U.P.S. to End Health Benefits for Spouses of Some Workers
By STEVEN GREENHOUSE
United Parcel Service has told its white-collar employees that it will stop providing health care coverage to their spouses who can obtain coverage through their own employers, joining an increasing number of companies that are restricting or eliminating spousal health benefits.
U.P.S., the world’s largest package delivery company, said its decision was prompted in part by “costs associated with” the federal health care law that is commonly called Obamacare. Several health care experts, however, said they believed the company was motivated by a desire to hold down health care costs, rather than because of cost increases under the law.
In a memo addressed to employees, U.P.S. said, “Limiting plan eligibility is one way to manage ongoing health care costs, now and into the future, so that we can continue to provide affordable coverage for our employees.”
The memo also estimated that about 33,000 spouses were covered under its insurance plan for white-collar employees and that “about 15,000 of these would have health care coverage available through their own employers.”
In explaining its move — which was first reported by Kaiser Health News and USA Today — U.P.S. told employees, “Since the Affordable Care Act requires employers to provide affordable coverage, we believe your spouse should be covered by their own employer — just as U.P.S. has a responsibility to offer coverage to you, our employee.”
“In an effort to maintain premiums at or below current cost,” Andrew McGowan, a U.P.S. spokesman, said, “U.P.S. made a change that affects a limited number of employees.”
U.P.S. is one of the biggest companies so far to drop spousal coverage for some segment of its work force, and its announcement was viewed by some as a harbinger of a broader trend in employers’ restrictions on health care benefits.
Tacking Health Care Costs Onto California Farm Produce
By SARAH VARNEY
HURON, Calif. — Farm labor contractors across California, the nation’s biggest agricultural engine, are increasingly nervous about a provision of the Affordable Care Act that will require hundreds of thousands of field workers to be covered by health insurance.
While the requirement was recently delayed until 2015, the contractors, who provide farmers with armies of field workers, say they are already preparing for the potential cost the law will add to their business, which typically operates on a slender profit margin.
“I’ve been to at least a dozen seminars on the Affordable Care Act since February,” said Chuck Herrin, owner of Sunrise Farm Labor, a contractor based here. “If you don’t take the right approach, you’re wiped out.”
The effects of the law could be profound. Insurance brokers and health providers familiar with California’s $43.5 billion agricultural industry estimate that meeting the law’s minimum health plan requirement will cost about $1 per hour per employee worked in the field.
“Everybody is afraid of the cost,” said J. Edward McClements, Jr., a senior vice president at Barkley Insurance and Risk Management, based in Oxnard, about 60 miles west of Los Angeles. “It’s difficult when you’ve got 1,000 workers who’ve never had health insurance before, to get an idea of what their costs will be.”
The concern is felt from vineyards in Napa County to the almond orchards outside Coalinga in the Central Valley. Farm labor contractors generally rely on a 2 percent profit, and they say they will have to pass the added health care costs required by the law on to growers.
Mr. Herrin, who can employ up to 2,000 farmworkers — many of them longtime employees — has been warning his customers of the coming price increase due to health insurance costs.
“It’s made for some heated battles,” Mr. Herrin said of his talks with growers, who include his father-in-law, the owner of a Central Valley farm.
Some farmers seem resigned to higher labor costs. “That cost is going to be borne by us at the end of the day,” said Scott Deardorff, a partner at Oxnard-based Deardorff Family Farms, which grows strawberries, cauliflower and chard, among other salad bar staples, all of which are likely to be more expensive for consumers down the line.
Health Care Costs Climb Moderately, Survey Says
By ANDREW POLLACK
Premiums for employer-provided health insurance have increased by relatively modest amounts this year, according to a new survey, a further sign that once-torrid health care inflation has abated for now.
The average annual premium for a family rose 4 percent in 2013, to $16,351, according to the survey results released Tuesday by the Kaiser Family Foundation. Annual premiums for individual policies purchased through an employer rose 5 percent, to $5,884.
The 4 percent increase for a family is relatively tame, at least compared with the roughly 10 percent annual increases experienced a decade ago. But it is still a far bigger rise than 1.8 percent increase in wages and the 1.1 percent rate of inflation in the last year, the foundation said.
