Wednesday, October 30, 2013

Why Insurers Cancel Policies, And What You Can Do About It

More From Shots - Health News HealthOnline Advice Can Hurt Teens At Risk For Suicide, Self-HarmHealthNotices Canceling Health Insurance Leave Many On EdgeHealthThe Long List Of Health Apps Features Few Clear WinnersHealthWhy Insurers Cancel Policies, And What You Can Do About It

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Victims Of Tainted Steroid Injections Still Struggling

More From Shots - Health News HealthOnline Advice Can Hurt Teens At Risk For Suicide, Self-HarmHealthNotices Canceling Health Insurance Leave Many On EdgeHealthThe Long List Of Health Apps Features Few Clear WinnersHealthWhy Insurers Cancel Policies, And What You Can Do About It

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Tuesday, October 29, 2013

Obamacare Enrollment Period Extended 6 Weeks

More From The Two-Way EuropeFrench Hostages Held In West Africa Since 2010 Win FreedomPoliticsAlabama Agrees To Permanently Gut Immigration LawNewsWATCH: BBC News Introduces The 'Hexacopter'NewsReport Details Industry's 'Cutthroat' Fight Of Miners' Claims

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Obamacare Enrollment Period Extended 6 Weeks

More From The Two-Way EuropeFrench Hostages Held In West Africa Since 2010 Win FreedomPoliticsAlabama Agrees To Permanently Gut Immigration LawNewsWATCH: BBC News Introduces The 'Hexacopter'NewsReport Details Industry's 'Cutthroat' Fight Of Miners' Claims

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Monday, October 28, 2013

Some Health Screenings May Harm More Than Help

More From Shots - Health News HealthUnlikely Multiple Sclerosis Pill On Track To Become BlockbusterHealth CareMore Technical Issues For Obamacare, But Good News For MedicareResearch NewsEeek, Snake! Your Brain Has A Special Corner Just For ThemHealthSome Health Screenings May Harm More Than Help

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Saturday, October 26, 2013

'Loyal Soldier' Sebelius Vows To Stay Put, Fix HealthCare.gov

Listen to the Story 3 min 57 sec Playlist Download Transcript   Enlarge image i

Health and Human Services Secretary Kathleen Sebelius speaks Thursday in Phoenix.

Laura Segall/Getty Images

Health and Human Services Secretary Kathleen Sebelius speaks Thursday in Phoenix.

Laura Segall/Getty Images

This has not been an easy month for Health and Human Services Secretary Kathleen Sebelius.

Republican Sen. Pat Roberts of Kansas � who learned the political ropes working for Sebelius' father-in-law, then a Kansas congressman � called for her to step down over the debut of HealthCare.gov, the problem-plagued website where people are supposed to apply for coverage under the Affordable Care Act.

Invited on the usually friendly-to-Democrats The Daily Show, Sebelius was lampooned by host Jon Stewart, who challenged her to a race of sorts: "I'm going to try and download every movie ever made, and you're going to try to sign up for Obamacare, and we'll see which happens first."

And while she was able to laugh off Stewart's opening gag, Sebelius had trouble clearly explaining why, if businesses have been given an extra year to implement Obamacare, individuals shouldn't have the same delay.

Sebelius served six years as the Democratic governor of largely Republican Kansas. She is the daughter of the late Ohio Gov. John Gilligan. University of Kansas political science professor Burdett Loomis says she remains popular at home, despite the hits she's been taking in Washington:

"This hasn't been an easy time for her. The Obamacare rollout has clearly been problematic; she pretty much got roasted on Jon Stewart; but she's been a loyal soldier to Barack Obama and I think she truly believes that Obamacare is in the best interest of the country."

Seven years ago the Bush administration unveiled Medicare Part D, which provides seniors with prescription drug benefits. The website for that program had a similarly rocky debut. The HHS secretary then was former Utah Gov. Mike Leavitt, who notes Sebelius did not make many of the key decisions regarding the rollout of Obamacare. Leavitt says he empathizes with Sebelius:

"It's much like being the pilot of an airplane full of passengers sitting on the tarmac with a series of complications you don't entirely control. It's better to say to the passengers, 'This is where we are. This is how much time we expect it'll take. ... Here's what we're doing to remedy it and here's how it's going to affect you. We're doing our best.' "

Before being elected governor, Sebelius was Kansas insurance commissioner. The Republican occupant of the job now, Sandy Praeger, says the glitches in the rollout of Obamacare are not Sebelius' fault.

