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Could your Fitbit data be used to deny you health insurance?

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Wearing a fitness tracking device could earn you cash from your health insurance company. At first, this sounds lucrative for the people who participate, and good for the companies, who want healthier insurance customers. But it’s not quite so simple. Under the program, people who have certain health insurance coverage plans with UnitedHealthcare (NYSE: UNH) can elect to wear a Fitbit (NYSE: FIT) activity tracker and share their data with the insurance company. The data would be analyzed by… Reported by bizjournals 6 hours ago.

The Denver Foundation to Award $5M to Increase Behavioral Health Care Access Across Colorado

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Colorado Health Access Fund seeks to fill gaps in behavioral care for homeless, low-income, and rural communities; proposal Deadline is March 10.

Denver, CO (PRWEB) February 21, 2017

The Colorado Health Access Fund of The Denver Foundation is now accepting funding proposals from organizations and collaboratives working to increase access to behavioral health care and improve health outcomes for high-need populations across Colorado.

Approximately $5 million is available for projects and programs that increase health outcomes across the state, particularly in rural communities. Applications are due Friday, March 10, and grants will be awarded in August 2017. Applicants must register with The Denver Foundation’s online application system by Wednesday, March 1. Complete guidelines are available online.

The intent of the Colorado Health Access Fund is to help ensure that health care services are equitably available to all Coloradans with high health needs by distributing funds to organizations that serve people in rural, urban, and suburban areas. The fund will prioritize programs that serve those who are low-income and/or experiencing homelessness; have multiple chronic or acute health conditions; and/or lack health insurance coverage, have inadequate coverage, or have significant barriers to accessing coverage. General operating support is also available.

Resources will be directed in four project areas:·     Education of those with high health needs, as well as their families and caregivers;
·     Transitions in care;
·     Innovation of care delivery; and
·     Improved access to care, particularly in rural communities.

According to a 2014 analysis of the health care landscape conducted by the Colorado Health Institute and commissioned by The Denver Foundation, 15 of the 21 Colorado Health Statistic Regions included mental/behavioral health as a top local public health priority. Furthermore, mental and behavioral health care was cited as a community priority in every community dialogue conducted by CHI. Discussions with health and community foundations identified access to mental health and substance abuse as the most pressing issues statewide. Thus, the Colorado Health Access Fund is focused on increasing access to behavioral health treatment.

In 2015, the Colorado Health Access Fund distributed nearly $2.2 million to 28 grantees across Colorado. A summary of the activities and impact of the first cohort of grantees is available here.

Overall, the Colorado Health Access Fund seeks to:

· Reduce and remove barriers for Coloradans with high behavioral health care needs in accessing behavioral health care treatment
· Build on innovations and investments already in place around behavioral health care treatment and support strategies for sustainability within the communities
· Support treatment solutions that will benefit and meet the needs of the local community, as well as explore how those solutions could be replicated and/or scaled to meet the needs of communities across the state; and
· Widely share solutions and approaches that improve access to behavioral health care treatment, as well as openly convey “lessons learned.”

For more information and to apply, please visit http://denverfoundation.org/community/page/colorado-health-access-fund.

About The Colorado Health Access Fund
The Colorado Health Access Fund was created in 2015 with an anonymous $40 million gift as a Field of Interest fund at The Denver Foundation. The intent of the fund is to support programs/activities that generally increase access to health care and strive to improve health outcomes for populations in Colorado with high health care needs. The fund will help to ensure health care services are equitably available to all Coloradans with high health needs by distributing the funds to organizations throughout the state. The Colorado Health Access Fund will distribute approximately $5 million per year through 2022.

About The Denver Foundation
The Denver Foundation is a community foundation that inspires people and mobilizes resources to improve life in Metro Denver. In 2015, the Foundation and its donors awarded more than $97 million in grants. The Denver Foundation has three roles: stewarding an endowment to meet current and future needs for Metro Denver, working with community leaders to address the core challenges that face the community, and managing more than 1,000 charitable funds on behalf of individuals, families, and businesses. For more information, visit http://www.denverfoundation.org. Reported by PRWeb 3 hours ago.

Iowa Farmer Warns GOP Senator That Obamacare Repeal Will Create 'One Great Big Death Panel'

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A pig farmer confronted Sen. Chuck Grassley (R-Iowa) at a town hall meeting early Tuesday morning to warn that Republicans would essentially create a giant death panel if they repealed the Affordable Care Act.

Chris Peterson, 62, told the senator that he has diabetes and that he would not be able to afford health insurance if not for the Affordable Care Act.

“You’re the man that talks about the death panel,” Peterson said at the packed town hall in Iowa Falls. “We’re gonna create one great big death panel in this country [if] people can’t afford to get insurance. Don’t repeal Obamacare, improve it.”

In 2009, Grassley helped fuel the false idea that Obamacare would create “death panels” to determine patients’ end-of-life care.


Angry constituents confront Chuck Grassley in Iowa: “If it wasn’t for Obamacare, we wouldn’t be able to afford insurance!” pic.twitter.com/vrbhbOiBMM

— Bradd Jaffy (@BraddJaffy) February 21, 2017


On Tuesday, Grassley insisted that the millions of people who gained insurance under the Affordable Care Act won’t lose their coverage if the law is repealed.

“Twenty million people won’t lose because we’ve made clear that those that are [on] the exchange, the subject will continue,” he said, referring to the Obamacare online markets.

Grassley’s Tuesday town hall was the latest in a series of events this month at which constituents across the country have angrily confronted their representatives over the GOP’s vow to repeal the Affordable Care Act soon. Republicans have yet to offer an alternative health care plan.

Grassley was also pressed on his decision last year not to hold hearings on the nomination of Judge Merrick Garland, President Barack Obama’s pick for the Supreme Court, as well as his more recent votes to confirm Betsy DeVos as education secretary and to repeal rules blocking the mentally ill from buying guns, according to the Des Moines Register. 

Zalmay Niazy stood up to say that he had worked as an interpreter for the U.S. Army in Afghanistan and had been seeking political asylum in the United States for two years. Grassley said he would help Niazy, the Des Moines Register reported.

Peterson the pig farmer brought Grassley a bottle of Tums that he said the senator would need for the next few years, according to The New York Times. Grassley later told reporters that the only time he needs the heartburn medication is when he has eaten chocolate ice cream before going to bed.

-- 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.

5 Big Things We Have To Lose If Republicans Repeal Obamacare

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As Republicans look at ways to replace or repair the health law, many suggest shrinking the list of services insurers are required to offer in individual and small group plans would reduce costs and increase flexibility. That option came to the forefront last week when Seema Verma, who is slated to run the Centers for Medicare & Medicaid Services in the Trump administration, noted at her confirmation hearing that coverage for maternity services should be optional in those health plans.

Maternity coverage is a popular target and one often mentioned by health law critics, but other items also could be watered down or eliminated.