“If you are comparing it to 10 years ago in health care, it seems modest,” said Helen B. Darling, chief executive of the National Business Group on Health, which represents large employers. “If you compare it to the economy and what inflation is doing, I don’t think it’s modest at all.”
The data also suggest that the new health care law is not leading, at least so far, to a rapid escalation of insurance costs.
“The critics will have a much harder time blaming big premium increases in employer insurance on Obamacare this year, because there aren’t any big premium increases,” Drew Altman, chief executive of the Kaiser foundation, said in a telephone news conference Tuesday.
Conversely, however, it is not clear if the Affordable Care Act, as the law is formally known, has contributed to the moderating of premium increases, Kaiser researchers said.
Premiums have been held in check partly by increasing out-of-pocket costs that workers pay through co-payments and deductibles.
Doctors Who Profit From Radiation Prescribe It More Often, Study Finds
By ROBERT PEAR
WASHINGTON — Doctors who have a financial interest in radiation treatment centers are much more likely to prescribe such treatments for patients with prostate cancer, Congressional investigators say in a new report.
The investigators, from the Government Accountability Office, said that Medicare beneficiaries were often unaware that their doctors stood to profit from the use of radiation therapy. Alternative treatments may be equally effective and are less expensive for Medicare and for beneficiaries, the report said. In other recent studies, the auditors found a similar pattern when doctors owned laboratories and imaging centers that billed Medicare for CT scans and magnetic resonance imaging.
The latest study focused on a common and costly treatment for prostate cancer known as intensity-modulated radiation therapy, which directs highly concentrated beams of radiation at cancerous tumors. In many cases, it said, doctors who recommend the treatment have financial relationships with those who provide it. For example, a group of urologists may own radiation therapy equipment that is used by other doctors in the same medical group to treat patients.
James C. Cosgrove, a director of the health care team at the Government Accountability Office, said that “financial incentives” appeared to be contributing to the higher use of this type of radiation therapy for patients with prostate cancer, one of the most common cancers in men.
Urologists “referred a substantially higher percentage of their prostate cancer patients” to radiation therapy when the doctors owned the equipment — linear accelerators — or had financial ties to those who provided the treatment, the report said.
The report comes as Congress is looking for ways to save money in Medicare and to make fundamental changes in the formula used to calculate payments to doctors treating Medicare patients.
“When you look at the numbers in this report, you start to wonder where health care stops and profiteering begins,” said Senator Max Baucus, a Montana Democrat who is the chairman of the Senate Finance Committee. “We have a law on the books designed to prevent these conflicts of interest, but an increasing number of physicians are skirting the law for personal gain.”
Planned Parenthood of Northern New England to get $145,000 in Obamacare funds for enrollment
Posted Aug. 16, 2013, at 8:24 a.m.
NEW YORK — Planned Parenthood will get federal funds to help Americans enroll in insurance via President Barack Obama’s healthcare program, U.S. officials said on Thursday, drawing fire from critics who oppose contraception and abortion in such coverage.
Across the country, 105 groups were awarded a total of $67 million in so-called navigator grants, ranging from the Epilepsy Foundation of Florida and AIDS Alabama, Inc. to the Greater Phoenix Urban League and the Legal Aid Society of Palm Beach County.
The inclusion of Planned Parenthood groups in three U.S. states, which provide women’s health services including contraception and abortion, drew new criticism from Republicans and others. The healthcare law has attracted major opposition and legal challenges from religious and conservative groups for requiring insurers to cover the cost of birth control.
“More than 90 percent of what our health centers do is provide basic, preventive care, including cancer screenings and annual well-woman exams,” said Eric Ferrero, vice president of Planned Parenthood Federation of America.
The navigator grants, he said, will enable local affiliates to help women enroll in insurance plans that cover preventive care and maternity care, and “have nothing to do with abortion and won’t be used for abortion services.”
Rep. Diane Black, a Tennessee Republican, blasted the grants to Planned Parenthood groups “despite assurances from the President when the law was passed that Obamacare would not give federal funding to abortion providers.”
Planned Parenthood of the Heartland, in Iowa, will receive $214,427. The Intermountain Planned Parenthood Inc. of Montana will receive $295,604, allowing it to provide assistance at its health centers or via phone, according to the Department of Health and Human Services.
