans on the exchanges in 2018 because of the unclear future.*
· *If insurers pull out of the exchanges because of the uncertainty, it could cause the "death spiral" Republicans have been talking about for years.*

The Republican plan to repeal and replace the Affordable Care Act (ACA), better known as Obamacare, has introduced a high level of uncertainty into the health insurance market and the CEOs of major insurers are concerned about the future.

Over the past few weeks, a number of insurance executives have expressed concern and uncertainty about their business strategy regarding the ACA's individual insurance exchanges.

The exchanges, where people not covered through their employer or Medicaid/Medicare can buy insurance, are one of the key parts of the ACA being target by the GOP's repeal strategy.

Given that Republican lawmakers are still in the midst of a repeal of the law and have not laid out a cohesive plan for replacement, insurance executives are taking a cautious look into the future.

*Insurers are nervous*

"We have no intention of being in the market for 2018," said Aetna CEO Mark Bertolini during his company's earnings call on Tuesday. "Currently, where we stand, we'd have to have markets worked up ... prices worked up for April 2017 to apply, and there is no possible way that we'll be able to do that given the unclear nature [of where] that regulation is headed."

Insurers must submit plans, including premium prices, to federal and state regulators for the 2018 plan year in April of this year.

Given the short turnaround time, it may be even harder to get insurers to commit to offering plans on the exchanges in 2018.

Anthem CEO Joseph Swedish echoed similar uncertainties during his company's earnings call on Wednesday despite the fact that the company expects its ACA plans to be "break-even to slightly profitable in 2017."

"While the direction in Washington has been positive, we still need certainty about short-term fixes in order to determine the extent of our participation in the individual market in 2018," said Swedish.

A number of high profile insurers, including Aetna, UnitedHealth Group, Cigna, and Humana — four of the five large public insurers — decreased their exposure to the ACA exchanges in 2017 due to financial losses.

Despite the already declining insurer participation, it seems that the uncertainty created by the repeal has only hastened the abandonment of the exchanges.

Even insurers that have been profitable on the exchanges are talking about leaving because of the repeal plan.

Mario Molina, CEO of Molina Healthcare, told Politico's Victoria Colliver that despite being successful on the exchanges, his company may not stick with the ACA if they continue to lack clarity on the future.

"People keep asking me, ‘Are you going to stay in?'" Molina told Politico. "I don’t know. It’s kind of like asking whether you’re going to buy a car in 2018. I’m not going to commit to something when I don’t know what the product looks like."

In a testimony before the Senate on Wednesday, Marilyn Tavenner, the CEO of the leading health insurance lobby group America’s Health Insurance Plans and former head of the Centers of Medicare and Medicaid Services, told lawmakers that quick action is needed for insurers to be able to make 2018 work.

"Right now, plans are trying to price for ‘18, and the uncertainty around cost-sharing subsidies and the tax credits would cause them to hesitate to price because we need to understand what the funding support is going to be, because that affects premiums," said Tavenner.

Tavenner also noted that the companies "need predictability for long periods of time" in order to offer effective plans.

*Creating a "death spiral"*

Republicans have long maintained that the law is collapsing on its own and is in a "death spiral" due to insurers' losses and declining numbers of insurers participating, eventually leading to lower consumer enrollment.

The nonpartisan Congressional Budget Office, however projected that enrollment and costs would stabilize over the nest 10 years. With insurers pulling out, however, health policy experts have said the uncertainty could end up creating the "death spiral" that the GOP has long feared.

President Donald Trump has expressed a desire to get a replacement plan in place quickly, which may mitigate some of the uncertainty and minimize disruptions in the individual health insurance markets. He also has reiterated that he doesn't want the exchanges to collapse and leave people with higher costs or no coverage even though Democrats would "own it."

*SEE ALSO: Obamacare's final countdown*

Join the conversation about this story »

NOW WATCH: Here's how to use one of the many apps to buy and trade bitcoin Reported by Business Insider 6 hours ago.

Another Warning Sign For Republicans Trying To Repeal Obamacare

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Republicans trying to repeal the Affordable Care Act have a new problem on their hands: The AARP isn’t happy.

The nation’s most famous retiree organization, which represents 38 million older Americans, has fired off letters critical of two proposals that have figured prominently in GOP discussions about replacing the Affordable Care Act. One of those proposals would relax the law’s “age bands.” The other would transform Medicaid into a so-called block grant.

The AARP’s objections alone aren’t enough to stop Republicans from including versions of these ideas in health care legislation, of course. But the organization represents a demographic that happens to be an essential part of the Republican voting coalition.

Taken together, the group’s warnings constitute one more reminder of the difficult policy trade-offs, and equally difficult politics, that Republicans are sure to confront as their effort to repeal “Obamacare” moves forward.

How Two GOP Health Care Ideas Could Hurt Older Americans

The creation of age bands was among the more important changes that the Affordable Care Act introduced for insurers selling directly to individuals. Previously, insurers in most states could adjust premiums based on the expected medical needs of new customers ― which meant, inevitably, charging older customers a lot more than younger ones.

The Affordable Care Act put a stop to that, by stipulating that insurers could charge their oldest customers no more than three times what they charge their youngest ones. This requirement is a big reason why many younger people pay more for insurance now than they did before the health care law came along.

Republicans love to talk about how relaxing or eliminating the age bands would mean lower premiums for younger people. And that’s true, even if the benefits for young consumers would be less dramatic than Republicans sometimes suggest.

What Republicans don’t mention is that, as a consequence, premiums for older people would go back up again. And in Wednesday’s letter, the AARP warned that such a change could hurt people just as they’re getting to the age when medical problems become more common. Such a change, the group warned, “would severely limit, not expand, access to quality, affordable healthcare.”