"The complexity of what she's having to deal with is massive and in an environment that's been pretty politically charged, to say the least. So I have a great deal of sympathy for what she's having to work through," says Praeger. "I know she's probably very frustrated."

Praeger says calls for Sebelius to resign are totally inappropriate. And in an appearance in Phoenix, Sebelius rejected Republican demands she step down.

'The majority of people calling for me to resign I would say are people who I don't work for and who do not want this program to work in the first place," Sebelius said Thursday. "I have had frequent conversations with the president and I have committed to him that my role is to get the program up and running, and we will do just that."

Sebelius is expected to testify before a House committee investigating the Affordable Care Act's implementation as soon as Wednesday.

Share Facebook Twitter Google+ Email Comment More From Health Care Health CarePR Experts: Obamacare Message (Not Just The Site) Needs FixPoliticsBipartisan Anger, Competing Interests Over HealthCare.govHealth Care'Loyal Soldier' Sebelius Vows To Stay Put, Fix HealthCare.govBusinessFor Obamacare To Work, It's Not Just About The Numbers

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Wednesday, October 23, 2013

White House Turns To 'Rock Star' Manager For Obamacare Fix

More From It's All Politics PoliticsWhite House Turns To 'Rock Star' Manager For Obamacare FixPoliticsGOP Pollster: What Went Wrong, And WhyPoliticsWednesday Morning Political Mix: Troll, Trial, TribulationPoliticsFor Democrats, Obamacare Web Woes Create 2014 Headache

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Tuesday, October 22, 2013

The HealthCare.gov 'Tech Surge' Is Racing Against The Clock

More From All Tech Considered Digital LifeOnline Dating Is On The Rise (But There Are Still Haters)TechnologyThe HealthCare.gov 'Tech Surge' Is Racing Against The ClockScienceWhat's Creepy, Crawly And A Champion Of Neuroscience?BusinessCredit Cards Under Pressure To Police Online Expression

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How Politics Set The Stage For The Obamacare Website Meltdown

More From Shots - Health News HealthWant Your Daughter To Be A Science Whiz? Soccer Might HelpHealth CareDoctors Enlist Therapists To Deliver Better, Cheaper CareHealthOnline Insurance Brokers Stymied Selling Obamacare PoliciesHealthHow Health Law Affects Fertility Treatment, Health Savings Accounts

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Monday, October 21, 2013

How Long Do They Really Have To Fix That Obamacare Website?

More From Shots - Health News Health CareHow Long Do They Really Have To Fix That Obamacare Website?HealthScientists Grow New Hair In A Lab, But Don't Rush To Buy A CombHealthFirst Polio Cases Since 1999 Suspected In SyriaHealthBreast Milk Bought Online Has High Levels Of Bacteria

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Friday, October 18, 2013

Obamacare Fight Leads Sen. Roberts To Turn Against Old Friend Sebelius

More From It's All Politics RemembrancesTom Foley, A House Speaker Who Embraced Compromise And ComityPoliticsConservative Group Backs Challenge To 'Liberal' McConnellPoliticsAfter Budget Fight, No Sign Of Cease-FirePoliticsObama's Immigration Pivot Hits A Bruised GOP's Weak Spot

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Wednesday, October 16, 2013

Hitches On Health Exchanges Hinder Launch Of Insurance Co-op

More From Shots - Health News HealthFamily Caregiving Can Be Stressful, Rewarding And Life-AffirmingHealth CareTo Reduce Patient Falls, Hospitals Try Alarms, More NursesHealthHitches On Health Exchanges Hinder Launch Of Insurance Co-opHealthBioethicists Give Hollywood's Films A Reality Check

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Tuesday, October 15, 2013

Why A Medical Device Tax Became Part Of The Fiscal Fight

Listen to the Story 3 min 33 sec Playlist Download Transcript  

Among the bargaining chips in the budget crisis on Capitol Hill, there's the small but persistent issue of taxing medical device manufacturers.

The 2.3 percent sales tax covers everything from MRI machines to replacement hips and maybe even surgical gloves. The tax was imposed to help pay for the Affordable Care Act. It didn't attract much attention at first � at least, not outside the world of medical device manufacturers.

