Archbishop William Lori of Baltimore, chairman of the US Bishops’ Ad Hoc Committee for Religious Liberty, welcomed news reports that the Trump administration is planning to broaden the scope of exemptions from the HHS mandate, which requires health insurance coverage of sterilization, contraception, and potential abortifacients. Reported by Catholic Culture 17 hours ago.

Embrace Pet Insurance celebrates reaching 100,000 protected pets.

Cleveland, OH (PRWEB) June 09, 2017

Embrace Pet Insurance celebrated a monumental achievement last Friday when it insured its 100,000th pet.

Embrace celebrated by encouraging social followers to nominate their favorite pet charity via Facebook. The randomly-selected winner, Bullies 2 The Rescue from Indian Trail, North Carolina, will receive a $1,000 donation to continue their mission to rehabilitate and rehome mistreated and abandoned bulldogs.

“We love our relationship with every single Embraced pet parent and their pets. It’s wonderful to see so many pets over the years benefiting from Embrace’s top-quality coverage,” said Laura Bennett, Chief Operations Officers and Co-Founder.

The first Embraced pet, a 12-year-old cat named Lily from Chagrin Falls, OH, was insured in 2006. Since then, Embrace has grown to over 100 employees and paid out more than $87.4 million in claims.

In tribute to the many unique and wonderful pets Embrace is proud to protect, a 12’ tall by 25’ wide photo mosaic wall was recently installed at their pet-friendly headquarters in Warrensville Heights, Ohio. The piece features photos of more than 2,500 Embraced pets that come together to create a larger image of Embrace’s logo.

Embrace Pet Insurance is an industry leader that has been in the marketplace for more than ten years. Veterinary hospitals across the country are already taking advantage of their new web-based application, Embrace360™, which electronically streamlines the claim submission process. With top customer ratings on review sites such as PetInsuranceReview.com, innovative technology, and great customer service, it’s clear they are trusted by pet owners throughout the United States.

About Embrace Pet Insurance
Embrace Pet Insurance is an Ohio-based pet health insurance provider, offering comprehensive, personalized insurance products for dogs and cats across the United States. Embrace is consistently ranked as one of the highest-rated U.S. pet insurance companies and is a proud member of the North American Pet Health Insurance Association. Embrace is the only company to offer a diminishing deductible feature, the Healthy Pet Deductible™, and continues to innovate and improve the pet insurance experience for pet parents across the country.

About the North American Pet Health Insurance Association
Embrace is a proud member of the North American Pet Health Insurance Association (NAPHIA). NAPHIA is comprised of reputable pet health insurance (PHI) organizations from across Canada and the United States. NAPHIA’s membership makes up over 99% of all pet health insurance coverage in effect in North America.

As a coalition, NAPHIA works to advance and grow the PHI industry through proactive research, data sharing, benchmarking initiatives, advocacy efforts, strategic partnerships, resource sharing and the dissemination of information to collaboratively address challenges and opportunities. To learn more, visit http://www.naphia.org/. Reported by PRWeb 17 hours ago.

The All-in-One Protection and Savings Plan

HONG KONG, June 9, 2017 /PRNewswire/ --* *Chubb Life in Hong Kong, the local branch of the life insurance division of Chubb, today announced the launch of *Critical Illness Combo 370* (the 'Plan'). It is a comprehensive life insurance plan with critical illness coverage, life protection and savings features. With different limited premium payment term options, the Plan provides coverage against 134 illnesses, including 69 Early Stage, Juvenile and Special Illnesses and 65 Major Illnesses, offering comprehensive protection for customers.

According to the statistics released by the Centre for Health Protection, Department of Health of the Government of the HKSAR, the number of Hong Kong people killed by diseases rose by 25% from 37,415 in 2006 to 46,662 last year. Cancer, diseases of the heart and cerebrovascular strokes are common types of critical illnesses, accounting for nearly 50% of all deaths in Hong Kong in 2016.

To address the potential threat of the major killer diseases in Hong Kong, Chubb Life's 'Criticial Illness Combo 370' Plan offers financial protection coverage starting from early stage with an Early Stage, Juvenile and Special Illness Benefit up to 50% of the Sum Assured of the Plan, and a Major Illness Benefit equivalent to 100% of the Sum Assured of the Plan. If the insured is subsequently diagnosed with cancer, heart attack or stroke after the Major Illness Benefit has been made, a maximum of two additional claim payments can be made.

In addition, in the first 10 policy years, an Extra Coverage Benefit upon valid claim for Major Illness Benefit or death benefit, is available. The Plan also helps customer accumulate wealth with a long-term savings element made up of guaranteed cash value and non-guaranteed Terminal Dividend.

Ben Ng, Chief Marketing Officer of Chubb Life in Hong Kong, said, "According to the 2015 statistic released by The Hong Kong Federation of Insurers, the average claim cost for in-patient treatment increased by about 6% to 13% comparing to 2014. With rising medical cost and improving chances of recovery from critical illness, we are launching the new Critical Illness Combo 370 featuring extensive coverage against 134 critical illnesses, additional coverage starting from early stage, protection against multiple occurrences of major illnesses and life protection up to age 100."

Customers can also enjoy Family Protection and Travel for Treatment offered by third party service provider through the Plan, providing post-hospitalization and health management support so that customers can focus on their own medical treatment and recovery. The assistance services range from assistance for follow-up treatement, hospital discharge assistance and psychological therapy, physiotherapy & occupational therapy referral services, meal delivery assistance, advisory service for care-takers, as well as arrangement for treatment abroad.

"We believe the Plan is an all-in-one solution to protect customers and their families from unexpected critical illness, offering them a better financial planning solution that can bring peace of mind," said Ben.

Note: This press release is for general reference only and is not part of the policy. It provides an overview of the key features of the product and should be read along with other materials which cover additional information about the product. Such materials include, but not limited to, product brochure that contains key product risks, policy provisions that contain exact terms and conditions, benefit illustrations (if any) and other policy documents and other relevant marketing materials, which are all available upon request. You might also consider seeking independent professional advice if needed.
This news release is intended to be published in Hong Kong and shall not be constructed as an offer to sell or solicitation to buy or provision of any products outside Hong Kong.

*About Chubb Life in Hong Kong *

Chubb is the world's largest publicly traded property and casualty insurance company.  With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse group of clients.  As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. The company is also defined by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength and local operations globally.  Parent company Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains executive offices in Zurich, New York, London and other locations, and employs approximately 31,000 people worldwide.

Chubb Life, the life insurance division of Chubb, operates in 30 countries around the world. In Asia, Chubb Life operates in Hong Kong, Indonesia, Korea, Taiwan, Thailand and Vietnam, and participates in a joint-venture in China. Chubb Life has been in Hong Kong since 1976, and launched its Global Wealth Management business from Hong Kong in 2015. To meet the financial protection and wealth management needs of its broad range of customers, Chubb Life in Hong Kong (Chubb Life Insurance Company Ltd.) offers a range of life protection, savings, accident and health insurance solutions through agents, brokers and banks.

Additional information can be found at: http://life.chubb.com/hk Reported by PR Newswire Asia 15 hours ago.

Oscar Health, the $2.7 billion health-insurance startup, is joining the ranks of businesses trying to pull healthcare data into a single platform that might be accessible to doctors treating a patient. 

Electronic health records allow doctors to get some information about your medical history. But they don't get it all — like information from an emergency room visit in another state, or notes from telemedicine appointments.

Some of that data can be important, but it's not easy to gather. 

As an insurer, Oscar is in a place to pull that information together, because it manages health insurance claims. That puts all of a patient's medical history in one place, no matter the source, Oscar's chief technology officer Alan Warren told Business Insider. 

Oscar isn't the only one to build one of these platforms. Google Health had a product that tried to do this, and Health IT giant Epic Systems operates a service called MyChart that helps patients see their information and communicate with doctors. There are also services that will store your personal health information though these are mainly managed by patients instead of doctors. 

Warren, who joined the startup in 2016, previously worked at Google and led the engineering team for the Health product there. Google Health had built a personal health information service, but the project was shut down in 2011.

*Here's how it works*

If you're an Oscar member (which, in 2017, Oscar had about 105,000 people enroll in its health plans), your doctor will have access to the Clinical Dashboard.

The dashboard pulls from Oscar's claims records and other data that Oscar collects about the patients' medical history to give the doctor more context on a person's health than what they might learn with their electronic health record alone. From there, Oscar plans to use machine learning to pull up the most relevant information out of all those records. Plus, because this is attached to an insurer, the doctor will also get to look in and see how much a particular treatment might cost the patient. 