As for Medicaid, Republicans have been talking about converting it into a block grant since long before Obamacare. The idea is to give states much more control over the program and, more importantly, to reduce the program’s funding ― perhaps by a dramatic amount. According to the Center on Budget and Policy Priorities, the most recent budget from House Speaker Paul Ryan (R-Wis.) would mean 33 percent less spending within the decade.Republicans boast about these savings for the federal Treasury, along with the control it would give governors who bristle under Washington’s oversight. But with less money to spend, states wouldn’t be able to finance as many benefits for as many people.

They’d have to make cuts of their own ― some of which would almost surely fall on older people, particularly since the majority of spending in Medicaid goes to elderly and disabled people who use it to supplement Medicare. Among other things, Medicaid is the nation’s largest payer of nursing home care.

Predictably, the AARP has noticed this too.

“Disabling conditions that affect older adults include Alzheimer’s disease, stroke, and chronic and disabling heart conditions,” the organization said in its letter. “Individuals may have low incomes, high costs, or already spent through their resources paying out-of-pocket for [long-term care], and need these critical services. For these individuals, Medicaid is a program of last resort.”

Why AARP Opposition Is A Warning Sign For Republicans

The AARP has a broad policy agenda, including two other items ― protecting Medicare and Social Security from cuts ― that are generally higher institutional priorities. But changes to the health care law and Medicaid are bound to affect millions of its members negatively. The AARP isn’t going to stay quiet about that. It’s safe to assume the group will also be reminding Republicans that older Americans voted for President Donald Trump and GOP candidates by large margins.

And it’s not like the AARP is the only group that is going to take a very active interest in what happens to the Affordable Care Act.

Republicans talk a lot about financing their schemes with changes to the tax treatment of employer health insurance. That’s bound to raise screams from both businesses and unions (just like a similar provision of the Affordable Care Act has).

Most Republican ideas for replacing the law involve some combination of fewer people insured and weaker coverage for those who have insurance. That doesn’t sit well with hospitals, which end up taking losses when people who need care can’t pay for it.

And then there are the proposed changes to Medicaid, which would be sure to alienate not just the AARP but a whole bunch of other constituencies, not least among them Republican governors who presided over expansion in their states.

Republicans can negotiate with these potential critics to win their consent, or at least mute their concerns. But trade-offs in health policy are inevitable, and every accommodation that Republicans offer to a group like the AARP, employers, hospitals or GOP governors will show up as a cost for somebody else.

Meanwhile, the negotiations themselves are bound to take time and effort, and create plenty of embarrassing news stories ― again, just as they did for Democrats in 2009 and 2010, when President Barack Obama and his allies were crafting the legislation Republicans now seek to erase.

What Republicans Can Expect Politically As Repeal Goes Forward

Democrats were willing to endure that bad publicity ― and, more broadly, to stick with a politically difficult process, even as it dragged out for over a year ― because making health care available to everybody had been one of the party’s most important priorities for something like three-quarters of a century.

Recent news suggests Republicans can expect a similarly difficult experience if they proceed. Already, lawmakers are getting flooded with calls and hearing from protesters worried about losing insurance. And if the polls are correct, the public suddenly feels more favorably about the ACA than it did before ― perhaps because the prospect of losing the program is making people think about the parts they like.

At last week’s party retreat in Philadelphia, during a private meeting recorded and leaked to the press, Republican lawmakers talked openly of their inability to deliver promises of better care at lower costs. Over the weekend, Rep. Dave Brat (R-Va.) practically begged his supporters to start speaking out, because town halls have gotten so difficult.

And on Tuesday, in an interview with Vox, Rep. Phil Roe (R-Tenn.) admitted that rolling back the Medicaid expansion “is going to be a little harder than I thought” because so many people, in so many states, have come to depend on the program.

Republicans still have the votes in Congress to pass repeal legislation, and in Trump they have a president who would sign that bill into law. Having invested so much time in the cause, having made such concrete promises to their voters and the many people unhappy with how Obamacare has worked for them, GOP leaders would find it difficult to walk away.

But seeing repeal through the legislative process would require an enormous investment of political capital and time ― leaving less of each for tax reform, spending bills and other priorities. And that’s to say nothing of how people would feel about a world in which the Affordable Care Act were gone ― to be replaced, maybe, with a system in which people face even greater exposure to medical bills.

That’s a high political price to pay. Republicans will have to decide if it’s worth it.

Want more updates on policy & politics from Jonathan Cohn? Sign up for his newsletter, Citizen Cohn, here.

-- 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 2 hours ago.

Insurers report late surge in enrollment in New York

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Local insurers and state officials report a major surge in the final days of enrollment for 2017 health insurance coverage. Nearly 50,000 people signed up during the final two days leading up to the Jan. 31 deadline, according to the NY State of Health, which runs the state’s online health exchange. The state reported an additional 800,000 New Yorkers enrolled through the online marketplace since last January, bringing the total enrolled through the site to 3.6 million, an increase of 28 percent… Reported by bizjournals 2 hours ago.

NCP promises to plug water leakage, provide free pure water

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Sharad Pawar led Nationalist Congress Party has promised to plug water leakage, provide free 700 litres of clean and pure water per family on a monthly basis and an annual health insurance for Rs 101. In its manifesto for the upcoming Mumbai civic polls, the NCP has said that it will provide free Wi-Fi zones in every ward and 24x7 emergency help centres during natural calamities. Reported by All India Radio 56 minutes ago.
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