A new study of past-due medical debt, by Michael Karpman and Kyle J. Kaswell of the Urban Institute, shows that the expansion of health insurance coverage subsequent to the Affordable Care Act is associated with a reduction in the proportion of adults with past-due medical debt.

In 2012, 29.6 percent of U.S. adults had past-due medical debt, versus just 23.8 percent in 2015. The study does not define “past-due” nor the average amount of medical debt that is past-due. However, an earlier Urban Institute study defines credit card debt as past-due if it is over 30 days late. That study also reported 35.1 percent of adults in 2014 had debt in collection (that is, more than 180 days past-due)! The average amount was $5,178, or 7 percent of average household income of $72,254. The first study cites research that almost half of debt in collections is owed to hospitals and other providers.

What to make of this? Although health insurance is supposed to protect us from such a situation, it often does not. And it is not clear what effect Obamacare has had. Among insured people, 26.6 percent had past-due medical debt in 2012, versus 22.8 percent in 2015. Among uninsured people, 39.8 percent had past-due medical debt in 2012, versus 30.5 percent in 2015.

If Obamacare is associated with a bigger impact on past-due medical debt among those who remained uninsured than the insured, that would be an odd outcome. (Actually, it is more likely the large improvement among the uninsured is a result of adverse selection into insurance due to Obamacare. Those who remained uninsured were more likely to be healthy, therefore have less medical debt.)

Further, other research indicates no change in the proportion of Americans having trouble paying medical bills from 2005 through 2015. What really stands out in the Urban Institute study is the proportion of 18 to 24-year olds with past-due medical debt: 27.3 in 2012 versus 21.1 percent in 2015.

Seriously? One in five Americans aged 18 through 24 has past-due medical debt? What could possibly be driving that? I suggest health insurance itself is a cause. We still have a system where insurers control prices and charges. People have little idea how much they will pay out of pocket until long after they receive care. Claims have to be processed, and Explanations of Benefits (EOBs) and invoices have to be mailed.

Indeed, it would be virtually impossible for an American patient to pay a medical bill within 30 days. If we paid our doctors directly, instead of sending our money on a convoluted voyage through insurers’ bureaucracies, medical debt would go down a lot.

This article appeared at The Beacon Reported by Eurasia Review 4 hours ago.

It’s no secret that Oregon’s health insurance market has gone through a turbulent period since the Affordable Care Act rolled out three years ago. Two health insurance “Co-ops,” or consumer operated and oriented plans, went out of business. Another insurer left the state. And yet another was bleeding so much money that it was placed under state supervision until it raised enough capital to stay in business. Rates rose by double-digits two years in a row. The Republican plan to replace the… Reported by bizjournals 2 hours ago.

You know plenty of younger people starting out in the world of work. Life has changed. According to the Bureau of Labor Statistics, today's youngest workers will hold 12 to 15 jobs during their lifetime. Achieving financial independence is all about having assets. How would you advise your godson, niece or young friend starting out in life? 1. Saving is tough — After paying federal and state taxes, Social Security, health insurance premiums and who knows what else, you might be lucky to see 70… Reported by bizjournals 15 minutes ago.

· *Premium income stable at €13.6 billion*

· Targeted development, particularly with very strong development of the unit-linked individual savings / pensions business
· Strong growth in group health insurance, driven by the new regulation in compulsory group health insurance, "ANI", a market sector in which Groupama is France's number one player
 

· *Net income of €322 million*

· Economic operating profit of €153 million
· Technical and operating performance impacted by a difficult environment due to the persistence of low interest rates and the higher rate of claims due to weather and severe claims
· A non-life combined ratio of 100.3%
· Active transformation of the life insurance portfolio with a share of unit-linked in individual savings reserves of 23.5%
 

· *A Solvency 2 ratio of 289%*

· Shareholders' equity rose by +6.5% to €8.8 billion
· A total of €190 million in mutual certificates  

"The strength of Groupama's mutual insurance model, the Group's presence regionally, and the unrelenting hard work of its elected representatives and employees have enabled the company to help its customers and members to deal with a year that was an unprecedented disaster from a climate standpoint, whether they were affected by floods in the spring, damage to goods or materials, or the series of bad weather that hurt crops. Our members show their appreciation for Groupama by subscribing to our mutual certificates in large numbers, and we're proud of that." , said Jean-Yves Dagès, Chairman of the Board of Directors of Groupama SA.  

"Thanks to our rigorous risk management, our 2016 results remained strong in spite of an exceptionally high level of claims on crops and an above-average level of claims for bodily injury.  This demonstrates the solidity of the Group's fundamentals, which we are constantly reinforcing by developing our human resources and investing in digital solutions that are recognised as being among the best in the market." , said Thierry Martel, Chief Executive Officer of Groupama SA.

Paris, 17 March 2017 - The board of directors of Groupama S.A. met on 16 March 2017, under the chairmanship of Jean-Yves Dagès, and approved the Group's combined financial statements and the consolidated financial statements of Groupama SA for fiscal year 2016. 

The Group ' s combined financial statements include all business of the Group as a whole (i.e. the activity of the regional mutuals and of the subsidiaries consolidated within Groupama SA). The consolidated financial statements for Groupama SA include the business of all subsidiaries as well as internal reinsurance (nearly 35% of the premiums from the regional mutuals ceded to Groupama SA).

The analysis below focuses on the combined scope. The key figures of the consolidated scope are presented in the appendices notes.   

· * Business activity focused on profitable growth *

At 31 December 2016, Groupama reported combined premium income of €13.6 billion for the year, a stable level compared to 2015.

Breakdown of Groupama ' s combined premium income by business activity as at 31 December 2016  

in millions of euros 31/12/2016 Like-for-like change (%)
Property and casualty insurance 7,163 +0.7%
Life and health insurance 6,280 -0.6%
Financial and banking businesses 133 +5.7%
*GROUP TOTAL* *13,576* *+0.1%*

· *In France*

Insurance premium income in France as at 31 December 2016 amounted to €10.8 billion, up +0.9% for the year.

In property and casualty insurance, premium income rose +0.6% to €5.4 billion. Insurance for individuals and professionals gained +0.3% over the year, finishing at €3.2 billion. This upward trend is the result of growth in home insurance (+1.2% to €1.0 billion) and business liability insurance (+2.0% to €0.4 billion), stable business for motor insurance (-0.2% to €1.5 billion), and a decline in construction insurance (-4.0%). Growth in the agriculture branch (+0,8%), development of the legal protection branch (+13.2%), and increased assistance business (+14.1%) also contributed to higher premium income  in property and casualty insurance.

In life and health insurance, premium income was €5.4 billion, up +1.1% compared with 31 December 2015. This increase was mainly due to strong growth in group insurance (+13.4%), driven by group health insurance (+26%), under the effect of the rise in policies following the new French regulation on compulsory group health insurance, "ANI", a market where Groupama is number one in France. The group protection segment also grew (+3.5%). The individual savings/pensions business dropped -4.0%, a change that results from growth in unit-linked products (+11.7%) while the  market dropped -1% (FFA) and a -11.1% decrease in euro-denominated savings products within a stable market (FFA). Unit-linked outstandings represented 23.5% of individual savings reserves at 31 December 2016 versus 20.7% at 31 December 2015.

· *International*

The Group is present in 11 countries around the world, mainly in Europe. It also has growth opportunities in Turkey, as well as in China, a country in which it ranks second among foreign non-life insurers with €256 million in premium income ^[1] . At 31 December 2016, international premium income totalled €2.647 billion, down -2.9% compared with 31 December 2015.

In property and casualty insurance, premium income was up +0.8% from 2015, at €1.8 billion as at 31 December 2016. This change was mainly due to the good performance of the agricultural business segment (+15.1%), particularly in Turkey; home insurance (+2.2%); and the growth in business activities with companies and local authorities (+2.9%). These gains offset the decrease in motor insurance (-1.1%).