There are some big hurdles, however. The health law requires that insurers who sell policies for individuals and small businesses cover at a minimum 10 “essential health benefits,” including hospitalization, prescription drugs and emergency care, in addition to maternity services. The law also requires that the scope of the services offered be equal to those typically provided in employer coverage.

“It has to look like a typical employer plan, and those are still pretty generous,” said Timothy Jost, an emeritus professor at Washington and Lee University Law School in Virginia who is an expert on the health law.

Since the 10 required benefits are spelled out in the Affordable Care Act, it would require a change in the law to eliminate entire categories or to water them down to such an extent that they’re less generous than typical employer coverage. And since Republicans likely cannot garner 60 votes in the Senate, they will be limited in changes that they can make to the ACA. Still, policy experts say there’s room to “skinny up” the requirements in some areas by changing the regulations that federal officials wrote to implement the law.

*Habilitative Services*

The law requires that plans cover “rehabilitative and habilitative services and devices.” Many employer plans don’t include habilitative services, which help people with developmental disabilities such as cerebral palsy or autism maintain, learn or improve their functional skills. Federal officials issued a regulation that defined habilitative services and directed plans to set separate limits for the number of covered visits for rehabilitative and habilitative services.

Those rules could be changed. “There is real room for weakening the requirements” for habilitative services, said Dania Palanker, an assistant research professor at Georgetown University’s Center on Health Insurance Reforms who has reviewed the essential health benefits coverage requirements.

*Oral And Vision Care For Kids*

Pediatric oral and vision care requirements, another essential health benefit that’s not particularly common in employer plans, could also be weakened, said Caroline Pearson, a senior vice president at Avalere Health, a consulting firm.

*Mental Health And Substance Use Disorder Services*

The health law requires all individual and small group plans cover mental health and substance use disorder services. In the regulations the administration said that means those services have to be provided at “parity” with medical and surgical services, meaning plans can’t be more restrictive with one type of coverage than the other regarding cost sharing, treatment and care management.

“They could back off of parity,” Palanker said.

*Prescription Drugs*

Prescription drug coverage could be tinkered with as well. The rules currently require that plans cover at least one drug in every drug class, a standard that isn’t particularly robust to start with, said Katie Keith, a health policy consultant and adjunct professor at Georgetown Law School. That standard could be relaxed further, she said, and the list of required covered drugs could shrink.

*Preventive And Wellness Services And Chronic Disease Management*

Republicans have discussed trimming or eliminating some of the preventive services that are required to be offered without cost sharing. Among those requirements is providing birth control without charging women anything out of pocket. But, Palanker said, “if they just wanted to omit them, I expect that would end up in court.”

*Pregnancy, Maternity And Newborn Care*

Before the health law passed, just 12 percent of health policies available to a 30-year-old woman on the individual market offered maternity benefits, according to research by the National Women’s Law Center. Those that did often charged extra for the coverage and required a waiting period of a year or more. The essential health benefits package plugged that hole very cleanly, said Adam Sonfield, a senior policy manager at the Guttmacher Institute, a reproductive health research and advocacy organization.

“Having it in the law makes it more difficult to either exclude it entirely or charge an arm and a leg for it,” Sonfield said.

Maternity coverage is often offered as an example of a benefit that should be optional, as Verma advocated. If you’re a man or too old to get pregnant, why should you have to pay for that coverage?

That a la carte approach is not the way insurance should work, some experts argue. Women don’t need prostate cancer screening, they counter, but they pay for the coverage anyway.

“We buy insurance for uncertainty, and to spread the costs of care across a broad population so that when something comes up that person has adequate coverage to meet their needs,” said Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute.

Please visit khn.org/columnists to send comments or ideas for future topics for the Insuring Your Health column.

-- 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.

Rise in premiums lays bare 2 Americas on health care

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Michael Schwarz is a self-employed business owner who buys his own health insurance. The subsidized coverage "Obamacare" offers protection from life's unpredictable changes and freedom to pursue his vocation, he says. Reported by FOXNews.com 4 hours ago.

HUFFPOST HILL - CPAC Refuses To Normolopoulize Pedophelia

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*Like what you read below? **Sign up for HUFFPOST HILL** and get a cheeky dose of political news every evening! *

Donald Trump paid a visit to the National Museum of African American History and Culture or, as he knows it, “Examples of People Who’ve Done an Amazing Job and Are Being Recognized More and More, I Notice.” The president went most of the day without tweeting, which might explain why all those coyotes finally stopped howling. And Milo Yiannopoulos was disinvited from this year’s CPAC, so as to avoid sullying the good name of the annual conference that has played host to such high-minded things as the “Andrew Breitbart Defender of the First Amendment Award,” the “If Heaven Has a Gate, A Wall, and Extreme Vetting, Why Can’t America?” breakout session and “Tomi Lahren.” This is HUFFPOST HILL for Tuesday, February 21st, 2017:

 *ADMINISTRATION RAMPING UP DEPORTATIONS - *Willa Frej: “A set Department of Homeland Security memorandums released Tuesday *reveal that President Donald Trump has declared an open season on the deportation of undocumented immigrants.* ‘The Department will no longer exempt classes or categories of removable aliens from potential enforcement,’ one document says. They also expanded Immigration and Customs Enforcement’s ability to perform expedited removals on people who have been living in the U.S. for up to two years. The U.S. will also prosecute the parents of unaccompanied minors as smugglers, according to the documents. DHS directed ICE to hire 10,000 additional people to get the job done, according to one of the memos. The document does indicate that the priority remains ‘removable aliens’ who have been convicted of a crime or charged with a crime. *It does not, to the chagrin of many conservatives, suggest any changes to the Deferred Action for Childhood Arrivals program, or DACA*.” [HuffPost] 

*WHY WE’RE LOCKING OUR DOORS - *In case you’re wondering why a lot of D.C.-based reporters made a big deal about a gunman showing up to Comet Ping Pong, this is why. Ariel Edwards-Levy: “A narrow majority of President Donald Trump’s supporters agree with him that the media is their enemy, a new HuffPost/YouGov survey finds, although most Americans overall don’t feel similarly. Trump tweeted last Friday that the media is the ‘enemy of the American People,’ a statement that drew criticism from many reporters and disavowals even from some members of his party. *Most Trump voters, 51 percent, say the media is an enemy to people like them, according to the poll*, with 36 percent considering the media unfriendly, and just 5 percent saying it’s friendly or an ally. Overall, 22 percent of Americans consider the media an enemy to people like them, with 19 percent saying it’s unfriendly, 21 percent that it’s friendly, and 14 percent that it’s an ally.” [HuffPost] 

*HuffPost Haircuts*: Arthur Delaney (h/t Christina Wilkie), Christina Wilkie (h/t Christina Wilkie), Whitney Snyder (h/t Jeffrey). 

