June 21, 2012
By RICARDO ALONSO-ZALDIVAR | Associated Press
WASHINGTON (AP) — Covering all the bases ahead of a momentous Supreme Court ruling, the Obama administration plans to move ahead with major parts of the president’s health care law if its most controversial provision does not survive, according to veteran Democrats closely involved with the legislation.
Even if the requirement that nearly every U.S. resident have health insurance is declared unconstitutional, the remaining parts of the law would have far-reaching impact, putting coverage within reach of millions of uninsured people, laying new obligations on insurers and employers, and improving Medicare benefits even as payments to many service providers get scaled back.
The White House says President Barack Obama is confident the whole law will be upheld when the court issues its ruling in the next week or two, but officials will be ready for any outcome.
“We do believe it’s constitutional, and we ... hope and expect that’s the decision the court will render,” senior adviser David Plouffe said Sunday on ABC. “We obviously will be prepared for whatever decision the court renders.” Administration officials have not wanted to discuss contingency plans to avoid creating the impression that the president is preparing for a high court rebuke.
Nevertheless, the Obama administration will move ahead to implement major elements of the law if the individual coverage requirement is struck down, two senior Democrats told The Associated Press. One is a leading Democrat familiar with the administration's thinking, the other a high-level Capitol Hill staffer. The two Democrats spoke on condition of anonymity to avoid appearing to be out of step with the administration’s public stance.
Because the law’s main coverage expansion does not begin until 2014, there would be time to try to fix serious problems that losing the individual coverage requirement may cause for the health insurance industry.
Surviving parts of the law would “absolutely” move ahead, said the congressional official. A Congress mired in partisan trench warfare would be unable to repeal or amend what’s left of the law, allowing the administration to advance. Much of the money for covering the uninsured was already provided in the law itself.
“Legislatively we can’t do a thing, and we are going to move full speed ahead (with implementation),” the official said.
How the Supreme Court will decide is unclear. It may uphold the law, strike it down entirely or do something in between. Skeptical questioning by the court's conservative justices during oral arguments this spring has fueled speculation that the court may invalidate the so-called individual mandate.
Opponents say the requirement that individuals have coverage is unconstitutional, that the federal government can’t tell people to obtain particular goods or services.
Supporters say the mandate is a necessary component of a broader scheme to regulate health insurance, which is well within the powers of Congress. By requiring people to carry health insurance or pay a fine, the law seeks to broaden the pool of people with coverage, helping to keep premiums affordable.
If the mandate is struck down, that would still leave in place a major expansion of Medicaid, the federal-state safety net program for low-income people.
The Medicaid expansion was originally estimated to account for about half the more than 30 million people slated to get coverage under the law. Without a mandate, the number would be smaller but still significant.
Federal tax credits to help middle-class people buy private health coverage would also survive, as would new state-based insurance markets.
Such subsidies have never previously been available, and millions are expected to take advantage of them, whether or not insurance is required by law. Still, it could be tricky to salvage the law's full blueprint for helping middle-class uninsured people.
Overturning the mandate would have harmful consequences for the private insurance market. Under the law, insurers would still have to accept all applicants regardless of health problems, and they would be limited in what they can charge older, sicker customers.
As a result, premiums for people who directly buy their own coverage would jump by 15 percent to 20 percent, the Congressional Budget Office estimates. Older, sicker people would flock to get health insurance but younger, healthier ones would hold back.
To forestall such a problem, the administration asked the court — if it declares the mandate unconstitutional — to also strike down certain consumer protections, including the requirement on insurers to cover people with pre-existing health problems. That would mitigate a damaging spike in premiums.
Whether or not the court goes along with that request, more work would be needed to find alternatives to a federal mandate. That could provide an opening for state officials, as well as major insurance companies, to join in finding workable substitutes for the mandate. Congressional approval would likely be needed.
Without the individual requirement, some 14 million people would still get coverage, budget office estimates suggest. Supporters of the law point out that’s still a lot of people.
March 06, 2014
LAWT News Service
As the First Lady’s Let’s Move! initiative celebrates its fourth anniversary, a recently published study shows that the rates of childhood obesity are beginning to decline among children ages two to five. The Centers for Disease Control and Prevention (CDC) released a report showing a forty-three percent drop in the obesity rate among children of preschool age over the past decade.
“I couldn’t be more excited by the news that obesity rates for 2-5 year olds declined by 43% over the last 10 years,” said First Lady Michelle Obama.