Here's what it'll look like:

This is just the first phase, Warren said. For now, the team will be making sure the information that makes its way in front of the doctor is actually useful, especially in cases where patients have a complex medical history. And there will be some data that won't be available. Any information that needs explicit consent before sharing, such as genetic information, won't be bundled into the dashboard. 

To start, the Clinical Dashboard will only be available to Oscar's team of virtual doctors and those at the Oscar Center in Brooklyn. Eventually, the hope is to roll it out to all of Oscar's in-network providers.

*SEE ALSO: A new kind of doctor's office charges a monthly fee and doesn't take insurance — and it could be the future of medicine*

*DON'T MISS: A startup CEO who watched his 84-year-old mother struggle after leaving the hospital is on a mission to change healthcare from the 'inside out'*

Join the conversation about this story »

NOW WATCH: I wear these computer glasses every day even though I have perfect vision — here's why Reported by Business Insider 10 hours ago.

MCMURRAY, Pa.--(BUSINESS WIRE)--Mark Farrah Associates assessed trends in enrollment, segment profitability and premiums found from their analysis of the Supplemental Health Care Exhibit (SHCE). Reported by Business Wire 8 hours ago.

A big Blue Cross-Blue Shield insurer is returning to the Affordable Care Act's health insurance exchanges next year in several states, including markets like Texas and Illinois. Coverage options are growing thin in many parts of the country on the exchanges, the only place where people can buy insurance with help from income-based tax credits. Reported by SeattlePI.com 8 hours ago.

The man tasked with overseeing Gizmodo Media Group in the wake of the demise of Gawker.com says he never regularly read the site in the first place.

"I'm well past the demographic they were aiming for," CEO Raju Narisetti said in an interview. "If you ask me if it was a place I spent a lot of time on on a daily basis, the answer is no."

Narisetti is leading GMG through the media company's merger with Fusion Media Group, which is owned by the Spanish-language juggernaut Univision. According to the CEO, the transition has been a success.

But conversations with over a dozen current and former employees painted a starkly different picture.

Since the deal, the six former Gawker Media sites — Gizmodo, Jezebel, Deadspin, Kotaku, Jalopnik, and Lifehacker — have struggled with indecision, a dysfunctional bureaucracy, and an exodus of top leadership and institutional knowledge that gave Gawker Media its editorial bite.

Mergers have a tendency to be messy, and Gawker Media's entry into Univision's portfolio is far from the most troubled media acquisition in recent history.

News Corp. bungled its mid-2000s takeover of Myspace after failing to cater to the social-media platform's users and trying to monetize the site too quickly, for example, while the 2000 merger of then newspaper giants Tribune Media and Times Mirror Co. generated massive turnover at the company, public infighting among shareholders, and eventually bankruptcy. Then there's the infamous AOL-Time Warner deal, and AOL's current complicated merger with Yahoo.

Still, many GMG staffers wonder what will remain of the clever, fearless attitude that defined the sites for millions of readers and set the tone for much of the independent web.

"A lot of people who made Gawker Media what it was have either left or been so beaten down that the company it used to be doesn't exist anymore," one GMG employee said.

"Some of the Gawker ethos is sort of showing up in the publications that people have dispersed to, but it's never going to be the same. Univision claimed that they wanted to buy Gawker because they believe in 'fearless journalism,' but every decision they've made seems to be an effort to either water the Gawker spirit down as much as possible or just bolster Fusion TV in some way."

*A 'pretty good,' 'challenging' year*

Univision bought Gawker Media last August in a fire sale. It shuttered the iconic Gawker.com, which was viewed as toxic after a court ordered Gawker Media to pay Terry Bollea — aka Hulk Hogan — $140 million for publishing a sex tape featuring the wrestler. The lawsuit was secretly funded by Peter Thiel, the early Facebook investor and board member who was publicly outed by the publication as gay years earlier.

The company bought Gawker Media, which it renamed Gizmodo Media Group, with the hope of broadening the audience to become the voice and reflection of an increasingly diverse young America, with a slightly less intense editorial focus on the trademark skepticism and disdain for powerful interests.

Now, several months into the merger, Narisetti said that contrary to the "conventional wisdom," data shows it's been a "pretty good" few months since the six sites were bought by Univision and joined with Fusion.net and The Root.

The CEO, who joined GMG in October from News Corp., rattled off top-line statistics that showed a company growing after a tumultuous multiyear legal battle with Hogan that took the company from a $250 million valuation to bankruptcy.

Narisetti said last week that even after he had hired 53 new full-time staffers across the websites, the company remained under budget and on target to experience a 30% increase in revenue across the sites in one year.

Traffic to the sites has remained steady at about 90 million monthly unique visitors since he took over in October, certainly an accomplishment considering Fusion's notoriously poor online traffic and the loss of the 15 million to 16 million monthly uniques that Gawker's flagship website generated.

Other Fusion Media Group sites that were integrated into the GMG portfolio have thrived. Since transitioning over to GMG's Kinja operating system in January, the African-American digital magazine The Root has 35% more uniques each month than it did in the same months last year.

Narisetti's longer-term goal is to turn the network of sites into a publication catering to a diverse, young America of the future. By 2028, Narisetti said, "a majority of young Americans will be nonwhite."

"Our view is," he added, "while there are a lot of go-to brands for Americans today, there aren't a lot of go-to brands for what is going to be a much more diverse young America."

But he acknowledges it hasn't always been easy to execute that vision.

"At an all-hands I joked, 'I've never lost more sleep and gained more weight in the same period,'" Narisetti said. "It's been a great and a challenging year."

For many GMG employees, "challenging" is an understated description of the past several months.

*The Gawker ethos is fading*

Conversations with more than a dozen current and former staffers over the past several weeks detailed a difficult integration that has chipped away the spirit and ethos of Gawker Media, founded 14 years ago by Nick Denton as two blogs covering media and tech gossip, which eventually evolved into the fiercely independent, proudly standoffish, endlessly navel-gazing media company targeted by Thiel and Hogan.

Staffers say they felt initial relief after Univision beat out the media company Ziff Davis to buy GMG out of bankruptcy for $135 million. But now the environment is, as one employee put it, "toxic," and as downcast as it was during some of the Hogan trial.

"Every day, morale got worse because it felt like Univision was determined to stamp out all the great things about working at Gawker Media," one former GMG staffer told Business Insider. "They had no interest in maintaining our editorial philosophy, having a functioning HR department, or retaining key talent."

In the nine months since the acquisition, the company formerly known as Gawker Media has seen an exodus of top talent and leadership.

Heather Dietrick, the president of Gawker Media and then of GMG, left in May for The Daily Beast. The editorial team's second-in-command, deputy executive editor Lacey Donohue, left in late 2016 and was followed by the executive managing editor, Katie Drummond, in March. Matt Hardigree left the company in May after working as the editor of Jalopnik and partnerships. High-profile reporters like Christina Warren and Ashley Feinberg have also left the company in recent weeks.

The heads of the human resources and legal departments, both figures with outsize power and importance at the formerly independent, freewheeling company, also departed in the early months of the acquisition.

Business Insider has counted the resignations of at least 26 former Gawker Media employees since the merger, many of them in editorial-leadership positions.

**GMG's women in leadership**

After years of questions about its own relationship with female leaders at the company, the final iteration of Gawker Media was one with women in the most senior roles in the company, a source of pride and loyalty for many staffers.

But months later, with top leaders departing, some employees wonder whether the company is doing enough to persuade respected female leaders to remain, and if the company will suffer from the talent and leadership losses its already experienced.

"People are really worried about this," one GMG employee said. "Just since Katie left, we've lost our president, our top video journalist, and our best reporter, and that's after a big all-hands meeting where people were really clear about how alarming the pattern was.

"There are women being promoted or hired into positions of power, and I'm sure there will be more, but even if the higher-ups do all the right things from now on, it's not like you can really fix it, because you've lost so many of the people who made the place what it was at its best."

As WWD reported, after Drummond's departure in March, the editorial union wrote a strongly worded letter to management criticizing the loss of top female leaders.

"We were extremely alarmed to hear that Katie Drummond will not become executive editor and instead leave Gizmodo Media," the letter said.

"It continues a disturbing pattern of top management's failure to retain women in positions of authority, and raises serious concerns about the company's commitment to honor its contractual obligation to editorial independence. Further, it is yet another sign that Univision still has not found a way to manage the successful independent media company it acquired months ago."

Drummond's departure remains a source of tension.