Costs rise for employer-provided health benefits, survey finds
Health insurance premiums rise 4% for family plans and 5% for individual plans in 2013, outpacing inflation and wage growth.
By Noam N. Levey and Marina Villeneuve
8:45 PM CDT, August 20, 2013
| advertisement |
WASHINGTON — American workers and their employers saw another rise in health insurance premiums this year, as the total cost of employer-provided health benefits ticked up 4% for family plans and 5% for individual plans, according to a closely watched national survey.
The 2013 increases are lower than in many previous years, undercutting claims by critics of President Obama's health law that the 2010 legislation is dramatically driving up costs.
Nor is there much evidence that many employers are dropping coverage — 57% of firms with at least three employees offered health benefits in 2013, according to the report by the nonprofit Kaiser Family Foundation and the Health Research & Educational Trust, an affiliate of the American Hospital Assn.
The report's authors noted that the share of employers providing health insurance is "statistically unchanged" from 2012, when 61% of employers offered health benefits, and 2011, when 60% of employers did so.
But as has been true in most previous years, the rise in premiums outpaced inflation and wage growth, adding to the increasing burden that healthcare costs are putting on Americans.
"It's still three or four times the general rate of inflation," said Helen Darling, president of the National Business Group on Health, a leading association of large employers. "We don't consider [the rise] modest at all."
The average total cost for a family health plan — which is split between employer and employee — hit $16,351 this year. The employee's share of that premium was $4,565, up about 6% from 2012.
The average employer's share of the premium, in contrast, increased just 3%, an indication that employers continue to shift more health costs onto their employees.
The survey did not measure premiums for the roughly 20 million people who buy health insurance on their own, though this group is dwarfed by the more than 150 million people who get employer-sponsored coverage.
Starting in October, Americans who do not get health benefits through their employer will have a new option. They will be able to shop for health plans on new Web-based marketplaces created by the Affordable Care Act. Low- and moderate-income consumers will qualify for federal subsidies to offset their premiums.
http://www.chicagotribune.com/health/la-fi-insurance-costs-20130821,0,3757605,print.story
When Doctors Discriminate
By JULIANN GAREY
THE first time it was an ear, nose and throat doctor. I had an emergency visit for an ear infection, which was causing a level of pain I hadn’t experienced since giving birth. He looked at the list of drugs I was taking for my bipolar disorder and closed my chart.
“I don’t feel comfortable prescribing anything,” he said. “Not with everything else you’re on.” He said it was probably safe to take Tylenol and politely but firmly indicated it was time for me to go. The next day my eardrum ruptured and I was left with minor but permanent hearing loss.
Another time I was lying on the examining table when a gastroenterologist I was seeing for the first time looked at my list of drugs and shook her finger in my face. “You better get yourself together psychologically,” she said, “or your stomach is never going to get any better.”
If you met me, you’d never know I was mentally ill. In fact, I’ve gone through most of my adult life without anyone ever knowing — except when I’ve had to reveal it to a doctor. And that revelation changes everything. It wipes clean the rest of my résumé, my education, my accomplishments, reduces me to a diagnosis.
I was surprised when, after one of these run-ins, my psychopharmacologist said this sort of behavior was all too common. At least 14 studies have shown that patients with a serious mental illness receive worse medical care than “normal” people. Last year the World Health Organization called the stigma and discrimination endured by people with mental health conditions “a hidden human rights emergency.”
I never knew it until I started poking around, but this particular kind of discriminatory doctoring has a name. It’s called “diagnostic overshadowing.”
According to a review of studies done by the Institute of Psychiatry at King’s College, London, it happens a lot. As a result, people with a serious mental illness — including bipolar disorder, major depression, schizophrenia and schizoaffective disorder — end up with wrong diagnoses and are under-treated.
That is a problem, because if you are given one of these diagnoses you probably also suffer from one or more chronic physical conditions: though no one quite knows why, migraines, irritable bowel syndrome and mitral valve prolapse often go hand in hand with bipolar disorder.