In life and health insurance, premium income was €880 million, reflecting a decrease of -9.7%, particularly following the decline in the individual savings/pension business (-18.8%), mainly in Italy and Greece. Indeed, in Italy, as part of the strategy focused on profitable development, the Group favours unit-linked policies (+55%) over traditional policies denominated in euros, which saw a decrease in inflows (-34%). Group life and health insurance was up +12.2%, supported by growth in the group retirement segment (+27.4%).

Breakdown of international premium income as at 31 December 2016

in millions of euros 31/12/2016 Like-for-like change (%)
Italy 1,456 -9.0%
Turkey 388 +4.6%
Hungary 316 +4.4%
Romania 208 +15.9%
Other countries* 279 +1.8%
*International insurance* *2,647* *-2.9%*

*Greece, Portugal, Bulgaria, Gan Outre-Mer

· *Financial businesses*

Group's premium income was €133 million at 31 December 2016, mainly coming from Groupama Asset Management for €128 million. Groupama Asset Management's business was driven by growth in assets under management, up €5 billion, reaching €96.8 billion as at 31 December 2016. 

On 22 April 2016, Orange and Groupama signed an agreement to develop an unprecedented 100% mobile banking offering. In October 2016, regulatory and prudential authorities, both in France and Europe, gave formal approval for the acquisition by Orange of 65% of the capital of Groupama Banque ^[2] , renamed Orange Bank on 16 January 2017.

· *Net income of €322 million*

The Group's economic operating income amounted to €153 million as at 31 December 2016. 

The contribution to economic operating income from international subsidiaries was positive, up +€51 million compared to 2015. 

Breakdown of the Group's economic operating income  

in millions of euros 2015 2016 2016/2015 change
Life and health insurance 152 198 +46
Property and liability insurance 118 25 -93
Financial and banking business 9 27 +18
Holding companies -117 -96 +21
*Economic operating income* *163* *153* *-10*

Economic operating income from insurance reached +€223 million as at 31 December 2016, despite an unfavourable environment:

· 2016 was marked by a higher rate of claims related to weather and severe claims.
· lingering low interest rates, which continued to have a high unfavourable impact of €121 million after taxes.

In property and casualty insurance, economic operating income totalled €25 million as at 31 December 2016. The non-life net combined ratio was 100.3% as at 31 December 2016, versus 99.2% as at 31 December 2015. This change takes into account the rise in weather-related and severe claims, which added +4.8 points. Reinsurance protections proved to be effective, reducing the impact of this category to 3.1 points. Favourable change in loss-related claims and changes over previous years also helped partially compensate for the increase. The net cost ratio improved +0.2 points to 27.7%.

In life and health insurance, economic operating income amounted to €198 million as at 31 December 2015, versus €152 million as at 31 December 2015, an increase of +€46 million. This growth resulted from the improved loss experience in the health and bodily injury businesses and the increased profitability of the life insurance business benefitting from the development of unit-linked policies in recent years in France.

The reconciliation from economic operating income to net income takes into account non-recurring items worth +€169 million as at 31 December 2016. In the 2016 financial statements, besides realised capital gains worth €234 million, the Group also had income from business disposals (Cegid and Groupama Banque) of +€66 million, and goodwill impairment in Turkey at -€88 million.

Overall, the Group's net income amounted to €322 million as at 31 December 2016.

· * A solid balance sheet *

The Group's shareholders' equity totalled €8.8 billion as at 31 December 2016 compared with €8.2 billion as at 31 December 2015.

This includes mutual certificates issued by all of Groupama's regional mutuals, worth €190 million. By issuing mutual certificates, the regional mutuals have acquired the necessary funding flexibility to invest in their territories and strengthen a long-term, quality relationship with members based on trust. 

As at 31 December 2016, insurance investments on the balance sheet amounted to €86.2 billion, and unrealised capital gains totalled €11.0 billion, including €7.7 billion on bonds, €0.9 billion on equities, and €2.4 billion on property assets.

The Group continued its asset de-risking policy, particularly by reducing its equity portfolio, which, net of hedges, represented 4.5% of the asset portfolio ^[3] as at 31 December 2016 versus 5.0% as at 31 December 2015. 

As at 31 December 2016, subordinated debt remained stable compared with 31 December 2015. Groupama's debt to equity ratio excluding revaluation reserves was 9.7% at 31 December 2016.

On 9 January 2017, Groupama launched an offer to exchange any and all of its undated deeply subordinated notes issued in 2007 and a portion of its senior subordinated notes issued in 2009 for new senior subordinated notes due 2027. Insititutional investors showed significant interest in the transaction. 

As at 31 December 2016, the Solvency 2 coverage ratio was 289%, up +26 points compared with 2015. Groupama calculates its Solvency 2 ratio at the Group level, incorporating the transitional measure on technical reserves in accordance with the statutory provisions. 

 

 

*Group Communications Department*

 

* Press contact * *Analyst and investor contacts*
Guillaume Fregni - + 33 (0)1 44 56 28 56

guillaume.fregni@groupama.com

  Yvette Baudron - +33 (0)1 44 56 72 53

yvette.baudron@groupama.com

Valérie Buffard - +33 (0)1 44 56 74 54

valerie.buffard@groupama.com

 

* * *

 

 

Groupama financial information on the accounts closed on 31/12/2016 includes:

· this press release, which is available on the groupama.com website,
· the Groupama combined financial statements as at 31/12/2016, which will be added to the website www.groupama.com on 21 March 2017 for the French version and on 6 April 2017 for the English version,
· Groupama SA ' s registration document, which will be filed with the AMF on 27 April 2017 and posted on the groupama.com website on 28 April 2017.

 
--------------------

^[1] On a basis of 100% of the premium income for Groupama Avic China, entity accounted for using the equity method in the Groupama's combined financial statements

^[2] Groupama Banque is accounted for using the equity method in the 31/12/2016 financial statements

^[3] Asset breakdown calculated at market value, excluding minority interests, unit-linked products, and repurchase agreements

* Appendix 1: key figures for Groupama - combined financial statements *

· *Premium income*

  2015 2016 2016/2015
* * Reported

premium

income Pro forma

premium

income* Reported

premium

income  

Change **
in millions of euros %
*> FRANCE* *10,695* *10,703* *10,796* *+0.9%*
Life and health insurance 5,341 5,341 5,400 +1.1%
Property and casualty insurance 5,354 5,362 5,396 +0.6%
*> INTERNATIONAL & France overseas* *2,770* *2,728* *2,647* *-2.9%*
Life and health insurance 983 974 880 -9.7%
Property and casualty insurance 1,787 1,753 1,767 +0.8%
*TOTAL INSURANCE* *13,465* *13,430* *13,443* *+0.1%*
*FINANCIAL AND BANKING BUSINESS* 280 126 133 +5.7%
*TOTAL* *13,745* *13,556* *13,576* *+0.1%*

  * Based on comparable data

** Change on a like-for-like exchange rate and consolidation basis   * *

*
*

· *Economic operating income** * *

in millions of euros 2015 2016 2016/2015 change
Insurance - France 271 173 -98
Insurance - International -1 50 +51
Financial and banking business 9 27 +18
Holding companies -117 -96 +21
*Economic operating income** *163* *153* *-10*

* * * * * Economic operating income : equals net income adjusted for realised capital gains and losses, long-term impairment provision allocations and write-backs, and unrealised capital gains and losses on financial assets recognised at fair value (all such items are net of profit sharing and corporate income tax). Also adjusted are non-recurring items net of corporate income tax, impairment of value of business in force, and impairment of goodwill (net of corporate income tax).  

