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What's The Senate To Do With The House Health Care Legislation?

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The party in power often overreaches. House Republicans did just that when they voted to repeal the Affordable Care Act and replace it with a flawed alternative that threatens the health coverage of millions of Americans.

The Republicans’ replacement would make insurance more expensive for most seniors, limit federal assistance to those middle-income families who struggle the most to pay for coverage and give states the ability to cover fewer people under Medicaid.

Instead of threatening coverage for those Americans who need to most help securing health insurance, Republicans would have been smarter to fix some of the obvious flaws in the Affordable Care Act. And Democrats would have been just as wise to join them.

First, eliminate the Independent Payment Advisory Board. IPAB was established to slow the growth of Medicare. The Affordable Care Act gives the panel broad discretion to reduce Medicare spending once the program eclipses a certain threshold. IPAB is unnecessarily bureaucratic and should be scrapped. Arbitrary price-setting is rarely successful.

Republicans and Democrats oppose IPAB because it threatens to limit what Medicare covers. Texas Sen. John Cornyn, the number two Senate Republican, and Oregon Sen. Ron Wyden, the top Democrat on the Finance Committee, introduced separate bills this year to block the board from forming. Sen. Wyden warned “it would be a huge mistake” to allow the panel to push “harmful cuts to Medicare with minimal input from Congress.”

Now, time is running out for Congress to correct this mistake because Medicare spending is soon expected to blow past the target that will force the president to set this process in motion.

Second, the Affordable Care Act created an imperfect formula to achieve those savings, essentially pegging reimbursement rates to much broader measures of inflation. But health care spending is climbing much faster than the rest of the economy, driven by unique demographic and financial variables.

Congress too often relies on arbitrary targets to slow the growth of federal programs, particularly Medicare. In 1997, former President Bill Clinton and congressional Republicans agreed to use the Sustainable Growth Rate to control Medicare costs.

In total, Congress voted 17 times to shield doctors from these cuts and ensure seniors continued access to their physicians. The annual ritual even earned a nickname, “The Doc Fix.” Republicans and Democrats finally abandoned that routine in 2015, saving doctors from a 21 percent pay cut under Medicare.

The bill also changed how doctors are reimbursed under the program. Instead of tying reimbursement rates to arbitrary targets, the new law transitions Medicare to a payment system that rewards doctors for the quality of their care, not the quantity of procedures they perform or patients they see. But these are not enough.

To control health care costs, we must eliminate fee-for-service medicine. Buying health care is not like buying a car. The free market cannot work in a field where consumers cannot control costs or make informed choices without the assistance of those who benefit financially from their choices. The only way to have predictable budgets for consumers and payers, both private and public, is to replace fee-for-service with an all-inclusive fee that covers all health care services.  We know this works, and it is the only cost-containment approach that does.

We have to move away from a model that has fueled the dramatic rise in health care costs for more than 30 years.  The Affordable Care Act established the seeds of this approach, which is one of reason I oppose efforts to repeal it. As Democrats, we should highlight the best parts of this law to show why it should be fixed, not eliminated.

Repealing President Barack Obama’s signature health law has become a crusade for Republicans. But yanking health insurance from millions of Americans is not the best way for President Donald Trump to help people who depend on it, including many who voted for him. Trump has many failings, but he is not ideological. So, it doesn’t make sense for him to govern that way.

Democrats should do everything in their power to prevent the president and his Republican allies in Congress from repealing the Affordable Care Act – even if that means agreeing to changes that will strengthen the program for Americans who depend on government health care programs.

Howard Dean is the former Governor of Vermont and an advisor to Dentons. The views expressed are his own and do not necessarily reflect the firm or its clients.

-- 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.

Delay in court case deepens health insurance uncertainty

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WASHINGTON (AP) " The Trump administration and House Republicans are asking a federal appeals court for a 90-day extension in a case that's casting a shadow of uncertainty over health insurance for millions of consumers.The case... Reported by New Zealand Herald 9 hours ago.

‘Don’t cry for me, golden retriever’ story teaches world the power of pet and parent bond

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Aquarium Software responds to an image that went viral of a dog hugging its owner; pointing out that the incident reported in the New York Post highlights again the bond between pet and pet parent.

(PRWEB) May 23, 2017

After images from Argentina of a dog hugging his injured owner while waiting for an ambulance went viral, senior executives at Aquarium Software (http://www.aquarium-software.com) say the emotional incident highlights the incredible bond between pet and pet parent. The technology expert asserts that while pets clearly go beyond the call of duty to care for people in a time of need, pet parents ought to do the same by investing more in pet insurance. The owner had suffered a bad fall from a tree and regained consciousness to find his dog, Tony, laying on him and refusing to move, even when the emergency services arrived to help. The man had found the dog on the streets and adopted him several years earlier. While recent research has suggested dogs mimic concern to get what they want from humans, such apparent altruism cannot be so easily explained.

“The cynics and the scientists will say the dog was looking after its meal ticket, after being taken from the streets and fed and watered,” said Mark Colonnese, VP Sales and Marketing for Aquarium Software. “However it does lend weight to the Mark Twain proverb that if you pick up a starving dog and make him prosperous, he will not bite you – he will do more - he will protect and stay with you. The best way we can keep our pets prosperous is by treating them well; having pet insurance is an important part of that mix and big data is making policies more affordable than ever.”