According to multiple sources familiar with the situation, Drummond was paid significantly less than the company’s previous top editor, John Cook, while essentially filling in for him for several months without a title change. And when she was offered the title of executive editor, the sources say, Drummond was told it was "rude" to ask for a raise.

Narisetti told Business Insider that although he would not discuss private discussions of compensation, the characterization was inaccurate, as Drummond was assisted by the newly created role of deputy executive managing editor specifically created to support her while the company mulled who would fill the executive editor position that would oversee now eight sites, including The Root and Fusion.

At the same time, two sources said, Dietrick "was almost completely sidelined" by management after the acquisition late last year, as Narisetti and others assumed many of her previous responsibilities.

Narisetti dismissed charges that GMG's struggle to retain women in top roles was a cultural problem at the company.

Though he said he was "not minimizing" the effect many top women like Dietrick and Drummond had during the past several years, he pointed out that GMG's editorial leadership remained slightly more female than male, and he emphasized he was not "going to play defense on it."

"Our ​track record ​and actual data ​on compensation, raises, promotions, diversity​,​ as well as our ability to attract and retain employees​ who ​want to​ ​stay dedicated to the impactful journalism being done ​every day a​cross​ GMG​, more than ​speaks for itself," Narisetti said in a statement.

"I'm more concerned about my character than my reputation, because my character is who I am and my reputation is what others think I am," he said previously. "One is permanent, and one is changeable based on people's views. I have no doubt that we've lost some people and no less and no more than a lot of companies do in the first year of an acquisition and a merger and an integration."

*'An unexpectedly bumpy transition'*

Beyond struggling with holding together the former Gawker editorial team and mission, Univision also lost the confidence of many employees with basic operational issues that surfaced while it tried to integrate its new acquisition.

Numerous bureaucratic problems became almost immediately apparent, making the formerly nimble independent company feel like a dysfunctional cog in a massive, sluggish machine. For example, employees say Univision's teams responded slowly or were unresponsive to significant payroll and benefits problems that roiled the company for months.

The company delayed annual raises, they continued, and multiple staffers received accidental notes that stated other employees' salaries. According to two sources with direct knowledge of the incident, one GMG editorial staffer was accidentally sent a list of individual salaries for the entire editorial union, amounting to hundreds of people. In it, the person discovered that a peer in the editorial staff was being paid more than $400,000, a significantly higher number than most of the newsroom.

Employees faced similar problems with benefits.

Several employees say they had their insurance denied on visits to the doctor and were unable to pick up prescriptions. Others were charged for insurance they did not select, a source said. Two people recalled a top site editor having their newborn child go weeks without health-insurance benefits.

Narisetti acknowledged that payroll and benefit issues had been a source of anxiety for the staff, telling Business Insider that the company "didn't have a plan B in place" when Gawker's HR team left en masse.

In an all-staff email sent in February that was provided to Business Insider, the CEO apologized and said GMG was working on the issues, though benefits and HR problems persisted to the point that the editorial union in April gave the company a one-month deadline to resolve them.

"It has been an unexpectedly bumpy transition, to put it mildly," he wrote. "And I want to personally acknowledge and apologize on behalf of Univision, FMG and GMG, for all the stress and angst this is causing. Like all of you, I am also inclined to focus on our journalistic and business challenges than dissipate any of our time and energy on fighting internal issues. But we clearly need to get these internal issues in order and we will."

*'Water down the Gawker spirit'*

For its part, GMG has made explicit attempts to continue Gawker's history of provocative investigations.

Cook — who moved from executive editor to oversee the special-projects desk — oversees a team primarily made up of former Gawker writers.

He told Nieman Lab last month that the creation of the investigations unit "sort of offset the loss of Gawker" by continuing to pursue provocative investigations such as showing it to be quite easy to spear-phish top government officials.



When Peter Thiel killed Gawker he forgot to kill its brains: https://t.co/AAVLP1AQo5

— Jack Shafer (@jackshafer) May 17, 2017

"From a distance, it seems like the acquirer values the investigative journalism from John Cook and his team," Denton, the Gawker founder, told Business Insider in an email when asked about the merger. "I'm glad to see Univision's support for investigative journalism at Gizmodo."

But GMG staffers are also having to adjust to a new environment under heightened internal legal scrutiny.

Stories have also had to clear higher legal barriers in a way that some employees feel is overly cautious and almost distrustful of the sites' aggressive, provocative journalism, but the company says is the standard operating procedure for most major media organizations.

According to employees with knowledge of the process, staff members on the special-projects desk are required to get the site's legal team to sign off on any story they write, even basic blog posts with no original reporting, and still have no official website months after launching, negotiating with other GMG sites about which site might best host an investigation.

Four current and former employees said the site's legal team was very cautious of publishing exclusives about Thiel's personal life and intentionally slowed reporting related to the tech billionaire, who financially supported the lawsuit that bankrupted Gawker.

In an email to members in June obtained by Business Insider, the editorial union said it unsuccessfully tried to remove a non-disparagement clause from separation agreements. Non-disparagement clauses are commonplace in separation agreements, but some employees have taken them as a sign of hostility from management to staff.

Staffers say they were similarly infuriated by the company's decision to remove controversial posts tied up in litigation and, without an official company policy, fear that it could happen again.

"It was extremely difficult to watch Univision's lawyer decline the opportunity to defend their own colleagues' work against a malicious legal attack," one GMG employee told Business Insider. "People are absolutely concerned that Univision will try to remove posts in the future."

FMG and GMG managers have also shied away at points from easy opportunities to hat-tip Gawker's legacy.

When in February staffers tried to host a public screening of "Nobody Speak: Trails of the Free Press," a documentary about Gawker's battle with Hogan, Narisetti, upon consulting with Univision executives, initially vetoed the proposal, eventually allowing only a private, staff-only screening of the film.

In an email praising the "rich, collective past/legacy" of Gawker, Narisetti noted that the company implemented a policy of not engaging in discussions or debates on Gawker Media estate issues.

"We continue to face some ongoing business challenges around effectively communicating the premise and promise of the new GMG/FMG, and to keep moving ahead in 2017, as we continue to still be hobbled by some (diminishing) past business perceptions," he wrote. "That is somewhat relevant in this particular context — though quite secondary to the company policy of not discussing Gawker issues — as a public forum/panel around the movie, hosted by FMG/GMG, can easily and unnecessarily add to that ongoing challenge." 

*'That was a rough six months'*

Narisetti argued that the hardest part of the transition was behind GMG.

Several employees who lamented the mess of payroll and benefits said that since the company brought on a new HR representative last month, fewer problems had spilled out into the open.

The company, too, has prepared to begin seriously building out the GMG properties for the first time since the merger.

Fusion, which confusingly ceded its Fusion.net domain last month to the Fusion television channel, is set to relaunch with a new domain name in June.

In addition to a parenting site it launched last week, according to one source, the company plans to launch at least three new sites. (Narisetti hinted at food, music, and the environment, though Business Insider could not confirm the details.)

The Univision-owned AV Club and Onion websites are expected to migrate over to Kinja during the slower summer months, creating one universal content management system and allowing the company to increase revenue by selling the entire package of sites to advertisers as a whole.

"My view is that we look back next year and say, 'That was a rough six months,'" Narisetti said. "Our journalism has held out, we're producing great stories. I use the famous Ronald Reagan line, which is, 'If you're committing acts of journalism at GMG, are you better off today than you were seven months ago?' I think almost everybody will have to answer the question 'yes.'"

Join the conversation about this story »

NOW WATCH: These size comparisons show the true scale of enormous things Reported by Business Insider 7 hours ago.

Sen. Claire McCaskill (D-Mo.) lit into some her Republican colleagues on Thursday for writing legislation that would repeal the Affordable Care Act behind closed doors and without formal hearings in order to rush a floor vote and pass legislation along party lines.

“We have no idea what’s being proposed,” McCaskill said. “There’s a group of guys in a back room somewhere that are making these decisions. … We’re not even gonna have a hearing on a bill that impacts one-sixth of our economy. We’re not gonna have an opportunity to offer a single amendment.”

McCaskill happens to be right. Ripping the guts out of the Affordable Care Act, commonly known as Obamacare, and putting a new coverage system in place would be every bit as consequential as she described. Health care really does account for one-sixth of the U.S. economy.

And if the new health care legislation ends up looking like the American Health Care Act, the Republican bill that the House of Representatives passed in early May, it could easily affect health insurance arrangements for the majority of Americans ― most obviously, by depriving 23 million people of coverage altogether, according to projections by the Congressional Budget Office. 