· *Net income*

  2015 2016 2016/2015 change
in millions of euros
*Economic operating income** *163* *153* *-10*
Net realised capital gains 269 234 -35
Long-term impairment losses on financial instruments -26 -15 11
Gains and losses on financial assets and derivatives recognised at fair value 38 -4 -42
Net income from disposal activities 66 +66
Goodwill impairment -88 -88
Amortisation of intangible assets and other transactions -75 -23 +52
*Net income* *368* *322* *-46*

*
*

* Contribution of businesses to combined net income *  

in millions of euros 2015 2016
Insurance and services - France 360 374
Insurance - international subsidiaries 1 67
Financial and banking businesses 11
Groupama SA and holding companies 2 1
Other -7 -120
*Net income* *368* *322*

  

· *Balance sheet* * *

in millions of euros 2015 2016
Shareholders' equity (Group share) * 8,219 8,752
Gross unrealised capital gains 10,156 10,955
Subordinated debt 750 750
Total balance sheet 107,295 98,085

  * Including perpetual subordinated debt recognised as equity instruments

  

· *Main ratios* * *

* * 2015 2016
Non-life net combined ratio 99.2% 100.3%
Debt-to-equity ratio 10.2% 9.7%
Solvency II margin* 263% 289%

  * incorporating the transitional measure on technical reserves in accordance with the statutory provisions

 

* Appendix 2: key figures for Groupama SA - consolidated financial statements *

  

*A/ Premium income*

  2015 2016 2016/2015
* * Reported

premium

income Pro forma

premium

income* Reported

premium

income  

Change **
in millions of euros %
*> FRANCE* *7,239* *7,247* *7,356* *1.5%*
Life and health insurance 4,021 4,021 4,090 1.7%
Property and casualty insurance 3,218 3,226 3,267 1.3%
*> INTERNATIONAL & France overseas* *2,770* *2,728* *2,647* *-2.9%*
Life and health insurance 983 974 880 -9.7%
Property and casualty insurance 1,787 1,753 1,767 0.8%
*TOTAL INSURANCE* *10,009* *9,974* *10,004* *0.3%*
*FINANCIAL AND BANKING BUSINESS* 282 128 136 5.6%
*TOTAL* *10,292* *10,103* *10,140* *0.4%*

  * Based on comparable data

** Change on a like-for-like exchange rate and consolidation basis

  

*B/ Economic operating income**  

in millions of euros 2015 2016 2016/2015 change
Insurance - France 82 -13 -95
Insurance - International -1 50 +51
Financial and banking business 9 27 +18
Holding companies -116 -96 +20
*Economic operating income** *-27* *-32* *-5*

  * * * Economic operating income : equals net income adjusted for realised capital gains and losses, long-term impairment provision allocations and write-backs, and unrealised capital gains and losses on financial assets recognised at fair value (all such items are net of profit sharing and corporate income tax). Also adjusted are non-recurring items net of corporate income tax, impairment of value of business in force, and impairment of goodwill (net of corporate income tax).
  

*C/ Net income*

in millions of euros 2015 2016 2016/2015 change
 
*Economic operating income** *-27* *-32* *-5*
Net realised capital gains 214 179 -35
Long-term impairment losses on financial instruments -24 -14 +10
Gains and losses on financial assets and derivatives recognised at fair value 34 -7 -41
Net income from disposal activities 66 +66
Goodwill impairment -88 -88
Amortisation of intangible assets and other transactions -65 -24 +42
*Net income* *133* *79* *-54*

*
*

* Contribution of business activities to consolidated net income *  

in millions of euros 2015 2016
Insurance and services - France 118 130
International insurance 6 67
Financial and banking businesses 11
Groupama SA and holding companies 4 3
Other -7 -120
*Net income* *133* *79*

  

*D/ Balance sheet* * *

in millions of euros 2015 2016
Shareholders' equity (Group share)* 4,811 5,613
Gross unrealised capital gains 9,102 9,892
Subordinated debt 750 750
Balance sheet total 99,345 90,484

  * Including perpetual subordinated debt recognised as equity instruments

 

Version pdf
--------------------This announcement is distributed by NASDAQ OMX Corporate Solutions on behalf of NASDAQ OMX Corporate Solutions clients.

The issuer of this announcement warrants that they are solely responsible for the content, accuracy and originality of the information contained therein.

Source: GROUPAMA via GlobeNewswire

HUG#2088516 Reported by GlobeNewswire 15 minutes ago.

New Accreditation Organization to Promote Next Generation of Quality Standards and Outcome Measures.

Annapolis, MD (PRWEB) March 17, 2017

Clear Health Quality Institute™ (CHQI) - a newly formed accreditation organization - promotes standards that incorporate the next generation of quality and outcome measures. CHQI will develop and offer an array of accreditation and certification programs, value-based purchasing standards and outcome measures.

“CHQI was formed in part to find new ways to update the traditional approach to accreditation in health care,” according to Garry Carneal, JD, MA, who is serving as Board Chair. “Many opportunities exist to rethink and improve how health plans, providers, and others meet quality-based standards and performance benchmarks. Today, health insurance functions and provider services are not always easily or appropriately regulated due to the complexity of those operations. CHQI is dedicated to creating new pathways to establish national measurement-based standards for emerging solutions in the health care marketplace.” Among other achievements, Carneal has supervised the development and launch of 22 health care accreditation programs since 1995.

CHQI is supported by a Board of Directors, along with several standards and accreditation committees. Volunteer experts representing different stakeholder perspectives populate each committee. The new organization also takes an educational approach to promoting quality operations and charges reasonable accreditation fees.

“With change occurring so rapidly in the health care field, it is imperative that regulations and accreditation standards keep pace with those innovations,” states Michael Gomes, former Executive Vice-President of BenefitMall and CHQI Board Member. “CHQI’s accreditation programs help assess, track and report on trends to enhance key insurance and provider outcomes. Unfortunately, many traditional accreditation organizations often fail to adopt more current standards and also create unnecessary administrative hurdles when processing applications. CHQI is committed to providing top level services in an efficient manner with fair pricing.”

For more information about CHQI, please contact Julie Irons at (410) 696-7634 or info(at)clearhealthqi.com.

###

About Clear Health Quality Institute™ (CHQI) (http://www.clearhealthQI.com)

Clear Health Quality Institute’s (CHQI) mission is to promote quality-based practices for health plans, providers and other stakeholders across the United States and its territories. Our accreditation and certification programs help assess, track and report on trends to enhance key insurance and provider outcomes. CHQI also offers educational programs, publishes issue briefs and underwrites research to raise awareness of patient safety issues and promote best practices. The organization is governed by an independent board and committee system, which is open to a wide-range of volunteers to ensure transparency and accountability. CHQI provides resources to serve patients, providers, payers, government agencies, and other stakeholder groups. To learn more about CHQI, please contact us at (410) 696-7634 or info(at)clearhealthQI.com. Reported by PRWeb 12 seconds ago.

Today I had the opportunity to share with Members of Congress what the impact of the American Health Care Act will be on people with intellectual and developmental disabilities. This bill is barreling through Congress – and too little attention is being paid to the dire consequences of the Medicaid cuts on the lives of people with disabilities. I’m sharing my testimony here because I’m dismayed by the fact that the mainstream media is not paying enough attention to the disability angle in this fight. The public needs to understand what’s at stake – so please take a few minutes to read my comments, and share them with your family, friends, and in your community. Then take the step to Join Our Fight.

I’d like to thank Minority Whip Steny Hoyer, Congressman Frank Pallone, and Congressman Bobby Scott for organizing this important hearing. You can watch the full hearing here.