The feelings our pets have for their owners, calculated or otherwise are clearly reciprocated, as 63 per cent of people would grieve the loss of a pet as much as a family member, according to YouGov research commissioned by Aquarium Software in 2016. What this all adds up to is that calculated or otherwise, pet parents care about their pets as part of the family. Since 47 per cent also think the cost of pet insurance is ‘about right’ it does leave a question as to why people do not have insurance when there is no Government funded health service for pets and the cost of treatment can be prohibitively high. The answer is critical to those looking to increase take up of pet health insurance policies.

“I think we have to recognise that buying insurance is a decision pet parents make on emotion rather than reason. Technologists and insurers alike need to understand that fact and act accordingly,” concluded Colonnese. Reported by PRWeb 9 hours ago.

He broke up by text, so does she keep the $53,000 ring? - A judge’s shocking verdict

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The couple lived together in Billittier’s Hamburg, New York, home as they prepped and planned for the wedding. Billittier paid for Clark’s cell phone and for her car and health insurance. Reported by Myjoyonline 8 hours ago.

Ask Brianna: Should I pick my first job based on my debt?

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In a 2015 survey of student loan borrowers by the education nonprofit American Student Assistance, more than half of respondents said they took a higher-paying job they were less interested in so they could pay off their loans. Federal student loan repayment programs make lower-paying work more sustainable, and some private companies help pay loan bills. More than a third of respondents in the American Student Assistance survey said student loans affected their choice to work at a private company rather than in the public sector. Some private companies offer student debt payments — say, $100 a month directly to the loan principal — as an employee benefit, similar to health insurance or 401(k) contributions. A 2016 report from the Society for Human Resource Management found that 4 percent of member companies and organizations surveyed offered student loan repayment assistance. Gradifi, an online platform that helps employers implement loan assistance programs, has signed contracts with more than 20 new companies in the past two months, says Meera Oliva, Gradifi's chief marketing officer. Most workers currently have to pay taxes on employer student loan contributions, Oliva says, which reduces the value of the benefit. "The fact that even private employers are feeling the pinch of not being able to attract good employees because of debt levels, that really tells us that policymakers have waited far too long to really get at the root of these problems," she says. Reported by SeattlePI.com 9 hours ago.

Absent Conversation in Media: Why Did GOP Reaffirm Health Insurance as a Right?

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The role the government should play in health care is a critically important one. The media need to present all sides of it and present it fairly. They don’t.

-- Reported by CNSNews.com 7 hours ago.

Ivanka’s Maternity Leave Plan Is A Cruel Joke

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At the urging of his daughter, Ivanka Trump, President Donald Trump made sure to include a provision for six weeks of paid parental leave in the budget plan his administration released Tuesday.

This should be a welcome, landmark development for women in the U.S., the only developed country that doesn’t require some kind of paid time off for new mothers.  

Instead, it amounts to nothing more than a cruel joke in a budget that proposes gruesome reductions to social programs over the next decade. The plan includes a breathtaking overall cut of $1.4 trillion to Medicaid (a figure that presumes repeal of Obamacare) and the Children’s Health Insurance Program. It also calls for a $193 billion slice out of food stamps and $272 billion in cuts to other programs that serve the poor.

The budget seeks $19 billion for paid parental leave over 10 years.

What good is the paid leave if you can’t afford to feed yourself, take your baby to the doctor, pay your hospital bills, or get access to quality pre- or post-natal care?

Advocates for paid leave, who’ve been fighting for years for change, were near universal in their condemnation of the proposal. “World’s worst parental leave plan,” said Katie Bethell, the founder of Paid Leave for the United States, a nonprofit group.

“It’s a testament to the national movement to solve the paid leave crisis that the Trump administration is even expected to offer a parental leave plan in its proposed budget. Unfortunately, based on details released so far, the proposal falls far short,”  Christine Owens, executive director of the National Employment Law Project, said in a statement.

Even if the leave provision did not come wrapped in a package of brutal cuts to social services, the policy still falls down in its details.

Trump did expand the six weeks of leave to fathers and adoptive parents, who were excluded from the plan rolled out during his presidential campaign. However, the policy leaves out those workers who would need time off in case of serious illness or to care for ailing relatives, considered a standard part of family leave.

The 1993 federal Family and Medical Leave Act, which provides 12 weeks of unpaid leave to workers at companies with more than 50 employees, includes that type of time off ― as do state paid-leave plans in Rhode Island, California, New Jersey, and the one scheduled to go into effect next year in New York.

For funding, the Trump leave plan would rely on the unemployment insurance system, already under-financed and under-utilized. The White House leaves the details entirely to the states to work out.

Unemployment benefits are woefully inadequate, paying an average of $344 week, according to the National Employment Law Project. In 14 states unemployed workers get less than $300 a week. Fewer unemployed women typically qualify for unemployment insurance.

Theoretically, Trump’s leave plan could help someone like Regina Mays, who took six weeks of unpaid leave from her job that pays her about $10 an hour at a Walmart in High Point, North Carolina, after she had a baby girl last year

With no money coming in, she struggled to feed herself and her four other children at home. “There was time when I paid the bills and I literally didn’t have money for food,” Mays told HuffPost recently. A relative came by with groceries for her and her kids so they didn’t go hungry.

There was at least one thing Mays said she didn’t have to worry about: paying her hospital or doctor bills, which were covered by Medicaid.