 *Like HuffPost Hill? Then order Eliot’s book*, The Beltway Bible: A Totally Serious A-Z Guide To Our No-Good, Corrupt, Incompetent, Terrible, Depressing, and Sometimes Hilarious Government 

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

*PRUITT: SAY ‘PLEASE’ AND ‘THANK YOU’ AS WE DESTROY THE EARTH* Also, he’s probably going to fire everybody. Alexander Kaufman: “Environmental Protection Agency chief Scott Pruitt mentioned a ‘toxic environment’ just once during his first address Tuesday to the embattled agency staff. But he wasn’t talking about industry pollution or conserving nature. He was referring to his critics’ political rhetoric. *‘Forgive the reference, but it’s a very toxic environment’ the controversial new administrator said in the speech, which lasted under 20 minutes. ‘Civility is something I believe in very much,’ he added. ‘We ought to be able to get together and wrestle through some issues in a civil manner.’* Then, at last, he began to outline his vision for the EPA. He described an agency that prioritized making it easier for polluters to comply with regulations. He promised to listen intently to companies before saddling them with new regulations. He admonished his new employees, some fearing layoffs amid looming budget cuts, for acting outside the agency’s legal mandate and running roughshod over states’ rights.” [HuffPost] 

*Oh right, this*: “Today is the deadline for former Oklahoma attorney general Scott Pruitt to hand over thousands of emails. A judge set the deadline last week, a day before Pruitt was confirmed as the new head of the Environmental Protection Agency. The Center for Media and Democracy first requested the emails in 2015 over concern for Pruitt’s interests with energy companies as attorney general, specifically oil, gas, and coal companies, and conservative organizations. Nearly 2,600 emails have been requested.” [KOTV’s Justin Dougherty] 

*HERE’S ANOTHER THING THAT MAY OR MAY NOT HAPPEN* - Maybe his tax returns will be included in the budget. Paul M. Krawzak: “President Donald Trump’s administration* is aiming to release a fiscal 2018 budget outline on March 14, a White House official confirmed Sunday to CQ.* The official, who spoke on condition of anonymity, said it is the White House’s ‘intention’ to release the outline, also called a ‘skinny’ budget, on that date. That date is not set in stone and could change. Mick Mulvaney, the new director of the Office of Management and Budget, has only just gotten to work in the White House budget office. He was confirmed and sworn into office on Feb. 16…. Some congressional aides and budget experts had earlier expressed doubts about whether the Trump administration would have time to craft a budget overview, depending on when the Senate confirmed an OMB director…. Previous presidents in their first year typically have released a budget outline in late February and the full budget in April or May.” [Roll Call] 

*WHITE HOUSE SHORTCHANGES TRANSGENDER KIDS - *Thank goodness that Ivanka is there to moderate President Trump. Amanda Terkel: “White House press secretary Sean Spicer gave a clear indication Tuesday that the new administration will not be a forceful defender of transgender rights, saying President Donald Trump believes that issue should be left up to the states. *The Trump administration is reportedly preparing to rescind a policy issued by President Barack Obama’s administration mandating that any school that receives federal money must treat a student’s gender identity as his or her sex.* Schools, for example, would therefore have to allow transgender individuals to use the restroom that corresponds to their gender identity, rather than the sex assigned to them at birth. Spicer declined to say exactly what the administration had in the works, although he said it was an issue that the Departments of Education and Justice are addressing…. ‘The president has maintained for a long time that this is a states’ rights issue and not one for the federal government,’ Spicer said.” [HuffPost] 

*PRESIDENT HAS TO INSIST HE’S NOT INTERESTED IN KRISTALLNACHT 2 - *Our correspondence with our pen pals on Earth 2 has really ground to a halt as we have to explain everything twice. Fred Barbash, Ben Guarino and Brian Murphy: “President Trump called anti-Semitic violence ‘horrible’ and vowed Tuesday to take steps to counter extremism in comments that followed criticism that the White House had not clearly denounced vandalism and threats targeting Jewish institutions. Hours before Trump’s remarks, Hillary Clinton called on her former presidential rival to speak out against anti-Semitic acts after more than 170 Jewish graves were found toppled at a cemetery in Missouri…. *The remarks by Trump also appear aimed at easing pressure on his administration, which faces claims from opponents that it has failed to distance itself from extremist ideology* and has emboldened right-wing groups through its populist, America-first themes.” [WaPo] 

*IT’S POSSIBLE TRUMP IS AN ENORMOUS HYPOCRITE - *It’s almost as though he thought Obama was “lazy” because of ugly stereotypes or something! Josh Dawsey: “Donald Trump regularly assailed President Barack Obama for playing golf, then spent the first weekends of his own presidency doing just that. He attacked Obama for using Air Force One to campaign, and did it over the weekend just a month into the job. He mocked Obama for heading out of Washington at taxpayer expense, but appears to have no qualms about doing so himself. *One month in, Trump is using the presidency to boost his political and personal goals — not breaking laws or ethics rules, experts say, but ignoring his past criticisms and vows.*” [Politico] 

*Trump is running out of non-crazy national security experts. *National Security Council spokesman and former CIA agent Edward Price explains why couldn’t work for this president in a brutal op-ed. [WaPo] 

*FRIENDLY REMINDER THAT STATE LEGISLATORS KNOW WHAT THEY’RE DOING *- Well, most of the time ― certainly more than the current administration. Ian Simpson: “*Virginia Governor Terry McAuliffe on Tuesday vetoed a bill that would have blocked funding for Planned Parenthood, which provides abortions and other health services. *The bill passed by the Republican-controlled legislature would have barred the state from providing funds to clinics that perform abortions not covered by Medicaid, the federal healthcare program for the poor. McAuliffe, a Democrat, said the measure would harm thousands of Virginians who relied on Planned Parenthood healthcare services and programs. He vetoed a similar measure last year. ‘Attempts to restrict women’s access to health care will impede the goal of making Virginia the best place to live, work, and run a business,’ he said in a statement. Advocates for the law had said it would underpin organizations that provide the widest range of services.” [Reuters] 

*North Carolina governor not completely devoid of powers*: “North Carolina Gov. Roy Cooper (D) announced Tuesday *he was dropping his state’s appeal to the U.S. Supreme Court over a 2013 voting bill that a federal appeals court called the most restrictive in the state ‘since the era of Jim Crow.’ *Last year, the U.S. Court of Appeals for the 4th Circuit struck down a North Carolina bill that required residents to show photo ID at the polls, shortened early voting and eliminated same-day registration. The court ruled that the law intentionally discriminated against African Americans ‘with almost surgical precision.’ With days left in his administration, former Gov. Pat McCrory (R), whom Cooper defeated last year, appealed the ruling to the Supreme Court.” [HuffPost’s Samuel Levine] 