*Testimony of Peter Berns, CEO, The Arc of the United States on The American Health Care Act March 16, 2017: *

The Arc of the United States appreciates the opportunity to submit testimony today on the draft legislation that repeals the Affordable Care Act, or ACA, and pays for it by decimating Medicaid, a program critical to the lives of people with intellectual and developmental disabilities.

The Arc is the largest national community-based organization advocating for people with intellectual and developmental disabilities, or I/DD, and their families, with over 650 state and local chapters nationwide. I’m here today standing on the shoulders of countless people with disabilities, their family members and friends, and professionals who support them, who have fought over more than 65 years for the rights of people with I/DD. We have come a long way, from a society that warehoused people in institutions to one in which people with intellectual and developmental disabilities are living, learning, volunteering, working, and doing so much more as members of their local communities.

We are once again calling on Congress to protect their fundamental moral, civil, and constitutional rights to be fully included and actively participate in all aspects of American life. The Arc opposes The American Health Care Act because it would turn back the clock on 65 years of progress.

Medicaid is the primary source of funding for the vast majority – about 77% -- of the supports and services that individuals with I/DD use to live in the community. These supports and services include help with meals, bathing and dressing, toileting, in-home skilled nursing, and communication support, to name but a few. These supports are critical to people with disabilities to be able to live their life in the community. In many cases, they can be the difference between life and death.

Just this week, we spoke with a mom from Maryland, whose eleven year old daughter has Rett syndrome. For years, she and her husband took turns staying up all night with their daughter, who required suctioning and other care around the clock just so she can keep breathing and stay alive. Medicaid provided a solution to this unsustainable situation. Through Medicaid, the family was able to get nighttime nursing care to keep their little girl alive, and Mom and Dad are able have some peace of mind and get some sleep too.

Families like this exist in every Congressional district in every state in our nation. Unfortunately, and fearfully for these families and individuals, the proposed law would leave many individuals with disabilities and their families without health insurance to cover essential medical care. Even more troubling, it is unconscionable to use the Medicaid program to pay for the repeal of the ACA and to provide tax cuts for businesses and individuals that don’t need them.

The current proposal to implement a per capita cap on the federal government’s investment in Medicaid – what I call Cap and Cut -- will reduce federal spending on Medicaid by $880 billion over a decade. What this means for people with disabilities is that optional Medicaid services like home and community based supports will become scarce. And this will happen despite the fact that these programs have long enjoyed bipartisan support.

Home and community based services are discretionary for the states and, when facing loss of billions in federal funding, they are what is likely to be cut first. There will be limited availability of home and community based services, fewer people eligible, reduced reimbursement rates for staffing which will lead to poorer quality of care, and the long waiting lists for services that exist today will grow even longer.

Medicaid is already a lean program, and many states already had to cut their human services budgets during and since the recession. So what else can they do to make up the difference in funding? Perversely, states will still be required to provide mandatory services such as institutional care and nursing home beds. We fear that states will return to outdated modes of serving people with disabilities, congregating large numbers of individuals in facilities with inadequate staffing and no real-life opportunities. Cap and Cut will pave a path backwards to institutional care and segregated services.

I would like to close by sharing how one Dad in North Carolina put it when he heard what was being proposed in Congress. He said "I'm old, and I'm going to die in the next five years. My life's work has been to keep my son in the community in a meaningful way. To give him a life. Do you mean to tell me that I'm gonna die, he's going to end up in an institution all alone, and what we built is for nothing?"

We, as a society, have a responsibility to this older gentleman and his family. We cannot let our answer be “yes, that’s right.” We cannot let the plans he so carefully put in place for his son’s future, which depend on Medicaid being there, to now unravel. And we cannot turn our back on the commitments we made as a society to all other people with intellectual and developmental disabilities and their families.

The Arc thanks you again for shining a light on the concerns of people with disabilities who, as President Kennedy once remarked, are too often living in the shadows. This hearing is critically important because the catastrophe that Cap and Cut will wreak in the lives of people with disabilities and their families is not getting the national attention it deserves.

These proposed Medicaid cuts will be life altering to children and adults with disabilities, they are morally reprehensible, and as a nation we cannot allow this to happen. Thank you.

The Arc is the nation’s largest and oldest human rights organization for people with intellectual and developmental disabilities (I/DD), serving more than a million individuals and their families. To support The Arc’s efforts - https://www.thearc.org/donatejoinourfight

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

Some GOP governors weighed in Thursday evening in a letter to congressional leaders saying the House bill gives them almost no new flexibility and lacks sufficient resources to protect the vulnerable. President Donald Trump, whose administration initially embraced the House health care bill, has lately called it "very preliminary," adding that "we will take care of our people or I'm not signing it." The House bill — called the American Health Care Act — would repeal major elements of former President Barack Obama's law, create a new, leaner system of tax credits for health insurance, and cap future federal spending on Medicaid for low-income people. In another warning signal, four GOP governors wrote congressional leaders Thursday saying the bill's approach to Medicaid would not work for states. Saying they represent most GOP governors, the four submitted a nine-page proposal that gives states more options to overhaul Medicaid and modifies the shift to federal spending limits envisioned by the House. Failing to pass a bill while his party controls both the House and Senate would be a devastating blow to his party and the premise of his presidency — that he was a dealmaker the country needed. Reported by SeattlePI.com 1 day ago.

Reported by Politico 20 hours ago.

A Tennessee woman who backs President Donald Trump credits God and the Republican health care bill — which hasn’t been voted into law — for her family’s dramatically lower insurance costs. Charla McComic’s son recently lost his job, and his health-insurance premium drop... Reported by Raw Story 19 hours ago.

Bill holds potentially devastating consequences for low-income LGBT people, people living with HIV.

Boston, MA (PRWEB) March 17, 2017

The Fenway Institute of Fenway Health released a policy brief titled What the American Health Care Act means for LGBT people and people living with HIV, outlining how the American Health Care Act (AHCA), the Trump Administration’s proposed replacement for the Affordable Care Act (ACA), could impact LGBT people, people living with HIV (PLWH), and Black and Latino Americans.

“This bill holds potentially devastating consequences for low-income LGBT people, people living with HIV, and Black and Latino people,” said Sean Cahill, PhD, Director of Health Policy Research for The Fenway Institute at Fenway Health. “The rates of uninsurance among LGBT people and people living with HIV have dropped dramatically since 2013, when the Affordable Care Act’s Medicaid expansion was implemented. While people of all races benefitted from the expansion of insurance access, on a per capita basis Black and Latino people benefitted disproportionately. Those gains could be completely erased if this bill becomes law.”

Between 2013 and 2015, the rate of uninsurance among lesbian, gay, and bisexual people decreased from 22% to 11%. The percentage of people living with HIV who lacked any kind of health insurance coverage was 22% in 2012 and dropped to 15% in 2014.

The Fenway Institute analysis also notes that while the ACA has benefitted Americans of all racial/ethnic backgrounds, reducing uninsurance rates among Whites by 42% from 2012 to 2014 (from 12% uninsured to 7% uninsured), the repeal of the ACA would disproportionately hurt Black and Latino Americans. On a per capita basis, Black and Latino people are overrepresented in the 20 million who have newly accessed insurance. Uninsurance among Blacks was nearly cut in half, from 19% to 11%, from 2012 to 2014. Over time, this expansion of insurance to Black Americans could play a key role in reducing health disparities affecting Black people.