"Will there be a hearing on the health care proposal?" Senator @clairecmc asked today in the Finance Cmte. You should watch: #Trumpcare pic.twitter.com/rmKB0rGnTM

— Senate Democrats (@SenateDems) June 9, 2017

When the House passed its bill, rushing so quickly that it couldn’t even wait for the CBO to issue its final analysis, Republican senators swore that they would do things differently. But the process in the Senate looks more and more familiar. Neither of the two committees with jurisdiction over the bill, the Finance Committee and the Health, Education, Labor and Pensions (HELP) Committee, have held hearings on the legislation’s details ― and, as of now, neither committee is planning to do so.

Instead, according to both printed accounts and lobbyists who have spoken to HuffPost, McConnell and his allies are working quietly to stitch together a majority coalition, or something close to it, in hopes of bringing a bill directly to the floor for a vote. Republicans might keep their word about waiting for an updated CBO score, but, once they have it, they’ll likely keep the debate short.


McConnell has absorbed the most important political lesson from the GOP’s House effort ― namely, that the American Health Care Act is wildly unpopular. The more the public knows about it, the less it seems to like it.

Democratic leaders, including the ranking members on the Finance and HELP committees ― Sen. Ron Wyden (D-Ore.) and Sen. Patty Murray (D-Wash.) ― have sent letters calling for a more deliberative process. But they lack the power to enforce their will.

As those two senators know well, and as McCaskill pointed out on Thursday, Democrats went about writing health legislation very differently eight years ago.

Here’s a summary from HuffPost a few months ago detailing the deliberation involved in creating Obamacare:

The process that first produced Obamacare in 2009 and 2010 unfolded a bit differently. It featured its share of backroom deals and at least one big vow that Democrats would break. (“If you like your health care plan, you can keep it.”) But it also featured more than a year of public deliberation, including upwards of 130 hearings across the five committees, according to a tally that Democratic staffers compiled at the time.  

Many of these hearings included testimony from both liberal and conservative experts, with opportunities for tough questions by both parties. And that followed a presidential campaign in which the Democratic candidates, including the eventual nominee and future president, coalesced quickly around a model for reform and spent their time litigating their relatively narrow disputes in detail. 

In case it’s not self-evident, McConnell’s decision to avoid this kind of process has nothing to do with making good policy. However tedious hearings may seem, they offer a chance for outsiders ― the media, the experts and eventually, the public ― to learn about legislation and develop opinions about it.

And that’s what happened in 2009 and 2010 ― even if lawmakers ended up talking too much about some fake issues (like “death panels”) and not enough about some real ones (like how new regulations would affect existing insurance plans). The process gave everybody a long time to contemplate reform and what it would mean.

But McConnell has absorbed the most important political lesson from the GOP’s House effort ― namely, that the American Health Care Act is wildly unpopular. The more the public knows about it, the less it seems to like it.

It was only after the bill appeared to fail in the House, and attention turned elsewhere, that Republican leaders were able to modify it and put together the votes they needed for passage ― and then stage a vote before opposition could mobilize all over again. 

By avoiding public scrutiny for as long as possible, and keeping the final debate brief, McConnell is trying to pull off a similar feat in his chamber. 

The question now is whether he’ll get away with it.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 6 hours ago.

The Americans who need the most help to afford health care will get the least under Republicans’ Obamacare replacement plan, according to a new analysis.

The American Health Care Act would put health insurance out of reach for the most vulnerable ― namely older, low-income people, the progressive Center on Budget and Policy Priorities reports in a paper published this week. House Republicans passed the legislation last month, and Senate Republicans are using it as the basis for a bill they aim to move swiftly through the upper chamber.

See the HuffPost infographic below for more information about health insurance costs under the American Health Care Act.

People currently covered by Medicaid would lose their coverage under the Republican proposal, and would be eligible for significantly less help paying for private health insurance.

The poor could face premiums that amount to more than they earn in a year, depending on the state in which they live. In New Hampshire, a 60-year-old with an income at or below poverty ― projected to be $12,600 in the continental United States in 2019 ― would have to pay 45 percent of her income on health insurance under the new law.

She’d be lucky. In nearly all of the 39 states the report surveyed, the cost of insurance would be more than a poor person’s income for the year. In Alaska, it’s an eye-popping 188 percent of the total ― in other words, unaffordable.

For the nation’s poorest, the new law is even bleaker. In New Hampshire, a 60-year-old with an income at half the poverty level would have to pay 90 percent of her income on health insurance. Again, she’d be lucky: Costs go up from there in the surveyed states. Insurance in Alaska, again an outlier, would cost 376 percent of income.

The GOP bill would eliminate major parts of the Affordable Care Act, including its Medicaid expansion and key consumer-protection rules, including those for people with pre-existing conditions. It would also fundamentally alter the Medicaid program itself, reducing its funding by one-quarter and allowing states to redesign the benefit to cover fewer people and services.

In contrast, the Affordable Care Act pegs its financial assistance to income ― not age, like the GOP bill does ― and its tax credits are more generous. Under the ACA, lowest-income enrollees pay nothing for Medicaid in states that expanded the program under Obamacare, and no more than 2 percent of income in states that didn’t. The poorest exchange customers also receive extra help covering out-of-pocket costs, which the Republican bill repeals. 

The Center on Budget and Policy Priorities’ report fleshes out the Congressional Budget Office’s findings about the American Health Care Act. According to the CBO, 23 million fewer people would have health coverage under the bill, compared to under the Affordable Care Act.

The budget office further found that while younger consumers may be able to find cheaper insurance, it would cover less and come with higher deductibles. And a primary reason for those lower costs is that older and sicker people ― who are costlier to insure ― would be priced out of the market.The Center on Budget and Policy Priorities based its findings on data from the Congressional Budget Office and other sources. The report only includes projections for the 39 states that have federally run health insurance exchanges accessed via HealthCare.gov. Data were not available for states with their own exchanges, like California and Idaho, the think tank explains.Politics hurt too much? Sign up for HuffPost Hill, a humorous evening roundup featuring scoops
from HuffPost’s reporting team and juicy miscellanea from around the web.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 5 hours ago.

OLDWICK, N.J.--(BUSINESS WIRE)--The sweeping changes and uncertainty in the U.S. health care industry increasingly are being felt by provider-owned health insurance plans, with 52.6% reporting an underwriting loss in 2016, according to a new A.M. Best special report. The Best’s Special Report, titled, “Growing Pains as More Providers Set-Up Their Own Health Plans,” states that the total population of plans in this report experienced a $1.2 billion underwriting gain in 2016; however, the underwr Reported by Business Wire 5 hours ago.

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President Donald Trump and Secretary of State Rex Tillerson espoused incompatible views of policy toward Qatar, but it’s OK because the Middle East is far too stable to be affected by what America does. If Trump really does have tapes of his conversations with Jim Comey, they’d still be ― at best ― the second-most embarrassing recording of him after that Pizza Hut commercial. And now that Infrastructure Week is almost over, let’s give a round applause for the White House’s uncanny impression of America’s crumbling bridges. This is HUFFPOST HILL for Friday, June 9th, 2017:

*PROMPTING THE QUESTION: DOES TRUMP KNOW WHAT AN OATH IS? *And this would definitely, totally prevent him from lying! Elise Foley and Arthur Delaney: “President Donald Trump said he was ‘100 percent’ willing to testify under oath about his conversations with former FBI Director James Comey, who claims the president inappropriately pressured him to drop an investigation…. *One way to help resolve the matter would be for Trump to release the ‘tapes’ he suggested he has of conversations with Comey.* The former FBI director said Thursday that he hoped Trump would release recordings ― but the president still won’t say whether they exist. *‘I’ll tell you about that in the very near future,’ Trump said*.... Trump later said in response to another question about tapes: ‘You’re going to be very disappointed when you hear the answer.’” [HuffPost]

*Trump also accused Comey of perjury. *“President Trump on Friday accused James B. Comey, the former F.B.I. director, of lying under oath to Congress in testimony that the president dismissed as a politically motivated proceeding. Mr. Trump also asserted that Mr. Comey’s comments on Thursday, in which the former F.B.I. director implied that the president fired him for pressing forward with the Russia investigation, had failed to prove any collusion between the Trump campaign and Moscow nor any obstruction of justice.” [NYT’s Julie Hirschfeld-Davis and Glenn Thrush]


Despite so many false statements and lies, total and complete vindication...and WOW, Comey is a leaker!