Trump’s budget would rip that rug out from under mothers like Mays who theoretically would get about $1,800 for her six weeks at home, but without healthcare would also be on the hook for potentially tens of the thousands of dollars in medical bills.

The math is terrifying.

Cutting Medicaid would be devastating for all low-income Americans, but particularly for women and mothers: 45 percent of childbirths in the U.S. were funded by Medicaid in 2010, according to data from the Center on Budget and Policy Priorities.  

Trump’s budget also cuts funding for after-school programs for children and support for domestic violence victims.

The budget proposal lays bear a perverse, reverse Robin Hood administration ― taking from the poor to give tax cuts to the wealthy (proposed earlier this month).

But on the bright side, like most White House budgets, Trump’s is unlikely to become reality. As for the parental leave plan, Democrats see it as too skimpy. And there’s little indication that GOP lawmakers, who are typically eager to cut taxes and slash social programs, would want to give Americans what the Republicans likely to view as a new entitlement.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 8 hours ago.

Poor and disabled big losers in Trump budget; military wins

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WASHINGTON (AP) — The poor and the disabled are big losers in President Donald Trump’s budget proposal while the Pentagon is a big winner. Trump’s plan makes deep cuts in safety net programs including Medicaid and the Children’s Health Insurance Program. The proposal also includes big cuts in Social Security’s disability program. Trump released his […] Reported by Seattle Times 3 hours ago.

Employee Benefit Adviser’s Open Enrollment Readiness Benchmark: Employers Falling Behind

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Many Fare Poorly In The Process Management And Post-Enrollment Analysis Categories

New York, NY (PRWEB) May 23, 2017

Employers whose benefits sign-up periods take place in the first quarter of 2018 lost some ground in their open enrollment preparations, according to Employee Benefit Adviser’s latest Open Enrollment Readiness Benchmark.

The composite OERB score for this group, which represents nearly 70% of all employers, dropped three points in March to an overall readiness level of 41 out of 100.

The number of activity-related red flags, which signal a significant lack of preparedness, rose from seven to ten, while the number of green flags indicating a solid state of readiness fell from three to two. The biggest setbacks occurred in the open enrollment management and post-enrollment analysis categories—which shed five and six points, respectively, month-to-month.

“Employers aren’t making as much progress as they should,” said John McCormick, Editorial Director of SourceMedia’s Employee Benefits group, which includes EBA and Employee Benefit News. “Many benefit executives blame the uncertainty around the Republican healthcare plan for impeding their progress.”

The Open Enrollment Readiness Benchmark is a data-based performance benchmark that gauges how prepared employers are for their annual employee benefits enrollment periods. The Benchmark is sponsored by ADP. To produce the Benchmark, SourceMedia Research and EBA survey more than 400 HR and benefits executives working in organizations of various sizes and across multiple industries. Respondents rate their progress for each of 26 distinct activities on a scale of 1 to 100, with a score of 100 signifying the employer’s full preparation for that activity.

Other highlights from the first quarter Benchmark report:· Smaller companies with 50 to 150 employees now trail their large and midsize brethren in all four phases of open enrollment readiness. This is most striking when it comes to benefit plan design and selection where, for example, only 60% of smaller companies have settled on a retirement plan for their next open enrollment period, versus 66% and 71% of midsize and large employers.
· There are a few exceptions, but midsize companies with 151 to 999 employees generally lag larger employers and remain a step ahead of smaller organizations in their open enrollment readiness. In particular, midsize companies face special challenges when it comes to health plan selection, goal setting and reviewing plan design; in these areas they lag both their larger and smaller counterparts by a substantial margin.
· Large companies in virtually every open enrollment activity are far ahead of their smaller and midsize counterparts. For instance, 41% of large employers, those with more than 1,000 employees, have already settled on a health plan for their next enrollment period, compared with only 27% and 26% of small and midsize employers.

Employee Benefit Adviser’s Open Enrollment Readiness Benchmark was developed by SourceMedia Research and EBA’s editors. Each month, SourceMedia Research surveys 400-plus prescreened HR and benefits executives at organizations of various sizes and across multiple industries. Respondents’ scores for the 26 individual activities are aggregated and used to produce a readiness mark for each of the four critical phases of open enrollment—benefit plan design, preparation, employee enrollment and post-enrollment analysis—as well as an overall composite score. A complete analysis of the most recent OERB data is available here.

About Employee Benefit Adviser
Employee Benefit Adviser (EBA) is the information resource for employee benefit advisers, brokers, agents and consultants, providing the current awareness and perspective they need to anticipate changes in the marketplace and optimally serve their clients. EBA delivers a broad range of critical content, including comparative market data, legal and regulatory updates, the latest products and services, and best practices in benefits delivery — including health insurance, vision and dental insurance, and voluntary and retirement benefits. The benefits broker community relies on EBA to stay connected, through its website comment forums, its social media communities and live events.

About SourceMedia Research
SourceMedia Research is a full-service B2B market research service that draws upon SourceMedia’s market expertise and proprietary database of engaged executives to develop information and insights for clients. SourceMedia Research provides research solutions for marketers, agencies and others targeting sectors such as banking, payments, mortgage, accounting, employee benefits and wealth management.

About SourceMedia
SourceMedia, an Observer Capital company, is a business-to-business digital marketing services, subscription information, and event company serving senior-level professionals in the financial, technology and healthcare sectors. Brands include American Banker, PaymentsSource, The Bond Buyer, Financial Planning, Accounting Today, Mergers & Acquisitions, National Mortgage News, Employee Benefit News and Health Data Management.