But they have waged a persistent campaign to undo the tax, and right now is the closest they have come to succeeding.

House Republicans have made repeated efforts to kill the tax, but Democrats had opposed any changes to the health care law.

Senate Finance Committee Chairman Max Baucus, D-Mont., last month dismissed changes in the medical devices tax. He told Politico that the industry had agreed to it when the bill was being written and "a deal's a deal."

But even Democrats have started softening that hard line.

Illinois Sen. Richard Durbin, the Senate's second-ranking Democrat, told CNN recently: "We can work out something, I believe, on the medical device tax � that was one of the proposals from the Republicans � as long as we replace the revenue."

Last week, a bipartisan compromise in the Senate included the idea of delaying the tax for two years.

Maine Republican Sen. Susan Collins spearheaded the proposal. She cited the lobbying campaign's work when she said the tax "will cause the loss of as many as 43,000 domestic jobs, according to industry estimates."

Related NPR Stories Shots - Health News How A Tax On Medical Devices United Political Rivals It's All Politics A Hint Of Bipartisanship On This Obamacare Tax? Shots - Health News Veterinarians Say Health Law's Device Tax Is Unfair To Pets

Those estimates are crucial to the lobbying effort.

The CEO of one of the industry's giants, Medtronic, said last fall that the company likes to "focus on things we can control." Medtronic, which is based in Minnesota, did not respond to an interview request Tuesday.

But one of Minnesota's senators is a leader of the anti-tax campaign.

Democrat Amy Klobuchar gave industry advocates some advice this summer.

"I think that at the beginning of this battle, people didn't understand in Congress how many medical device manufacturers they had," she said. "I think just making the case at home and also back in Washington makes a difference."

And that is what the medical device industry has been doing, quietly but assiduously.

Cook Group, the largest privately owned maker of medical devices, boosted its lobbying outlays significantly in the past two years. It's also working with an industry consultant, Joe Hage, on a website called no2point3.com.

The website collects stories of anger and anguish from the small-business people who run a lot of the companies. It also has a petition to repeal with 11,000 signatures. It's all fueled by a LinkedIn group that Hage runs.

"The medical devices group is not in league with Washington lobbyists directly," Hage says, but he quickly adds: "We like to think that this effort complements their effort by giving them another bow in their quiver."

Still, it's hardly clear whether those efforts will move votes or whether the whole tax question will be just a pawn in the much larger debate over the budget and the debt limit.

Share Facebook Twitter Google+ Email Comment More From The Government Shutdown PoliticsShutdown Diary: Hope Turns Into Wall Street WarningPoliticsWhy A Medical Device Tax Became Part Of The Fiscal FightPoliticsOn Capitol Hill, A Flurry Of Activity But Still No Deal BusinessJPMorgan To Front Customers If Federal Shutdown Drags On

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Why A Medical Device Tax Became Part Of The Fiscal Fight

Listen to the Story 3 min 33 sec Playlist Download Transcript  

Among the bargaining chips in the budget crisis on Capitol Hill, there's the small but persistent issue of taxing medical device manufacturers.

The 2.3 percent sales tax covers everything from MRI machines to replacement hips and maybe even surgical gloves. The tax was imposed to help pay for the Affordable Care Act. It didn't attract much attention at first � at least, not outside the world of medical device manufacturers.

But they have waged a persistent campaign to undo the tax, and right now is the closest they have come to succeeding.

House Republicans have made repeated efforts to kill the tax, but Democrats had opposed any changes to the health care law.

Senate Finance Committee Chairman Max Baucus, D-Mont., last month dismissed changes in the medical devices tax. He told Politico that the industry had agreed to it when the bill was being written and "a deal's a deal."

But even Democrats have started softening that hard line.

Illinois Sen. Richard Durbin, the Senate's second-ranking Democrat, told CNN recently: "We can work out something, I believe, on the medical device tax � that was one of the proposals from the Republicans � as long as we replace the revenue."

Last week, a bipartisan compromise in the Senate included the idea of delaying the tax for two years.

Maine Republican Sen. Susan Collins spearheaded the proposal. She cited the lobbying campaign's work when she said the tax "will cause the loss of as many as 43,000 domestic jobs, according to industry estimates."

