Quantcast
Channel: Health Insurance Headlines on One News Page [United States]
Viewing all 22794 articles
Browse latest View live

IdeaCrew Adds Accomplished Health and Regulatory Leader Dr. Patrick Canavan to Management Team

0
0
Dr. Canavan brings 20-plus years’ experience in health system and government agency management to IdeaCrew, an innovative new mover in healthcare technology

Washington D.C. (PRWEB) March 21, 2017

To support its growing benefits enrollment and technology-based health services business, IdeaCrew is pleased to announce that Patrick Canavan, Psy.D., has joined the company as Vice President of Consulting Services.

In this senior role, Dr. Canavan will serve as Information Technology (IT) Project Director for the implementation of a Small Business Health Options Program (SHOP) Marketplace for a New England State-based Exchange. He will also oversee IdeaCrew’s work in a fast-growing new area: IT-enabled behavioral support to improve outcomes for people in recovery from mental illness. His comprehensive approach to behavior support elevates access to care, reduces red tape and delivers transparency at a fraction of the price.

Dr. Canavan brings to the position executive level experience in healthcare, most recently as a Managing Director of Paladin Healthcare Management, and an outstanding track record in health facility turnaround and financial, regulatory and treatment reform. He has led the successful resolution of federal civil rights and financial management suits. His leadership experience includes serving as CEO of St. Elizabeth’s Hospital and as Director of the DC Department of Consumer and Regulatory Affairs, a key regulatory agency in the District of Columbia.

“Truly successful health technology service offerings start with the ability to envision the whole solution,” said Dan Thomas, IdeaCrew’s CEO. “There’s no substitute for operational-level experience providing services, along with a gut-level feel for the clients we serve. That’s what having Patrick Canavan on board enables us to deliver.”

Dr. Canavan will play a lead role as IdeaCrew extends the approach that helped Washington DC’s health insurance exchange technology become the nation’s #1 top-rated system (Clear Choices Campaign 2017 Report Card), expanding it to serve other states and new benefits markets.

“This is an exciting time for our industry and this team,” said Canavan. “I am delighted to be with a company that understands that access to care and on-time connection to the right provider are the future of successful health care systems. It’s a pleasure to join with forward-looking thought leaders who get the job done efficiently and effectively.”

ABOUT IDEACREW:
IdeaCrew connects people to healthcare through modern, Agile-based technology. Founded in 2002 by CEO Dan Thomas, IdeaCrew applies integrative and disruptive thinking to build enterprise software, web applications and mobile solutions that achieve real-world results at a fraction of the cost of traditional Big Health solutions. IdeaCrew is committed to guiding clients’ use of technology to become more data-enabled, customer-focused and accountable.

PR Contact:
Media(at)IdeaCrew(dot)com
### Reported by PRWeb 22 hours ago.

Obamacare Architects 'Sad,' 'Irritated' And 'Determined' As Repeal Looms

0
0
“Disturbing.” “Tragic.” “Extraordinarily troubling.” “Disconcerting.” “Sad.”

Those are just some of the words original architects of the Affordable Care Act used in interviews with The Huffington Post to describe the effort by President Donald Trump and congressional Republicans to speed through a bill to repeal major parts of the law and “replace” it with a more meager set of health care reforms.

It’s easy to see why key figures behind the biggest expansion of the social safety net in decades would be aghast at what’s happening now. On Thursday ― seven years to the day since President Barack Obama signed the Affordable Care Act into law ― the House is tentatively scheduled to advance its repeal measure.

“More people are going to get hurt under the Republican version than under the ACA. They may not like the ACA, but we could certainly work on it and improve it,” said former Sen. Max Baucus (D-Mont.), who chaired the Finance Committee during the period the Affordable Care Act passed Congress. The legislation that emerged from the committee in September 2009 formed the backbone of the eventual law.

“But they’re going to hate the Republican version,” Baucus continued, “because it’s going to give much more benefits to the wealthy at the expense of others, and a lot of people are going to get hurt along the way.”

If House Speaker Paul Ryan (R-Wis.) and the White House succeed in this gambit ― a far from certain prospect, given major schisms among Republican lawmakers about the bill ― the consequences would be significant.

A law that extended coverage to 20 million previously uninsured people and reduced the national share of Americans without health coverage to its lowest-ever percentage would be throttled. Almost $1 trillion in money currently financing health benefits for low- and middle-income households would be diverted for tax cuts on the wealthy and health care companies.

In the process, if the Affordable Care Act does not remain in place, 24 million more people would lack health coverage a decade from now, according to a Congressional Budget Office review of the legislation approved by three House committees this month.


We Americans have to ask ourselves: Are we in this together or are we not?
Former Sen. Max Baucus (D-Mont.)
Older Americans, especially those with less income, would exit the health insurance market because they wouldn’t be able to afford policies, the CBO projected. States would lose $880 billion in Medicaid funding, forcing cutbacks to that program. House leaders have made changes to the bill since that analysis, but do not have a new CBO score yet.

“We’re in a very tough spot, and it’s sad. It really is very sad. But what do we do about it? People who care about all this have to just keep presenting the facts,” Baucus said.

And the Democratic Party’s decades-long mission to strengthen the social safety net, dating back to President Franklin Roosevelt’s New Deal, would suffer a major setback.

“It really comes down to an attitude. We Americans have to ask ourselves: Are we in this together or are we not?” asked Baucus, who served six terms in the Senate before becoming Obama’s ambassador to China from 2014 until Trump’s inauguration.

“The Republican bill answers that question by saying, no, we’re not in this together, that insurance is really available for those who can afford it and is not really as available for those who can’t afford it. The sort of underlying basis of the ACA was: We’re in this together, we’re all Americans,” Baucus said.

Kathleen Sebelius, who served as Obama’s secretary of health and human services from 2009 to 2014, is worried about the people she’s encountered who would be worse off under the House Republican bill.

“I am really troubled to my soul and very disturbed about what is going to happen to the people I meet on a still-regular basis who tell me about their family situation, about their stories, about their worries that ― whether it’s themselves or their children or their parents who finally have some health security, who finally have a sense that they can count on affordable health coverage ― now this is going to be swept away,” Sebelius said.

“I find it extraordinarily troubling that individuals are rushing to take away people’s health care, to shift costs onto people who are in difficult medical situations,” Sebelius said. “It’s hard to see who the beneficiaries are.”Beyond the human cost, those who spent all of 2009 and one-quarter of 2010 writing the Affordable Care Act in Congress see a deep irony in GOP leaders’ rush to pass their repeal and “replace” bill within three months of Trump taking office.

“We spent more time going through the particulars of any bill in all of my years here,” said Rep. Sandy Levin (D-Mich.), who’s serving his 18th term in the House. Levin chaired the Ways and Means Committee during the final months of the Affordable Care Act debate in 2010.

When Baucus and other key lawmakers wrote their legislation, they held dozens of hearings and spent many days marking up and amending the bill in committee. By contrast, two House committees approved the Republican bill without a Congressional Budget Office analysis of its impact.


I am really troubled to my soul.
Former Health and Human Services Secretary Kathleen Sebelius
“It makes me very irritated, and it’s sad, because we were open, we Democrats were,” Baucus said. Accusations that Democrats rushed their bill by lawmakers who are now doing just that are adding “insult to injury,” he said.

The Finance Committee approved its version of the Affordable Care Act after eight days of debate, some of which stretched into the night. The Senate Health, Education, Labor and Pensions Committee spent even longer on the bill in June and July 2009.

The Finance Committee action came after Baucus ― with the Obama White House’s support ― spent months courting Republican senators, including Chuck Grassley (Iowa), Mike Enzi (Wyo.) and Olympia Snowe (Maine). In the end, all he got was Snowe’s vote in committee, before she opposed it on the floor two months later.

“As we were starting to put it together, regrettably, it became partisan. You just feel it falling away at the very end,” Baucus said. “Republicans saw a major political opportunity to try to demonize Obama, demonize the Democrats and all vote against it. And they’ve been demonizing the ACA every since.”

Even the lengthy committee work in 2009 understates the groundwork Democrats laid in Congress before Obama took office. “For two years, we worked on this. Worked very hard. Had all kinds of groups and subgroups. It was all nonpartisan. We all worked together,” Baucus said.

In 2007 and 2008, Baucus convened 14 hearings on health reform, plus eight more in 2009. Eight days after Obama won the 2008 presidential election, Baucus released a 98-page white paper laying out options for health care legislation. Before the election was even over, Sen. Edward Kennedy (D-Mass.), dying from a brain tumor, and his staff convened meetings with a wide array of interest groups that would be affected by health care reform.

The contrast with today’s proceedings is stark. At present, the Senate isn’t even planning committee action on the House bill and will take it directly to the floor if it passes the lower chamber.

“There is this sort of beat-the-clock mentality of ‘We have to fulfill campaign promises at any cost’ [that is] is very, very troubling in an area where there are real life and death consequences,” Sebelius said.

Levin is the last person who chaired a committee that passed a version of the Affordable Care Act who’s still in Congress, so he’s seeing all this firsthand. He still serves on the Ways and Means Committee and participated in its markup of the Republican health bill that went until 4:30 a.m.

Levin shares Baucus’ frustration about the alternative history told by Republicans opposed to the Affordable Care Act. As a sitting member of Congress, however, he is “absolutely determined” to use his position to push back, directly and in concert with voters and allied interests. “We’re in battle trim,” he said.

“What we need to do is to battle them here, but to combine resources, to coordinate, to organize,” Levin said. “What we need is just a massive outpouring. The people, I think, will speak and we need to help them speak out, to provide more and more opportunities and to organize.”

-- 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 18 hours ago.

And Gorsuch Makes Three: With Trump And DeVos, A Special Needs Nightmare

0
0
First, I want to thank you, sincerely, for helping our son.

Ben suffers from severe autism. His needs are immense, as are the bills, for him and the hundreds of thousands like him. If you pay taxes, you have made it possible to give him a critical chunk of what he and his fellow sufferers desperately need.

If you resent that a bit of your tax dollar goes toward helping guys and gals like Ben – people with special needs who will require an intensive level of care and support for their entire lives – we still appreciate it. Count your blessings that your family has never needed such huge help. It can be managed out of pocket by not the “1 percent,” but maybe the top tenth of the 1 percent.

We never take it for granted.