About ADP
Powerful technology plus a human touch. Companies of all types and sizes around the world rely on ADP’s cloud software and expert insights to help unlock the potential of their people. HR. Talent. Benefits. Payroll. Compliance. Working together to build a better workforce. For more information, visit http://www.adp.com/business.

For more information, please contact:

Dana Jackson                                        
dana.jackson(at)sourcemedia(dot)com        
212-803-8329                                            

John McCormick
john.mccormick(at)sourcemedia(dot)com
212-803-8509 Reported by PRWeb 5 hours ago.

Report: 445,000 Mass. residents would lose insurance in five years under GOP plan

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A study commissioned by the Blue Cross Blue Shield Foundation contends that the Republican bill to repeal and replace the Affordable Care Act would cost Massachusetts $1.4 billion annually and cause nearly half a million residents to lose health insurance by the time it's fully implemented in 2022. The analysis, performed by the Urban Institute, looked at the bill approved by House Republicans in early May, called the American Health Care Act. The bill is currently being reviewed and reworked by… Reported by bizjournals 3 hours ago.

4 types of insurance you should consider, but probably haven’t

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Most Americans understand the need for health insurance, car insurance and homeowner’s insurance — these foundational policies ensure that if we get sick we will be covered, if we are robbed things will be replaced, or if we are in a car accident we will be shielded from the cost of damages. These coverages make a lot of sense. But, what if a tornado ripped through St. Louis and destroyed your home and car? Are you properly insured to cover those damages? What if the aforementioned car accident… Reported by bizjournals 4 hours ago.

Senate Republicans face mounting pressure to buck Trump and stabilize health insurance markets

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Senate Republicans face increasing pressure to rescue health insurance markets and protect coverage for millions of Americans amid growing fears the Trump administration is going let the markets collapse.

In recent days, leading hospitals, physician groups, health insurers and the U.S. Chamber... Reported by L.A. Times 3 hours ago.

With healthcare in turmoil, Senate Republicans are under pressure to buck Trump

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Senate Republicans face increasing pressure to rescue health insurance markets and protect coverage for millions of Americans amid growing fears the Trump administration is going let the markets collapse.

In recent days, leading hospitals, physician groups, health insurers and the U.S. Chamber... Reported by L.A. Times 20 minutes ago.

Trump’s Cruel And Deviant Budget

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For years, conservatives warned that liberals were “defining deviancy downward.” They said that by tolerating bad social behavior, liberals in effect lowered what was deemed acceptable behavior overall – allowing social norms to decline.

There was never a lot of evidence for that view, but there’s little question that Donald Trump is actively defining deviancy downward for the nation as a whole – whether it’s by lying, denigrating basic democratic values, celebrating tyrants around the world, using his office to build his family wealth, or stopping at nothing to win the presidency.

Now comes his budget. Budgets are overall expressions of values and priorities. Trump’s budget is cruel and deviant. He proposes to cut federal spending by more than $3.6 trillion over the next decade, much of it for programs that help the poor (Medicaid, food stamps, Social Security disability, and health insurance for poor children) – in order to finance a huge military buildup and tax cuts for corporations and the rich.

Trump’s budget won’t get through Congress, but it defines deviancy downward in 3 respects:

1.* It imposes huge burdens on people who already are hurting. *Not just the very poor, but also the working class. In fact, among the biggest losers would be people who voted for Trump – whites in rural and poor areas of the country who depend on Medicaid, food stamps, and Social Security disability.

Yet will they know that Trump is willing to sell them out to the rich and corporate interests, or will they fall for the right-wing Republican propaganda (amplified by Fox News and yell radio) that the budget is designed to help people take more responsibility for themselves?

2. *It sets a new low bar for congressional and public debate over social insurance in America, and of government’s role* – far lower than anything proposed by Ronald Reagan or George W. Bush. It pushes the idea that each of us is and should be on our own, rather than that we are part of a society that benefits from social insurance – spreading the risks and costs of adversity that could hit any one of us.

As White House OMB director Mick Mulvaney absurdly put it, the government should show “compassion” for low-income Americans but it should “also…have compassion for folks who are paying [for] it.” That illogic eliminates the justification for social insurance altogether.

The budget thereby frames the debate over Trumpcare, for example, as “why should I pay for her pre-existing health problem if I’m healthy?”

3. *Finally, the budget eviscerates the notion that an important aspect of patriotism involves sacrificing for the common good* – paying for public services you won’t use but will be used by others and will thereby help the nation as a whole, such as schools, roads, clean air, and health care.

Trump’s budget celebrates a cruel and virulent form of individualism – much like Trump himself. Until Trump, this view of America was considered deviant. But Trump is defining deviancy downward.

We are a better nation than this.

-- 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 38 minutes ago.

Trump Threatened To Let Obamacare 'Implode.' That's One Promise He's Keeping.

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President Donald Trump has been telling us all along that he believes his best course politically is to do what he can to ensure that Obamacare breaks. What you may not have noticed is that he’s actually been executing that plan.

The Affordable Care Act has had its share of problems, some them serious ― like health insurance premiums that middle-class families can’t afford, and swaths of the country with little to no competition among insurers.

Since the beginning of the year, the actions of Trump and his team have exacerbated those problems. And unless they start doing something different, much of what some consumers don’t like about Obamacare is going to be even worse next year.

