WBEZ | ACA http://www.wbez.org/tags/aca Latest from WBEZ Chicago Public Radio en House calls for the homebound make a comeback http://www.wbez.org/news/house-calls-homebound-make-comeback-113747 <p><p>&nbsp;</p><p style="text-align: center;"><iframe frameborder="0" height="338" scrolling="no" src="http://www.npr.org/templates/event/embeddedVideo.php?storyId=455470438&amp;mediaId=455481394" width="600"></iframe></p><p>Dr. Roberta Miller hits the road at 8 a.m. to see her patients.</p><p>Many are too old or sick to go to the doctor. So the doctor comes to them.</p><p>She&#39;s put 250,000 miles on her Honda minivan going to their homes in upstate New York. Home visits make a different kind of care possible.</p><p>&quot;You can evaluate the person as a whole,&quot; says Miller, who has been a home care physician in Schenectady, N.Y., for more than 20 years. &quot;You see everything that influences their health and well-being: the environment, the surrounding people, the support system, whether they had or didn&#39;t have food.&quot;</p><p>Miller spends about an hour at each house call. Conversation with patients and their family members flows so naturally that it&#39;s easy to miss that she&#39;s also checking vital signs, gently stretching a hand, noting which pill bottles are empty.</p><p>Although Miller&#39;s practice may harken back to the country doctor of decades past, it could be the future of medicine. In 2013, about 2.6 million Medicare claims were filed for patient home visits and house calls. That&#39;s up from 2.3 million visits in 2009 and 1.4 million visits in 1999, according to Medicare statistics.</p><p>The trend is&nbsp;<a href="http://www.aafp.org/afp/2011/0415/p925.html">expected to accelerate</a>&nbsp;as baby boomers grow older. One in 20 people over the age of 65 is homebound in the U.S., according to a&nbsp;<a href="http://archinte.jamanetwork.com/article.aspx?articleid=2296016">study</a>&nbsp;published in July inJAMA Internal Medicine.</p><p>&quot;That&#39;s just the nature of the population we treat,&quot; Miller says. &quot;They&#39;re extremely ill. Homebound patients often have up to 12 or 13 problems, not just one.&quot;</p><p>And they&#39;re often invisible. These people could be living just down the block, and you&#39;d never know it. Many of them never leave their homes.</p><p>Miller&#39;s patients include a 55-year-old woman with ALS who can communicate only with her eyes, a 27-year-old former quarterback left quadriplegic and in a coma after surgery on an Achilles tendon, a 92-year-old woman cared for by her daughter, and a severely depressed man who lives alone.</p><p>After the Affordable Care Act took effect in 2014, Miller saw a spike in new patient requests after Medicare reimbursements increased for people who are disabled or 65 and older.</p><p>&quot;Now we can afford to see them and take care of them. Because they haven&#39;t had medical care, they have multiple medical needs and psychosocial needs,&quot; she says. &quot;It has given us access to a group of people, but more importantly, they have access to us.&quot;</p><p>But reimbursements declined in 2015 because of sequestration. And now Medicaid reimbursements rates are starting to fall as well.</p><p><em>Editor&#39;s note: This is an abbreviated version of a&nbsp;<a href="http://www.npr.org/2015/11/08/448406540/doctor-treats-homebound-patients-often-unseen-even-by-neighbors">story</a>&nbsp;that ran on Sunday, Nov. 8.</em></p><div class="image-insert-image "><a href="http://www.npr.org/2015/11/08/448406540/doctor-treats-homebound-patients-often-unseen-even-by-neighbors" target="_blank"><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/see-more-here_custom-d0f9b8fb9bd953bf8cf1f5b9bcb0a041dc792d31-s800-c85.jpg" style="height: 414px; width: 620px;" title="(Misha Friedman for NPR)" /></a></div></p> Wed, 11 Nov 2015 16:51:00 -0600 http://www.wbez.org/news/house-calls-homebound-make-comeback-113747 New protections for transgender patients are coming http://www.wbez.org/news/new-protections-transgender-patients-are-coming-113584 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/A poster from a 2013 rally in Washington, D.C. supporting equal health and livelihood of trans people..jpg" alt="" /><p><p><img alt="" id="1" src="http://www.marketplace.org/sites/default/files/styles/primary-image-766x447/public/8604815836_71ec0d624a_z.jpg?itok=afd2pRX-" style="height: 362px; width: 620px;" title="A poster from a 2013 rally in Washington, D.C. supporting equal health and livelihood of trans people. Friday marks the deadline for the Obama administration to finalize rules that will include protections for transgender patients. (flickr/Ted Eytan)" typeof="foaf:Image" /></p><div><div><div>For years, transgender adults have faced discrimination in healthcare so hostile it&rsquo;s almost laughable. Almost.