Four provisions in the AHCA would impact low-income LGBT people and PLWH, in particular:· By 2020, the AHCA would revise eligibility criteria for enrollment in Medicaid so that in addition to being low-income, an enrollee would also need to be disabled or a parent of dependent children. PLWH must let their disease progress to AIDS in order to meet the definition of disabled, and many low-income LGBT people are not parents.
· The AHCA would not impact anyone already enrolled in Medicaid as of 2020. But anyone who drops their coverage would need to meet the new eligibility criteria in order to re-enroll. That provision creates an incentive for low-income adults living with HIV who are not parents to decline a higher paying job with private insurance. Because their health is dependent upon affordable access to life-saving HIV medicines, the risk of not being able to re-enroll in Medicaid if they were to lose their job might not be one that is worth taking.
· The AHCA would replace the individual mandate with a continuous coverage requirement that would levy a one-year 30 percent insurance surcharge on anyone who takes more than 63 days to leave one health insurance plan for another. Healthy people who lose insurance and are unable to replace it within 63 days may opt to stay out of the insurance market until they really need it in order to avoid paying the 30% surcharge. But PLWH require access to affordable health care and medicine to remain alive. PLWH who lose their health insurance through job loss, and are unable to replace it within the 63-day window, would be forced to pay the 30% surcharge once they do obtain insurance again.
· The AHCA would prevent states from using Medicaid funding to reimburse “prohibited entities” from providing health care. Planned Parenthood is one of the few providers of health care that meets the definition of the AHCA’s “prohibited entities.” The LGBT population experiences disproportionate burden related to sexual health outcomes. Gay and bisexual men, as well as transgender women, are disproportionately burdened by HIV and other STIs. Lesbian and bisexual adolescent women are at greater risk of unwanted pregnancies than heterosexual adolescent women. The sexual health and family planning services that Planned Parenthood offers play a role in reducing these disparities.

All of these changes would affect LGBT people of color and PLWH who are Black and Latino, in particular. Black and Latino men who have sex with men experience the highest HIV burden among all sub-populations, and transgender women of color have disproportionately high rates of HIV and other sexually-transmitted infections.

The AHCA would make no changes to the many insurance industry reforms enacted under the ACA, such as the ban on insurance companies denying coverage to people with preexisting health conditions that has been life-saving for PLWH. In order to pass the AHCA with a simple majority vote in the Senate, the bill can only make changes that would impact the federal budget. Sixty votes are required to make more substantive changes, such as rescinding reforms to the insurance industry enacted under the ACA. Reported by PRWeb 20 hours ago.

The majority of Americans doesn’t want to see mass deportations. Most of President Trump’s opponents don’t understand why anyone approves of him. And the new GOP health care bill is off to a rocky start in gaining public support. This is HuffPollster for Friday, March 17, 2017.

*AMERICANS BREAK WITH TRUMP ON IMMIGRATION* - Tal Kopan and Jennifer Agiesta: “Americans disagree with President Donald Trump’s immigration priorities, according to a new CNN/ORC poll, with nearly two-thirds of Americans saying they’d like to see a path to legal status for undocumented immigrants rather than deportations. Trump has made tough border security and strict enforcement of US immigration laws a focal point of his campaign and presidency ― using some of his first executive orders to pave the way for far more deportations and detentions as well as ordering the construction of a Southern border wall. But a CNN/ORC poll released Friday finds that the public is actually moving in the opposite direction since Trump has won election. All told, *60% say the government’s top priority in dealing with illegal immigration should be developing a plan to allow those in the US illegally who have jobs to become legal residents*….The number who prioritize legal status for those working in the US illegally is up from 51% who said so last fall. That shift comes across party lines, with Democrats and independents each 10 points more likely and Republicans 8 points more likely to choose a plan for legal status now compared with last fall.” [CNN]

*MANY AMERICANS CAN’T UNDERSTAND WHAT THEIR POLITICAL OPPONENTS ARE THINKING * - HuffPollster: “Nearly half of Americans have already gotten into a political argument this year, a new HuffPost/YouGov survey finds….While 48 percent of Americans who personally approve of [President] Trump’s job performance say they understand why someone would disapprove of him, 43 percent say they can’t understand that, the poll finds.* Trump’s opponents are even more vehement, with two-thirds of those who disapprove saying they can’t understand why anyone would approve of him, and just 23 percent that they can understand his supporters*….People generally say their closest circle mostly shares their views of the president: 60 percent of those who approve of Trump’s job performance say most or all of their family and close friends also approve, while 76 percent of those who disapprove of the president say that opinion is shared by most or all of their friends and family.” [HuffPost]
*MOST POLLS SHOW LITTLE SUPPORT FOR GOP HEALTH CARE PLAN* - HuffPollster: “Republican plans to repeal the Affordable Care Act have been met with a largely frosty reception by the public, according to the latest polling released this week. *A Fox News poll published Wednesday night finds that just 34 percent of registered voters support the GOP’s health care plan, with 54 percent in opposition ― 36 percent oppose because it makes too many changes to the Affordable Care Act, also known as Obamacare, and 11 percent because it makes too few. *A SurveyMonkey poll shows similar reactions, with most Americans opposed to the Republican bill, 55 percent to 42 percent. The poll finds more intense opposition than support, with just 18 percent saying they strongly support the bill, while 38 percent say that they’re strongly opposed to it. The Democratic firm Public Policy Polling, meanwhile, puts opposition at 49 percent, with just 24 percent approving. A fourth poll from Morning Consult and Politico, released Wednesday, finds considerably more positive views of the bill, with 46 percent of voters approving and 35 percent disapproving. (Perhaps relevantly, theirs was also the only survey not to explicitly identify the bill as being a Republican proposal.)...Most of the surveys find significant splits across party lines.” [HuffPost, more from Fox, SurveyMonkey, PPP (D) and Morning Consult/Politico]

*Many expect the plan to make things worse* - Ashley Kirzinger, Liz Hamel, Elise Sugarman, Bryan Wu and Mollyann Brodie: “About half (48 percent) the public thinks the Republican replacement plan will decrease the number of people who have health insurance, while one in five (18 percent) say the number of insured people will increase and three in ten say it will stay about the same….When it comes to costs, about half (48 percent) expect the new plan to increase costs for people who buy insurance on their own, while about a quarter each say costs for these people will decrease (23 percent) or stay about the same (25 percent)....However, the public does not see a distinction in how the replacement plan would impact costs for these different groups of individuals, except when it comes to income. About four in ten Americans expect costs to increase for younger, older, urban-dwelling, and rural-dwelling people buying insurance on the individual market, while between about two in ten and one quarter expect them to decrease.” [Kaiser Family Foundation]

*TRUMP’S TWEETS ARE RATED MUCH WORSE THAN TWEETS FROM HIS AIDES - *HuffPollster: “Tweets from President Donald Trump’s account that are registered as being sent from from an Android ― generally a sign that the president wrote them himself ― get significantly worse scores from the public than the more innocuous tweets sent from an iPhone (presumably written by his staff)....The YouGov TweetIndex catalogues Trump’s tweets and has a representative public sample rate for each of them….The Huffington Post collected the data and separated it by whether the tweet came from Trump’s Android or an iPhone. *When the tweet came from an iPhone, it scored an average of 8 points in YouGov’s TweetIndex*….However, tweets that came from Trump’s Android received an average score of -21 points, 29 points worse than those presumably sent by his staff.” [HuffPost, TweetIndex]

*VIEWS ON PAYING COLLEGE ATHLETES DIVIDE ALONG RACIAL LINES* - Travis Waldron: “As the men’s and women’s NCAA tournaments kick off this week, a majority of Americans who have any opinion on the subject are still opposed to paying college athletes, according to a new HuffPost/YouGov poll. *The survey found that 37 percent of Americans strongly or somewhat oppose paying college athletes ― beyond their scholarships, that is ― while 30 percent strongly or somewhat support the idea.* The remaining third aren’t sure. But dig a little deeper, and an interesting picture emerges: White and black Americans are sharply divided on the issue. A majority ― 52 percent ― of black respondents are strongly or somewhat in favor of paying college athletes, while only 15 percent strongly or somewhat oppose the idea. Among whites, however, the numbers flip: Just 27 percent support paying those athletes, while 43 percent oppose it.” [HuffPost]

*MOST AGREE THAT TRUMP’S TIES TO RUSSIA SHOULD BE INVESTIGATED - *Dana Blanton: “Majorities of voters think Congress should investigate if Russia interfered with the election and allegations of coordination between the Trump campaign and Russia. That’s according to the latest Fox News Poll, taken amidst a new volley of allegations of ties between Trump and Russia, and wiretapping of Trump Tower.* Sixty-six percent want a Congressional investigation into Russia’s attempts to influence the election, and 63 percent want lawmakers to look into possible connections between the Trump campaign and Russia.* Voters are split 46-49 percent over whether lawmakers should investigate the wiretapping allegation. Views are clear on whether the president should produce evidence of his claim about the wiretaps:  76 percent think he should.  That isn’t just Democrats, although most agree (88 percent).  Republicans (63 percent) and independents (70 percent) also think he should show proof.” [Fox]

*HUFFPOLLSTER VIA EMAIL! *- You can receive this daily update every weekday morning via email! Just click here, enter your email address, and click “sign up.” That’s all there is to it (and you can unsubscribe anytime).

