Tag Archives: Affordable Care Act

Humana to quit Obamacare exchanges in 2018, providing fuel for Trump’s ‘repeal’ efforts

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From Yahoo:  While Republicans continue to grapple with plans to repeal and replace Obamacare and stabilize health insurance rates, Humana (HUM) is the first major insurer to say it is dropping out of the individual market for 2018.

“Based on our initial analysis of data associated with the company’s health-care exchange membership following the 2017 open enrollment period, we continue to see further signs of an unbalanced risk pool,” said Humana CEO Bruce Broussard, on a conference call with analysts Tuesday. “Therefore, the company has decided that it cannot continue to offer this coverage for 2018.”

In the wake of the news, President Donald Trump tweeted that the insurer’s decision was another example of the failure of the Affordable Care Act, and he reiterated his plan to “repeal, replace & save healthcare for ALL Americans.”

The health insurer made the announcement with its earnings update, following the mutual termination of its $34 billion merger agreement with Aetna (AET) earlier in the day. The two insurers agreed to part ways , after a federal court judge blocked the deal on antitrust grounds.

Humana now expects to earn $10.80 to $11.00 per share for 2017, excluding anticipated losses on its exchange business.

Humana cut back its Affordable Care Act exchange participation to 11 states last July, when the Department Of Justice sued to block its deal with Aetna. The insurer said that despite efforts to mitigate losses on its exchange plans in 2017 through narrower networks and selective market participation, it is seeing early signs of high pharmacy utilization among its new members.

Right now, the insurer estimated that it will lose a modest $45 million on ACA exchange plans, but it cautioned that this is an early estimate and “a number… that we’re going to have to evaluate.”

Other health insurers have threatened to pull out of the individual market if there is no clarity from Capitol Hill or Trump’s health officials on stabilizing the markets, but Humana is the first to say that it will pull out altogether.

Leading up to 2017 open enrollment, the exchange markets experienced tremendous turbulence last year, after most major insurers, including Humana, cut back on participation after suffering big losses on exchange plans.

Humana is a leading Medicare Advantage plan provider, and executives said that they don’t believe that they can achieve the same kind of health-care models on the Obamacare exchanges that they achieve with health plans for seniors.

The company does not hold out hope for more detail on Republican “repeal and replace” plans in the near term.

“We’re really feeling that this organization needs to stay focused on what we do well,” Broussard said, and the company can’t do that with Obamacare plans. “I think with that particular program, the way it is designed today and most likely the way it is designed in the future, will limit our ability… to get back into that marketplace.”

DCG

 

 

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Disney Princesses Show the Terrifying Reality Facing Women in Trump’s America

mindsaymohan-instagram

From mindsaymohan Instagram

Trump Derangement Syndrome on steroids.

From Glamour: Just days into his presidency, President Donald Trump began to take steps toward repealing the Affordable Care Act (also known as Obamacare). After a midnight Senate vote left the road clear for Trump to gut the health care plan, millions of Americans stand in limbo—uncertain if they stand to lose the coverage they gained under the Act, and even more unclear on what plan Trump has to replace it. What is certain, however, is that the effects of repealing Obamacare will be devastating, especially for women (nevermind the fact that because of Obamacare, my health insurance premiums went up 80% this year and I have a crazy high deductible).

To help drive this point home, illustrator Maritza Lugo and writer Danielle Sepulveres employed their “god-given talents” to combat the “GOP’s war on women,” Lugo writes on Instagram. The Latina duo revamped their series of illustrations featuring Disney princesses attempting to go to the gynecologist (which first debuted last year as part of cervical cancer awareness month)—and it now includes the new, terrifying realities these princesses would face if the Affordable Care Act was repealed.

They include Elena of Avalor being turned away from Planned Parenthood, Aladdin and Jasmine forced to hold a funeral for their miscarried child, Belle having to pay out-of-pocket for birth control, Pocahontas being denied coverage for a pre-existing condition, and Tiana having trouble getting her HPV vaccine. Lugo draws the Disney illustrations, Sepulveres writes the captions, and the results are poignant, to say the least.

The picture above is of Elena of Avalaor, Disney’s first Latina princess, “going to Planned Parenthood to stand against the evil stepsisters of the GOP.” Belle “was super happy to get birth control. As someone who was dependent on it, finding out she was denied her refill will only make Belle’s life a little harder.”

Read the rest of the hyperbole here.

DCG

NY gov requires insurance companies to cover contraception

strong-women-free-stuff

From Fox News: New York governor Andrew Cuomo said Saturday said he was requiring health insurance companies to cover medically necessary abortions and most forms of contraception at no cost to women, a move that further protects and safeguards coverage under the federal Affordable Care Act.