*JESUS RODE ON DINOSAURS, PT. 230,351,757 - *That is, before he smote the dinosaurs so we could have fossil fuels. James Nord and Hannah Weikel: “*South Dakota legislators are weighing whether to let teachers decide how much skepticism to work into lessons on contentious scientific topics such as evolution and climate change*. A House committee on Wednesday is set to consider the measure, which would give legal protection to teachers who want to discuss ‘in an objective scientific manner the strengths and weaknesses’ of the subjects. South Dakota is one of at least three states, along with Texas and Oklahoma, considering such a bill. Louisiana, Mississippi and Tennessee have enacted similar laws, according to Glenn Branch, deputy director of the California-based National Center for Science Education, which opposes the proposal. Branch said there are concerns that such a bill would embolden some teachers to start presenting creationism in their classrooms.” [AP] 

*SERIOUS PIG FARMER PWNAGE* - Assume Grassley town hall dead. Samuel Levine:”A pig farmer confronted Sen. Chuck Grassley (R-Iowa) at a town hall meeting early Tuesday morning to warn that Republicans would essentially create a giant death panel if they repealed the Affordable Care Act. Chris Peterson, 62, told the senator that he has diabetes and that he would not be able to afford health insurance if not for the Affordable Care Act. *‘You’re the man that talks about the death panel,’ Peterson said at the packed town hall in Iowa Falls. ‘We’re gonna create one great big death panel in this country [if] people can’t afford to get insurance. Don’t repeal Obamacare, improve it.’*” [HuffPost] 

*MILO OUT - *Hey, Socrates was another Greek guy down with pedophelia, maybe he’s available. Michael Calderone: “Milo Yiannopoulos resigned Tuesday from Breitbart News, the right-wing nationalist site where he’s served as a senior editor and high-profile contributor…. He said it would be ‘wrong to allow my poor choice of words to detract from my colleagues’ important reporting’ and added that the decision to leave was his own. Yiannopoulos ― a conservative provocateur banned by Twitter and known for mocking Muslims, feminists, transgender people, the Black Lives Matter movement and liberal student activists ― seemed to have finally crossed a line Monday with a major publisher and a conservative organization that was giving him a platform. *His apparent defense of sexual relationships between men and boys as young as 13 during an interview last year on the Drunken Peasants* podcast began circulating recently and led to the quick unraveling of a career built on outrage and offensive behavior. “ [HuffPost] 

*BECAUSE YOU’VE READ THIS FAR *- Here’s a wounded owl with a cast. 

*NICE TRY, NEW YORK CITY BULL -* But no one escapes from all this hideousness until we all do. Ali Bauman: “The bull that was first spotted Tuesday morning on Lakewood Avenue near Sutphin and Archer in Jamaica has died.* It escaped from a slaughterhouse on Jamaica Avenue*…. After being captured alive, the bull was loaded into a trailer but sadly died en- route during transport to the Center for Animal Care and Control on Linden Blvd in Brooklyn.” [WCBS]
*COMFORT FOOD*

- This is why astronauts can’t get drunk in space. 

- Alex Trebek reading rap lyrics.- UPS is getting in on the drone delivery game.

 *TWITTERAMA*

@Max_Fisher:

2015: i’ll just mute breitbart guy tweeting racial slurs at me
2017: scrutinize internal breitbart politics to divine future of our nation 

@electrolemon: you guys do not have a good case to say “his fake news claims are nuts” when you keep retweeting fake sally yates &“rogue govt” accounts 

@Rossalincoln: This Milo thing has taught conservatives a valuable lesson: properly vet nazis to ensure they only heterosexually sexualize pubescent kids.

 Got something to add? Send tips/quotes/stories/photos/events/fundraisers/job movement/juicy miscellanea to Eliot Nelson (eliot@huffingtonpost.com)

 

-- 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.

Vaccination funding may be cut if Obamacare ends, public health experts warn

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Many worry that up to 1 million Illinois consumers could lose their health insurance if Obamacare is repealed.

But Chicago Department of Public Health leaders aren't just worried about that part of the Affordable Care Act being repealed. They're also concerned about the possible loss of funds used... Reported by ChicagoTribune 22 hours ago.

Health law created winners and losers when buying insurance

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Known as the ACA, the law rewrote the rules for people buying their own health insurance, creating winners and losers. [...] other consumers who also buy their own insurance and don't qualify for financial help feel short-changed by Obama's law. Consumers who didn't qualify for government financial help wound up bearing the full cost of premiums. If Trump and congressional Republicans aren't careful, their actions could stoke fresh grievances without solving longstanding problems of access and cost. If Republicans take away his subsidy, "I would have to change careers and find a job that offered health insurance," he said. The Congressional Budget Office estimates that the pool of people buying individual health insurance is basically split down the middle among subsidized customers like Schwarz and those who get no help, like Dorsch. Republican proposals to tie tax credits to age, not income, would help Dorsch. Caroline Pearson, of the consulting firm Avalere Health, studied consumers on government marketplaces like HealthCare.gov — where nearly 90 percent get subsidies — and compared them with those who purchase directly from an insurer and pay full cost. For those with a standard plan, per-person medical claims averaged $376 per month in 2015, compared to $312 for unsubsidized customers who bought policies directly from an insurer. Reported by SeattlePI.com 17 hours ago.

Could your Fitbit data be used to deny you health insurance?

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Wearing a fitness tracking device could earn you cash from your health insurance company. At first, this sounds lucrative for the people who participate, and good for the companies, who want healthier insurance customers. But it’s not quite so simple. Under the program, people who have certain health insurance coverage plans with UnitedHealthcare (NYSE: UNH) can elect to wear a Fitbit (NYSE: FIT) activity tracker and share their data with the insurance company. The data would be analyzed by… Reported by bizjournals 15 hours ago.

Here’s how many people could lose Obamacare coverage in your district

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If the Affordable Care Act, also known as Obamacare, is repealed without a comprehensive replacement more than 301,000 people living in the U.S. congressional districts that make up Central Florida are expected to lose coverage, according to a recent analysis. Nationwide, between 20 million to 30 million people may lose their health insurance, according to the analysis by Charles Gaba, a Michigan-based healthcare analyst and owner of acasignups.net. Gaba looked at congressional districts across… Reported by bizjournals 15 hours ago.

United States: Recent Florida Case Law On Letters Of Protection - Lewis Brisbois Bisgaard & Smith LLP

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Letters of Protection complicate accurate valuation and defense of cases involving bodily injury. When a person receives healthcare under a private health insurance plan or governmental insurance Reported by Mondaq 15 hours ago.

‘Dreamer’ Doctors Fear Deportation Under Trump Migrant Crackdown

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At a medical school in Chicago that has more undocumented students than any other program in the U.S., recipients of Obama’s Deferred Action for Childhood Arrivals (DACA) contemplate their future in the uncertain first weeks of Trump’s presidency.

CHICAGO – The past few years have been an emotional roller coaster for Belsy Garcia Manrique.