*FRIDAY’S ‘OUTLIERS’* - Links to the best of news at the intersection of polling, politics and political data:

-YouGov finds an increasingly wide partisan gap on transgender bathroom rights. [YouGov]

-Chuck Todd and Carrie Dann argue that that “Big Data broke American politics”; Seth Masket disagrees. [NBC, Vox]

-Kyle Kondik lays out initial ratings for the 2018 House elections. [Sabato’s Crystal Ball]

-Stephen Wolf (D) outlines the gubernatorial races Republicans want to win in 2018. [Daily Kos]

-Reid Wilson maps out 2016 voter turnout. [The Hill]

-Jeff Stein looks at a Democratic report on Michigan’s Macomb County, which swung hard against Hillary Clinton in 2016. [Vox]

-A Democratic poll of Obama/Trump voters finds Obamacare could help Democrats win back support. [American Bridge (D)]

-Ryan Grim and Jason Cherkis look back at the role of fake news in last year’s Democratic primary. [HuffPost]

-Harry Enten has a “cautionary tale” for liberals hoping to primary Sen. Joe Manchin (D-W.V.) [538]

-A Moscow court upholds the ruling that the Levada Center, an independent Russian pollster, should be added to the nation’s federal registry of “foreign agents.” [Moscow Times]

-- 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 20 hours ago.

The theme that unites all of Trump’s initiatives so far is their unnecessary cruelty.

*1.* *His new budget* comes down especially hard on the poor – imposing unprecedented cuts in low-income housing, job training, food assistance, legal services, help to distressed rural communities, nutrition for new mothers and their infants, funds to keep poor families warm, even “meals on wheels.”

These cuts come at a time when more American families are in poverty than ever before, including 1 in 5 children. 

Why is Trump doing this? To pay for the biggest hike in military spending since the 1980s. Yet the U.S. already spends more on its military than the next 7 biggest military budgets put together.

*2.* *His plan to repeal and “replace” the Affordable Care Act* will cause 14 million Americans to lose their health insurance next year, and 24 million by 2026.

Why is Trump doing this? To bestow $600 billion in tax breaks over the decade to wealthy Americans. This windfall comes at a time when the rich have accumulated more wealth than at any time in the nation’s history. 

The plan reduces the federal budget deficit by only $337 billion over the next ten years – a small fraction of the national debt, in exchange for an enormous amount of human hardship.

*3.* *His ban on Syrian refugees* and reduction by half in the total number of refugees admitted to the United States comes just when the world is experiencing the worst refugee crisis since World War II.

Why is Trump doing this? The ban does little or nothing to protect Americans from terrorism. No terrorist act in the United States has been perpetrated by a Syrian or by anyone from the six nations whose citizens are now banned from traveling to the United States. You have higher odds of being struck by lightning than dying from an immigrant terrorist attack.  

*4.* *His dragnet roundup of undocumented immigrants* is helter-skelter – including people who have been productive members of our society for decades, and young people who have been here since they were toddlers.

Why is Trump doing this? He has no compelling justification. Unemployment is down, crime is down, and we have fewer undocumented workers in the U.S. today than we did five years ago. 

Trump is embarking on an orgy of cruelty for absolutely no reason. This is morally repugnant. It violates every ideal this nation has ever cherished. We have a moral responsibility to stop it.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 15 hours ago.

Nothing is ever done until everyone is convinced that it ought to be done, and has been convinced for so long that it is now time to do something else. — F.M. Cornford

There are no simple solutions to complex problems — unless they’ve become so complex that only a simple solution will do. Welcome to health care and insurance in all of their complexity.

Engineers like to say that if a new machine of structure has too many parts, it’s not ready. Not a bad idea to keep in mind when creating a societal structure like health care. One should know where one wants to go; knowing what one doesn’t want isn’t a starting point.

I submit that the goal of health policy, stripped of its advocates, denigrators and rentiers, should be to get everyone insured for the minimum amount of money and best care result. Simple, eh?

Some aspects:
· There ought to be enough money for the United States to have universal health care, not a patchwork — a crazy quilt with holes and weak seams. We spend 19 percent of our GDP on health care, but Germany and the Netherlands spend just under 12 percent of theirs on hybrid public/private, comprehensive systems.· Insurance is a probability game, ergo it’s not unreasonable to ask the able-bodied to pay for the sick.· Mandates are not alien to us. We are mandated to pay taxes, drive with licenses and even wear clothes.· The more people covered by insurance, the lower the cost to all.· There seems to be no good explanation in the public record as to why medicine is so expensive in the United States — so much more expensive than elsewhere on earth, under wildly different systems.· The United States is the only country that leans on employers to provide health insurance to employees and to administer the policy and deal with issues that arrive with disputes.· The cost of the service patients receive is opaque once a third-party payer is responsible: the insurer. The basis of a hospital charge is hidden from the patients and policymakers. The patient has little idea what a procedure costs and who benefits from the expenditure, including doctors who own imaging companies, testing labs and even operating theaters. At the time of delivery, as Norman Macrae noted in The Economist years ago, neither the doctor nor the patients has an interest in the cost.· Hospitals are burdened with emergency rooms that can’t refuse the uninsured and hide this cost by overcharging elsewhere.
For more than 30 years, I operated a publishing business and provided health care for my employees. It cost. It cost in time. It cost in premiums. It cost in employee well-being because as the premiums (well before Obamacare) rose by 15 percent to 25 percent, I was forced to shop for providers — which meant, in many cases, new doctors for my employees every year.

After salaries, health care was the big expenditure. I thought I was in the publishing business, but I was also, reluctantly, in the health care business.

I was keen that people have the security that goes with not having to be frightened of getting sick or falling off a bicycle. Some of my employees were on a spouse’s policy as well as mine and didn’t tell me. One man, a printer, said he didn’t like to fill in forms, so he, his wife and three children just told the hospital emergency room that the family had no money. He wanted me to give him what I was paying the insurer so he could spend it.

None of the proposals now before Congress, nor those codified in Obamacare, address the fact that as a nation we backed into health care and created complex set of stakeholders — some of whom should leave the field.

For someone who has wrestled with health care as a provider, as in other things, I believe that if the purpose is not defined, you’ll get the wrong result no matter how hard you try.

The big questions Congress should be asking of the House Republican health care plan, backed by President Donald Trump, are: Will it save money? Will everyone be covered adequately? From my point of view, Congress is proposing to replace a monster with a monstrosity.

That’s no prescription for a healthy nation, free from fear of accident or illness. Time to grab a clean sheet of paper and start again, maybe check on what works around the world, if that isn’t too damaging to our self-esteem.

-- 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 13 hours ago.