The state department of financial services is mandating that health insurers in New York provide for at least one form of FDA-approved contraception exceeding a month’s supply at a time. And women must be provided medically necessary abortions without co-pays or deductibles.

President Donald Trump and Republican members of Congress have said they will repeal the health care act as soon as possible, and that is why New York must act fast to ensure women’s access to coverage and care, Cuomo said.

“These regulatory actions will help ensure that whatever happens at the federal level, women in our state will have cost-free access to reproductive health care and we hope these actions serve as a model for equality across the nation,” Cuomo said. “Women deserve to make a fair wage and the same salary as any man, they deserve to work in an office free of sexual harassment, they deserve comprehensive paid family leave, and they deserve control over their health and reproductive decisions.”

The regulations go a step further to ensure insurance companies can’t skirt laws in any way to deny coverage. Insurance companies would face steep fines if found to be violating the mandate.

DCG

U.S. judge blocks transgender, abortion-related Obamacare protections

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U.S. District Judge Reed O’Connor

From Yahoo: A federal judge in Texas on Saturday issued a court order barring enforcement of an Obama administration policy seeking to extend anti-discrimination protections under the Affordable Care Act to transgender health and abortion-related services.

The decision sides with Texas, seven other states and three Christian-affiliated healthcare groups challenging a rule that, according to the judge, defines sex bias to include “discrimination on the basis of gender identity and termination of pregnancy.”

In granting an injunction one day before the new policy was to take effect, U.S. District Judge Reed O’Connor held that it violates the Administrative Procedure Act, a federal law governing rule-making practices.

The judge also ruled that plaintiffs were likely to prevail in court on their claim that the new policy infringes on the rights of private healthcare providers under the Religious Freedom Restoration Act.

As explained in O’Connor’s 46-page opinion, the plaintiffs argued that the new regulation would “require them to perform and provide insurance coverage for gender transitions and abortions, regardless of their contrary religious beliefs or medical judgment.”

The same judge issued a similar court order in August blocking a separate Obama administration policy that would have required public schools, over the objections of 13 states, to allow transgender students to use restrooms of their choice.

It was not immediately clear whether the Obama administration, which has just 20 days left in office, would seek to appeal the latest injunction.

White House spokeswoman Katie Hill decried the ruling. “Today’s decision is a setback, but hopefully a temporary one, since all Americans – regardless of their sex, gender identity or sexual orientation – should have access to quality, affordable health care free from discrimination,” she said.

The Affordable Care Act (ACA), also known as Obamacare, was passed in 2010 with an anti-discrimination section designed to prevent insurers from charging customers more or denying coverage based on age, race, national origin, disability or sex.

The rule in dispute on Saturday was adopted by the U.S. Health and Human Services (HHS) Department to implement those provisions, including definitions for sex discrimination that encompassed transgender and abortion services.

According to the court opinion, gender identity was defined under that rule as “an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female, and which may be different from an individual’s sex assigned at birth.”

The state of Texas has led a string of legal cases brought by Republican-controlled states contesting various social policies advanced by President Barack Obama, most notably his 2014 executive action to protect millions of immigrants in the United States illegally and give them work permits.

That plan, challenged by Texas and other states, has been barred by the courts. But the U.S. Supreme Court in 2012 and 2015 issued rulings that kept the Affordable Care Act, his top legislative achievement, intact.

DCG

Nearly half of Americans want to keep ObamaCare

I’ll bet that those in favor of Obamacare didn’t receive an 80 percent increase notice for their health care premiums for 2017.

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Via NY Post: Barely a quarter of Americans want ObamaCare completely dismantled, while nearly half want it kept as is — or even expanded, pollsters said Thursday.

In a post-election poll commissioned by the nonpartisan Kaiser Family Foundation, 26 percent of respondents said they want all of the Affordable Care Act repealed. Pollsters found that 19 percent of those surveyed said they like the status quo, and 30 percent want ObamaCare expanded.

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President-elect Donald Trump — who spent the campaign trashing ObamaCare and promising to repeal it — has already backtracked on that pledge.

Trump now says he wants to keep at least two major ObamaCare provisions — allowing children to remain on a parent’s plan until age 26, and barring insurers from denying coverage based on pre-existing conditions.

That approach seems to match with 17 percent of poll respondents, who want ObamaCare scaled back but not thrown out entirely.