— Donald J. Trump (@realDonaldTrump) June 9, 2017

*COMEY MUST BE QUAKING IN HIS BOOTS - *Nostalgia for Republicans decrying frivolous lawsuits is at an all-time high. Christina Wilkie: “President Donald Trump’s personal defense lawyer threatened Friday to file legal complaints against former FBI Director James Comey, over Comey’s decision to give his longtime friend notes he had written after his conversation with Trump…. But according to legal experts,* filing a complaint against Comey to the Justice Department, his former employer, after he was already fired is effectively pointless*…. Trump’s lawyer claimed Thursday that the memo was somehow ‘privileged,’ but he did not explain what he meant by that. The memo was not classified, and Trump did not invoke executive privilege to prevent Comey from disclosing what the two men discussed.” [HuffPost]

*TRUMP SAYS QATAR IS BAD...* AP: “President Donald Trump is accusing Qatar of funding terrorism at a ‘very high level’ and says it must stop now. Trump says the country, which hosts roughly 10,000 U.S. troops and serves as a major staging base, has ‘historically been a funder of terrorism at a very high level,’” [AP]

*...RIGHT AFTER TILLERSON SAYS A VERY DIFFERENT THING - *Is anyone actually in charge? Nick Wadhams: “U.S. Secretary of State Rex Tillerson called on a Saudi Arabia-led coalition to ease its blockade of Qatar, saying that the cutoff is hindering the fight against Islamic State and provoking food shortages…. The announcement by Tillerson reflected the return of a more even-handed approach after President Donald Trump offered what seemed an offhand endorsement of the Saudi-led move, writing on Twitter on Tuesday: ‘During my recent trip to the Middle East I stated there can no longer be funding of Radical Ideology. Leaders pointed to Qatar ― look!’” [Bloomberg]


Tillerson, who called on other Arab countries to ease blockade on Qatar an hour ago, is sitting in Rose Garden watching Trump assail Qatar.

— Philip Rucker (@PhilipRucker) June 9, 2017

*SURELY EUROPE WILL BREATH A SIGH OF RELIEF -* No reason would NATO countries have to doubt Trump’s word! Willa Frej: “President Donald Trump, days after returning from a European trip to meet with NATO allies, waited until Friday to publicly announce U.S. commitment to NATO’s Article 5, the group’s collective security clause…. What’s puzzling is that the president’s staff had reportedly written a line explicitly stating his commitment into the Brussels speech, according to Politico. It was likely taken out at the last minute.” [HuffPost]

*Time for beddy-bye, Mr. President. *“House Minority Leader Nancy Pelosi (D-Calif.) has some simple advice for President Donald Trump: Go to sleep…. ‘Well, what I have advised him to do: Go to sleep,’ Pelosi said. ‘Get some sleep. Bring yourself to a place where the synapses are working.’” [HuffPost’s Hayley Miller]

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

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

*GOP LEARNS TO LOVE REDISTRIBUTION OF WEALTH - *It’s all about the direction of the redistribution, you see. Sahil Kapur: “Republicans searching for consensus on how to pay for tax cuts are beginning to weigh attacking spending in potentially sensitive areas of the budget…. Representative Jim Jordan of Ohio, a leader of the ultraconservative House Freedom Caucus, called for *$400 billion in unspecified cuts to welfare programs to help cover the cost of tax cuts*.” [Bloomberg]

*Wow, someone actually got in trouble for violating the Hatch Act.* “Dan Scavino Jr., the White House director of social media, violated a federal law that prohibits political activity by government employees, the federal agency empowered to enforce the law has concluded, citing the tweet Mr. Scavino sent in April calling for the defeat of a Republican member of Congress who has been critical of President Trump.” [NYT’s Eric Lipton]

*MCCASKILL IS SICK AND TIRED OF THIS $^ - *This hurry to pass the health care bill doesn’t exactly make Republicans look proud of it. Jonathan Cohn: “Sen. Claire McCaskill (D-Mo.) lit into some her Republican colleagues on Thursday for writing legislation that would repeal the Affordable Care Act behind closed doors and without formal hearings in order to rush a floor vote and pass legislation along party lines. *‘We have no idea what’s being proposed,’ McCaskill said.* ‘There’s a group of guys in a back room somewhere that are making these decisions.… *We’re not even gonna have a hearing on a bill that impacts one-sixth of our economy. *We’re not gonna have an opportunity to offer a single amendment.’” [HuffPost]

*ABOUT THAT HEALTH CARE BILL -* Jeffrey Young: “The poor could face premiums that amount to more than they earn in a year, depending on the state in which they live. In New Hampshire, *a 60-year-old with an income at or below poverty ― projected to be $12,600 in the continental United States in 2019 ― would have to pay 45 percent of her income on health insurance under the bill*…. For the nation’s poorest, the bill is even bleaker. In New Hampshire, a 60-year-old with an income at half the poverty level would have to pay 90 percent of her income on health insurance. Again, she’d be lucky: Costs go up from there in the surveyed states. Insurance in Alaska, again an outlier, would cost 376 percent of income.” [HuffPost]

*Oh, right — infrastructure week!* “President Donald Trump on Friday announced the creation of two new government offices, as he seeks to streamline the federal approval process for infrastructure projects and help project managers navigate bureaucratic obstacles. Mr. Trump said the new offices would help speed up work on transportation and other infrastructure projects.” [WSJ’s Michael C. Bender]

*POLLS LOOKING GOOD FOR OSSOFF - *Ariel Edwards-Levy and Grace Sparks: “Democrat Jon Ossoff may have the upper hand over Republican Karen Handel in the closely watched runoff to fill the seat for Georgia’s 6th District, according to two newly released surveys. *Ossoff holds a 7-point edge, 51 percent to 44 percent*, in a live-caller Atlanta Journal-Constitution poll conducted by Abt Associates and released Friday. Ossoff also holds a 10-point edge in favorability over Handel, the survey finds, and has more crossover appeal, taking 13 percent of the GOP vote to Handel’s 3 percent among the district’s Democrats…. The runoff is scheduled to be held June 20.” [HuffPost]

*BECAUSE YOU’VE READ THIS FAR *- Here’s a panda handler having a bad day.

*SENATOR SAYS NAUGHTY WORD -* Tee hee. Chris D’Angelo: “Sen. Kirsten Gillibrand (D-N.Y.) doesn’t mince words on the subject of whether President Donald Trump has kept his promises to the American people…. Gillibrand says,* ‘Has he kept any of these promises? No. F**k no.’* … ‘Even though we as Democrats are on the right side of almost all issues, many hardworking families haven’t felt that we’ve been fighting for them,’ she said. ‘Fundamentally, if we are not helping people, we should go the fuck home.’” [HuffPost]

*COMFORT FOOD*

- The most influential tweets in Twitter’s history.

- Why do dogs roll in poop?

- What country are international airports in?

*TWITTERAMA*


wearing American flag clothing in DC is like wearing the band's shirt to their concert

— Elle Cayabyab Gitlin (@evoque) June 3, 2017


Ready for infrastructure weekend.

— Brian Beutler (@brianbeutler) June 9, 2017


My three-year-old is sobbing that Gillibrand saying "fuck" has ruined his favorite event of the year, Personal Democracy Forum

— Tim Dotcom (@timothypmurphy) June 9, 2017

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

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 2 hours ago.

The Thai embassy in Japan has urged Thai visitors to buy more health insurance coverage before travelling to the country, where medical treatment is expensive. Reported by Bangkok Post 16 hours ago.

Last night, Washington's Insurance Commissioner Mike Kreidler sent out a press release noting that two counties in his state, Klickitat and Grays Harbor, would be left with no health insurance options in 2018.  Per the press release, the ~3,330 people in those counties currently signed up on the exchange would be able to buy insurance through the state's high-risk pool but they would lose access to taxpayer-funded subsidies.



Currently, no insurer has filed plans in two counties – Klickitat and Grays Harbor.

 

*As of March 2017, 1,119 people in Klickitat County and 2,227 in Grays Harbor County were enrolled in the individual market.*

 

Under current state law, if no health insurer is available in a particular county, the only coverage option is through Washington state’s high-risk pool, WSHIP. However, because WSHIP is not a qualified Exchange insurer, *subsidies would not be available.*



And while it's not terribly surprising that the Obamacare markets are collapsing in the state of Washington (they're collapsing everywhere, just see here, here and here for a couple of examples), *what is somewhat 'surprising' is that Washington's Insurance Commissioner has decided to place the full blame for Obamacare's collapse, which has been ongoing and obvious for several years now, at the feet of the Trump administration.*



*“I’m deeply troubled by the changes we’re seeing for next year’s health insurance market,”* said Kreidler. *“The proposed drop in insurers and coverage areas clearly indicates to me that the uncertainty the Trump administration and the GOP-controlled Congress has sowed for months is sabotaging the progress we’ve made.* Their actions, including failing to commit to fund the cost-sharing subsidies, not enforcing the individual mandate, and continuing to push in secret the severely flawed American Health Care Act are eroding confidence health insurers have in the market here and across the nation. These actions only increase premiums and decrease insurer participation.