Related NPR Stories Shots - Health News How A Tax On Medical Devices United Political Rivals It's All Politics A Hint Of Bipartisanship On This Obamacare Tax? Shots - Health News Veterinarians Say Health Law's Device Tax Is Unfair To Pets

Those estimates are crucial to the lobbying effort.

The CEO of one of the industry's giants, Medtronic, said last fall that the company likes to "focus on things we can control." Medtronic, which is based in Minnesota, did not respond to an interview request Tuesday.

But one of Minnesota's senators is a leader of the anti-tax campaign.

Democrat Amy Klobuchar gave industry advocates some advice this summer.

"I think that at the beginning of this battle, people didn't understand in Congress how many medical device manufacturers they had," she said. "I think just making the case at home and also back in Washington makes a difference."

And that is what the medical device industry has been doing, quietly but assiduously.

Cook Group, the largest privately owned maker of medical devices, boosted its lobbying outlays significantly in the past two years. It's also working with an industry consultant, Joe Hage, on a website called no2point3.com.

The website collects stories of anger and anguish from the small-business people who run a lot of the companies. It also has a petition to repeal with 11,000 signatures. It's all fueled by a LinkedIn group that Hage runs.

"The medical devices group is not in league with Washington lobbyists directly," Hage says, but he quickly adds: "We like to think that this effort complements their effort by giving them another bow in their quiver."

Still, it's hardly clear whether those efforts will move votes or whether the whole tax question will be just a pawn in the much larger debate over the budget and the debt limit.

Share Facebook Twitter Google+ Email Comment More From The Government Shutdown PoliticsShutdown Diary: Hope Turns Into Wall Street WarningPoliticsWhy A Medical Device Tax Became Part Of The Fiscal FightPoliticsOn Capitol Hill, A Flurry Of Activity But Still No Deal BusinessJPMorgan To Front Customers If Federal Shutdown Drags On

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Friday, October 11, 2013

FAQ: How Obamacare Affects Employers And How They're Responding

This is one of several explainers to help consumers navigate their health insurance choices under the Affordable Care Act, or as some call it, Obamacare. Click here for answers to other common questions. Have a question we missed? Send it to health@npr.org. We may use it in a future on-air or online segment.

Do employers have to do anything different under the Affordable Care Act?

Not right away. The only thing required of employers at the start is that they notify workers that the new health insurance exchanges have opened. You may have received a letter from your employer to this effect � you probably don't need to do anything.

Starting in 2015, large employers with 50 or more workers have a responsibility � but no mandate � to offer employees health coverage. If they don't, they may face fines, but only if their workers go to health insurance exchanges and have earnings low enough to qualify for federal subsidies. Stores and restaurants � less likely to offer health insurance in the past � may be most affected. The coverage rule doesn't affect workers who put in less than 30 hours a week.

There are no responsibilities for small employers with fewer than 50 workers. If they want to buy coverage for their employees, the insurance exchanges represent a new option for them in terms of where to shop. Certain employers with fewer than 25 workers are eligible for federal tax credits. To qualify, the company has to cover at least half of the premium for all of its employees, and also have average wages of less than $50,000. For details on these tax credits, see this answer sheet from the IRS.

Will my employer cut back on my insurance coverage?

A number of employers have been overhauling the health benefits they offer employees, citing rising costs.

There are two themes to what they are doing. In trying to control their own spending, employers often are shifting health costs to employees. So the average annual deductible for an individual � what consumers pay before insurance kicks in � nearly doubled in the past seven years, from $584 in 2006 to $1,135 this year, according to the Kaiser Family Foundation.

But employers aren't just making workers pay more. They're trying to make them think more about health-related expenses and behavior.

Companies such as grocer Kroger Co. pay only a fixed amount for particular drugs or procedures, giving patients incentive to shop around for the best price. IBM started giving rebates to workers who adopt healthy lifestyles. Penalizing smokers with surcharges is one of the few discriminatory measures the health act allows.

What about part-time workers?

Nothing in the Affordable Care Act says that employers have to cover part-time workers. The law defines part time as someone who works less than 30 hours a week.

Some employers that have offered part-time workers minimal coverage, such as Trader Joe's and Home Depot, have dropped it on the grounds that those workers can now find coverage through the insurance exchanges. Most workers in this situation will be pleased with the outcome. They'll likely find better coverage than what they had for less money. Although depending on the situation, some people may see their premiums go up.