Premiums will be higher than they would have been. Fewer insurance companies will sell policies to people who buy their coverage directly or through an exchange like HealthCare.gov (as opposed to people who get health benefits at work or from a government program like Medicare or Medicaid).

“We could see less progress in covering the uninsured, or possibly even some areas of the country could see increases in the uninsured rate with people being priced out,” said Cynthia Cox, an associate director at the Henry J. Kaiser Family Foundation.

And this is only tangentially related to the push from Trump and the Republican-led Congress to repeal the Affordable Care Act and “replace” it with a new bill that would cover millions fewer Americans, weaken protections for people with pre-existing conditions and severely cut back on aid for low-income households.

When Trump became president, he took stewardship of the federal government and all the programs it runs. When it came to the Affordable Care Act ― a law the GOP has vowed to kill for over seven years ― Trump faced a choice: Manage it as best as he could while Congress debated what would come after it, or deliberately mismanage it. He has chosen the latter.

This all fits a pattern dating back to the ACA’s enactment in 2010.

Republicans in 19 states have refused to expand Medicaid, leaving millions uninsured. GOP-led states put roadblocks in front of insurance enrollment counselors tasked with assisting people shopping for coverage. The Republican Congress cut funding for insurance companies that greatly contributed to their financial difficulties with the exchanges, and to the closure of many nonprofit “co-op” insurers created under the law. And Republicans have led or championed a slew of legal challenges to the law, including two cases that went to the Supreme Court and a cost-sharing lawsuit still causing uncertainty.

Rather than take steps to mitigate premium increases and insurers exiting the exchanges, Trump and the GOP have cheered them along. Rather than reassure insurance companies that the federal government will honor its agreements with them, Trump is going out of his way to make them believe it won’t. Rather than consider the millions of people who rely on this coverage, Trump declares Obamacare “dead” and washes his hands of it.

Governors, state insurance regulators, insurance companies, health care providers and the business community are pleading with the Trump administration (and Congress) to provide some clarity about what’s going to happen next year. They aren’t getting it. State insurance commissioners and companies are saying they don’t even know who to talk to, and can’t get straight answers from anyone in the administration.

Health insurance companies have already started hitting deadlines with state governments to state their intentions for next year about whether they’ll participate in these markets and how much they’ll charge.

More deadlines are looming in the coming weeks with state and federal regulators. Unless Trump changes course, it’s looking more and more likely that everyone will assume the worst, and either abandon the health insurance exchanges or jack up prices even more to protect themselves.Trump told us he was going to do this

Trump warned everyone about this. At a January news conference nine days before his inauguration, Trump articulated his thinking on this very clearly. Standing by and doing nothing to make the health insurance exchanges function better would help him politically, in his view, because Democrats ― many of whom were actually concerned about the welfare of people covered under the Affordable Care Act ― would flock to him and agree to his plan to repeal the law.

“The easiest thing would be to let it implode in ’17,” Trump said at the time. “They would come, begging to us please, we have to do something about Obamacare.”

When the House failed at its first attempt to pass a health care reform bill in March, Trump talked about this some more. “I’ve been saying for the last year and a half that the best thing we can do politically speaking is let Obamacare explode,” he said.

Statements like these are echoed by GOP lawmakers, and by the two officials chiefly in charge of Affordable Care Act programs ― Health and Human Services Secretary Tom Price and Centers for Medicare and Medicaid Services Administrator Seema Verma. It therefore seems clear that the political leaders of the health care bureaucracy aren’t spending a lot of time worrying about the Obamacare marketplaces or the people currently using them to get covered.

The damage done

Actions, of course, speak louder than words, and the Trump administration’s actions have caused real harm to this part of the health insurance system. The reckoning will come in autumn, when consumers set out to shop for next year’s policies.

On his first day as president, Trump issued an executive order instructing the agencies responsible for the Affordable Care Act to relax regulations and enforcement of its rules.

The IRS responded by announcing it wouldn’t reject tax returns that left the part about health coverage ― a key enforcement mechanism for the law’s individual mandate ― blank. That was merely a continuation of the agency’s previous policy, which the IRS had planned to change this year. But it signaled to insurers, tax preparers and consumers that Trump wouldn’t enforce the mandate, which functions as a way to nudge healthy people into the insurance pool lest they pay a fine for being uninsured.

“Most of our CEOs and plans, based on communication from the IRS, are doubtful about enforcement,” said Ceci Connolly, CEO of the Alliance of Community Health Plans, a trade group representing insurers including Kaiser Permanente and Geisinger Health Plan.

Also in January, the administration canceled advertising intended to promote the end of the sign-up period on the health insurance exchanges, for which President Barack Obama’s administration had already paid. When the final enrollment numbers came in, they were lower than for 2016, an outcome partially attributable to lost sign-ups during the final days, which had proved busier during the first three annual enrollment campaigns.

Most damaging has been Trump’s cavalier attitude toward paying health insurance companies that serve the lowest-income exchange customers money they’re owed. Anthem, a big Blue Cross Blue Shield insurer with a major presence on the exchanges, has said it plans to keep selling policies on these marketplaces ― unless these payments go away, which could make the company reconsider.“We remain pretty confused as to what the administration’s position on cost-sharing reductions is, exactly,” Connolly said. “The messages have been so radically different from day to day and hour to hour that it’s nearly impossible for any responsible business to make plans for the future based on the commentary.”