At the same time, to the millions who are assisted by things like Obamacare – you are, sincerely, very welcome.

My family is lucky that I have a job with excellent health insurance. We get little if anything out of Obamacare at this point, but a bit of our tax dollar goes to it, whether we mind or not.

We don’t. Maybe Ben’s needs have sensitized us a little to the needs of others, but I’ve never had a problem with the idea of our country helping its huddled masses. Does that make me a socialist? Whatever.

Our personal category of huddled masses are Ben and his cohorts, and one critical piece of his life (and please bear with me for a wonk-ish few moments) comes courtesy of the Individuals with Disabilities Education Act (IDEA). The most significant provision of IDEA is known by the acronym, FAPE, for Free and Appropriate Public Education. It is the most significant provision of IDEA, a federal government guarantee requiring state and local government to educate people like Ben.

Legally, it is a right, established in 1973, 20 years before Ben was born. Thank goodness.

FAPE assures (or should assure) the “provision of regular or special education and related aids and services that are designed to meet individual needs of handicapped persons,” and guarantees an “educational program that is individualized to a specific child, designed to meet that child’s unique needs.”

But there is wiggle room, and how much wiggling is something that has played out in court. The tastiest word to someone (like a judge) seeking a way out of providing what it was designed to provide, is the “A” of FAPE:

“Appropriate.”

The Supreme Court ruled that “appropriate” does not mean the best education that money can buy.

But how many publicly educated kids without disabilities in the U.S. get that, anyway? Money is limited, and “appropriate” has been, if not always great, good enough as a guarantee. The gap from best to worst is wide, but the goal is a heck of a lot better than the bare minimum as a standard.

People like Ben are more expensive. Specialized training, smaller class sizes, one-on-one aides ― the list of needs is, yes, special, and they don’t come cheap. But Ben and his peers are some of the most vulnerable members of our society.

So how do you define “appropriate”?

Neil Gorsuch, Donald Trump’s Supreme Court nominee, defines “appropriate” as just barely above the minimum.

Literally.

As the Huffington Post headline put it: “Neil Gorsuch Relied On A Legal Standard That Weakens Promises To Kids With Disabilities: Now his would-be colleagues on the Supreme Court may toss aside that standard.”

That legal standard is called “merely de minimis,” and it is what it sounds like, a bar lowered (nearly) as low as it can go, to the bare minimum ― a hair more than zilch.

Merely de minimis – the “de” even gives it a ring of Chicagoese, as in “barely da minimum.” The Huffington Post describes it as “a phrase that could undercut protections for students with disabilities across the country” in reducing the “educational benefits those children are promised under the federal Individuals with Disabilities Education Act.”

In 2008, as an appellate judge, Gorsuch was largely responsible for applying this (sub)standard.

It’s pretty hard to view “merely de minimis“ as anything less than the denial of a civil right, unless the barest minimum is the standard that should apply to all the children of the United States of America.

The case to which Gorsuch applied this medieval measure is called “Thompson R2-J School District v. Luke P., and what is so chilling to us personally is that Luke P. sounds a lot like Ben R. ― our boy.

They shared grossly inappropriate, sometimes even violent behavior at home and in public places, horrible sleep problems, and volitional “toileting” issues that have nothing to do with a toilet but with floors and walls – to name just some of our families’ “challenges” (to use a barely “appropriate” word).

It wasn’t Luke’s or Ben’s fault. It wasn’t our families’ fault.

It is autism’s fault.

And it is Gorsuch’s fault that Luke got screwed by the court system whose job it is to protect his rights and him.

Ben was luckier than Luke, because our school district recognized that he needed the residential placement we were seeking. That Ben injured and sent his classroom aide to the ER during our decision-making meeting no doubt helped seal the deal.

Luke and his family were less fortunate. Before Gorsuch got to them, a hearing officer, administrative judge and federal district judge ruled, in three separate decisions, that the school district needed to reimburse Luke’s parents for a private school placement.

Along came Gorsuch from his Tenth District federal bench to lead the charge.

Those three prior decisions? Reversed. The bill for providing, appropriately, young Luke’s needs? Send it to Mom and Dad.

The school was helping Luke become more independent and less reliant on life-long services ― which also translates to being less expensive to society as an adult with special needs.

Just like Ben. When he left our home for a residential program at age 12 (he’s now 23), Ben was a different person in many ways. He has grown into a more functional member of society, more able to adapt and interact, better able to express his needs and desires, more willing to be out in the world, be productive in a work setting, and enjoy his life and the people he shares it with.This would absolutely not have happened without a Free and Appropriate Public Education. FAPE steered his fate.

Mine is not a minority opinion. If you are a person touched by a disability like, in our case, severe autism, I’m preaching to the choir. And among my fellow choristers are dozens of disability advocacy groups, more than a hundred civil and human rights organizations, the American Civil Liberties Union (ACLU), and the National Education Association, which states that it is “incomprehensible that Judge Gorsuch has gone out of his way to impose extra legal barriers for students with disabilities rather than helping them to overcome obstacles. In his court decisions, Judge Gorsuch endorsed the lowest of expectations for students with disabilities, which allowed public schools to provide our highest-needs students with the bare minimum educational benefit. We should all be concerned by this troubling trend in Gorsuch’s record.”

Gorsuch’s thinking is in line with our newly elected government. Cut-cut-cut funding for critical services (i.e. reduce taxes). Let the chips fall where they may (i.e. lower standards for the 99 percent, more money for the one percent). Let future generations ― and administrations ― pay down the road (i.e. for adults with special needs who are less independent and in worse shape and thus more expensive).

Gorsuch is the guy President Trump wants to send to the Supremes and, to make matters worse, at the dawn of our new education era headed by Betsy DeVos.

Talk about the potential for a perfect storm, from which millions of special needs children and their families will be looking for shelter.

In the Age of Trump, where will they find it?

~~~

Want to resist Gorsuch? This site makes it quick and easy: 5 CALLS

The links:

Individuals with Disabilities Education Act (IDEA):

Free and Appropriate Public Education (FAPE):

Judge Gorsuch and disabilities:

Endrew F. v. Douglas County School District - the current Supreme Court case:

Endrew and “merely de minimis” — defined, described and discussed:

Thompson R2-J School District v. Luke P.:

Supreme Court ruling that “appropriate” education does not mean “the best”:

Ben’s IEP meeting (Chicago Tribune Magazine: The Chronicles of Ben):

Ben’s move to a residential program (This American Life episode):

National Education Association statement on Gorsuch:

American Progress education report on Education Secretary Betsy DeVos:

~~~

The Chronicles of Ben Blog: http://juggling-autism-the-chronicles-of-ben-royko.com/

Ben Stories: http://www.davidroyko.com/benstories.htm

http://www.davidroyko.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 11 hours ago.

How much the Republican health care plan will cost New Mexicans

0
0
The American Health Care Act, the Republican bill to replace the Affordable Care Act, is expected to be voted on by the House of Representatives on Thursday. If the bill is passed, New Mexicans can expect to see some big price changes. The current proposed plan, in about one or two years from now, would raise the average health insurance premium for an individual policyholder by 15 to 20 percent and lower federal subsidies, according to a WalletHub report. However, the Congressional Budget Office… Reported by bizjournals 11 hours ago.

Insurance Executive Blasts GOP Health Care Proposal: 'This Bill Is Terrible'

0
0
Most insurance industry executives have been circumspect about the repeal of the Affordable Care Act and its proposed replacement, the American Health Care Act. Mario Molina is an exception.

“I think this bill is terrible,” Molina, the CEO of Molina Healthcare, told The Huffington Post in a lengthy interview Friday.

The company covers more than 4 million people scattered across 13 states ― including California, where it’s headquartered, as well as Florida, Michigan, New York and Texas. That makes it the 10th-largest health insurance company in the U.S., according to a 2015 government survey.

Molina’s main argument against the bill is the same one critics have been making for months ― that the measure would expose millions of lower-income Americans to crippling medical bills, by taking away their Medicaid coverage or the federal tax credits that make it possible for them to buy private insurance.

These warnings are consistent with the findings of multiple independent analysts, including the Congressional Budget Office, which last week predicted that the Republican proposal would drive up the number of uninsured Americans by 14 million within a year and 24 million within a decade. Among those taking the hardest hits, the CBO said, would be poor Americans who now rely on Medicaid and older consumers whose premiums would skyrocket because the bill would allow insurers to charge them much more than they can today.

Even those who held onto coverage could expect that it would be less generous than it is today, the CBO noted, as the combination of looser regulations and redirected financial assistance shifted the market toward policies with higher out-of-pocket expenses. 


You can’t say this is not my problem. ... This is your problem. You just don’t know it yet.
Mario Molina, CEO of Molina Healthcare
Molina, a physician, has an up-close perspective on what this would mean, making his commentary more valuable, less reliable or both ― depending on your perspective.  

Molina’s father, also a physician, established the company in 1980 to serve low-income people in Southern California. And it has never strayed far from its roots. Its business consists mostly of insuring people on Medicaid (states contract with Molina to provide coverage) or selling plans to people who buy on the Obamacare exchanges and, because of their low incomes, qualify for extensive subsidies.

The Republican bill would likely deal a significant blow to Molina Healthcare’s revenue and the skeptical take on its CEO’s perspective is that he’s simply trying to protect his company’s bottom line. But precisely because Molina Healthcare has a long history of working with lower-income consumers, it may understand the Obamacare private insurance markets better than many of the larger, nationwide carriers that make headlines in the national media.

Molina is accustomed to managing care aggressively, by nudging newly insured patients into the primary care system quickly ― something of particular importance when it comes to insuring people who have gone months or years without coverage, and without ongoing care for chronic conditions. Molina also has a history of tough negotiation with doctors and hospitals, and limiting networks to only those who will agree to lower reimbursement ― thereby allowing the company to keep premiums low.

As a general rule, the big companies with the names that everybody recognizes focus on other lines of insurance, such as administering employer plans or offering private Medicare Advantage plans, in which the market dynamics are very different. The people who buy those plans care a lot more about having big networks and aren’t as sensitive on prices.

Those companies have tended to struggle more trying to sell individual coverage ― in particular, they have struggled to attract enough young and healthy people, whose premiums insurers require to offset the cost of paying bills for people with serious medical problems. Critics of the law say the skewed risk pool represents a structural problem with the law, because the coverage insurers are selling just isn’t very attractive to consumers unless it comes with huge subsidies that discount it deeply for the near-poor.