Are employers reducing their workforce as a result of the Affordable Care Act?

There have been reports of employers holding back on hiring in order to stay under the 50-employee threshold that triggers health insurance responsibilities. There also have been reports of employers cutting workers' hours to below 30 per week so that they don't count as full-time. While there is anecdotal evidence of both things happening, there's no evidence that those cases have added up to a broader drag on the economy as a whole.

Will my company stop offering coverage to my spouse and dependents?

Some companies, including UPS, have decided to stop covering working spouses if they have access to coverage at their own jobs. The health law does not require employers to cover spouses, but surveys show that only a minority of companies have implemented a "spousal exclusion."

However, employers increasingly offer incentives to get spouses off their plans. They may charge workers extra if a covered spouse has access to other insurance, or they may pay bonuses when spouses are not on the company policy.

The health law requires employers who offer coverage to employees to also offer coverage to dependent children, or pay a penalty.

See other Frequently Asked Questions on the Affordable Care Act:

Understanding The Health Insurance Mandate And Penalties For Going Uninsured All About Health Insurance Exchanges And How To Shop At Them A Young Adult's Guide To New Health Insurance Choices What Retirees And Seniors Need To Know About The Affordable Care Act Where Medicaid's Reach Has Expanded � And Where It Hasn't


Additional coverage from NPR Member Stations:

California (KQED, San Francisco) California (KPCC) California (KXJZ Capital Public Radio, Sacramento) Colorado (Colorado Public Radio) Massachusetts (WBUR, Boston) Minnesota (Minnesota Public Radio) Georgia (WABE, Atlanta) New York (WNYC) Oregon (Oregon Public Broadcasting) Pennsylvania (WHYY newsworks.org) Texas (KUHF) Texas (KUT, San Antonio)

This FAQ was produced through a collaboration between NPR and Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonpartisan health-care policy research organization. The Kaiser Family Foundation is not affiliated with Kaiser Permanente.

Share Facebook Twitter Google+ Email Comment More From The Affordable Care Act, Explained HealthFAQ: Where Medicaid's Reach Has Expanded � And Where It Hasn'tHealthFAQ: How Obamacare Affects Employers And How They're RespondingHealthFAQ: What Retirees And Seniors Need To Know About The Affordable Care ActHealthFAQ: A Young Adult's Guide To New Health Insurance Choices

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California Trains Helpers To Meet Demand For Health Insurance

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Single-Payer Prescription for What Ails Obamacare

�We apologize for the inconvenience. The Marketplace is currently undergoing regularly scheduled maintenance and will be back up Monday 10/7/3013.� You read it right, 3013. That was the message on the homepage of the New York state health insurance exchange website this past weekend.

Yes, the Affordable Care Act (ACA), popularly known as Obamacare, is going through difficult birth pains, as the marketplace websites went live only to crash. The government is not giving out numbers, but informed observers speculate that very few people have succeeded in signing up for any of the plans so far.

The ACA rollout occurred as Republicans shut down the government in their attempt to defund Obamacare. But their strategy backfired. Had there been no shutdown, all of the attention would have been on the disastrous rollout. The fundamental issue, at the core of the health-care dispute, is typically ignored and goes unreported: The for-profit health-insurance industry in the United States is profoundly inefficient and costly, and a sane and sustainable alternative exists�single-payer, otherwise known as expanded and improved Medicare for all. Just change the age of eligibility from 65 to zero.

�When Medicare was rolled out in 1966, it was rolled out in six months using index cards,� Dr. Steffie Woolhandler told me Monday. �So if you have a simple system, you do not have to have all this expense and all this complexity and work.� Woolhandler is professor of public health at CUNY-Hunter College and a primary-care physician. She is a visiting professor at Harvard Medical School and the co-founder of Physicians for a National Health Program, or PNHP. PNHP is an organization with 17,000 physicians as members, advocating for a single-payer health-care system in the U.S.

