ObamaCare

John McCain has a good heath care plan, and if has his way, you won't. The Senator most often accredited for thinking for himself (that's a lie) will vote with Russian agent Donald Trump and the rest of the Republicans to take away Obama care. The moment he gets a chance. However, he can't right now because he is indisposed, recovering form surgery. We at Greg Laden's Blog wish Senator McCain a speedy recovery and hope he is well. But we also urge him to think about his privilege and not take access to the sort of health care he has from other Americans. Speaking of the Russians, The Looking…

In a current poll, 61% of Americans want to retain Obamacare, and improve this already implemented and existing program. A mere 37% want to "repeal and replace" it. About 69% of American want the Republicans, including the Republican President, to to do some combination of working with Congressional Democrats or a combination of Democrats and Republicans to improve the plan. The preference for having the Democrats do this as opposed to a combination is about 2:1. People have apparently observed that the Republicans are not capable of coming up with a usable plan. The Republicans, including…

Yesterday, House Republicans failed to find enough votes to pass their Affordable Care Act replacement. It was a very good day for the millions of Americans projected to lose their coverage under the GOP plan. But let’s be clear: Obamacare is not safe. In a last-ditch effort to round up more votes, House Speaker Paul Ryan, R-Wis., proposed an amendment that would have, beginning in 2018, allowed states to determine the kinds of essential health benefits required in insurance plans purchased with tax credits. Under Obama’s health care law, insurance plans sold via the federal health care…

In real estate. I'm not an expert on this but I've seen the sausage being made a few times. Individuals with investment money, commercial businesses that might use new space, other possible tenants, maybe or maybe not some designers or builders, municipal or other government stakeholders, community stakeholders such as neighborhood associations, etc. consider a real estate deal. Perhaps there is a bit of condemned land the county wants to sell cheap if only you clean up the brownfield and develop something nice. Maybe the investors include a person who owns an underexploited business…

Today, The Pump Handle had its own bizarre experience with the Trump Administration. It came via an email sent by HHS spokesperson Matt Lloyd to members of the Association for Health Care Journalists. Some of those professionals were reporting on the data released today by the Centers for Medicare & Medicaid Services (CMS) on insurance enrollment on Healthcare.gov. The 90-day open enrollment period ended this week. CMS's plain-spoken news release indicates that 9.2 million individuals selected plans from the ACA marketplace, including three million new consumers. Many of these Americans…

We’re just a humble little public health blog. But we can still do our part. If you or someone you know need help getting health insurance coverage before next week’s enrollment deadline on Jan. 31, here are some good resources. First, why do this? Because this week, the Trump administration abruptly canceled advertising and outreach scheduled to run during this final week of Affordable Care Act enrollment. Apparently, he even pulled ads that were already paid for. But, you can still enroll. According to Paul Demko at Politico: (The Trump administration) is also halting all media outreach…

As Congressional Republicans continue taking steps toward repealing the Affordable Care Act without providing a detailed, workable plan to replace it, more people are speaking out against ACA repeal. GOP Governors John Kasich of Ohio and Rick Snyder of Michigan are speaking to journalists about how the ACA’s Medicaid expansion has helped their states. Governor Snyder explained to The Detroit News that the state accepted the Medicaid expansion but added requirements for recipients earning between 100% and 133% of the federal poverty level, and that the program is working and has the potential…

Recent news has highlighted just how important and popular the Affordable Care Act has been, but its fate under a Trump administration and Republican Congress is uncertain. Congressional Republicans have voted repeatedly to repeal the ACA, but now that they actually have a shot at doing that, journalists and commentators are focusing on how hard it will be to preserve the provisions voters like and politicians vow to keep – let alone the gains in insurance coverage and financial stability. Between the law’s passage in 2010 and early 2016, an estimated 20 million people gained health insurance…

I’m always hesitant to write about matters that are more political than scientific or medical, although sometimes the sorts of topics that I blog about inevitably require it (e.g., the 21st Century Cures Act, an act that buys into the myth that to bring "cures" to patients faster we have to neuter the FDA and a retooled version of which is still being considered). This is one of those times. Yesterday, I woke up to the news that President-Elect Donald Trump had chosen Rep. Tom Price (R-GA) as his new Secretary of Health and Human Services. The Department of Health and Human Services (DHHS),…

After a busy day yesterday and falling asleep early on the couch, I only have time for a quick take today. So file this under "only in America": A 23-year-old Metro Detroit man robbed a South Lyon credit union earlier this month for his daughter, he told investigators according to South Lyon Police Lt. Chris Sovik. Brian Randolph, who is currently jailed on a $500,000 bond and facing up to life in prison for robbery of a banking institution, told detectives he recently lost insurance coverage necessary to pay for cancer treatment his daughter required, Sovic said. Randolph said his daughter…