The High Cost of ObamaCare
This is the reason many people don’t like ObamaCare. It’s also part of why people wind up making fun of the president at state fairs. (On that, everyone should breathe deep and remember, as the noted political philosopher Orson Welles once put it: “It’s the business of the American people to take the mickey out of the president.” It’s not only what we do, it’s what we should do. Welles was speaking on a talk show; it was the 1970s; he was talking about people making fun of some Republican president, Nixon or Ford. So what? They can take it. And they’re not kings. Let me suggest a classy Obama move that might go over well. From his Vineyard vacation spot he should have the press office issue a release saying his reaction to finding out a rodeo clown was rudely spoofing him, was, “So what?” Say he loves free speech, including inevitably derision directed at him, and he does not wish for the Missouri state fair to fire the guy, and hopes those politicians (unctuously, excessively, embarrassingly) damning the clown and the crowd would pipe down and relax. This would be graceful and nice, wouldn’t it? He would never do it. He gives every sign of being a person who really believes he shouldn’t be made fun of, and if he is it’s probably racially toned, because why else would you make fun of him?
But back to health care. The piece I linked to, by Yuxing Zheng of the Oregonian, makes quick work of a complicated subject. A woman in Cornelius, Ore., takes care of her disabled 22-year-old daughter. The daughter has cerebral palsy, spina bifida and a condition called automonic dysreflexia. She requires 24-hour care. The mother provides it, receiving for this $1,400 a month. The mother fears—and is apparently right to fear—a provision of the Affordable Care Act that will, as Zheng reports, “largely prohibit guardians from serving as the paid caregiver of an adult child with developmental disabilities.” The mother is afraid this will mean foster care for her daughter, or a lengthy and costly process in which she herself will be forced to transfer legal guardianship to someone else. The provision, the paper says, will likely cause hardship for hundreds of Oregon families in which the guardian and the caregiver are the same person.
A wide divide across New England on health overhaul
WASHINGTON — Massachusetts residents will be able choose among insurance plans offered by 10 companies when a key element of President Obama’s health care law takes effect on Oct. 1. But Connecticut residents will be choosing from only three, while New Hampshirites will have just one option.
These are among the disparities — some of which are just now coming to light — that consumers who lack employer-provided plans and are ineligible for Medicare will face as they begin shopping online for health insurance under the federal health reform law.
The differences highlight how the consumer experience will vary widely under health reform, despite the law’s intent to make the complex world of health care more transparent, affordable, and equitable. That has led some supporters of the health care law to worry that consumers will be confused and upset by the state-by-state variations, just as the heart of the law — an online portal allowing people to shop for insurance, called a marketplace — is being implemented.
“For consumers in some states, it means there’s less choice. It’s a real problem because it reduces the competitive pressure on pricing and on other performance criteria,” said Jon Kingsdale, who set up the Massachusetts health insurance marketplace under the state’s groundbreaking 2006 law and who is now a consultant helping other states start their own marketplaces.
The wide range in the number of insurers reflects the states’ varying market conditions. Uncertainty about how the new system will work has led some carriers to postpone participation, especially in states like New Hampshire, which has actively resisted the health care overhaul.
‘It’s a real problem because it reduces the competitive pressure on pricing and on other performance criteria.’ — Jon Kingsdale, on a lack of options offered by some states
About 10 percent of consumers are expected to buy insurance through the marketplaces for benefits that would start in January. The law requires most Americans to obtain insurance by Jan. 1 or face a financial penalty.
New England’s six states reflect the patchwork manner in which the 2010 law is being adopted across the country. In addition to the variable number of insurance options and differences in pricing, consumers will also confront inconsistencies in service and — for low-income residents — coverage, depending upon whether their state officials embrace or reject the health law, known as “Obamacare.”
http://www.bostonglobe.com/news/nation/2013/08/24/differences-emerge-how-states-will-implement-president-obama-health-care-plan-new-england/sRGR0GzCfZoKbSpv0WoM2N/story.html?s_campaign=email_BG_TodaysHeadline
The biggest change for small businesses under Obamacare you haven’t heard of
Posted Aug. 23, 2013, at 1:43 p.m.
Since the Affordable Care Act was made law in 2010, the impact it would have on businesses has been debated in Maine and throughout the country.
Today, a mere five weeks from the beginning of open enrollment on Oct. 1, the debate is still raging.
Much of the attention about the act’s impact on businesses has focused on the employer mandate, which will require employers with more than 50 full-time equivalent employees to offer health insurance or pay a penalty.
But with that provision delayed until 2015, large companies buying insurance will likely see “very few changes” come Jan. 1, 2014, according to Mitchell Stein, policy director for Consumers for Affordable Health Care in Augusta.