 

*“The Affordable Care Act has worked in Washington state* because we fully embraced the reforms it offered – including expanding Medicaid and creating our own state Exchange. These decisions helped increase competition, provided better coverage and access, and fueled the largest drop in our uninsured in decades. Much more could be done to improve upon our progress, but that would take congressional action focused on shoring up the law, versus taking it down.

 

*“For months, we’ve worked closely with our health insurers and other stakeholders in a concerted effort to try to explain to the Trump administration and congressional leaders what the impact could be to our market* and most importantly, to our consumers, if this level of uncertainty and volatility continued. Today, our predictions came true."



*And while we have every confidence that Kreidler would never attempt to mislead the residents of his state and/or engage in outright fearmongering for political purposes, we would kindly remind him that the insurance markets in his state, much like the rest of the country, collapsed in the 2017 plan year.*  Moreover, even though he should be aware, Kreidler seems to forget that 2017 participation and plan rates were set in the summer of 2016, when Hillary was expected by almost every pollster in the country to be on the verge of a blowout victory.

 

We would also remind the Commissioner that *lawsuits challenging the constitutional basis of Obama's healthcare 'penalties', which are mandatory and kinda sorta behave like...oh we don't know....a tax, also started long before Trump took office.*  But sure, it's Trump's fault.  Reported by Zero Hedge 1 day ago.

Murphy’s leadership strengthens board of directors

Dallas, Texas (PRWEB) June 10, 2017

HealthSmart is pleased to announce the appointment of John M. Murphy to the Board of Directors. He is a senior executive in the health insurance industry, whose wide range of skills include managing profit/loss, mergers/acquisitions and leading health plans and brokerage firms.

Murphy was the Managing Director of Wells Fargo Insurance Services USA, Inc. from 2005 to 2013 and was responsible for managing all aspects of the company. He served at Anthem, Inc. for 17 years as a Senior Officer and was instrumental in preparing the public offerings of both Acordia, Inc. in 1992 and Anthem, Inc. in 2001. From 2000 to 2005, he served as President of Anthem Specialty Business, which included Prescription, Behavioral, Life, Dental and Vision benefits, increasing revenue from $300M to $1.2B. Murphy also served as General Manager and Head of Operations at Anthem Midwest from 1997 to 2000.

Previously, Murphy served as President and CEO of Acordia Senior Personal Benefits, President and CEO of Anthem Life of Indiana, and Vice President of Marketing at American National Insurance Company. He began his career as an auditor for the New York Insurance Department and later as Chief Accountant for GEICO.

Murphy has been President of the Ivy Tech Community College Foundation since 2013. He has been instrumental in making it the largest community college foundation in the United States, by increasing major gifts, fund donations and creating a collaborative, teamwork-based culture.

“We provide every service that plan sponsors need to reduce healthcare costs; we manage members with dignity and respect—a mark of our excellence in service. John’s vast experience and personality make him a perfect fit and leader for our Board and our Company,” said Phil Christianson, CEO.

“I am honored to join the HealthSmart Board of Directors and look forward to working with the company,” said Murphy. “HealthSmart is poised to be the gold-standard of the industry.”

Murphy received both his B.S., Accounting and MBA, Finance from St. John’s University.

About HealthSmart
For more than 40 years, HealthSmart has offered a wide array of customizable and scalable health plan solutions for self‐funded employers. HealthSmart’s comprehensive service suite addresses individual health from all angles. This includes claims and benefits administration, provider networks, pharmacy benefit management services, business intelligence, onsite employer clinics, care management, a variety of health and wellness initiatives and web‐based reporting. The Company’s headquarters is in Dallas, Texas, with regional hubs throughout the country. HealthSmart’s mission is to improve member health and reduce healthcare costs. Reported by PRWeb 17 hours ago.

HUNTINGTON BEACH, Calif. ― There was a time when George Balteria worried the Affordable Care Act would put him out of business.

It was late 2013, right as the law was about to take effect. Balteria, who had been selling health insurance to individuals for more than a decade, had set up a tent in the parking lot of the office building where he worked. The tent had a blue “Obamacare Enrollment Center” banner stretched across the top, with some American flags and balloons for decoration. A placard to one side touted the features of the new plans, including free preventative care, subsidies for people with low incomes and guaranteed coverage for those with pre-existing conditions.

After many years of selling coverage, Balteria had come to know the system’s dysfunctions well. But he didn’t know how many people would buy Obamacare’s newly upgraded plans — which in some cases would be more expensive than what they had before — or whether there’d be enough customers to keep his agency going. When the online version of California’s new marketplace, called “Covered California,” had technical glitches in the first few weeks, he got even more nervous. “People involved in our business were inflating their life vests to survive the storm,” Balteria remembers.

But California officials fixed their system, the folding chairs in front of the tent started filling up, and Balteria realized that Obamacare was going to boost his business rather than ruin it. Walk-in customers ended up generating about half of his insurance business, so Balteria decided to open up a permanent walk-in retail establishment the next year in Westminster, a small city just east of Long Beach. Today he has four more stores like it scattered across Los Angeles and Orange County.

Balteria’s Huntington Beach branch, where I first met him a few months ago, sits on a major commercial thoroughfare. Its large “Covered California” signage looks perfectly natural alongside a Circle K shop and across the street from a Jeep dealership. The actual name of Balteria’s agency is Quote Selection Insurance Services, but the state lets brokers use the Covered California name and logo free of charge. Balteria makes a point of wearing Covered California promotional polo shirts whenever possible, even if he’s just buying food at the grocery store, and now gives lectures on the state’s program as part of an advisory board.Balteria understands that the new health care law hasn’t worked out for everybody, and he’s got some ideas about how to improve it. Even so, he says, Obamacare’s net impact on his community and his state has been strongly positive. “I definitely think it’s better than what it was before,” he says.

Balteria is not the only one who thinks that way. Close observers of health policy routinely cite California as a success story ― “as close to a model of how the ACA was intended to work as anywhere in the country,” according to Larry Levitt, senior vice president at the Henry J. Kaiser Family Foundation, which happens to be based in Palo Alto. And it’s easy to see why the experts feel that way. 

Insurer competition has been strong: Going into this year, all of the state’s consumers could choose policies from at least two carriers, and in the major population centers they could choose from many more. The prices have been good, too, at least by the standards of American health insurance, with premiums that compare well to employer policies. Last year’s increase of 13 percent followed two years of premium inflation in the low single digits, and as of 2017 the balance of healthy and sick customers was stable, according to an analysis that Covered California’s officials published last month in the journal Health Affairs.

The idea of a well-functioning Affordable Care Act marketplace runs counter to the narrative of Obamacare as a “failed” program that is “imploding” ― a narrative that Republican leaders like President Donald Trump and House Speaker Paul Ryan (R-Wis.) have promoted relentlessly and used to justify their efforts at repeal. The narrative has stuck, in part, because of real and serious problems in the newly reformed markets of many states.

In Arizona, North Carolina and Tennessee, just to name a few, insurers have jacked up premiums or withdrawn altogether because they haven’t attracted enough young and healthy customers. Last month, two Iowa insurers announced they would no longer offer their plans there, leaving just one insurer in most of the state. That insurer, Medica, has warned it may have to pull up stakes, too. If that happens, and if no public or private insurer provides an alternative, then tens of thousands of Iowans who buy coverage on their own would have no way to get comprehensive health benefits.

But one reason for those struggles is a combination of neglect and, especially under Trump, outright sabotage from Republican leaders at the state and federal level. California, by contrast, has public- and private-sector leaders committed to program success. Over the past few years, they have made some key policy decisions, offering valuable lessons to any policymaker sincerely interested in making the Affordable Care Act work in more states. But Republicans won’t even acknowledge what’s happening in California ― let alone learn from it.

In California, Obamacare has gotten plenty of support.

Many people know that Massachusetts blazed the path for national health care reform, by creating a coverage system that became the Affordable Care Act's template. Few remember that California very nearly played the same role. More than a decade ago, its leaders were trying to create a nearly identical system, at nearly the same time.