The 26-year-old undocumented immigrant from Guatemala studied biology, chemistry and math at Mercer University in Macon, Georgia, with little hope of becoming a doctor, her dream job.

Then, in 2012, President Barack Obama announced the Deferred Action for Childhood Arrivals (DACA) program, which gave hundreds of thousands of undocumented young people like Manrique who came to the U.S. as children access to work permits in the United States and a two-year, renewable reprieve from deportation. While it was not a path to citizenship, they could live openly and start careers that matched their potential.

“It was exciting,” said Manrique, who speaks with a warm Southern drawl. “It was that feeling of, things are going to change, they’re going to get better.”

Now in her second year at the Loyola University Chicago Stritch School of Medicine, Manrique is once again filled with uncertainty. While campaigning, Donald Trump pledged to dismantle DACA. He has since said he’ll “work something out” for people covered by DACA. But amid reports of immigration sweeps and the arrest of at least one DACA recipient, many of the nation’s 750,000 DACA beneficiaries are nervous.

The United States is home to some 11 million undocumented immigrants. Though many escaped violence and persecution, particularly in Central America, seeking asylum is not an option if they’ve been in the country longer than one year.

Many DACA recipients – also known as “dreamers” after the DREAM Act, a failed federal legislative proposal to legalize their status – grew up studying hard in school, wanting to believe that academic success would somehow earn them legal status one day. Meanwhile, their parents lived and worked in the shadows.

Now they worry they might get caught in Trump’s immigration dragnet and deported to dangerous countries they hardly know.

“I got too safe and complacent” after DACA, said Manrique, who arrived in the United States when she was seven years old and recalls her mother pulling her across the Rio Grande River in a floating tire. “This election burst that bubble.”

“I’m just trying to prepare for the worst,” she added.

*‘Dreamer’ Doctors*

Manrique’s school, Loyola Stritch, currently has 28 undocumented medical students, more than any other program in the country. About 70 undocumented students are enrolled in medical schools nationwide, according to the Association of American Medical Colleges.

Loyola Stritch was one of the first programs to actively recruit undocumented applicants after DACA was introduced. This is in line with the university’s Jesuit tradition of openness, said Mark Kuczewski, who chairs Loyola Stritch’s department of medical education. It also serves a practical purpose, he added, whereby undocumented students can eventually help fill the United States’ projected shortage of up to 90,400 physicians by 2025.

Loyola Stritch’s first class of DACA enrollees, who matriculated in 2014, are completing their clinical rotations in teaching hospitals. But if DACA is revoked and they lose their work authorization, they will not be able to start medical residencies and move to the next stage of their career.

Many of the students finance their medical education through hundreds of thousands of dollars in private loans – and if they can’t work as doctors, there’s little chance they’ll be able to pay it back.

“These young people are social capital,” said Kuczewski, a bioethics professor. “They’re ambitious, they’re all at least bilingual and bicultural, and they’re incredibly well-suited to serving patient populations that are underserved.”

Manrique’s classmate, Cesar Montelongo, was 10 years old when his family fled to the United States to escape drug-cartel turf wars in their hometown of Ciudad Juarez, Mexico, one of the world’s most dangerous cities. They crossed the U.S. border legally and overstayed their tourist visas.

It took more than a decade for a family-sponsored visa application submitted by Montelongo’s American uncle to be approved, by which time Montelongo and his sister were too old to qualify as part of the family.

A joint MD-PhD candidate in Loyola Stritch’s highly competitive program, Montelongo says that without DACA his only option to legalize his status would be to apply for a visa through his younger brother, who was born in the United States. This will take about 20 years at current rates. By then, Montelongo would be nearly 50, and he could face deportation in the meantime.

“There is so much good I can do in that time,” said Montelongo, whose bioinformatics research is aimed at developing tools for more personalized medicine through genome sequencing and transcription. “It’d be a loss not to perform to my potential until 20 years from now.”

Both Manrique and Montelongo said they were drawn to medicine because their undocumented status meant their families went without health insurance. They couldn’t afford to see doctors until their illnesses were too severe to ignore.

*Immigration Crackdown*

Growing up in Calhoun, Georgia, Manrique feared random daytime phone calls that could signal trouble for her undocumented parents.

The dreaded call finally came in 2011. Immigration and Customs Enforcement (ICE) agents arrested Manrique’s father at their home and detained him after they raided employment records at the carpet factory where he worked. A lawyer saved him from deportation.

With Trump’s recent executive actions on immigration, Manrique said, “I’m worried about my parents all the time. It’s terrifying.”

Two days before Trump’s executive order banning immigration from seven countries and halting refugee resettlement, which is currently suspended by the courts, the U.S. president issued another order that has caused widespread alarm among undocumented immigrants.

The January 25 order greatly expands the definition of who is considered a criminal and therefore a target for deportation. It prioritizes removal of undocumented immigrants who have “committed acts that constitute a chargeable criminal offense,” regardless of whether they’ve been charged or convicted of a crime.

Even if Trump does not end the DACA program, hundreds of DACAbeneficiaries could be subject to deportation under the expanded definition, said attorney Leon Fresco, who headed the U.S. Department of Justice’s Office of Immigration under President Obama. At particular risk are DACA recipients with outstanding orders of removal from the country. Any run-in with the law they might have had, however minor, could endanger their reprieve from deportation under DACA.

“There is a 100 percent guarantee that some will have their DACA status revoked and they’ll be deported,” Fresco said. “It could happen any moment.”

Universities, municipal governments and workplaces across the country are setting up legal defense funds and hotlines to protect undocumented people from deportation. Loyola Stritch brought in an immigration lawyer to speak with students about their rights.

Meanwhile, the American Medical Association and Loyola Stritch are lobbying for a bipartisan bill that would grant temporary legal status to DACA beneficiaries if Trump does away with the program.

“DACA is inherently a short-term solution,” Montelongo said. “And now there’s really going to be no long-term solution. Staying in this limbo is the best we can hope for.”

This article originally appeared on Refugees Deeply. For weekly updates and analysis about refugee issues, you can sign up to the Refugees Deeply email list.

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

Insurer to lay off 119 in Denver area

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UnitedHealth Group Inc. plans to permanently lay off 119 employees of its Optum unit in Centennial, the health-insurance giant has told Colorado labor officials. The layoffs are mostly of sales and customer service representatives working at the Optum offices at 10730 and 10770 Briarwood Avenue. The layoffs are effective April 16, accosing to a notice filed by UnitedHealth Group (NYSE: UNH) with the Colorado Department of Labor and Employment. Under the federal Worker Readjustment and Retraining… Reported by bizjournals 11 hours ago.