Because of a lawsuit that House Republicans brought in 2014 and won in lower court last year against the Obama administration, Trump has the power to unilaterally make or refuse to make these payments, which totaled $7 billion in 2016. Under the Affordable Care Act, insurers must reduce out-of-pocket costs like deductibles and copayments for poor enrollees, and the federal government is supposed to reimburse them for the expense. Almost 60 percent of exchange customers, or about 7 million people, qualified for these cost-sharing reductions this year.

So far, Trump has kept the money flowing ― but he keeps threatening not to. And even though Trump and House Republicans requested a delay in the lawsuit proceedings from a federal appeals court Monday instead of agreeing to halt the payments, all this uncertainty is making health insurance companies very nervous. There’s a good chance that will lead them to price next year’s coverage under the assumption they won’t get paid for the cost-sharing reductions.

“Health plans in the rest of the nation are sitting on edge of their seats waiting to see what the federal government is going to do,” said Peter Lee, the executive director of Covered California, the Golden State’s health insurance exchange. “A decision [to stop paying] CSRs is an early indicator that the federal government is maybe ready to walk away from the individual markets.”

Amid all this, the administration has taken a few positive steps with respect to the exchanges, such as issuing an insurer-friendly regulation that, among other things, make it harder for consumers to cancel insurance policies right after receiving costly treatments. But those efforts haven’t balanced out the administration’s other actions, and have even contributed to the confusion about how Trump and his team will run these programs.

Obamacare versus Trumpcare

Whatever Trump’s actions and statements, the health insurance exchanges struggled before he took office. Rate increases for 2017 were substantial. Analyses from the Kaiser Family Foundation, Standard & Poor’s, the Congressional Budget Office and others have concluded the financial performance of these marketplaces and the insurers that use them are improving this year, in part because insurers have priced their policies more in line with their customers’ medical costs.

On Tuesday, for example, Health Care Service Corp., which runs Blue Cross and Blue Shield plans in five states, announced it had reversed its losses on the exchange markets and earned a profit during the first quarter of this year.


The messages have been so radically different from day to day and hour to hour that it’s nearly impossible for any responsible business to make plans for the future based on the commentary.
Ceci Connolly, CEO, Alliance of Community Health Plans
“There’s a bit of irony here in that the individual market was starting to stabilize,” Connolly said, even though it remains “far from perfect.”

Insurers in some regions are still losing money and fleeing the markets, and more premium increases would have arrived next year, regardless. The question is, how much of this is attributable to Obamacare’s lingering problems and how much is because of the way Trump has overseen it (or failed to)?

“We don’t know what the premium increases would’ve been in Earth 2,” Cox said. “But it seems fair to say that some portion of these premium increases and some portion of the insurers’ decision to leave is because of the uncertainty they’re facing for next year.”

Accurately quantifying what share of rate hikes is because of the law itself, and what share is because of Trump, would be hard, if not outright impossible.

But one at least one insurance company tried. CareFirst BlueCross BlueShield asked Maryland regulators for a huge average premium increase next year ― 52 percent ― and said 15 percentage points of that is related to fear that Trump won’t make the cost-sharing reduction payments. In other words, what was going to be bad will probably be worse as a direct result of the administration’s posture.

Most premiums won’t go up as high as CareFirst is requesting ― and it’s a good bet Maryland will squeeze the company to accept less.

But considering just the cost-sharing reduction payments issue, the Kaiser Family Foundation projects that would force insurers to raise premiums by an average of 19 percent above and beyond what they would’ve done next year if Trump stops reimbursing them.

And, ironically, ending the payments would increase total federal spending, because the higher insurance prices would entitle qualified consumers to larger tax credits to defray their monthly premiums, the foundation also found.

Not too late

There’s still time, although not much, for Trump or even Congress to intervene and reassure health insurance companies and consumers that the federal government will resume active stewardship of the exchanges.

“It can still be salvaged,” said Christina Pearson, a senior vice president at the consulting firm Avalere Health.

Making clear that the cost-sharing reduction payments will be made through the end of next year, and that the IRS will enforce the individual mandate, would go a long way toward making 2018 better for insurance companies and their customers.

But if Trump doesn’t change his mind about all this, it will lead to to a health insurance market that simply doesn’t work as well as it could. And that will be a result of the administration caring more about highlighting the market’s failures than trying to make it as good as possible for the millions of people who use it.

The consequences, Cox said, are straightforward: “We could see less progress in covering the uninsured, or possibly even some areas of the country could see increases in the uninsured rate with people being priced out.”

Jonathan Cohn contributed reporting.

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-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 9 minutes ago.

23 Million Fewer Americans Would Have Health Coverage Under Obamacare Repeal Plan, Budget Office Confirms

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Twenty-three million fewer Americans would have insurance under legislation that House Republicans narrowly passed last month, the Congressional Budget Office reported on Wednesday.

The agency also predicted the deficit would come down by $119 billion over the next decade ― and that premiums for people buying insurance on their own would be relatively lower than those premiums would be if the Affordable Care Act stays in place.

But the reasons health insurance would be less expensive for some aren’t much to cheer about, the budget report makes clear. Prices would come down for healthy people because those who are sick or have illness in their medical histories would have less access to coverage ― and the policies available on the market would tend to be a lot less comprehensive.

In other words, the price for lower premiums would be some combination of higher out-of-pocket costs, fewer covered services, and coverage that would be harder to get for the people who need it most.