This year the CEO of one of those big national companies, Aetna’s Mark Bertolini, declared that the program was actually in a “death spiral” ― the line that President Donald Trump, House Speaker Paul Ryan (R-Wis.) and other GOP leaders have cited over and over again as a rationale for repealing the law as quickly as possible.

But analysts at the CBO and the Brookings Institution, among others, have disputed that verdict, arguing that insurers simply under-priced premiums for the first two years and are finally catching up.

And just like Molina Healthcare has its own self-interest, Aetna does too. Specifically, it has been fighting to win federal approval for a controversial merger with Humana. Documents that surfaced in recent litigation over that merger led a federal judge to conclude the company has been trying to “leverage its participation in the exchanges for favorable treatment” from federal regulators.

Aetna has denied this. Molina is not convinced. “There’s a lot of politics going on between Aetna and the administration, so you have to take that with a grain of salt,” Molina said.

As for the state of the Affordable Care Act overall, Molina acknowledges some problems with the private insurance markets. But he thinks they are largely isolated to states such as Arizona and Tennessee ― and amenable to minor fixes rather than an overhaul. “You can think of it almost like a patchwork quilt,” Molina said, noting that states like California and Michigan have stable marketplaces. “In some states it’s working well and in other states it’s not.”

Molina Healthcare itself posted a small loss in the last quarter of 2016, after posting small profits during the law’s first two years. But the CEO said that was only because it was required to pay into a “risk adjustment” scheme, designed to protect insurers from losses, under a flawed formula. The company had been complaining about this for years and the regulation has since been fixed, Molina said.

“We added about half a million members this year,” Molina said. “Some plans grew a lot, and some plans probably got smaller, and they probably got smaller deliberately because they raised their premiums intentionally. So I don’t think it’s imploding right now.”

Molina was careful to say that the current political environment has introduced a new element of uncertainty ― in part because, quite apart from the question of repeal, there’s the question of whether the federal government will continue to pay for special subsidies that low-income consumers get to defray out-of-pocket costs. Those subsidies are in limbo, thanks to a court ruling last year, and neither the administration nor Congress have indicated clearly whether they will act to make sure the money continues to flow.

The lack of clarity, Molina said, means that even his company, which has been among the Affordable Care Act’s most enthusiastic proponents, is not sure what it will do in 2018 ― or beyond.

Molina warned that if the GOP bill or something like it passes, and many millions of Americans end up losing coverage, the effects will eventually spread. He said the loss of payments would eventually hit the hospital sector, forcing closures particularly in rural areas, while eroding the quality of coverage available to everybody.

“You can’t say this is not my problem ― I have insurance, this is not my problem,” Molina said. “This is your problem. You just don’t know it yet.”

-- 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.

A former investment banker turned 'She-E-O' launched a 'period underwear' startup — now the company is embroiled in an alleged sexual harassment disaster

0
0
A former investment banker turned 'She-E-O' launched a 'period underwear' startup — now the company is embroiled in an alleged sexual harassment disaster Miki Agrawal cofounded Thinx, an underwear start-up meant to replace feminine hygiene products, in 2011. 

But according to recent reports in Racked and New York Magazine, Agrawal has stepped down from her role as CEO of the company amid allegations that she behaved inappropriately with her employees and created a workplace culture that ran counter to the startup's feminist marketing. 

One former employee, Chelsea Leibow, has filed a complaint with the City of New York Commission on Human Rights, alleging that Agrawal "touched an employee’s breasts and asked her to expose them, routinely changed clothes in front of employees, and conducted meetings via videoconference while in bed, apparently unclothed," according to New York Magazine.

The complaint also names the company's chief financial and chief operating officers.

In a statement to Business Insider, Thinx highlighted that the company had not been served with any official complaint or charge: 

"Miki Agrawal is no longer CEO, and we are working to put new leadership and policies in place so we can continue to grow and thrive. To support this effort, we have hired an executive search firm to assist in the recruitment of a new CEO. We are also hiring a human resources executive and, in the interim, have engaged a human resources professional who is working in our offices to support our progress."

Related to Ms. Leibow’s allegations, THINX has not been served with a legal complaint or charge from any agency. When the issues were brought to our attention following Ms. Leibow's departure from THINX, the company commissioned an investigation that concluded the allegations had no legal merit. The company cannot comment further on these legal matters.

In a self-published post on Medium, Agrawal denied the allegations: 

"The company commissioned a third party employment law firm to conduct extensive diligence on each allegation and they all came back false and without any merit. Thank you for the thousands of wonderful messages of support during this strange time, each one has meant a lot. To be crystal clear, I know I’m passionate and oft unruly in my ways (as a taboo breaker must be), but I have never, ever crossed the line in the inflammatory ways described. This is all I am going to say on this matter."

The complaint also alleges that Agrawal discussed other topics that reportedly made employees uncomfortable, such as the size and shape of coworkers' breasts and her own sexual experiences. Agrawal told New York Magazine that the sexual-harassment claims were "baseless" and had "absolutely no merit." Leibow was fired from Thinx in December, reportedly after several months of complaining about Agrawal's actions in the office. 

"I can recall multiple occasions when I tried to be honest about salaries or employment policies," Leibow said to New York Magazine. Agrawal "would stew, treat you like s---, then pick a moment to blow up and tell you how ungrateful you are and how you should be thanking her for the opportunity, how dare you."

According to Racked, 10 of the company's 35 employees have left since January. The articles in both Racked and New York Magazine also say that the startup does not have a formal HR department and offers comparatively low pay and expensive health insurance to its employees (a $200 per month premium as the cheapest option). Employees claim that the company offered a parental leave policy of two weeks of full pay for the birthing parent, plus one week at half pay. The non-birthing parent would receive one week of full pay and one week of half pay. 

"I remember one of my coworkers started crying," one source told Racked. "She said, you know, 'I love working here. I love working for women. But it hurts to know that I'm giving my whole life to Thinx basically, like I work all the time, but I can't even afford birth control. And what does that mean if we're at a feminist company and I can't afford to keep myself safe and protected?'"

Shortly after word got out that Agrawal would be stepping down from her role at Thinx (as well as Icon, a "pee-proof" underwear company she cofounded) she told staff that she would stay on as the company's "SHE-E-O," a title that she often uses to describe herself, Racked reported. Thinx's board of directors is reportedly looking for a "professional CEO" to take Agrawal's place.

She responded to the Racked article with a Medium post explaining why the company didn't have set policies in place for things like maternity leave and benefits:

"I didn't take time to think through it. We grew so quickly and I didn't hire an HR person (it was hard to rationalize hiring an HR person at the time with only 15 employees and then all of a sudden we were 30 people) ... All of a sudden, health insurance, vacation days, benefits and maternity leave were brought up (at the time we didn’t have any pregnant women on the team unlike now where we have 3, including me! :-)) and when you're a start-up and you’re growing and moving so fast (remember, we’ve only really hit this crazy growth period 18 months ago), to sit down and get an HR person and think about those things were left to the bottom of the pile of things to get done."

Join the conversation about this story »

NOW WATCH: A serial entrepreneur reveals her 3 key steps for success​ Reported by Business Insider 11 hours ago.

6 Ways Seniors Lose Out Under Trump's Budget

0
0
Being charged higher premiums for health insurance or possibly not being able to access affordable health coverage at all if you are in your early 50s to mid 60s is just the tip of the iceberg of what older people can expect from President Donald Trump’s proposed health care agenda. 

The Republican plan to repeal the Affordable Care Act is a sucker punch to the gut for this vulnerable and hard-to-insure age group, especially because it will no longer require big companies to provide a group plan and will raise the ceiling on how much older workers can be charged. But Trump’s budget announced Thursday delivered a second blow for older people. While funding for Defense, Homeland Security and Veterans Affairs is to increase, multiple programs that directly assist seniors are on the chopping block: 

1. The Low-Income Home Energy Assistance Program.

This program provides short-term aid to pay heating and cooling bills for 6.7 million people. Nearly one-third of households receiving this help have a member who is age 60 or older. LIHEAP is slated for elimination, literally leaving the poor out in the cold.

LIHEAP provides energy assistance to vulnerable households who suffer short-term financial difficulties due to illness, job loss or other unanticipated expenses. The budget proposal shows “a dangerous lack of understanding about the critical nature of this program,” said Michael Bracy, director of the Campaign for Home Energy Assistance, a Washington, D.C.-based group that advocates on behalf of LIHEAP. 

Bracy called the Trump administration’s plan to eliminate the program “nothing short of appalling.”  

2. Senior Community Service Employment Program.

This program trains and places low-income, unemployed seniors in unsubsidized jobs within the community. It is the only federal program that targets older workers in this way and it will be wiped out if the budget is passed as proposed.

For workers who are 55 years or older earning less than $20,000 per year, the jobless rate is three times higher than for older workers who earn above that threshold. And older workers take twice as long as younger workers to find employment. The toll of long-term joblessness on the emotional and financial well-being of older men and women has been well-documented. Those looking for work for six months or longer are more than three times as likely to be suffering from depression as those with jobs. 

SCSEP participants have provided more than 40 million hours of community service as they receive on-the-job training. 

3. Health professions and nursing training programs.

As the Baby Boomer generation ages, the supportive health care fields are going to become increasingly critical: whether nursing, physical therapy or home care.

In 2014, the latest year for which data is available, 46.2 million people in America were 65 years or older. They accounted for 14.5 percent of the U.S. population, about 1-in-7 Americans, according to the Department of Health and Human Services. By 2040, people 65 or older are expected to account for 21.7 percent of the population ― more than 1-in-5. And they will need help.

Trump’s budget would cut more than $400 million earmarked for medical training programs: His administration claims they don’t work. The American Nurses Association says the U.S. is “in dire need” of more than 1 million new nurses by 2022 to provide care for the aging population. Decreasing funding by $403 million will “significantly cripple” recruitment and training efforts for nurses to practice in rural and medically underserved communities, ANA president Pamela F. Cipriano said.

4. Section 8 housing for seniors.

The Department of Housing and Urban Development’s rental assistance program known as Section 8 will be reformed, according to the administration. HUD pays landlords the difference between what the household can afford and the rental cost of the unit. This is known as a Section 8 voucher. About 1.4 million households receive Section 8 housing assistance. Seniors account for 1-in-6 recipients of this aid.