SALT LAKE CITY (AP) — Rep. Jason Chaffetz has strolled to four easy re-election wins in his Republican-friendly Utah congressional district, but now he's facing a surprising challenge from a Democratic political newcomer who raised nearly a half million dollars — by tapping into anger over Chaffetz' recent comment suggesting people should spend their money on health insurance instead of iPhones. Dr. Kathryn Allen has been transformed from a political unknown into a liberal hero for calling out Chaffetz on Twitter, giving her an early boost in name recognition ahead of the November 2018 election. Chaffetz' was asked on March 7 by CNN how lower-income Americans would get access to health insurance when the Affordable Care Act is replaced. The remarks triggered a firestorm of criticism on social media with people comparing how many iPhones they could buy if they didn't have to pay medical bills in the tens of thousands of dollars. Half of the voters are registered Republicans in Chaffetz' 3rd congressional district, which stretches from Salt Lake City's southeastern suburbs to desert towns in southeastern Utah and includes heavily conservative Mormon areas. President Donald Trump's election victory led Allen to consider running for office, and she decided to do so after attending a Chaffetz town hall in February. Reported by SeattlePI.com 15 hours ago.

Blue Cross and Blue Shield of Alabama has promoted three company veterans to new positions, including naming a new chief operating officer. Tim Vines, who has worked with Blue Cross for 23 years, was named executive vice president and COO for the insurer, which is the state's largest health insurance provider. Vines most recently served as chief administrative officer, where he was responsible for all aspects of enterprise resources, information technology, legal services and finance. He also previously… Reported by bizjournals 14 hours ago.

Why did the article “Insurance or phone, ‘Why is that the choice?’ ” focus on justifying the possession of a cellphone? [March 12, A11] The real issue is that Rep. Jason Chaffetz, R-Utah — who chides low-income families for buying iPhones — apparently has no idea whatsoever of the cost of a health-insurance policy for a […] Reported by Seattle Times 14 hours ago.

WASHINGTON ― One of the most heralded aspects of the Affordable Care Act was the fact that it no longer made being a woman a pre-existing condition.

Before 2010, women often had to pay more than men for the same coverage. Only 12 percent of individual market plans covered maternity leave. And it was completely legal for insurance companies to refuse coverage to women who were pregnant or might become pregnant in the future.

Obamacare changed that. The law created a list of 10 essential health benefits that all plans on the marketplace must cover. Pregnancy, maternity and newborn care are on that list. 

President Donald Trump wants to get rid of that mandatory benefit. On Tuesday, White House spokesman Sean Spicer pointed to maternity care as a reason that insurance costs were so high and said it was unfairly burdening men and older people who don’t need such services. 

He argued that costs would go down if people had more choices for a la carte services.

“A 54-year-old doesn’t need certain things. They don’t need maternity care,” Spicer told reporters in his press briefing. “They don’t need certain medical services that are being provided to them by this government product that is being forced on them right now.”

“You’ve got young people being told to buy packages that have end-of-life care that they don’t necessarily need, you have people in their older phases of life having to buy stuff for maternity that may not be a service that they need at their stage of life,” he added. 


When a mom can go and get prenatal care and a baby is born healthy, we all benefit by that.
Sen. Debbie Stabenow (D-Mich.)
The GOP’s current bill to replace Obamacare would not change the requirement for insurers to offer maternity care. But the Trump administration has made clear that the American Health Care Act is only the first step in what it sees as an approach with “three prongs” that would include the types of changes to coverage that Spicer outlined.

“Sean Spicer’s comments illustrate how dangerous it is to allow people to propose health policy for this country when they don’t understand how insurance works and apparently don’t believe in ending discrimination against women,” said Gretchen Borchelt, vice president for reproductive rights and health at the National Women’s Law Center.

The way insurance works is that everyone pays into a system so that those who need the money get it in their time of need. You may never have cancer, but your insurance payments are helping to fund others who will. Women don’t have prostates, but their insurance premiums go to men’s prostate cancer screenings and treatments. 

“We shouldn’t allow insurance companies to say men’s health care is basic health care, but women’s health care is not,” Sen. Debbie Stabenow (D-Mich.) said. 

Removing the maternity care requirement would return the health care system to a time when women faced a high price simply because of their gender. Insurance companies would have more power on what to cover and whom they could deny.

With only a fraction of plans on the marketplace offering maternity care, women often had to bear the extra cost burden since insurance companies didn’t have to. They might have had to pay thousands of dollars for a maternity coverage rider and typically had higher deductibles. 

Andy Slavitt, who was President Barack Obama’s acting administrator of the Centers for Medicare and Medicaid Services, told ABC News that if maternity care and other services were made optional, they’d likely become scarce. 

“Once something is not required, it becomes difficult for one company to offer it,” he said. “It can be a tough business decision. The fear is that you may attract only sicker folks. It can be a race to the bottom, in terms of what’s offered.”

And even though nearly half of the pregnancies in the United States are unplanned, women would have to purchase this maternity coverage months in advance of being pregnant ― otherwise it could be considered a pre-existing condition for which insurance companies could deny coverage. 

“Picking and choosing among health services undermines the fundamental principles of insurance, and it leaves individuals without the care they need when they need it,” Borchelt added. “We saw this before the Affordable Care Act, when only 12 percent of individual plans covered maternity care, yet charged women more than men for coverage that didn’t even meet their needs. This left women without the care they needed, and left women and families saddled with huge bills. The health care law ended this discriminatory practice, making sure plans cover maternity alongside other essential health benefits.”

Many experts also say that maternity care has not been a significant factor in higher costs. A 2016 study by Blue Cross Blue Shield Association, for example, said new enrollees in the previous two years tended to be sicker and require more expensive medical care. 

“Relative to other market changes, there is no indication that required coverage for women’s health benefits was a primary driver of premium increases,” Caroline Pearson of the consulting firm Avalere Health told The Associated Press. But even as the Affordable Care Act was being debated, many Republicans were baffled as to why women shouldn’t have sole responsibility for paying for plans that cover maternity care. One of the most memorable moments from the congressional debate was during a hearing in 2009, when Stabenow reminded a male GOP senator why services such as maternal care benefit everyone.

“I don’t need maternity care, and so requiring that to be in my insurance policy is something that I don’t need and will make the policy more expensive,” then-Sen. Jon Kyl (R-Ariz.) argued during a hearing in September 2009.

“I think your mom probably did,” Stabenow shot back. 

“The point of it was, we are all connected,” Stabenow explained to The Huffington Post this week. “There are essential basic services in health care that should be available for men and women, as well as children. ... When a mom can go and get prenatal care and a baby is born healthy, we all benefit by that.”

“Providing maternity care as part of basic health care actually saves tremendously in health care costs ― rather than a complicated pregnancy [and] health problems for babies,” she added. “It not only makes sense from a quality of life standpoint and the standpoint of women being able to be treated fairly in the health insurance market ... but it also saves dollars overall in the health care system.”

*Want more updates from Amanda Terkel? Sign up for her newsletter, Piping Hot Truth, **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 11 hours ago.

President Trump has promised to make health insurance more available and more affordable. He's also vowed to take care of the poor. But the Republican health care bill doesn't accomplish that. Reported by CNNMoney 11 hours ago.

MINNEAPOLIS (AP) — Mayo Clinic is facing questions from the state of Minnesota after its CEO told employees that if patient conditions are equal, its hospitals should prioritize privately insured patients over those under government-subsidized programs such as Medicaid. In an internal discussion I used the word 'prioritized' and I regret this has caused concerns that Mayo Clinic will not serve patients with government insurance. "Changing demographics, aging of Americans and budgetary pressures at state and federal government pose challenges to the fiscal sustainability in healthcare today," he said. "To fund its research and education mission, Mayo needs to support its commercial insurance patient numbers in order to continue to subsidize the care of patients whose insurance does not cover the cost of their care," the statement said. "Health insurance coverage for health insurance coverage's sake is not the end goal," she said. Reported by SeattlePI.com 10 hours ago.