In the end, Gov. Arnold Schwarzenegger couldn’t do for his state what Gov. Mitt Romney did for his, in part because California lawmakers couldn’t agree on how to come up with the necessary money. But they were ready to pounce when the Affordable Care Act became law, making federal dollars available for the very same kinds of reforms. Just six months after then-President Barack Obama presided over a signing ceremony in Washington, Schwarzenegger presided over one in Sacramento, as California became the first state to authorize a new insurance exchange to implement its version of Obamacare.

The legislation creating Covered California gave it the power to be an “active purchaser” of insurance, meaning that it could bargain directly with insurers over premiums and plan design and ― critically ― that it could choose to exclude carriers that wouldn’t meet its demands. (In most states, regulators don’t have that kind of power.) Covered California has used that authority aggressively, setting rules for insurance design that go beyond the standards that the Affordable Care Act set nationally.One of those rules requires California insurers to cover most outpatient services, except for modest co-payments, even for consumers who haven’t met their annual deductibles. Peter Lee, Covered California’s executive director, thinks this has made coverage more attractive to consumers, because now even the skimpy plans offer decent coverage for routine medical care.

Another California rule limits the ability of insurers to vary benefits, so that consumers understand what they are buying. Within the various metal tiers that the Affordable Care Act establishes for plan generosity ― platinum, gold, silver and bronze ― insurers really don’t have much leeway over what they cover. “If you are a consumer thinking about a silver product, you’ll usually find six or seven silver products, and the difference will be that they have different doctors and maybe a different philosophy,” Lee explains. “What’s not different is benefit design. Consumers aren’t confused about what their co-pays will be, etc.”

The idea that a market could work better with fewer choices, rather than more, might seem paradoxical. But a large body of research, much of it based on seniors choosing from among private Medicare plans, has shown that consumers prefer to choose from a few clearly defined options rather than a large number of more confusing ones.

Balteria, for one, says he has seen this firsthand: “When I was selling plans before, if you were to look at the roster of all the companies, which are very similar to the companies in the market today, you might have had 100 different options that you could select. ... We’ve really narrowed that down now, and there are lots of options for consumers based off the company, but there are less ways for them to make a bad decision.”

California officials made yet another critical decision in late 2013, when many consumers who had previously purchased individual plans got their first look at coverage available under the Affordable Care Act ― and were shocked to discover their insurers had either jacked up premiums or canceled old plans altogether because they didn’t meet the new law’s coverage standards. The same thing was happening nationally. In response to this “rate shock,” the Obama administration said states could allow insurers to keep the old plans going. California was among the few states that said no thanks and shut down the old plans on schedule.


Our political leaders and various stakeholders wanted it to work.
Anthony Wright, executive director of Health Access California
As a result, nearly everybody buying coverage on their own, including those in relatively good health who had been able to get coverage under the old system, became part of the new insurance pools. That helped insurers get a better mix of healthy and sick consumers, while simplifying management of the various plans ― all of which has helped carriers keep premiums relatively low. “Pushing everybody into a single risk pool, that’s good for the risk pool and it’s helpful administratively too,” says Sean Mullin, a senior director at Leavitt Partners who has studied California’s market closely.

The ultimate proof of California’s performance is the prices people pay for their insurance. A 40-year-old single consumer living in or around Los Angeles and shopping for a “silver” plan during this year’s open enrollment could choose from among seven different insurers. Depending on the plan selection, he or she would pay anywhere from $289 to $369 a month.

That’s a less than the full cost of a typical corporate insurance policy, even after adjusting for the comparatively higher out-of-pocket costs that come with sliver plans. An Urban Institute study last year confirmed this. And Affordable Care Act plans in California are an even better bargain for people in households with incomes below four times the poverty line, or about $48,000 annually for an individual and $98,000 for a family of four, because they qualify for subsidies that reduce premiums and in some cases out-of-pocket expenses as well.

Outside California, Obamacare has been neglected ― or worse.

California has some natural and relatively unique qualities that make it particularly hospitable to insurers. The state’s combination of size and population density is high on that list of advantages. It means that insurers can reliably attract large numbers of subscribers, sufficient to broadly spread the risk of high medical bills. It also means that insurers can negotiate lower prices from doctors and hospitals by playing them against one another, particularly in the big metropolitan areas that have so many large health care systems.

That’s obviously not the case in predominantly rural states, which frequently have one dominant physician or hospital group that can more or less dictate prices. And in states with relatively small populations, insurers may not attract large enough groups of people to insulate them from the effects of a handful of customers with unusually high medical expenses. This has apparently been a big problem in Iowa, where Wellmark, the state’s Blue Cross affiliate, recently announced it was withdrawing because it could no longer cover its costs. One reason for that, Wellmark officials have said, is a single patient with a genetic disorder who supposedly generates more than $1 million in new claims each month.

But size and population density alone can’t explain the rough going in those states. Most of the states where the markets are struggling did not expand Medicaid eligibility, as the Affordable Care Act’s architects intended. Many experts believe this has made the markets in those states weaker, because private insurers have ended up picking up low-income people with serious medical problems who otherwise would have been part of the Medicaid pool.

Another common element in the states with struggling markets was a decision to let more people stay in the old, unregulated plans. The people keeping their original plans tend to be in relatively good health ― the same group insurers need in their new plans in order to balance their books.

This is a particularly acute issue in Tennessee, where a loophole in the law has allowed the state’s Farm Bureau to continue enrolling people in a health plan that screens for pre-existing conditions ― a practice that Obamacare is supposed to outlaw altogether. “The general consensus is that those people who did not get into the ACA markets, the ones remaining in grandfathered plans, are a healthy subset of the population as a whole,” Mullin says.More generally, officials in states with failing markets haven’t taken aggressive steps to regulate their new insurance markets, or to promote them aggressively in the way California did. And in many of these states, private sector leaders aren’t doing much, either ― again, quite in contrast to California, where the heads of insurance companies and hospital systems seemed every bit as enthusiastic about the scheme as government officials.

“Part of the success of the Affordable Care Act in California is that our political leaders and various stakeholders wanted it to work,” says Anthony Wright, executive director of the consumer advocacy group Health Access California.

Overall, California’s record “highlights what can be accomplished if government officials and industry leaders work together to expand insurance, control costs and protect consumers,” Noam Levey, who has written about health insurance markets across the country for the Los Angeles Times, wrote last year.

California still has problems with its newly reformed insurance market. Many of the issues existed before, but in some cases have become more acute because of how the market has changed. An example is the ongoing difficulty with getting insurers to maintain up-to-date lists of which physicians remain in their networks. “While many patients were locked into their health plan previously, now many have the ability to make different choices each enrollment period ― so the accuracy of provider directories becomes even more important to allow people to comparison shop,” Wright says.

Wright would like to see more aggressive efforts to maintain accurate lists. He’d also like to see more work to bring down the price of drugs and other medical goods and services, as well as more financial assistance for consumers. Particularly in the Bay Area and Southern California, where housing costs are so high, people whose incomes are too high to qualify for generous subsidies still struggle with insurance costs.

But Wright wants to bolster the law, not get rid of it ― in no small part because he remembers how health insurance worked before the Affordable Care Act came along. “There’s a host of industry abuses ― rescissions, denial of coverage for childhood acne, hospital-only coverage, multiple rate hikes in one year, the disappearance of maternity coverage as a benefit in the individual market, etc. ― that no longer exist due to new consumer protections,” Wright says. “Even though it is early, we are starting to see improvements in debt and bankruptcy data.”

Shoring up Obamacare would be easy, if officials were willing.

There’s no clear-cut formula for making the Affordable Care Act’s new markets work, experts say, and even state officials committed to the law’s success sometimes struggle. Minnesota is a perfect example. It’s a lot like California in that public- and private-sector officials have a long history of working together in order to expand access to health care. But its newly reformed market has been volatile, with some consumers facing 50 percent rate hikes last year.

Minnesota officials didn’t give up. They appropriated money to rebate premiums for those hit with big rate hikes, and have since taken steps to create a “reinsurance” program that will reimburse insurers that end up with unusually high medical expenses, thereby allowing them to reduce premiums. Alaska has done the same thing, and officials in other states with struggling Obamacare markets could too. They could take other steps as well, like expanding their Medicaid programs if they haven’t already ― and requiring insurance companies to offer exchange coverage as a condition of participating in other state programs.

Even with such efforts, markets in some states may keep faltering, for any number of idiosyncratic reasons. Mullin, for one, thinks that a key factor in state success is the magnitude of initial pricing errors. The bigger the error in year one, he says, the more likely a state market never recovers. And states with less competitive insurance markets today tend to be the ones that had less competitive markets before the Affordable Care Act, as a recent New York Times analysis showed.