The American Public Health Association (APHA) takes the prize for the best headline in response to today’s Supreme Court’s decision on the Affordable Care Act (ACA): "Six million sighs of relief." APHA’s executive director Georges Benjamin, MD elaborated: “We are pleased the court understood the legislative history and intent of this law… We know that when people can’t afford health insurance, they don’t get health care — and get sicker as a result. …APHA and the public health community rejoice in today’s decision, and look forward to working with the administration and Congress to realize…

One of the things policy wonks are keeping an eye on as the Affordable Care Act is fully implemented is the proportion of employers who stop offering employees insurance and instead give their workers money they can use to pay premiums of plans sold on health insurance exchanges (or marketplaces). As Robert Pear reports in the New York Times, though, a new IRS ruling will discourage employers from doing that. The IRS will not consider employer arrangements that give workers premium funds (for purchasing insurance through exchanges) to satisfy the ACA requirements, which means employers could…

Last week was National Women’s Health Week, and the Kaiser Family Foundation used the occasion to release the report Women and Health Care in the Early Years of the ACA: Key Findings from the 2013 Kaiser Women’s Health Survey, by Alina Salganicoff, Usha Ranji, Adara Beamesderfer, and Nisha Kurani. The telephone survey of 3,015 women ages 15 – 64 was conducted before the launch of the health-insurance exchanges and several states’ Medicaid expansions, but after several other key provisions of the Affordable Care Act took effect. Starting with plan years beginning after September 22, 2010,…

by Anthony Robbins, MD, MPA President Obama's health reform has been derailed in a collision with health insurance software, but this is hardly a unique experience. In 1995, I was invited to Prague to try to help the Czech Republic reconcile two co-existing public health practice cultures–the hygiene police of the Soviet era and the German tradition of social medicine. Our delegation found another crisis in the works, around the creation of private health insurance that had started in 1990. Payroll deductions bought private health insurance that covered basic physician and hospital service.…

Wonkblog's Sarah Kliff has helpfully compiled "A guide to surviving Obamacare debates at Thanksgiving," and it starts off with a good one: "Your mom wants to know whether Obamacare is a total disaster." Kliff's response focuses on the disastrous rollout of Healthcare.gov, the online marketplace that was supposed to allow for easy health-insurance enrollment for people who need to get coverage. With the website improving but by no means problem-free, the enrollment numbers so far are dismally low. Kliff points out that some states that built their own online marketplaces have successfully…

If you only have time for one long read this week, make it the excellent "Breathless and Burdened" series by Chris Hamby of the Center for Public Integrity. The series website explains, "This yearlong investigation examines how doctors and lawyers, working at the behest of the coal industry, have helped defeat the benefits claims of miners sick and dying of black lung, even as disease rates are on the rise and an increasing number of miners are turning to a system that was supposed to help alleviate their suffering." This is investigative reporting at its finest! Other recent pieces I've…

Blogging is a rather immediate endeavor. Over the last nine years (nearly), I've lost track of how many times I saw something that I wanted to blog about but but by the time I got around to it was no longer topical. Usually what happens is that my Dug the Dog tendencies take over, as I'm distracted by yet another squirrel, although sometimes there are just too many targets topics and too little time. Fortunately, however, sometimes the issue is resurrected, sometimes in a really dumb way, such that I have an excuse to correct my previous oversight. This is just such a time, and the manner in…

The Washington Post’s Lena H. Sun writes about Obamacare implementation, and finds that it differs greatly between Maryland and Virginia, which share a border but have very different attitudes toward the Affordable Care Act. Both have large uninsured populations (around 800,000 in Maryland and 844,000 in Virginia), but Virginia’s opposition to the law means it’s getting far less federal money and leaving its poorest residents with fewer options for affordable insurance coverage. The lawmakers who wrote the ACA included two main ways to help those without employer-sponsored health insurance…

My mailbox today contained an example that Obamacare is working for healthcare consumers.   In an envelope from my health insurance provider was a check for $124.08.   The cover letter from Humana explained it was a rebate of a portion of my premium, as required by the Affordable Care Act's (ACA) Medical Loss Ratio standard. Under the law, health insurers are required to report to HHS's Center for Medicare and Medicaid Services (CMS) how income from premium dollars are spent.  (The first year of reporting was 2011 with the previous year's spending data.)   For individual and small group plans…

Steven Brill's extensive piece in Time has generated a good discussion once again on why Americans pay so much more for health care than other countries, and while I agree with most of his critiques, he seems to have gotten overly hung-up on the hospital chargemaster. Readers of this blog know I've also discussed reform in health care, the diverse sources of excess cost including price gouging on pharmaceuticals, defensive medicine, expensive end-of-life care, the high cost of primary care in the ER etc, and both Brill and I appear to have relied on the same sources of data in the McKinsey…