What is single-payer? Critics denounce it as �socialized medicine,� while ignoring that single-payer is already immensely popular in the U.S., as Medicare. A 2011 Harris poll found that Medicare enjoyed 88 percent support from American adults, followed closely by Social Security. Woolhandler explained that with a Medicare-for-all system, �you would get a card the day you�re born, and you�d keep it your entire life. It would entitle you to medical care, all needed medical care, without co-payments, without deductibles. And because it�s such a simple system, like Social Security, there would be very low administrative expenses. We would save about $400 billion [per year].� Dr. Woolhandler went on, rather than �thousands of different plans, tons of different co-payments, deductibles and restrictions�one single-payer plan, which is what we need for all Americans to give the Americans really the choice they want … not the choice between insurance company A or insurance company B. They want the choice of any doctor or hospital, like you get with traditional Medicare.�

Monthly premiums in most cases are expected to decrease with Obamacare�s health-exchange systems, which will enhance the transparency and ease of comparison for people shopping for a health-insurance policy. If and when the technical problems are eliminated from the online health insurance exchanges, and people can easily shop, there will likely be a huge number of people buying policies for the first time. The ACA offers important advances, which even single-payer advocates acknowledge: subsidies for low-income applicants will make insurance affordable for the first time. Medicaid expansion also will bring many poor people into the umbrella of coverage. Young people can stay on their parents� insurance until the age of 26. People with so-called pre-existing conditions can no longer be denied insurance.

While the ACA was deemed constitutional by the Supreme Court, the opinion gave states the option to opt out of the Medicaid expansion, which 26 states with Republican governors have done. A New York Times analysis of census data showed that up to 8 million poor people, mostly African-Americans and single mothers, and mostly in the Deep South, will be stranded without insurance, too poor to qualify for ACA subsidies, but stuck in a state that rejected Medicaid expansion.

So, while partisan bickering (between members of Congress who have among the best health and benefits packages in the U.S.) has shut down the government, the populace of the United States is still straitjacketed into a system of expensive, for-profit health insurance. We pay twice as much per capita as other industrialized countries, and have poorer health and lower life expectancy. The economic logic of single-payer is inescapable. Whether Obamacare is a pathway to get there is uncertain. As Dr. Woolhandler summed up, �It�s only a road to single-payer if we fight for single-payer.�

Tuesday, October 8, 2013

The Religious Alternative To Obamacare's Individual Mandate

Listen to the Story 7 min 43 sec Playlist Download Transcript   Private Vs. Public Health Care Options

No matter what happens in Congress, the Affordable Care Act deadlines are still in effect. On Tuesday, public exchanges will open for business. Already, several companies are making changes to how they provide health care to their employees.

Host Arun Rath speaks with NPR's Julie Rovner about those changes and the difference between public and private options. You can hear their conversation � and the full story on the health care sharing ministries � at the audio at the top of the page.

The Affordable Care Act requires nearly every American to have health insurance or pay a penalty, beginning Jan. 1. The so-called "individual mandate" has been controversial ever since the law was passed.

But for people who fall into a few select categories, the mandate doesn't apply. Like Native Americans who get health coverage through the Indian Health Service, or people who are incarcerated.

Another exception is for members of "health care sharing ministries," a way for individuals with a "common set of ethical or religious beliefs" to share medical bills.

Sharing Health Burdens

The sharing ministries are not insurance: there's no guarantee that a given bill will be covered. Instead, it's like a co-op, where members decide what procedures to cover, and then all pitch in to cover the cost as group.

"It's a group of people, in this case Christians, who band together and agree that they want to share one another's burdens," says Andrea Miller, medical director for the largest Christian health-insurance alternative, Medi-Share.

She says members put aside a certain amount of money every month, which then goes to other Christians who need help paying their medical bills. Medi-Share's monthly fees vary, but its website advertises that family options "average less than $300 a month."

There are a few requirements to fulfill before participating, Miller says. The first is that you have to be Christian. "Second, you need to agree to living a Christian lifestyle, including no smoking, including not abusing alcohol or drugs," she says.

To constitute as a health care sharing ministry � and therefore be exempt from the Affordable Care Act requirements � the nonprofit has to have been in existence since 1999 (Medi-Share has existed since '93). The ministries also have an independent accounting firm conduct a publicly available annual audit.

Footing The Bill

Tens of thousands of Americans belong to Christian health sharing ministries, including Fred Bennett of Chattanooga, Tenn.

Bennett and his wife, Beth, have belonged to a health care sharing ministry for 19 years. They've always been healthy, but in the last few years, as they've entered their 60s, they started to have medical trouble.