To be clear, “stability” alone isn’t the only criteria for success. Recent insurer filings suggest that carriers are increasingly figuring out how to cover their costs, with the all-important Blue Cross plans on what looks like a path to financially sustainable operations in most of the country. But to get there, many plans have raised premiums substantially ― in some cases, to the point where people who don’t qualify for generous subsidies find the plans to be unaffordable, particularly when they come with high out-of-pocket costs.

Here is where the federal government could intervene, whether by offering more financial assistance to consumers, reimbursing insurers for the most expensive beneficiaries, or forcing down the prices of prescription drugs and other underlying medical expenses. In principle, such steps could include the expansion of existing government insurance programs or even the creation of new ones.But this kind of agenda, which both Obama and former Democratic presidential candidate Hillary Clinton once endorsed, is not what Republicans have in mind for health care. They have spent the last few years neglecting and in some cases actively undermining the Affordable Care Act. Most memorably, in 2015 they pushed to defund a key Obamacare provision called “risk corridors” that would have reimbursed insurers for unexpected losses in their early years. Trump has made efforts at sabotage even more explicit, threatening to cut off some funds the law promised to insurers but that Congress never explicitly appropriated.

Not even California is immune to this kind of disruption. Lee has warned that the loss of those subsidies would force California insurers to raise premiums by an average of 17 percent, above and beyond their regular annual increases. And even if the money keeps flowing, Lee says, the uncertainty is already rattling insurers, both in California and elsewhere ― potentially pushing some to leave because they can’t count on the federal government as a reliable partner.

Just this week, Anthem announced it was withdrawing from Ohio. Uncertainty over insurer payments is likely the critical factor, according to multiple analysts. “Ohio has one of the stronger exchange markets,” says Cynthia Cox, a senior director at the Kaiser Family Foundation. “On average, insurer financial performance was a bit better in Ohio than other states last year. This exit seems to be driven by political uncertainty around [the future of the insurance subsidies].”

Of course, the really big changes for the Affordable Care Act are the ones Trump, Ryan and other Republicans have in mind for the future ― repealing the law and replacing it with a system in which insurance would be far less available to the poor and to the sick, and in which the coverage itself would be less comprehensive than what the law currently guarantees. The American Health Care Act, which the House passed last month and the Senate seems unlikely to change substantially, would mean 23 million fewer people with health insurance, according to the Congressional Budget Office.

Republicans have tried to justify this change, and the apparent pain it would entail, by arguing that the Affordable Care Act is collapsing on its own. But Californians like Balteria can’t square that claim with their own experience. “There is no such thing as perfection,” Balteria says. “But it would be a shame to get rid of what’s working right now.”type=type=RelatedArticlesblockTitle=Related Coverage + articlesList=591f541be4b034684b0c6212,591ad88de4b07d5f6ba5dee3,5916466de4b00f308cf55a21

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By David Campbell, Binghamton University, State University of New York and Kristina Lambright, Binghamton University, State University of New York

Here’s how Office of Management and Budget Director Mick Mulvaney has tried to justify the Trump administration’s bid to cut or scrap many safety net programs: 

“We are no longer going to measure compassion by the number of programs or the number of people on those programs. We are going to measure compassion and success by the number of people we get off of those programs to get back in charge of their own lives.”

In other words, Mulvaney is arguing that the main criterion for a program’s success should be whether it leads to self-sufficiency. But as researchers who have studied ways to evaluate social services, we don’t think this metric makes sense in this case.

*Evaluating government programs*

Determining whether a government program works involves looking at its goals and whom it’s supposed to help.

Congress created and has sustained a safety net to help people meet basic needs and reduce poverty, and these are its goals. Many of the people who benefit from it are already working or cannot work because of a disability.

In short, government-provided social services and benefits are often not simply handouts on the road to a job that will pay the bills for Americans temporarily facing hard times. They also make it possible for the working poor, the disabled, the elderly and children living in poverty to get the food, shelter and medical care they need to survive.

The proposed cuts are surprising because many of these programs enjoy widespread bipartisan support, according to polling by the University of Maryland’s Program for Public Consultation.

*Energy and food aid*


As your President, I have no higher duty than to protect the lives of the American people. pic.twitter.com/o7YNUNwb8f

— Donald J. Trump (@realDonaldTrump) January 26, 2017

Our research involves looking at how funders and providers of social programs assess the work they do.

In one study, we surveyed 145 funders and providers. The average respondent told us that the most important reason they assess outcomes is to see if their programs are accomplishing their goals. Based on follow-up interviews with a subset of this group, we learned that their goals varied depending on the purpose of the program. For example, early childhood education programs can measure the academic achievement of the kids who benefit from it a few years later, and teen pregnancy prevention programs may assess success based on how many participants get pregnant before adulthood.

If you apply this basic standard to the programs the Trump administration seeks to cut, the evidence indicates safety net programs are meeting their goals.

Take the Low-Income Home Energy Assistance Program (LIHEAP), established by Congress in 1981, which helps poor Americans pay their utility bills. That program, which the Trump administration wants to eliminate, targets the elderly, disabled and households with young children. By helping to keep the heat on when it’s cold out so no one in a household freezes and the air conditioning humming during heat waves, it’s clearly aimed at meeting basic needs.

Research about its effectiveness, including a study by Anthony Murray of the Federal Reserve Bank of Richmond and Bradford Mills of Virginia Polytechnic Institute and State University, shows that the program works. They note that LIHEAP significantly reduces energy insecurity – a measure of whether people have enough home energy to meet their basic needs. Eliminating the program would increase energy insecurity among low-income Americans by 18 percent, they calculated.

The Supplemental Nutrition Assistance Program (SNAP), popularly known as food stamps, is another safety net program on the chopping block that appears to be working well. The program’s explicit purpose is reducing hunger, and research indicates that it achieves this goal.One recent study from The Urban Institute, a think tank that researches government policies, found that getting food stamps reduced the chance that eligible Americans would would go hungry by approximately 30 percent. Analysis by the Center for Budget and Policy Priorities, another think tank that evaluates government policies, found that food stamps kept or lifted 10.3 million Americans out of poverty – an additional sign it is an effective piece of the safety net.

Yet, Trump’s reductions would cut federal spending on food stamps by US$193 billion – more than a 25 percent reduction – over 10 years.

Other safety net programs are also at risk. The proposed federal budget would decrease housing assistance for 250,000 people, cut $1.8 billion from public housing and eliminate after-school programs serving the poorest members of our society. In addition, it would add to the House-approved health care bill’s $834 billion in Medicaid cuts by taking another $610 billion from the program over a decade, further reducing health insurance coverage for low-income and disabled Americans.

In short, the Trump budget conveys skepticism about the idea of even having a safety net.

*Mulvaney’s standard*

Self-sufficiency is certainly an appropriate way to measure the success for some social programs, such as job-training initiatives – which Trump’s budget request would slash by 40 percent despite the president’s own explicit support for vocational training. But does Mulvaney’s view that a declining number of beneficiaries should be the primary indicator of success for every program designed to meet basic human needs make sense?

Here are the kinds of people the proposed safety net cuts would affect: severely disabled parents who can’t afford food for their toddlers. An elderly couple who can’t foot their heating bill in the winter. A single mom working two jobs and nevertheless struggling to feed her three children with what she earns. It makes little sense for the government to deny assistance to these people because they can’t get a job or because they have a job but don’t earn enough to make ends meet.

The Agriculture Department, which oversees food stamps, says that 75 percent of the Americans receiving those benefits in 2015 were children, elderly or disabled. Further, it reports that among households that included someone able to work, more than 75 percent included someone who had held a job in the year before or after receiving food stamps. Many others worked for low wages while receiving benefits. LIHEAP serves a similar population.

Leaving aside the question of why so many low-income workers don’t earn enough money to feed their families, what would it mean for children, the elderly and the disabled to be more, as Mulvaney puts it, “in charge of their lives”? Doesn’t our society want to spend money ensuring the very neediest and most vulnerable people don’t starve or freeze to death?

As researchers, we embrace evidence-based decision-making. We are confused by Mulvaney’s metric of success. We want to know why, if experts have deemed these popular programs a success, the Trump administration doesn’t seem to agree.

David Campbell, Associate Professor of Public Administration, Binghamton University, State University of New York and Kristina Lambright, Associate Dean of the College of Community and Public Affairs, and an Associate Professor of Public Administration, Binghamton University, State University of New York

This article was originally published on The Conversation. Read the original article.

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