The Republican case for repealing the Affordable Care Act and moving swiftly to enact a “replacement” plan largely rests on oft-repeated arguments that the law is floundering so badly, urgent action is needed.

President Donald Trump uses terms like “disastrous” and “failing.” House Speaker Paul Ryan (R-Wis.) calls repeal-and-replace a “rescue mission,” because the law has a “fatal conceit” ― a design flaw that means insurers aren’t attracting enough young and healthy people to cover the costs of customers with big medical bills.

The health insurance markets regulated by the Affordable Care Act are actually in better shape than Republicans admit. Just this week, the Congressional Budget Office said the marketplaces were on their way to stability.

But the struggles that Trump and fellow Republicans describe in their speeches are real enough. Particularly in states like Arizona and Tennessee, premiums have shot up and insurers have fled, leaving few choices for consumers.

What Republicans fail to mention is that many of these problems are the handiwork of state and federal Republican officials who spent years undermining the law, contributing to the conditions they now say oblige them to dismantle it.

These efforts are not by any means the only reason so many insurers have struggled. But they have played a significant role.

Defunding Risk Corridors

When Democrats wrote the Affordable Care Act, they understood that insurers might initially have a hard time figuring out where to set prices. Because insurers hadn’t sold these kinds of policies (with comprehensive benefits) under these conditions (without exclusions for pre-existing conditions), they didn’t have actuarial data on which to base pricing decisions.

In order to reassure insurers that might hesitate to enter the markets amid such unknowns, and in order to protect them against crippling losses, the law’s architects created a “risk corridor” program, in which the government promised to reimburse insurers, mostly, for excessive losses. (Insurers that misjudged in the other direction, and had unexpected windfalls, would pay part of that money into the program.)

The idea was not novel. Medicare Part D, the program that provides seniors with prescription drug coverage, also has a risk corridor program. And it has never been controversial ― even though it’s a permanent part of the program, unlike the temporary one in the Affordable Care Act.

But conservative groups targeted the program, calling it a “bailout” for health insurance companies, despite the fact that it was included in the law from the beginning. Sen. Marco Rubio (R-Fla.) picked up the mantle and led a crusade to undercut the program’s funding.

In 2014, Rubio got his proposal into the year-end spending agreement and President Barack Obama, feeling the rest of the legislation was necessary to keep the government functioning, signed it. Later, during a presidential debate, Rubio even bragged about it.


Congress not funding the risk corridor program was the most consistent issue
Kevin Counihan, former HHS official, on what he heard from insurance executives
Insurers ended up filing $8.3 billion in claims for 2014 and 2015, but the program ended up paying out just $362 million. Several insurers have since sued to get the money they claim to be owed, and one has already won its case. But it’s not clear they will ever get the money.

Kevin Counihan, who ran HealthCare.gov for the Obama administration after overseeing Connecticut’s health insurance exchange, said he heard about risk corridors all the time last year, while he was meeting with insurers about participation for 2017.

“Congress not funding the risk-corridor program was the most consistent issue,” Counihan said. “Many carriers established their 2014 and 2015 rates with the assumption that the government would make good on this part of the law. Not doing so hurt both their financials, our credibility, and their board’s commitment to remain in the program.”

And this is about more than just health insurance companies losing money. The true purpose of these payments is to reduce premiums by allowing insurers to charge lower rates, knowing they’re protected if they get hit with higher-than-expected costs. Premiums were 10 percent to 14 percent lower in 2014, and 6 percent to 11 percent lower in 2015, because of this program, according to the American Academy of Actuaries.

Insurance companies got no payments from this fund for 2015 because the government had no money left. The realization that this money wouldn’t be available again for 2016 and 2017 contributed to insurers’ decisions to institute large premium increases this year and, likely, more rate hikes next year.

Blocking the Medicaid Expansion

The theory of the Affordable Care Act’s coverage expansion was pretty simple. People with incomes above 133 percent of the poverty line, or about $32,000 for a family of four, would buy coverage through the exchanges, where low- and middle-income people can apply for tax credits to reduce their premiums. People with incomes below that threshold would get coverage through Medicaid, once states took advantage of new federal funding to expand eligibility.

The theory didn’t count on the Supreme Court, which in 2012 affirmed that states have the right to reject the money to expand Medicaid and keep the limited eligibility they had before. Initially, more than half the states did precisely that. All had Republican governors or majority-Republican legislatures, although a number of GOP-led states, like Arizona and North Dakota, did adopt the expansion.

The immediate consequence of refusing to expand Medicaid was to deprive  millions of Americans living in those states of insurance. But those decisions also had a spillover effect.

Exchanges in these states are picking up more of the lowest-income customers ― the ones with incomes between 100 percent and 133 percent of the poverty line, or between $24,600 and $32,718 for a family of four. (Under the law, people with incomes below the poverty line are not eligible for the subsidies.) It might not sound like a big deal, but it had a direct impact on premiums for everyone.

Those extra enrollees tended to be in worse health than the rest of the population. In states that did not expand Medicaid, these people ended up signing up for exchange plans ― where their relatively high medical bills drove up costs for the insurers, eventually contributing to losses and higher premiums for all customers.

On the whole, rates in expansion states were about 7 percent lower than in non-expansion states, according to a Department of Health and Human Services study that controlled for demographics and other factors.

Undermining Outreach

Enrolling a sufficiently large population in the new insurance plans was always going to be a challenge, because many of the uninsured had little experience shopping for and buying coverage ― and because, particularly among middle-class consumers, the prices were in many cases going to seem high.

And while the federal government took on some of that responsibility, state officials had a special role to play, because they retain a lot of regulatory authority over insurance and, crucially, they better understood the idiosyncrasies of their insurance markets and their states’ residents.

Some states, typically the ones that had decided to create their own exchanges, promoted enrollment enthusiastically. But other states didn’t offer support. A few ― again, all with Republicans in power ― actually did their best to make enrollment difficult.

Georgia’s insurance commissioner, Ralph Hudgens, put it unusually bluntly. “Let me tell you what we’re doing,” he said in August 2013, just two months before the first open enrollment period. “Everything in our power to be an obstructionist.” Hudgens also said, “I’m not going to do anything in my power to make this law successful.” In other words, rather than assist Georgians who elected him with getting health coverage, Hudgens prioritized resisting Obama.

The impact of these efforts isn’t clear. But enrollment in states that ran their own exchanges, which is a pretty good proxy for enrollment enthusiasm, was moderately higher overall than in states that relied on HealthCare.gov, according to a 2016 paper by economists Molly Frean, Jonathan Gruber, and Benjamin Sommers.

One constant for the early years of the Affordable Care Act was enthusiastic support from Washington. That obviously changed in January, when Trump became president ― and open enrollment for this year was entering its final days.

The very day Trump was inaugurated, he issued an executive order instructing agencies to relax Affordable Care Act rules. The IRS responded a short while later by announcing it wouldn’t fully enforce the law’s individual mandate, which has the potential to suppress enrollment among healthy people who need the coverage less.

The end of open enrollment period has historically seen a surge of signups, as people rush to meet the deadline, and the late signups tend to be healthier on average, helping the risk pool. But the Trump administration canceled some planned digital and television advertising and, this year, only about 400,000 people signed up in the final two weeks. In the same period last year, 700,000 did.

That drop may help explain why, this year, overall signups for HealthCare.gov policies fell slightly this year. It’s also a reminder that the kind of people who have been trying to undermine Obamacare are now in charge of it. They may yet do more damage, unless they manage to repeal it altogether.

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