Instead, small businesses that choose to buy their insurance from the small-group market — which insured roughly 93,000 individuals in Maine in 2011 — are more likely to feel the law’s impact next year.
A little-discussed provision in the act will change what’s known as the “community rating.” This is how insurance carriers such as Anthem rate the risk among individuals and small groups and set the price of insurance.
“That’s a big change, and unless they’ve talked to their brokers, small businesses don’t know that’s coming,” said Ed Feibel, an employee benefits lawyer in Eaton Peabody’s Portland office.
Eric Jermyn, Anthem’s director of small-group sales, said that while most of the questions Anthem receives from business owners are about the much-discussed employer mandate penalties, the change in how insurers set rates has the most potential to affect the rates those business owners pay.
Currently, an insurance carrier offers customers buying in the small-group market composite rates. If a company with 15 employees buys health insurance, all employees of that company would have their rates determined by being put into one of four buckets — an individual employee, the employee and his or her spouse, the employee and children, and everyone else. Each bucket offers the same rate, and the insurance company doesn’t care if your spouse is 65 or 32, or if your 24-year-old son who’s a dependent on your plan is a smoker.
Having only four groups “smooths things out,” said Stein from Consumers for Affordable Health Care. “You have fewer highs and fewer lows because everyone is in those larger groups.”
Health reform 101
Posted Aug. 23, 2013, at 1:43 p.m.
Here are the answers to some frequently asked questions about the Affordable Care Act, from Kaiser Permanente:
What is health reform? Health reform refers to the federal law passed in 2010 called the Affordable Care Act, plus any state laws passed to implement it. The point of the law is to expand health coverage to more people and improve medical care.
What do I need to do now? The best thing to do now is learn how health reform may affect your coverage and get ready for Oct. 1 when the health insurance marketplaces open.
What are the health insurance marketplaces? Sometimes called “exchanges,” the marketplaces are where you can go to shop for health plans. They are for people who buy insurance on their own or currently don’t have coverage. You will be able to compare plans, shop for coverage and find out whether you’re eligible for financial assistance. The exchanges open Oct. 1, and the policies take effect Jan. 1. Visit www.healthcare.gov for information on shopping for insurance plans offered through state exchanges. Insurers like Anthem also have websites explaining the impact of the health care reform law.
Do I have to buy from the marketplaces? Not necessarily. You can still get coverage through your employer, directly from an insurance company or from Medicare or Medicaid if you’re eligible. You will need to purchase a plan from the marketplace if you want financial help, however.
Who has to buy health insurance? Most U.S. citizens and legal immigrants must have health coverage starting Jan. 1. Those with certain religious beliefs, members of Native American tribes, undocumented immigrants, people in prison and people with income below a certain level will not be required to buy insurance.
What if I can’t afford health care coverage? The government will provide subsidies to help people with certain incomes pay. If you’re single, the qualifying income bracket could be $15,282 to $45,960. For couples, $20,628-$62,040. For a family of four, $31,322-$94,200.
What happens if I don’t buy coverage? If you go without coverage for three months or longer, starting Jan. 1., you’ll face a penalty. If you get coverage within that three-month grace period, you will not be charged a tax penalty.
Can anyone get coverage? Yes. Under the ACA, insurers can no longer deny people because of their medical conditions.
Defunders vs. Delayers: Conservatives are split over Obamacare strategy
You would be hard-pressed to find a conservative who supports President Barack Obama’s health care law, but when it comes to the actual strategy to bring it down, there isn’t nearly as much unity.
Republicans are divided over how to continue the fight against the 2010 law known as Obamacare, which the U.S. Supreme Court deemed constitutional in 2012. There is a disagreement within the conservative movement between those who want to defund the law and those who think it would be better to delay its implementation.
Both share the same aim: the eventual destruction of Obamacare. But the two sides have significant tactical disagreements over how to reach that goal.
On the Defunder side, a group of conservatives in Congress has threatened to vote against any government spending measure (known as a continuing resolution, or CR) that includes federal funding to implement the law. Congress must agree to a new CR by the end of September, when the last short-term extension of federal spending levels expires, or risk shutting down the government. So far, 13 Republican senators have signaled support for the effort by refusing to vote for any CR that includes health care law funding. Even more Republicans have said they will support a bill that cuts out Obamacare funding, but have not made the commitment to reject a CR if the defund effort fails.