Trump’s budget proposes a $6.2 billion cut from HUD next year ― a 13.2 percent decrease from this year’s funding level. HUD is expected to cut hundreds of thousands of vouchers from the program. Some public housing agencies have decided not to reopen waiting lists for Section 8 vouchers because of the uncertainty surrounding funding. 

More than half of all recipients who lived in federally subsidized housing in 2015 were elderly or disabled, and more than one-quarter of all households had a working adult, according to the Center on Budget and Policy Priorities. This is a real sticking point for the GOP, which has repeatedly opined that HUD rental assistance programs, such as Section 8 vouchers and public housing, actually obstruct upward mobility. Republicans say they should be aligned with cash assistance for “work-capable” recipients to “encourage” them to move toward jobs and economic independence.

5. Amtrak’s long-distance train service.

Trump wants to slash the Department of Transportation’s budget by 13 percent, which would, among other things, completely eliminate funding for Amtrak’s long-distance routes. 

The money is expected to be diverted toward making desperately needed repairs to Amtrak’s Northeast Corridor line which services far more people than the long-distance train lines. But this move will not serve older people.

Amtrak operates 15 long-distance routes across the nation, which are the only Amtrak service in 23 of the 46 states the company serves and as the AARP notes, older travelers make up as many as two-thirds of Amtrak’s long-distance riders.

6. Meals on Wheels may be dinged, but not eliminated.

The president’s budget cuts $3 billion in Community Services Block Grants and $1.2 billion in Community Development Block Grants, money that, in part, is used to support the popular Meals on Wheels program where volunteers deliver hot meals to shut-in individuals, many of them elderly. 
This is the only program not at risk of being eliminated ― no thanks to Trump’s budget, though. The grants that are being cut do help fund Meals on Wheels America, but aren’t its sole support.  The 5,000 home-meal delivery organizations around the country that operate under the Meals on Wheels umbrella get about 35 percent of their funding from the federal government, allocated by the Older Americans Act and distributed by the Administration on Aging within the Department of Health and Human Services. 

Early news reports that Meals on Wheels was in jeopardy led to a 500 percent surge in volunteers and 50 times more donations.

-- 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.

Women Step Up To Share Their Abortion Stories As Congress Moves Against Their Rights

0
0
WASHINGTON ― Benny, 26, had never really shared her abortion story with anyone before she told it to the world on Tuesday. 

She was 20 back then, a college student in a physically abusive relationship. She hadn’t intended to become pregnant, and neither she nor her boyfriend felt prepared to raise a child. Plus, if she continued her pregnancy, she would “be forever linked to this other person who had done so much harm to me,” Benny told HuffPost.

Benny said that she never told anyone the reasoning behind her decision and that her parents still don’t know that she had an abortion. But in the current political climate, with Congress trying to limit reproductive rights and family planning services, she decided it was time to speak out in an effort to reduce the stigma around the procedure. 

“The day after I had an abortion, my sister said, ‘I never thought you’d be one of those women,’” Benny said. “I think that ‘othering’ has always stayed with me. As much as I disagree with it, someone speaking to you in a lesser way because you’re choosing to access health care stayed with me.” 

Benny joined more than 60 other women sharing their abortion stories via livestream on Tuesday, as part of the 1 in 3 Campaign’s “Stories From the Resistance” event. Other women told their tales through megaphones on the steps of the U.S. Capitol and then visited lawmakers to lobby for abortion access. 

There’s a flurry of anti-abortion activity in Congress. Republicans are trying to repeal Obamacare and replace it with a health care bill that would defund Planned Parenthood and effectively eliminate abortion coverage in the individual insurance market. Sen. Lindsey Graham (R-S.C.) is reviving his fight to ban abortion at 20 weeks of pregnancy, and the Senate is holding a confirmation hearing for Supreme Court nominee Neil Gorsuch, who has a record of ruling against birth control access and Planned Parenthood funding.

“Telling our stories is an act of resistance – resistance against restrictions on access, resistance against threats from the Trump administration and resistance against the shame that’s kept us quiet for too long,” said Debra Hauser, president of Advocates for Youth, the parent organization of the 1 in 3 Campaign. “Too often the political has overpowered the personal in the fight for abortion access, and now more than ever we cannot afford to remain silent and let stigma invade the conversation around a procedure that one in three women will have in her lifetime.”

Women of many different ages, races and income levels participated in Tuesday’s event. Some shared stories of having abortions before the Supreme Court legalized the procedure nationally in the 1973 Roe v. Wade decision.

“In 1965 I had an illegal, terrifying, pre-Roe abortion in Tijuana, Mexico,” said Anne Hopkins, 71. “Now, when I see the assault on a woman’s private abortion decisions and the attempts to thwart her responsible contraceptive choices, I am beyond furious. So I lend my voice to protect our daughters.” 

Benny said she now depends on Planned Parenthood for birth control and is applying to Medicaid for health insurance, so she is watching closely what Congress does to her health care options. She also works with survivors of sexual abuse and domestic violence, who provide a daily reminder of her own history and how glad she is not to be raising a child with her abuser.

“The current policies being introduced are so dangerous,” she said. “Without access, there actually is no choice.”  

-- 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.

Donald Trump Has A Weird Way Of Showing How Much He Loves Farmers

0
0
President Donald Trump tweeted his support for farmers and ranchers Tuesday, thanking them for their hard work and dedication. Meanwhile, his administration is pushing legislation that could have devastating effects on their livelihoods. 


Today on #NationalAgDay, we honor our great American farmers & ranchers. Their hard work & dedication are ingrained in our nation's fabric. pic.twitter.com/HG9BGCmSmc

— Donald J. Trump (@realDonaldTrump) March 21, 2017


In a statement proclaiming March 21, 2017, as National Agriculture Day, Trump wrote that the industry is the “heart and soul” of America.

“The agriculture sector of the United States is endlessly innovative,” Trump wrote. “It continuously builds on its centuries of progress through advances in science, research, technology, safety, production, and marketing to meet the demands of changing consumer needs and complex world markets.”

But progress through advances in science and research could come to a grinding halt under the Trump administration. 

-Climate change-

Farmers’ crops nationwide are at risk from climate change, but Trump’s budget cut proposals introduced last week take aim at climate change research initiatives across federal agencies. The Environmental Protection Agency faces a 31 percent slash in funding under the proposed budget and would have to ax programs aimed at combating man-made global warming.

Severe weather conditions, such as hurricanes and droughts, have increasingly threatened farmland and livestock, and scrapping climate change action plans would only magnify the potential ramifications.

Last week, The New York Times published a report examining a farm in Kansas where climate change wreaked havoc on its resources. Unusually high late-winter temperatures combined with weeks of low precipitation fueled wildfires that destroyed the ranchers’ land and killed dozens of their cattle.Despite the overwhelming evidence that humans are contributing to the rapid increase of the Earth’s temperature, White House Budget Director Mick Mulvaney isn’t concerned by the mounting threat and sees no reason to invest in climate change research.

“We’re not spending money on that anymore,” Mulvaney said during a press briefing earlier this month. “We consider that to be a waste of your money.”

-USDA-

The Trump administration has also proposed cutting the U.S. Department of Agriculture’s discretionary budget from $22.6 billion to $17.9 billion, a 21 percent reduction. 

The proposed cuts would scrap funding for rural clean water initiatives as well as decrease county-level staff and some statistical services that many farmers rely on for planning.

Industry leaders, including Republican lawmakers, have pushed back on the proposed cuts, claiming they could hurt the rural communities that helped get Trump elected in November.

“America’s farmers and ranchers are struggling, and we need to be extremely careful not to exacerbate these conditions,” Rep. Michael Conway (R-Texas), chairman of the House Agriculture Committee, said in a statement last week.-Health care-

Americans across party lines have expressed concern over the GOP’s health care bill ― and farmers are no exception.

The Republicans’ plan to repeal and replace Obamacare would shrink protections for low-income Americans, which could have devastating effects on many rural farmers.

Rural farmers are already struggling with reduced access to health care after the closure of 80 rural hospitals throughout the country since 2010, Maggie Elehwany, a spokeswoman for the National Rural Health Association, recently told NPR.

The bill, she told the station, does nothing to address that problem.

National Farmers Union, the second-largest agriculture industry group, is staunchly opposed to the bill.

“We believe the American Health Care Act would have serious negative impacts on farmers’ and ranchers’ access to affordable health insurance coverage,” NFU President Roger Johnson said in a statement Tuesday.

Last week, Trump declared he’s “100 percent” behind the bill, which could strip 24 million Americans of their health insurance, according to a report from the Congressional Budget Office.

-Immigration-

The agriculture industry could be rocked by Trump’s crackdown on undocumented immigrants. Dairy farmers and fruit and vegetable growers, both of whom rely heavily on an immigrant workforce, are expressing fears that Trump’s promise to tighten immigration enforcement and build a border wall with Mexico could eliminate much of its labor pool.

States that have passed laws targeting undocumented immigrants have endured decimated workforces and millions of dollars worth of lost crops. In 2011, Georgia passed anti-immigration legislation that resulted in a 40 percent reduction of the state’s agricultural workforce and roughly $140 million worth of crops left rotting in the fields.

U.S. citizens, the farm industry says, simply are not interested in filling ― or able to fill ― the gap left by a loss of migrant farmworkers, and the limited research on the subject bears that argument out.

A study conducted in North Carolina found that, of 245 unemployed U.S. citizens hired to work on farms one summer, just 163 (66.5 percent) of them even showed up to work on their first day. Only seven of them (3 percent) lasted the entirety of the growing season.The irony of Trump’s proclamation of support amid these pressing challenges to their businesses was not lost on some farmers.

Clare Hintz owns Elsewhere Farm, a 40-acre farm on the shores of Lake Superior in northern Wisconsin. Hintz grows vegetables and fruit using sustainable methods and also raises rare livestock breeds, including Icelandic chickens and Guinea hogs.

Hintz described her reaction to Trump’s Tuesday tweet in an email to The Huffington Post.

When I read the tweet, I think: 1. Then don’t take away our health care. 2. Start being proactive about climate change and 3. Stop the bigotry against all the people who actually farm: immigrants, Mexican Americans, and so many others!

Despite these frustrations, Hintz said she remains dedicated to helping create a more just, and more earth-friendly, food system — even if it’s without the support of the current administration.