Wednesday’s assessment of the American Health Care Act ― the House bill to repeal Obamacare ― is relatively similar to the evaluations the Congressional Budget Office issued previously, when it studied earlier versions of the legislation.

But in late April, House leaders rushed to vote on the bill less than 24 hours after making significant modifications, without waiting for the budget office to study how those changes might affect insurance coverage or the federal deficit.

One of those changes would allow states to waive a rule that prohibits insurers from charging higher premiums to people at greater risk of medical problems. Without that rule in place, insurers could jack up rates for people with pre-existing conditions, effectively making standard coverage unavailable ― and violating a key promise to guarantee insurance for everybody regardless of medical status, which most Republicans had endorsed.

That one provision had the potential to require major revisions of the bill’s effects on insurance coverage and the deficit, and in the past week some observers had wondered whether the Congressional Budget Office would conclude that the bill might actually cause the deficit to increase.

Such a finding would have thrown the repeal process into chaos, because Republicans are trying to pass their legislation using the budget reconciliation process ― a special procedure that would effectively make it impossible for Democrats to block the bill using the filibuster in the Senate. But reconciliation bills must meet several conditions and one of those is that they may not cause higher deficits.

As it turns out, the Congressional Budget Office still expects the deficit to come down as a result of the legislation ― although whether the entire bill can get through reconciliation will ultimately depend on rulings from the Senate parliamentarian, who has yet to make a formal pronouncement on the legislation.

There’s no magic behind the bill’s effects on the budget deficit: The House approved a measure that slashes federal support for low- and middle-income families to obtain health coverage.

Most of the money saved by cutting hundreds of billions of dollars from Medicaid and billions more from financial assistance for those buying private health insurance will be transferred to wealthy households and health care companies in the form of tax cuts, with a small amount left over for deficit reduction.

The Affordable Care Act, President Barack Obama’s signature domestic policy achievement, brought the number of Americans without insurance to a record low. The law did so by offering tax credits for private insurance and by expanding the Medicaid program, which offers government-sponsored insurance to low-income people.

The Affordable Care Act has also prohibited insurance practices ― like placing annual or lifetime limits on benefits ― that made it difficult for people with the most serious medical problems to pay their bills. And, crucially, the law includes an outright prohibition against insurers rejecting people with pre-existing conditions or charging them higher rates than healthy people.

But to finance the coverage expansion, the Affordable Care Act raised taxes, predominantly on health care companies and the very wealthy. It also forced some people, particularly those whose relatively good health once gave them access to cheap coverage, to pay substantially higher premiums.

Some of these people have decided not to get insurance altogether, making it harder for insurers to balance their books ― to the point where many insurers have jacked up rates considerably or abandoned some local markets altogether.

Democrats have generally called for bolstering the law ― by making tax credits more generous, for example, or using government bargaining power to drive down drug prices, while leaving in place the expansions of Medicaid and all the new insurance rules.

Republicans, by contrast, have sought to weaken or eliminate those rules, and to ratchet back spending on tax credits and Medicaid ― all while rolling back Obamacare’s taxes, giving relief to the corporations and wealthy people who pay them.

The House bill would do that, and now it’s up to the Senate to consider, modify or rewrite that legislation. Even before the House bill passed, a number of Senate Republicans were raising objections about the number of people who might lose coverage as a result. Nevertheless, the Senate GOP is on track to put together legislation of their own that would massively cut back the Medicaid program and provide far less help for those who buy private insurance.

Republicans face a backlash from some voters for undoing the Affordable Care Act’s most popular provisions, and the bill violates President Donald Trump’s oft-stated promises that he would replace the Affordable Care Act with something better that covered everyone with lower premiums and lower out-of-pocket costs.

But Republicans also fear the wrath of their own core supporters, who strongly support the GOP keeping its years-old vow to repeal the Affordable Care Act.

Republican leaders in the Senate have said they hope to vote on a bill before adjourning for the August recess.

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-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 3 hours ago.

23 million fewer Americans insured under House GOP bill, says CBO

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The House Republican health care bill would leave 23 million fewer Americans with health insurance by 2026 than under Obamacare, the nonpartisan Congressional Budget Office said Wednesday. Reported by CNNMoney 4 hours ago.

The Fenway Institute: President Trump's Proposed Budget Would Sharply Cut HIV and Chronic Disease Prevention, Eliminate Important HIV Care Programs

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If enacted, budget budget would sharply reduce spending for healthcare and disease prevention

BOSTON, MA (PRWEB) May 24, 2017

This week, President Trump released a proposed budget that, if enacted, would sharply reduce spending for healthcare and disease prevention. The proposed budget would cut Medicaid by $800 billion over 10 years. It would also cut the Children’s Health Insurance Plan (CHIP) by 20% over the next two years. One in three American children—46 million in total—receive health care either through Medicaid or CHIP. People living with HIV, Black and Latino people, and the children living in these families would be among those most affected by Trump’s $4 trillion budget, which sets government spending priorities for the fiscal year that begins in October.

“The Trump-Pence Administration’s proposed budget would dismantle the public health infrastructure first put in place by Lyndon Johnson’s Great Society Program in 1965,” said Sean Cahill, PhD, Director of Health Policy Research at The Fenway Institute. “Black and Latino people, people living with HIV, and children living in poverty experience poorer health and health outcomes than the general population. They rely disproportionately on Medicaid and CHIP. These cuts will be devastating to some of the most vulnerable people in our society.”