The Defunders have the backing of large conservative groups such as the Heritage Foundation and its advocacy arm, Heritage Action. Heritage President Jim DeMint has spent the month of August hosting town hall meetings across the country to pressure lawmakers to commit to demanding that the law be stripped of funding — even if it means risking a shutdown.
http://news.yahoo.com/in-the-war-over-obamacare--a-battle-on-the-right-over-strategy-212531620.html#
Our View: Forensic patients swamp state mental hospital
1:00 AM
People with mental illness are put at risk or denied care because of insufficient resources.
For whatever reason, Mark Murphy didn't get the treatment he needed nine years ago, before he broke into a neighbor's home and was stopped by a bullet to the chest.
That incident, and the mental illness that precipitated it, set in motion a series of events with far-reaching implications and significant costs, both financial and emotional.
Found not criminally responsible due to mental illness, Murphy was sent to Riverview Psychiatric Hospital in Augusta, where in the following seven years he frequently attacked staff members.
In March, he seriously injured a 26-year-old mental health worker, punching her and stabbing her with a pen before he was subdued by another patient.
That attack and other incidents at the hospital that have led to injuries show why patients like Murphy have no business being at the hospital.
At the same time, Riverview has been feeling the brunt of a mental health system beset by budget cuts and short-term thinking at a time of increasing illness. At each step, patients are falling through the cracks. Their state of mind worsens, rehabilitation grows more unlikely, and the social costs mount. Absent a comprehensive solution, all the mental health system can do is stop the worst from happening. And the cracks are showing.
http://www.pressherald.com/opinion/forensic-patients-swamp-state-mental-hospital_2013-08-25.html?pagenum=full
‘It’s a real problem because it reduces the competitive pressure on pricing and on other performance criteria.’ — Jon Kingsdale, on a lack of options offered by some states
The biggest change for small businesses under Obamacare you haven’t heard of
Posted Aug. 23, 2013, at 1:43 p.m.
Since the Affordable Care Act was made law in 2010, the impact it would have on businesses has been debated in Maine and throughout the country.
Today, a mere five weeks from the beginning of open enrollment on Oct. 1, the debate is still raging.
Much of the attention about the act’s impact on businesses has focused on the employer mandate, which will require employers with more than 50 full-time equivalent employees to offer health insurance or pay a penalty.
But with that provision delayed until 2015, large companies buying insurance will likely see “very few changes” come Jan. 1, 2014, according to Mitchell Stein, policy director for Consumers for Affordable Health Care in Augusta.
Instead, small businesses that choose to buy their insurance from the small-group market — which insured roughly 93,000 individuals in Maine in 2011 — are more likely to feel the law’s impact next year.
A little-discussed provision in the act will change what’s known as the “community rating.” This is how insurance carriers such as Anthem rate the risk among individuals and small groups and set the price of insurance.
“That’s a big change, and unless they’ve talked to their brokers, small businesses don’t know that’s coming,” said Ed Feibel, an employee benefits lawyer in Eaton Peabody’s Portland office.
Eric Jermyn, Anthem’s director of small-group sales, said that while most of the questions Anthem receives from business owners are about the much-discussed employer mandate penalties, the change in how insurers set rates has the most potential to affect the rates those business owners pay.
Currently, an insurance carrier offers customers buying in the small-group market composite rates. If a company with 15 employees buys health insurance, all employees of that company would have their rates determined by being put into one of four buckets — an individual employee, the employee and his or her spouse, the employee and children, and everyone else. Each bucket offers the same rate, and the insurance company doesn’t care if your spouse is 65 or 32, or if your 24-year-old son who’s a dependent on your plan is a smoker.
Having only four groups “smooths things out,” said Stein from Consumers for Affordable Health Care. “You have fewer highs and fewer lows because everyone is in those larger groups.”
Health reform 101
Posted Aug. 23, 2013, at 1:43 p.m.
Here are the answers to some frequently asked questions about the Affordable Care Act, from Kaiser Permanente:
What is health reform? Health reform refers to the federal law passed in 2010 called the Affordable Care Act, plus any state laws passed to implement it. The point of the law is to expand health coverage to more people and improve medical care.