Republican respondents, at a 52 percent clip, were strongly in favor of killing ObamaCare altogether, this poll found. But even that’s a shift down from 69 percent of GOP backers who said a month ago they wanted all of ObamaCare trashed.

This poll was conducted between Nov. 15 and 21 with a margin of error of plus or minus 3 percentage points.

DCG

Shocker, not: Millennials not sure why they love Obama

The good folks at Campus Reform interviewed some students at the University of Maryland to find out what they were thankful for about Obama’s presidency. And in typical fashion, the young Obamabots had no clue.

I’m so glad we are almost done with this eight-year experiment of having a “cool” president.

DCG

Harvard’s minimum wage protests were caused by its own professors

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Via NY Post: The social-justice warriors of Harvard are on the march again, this time in solidarity with the university’s dining-hall workers. Students and faculty have spent the past few days protesting low wages and an increase in health-care premiums for the people serving their grilled cheese, french fries and occasional lobster dinners.

On Oct. 5, about 750 workers went on strike. It was Harvard’s first such revolt in 33 years, and strikes are becoming more common at colleges across the country. In Pennsylvania, thousands of faculty went on strike at 14 colleges and universities on Wednesday alone.

Harvard was fortunately prepared, having stocked up on frozen food for students in the days leading up to the walkout. But who knows when their TV dinners will run out. Two weeks later, things seem to have reached an impasse. Harvard has closed six of its 14 dining halls, staffing its remaining ones with temporary workers and giving students money to spend at local pizza joints.

In its defense, Harvard says, the dining-hall workers make an average of almost $22 per hour, more than the $15 living wage required by the People’s Republic of Cambridge. Moreover, the university says that health-care costs are going up all over the country and dining-hall workers are going to have to bear some of the brunt of that.

The Chronicle of Higher Education sums up Harvard’s problem pretty well. “How does the richest university in the world negotiate with some of its lowest-paid workers?” the publication asks. When your endowment is over $37 billion, why don’t you pay the people who serve food more than $30,000 per year?

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The argument seems to be carrying weight. Earlier this week, Harvard divinity students wore yellow flowers in their hair and sang “Lean On Me” and “We Shall Overcome” as they protested outside the Science Center. They ate bread together, which, according to divinity student Nestor J. Pimienta “symbolized that we’re sharing in the struggle.”

It’s always fun to share in the struggle when you get to skip out on class. According to an account in the Crimson, “After chants of ‘No justice, no peace!’ subsided, [professor] Timothy P. McCarthy ascended the steps of University Hall to address the crowd, which had reached hundreds of people. McCarthy announced to cheers that he had ‘cut short’ his lecture in ‘American Protest Literature from Tom Paine to Tupac’ to walk out with his students.”

Harvard’s undergraduates clearly see the plight of its dining-hall workers as the latest story of oppression in American history. But they seem not to see that Harvard professors actually support the very policies that have put the university in this bind.

In 2014, 10 Harvard scholars sent a letter to Congress insisting that an increase in the minimum wage would not negatively affect employment rates. Indeed, former Harvard Law professor and current Massachusetts Sen. Elizabeth Warren has testified before Congress in favor of a $22 minimum wage.

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The assumption of these liberal scholars is that the rich who run corporations (or “nonprofit” institutions in this case) are simply hoarding money. If we want the poor to get more money, employers of these workers should just pay them more. And if they don’t, we should get the government to mandate that they do.

Who cares if you’re paying more than minimum wage? If you have more money, fork it over. Why shouldn’t dining-hall workers make as much as English professors? The laws of supply and demand simply don’t enter into the thinking of pointy-headed students and faculty.

The real sticking point in negotiations with the dining-hall workers is rising health insurance premiums. The cost of health insurance has gone up somewhere around 20% nationwide because of the Affordable Care Act. Insurance companies are canceling plans left and right, and the pool of insured people are older and less healthy than forecasters projected — meaning that it’s going to get worse.

As a 2015 article in the National Interest pointed out, “the Harvard faculty is chock-a-block with ObamaCare’s biggest boosters. The new plan was approved by Harvard’s provost, the economist Alan M. Garber, who had signed on to a 2009 open letter assuring the president that a tax on high-end insurance plans “offers the most promising approach to reducing private-sector health-care costs while also giving a much needed raise to the tens of millions of Americans who receive insurance through their employers.”

The Harvard faculty screamed bloody murder last year when the administration tried to raise their health-insurance premiums. Obviously, their dining-hall workers are less able to absorb these increases. But the policies pushed in Harvard’s faculty lounges have left everyone — not just the students eating ramen noodles — much worse off.

DCG