Some of the more worrisome Trump-Pence Administration budget proposals include the following:· A 16.6% cut in funding for the prevention of HIV/AIDS, viral hepatitis, sexually transmitted disease, and tuberculosis at the Centers for Disease Control and Prevention. Of the approximately 40,000 Americans newly diagnosed with HIV each year, nearly half are African American, and about two-thirds are gay and bisexual men or transgender women. Nearly 20 million new sexually transmitted diseases are diagnosed each year in the U.S., half of them among 15- to 24-year-olds. Diagnoses of chlamydia, gonorrhea, and syphilis are increasing and cost an estimated $16 billion a year to treat. Funding for the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention is critical to address these health concerns. Because we don't have a cure or vaccine for HIV and STDs, cutting funding for evidence-based detection and prevention programs guarantees that these epidemics will continue to grow, costing more resources later.
· Reduced funding of the Ryan White HIV/AIDS Program (a cut of $59 million). The program is critical to the people living in the U.S. with HIV, a population that increases annually as approximately 40,000 people are newly diagnosed with HIV each year and people live longer thanks to better antiretroviral medications. Additionally, the Ryan White HIV/AIDS Program would become even more critical if people living with HIV lose subsidized marketplace insurance or Medicaid if the Affordable Care Act is repealed and replaced by the American Health Care Act. The Ryan White Program has been essentially flat funded since the early 2000s, even though the number of people accessing Ryan White services has nearly doubled, and the value of the funding has decreased due to inflation.
· Total elimination of AIDS Education and Training Centers and Special Projects of National Significance, which are run under the auspices of the Ryan White HIV/AIDS Program. The education and training centers and the special projects program are laboratories of innovation in finding ways to keep people with HIV engaged in the healthcare system, particularly those who have long experienced discrimination in healthcare settings—such as transgender people—and those who face unique challenges and issues, such as formerly incarcerated people and older adults living with HIV. When people with HIV are able to sustain their healthcare treatment regimens, their viral load lowers, which makes it much more difficult to transmit the virus to other people. The education centers and special projects program also assist with rapid response to outbreaks of disease. When nearly 200 people were diagnosed with HIV in rural Scott County, Indiana over a 15-month period in 2014-15, the Midwest AIDS Education and Training Centers provided in-depth training to doctors and care providers in the area and helped get those newly diagnosed with HIV into immediate care.
· A reduction in funding for the National Institutes of Health of $5.7 billion, or 17.4% overall, for FY18. The Trump budget would cut funding for the National Institute of Allergy and Infectious Diseases, where most HIV/AIDS research is conducted, by $838 million, an 18.1% cut.
· A reduction of $1.1 billion in funding for treatment of people living with HIV in Africa and other parts of the world. amfAR estimates that this cut of nearly 20% in global HIV funding would cost more than 1 million lives and cause 300,000 children to become orphans.
· A 13.1% cut in funding for the Office of Civil Rights at the Department of Health and Human Services, and a 36.7% cut in funding for the Office of the National Coordinator for Health Information Technology. Under the Obama Administration, Office of Civil Rights was instrumental in promoting nondiscriminatory care for transgender patients. The Office of the National Coordinator for Health Information Technology has led important efforts to shift the U.S. health system from paper medical records to electronic health records, and has promoted the collection of sexual orientation and gender identity data from patients to better understand and address LGBT health disparities.
· President Trump’s proposed budget cuts funding for a number of other important centers for research at the CDC. For example, the proposed budget would cut funding for the National Center for Chronic Disease Prevention and Health Promotion by 18.9%. Chronic diseases like obesity, diabetes, and heart disease are major drivers of rising health care costs in the U.S. Funding for the Center for Global Health would be cut by 17.8%. The proposed budget would also cut the Prevention and Public Health Fund, which was created by the Affordable Care Act and currently funds many important public health projects and initiatives at the CDC, by 37.3%.

“This budget proposes a radical rejection of the social compact that has sustained our country for half a century,” Cahill added. “It would also undermine important progress we have made in preventing and treating HIV here and in Africa. It casts our most vulnerable people aside and leaves them to fend for themselves without the resources they need to succeed.”

Since 1971, Fenway Health has been working to make life healthier for the people in our neighborhood, the LGBT community, people living with HIV/AIDS and the broader population. The Fenway Institute at Fenway Health is an interdisciplinary center for research, training, education and policy development focusing on national and international health issues. Fenway’s Sidney Borum Jr. Health Center cares for youth and young adults ages 12 to 29 who may not feel comfortable going anywhere else, including those who are LGBT or just figuring things out; homeless; struggling with substance use; or living with HIV/AIDS. In 2013, AIDS Action Committee of Massachusetts joined the Fenway Health family, allowing both organizations to improve delivery of care and services across the state and beyond. Reported by PRWeb 4 hours ago.

Trump's newest healthcare bill will cause 23 million to lose insurance, says CBO

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Donald Trump's revised American Health Care Act (AHCA) - the replacement for Obamacare - would leave 23 million Americans without health insurance by 2026, the Congressional Budget Office (CBO) has found. Reported by Independent 3 hours ago.

Estimated 23 mln would lose health insurance under Republican bill -CBO

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The CBO score raises the stakes for Republican senators working on their own version of legislation passed by the House of Representatives earlier this month. Reported by DNA 3 hours ago.
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