“It’s easy to despair, but we don’t have the luxury of despairing,” Hintz said. “It’s harder now, but the farming community has been farming in resistance to dominant forces for years. The attitude is that we’re just rolling up our sleeves some more. We have to keep working.”

How will Trump’s first 100 days impact you? Sign up for our weekly newsletter and get breaking updates on Trump’s presidency by messaging us here.type=type=RelatedArticlesblockTitle=Related... + articlesList=58a33ddce4b094a129ef5e22,58ca746be4b0be71dcf1ad3d,58c1d07fe4b0ed71826b55e0

-- 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.

Judge Gorsuch nomination backed by dozens of pro-life groups

0
0
Washington D.C., Mar 22, 2017 / 12:16 am (CNA/EWTN News).- Judge Neil Gorsuch deserves “swift confirmation” to the U.S. Supreme Court, leaders of pro-life and pro-family groups have said.

“Neil Gorsuch has proven himself to be a defender of the most basic human rights,” said the March 20 letter, organized by the Susan B. Anthony List and addressed to U.S. Senators.

The letter cited Gorsuch’s book, “The Future of Assisted Suicide and Euthanasia,” in which he said “human life is fundamentally and inherently valuable and the intentional taking of human life by private persons is always wrong.”

Over 50 leaders signed the letter, including representatives of the Susan B. Anthony List, Live Action, National Right to Life, Students for Life, and state pro-life groups and pro-family groups.

They praised Gorsuch as an intelligent and fair-minded nominee with a fitting temperament, citing his 2006 unanimous confirmation by the Senate to his current seat on the 10th Circuit Court of Appeals.

“We believe that Judge Gorsuch’s thoughtful opinions illuminate how he would decide difficult questions on the Supreme Court,” the letter said.

If approved by the Senate, Gorsuch’s presence on the Supreme Court could affect important cases involving religious freedom and legal abortion, among others.

The letter praised the judge’s “keen understanding and respect for religious liberty” in the cases of Hobby Lobby and the Little Sisters of the Poor. Both faced federal requirements to provide employee health insurance coverage for drugs and procedures they considered to be violations of religion and ethics. They filed legal challenges saying the mandates were unconstitutionally burdensome on their religious freedom.

“Many of our organizations applauded Judge Gorsuch when he evinced a keen understanding and respect for religious liberty in cases involving Hobby Lobby and the Little Sisters of the Poor, concluding that application of the Affordable Care Act’s preventive service mandate, coupled with massive fines on religious objectors to elements of the mandate, substantially burdens religious liberty.”

The letter also cited Gorsuch’s dissent in a 10th Circuit panel decision that sided with abortion provider Planned Parenthood.

The panel overrode the finding of a federal district court over Planned Parenthood’s alleged involvement in violations of laws barring the procurement of fetal tissue for profit. The panel also issued an injunction against the Utah governor’s decision to defund Planned Parenthood over the allegations.

Gorsuch said the panel majority failed to follow appropriate standards of judicial review and failed to show customary deference to the lower court’s factual findings.
 
According to the March 20 letter, Gorsuch would apply an “originalist” approach to the U.S. Constitution and would respect the separation of powers in the tradition of late Supreme Court Justice Antonin Scalia. The letter praised the Gorsuch’s statement that judges should “administer justice equally to rich and poor alike, following the law as they find it and without respect to their personal political beliefs.”

Several of the letter’s signers, including Marjorie Dannenfelser of the Susan B. Anthony List and Father Frank Pavone of Priests for Life, served on the Catholic advisory board to President Donald Trump’s 2016 campaign for president.

Gorsuch, an Epsicopalian, has clerked for Supreme Court Justices Byron White and Anthony Kennedy. He attended Columbia University and Harvard Law School. He earned his doctorate at Oxford University, where his studies were supervised by the influential Catholic legal philosopher and natural law theorist John Finnis.

  Reported by CNA 3 hours ago.

The Republican Health-Care Unraveling

0
0
Michael Reynolds/picture-alliance/dpa/AP Images

Speaker of the House Paul Ryan and House Majority Leader Kevin McCarthy discuss the House Republican's new health-care plan to repeal and replace the Affordable Care Act. 

This is the first part of a two-part article. The full version appears in the Spring 2017 issue of The American Prospect under the title: “The Republican Health-Care Unraveling: Resist Now, Rebound Later.” This is the “resist” part. Subscribe here to the magazine.

Imagine if Donald Trump had been a genuine populist and followed through on his repeated promises to provide health insurance to everybody and take on the pharmaceutical and insurance industries. Populists in other countries have done similar things, and Trump might have consolidated support by emulating them.

Of course, Trump’s promises about health care weren’t any more genuine than his promises about Trump University. But even if he had been in earnest, he would have still faced a problem. Unlike right-wing populists elsewhere, Trump did not come to power with a party of his own or well-developed policies. He came tethered to the congressional Republicans, entirely dependent on them to formulate and pass legislation. That dependence will likely complicate Trump’s ambitions in such areas as trade policy. But nothing so far has made more of a mockery of Trump’s populism than the health-care legislation introduced in early March by Paul Ryan and the House Republican leadership and fully backed by Trump.

The Ryan bill is abhorrent for many reasons. It calls for a massive tax cut for people with high incomes, while costing millions of other Americans—24 million by 2026, according to the Congressional Budget Office—their health coverage. It would turn Medicaid from a right of beneficiaries into a limited grant of funds to the states, and it pays for the tax cuts for the rich with cuts in health care for the poor. The bill’s reduced tax credits for insurance make no adjustment for low income, while some credits would go to people with incomes over $200,000.

But what is most amazing about the bill is how badly it treats constituencies and states that voted for Trump and the GOP. The changes it calls for in the individual insurance market would hammer older people (those between the ages of 50 and 64) and residents of red states and rural areas. Republicans appear to be so determined to cut taxes on top incomes that they are willing to sacrifice the interests not only of the poor—we knew that—but of many of their own voters. The same pattern is evident in the federal budget that Trump has proposed.

While the whole effort to “repeal and replace Obamacare” poses an enormous political risk for Republicans, it presents an equally significant political opportunity for liberal and progressive Democrats. I am not talking only about short-term resistance to the Republican rollback of the Affordable Care Act. Now that Republicans have shown their true hand on health care, they are creating new possibilities for long-term progressive organizing and policy alternatives.

The struggles to achieve health insurance for all in the United States have long suffered from one fundamental political handicap. The uninsured and underinsured (people enrolled in plans riddled with exclusions and limits) have been an inchoate population without any organization or voice of their own. The combination of measures America adopted in the mid-20th century produced a large, protected public: employees with good fringe benefits, seniors and the disabled with Medicare, veterans, and the low-income groups that qualified for Medicaid. The people who were left out—mainly low-wage workers, people in part-time work, the unemployed, and individuals with pre-existing conditions—did not share a common identity or cohere politically.

But the Republican effort to undo the ACA could provide the long-missing organizational impetus. It is one thing to go without health insurance; it is another thing to have that insurance threatened or taken away. It also matters who would be losing coverage. Overall, according to the CBO, the Ryan bill would raise the number of uninsured in 2026 to 52 million, or 19 percent of the nonelderly population (compared with a projected 10 percent under the ACA). But the uninsured under Ryan’s legislation would be concentrated among 50- to 64-year-olds. That’s primarily because the bill would allow insurers to charge 60-year-olds five times as much as 20-year-olds, instead of the 3-to-1 ratio in the ACA. (The adjustments for age in the bill’s tax credits do not come close to offsetting the higher premiums; a last-minute amendment, allowing increased tax deductions for medical expenses, provides little or no benefit to low-income people but may be changed in the Senate.) When twenty-somethings don’t have insurance, many give it little thought because they may not expect to need medical care. But older people aren’t so oblivious. Take away their health insurance, and they are going to be angry.

Besides pushing a lot of older people out of coverage, the Ryan bill is brutal on states with high health costs because it would provide a flat tax credit that doesn’t vary according to geography (unlike the ACA, which provides greater subsidies in high-cost states to make coverage affordable). The Ryan bill’s tax credits are substantially smaller on average than those in the ACA, but people in high-cost states would face especially sharp increases in premiums because of the way the bill structures its tax credits.

According to an analysis by the Center on Budget and Policy Priorities, Ryan’s bill would reduce premium tax credits by more than half in Alaska, North Carolina, Oklahoma, Alabama, Nebraska, Wyoming, West Virginia, Tennessee, Arizona, South Dakota, and Montana. The net cost of insurance would rise dramatically as a result. Notice something about those states? They elect a lot of Republicans—or at least they did.

Within states, rural areas generally have higher premiums than urban areas. So the flat tax credits provide less help in affording insurance there, too. The big Medicaid cuts that Republicans are calling for will also have a severe impact in rural areas. The resulting declines in coverage will force some rural hospitals and clinics to close, with spillover effects on middle-class people who depend on the same facilities and services.

Ryan and other House Republicans have touted one CBO finding: After initially increasing insurance premiums, their bill would reduce premiums after 2020 compared with the ACA. But that’s because their measure would force so many older people to drop coverage that the average age of the insured population would drop. It’s nothing to be proud of. Trump and the Republicans promised more coverage and lower costs when they replaced Obamacare. It is now transparently obvious that they can’t deliver on that promise and that they are willing to deny health insurance even to millions of people who voted for them.

**Blocking Trump’s Chaos Option**

If Trump and the Republican Congress cannot pass legislation this year, they do have a fallback option. They can claim that the ACA is collapsing and make sure that it does. Then they can return to health-care legislation later and say they have no choice except to repeal Obamacare. This is the option Trump at times has seemed to prefer. “Let it be a disaster, because we can blame that on the Dems,” he told the National Governors Association on February 27. “Let it implode, then let it implode in 2018 even worse. … Politically, I think it would be a great solution.”

When Trump talks about Obamacare imploding, he is talking not about the entire program (although he seems to think so), but rather one specific part: the insurance exchanges in the individual market. The danger he and other Republicans invoke is a “death spiral”—a situation where rising premiums drive the healthy out of the market, forcing premiums up and more healthy people out, until the market fails. The exchanges are nowhere near that point. Although rates in the exchanges did rise sharply in 2016, they rose to the level originally projected by the CBO (premiums had come in lower than expected earlier). Moreover, the vast majority of individuals who buy insurance in the exchanges receive subsidies that cap the cost of their premiums; many of them also receive subsidies covering a share of deductibles and co-pays. Consequently, as the CBO and other studies have found, the exchanges have some protection against a death spiral—as long as the subsidies are fully funded and the individual mandate is enforced.