Recycling Unused Medication To Save Lives

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Elizabeth Landsverk, MD, with ElderConsult Geriatric Medicine Explains Surplus Drug Distribution

Burlingame, CA (PRWEB) February 22, 2017

In a 2012 survey, over a quarter (28%) of American adults with chronic conditions reported skipping doses or not filling a prescription because they could not afford to pay for it. Among those who were uninsured or under-insured, rates of cost-related problems getting medications were 30-60%*. At the same time, hospitals, pharmacies, manufacturers and nursing homes dispose of unused medications worth billions of dollars every year, much of which is dumped or burned and ends up in the water we drink and the air we breathe.

“The costs of prescription medications have reached crisis levels,” says Elizabeth Landsverk, MD, founder of ElderConsult Geriatric Medicine. “Many people cut back on basics like food and utilities to pay for their prescriptions and many suffer serious declines in their health, increased hospitalizations, and even premature death by taking less medication than directed.” Now, innovative programs are saving lives by bridging the gap between unused pharmaceutical supplies and those in need.

State legislatures began taking action on pharmaceutical donation and reuse programs in 1997. These programs create repositories that provide for unused prescription drugs to be donated and re-dispensed to patients. As of mid-2016, 38 states have enacted donation and reuse laws although not all these states have functioning programs. California enacted initial legislation in 2005 and significantly expanded its donation and redistribution law in 2012. In California, as in most states, redistribution does not include controlled substances and donations cannot be made by individual consumers, only by institutions such as hospitals and licensed, skilled nursing facilities. In 2015, the Santa Clara County Public Health Department opened the Better Health Pharmacy in downtown San Jose, the first dedicated drug donation pharmacy in Northern California.

“The goal of the Better Health Pharmacy is to improve health by increasing medication access for all and serve patients who cannot afford their medications,” says Dr. Landsverk. “It provides medication without charge to the patient. There is no copay for insured patients and no need to have insurance. All that is needed is a valid prescription from a licensed U.S. physician and an ID. No proof of citizenship, residency, or income is required.”

The pharmacy receives unused, unopened, and unexpired medications from licensed healthcare facilities. The drugs most commonly distributed are for asthma, high blood pressure, diabetes and depression. Because of the unpredictable nature of donations and demand, inventory is constantly changing and specific medications may not always be available. Commonly stocked drugs are listed on the pharmacy's web site and patients are advised to phone in advance for an inventory check.

“Patients who take less medication than directed are not only risking their health and perhaps even their lives,” says Dr. Landsverk, “they also drive up costs by having more visits to the emergency room and stays in the hospital. This service is not only vitally beneficial for patients but it helps control healthcare costs and prevents the environmental pollution caused by disposing of millions of pills.”· Commonwealth Fund Biennial Health Insurance Survey, 2012; http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2013/Apr/1681_Collins_insuring_future_biennial_survey_2012_FINAL.pdf

Elizabeth Landsverk, MD, is founder of ElderConsult Geriatric Medicine, a house-calls practice in the San Francisco Bay Area that addresses the challenging medical and behavioral issues often facing older patients and their families. Dr. Landsverk is board-certified in internal medicine, geriatric medicine and palliative care and is an adjunct clinical professor at Stanford University Medical School. http://www.elderconsult.com Reported by PRWeb 11 hours ago.

One thing Paul Ryan's health care plan has in common with Obamacare

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House Speaker Paul Ryan says he has a solution for making health insurance more affordable: refundable tax credits. Reported by CNNMoney 10 hours ago.

One thing Paul Ryan's plan shares with Obamacare

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House Speaker Paul Ryan says he has a solution for making health insurance more affordable: refundable tax credits. There's just one issue: Obamacare's subsidies are also advanceable, refundable tax credits. It's just that most people don't know that. Reported by CNNMoney 9 hours ago.

A JPMorgan economist explains why small and midsized businesses are feeling optimistic

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A JPMorgan economist explains why small and midsized businesses are feeling optimistic Following the recession, small and midsized businesses in America faced a slow and uncertain recovery.

Confidence tumbled during the recession and remained low for years afterward; in early 2016, eight years into the recovery, business owners were still considerably more pessimistic than they had been at virtually any point in the previous 30 years.

Over the past year, however, business optimism has skyrocketed. Multiple surveys—including JPMorgan Chase’s 2017 Business Leaders Outlook—confirmed that the nation’s small and midsized businesses expect the economy to improve over the coming year. Indeed, for the first time since the recession, the majority of businesses are planning to expand their workforces and make new capital investments—and since small firms make up a disproportionate share of new hiring activity, this small business revival will likely result in good news for job seekers.

**Why So Sunny?**

The surge in business optimism is largely driven by the growing strength of the American economy. The recovery has created 16 million jobs, pushing the labor market back toward full employment, and low debt burdens have freed up discretionary income for American households, spurring a boom in consumer spending. As the underwater mortgage problem has faded from view, home prices have stabilized and new construction is finally picking up. Real GDP per capita recently surpassed its prerecession peak, and the economy’s strength is providing a solid foundation for businesses to expand.

Stabilizing energy prices are also helping businesses grow. The global oil glut halted drilling activity in many of America’s shale fields; many projects became unprofitable when oil fell to $30 per barrel. Now that oil has found its footing, capital investment is recovering and the outlook is brightening for the small contractors that provide oil field services.

Businesses are also optimistic about the shifting political landscape. They are often challenged by complex regulations and tax provisions, and the rising cost of health insurance has become a new source of financial uncertainty. However, many business owners are hoping that the new Trump administration will be able to reform regulations, cut taxes and control healthcare costs—in fact 76 percent of business leaders surveyed in this year’s Business Leaders Outlook expect that the new administration will have a positive impact on their businesses.

**The Employment Upshot* *

Because of the cyclical and often seasonal nature of their work, small businesses make up a disproportionate amount of hiring activity. Unlike larger companies, which sell to a stable international customer base, small businesses are more likely to need to add workers to fulfill a new contract or keep pace with a growing local economy. Conversely, during downturns, they are more likely to undergo layoffs, as they lack the financial cushion to retain workers through periods of weak demand.

During the recession, small businesses suffered drastic workforce cuts, laying off an average of more than 1 million employees every month during the worst of the downturn. Now that demand has recovered, the smallest businesses are creating the bulk of the nation’s new jobs; according to the US Department of Labor, businesses with fewer than 50 employees added an average of 75,000 to 100,000 new workers every month in the past year, creating almost 20 times more jobs than the nation’s largest companies did during that same time.

As small and midsized businesses continue to expand, hiring activity should accelerate, too. Currently, 5.5 million job openings are unfilled, and according to this year’s Business Leaders Outlook, 38 percent of midsized businesses are extremely or very concerned about the limited supply of candidates with the right skill sets. As the economy nears the top of the business cycle and more jobs are created, workers should enjoy rising wages and new incentives for training and professional development. Growing optimism in the business community will soon benefit workers everywhere.

View our economic commentary disclaimer.