What do I need to do now? The best thing to do now is learn how health reform may affect your coverage and get ready for Oct. 1 when the health insurance marketplaces open.
What are the health insurance marketplaces? Sometimes called “exchanges,” the marketplaces are where you can go to shop for health plans. They are for people who buy insurance on their own or currently don’t have coverage. You will be able to compare plans, shop for coverage and find out whether you’re eligible for financial assistance. The exchanges open Oct. 1, and the policies take effect Jan. 1. Visit www.healthcare.gov for information on shopping for insurance plans offered through state exchanges. Insurers like Anthem also have websites explaining the impact of the health care reform law.
Do I have to buy from the marketplaces? Not necessarily. You can still get coverage through your employer, directly from an insurance company or from Medicare or Medicaid if you’re eligible. You will need to purchase a plan from the marketplace if you want financial help, however.
Who has to buy health insurance? Most U.S. citizens and legal immigrants must have health coverage starting Jan. 1. Those with certain religious beliefs, members of Native American tribes, undocumented immigrants, people in prison and people with income below a certain level will not be required to buy insurance.
What if I can’t afford health care coverage? The government will provide subsidies to help people with certain incomes pay. If you’re single, the qualifying income bracket could be $15,282 to $45,960. For couples, $20,628-$62,040. For a family of four, $31,322-$94,200.
What happens if I don’t buy coverage? If you go without coverage for three months or longer, starting Jan. 1., you’ll face a penalty. If you get coverage within that three-month grace period, you will not be charged a tax penalty.
Can anyone get coverage? Yes. Under the ACA, insurers can no longer deny people because of their medical conditions.
Defunders vs. Delayers: Conservatives are split over Obamacare strategy
You would be hard-pressed to find a conservative who supports President Barack Obama’s health care law, but when it comes to the actual strategy to bring it down, there isn’t nearly as much unity.
Republicans are divided over how to continue the fight against the 2010 law known as Obamacare, which the U.S. Supreme Court deemed constitutional in 2012. There is a disagreement within the conservative movement between those who want to defund the law and those who think it would be better to delay its implementation.
Both share the same aim: the eventual destruction of Obamacare. But the two sides have significant tactical disagreements over how to reach that goal.
On the Defunder side, a group of conservatives in Congress has threatened to vote against any government spending measure (known as a continuing resolution, or CR) that includes federal funding to implement the law. Congress must agree to a new CR by the end of September, when the last short-term extension of federal spending levels expires, or risk shutting down the government. So far, 13 Republican senators have signaled support for the effort by refusing to vote for any CR that includes health care law funding. Even more Republicans have said they will support a bill that cuts out Obamacare funding, but have not made the commitment to reject a CR if the defund effort fails.
The Defunders have the backing of large conservative groups such as the Heritage Foundation and its advocacy arm, Heritage Action. Heritage President Jim DeMint has spent the month of August hosting town hall meetings across the country to pressure lawmakers to commit to demanding that the law be stripped of funding — even if it means risking a shutdown.
http://news.yahoo.com/in-the-war-over-obamacare--a-battle-on-the-right-over-strategy-212531620.html#
Our View: Forensic patients swamp state mental hospital
1:00 AMPeople with mental illness are put at risk or denied care because of insufficient resources.
For whatever reason, Mark Murphy didn't get the treatment he needed nine years ago, before he broke into a neighbor's home and was stopped by a bullet to the chest.
Found not criminally responsible due to mental illness, Murphy was sent to Riverview Psychiatric Hospital in Augusta, where in the following seven years he frequently attacked staff members.
In March, he seriously injured a 26-year-old mental health worker, punching her and stabbing her with a pen before he was subdued by another patient.
That attack and other incidents at the hospital that have led to injuries show why patients like Murphy have no business being at the hospital.
At the same time, Riverview has been feeling the brunt of a mental health system beset by budget cuts and short-term thinking at a time of increasing illness. At each step, patients are falling through the cracks. Their state of mind worsens, rehabilitation grows more unlikely, and the social costs mount. Absent a comprehensive solution, all the mental health system can do is stop the worst from happening. And the cracks are showing.
http://www.pressherald.com/opinion/forensic-patients-swamp-state-mental-hospital_2013-08-25.html?pagenum=full
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