But the insurance exchanges could soon face a dire crisis because the Trump administration has created uncertainty for both insurers and enrollees about the survival of the program and enforcement of the mandate. If the administration doesn’t enforce the mandate—or if Congress eliminates the penalty for failing to insure, as the House bill would do for this year—the incentive for healthy people to pay for coverage will fall, threatening the viability of the market.

Some damage has already been done. As soon as the Trump administration came into office, it canceled outreach efforts in the final phase of the open-enrollment period for 2017. Since individuals who enroll early tend to be those who know they will have high medical costs, while late enrollees are a healthier group, the cutoff of late outreach not only reduced total enrollment but also led to a higher-cost pool. The Trump administration is also proposing to shorten the open-enrollment period for 2018.

Other measures the administration favors could encourage insurers to stay in the market, albeit with mixed effects on enrollees. The administration wants to tighten up special enrollment outside of the open-enrollment period, which may well be justified; it also proposes requiring people to pay any unpaid premiums before enrolling for the next year. In a step that would help keep premiums down, the administration has encouraged states to seek waivers to develop reinsurance programs for the individual market, as Alaska has already done. (Reinsurance spreads the cost of high-cost cases across the entire market.) Alaskans buying insurance individually faced a possible 40 percent rate increase because of 37 very high-cost cases, accounting for one-quarter of claims. The reinsurance measure adopted by the state, using funds from an existing premium tax, kept premium increases by Premera Blue Cross, the sole insurer in Alaska’s exchange, to 9.8 percent.

Insurance companies need to indicate by June whether they will offer coverage in the exchanges for 2018. Uncertainty about the rules is a recipe for chaos. If they believe the mandate will not be enforced, they are likely to jack up premiums or withdraw entirely from the market. About a third of the exchanges, mainly in rural areas, have only one carrier offering coverage this year; additional withdrawals for 2018 could create just the kind of crisis that Trump and the Republicans need as a pretext to undo the ACA.

This problem has a ready solution. If Republicans in Congress do not replace the ACA for the coming year, the Trump administration needs to make clear that it will enforce the law as it stands for 2018 and fully fund the program (including cost-sharing subsidies). Moreover, Republicans cannot plead there is no way to strengthen the individual market. The Ryan bill contains a Patient and State Stability Fund of $100 billion over ten years that the CBO believes states would use largely to cover high-cost enrollees in the individual market and thereby prevent a death spiral. In the absence of comprehensive new legislation, Congress should provide those funds in a separate measure to stabilize the market for 2018. The Republicans cannot blame a collapse on Democrats when they have it in their power to maintain coverage for the millions of people who depend on the market now.

Tomorrow: The Next Progressive Health Agenda

  Reported by The American Prospect 5 minutes ago.

The GOP drive to repeal Obamacare threatens a quiet revolution in how U.S. cities care for their poor

0
0
Over the last four years, this city at the foot of the Rocky Mountains has quietly transformed how it cares for its poorest residents.

As hundreds of thousands of Coloradans gained health insurance through the Affordable Care Act, known as or Obamacare, Denver built an extensive new system to keep... Reported by L.A. Times 23 hours ago.

Ziegler Wealth Management Promotes Financial Advisor Dryden Geronimi to First Vice President

0
0
Ziegler Wealth Management has announced the promotion of Dryden Geronimi to first vice president and financial advisor. Geronimi has been with Ziegler for 17 years and serves out of the firm's Middleton, Wisconsin branch location at 8215 Greenway Boulevard.

Chicago, IL (PRWEB) March 22, 2017

Ziegler Wealth Management has announced the promotion of Dryden Geronimi to first vice president and financial advisor. Geronimi has been with Ziegler for 17 years and serves out of the firm's Middleton, Wisconsin branch location at 8215 Greenway Boulevard.

"For the past 17 years, Dryden's commitment to Ziegler and his clients has been unwavering," stated Robert Moats, Senior Managing Director and Head of Ziegler Wealth Management. "In these times, it’s refreshing to see an individual like Dryden not only develop longevity with one firm, but also flourish in his dedication to his clients. I’ve worked in the financial services industry for 30 years, and know it’s rare to find an advisor so committed to client education and communication."

Geronimi holds Series 7, Series 66, and life/health insurance licenses. He is consistently among Ziegler’s top financial advisors and has won numerous awards during his tenure with the company by holding on to the simple principle of “clients come first.” A resident of Verona, Wisconsin, Geronimi enjoys spending time with his children, as well as traveling and understanding different cultures. His full biography and contact information are available on his website, http://www.ziegler.com/dryden-geronimi.

“I am honored by this recognition and truly enjoy working with my clients to help them reach their financial goals,” commented Geronimi.

Ziegler Wealth Management provides individuals and businesses an array of solutions to help achieve their unique financial goals. Our experienced financial advisors have a responsive, personal approach to understanding our clients’ specific needs. Through traditional brokerage services, professionally managed accounts or financial planning services, our customized solutions encompass full-service financial advice and planning.

About Ziegler:
Ziegler is a privately held investment bank, capital markets, wealth management and proprietary investments firm, celebrating its 115th anniversary this year. Ziegler is ranked No. 1 in the country in healthcare/senior living underwriters by issuance and No. 4 by par amount (Thomson Reuters, 2016), and is ranked in the top 20 municipal underwriters in the country by volume (Bloomberg, 2016). Specializing in the healthcare, senior living, education and religion sectors, as well as general municipal and structured finance enables Ziegler to generate a positive impact on the communities it serves. Headquartered in Chicago with regional and branch offices throughout the United States, Ziegler provides its clients with capital raising, strategic advisory services, equity and fixed income sales & trading, wealth management and research. To learn more, visit http://www.ziegler.com.

Certain comments in this news release represent forward-looking statements made pursuant to the provisions of the Private Securities Litigation Reform Act of 1995. This client’s experience may not be representative of the experience of other clients, nor is it indicative of future performance or success. The forward-looking statements are subject to a number of risks and uncertainties, in particular, the overall financial health of the securities industry, the strength of the healthcare sector of the U.S. economy and the municipal securities marketplace, the ability of the Company to underwrite and distribute securities, the market value of mutual fund portfolios and separate account portfolios advised by the Company, the volume of sales by its retail brokers, the outcome of pending litigation, and the ability to attract and retain qualified employees.
# # # Reported by PRWeb 20 hours ago.

Republican Change To The ACA: A Health Care 'Minimum Income'

0
0
A key piece of the American Health Care Act is changing the ACA’s income-based subsidies to a blend of income- and age-based tax credits. For consumers under the income-eligibility threshold, this essentially creates a health care “minimum income.”

The term “minimum income” has been used in more and more policy circles in recent years. What is it? A minimum income is a type of welfare program intended to reduce poverty by providing all citizens with a liveable income.

It might sound a bit socialist, but the minimum income approach actually has some Founding Father and conservative credibility. Thomas Paine was an advocate, calling it a “citizen’s dividend,” which he believed was owed to people for their loss of land access through the creation of property rights.

In his essay “Agrarian Justice,” Paine argued people who own land owe the community, especially non-land owners, for their loss of access to formerly public property where they may have previously hunted or fished to be able to eat. He used this to justify an argument for a tax funding a minimum income of £15 per year to every person age 21 or older.

The economist Milton Friedman, advisor to Ronald Reagan and Margaret Thatcher, was also an advocate for the minimum income, which he called a negative income tax. A free market capitalist, Friedman thought the minimum income would be more efficient than than existing programs like Social Security or food stamps. He also argued that it would end the “welfare trap,” where low-wage work is not more beneficial than safety net programs, disincentivizing recipients to get off of government assistance.

Many who are initially against this idea begin thinking about it differently when understanding it could replace all other government assistance. Instead of only people under a certain income getting government assistance, everyone just gets a flat payment.

This seems to be the approach Republicans are taking when it comes to health care, though not as purely as Friedman or Paine might have liked. The Republican plan does integrate income-based eligibility, meaning only individuals making less than $75,000 per year or couples making less than $150,000 per year could receive this health care “minimum income.”

For consumers under these income thresholds, the AHCA’s tax credits would not vary by consumer. They would not take regional cost differences for insurance into consideration, nor would it give lower-income individuals more than those right under the $75,000 threshold. This is different than the ACA’s subsidies, which did take these things into account. Instead, the AHCA would simply create the following annual health care “minimum incomes”:

•$2,000 for consumers under 30

•$2,500 for consumers between 30 and 40

•$3,000 for consumers between 40 and 50

•$3,500 for consumers between 50 and 60

•$4,000 for consumers over 60

Instead of attempting to offer more support to lower-income Americans, age-based credits would create an across-the-board benefit for everyone under the income threshold. The credits would only be accessible by those with individual plans, meaning those with employer coverage, Medicaid, or Medicare benefits would not be eligible.

Like minimum income supporters, advocates of the age-based tax credit say they are simpler to execute than income-based subsidies. However, critics say the program will lead to reduced assistance for those who need it most. Under an age-based system, a person making $74,000 and living in Illinois would receive the same help as someone making $25,000 and living in Alaska, where insurance prices are much higher.

Further, while age is often correlated with health status, it isn’t always. Under an age-based system, a healthy 50-year-old would receive more than twice as much assistance as a 25-year-old with cancer, even though the 25-year-old would likely need a more comprehensive and expensive health plan than the 50-year-old.

Even so, a minimum health care income would be an novel approach to solving health care unaffordability. Taken even further, one could imagine that this might incentivize removing the income threshold in favor of a fully comprehensive health care minimum income, which could lead to eradicating group health insurance altogether.

Instead of employers, tax credits, Medicare and Medicaid providing assistance to different groups on a piecemeal basis, every American would receive a guaranteed annual health care allowance to do with as they please. Who knows ― this may even be paving the way for minimum income policy outside of health care, like what Paine dreamed of for all Americans.

Regardless of what happens, it is notable that the AHCA offers federal assistance at all in the individual market. Before the ACA, there was no federal assistance for individual market buyers. Even if the law is repealed, the ACA has made a lasting impact on U.S. health care policy.