As Managing Director and Head Economist for Commercial Banking, Jim Glassman provides market insights to help clients better understand the changing economy and its impact on their businesses.

Join the conversation about this story »

NOW WATCH: 'It's a lie': Jake Tapper calls out Trump during a fiery interview with Kellyanne Conway Reported by Business Insider 8 hours ago.

InsurTech Firm, Ventiv Technology, Announces Peter Yang as Chief Information Officer

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Bill Diaz names Peter Yang as new chief information officer

ATLANTA (PRWEB) February 22, 2017

Ventiv Technology announced that Peter Yang has joined the company as chief information officer, effective immediately. The announcement was made by Bill Diaz, chief executive officer of Ventiv Technology.
 
In his role as chief information officer, Yang will be responsible for overseeing the DevOps of the company – architectire, development, data tools, and hosting.

“Peter is a deeply technical and hands-on manager,” says Diaz. “He can roll up his sleeves to perform architectural design, code reviews, and help solve the most challenging application issues. I am deeply confident his RMIS/claims domain expertise will provide tremendous value to Ventiv.”

Prior to beginning work at Ventiv, Yang spent four years as chief technology officer at FIS Insurance, leading development operations across a wide range of products across life & annuity, health insurance, property & casuality and financials. Prior to FIS, he spent 13 years holding engineering leadership roles at Marsh ClearSight. His expertise lies in building effective teams and architecting scalable, secure, cloud-friendly and high-performing enterprise applications and data/BI solutions.

“I like the vision the team at Ventiv has and I am very excited to be a part of it,” says Yang. “I’m confident in our company’s dedication to delivering innovative and effective business solutions to our clients.”

Yang holds a B.E. in biomedical engineering from Huazhong University of Science and Technology and an M.S./PhD in computer science and hearing science from Vanderbuilt University. Reported by PRWeb 8 hours ago.

The Problem For Obamacare Repeal Is That Americans Mostly Like What The Law Does

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Americans are not fond of this thing called the Affordable Care Act, but as the polls keep showing, they like a lot of what it does. Therein lies the dilemma for those pushing its repeal.

Faced with the overall question, 51 percent of Americans said they want to partially or completely repeal the health care law, according to a new Morning Consult/Politico poll released Wednesday. 

Respondents were also asked about nine different elements of Obamacare, from coverage of pre-existing conditions to expansion of Medicaid. The majority wanted to keep every aspect except “requiring nearly all Americans to have health insurance or else pay a fine.” Fifty-seven percent said that element should be repealed.Even among those who voted for President Donald Trump, there is widespread support for many of the health care law’s individual provisions. Eighty-one percent of Trump voters said Obamacare should be partially or completely repealed. But the majority said they would keep all the specific elements highlighted except “requiring health insurance companies to cover prescription birth control,” “removing lifetime and annual limits on the amount of money health insurance companies can pay out for an individual’s care,” and requiring nearly all Americans to have insurance.

Another recent Morning Consult/Politico poll found that one-third of Americans still don’t know that Obamacare and the Affordable Care Act are the same thing. This ongoing confusion has led others to wonder how much of the opposition to Obamacare is based on its association with the previous president and how much is dislike of what the law actually does.

Support for Obamacare has risen over the past few months and support for its repeal has dropped 8 percentage points since the beginning of the year, even as Trump and the Republican-controlled Congress pledge to repeal it.

The national online survey from Morning Consult/Politico polled 2,013 registered voters Feb. 16-19. It has a margin of error of plus or minus 2 percentage points.

-- 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.

Repeal, Replace, Repair, Rename? Here Is The Latest On Obamacare, And Why It's Bad For Stocks

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Repeal, Replace, Repair, Rename? Here Is The Latest On Obamacare, And Why It's Bad For Stocks During his campaign, Trump vowed to America's middle class that he would get rid of (since then the phrase has been amended to "repeal and replace" for various reasons) Obamacare as soon as he got into office. Well, Trump is out of his 30 day honeymoon, and the confusion and chaos over the future of Obamacare has never been greater, to a large extent due to growing pushback he has been getting in Congress.

Below is an update of the latest developments and progress, or lack thereof, regarding the repeal and replace, or perhaps repair and rename, of Obamacare.

In a nutshell, Congressional Republicans hope to pass legislation by April to repeal and at least partially replace the health insurance coverage expansion under the Affordable Care Act. However, none of the several approaches that have been floated appear able to win a majority in the Senate.

One base case, pitched by Goldman Sachs, is that Congress will enact ACA legislation in Q2 that modifies the tax credits under the law for health insurance coverage and increases state flexibility under Medicaid.

However, this process is likely to take longer than expected, *which is likely to delay the upcoming debate over tax reform; this in turn will have adverse consequences for the market, which has already largely priced in substantial passage of Trump's tax reforms even if no details are known yet. *More importantly, as Goldman writes in an overnight note, the difficulty the Republican majority is having addressing a key political priority suggests that lawmakers might ultimately need to scale back their ambitions in other areas as well, such as tax reform.

Here are the details on why Trump may have suddenly found himself trapped on next steps when it comes to both Obamacare, and tax reform, courtesy of Goldman's Alec Phillips:

The outcome of congressional Republican plans to repeal and replace the Affordable Care Act (ACA) is as hard to predict as any legislative issue we can recall. For the last several years, congressional Republicans have sought to repeal the law, and now have the potential to do so. *However, despite holding a majority in both chambers of Congress, Republicans appear to lack a majority for any particular option currently under consideration*. The disagreement relates to substance—*whether to continue the expansion of subsidies under the ACA but in different form or to substantially reduce subsidized benefits to the pre-ACA level*—and process—*whether to repeal first and enact a replacement program later, or to do both in the same legislation*.

The original Republican strategy was to address the law in two phases. The first phase was to repeal most of the fiscal provisions via the reconciliation process, which allows passage in the Senate with only 51 votes, and therefore potentially only with Republican support. *These provisions would take effect with a delay, preserving the status quo for perhaps two years*. In the second phase, Congress would enact a replacement program to provide some continuation of the coverage provided under the ACA, with the details to be determined during the two-year transition period.

This two-stage approach would theoretically have two advantages over addressing the issue in one piece of legislation.

· First, it would have allowed congressional Republicans and President Trump to quickly follow through on a key campaign priority, without spending much of the first year of the new term, when political momentum is greatest, sorting out the details of any replacement.
· Second, it would have allowed repeal to pass via the reconciliation process with only 51 votes—presumably only Republican votes—but the replacement to pass under regular order with 60 votes. This would allow for changes to insurance market regulation and other non-fiscal policies that cannot be addressed via the budget reconciliation process.

Some centrist Republicans, particularly in the Senate, have signaled support for a substantial continuation of expanded benefits and have called for at least some elements of the replacement program to be included in the repeal legislation. *By contrast, some conservative lawmakers support repeal of the law with limited replacement of the current subsidies*. Republican leaders have taken a position that is in between these approaches.