“Progress of this magnitude can only be explained by the leadership and hard work we are seeing across this country. From parents to teachers, doctors to community leaders, everyone is stepping up to make small changes that are having a huge impact – and today, healthy habits are becoming the new norm for our kids. We have a long way to go, but I am more confident than ever that we can give all our children the bright, healthy futures they deserve.”
The new report follows CDC’s findings from last summer, which showed that obesity rates among low-income preschoolers declined in 19 states and territories across the country.
Getting kids off to a healthy start is absolutely critical to their long term health, according to health experts and the Let’s Move! officials said they have made early childhood a top priority of their campaign. In 2011, Let’s Move! Child Care was started to empower child care and early education providers to help give kids a healthy start to life. The program encourages 1-2 hours of physical activity, reduced screen time, healthy food such as fruits and vegetables as snacks, no fried foods, only non-sugar sweetened beverages like water and low fat milk, and support for mothers who continue to breastfeed.
“There is tremendous progress being made, but much work remains,” they said.
“ Simple actions by parents can have a major impact on their kid’s health. As part of our continued efforts through Let’s Move! Child Care, here are four simple tips for parents who are working hard to keep their kids healthy:”
1. If you can breastfeed, breastfeed.
2. Fill half your kids’ plates with fruits and vegetables.
3. Serve your kids only water or low-fat milk.
4. Make sure your kids get at least 60 minutes of active play every day.
February 27, 2014
By Cora Jackson-Fossett
The celebratory aura that usually accompanies Black History Month turned solemn on February 23, as the AIDS Healthcare Foundation (AHF) and Holman United Methodist Church united to present ‘A Day of Action’ in South Los Angeles.
Focusing on the disproportionate impact of HIV/AIDS on African American and Latino communities, AHF and Holman UMC collaborated on a local launch of the national public awareness campaign, ‘AIDS is a Civil Rights Issue.’
Church members, elected officials and civic leaders filled the sanctuary to kick-off the campaign at the 11 a.m. worship service led by Holman Pastor Kelvin Sauls. Following remarks by Mayor Eric Garcetti, NAACP—LA President Leon Jenkins, and AHF President Michael Weinstein, the audience was captivated by the powerful message from the keynote speaker, the Rev. Al Sharpton.
“Fifty years past the Civil Rights Act…and we’re still somehow confused into believing that civil rights is only for some of us, not all of us,” Sharpton declared.
“As we deal with HIV/AIDS as a civil right, I see the progressives out there, but where are the rest of them? Those for whom people fought and died so they could live in the suburbs…and walk through the gates of Ivy League schools…”
Confirming his commitment to Christian doctrine, he noted, “Jesus heals the sick. He did not judge the sick. The reason I fight for gays and lesbians, the reason why I stand by the afflicted, is because I want to be like Jesus.”
Following the service, a standing room only crowd packed the ‘AIDS is a Civil Rights Issue’ town hall discussion. With KJLH broadcaster Dominique DiPrima moderating, the panelists shared insight and personal experiences with HIV/AIDS.
“Our ‘AIDS is a Civil Rights Issue’ public awareness campaign is intended to open dialogue with stakeholders in the community, the public health arena, and faith-based groups as well as public officials about health disparities and the importance of universal access to HIV prevention and care and treatment,” said AHF President Weinstein.
Hydeia Broadbent, an HIV/AIDS activist and humanitarian, said, “I was diagnosed with AIDS at the age of three and they said I wouldn’t live past the age of five. I turn 30 this year.
“Let us think that this is our issue. The ‘H’ in HIV stands for ‘human,’ which means it can affect any one of us. It takes us to make a difference for our brothers and sisters,” she insisted.
The panel also included the Rev. Dr. Cecil ‘Chip’ Murray, senior fellow at the Center for Religion and Civic Culture at USC and former pastor of First A.M.E. Church; the Rev. James M. Lawson, pastor emeritus at Holman UMC and veteran civil rights activist; Gabriel Maldonaldo, CEO of TruEvolution and In the Meantime Men’s HIV campaigner; Claudia Spears, mother of an HIV-positive individual and activist; and Samantha Granberry, senior director at AHF Worldwide.
Closing out the ‘Day of Action,’ the Holman Choir performed in the 54th Annual Concert of Negro Spirituals. Once again, the sanctuary was filled to hear the choir sing an array of musical selections reflecting African Americans history.