Have you or your family benefited from the Affordable Care Act? If you’d like to share your story on HuffPost, email us at ACAstories@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 12 hours ago.

Feds probe Humana on false claims to Medicare

0
0
The U.S. Justice Department disclosed last week that local health insurance giant Humana Inc. (NYSE: HUM) is under investigation for defrauding Medicare. According to a report by Reuters, the Justice Department is looking into U.S. False Claims Act violations of four companies: Humana, Aetna Inc. (NYSE: AET), Health Net Inc. (NYSE: HNT) and Cigna Corp. (NYSE: CI) company Bravo Health Inc. Humana spokesperson Kate Marx said in an emailed statement that the company has publicly disclosed it was part… Reported by bizjournals 19 hours ago.

Trump Seeks To Nail Support For Health Care Bill Before House Vote

0
0
WASHINGTON, March 22 (Reuters) - U.S. President Donald Trump and Republican congressional leaders appeared on Wednesday to be losing the battle to get enough support in the House of Representatives to pass their Obamacare rollback bill, watched by wary investors in financial markets.

Repealing and replacing Democratic former President Barack Obama’s 2010 Affordable Care Act is a first major test of Trump’s legislative ability and whether he can keep his big promises to business.

The current House Republican rollback plan is scheduled for a floor vote on Thursday but faces stiff resistance from some conservative Republicans, who view it as too similar to Obamacare, and from moderates concerned it will hurt some voters.

Mark Meadows, who heads the conservative House Freedom Caucus, said after a White House meeting on Wednesday there were still not enough votes to pass the bill. He remained hopeful for potential changes to the legislation.

Vice President Mike Pence discussed “a couple of options” to win votes from caucus members, Meadows said, adding the White House was still willing to listen and “hopefully reach consensus.”

Trump and Ryan, the measure’s leading proponent, can afford to lose only about 20 Republican votes or risk failure, since Democrats are united against it. By some estimates, 26 House Republicans have signaled their opposition.

Trump’s promises during his election campaign and his first two months in office have lifted U.S. stock markets to new highs. But stocks fell back sharply on Tuesday as investors worried that a rough ride for the healthcare legislation could affect Trump’s ability to deliver on other big pieces of his agenda, from cutting taxes and regulation to boosting infrastructure.

Stocks were trading around flat on Wednesday, with the Nasdaq up slightly and the S&P trading just above water, although the Dow was weaker. Investors were waiting to see what would come of Thursday’s healthcare vote, after the benchmark stock indexes posted their biggest one-day loss since before the November election on Tuesday.

“The Trump agenda is like a one-lane road with this big truck called ‘healthcare’ in the lead,” said Brookings Institution senior fellow William Galston. “If that truck breaks down, everything else will back up.”

While paying little attention to the details of the House Republican effort, Trump has put considerable effort into shoring up the bill, actively courting conservative lawmakers with objections to the bill.

In a trip to Capitol Hill on Tuesday he warned Republicans that failure could have sharp repercussions in next year’s congressional midterm elections.

Trump kept up his efforts to sell the plan, called the American Health Care Act, on Wednesday, meeting with about 10 House members at the White House, said Representative Patrick McHenry.

“The president is meeting with a mixed bag of members to continue moving support for the bill,” a White House official said.

“Big day for healthcare. Working hard!” tweeted Trump, who took office in January.

Trump declined to say what he would do if the proposed legislation fails in the House. Asked if he would keep pushing the bill, he told reporters: “We’ll see what happens.”

“GET HEALTHCARE DONE”

At rallies this week in Nashville, Tennessee, and Louisville, Kentucky, meant to drum up support for the bill, Trump spent little time discussing specifics and made clear he saw it as a step on the road in a broader agenda that includes his planned tax cuts.

Obamacare overhauled the U.S. health insurance system and aimed to reduce the numbers of Americans with no health insurance. Twenty million people gained insurance under the law, but Republicans have long targeted it as government overreach because of its mandates on individuals and employers, and they have criticized rising costs of insurance premiums.

The nonpartisan Congressional Budget Office estimated 14 million people would lose medical coverage under the Republican plan by next year. It also said that 24 million fewer people would be insured by 2026.

Republicans argued this would not be because 24 million people would be pushed off insurance plans under the proposal. Some would be people dropping out because there would no longer be a penalty for not being covered, said Representative Kevin Brady, Republican chairman of the Ways and Means committee.

In a series of radio interviews on Wednesday, Ryan pressed his case that Republicans had to keep their campaign promise to jettison Obamacare and that all factions of the party should unite to deliver the bill.

“We can get it done,” Ryan said on “The Jay Weber Show.”

He said conservatives who oppose the bill need to recognize that the House bill has to be crafted so it can pass the Senate, where Republicans hold a slimmer majority, and that they will have opportunities to pursue changes later.

Even if the legislation passes the House, its fate is uncertain in the Senate, where a number of Republicans have spoken out against the House version.

Ryan said he expected the Senate to work on the bill next week and another House vote on the final measure to be held in the week of April 3, with it headed to the White House for Trump to sign it into law by Easter, April 16.

That optimistic timeline would depend on a rapid end to Republican resistance to the bill.

Republican leaders made some changes to the bill this week to try to satisfy critics from their own party but that and Trump’s visit to Congress on Tuesday did not appear to sway members of the House Freedom Caucus.

At a meeting that could last all day Wednesday, the House Rules Committee was due to set the rules for Thursday’s expected floor debate, including deciding what amendments, if any, will be allowed. It faced a list of more than two dozen proposed amendments from both Republicans and Democrats.

(Additional reporting by Doina Chiacu, Susan Cornwell, Susan Heavey, Jeff Mason, Steve Holland in Washington and Megan Davies in New York; Writing by Frances Kerry; Editing by Kevin Drawbaugh and Bill Trott)

-- 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 16 hours ago.

Humana places near top in national customer experience survey

0
0
Louisville-based Humana Inc. (NYSE: HUM) ranks No. 2 for best customer experience in the health insurance industry, according to a national customer experience survey. Kaiser Permanente, an Oakland, Calif.-based not-for-profit health insurer, took No. 1 for the second year in a row, according to a news release from the Temkin Group, a Massachusetts-based customer experience research, consulting and training firm. The company surveyed 10,000 U.S. consumers to evaluate their experiences with 331… Reported by bizjournals 17 hours ago.

The GOP's tax cut for healthcare CEO pay is a bigger ripoff of American taxpayers than it seemed

0
0
As the House of Representatives prepares to vote Thursday to repeal the Affordable Care Act, there’s a new estimate of the cost of one of its hidden provisions, a rollback of rules designed to restrain executive pay at health insurance companies.

Here’s the bottom line: Rolling back the provision... Reported by L.A. Times 16 hours ago.

Eliminating essential health insurance benefits is a lousy idea that won't save money. Here's why.

0
0
You can add this to the list of proposed conservative “reforms” to the healthcare system that won’t work to lower costs and is a terrible idea in general: paring back the list of essential health benefits required to be covered by every Obamacare plan.

David Anderson of Duke points us to a recent... Reported by L.A. Times 14 hours ago.

Stockman On Thursday's Defining Moment: Defeat Obamacare Lite Or Be Buried By The Welfare State

0
0
Stockman On Thursday's Defining Moment: Defeat Obamacare Lite Or Be Buried By The Welfare State Authored by David Stockman via Contra Corner blog,

Thursday's vote on Speaker Ryan's wrong-headed plan to repeal and replace Obamacare involves* far more than keeping faith with a crucial campaign pledge* or the Donald's notion that it's just the preliminaries to "cutting the hell out of taxes".

In fact, *the passage of Obamacare Lite would mean the triumph of a runaway Welfare State in aging and job-deficient America. *It would eventually result in fiscal catastrophe and the certainty of tax increases - not cuts - as far as the eye can see.

As we pointed out the other day, the nation's* bloated and unsustainable health care system consumes 18% of GDP compared to 10-12% in most of the world's social welfare democracies.* And it's an open-ended fiscal time bomb because unlike the state controlled single payor systems elsewhere, the US system is a mutant hybrid of socialism for the recipients and crony capitalism for the providers.

*Consequently, there is no brake on the volume and price of services. *Health care demand is only limited by what the crony capitalist lobbies for every medical specialty and delivery system vertical can extract from payors---mainly the state.

We refer here to the staggering sum of *$24 trillion *in health care entitlement spending. That's what government financing of medical programs will cost over the next decade. This total includes CBO's *$16.5 trillion *cost estimate for the Federal medical programs----plus *$4 trillion *in tax exclusion benefits for employer health plans and *$3.5 trillion *for the state share of Medicaid.

For perspective, that sum is nearly 2X the projected *$13.2 trillion *cost of the entire Social Security system over the next ten years, which will have *8o **million *retires, dependents and disability recipients by 2027.

Needless to say, the Speaker's Obamacare Lite plan does not even address the runaway costs drivers of the medical delivery system and merely fiddles with the entitlements along the edges. For example, the combined Federal/State cost of Medicaid over the next decade would be $8.5 *trillion *under current Obamacare law, representing the single most explosively growing entitlement in existence.

Under the Ryan plan's rollback of the matching ratios and the indexed per capita funding formula, the "savings" would be about *$500 billion *after off-setting the added costs of the State Stability Fund, repeal of the disproportionate share hospital cuts and the 11th hour "manager's amendment" to index state Medicaid grants to a more generous medical inflation factor. But spending $8.0 *trillion *on Medicaid---a mere 7% cut---- from a veritable fiscal time bomb is not remotely what the doctor ordered.

Likewise, Ryan replaces the income-based Obamacare health exchange subsidies with age-based tax credits bedecked with phony eligibility caps. The former provision would save *$673 billion *over the decade according to the CBO, while Ryan's tax credits and HSA (health savings account)

expansion would cost around *$400 billion *as presented; and would eventually eat-up the full *Obamacare exchange subsidy savings *via the more generous tax credits that would be needed to have any hope of passage in the Senate.

*Moreover, we doubt whether anyone who can do 5th grade math will be fooled by Ryan's double shuffle.* The new provisions still amount to a *massive tax **credit entitlement *that in some ways is for more profligate than Obama's health exchange premium subsidies for families up to 4X the poverty line or about $100k per year.