Exhibit 1 contrasts the current program with three proposals: *the legislation that Congress passed and President Obama vetoed in 2015; legislation introduced by Republican Sens. Cassidy (R-LA), Collins (R-ME), Isakson (GA), and Moore-Capito (WV), and the approach that House Republican leaders outlined on February 16.*

Exhibit 1: Many proposals but little agreementSource: DHHS, Congressional Budget Office, House Ways and Means Committee, Office of Sen. Collins

The outcome of this debate is hard to predict, but certain changes appear more likely than others:

· *Coverage mandates are likely to disappear. *The mandates on individuals to obtain health insurance and on employers to provide it look very likely to be repealed. Most Republican proposals would repeal them, and the Internal Revenue Service (IRS) has already announced that they will not enforce the penalties as a result of President Trump's recent executive order.
· *Tax hikes and tax credits are likely to change, but timing and details remain unclear*. There is general agreement among congressional Republicans that most if not all of the new taxes used to fund part of the cost of the coverage expansion should be repealed. However, it is unclear whether these taxes will be repealed retroactively for 2017 or prospectively. It is also possible that at least one of the taxes—the so-called Cadillac tax—might be modified rather than repealed entirely; instead of imposing a 40% excise tax on high-cost employer-sponsored health insurance plans starting in 2020, Republican leaders appear to be contemplating capping the exclusion for employer-sponsored benefits instead. This would have a similar effect to current law, which should reduce the offer of high-cost plans to employees and increase their taxable wages instead, but changes in how the tax is applied could affect the incidence of the tax and the amount of tax revenue it generates.
· *Changing the Medicaid expansion is likely to be the hardest to pass, but “repeal” may not be able to pass without addressing the issue*. 20 Republican senators represent states that have expanded Medicaid eligibility, and many of them support allowing “expansion states” to continue to receive 90% of the cost of covering the new population, as the ACA calls for. However, 32 Republican senators represent states that did not expand, and many of them object to the spending increase. Ultimately, the way out of this political impasse may be to provide states additional flexibility to use federal Medicaid funds, with a gradual equalization in funding for expansion and non-expansion states.
· *Regulatory changes and Medicare reimbursement cuts are off the table in the near term, we believe*. For entirely different reasons, two areas of the ACA are likely to remain unchanged in the near term, at least as far as Congress is concerned. First, the cuts to Medicare reimbursement that were used to offset part of the cost of coverage expansion look very likely to be maintained, with neither party seemingly interested in repealing them. Regulatory changes, such as the 3:1 limitation on variation in premiums based on factors like age, are unlikely to change as a result of near-term legislative efforts, since they are politically popular and, more importantly, probably cannot be addressed via the reconciliation process because they do not directly affect federal spending or revenues.

For the health care sector, *the current political debate reinforces the view that most of the current health subsidies are likely to be maintained regardless of the specific changes that Congress agrees upon. *As noted above, it seems likely that Medicaid subsidies will be largely maintained over the near term and, while tax credits for private insurance plans will be modified, we would be surprised if the overall amount of subsidy spending declines considerably. In fact, it is possible that overall ACA-related spending could increase slightly, if Congress tries to increase support among non-expansion states by temporarily increasing their subsidies to the level that expansion states receive. It is also worth noting that *if congressional Republicans pass ACA repeal legislation along party lines, some other policy changes that might be the subject of congressional horse-trading would be less likely, such as initiatives to control pharmaceutical prices, would be less likely since bipartisan support would not be needed*.

*More broadly, the difficulty congressional Republicans are having in addressing the ACA raises two important issues for the rest of the agenda, and fiscal policy in particular.* First, the longer this debate takes to resolve, the less capacity congressional Republicans will have to address other issues such as tax reform or infrastructure. Not only will lawmakers need to set priorities in order to focus political attention, but the same committees responsible for much of the ACA legislation—the House Ways and Means Committee and the Senate Finance Committee—are also responsible for tax reform and potentially infrastructure if financed through the tax code.

Here is the part where traders should tune in:

*Delays in addressing health legislation are also likely to set back tax reform procedurally. *The ACA repeal/replace bill is being addressed as part of the FY2017 budget resolution, which would have normally passed last year but which Congress passed several weeks ago in order to create a procedural pathway for passage of ACA repeal legislation via the budget reconciliation process, which allows it to pass with only 51 votes in the Senate. Once the ACA legislation is enacted, congressional Republicans hope to pass the FY2018 budget resolution, which will lay out tax and spending plans for the coming ten years and provide a second set of reconciliation instructions, this time for tax reform. *Since Congress follows whatever budget resolution has passed most recently, passing the FY2018 resolution before the ACA bill has passed would remove the procedural protections from the repeal/replace bill, subjecting it to a 60 vote threshold in the Senate. *

*Congressional leaders hope to pass ACA repeal/replace legislation by April, which would allow them to stay nearly on track with the usual timing of the annual budget resolution*—that process usually starts in March and ends in April or May—and would allow them to try to provide some clarity to health insurers ahead of May when they need to indicate their intent to provide benefits in the health exchanges in 2018. Passage in April could also increase the support for additional funding or other changes to stabilize the health exchanges for 2018; *the most likely vehicle for such changes is the upcoming appropriations legislation, which needs to pass by April 28 to avoid a government shutdown.*

If ACA legislation does not pass by April or so, congressional leaders have several other options. One option is simply to delay the FY2018 budget resolution until the ACA repeal bill has passed, whenever that occurs. *This is the simplest strategy, but resolving differences among Republicans could take several more months*. An alternative would be to *use the current reconciliation instructions to pass tax reform, and the FY2018 instructions to address the ACA*, flipping the sequencing of the current approach. However, for technical reasons it would be difficult to use the current reconciliation instructions to pass tax reform, in our view, so congressional leaders might consider this only as a last resort. Another third possibility would be to roll ACA repeal/replace together with tax reform creating one bill that could be passed via the FY2018 reconciliation process.* While this is procedurally possible, the complexity of combined ACA and tax reform legislation would reduce the probability of substantial changes in either area, in our view. *

* * *

Beyond the issues of timing and process, the current situation highlights the difficulty that congressional Republicans are likely to encounter in trying to make significant structural reforms on a party-line basis. If legislation addressing a longstanding political priority like Obamacare repeal is having difficulty attracting 51 votes in the Senate, it suggests Republican leaders will need to scale back their ambitions on other issues too, *including tax reform*. Ultimately, we continue to expect an expansion of the deficit of around 1% of GDP, with nearly all of this coming in the form of tax cuts. However, as we noted recently, the current debate suggests that tax legislation might not be finalized until late 2017 or early 2018. *Along with the potential for a phased-in tax cut, this would likely spread the growth effects between 2018 and 2019.* Reported by Zero Hedge 4 hours ago.
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