"In '04, my wife was rushed to the hospital with E.coli in her kidneys and, actually, it spread to all of her body," he says.

She recovered, but the hospital bill was staggering. After six days in the hospital, most of which was spent in intensive care, the cost came to about $70,000.

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And that bill was just the beginning for the Bennetts.

"She hasn't had many claims, but unfortunately, I had a stretch of five or six years there that things were pretty rough," Bennett says, including multiple surgeries and a heart attack.

The medical bills reached tens of thousands of dollars, but for each incident, the Bennetts paid only their $250 deductible. The rest was paid by fellow Christians through Medi-Share.

Of course, the same would have been true if they had normal health insurance. But Bennett says he prefers the health sharing ministry because the ministry doesn't pay for procedures he thinks are immoral, like abortions.

"The part I liked about it was that I wouldn't have to be having some of my premiums spent to take care of someone who wasn't taking of themself, physically or spiritually, either one," he says.

What's Not Covered

While the federal health law includes an exemption for health sharing ministries, some states have sued to try to keep them out. The concern is that consumers shopping for insurance will be confused about what ministries really guarantee in the way of coverage.

"We do not share in every medical need that a person has," Miller of Medi-Share says. "Some of the things we don't share in are related to lifestyle issues, such as an abortion. But others of them are related to things that the members have agreed that they would rather pay for themselves."

For example, she says, members tend to pay for their own preventative care (with the exception of very young children). There are also some restrictions on pre-existing conditions.

At Medi-Share, Miller works with a steering committee of health share members who discuss what kind of care is covered by the guidelines. "Any significant change in the guidelines is something that has to be passed by all the members," she says.

In August, CNBC reported that members whose claims are rejected have the right to file an appeal. In the current fiscal year, 76 percent of the bills submitted to Medi-Share were considered eligible, and all of those were covered, Medi-Share told CNBC.

Spiritual Support

Bennett of Tennessee points out that because all the members decide what to share the cost of, health ministries often cover things insurance rarely does, like adoption fees and funeral costs. Plus, he says, his health sharing ministry gives him a service he could never get from an insurance company.

"The night before my surgery, the lady who'd helped me locate the right providers and everything called me back and said, 'Would it be OK if I prayed with you for your surgery tomorrow?'"

Three days later, she called back to ask how the surgery went.

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Lower Health Insurance Premiums to Come at Cost of Fewer Choices

From the New York Times –

Federal officials often say that health insurance will cost consumers less than expected under President Obama�s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers.

From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.

When insurance marketplaces open on Oct. 1, most of those shopping for coverage will be low- and moderate-income people for whom price is paramount. To hold down costs, insurers say, they have created smaller networks of doctors and hospitals than are typically found in commercial insurance. And those health care providers will, in many cases, be paid less than what they have been receiving from commercial insurers.

Some consumer advocates and health care providers are increasingly concerned. Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.

Consumers should be prepared for �much tighter, narrower networks� of doctors and hospitals, said Adam M. Linker, a health policy analyst at the North Carolina Justice Center, a statewide advocacy group.

�That can be positive for consumers if it holds down premiums and drives people to higher-quality providers,� Mr. Linker said. �But there is also a risk because, under some health plans, consumers can end up with astronomical costs if they go to providers outside the network.�

Insurers say that with a smaller array of doctors and hospitals, they can offer lower-cost policies and have more control over the quality of health care providers. They also say that having insurance with a limited network of providers is better than having no coverage at all.

Cigna illustrates the strategy of many insurers. It intends to participate next year in the insurance marketplaces, or exchanges, in Arizona, Colorado, Florida, Tennessee and Texas.

�The networks will be narrower than the networks typically offered to large groups of employees in the commercial market,� said Joseph Mondy, a spokesman for Cigna.

The current concerns echo some of the criticism that sank the Clinton administration�s plan for universal coverage in 1993-94. Republicans said the Clinton proposals threatened to limit patients� options, their access to care and their choice of doctors.

Continue reading…

After Years Of Political Talk, The Obamacare Fight Gets Real

Listen to the Story 4 min 46 sec Playlist Download Transcript   Enlarge image i

A woman looks at the HealthCare.gov insurance exchange site on Tuesday in Washington, D.C.