For example, consider a family consisting of three children under 20-years old and two mid-40s adults with an annual income of $149,000---putting them on the top *5% *of the income ladder. Yet under the new Ryan plan, this family would be eligible for $12,000 of tax credits against its insurance premiums compared to *zero *under Obamacare.

Finally, the Ryan plan merely fiddles with the regulatory straight jacket on the insurance market that caused premiums to soar under Obamacare. Ryan's nanny state requisites include retention of the ban on annual and lifetime benefit caps, limits on age based premium variation, mandated coverage of pre­existing conditions, coverage of children until the age of 26 and etc.

*But these serious structural deficiencies are not the half of it. What is missing entirely in Ryan's plan is an alternative policy vision and, even more importantly, a political model that can actually connect with Trump's Flyover America constituency.*

As written, the bill is just the opposite----an embodiment of Ryan's small-ball beltway wonkdom that truly amounts to Obamacare Lite. For that reason it is destined to be a political looser and to never make it through the Senate and conference to the Donald's desk. And in the process of failure----or legislative compromise nearly all the way back to full Obamacare----the GOP will pay an enormous political price.

*That's because its watered-down version of Obamacare can't compete on a Washington playing field that measures policy effectiveness by the number of people provided coverage and the amount of "help" with medical costs supplied by Uncle Sam.*

We actually believe there is a better way, which is briefly described below. It re-mixes the policy menu drastically and provides a fresh start political model that would actually allow the GOP to fundamentally change the terms of debate in its favor.

But first Ryan's plan must be stopped dead in its tracks and Obamacare allowed to continue its built-in death spiral until the GOP can come back with an altogether different Plan B. Fortunately, the two dozen or so members of the House Freedom Caucus seem to grasp the enormity of the historic inflection point at hand.

In particular, caucus chairman Mark Meadows appears fully cognizant that it is up to him and his small band to stop the nation's slide into welfare state bankruptcy:



*This is a defining moment for the Freedom Caucus," he added. 7 don't think there is a more critical vote for the Freedom **Caucus than this particular one."** *



Another stalwart Freedom Caucus member, Justin Amash of Michigan, also believes the group must hold together to block the bill after the GOP leadership ignored their demands.



*"We've made suggestions all the way through," he said Monday night. "If they don't want to listen to them then that's on **them."*



-*So here is the outline of a true policy and political alternative to Obamacare Lite.*-

It starts with a fundamental parsing of the issue into three separate domains.These are workfare, welfare and free market reform of medical care.

The underlying idea is that: (1) the Federal government retains responsibility for "workfare" by supplementing lower-end market wages with earned income tax credits (EITC); (2) the states takeover all means-tested welfare included Medicaid, food stamps, housing and family assistance via a Super-Block Grant; and (3) the free market is powerfully activated in the cause of medical cost control and delivery innovation via deregulation and by permitting millions of workers with employer plans to elect an equivalent amount of tax-free cash to spend for their own health care needs via HSAs (health savings accounts).

Needless to say, these three policy domains cannot be addressed through the awkward tool of a single reconciliation bill---so that dead-end legislative expedient needs to be ash-canned at the get-go.

Instead, we would envision the "workfare" component to be incorporated into the pending tax cut and reform bill and that the welfare Super-Block Grant and Free Market Health Care Plan would be developed separately and carefully on their own legislative tracks. No more Nancy Pelosi moments of passing thousands of pages of statute so Congress can find out what's in the bill----as happened with the ferociously negative public feedbacks on Obamacare.

Embedded in the above approach is an exciting opportunity to bring sweeping disruptive change to America's bloated, moribund medical care delivery system by unleashing tens of millions of cost and service conscience health care consumers on the market. At the same time, financial empowerment of lower income workers with an enhanced system of pro-work earned income tax credits would be a huge positive politically, as would a *$650 billion *Super-Block Grant to the mostly GOP-run state governments .

A decided advantage is that this approach would get the welfare question and helping the poor out of Washington once and far all. Better that coverage of the welfare policy debate be handled by the *Arkansas Gazette *and the *Indianapolis Star *rather than *CNN *and the *New York Times.*

Likewise, in the kind of atomized HSA/consumer driven health market this approach envisions, the liberal media's focus on counting the number of covered persons would be eliminated entirely; and the CBO's green-eyes shades would be precluded from their current de facto policy-making role. That is, pricing-out the fiscal dimension would involve nothing more than tabulating the cost of the EITC and tracking a hard statutory number for the block grant.

*As to the details of this potential Plan B, the first point is to recognize that Medicaid is essentially a welfare issue and must be separated from health care reform.* That's because Medicaid does nothing for the supply side of the delivery system. It is designed to subsidize access to health care for the poor and is ultimately a form of income transfer payment. In Milton Friedman's ideal world of pure cash transfers, it would better be accomplished through a negative income tax.

That would be a Super-Block Grant for all Federal welfare programs that would permit the states to become true "laboratories of democracy" in Justice Brandeis' felicitous phrase.

That is to say, it should be clear by now that there is no one-size fits all welfare policy design with respect to the mix of cash versus in-kind (medical, food, housing) benefits, the manner in which benefit loss and work incentives and requirements are structured, the interactive effects of multiple benefit programs and the level of transfer payments relative to the huge cost of living variances across the US.

So we would let the states experiment and compete for the best designs and solutions to the welfare problem by giving to each a single no-stings block grant that could be spent on medical, housing, cash welfare or any other form of means-tested assistance they would choose. In that context, the current policy baseline for *2020 *includes *$450 billion *for Medicaid, *$67 billion *for food stamps, $95 *billion *for family assistance and SSI and another *$50 billion *for housing aid, child nutrition and several smaller programs.

We are here also talking about reviving a vibrant Federalism. The Imperial City cannot run every government function in America----and transfer payments to the poor is one of those functions, albeit a complex and vexing one. So whack up the *$650 billion *that Uncle Sam is now spending for welfare and devolve it to the states, which are knee deep in that function already.

In fact, when you add-in the *$350 billion *state share of Medicaid, it is evident that America already has a *$1 trillion *per year welfare program for the needy. Moreover, when you acknowledge that welfare is not a constitutional right and that there is no right way to design these programs----then there is nothing at all wrong with delegating that function of government to the states, which are far closer to the facts and circumstances of their communities and people, anyway.

Needless to say, under this grand scheme of a welfare Super-Block Grant the coverage counting fetish of the elite media and Democrat politicians would be entirely abrogated. Dollars would flow into many different designs and cash versus in-kind mixes, thereby transforming the issue into questions about the efficacy of the help being given and the results being obtained, not the beneficiary count in each basket of Federal aid.

On the question of "workfare" there is a good reason to retain Federal responsibility via the EITC. The latter piggybacks on the income tax collection machinery that exits anyway and is a form of transfer payment that is job-based and pro-work. While the design of the current EITC may not be ideal, it does reward rising earnings with more benefits; and after $50,000 of family income, it phases out at a low 21% rate, thereby avoiding the so-called "notch" effects that plague most welfare programs.

Under current law, the EITC is projected to cost about *$90 billion *per year---or upwards of *$1 trillion *over the next decade. It would not even be unreasonable to allocate some of the $675 *billion *saved from repealing the Obamacare exchange subsidies to enhancing benefit levels under the EITC.

After all, the target for the exchange subsidies was working families who needed help purchasing their health care. Under an enhanced EITC, a family of four earning $37,000 per year, for example, could be rewarded with a *$13,000 tax credit, *bringing their total income to $501c.

The difference, of course, is that they would not have a Washington nanny telling them how much of that to spend on health insurance or what policy structure best fits their needs. In a free society, adult citizens and their families do that.

Finally, the most exciting part of this potential Plan B is to truly liberate the free market in health care, and there is one mind-blowing way to do it that would be enormously popular among the Trump constituencies of Flyover America.

*To wit, get the dead-hand of Franklin Roosevelt (owing to the 1944 IRS decision) off the large and growing portion of their wages **that are paid in tax free group health plans. Instead, give every employee the option to elect to receive the actuarial cash equivalent from their employer, and make it tax-free as long as it's put in an HSA.** *

In the mainstream job market with employer plans, the cash equivalent would range between $8,000 and $20,000 per year for workers with families. Turn them loose to shop with their own HSA dollars, and the health care delivery system will be Wal-Martized in no time.

So doing, the American public---not Washington bureaucrats and rule-writers----would be enlisted in attacking the heart of our roaring health inflation problem. That is, the current giant third-party payment system which essentially eliminates market pricing and consumer shopping behavior.

Instead, what passes for government and private "insurance" amounts to aforrn *of health service pre payment under which cost pooling and **community rating ofpremiums generates endemic overutilization, overpricing, andfree-riding.*

In fact, when virtually everything is paid for by third-parties, you do not have price-conscious, shopping-oriented, cost-minimizing consumers who have their own money at risk----just several hundred million cost-indifferent patients with various kinds of prepaid cards (e.g. medicare, Medicaid, blue cross, employer plans etc.).

*Needless to say, there is no such thing as an efficacious free market when their are no real consumers. *What passes for the health care market today is just a bureaucratic clearing house where provider cartels attempt to maximize their billings while insurance companies, HMOs, PPOs and utilization review and pre-approval agencies seek to minimize what they certify for payment.* *

As a result, the medical professions and delivery system have morphed into Washington's greatest crony capitalist lobby. Their ability to milk the payment pools and maximize their incomes is entirely a function of reimbursement rules under Medicare/Medicaid and collective bargaining power versus private insurers and employer plans.

*The consequence, in turn, is high prices, endless hassles over coverage and pre-approvals and a complete loss of consumers' sovereignty over their own health care costs and quality. *And that is what the public--whether it fully recognizes it or not----is fundamentally objecting to under the rubric of "Obamacare".

At the end of the day this is health care socialism and it is what will finally bankrupt America, yet Speaker Ryan's Obamacare Lite plans keeps that system fully in place. After all, the K-Street lobbies which essentially drafted his bill would have it no other way.

*So what needs to happen now is that Obamacare Lite is ash-canned this week---so that the GOP can launch a fresh start plan. Liberating consumers to drive an honest, efficient, innovative health care market is the essential RX for what ails America's health care system today.*

And when America's middle class families go to work driving down the cost of health care in their own interest, it will redound to the less fortunate part of the population as well. Medicare will buy more for less, and the state based welfare systems will do the same. Reported by Zero Hedge 12 hours ago.
Viewing all 22794 articles
Browse latest View live




Latest Images