“Under the direction of William Campbell, Jr., this concert celebrated the power and purpose of the freedom song as an example of extraordinary imagination of what freedom and equality can look like,” said Pastor Sauls.
“Leveraging the vision of our ancestors articulated through song, the "Day of Action" was a call to provoke ongoing catalytic action towards robust and strategic collaboration between progressive faith and community organizations to sound the alarm on new and improved systems and schemes of discrimination and marginalization,” he added.
January 23, 2014
By Charles Ornstein
Special to the NNPA from ProPublica
The first half of the Obamacare open enrollment period is over, and yesterday,federal health officials announced sign-up figures from the first three months.
After a disastrous start, HealthCare.gov(which handles enrollment for 36 states) began functioning properly. It, along with state-run insurance exchanges, netted more than 2.1 million signups between Oct. 1 and Dec. 28.
But are sign-ups on pace to meet theCongressional Budget Office’s projection of 7 million this year? And is there an adequate balance between young and old, sick and healthy, to keep costs in line? That’s harder to say.
Here’s what we know:
Some states are performing much better than others.
Connecticut has already exceeded the target the Centers for Medicare and Medicaid Services (CMS) wanted it to have by the end of March, according to acasignups.net. New York and Rhode Island are also on pace to beat expectations. But other states are lagging. They include Maryland, Oregon and Massachusetts, which run their own exchanges and continue to be plagued by website problems. Also far behind are New Mexico and Mississippi, which rely on HealthCare.gov.
Enrollees are skewing older.
Currently, 33 percent of enrollees are 55 to 64 years old, compared to only 30 percent who are under 35. In Arkansas, Maine, Ohio, West Virginia and Wisconsin, at least 40 percent of enrollees are over 55. A higher proportion of younger enrollees are going to have to sign up before the end of March in order to help offset the costs of older ones. CMS officials say younger enrollees tend to sign up later in the process, as they did several years ago when Massachusetts implemented its individual mandate.
The vast majority of those signing up qualify for financial assistance.
About 79 percent of the early sign-ups will receive financial assistance, just a bit less than what the Congressional Budget Office estimated (86 percent – see page 3). That ranges from an implausible low of 9 percent in Washington D.C., to 100 percent in Oregon.
Here’s what we don’t know:
How many of those who signed up for coverage previously had plans canceled by insurance companies
If the policies are merely replacing coverage that individuals already had, the law won’t make the dent in the uninsured that proponents hoped for. In New York, for example, only 44 percent of the early enrollees had been uninsured.
The health status of early enrollees. While some people consider age a proxy for health status, in truth, it isn’t a very effective stand-in. Experts say they need to know more about the health of those who enrolled to know if the insurance risk pool will be balanced, keeping premiums from exploding in the years to come. Health insurerHumana reported last week that the mix of its early enrollees was “more adverse than previously expected,” in part because the Obama administration gave those with canceled policies the ability to stay in them for another year. That assumes those who chose to stay were healthier than others.
Whether enrollees have paid their first month’s bill.
Coverage does not take effect unless consumers pay their initial bill. There has been plenty of confusion about the deadline to sign up – and confusion about when the first payment is due. Dates have changed and vary from state to state, insurer to insurer. Some insurers set a deadline of Jan. 10; others have set other dates in January for coverage that began Jan. 1. “It’s been pulling teeth,” Shaun Greene, chief operating officer of Utah-based Arches Health Plan, told the Wall Street Journal. The newspaper reported that, as of Thursday, Arches had collected about 60 percent of premiums for people who signed up for coverage that took effect Jan. 1.
How many people have signed up for coverage outside of the exchanges.
In order to receive a premium tax credit to offset the monthly cost of coverage, individuals have to sign up using one of the health exchanges created under the law. But those who do not qualify or don’t want to bother can sign up directly with an insurance company. Ultimately, those figures will be publicly reported, but that will take months, or even years.
Will the open-enrollment period close strong as it did in Massachusetts?
Supporters of the Affordable Care Act regularly point to the experience of Massachusetts, which implemented a similar individual mandate in 2007, and saw a late surge of enrollment, particularly among the young. The open enrollment period for Obamacare runs through March 31, leaving plenty of time for folks to sign up.
Editor’s Note: This post is adapted from Ornstein’s “Healthy buzz” blog. Have you tried signing up for health care coverage through the new exchanges? Help us cover the Affordable Care Act by sharing your insurance story.
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