Karen Bleier/AFP/Getty Images

A woman looks at the HealthCare.gov insurance exchange site on Tuesday in Washington, D.C.

Karen Bleier/AFP/Getty Images

In the three years since President Obama signed the Affordable Care Act into law, it has survived more than 50 votes in Congress to defund or repeal it, a Supreme Court challenge, a presidential election and, as of Tuesday morning, a government shutdown. Much of the spending for the law is mandatory and won't be cut off.

But now, it must survive its own implementation.

Tuesday is the day that Obamacare goes operational. Americans can begin signing up for health insurance on online marketplaces known as exchanges.

And that begins a new chapter in the nearly five-year-old political battle over Obamacare, says GOP pollster Bill McInturff.

"What happens today is we're going to move from this policy debate about Obamacare to a reality outcome debate: What impact does it have on millions and millions of Americans, and do they judge it to be good or bad?" McInturff says. "And I believe attitudes will shift based on that reality of the outcome of Obamacare."

The Political Costs

The president is confident that attitudes will shift in his direction. Like the Green Eggs and Ham story invoked by Republican Sen. Ted Cruz � Obamacare's chief antagonist in Congress � Obama is certain that when Americans try it, they will like it.

"That's what's going to happen with the Affordable Care Act," the president has said. "And once it's working really well, I guarantee you they will not call it Obamacare."

But Obamacare � as it will be called for the foreseeable future � has already exacted a stiff political price from the president.

Opposition to the health care overhaul fueled the rise of the Tea Party, which led to the Democrats' historic loss of their House majority in 2010. But Republicans paid a political price, too. Their efforts to repeal the law in 2012 failed, and Democrats held on to the White House and the Senate.

Through it all, public opinion has been consistent � consistently negative about the law, even if voters don't want it defunded. Health care historian Jonathan Oberlander says that's why he's not sure even a flawless rollout will change perceptions.

"This is not a program like Medicare or Social Security; it is a program that really is a series of policies and regulations and subsidies," he says. "And that makes it difficult to explain to the uninsured what the benefits are, and I don't think it's going to be easy for Obamacare, regardless of how well or not it does in the next year to overcome that chasm."

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Why The Debate Hasn't Gone Away

Both parties think the law helps them politically.

Democratic pollster Geoff Garin says Republicans have overreached by staking everything on stopping the law.

"The Republicans have made the debate about Obamacare a debate about them and their tactics and their wanting to repeal it totally," Garin says, "rather than a debate about Democrats or whether Obamacare is a good or a bad thing."

But Republican economist Douglas Holtz-Eakin says there are good reasons the GOP has planted its flag on Obamacare.

"I've had many people come up to me and say, 'Why do Republicans do this?' And I say, well, the polling tells them to," he says. "It continues to be the single thing that moves independents. So you get the famous swing voters. Nothing generates more political animation than Obamacare, so if you look at intensity and turnout, it still works."

Republicans see independent voters as the key to their two goals in 2014: regaining control of the Senate and expanding their majority in the House. And there's also another dynamic motivating Republicans: Many feel this is their last chance to stop the law.

"If we don't do it now, in all likelihood, Obamacare will never, ever be repealed," Cruz said recently on Fox News. "Why is that? Their plan is to get the American people addicted to the sugar, addicted to the subsidies."

A 'Sort Of Paralysis'

Surrender is unthinkable for either side in this fight. That's because the health care debate reflects the deepest divide in American politics: the core beliefs of the two parties about the role of government. That debate is � for now � at a standoff.

"We ask very simple questions," says McInturff, the GOP pollster. " 'Do you think the government should do more or less?' And that's a 48-48 proposition right now in the country. And it's been that way for about a decade. And guess what, if you've got a country that's poised at 48-48 about whether government should do more or less, and we have a health care issue that is absolutely wrapped around that question, it's not surprising that it's led to this sort of paralysis that has made this a very contentious issue for cycle after cycle."

Obamacare is not only the law of the land. It's also, as of Tuesday, a practical reality for millions of Americans. But as a political issue, it's far from settled � and won't be anytime soon.

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Monday, October 7, 2013

Administration Touts Lower-Than-Expected Obamacare Premiums

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One Key Thing No One Knows About Obamacare

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Tech Problems Plague First Day Of Health Exchange Rollout

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