</div><div>&nbsp;</div></div></div><p>&ldquo;A trans-woman broke her arm playing softball,&rdquo; said Mara Keisling, executive director the National Center for Transgender Equality. &ldquo;The insurance company refused to pay for it because if she hadn&rsquo;t been transgender she wouldn&rsquo;t have been playing softball. There&rsquo;s just a million stories like that.&rdquo;</p><p>The U.S. Department of Health and Human Services is finalizing specific provisions of a rule under the Affordable Care Act that broadens civil rights protection.</p><p>This is the first federal law to prohibit discrimination on the basis of sex in healthcare, which means hospitals, nursing homes, health insurers and doctors are barred from discriminating against transgender Americans&nbsp;&mdash;&nbsp;as well as others based on sex.</p><p>This new rule puts the entire industry on notice. It&rsquo;s now illegal to discriminate against people based on their sexual orientation, just like it&rsquo;s been illegal to deny care to people based on age, religion or race.&nbsp;Friday is the deadline for the Obama Administration to finalize new rules.</p><p>HHS&rsquo;s Jocelyn Samuels said that means insurers can no longer categorically deny services. For example, take gender transition care.&nbsp;</p><p>&ldquo;If an insurer said, &#39;we will not cover any services related to gender transition, we will treat that as a denial of access to coverage&#39;&nbsp;&mdash;&nbsp;that is prohibited by the ACA,&rdquo; she said.</p><p>Once the final rule is in place, University of Michigan Law Professor Sam Bagenstos, a former assistant attorney general for civil rights under the Obama Administration, said he can imagine scenarios where an insurer covers some services, but gender transition remains expensive.</p><p>&ldquo;It gets gray pretty quickly,&rdquo; he said. &ldquo;I think the real question is how much is HHS going to feel willing to say in the abstract about these questions.&rdquo;</p><p>While this likely opens the doors to more lawsuits, Keisling of the National Center for Transgender Equality noted this gives people legal standing for the first time.</p><p>&ldquo;When they go to the doctor and the doctor says, &#39;I don&rsquo;t feel comfortable,&#39; they know they have the ability to say, &#39;I am a human being and you have to treat me. I have a legal right to get medical care,&#39;&rdquo; Keisling said.</p><p>Keisling estimates there are some 1 million transgender Americans, some of whom have stopped seeking medical care due to bad experiences in the past.</p><p>&mdash; <a href="http://www.marketplace.org/topics/health-care/new-protections-transgender-patients-are-coming" target="_blank"><em>via Marketplace</em></a></p></p> Mon, 02 Nov 2015 09:37:00 -0600 http://www.wbez.org/news/new-protections-transgender-patients-are-coming-113584 Obamacare fans out new apps, allies to persuade the uninsured http://www.wbez.org/news/obamacare-fans-out-new-apps-allies-persuade-uninsured-113577 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/health-enrollment_custom-1ed8caffa24ce8eed18e5730750ba946602accae-s800-c85.jpg" alt="" /><p><div id="res452910804" previewtitle="Aymara Marchante (from left) and Wiktor Garcia talked with Maria Elena Santa Coloma, an insurance adviser with UniVista Insurance, during February 2015 sign-ups for health plans in Miami, Fla."><div data-crop-type=""><img alt="Aymara Marchante (from left) and Wiktor Garcia talked with Maria Elena Santa Coloma, an insurance adviser with UniVista Insurance, during February 2015 sign-ups for health plans in Miami, Fla." src="http://media.npr.org/assets/img/2015/10/29/health-enrollment_custom-1ed8caffa24ce8eed18e5730750ba946602accae-s800-c85.jpg" style="height: 412px; width: 620px;" title="From left, Aymara Marchante and Wiktor Garcia talked with Maria Elena Santa Coloma, an insurance adviser with UniVista Insurance, during February 2015 sign-ups for health plans in Miami, Fla. (Joe Raedle/Getty Images)" /></div><div><div><p>Ten million people still don&#39;t have health insurance two years after the Affordable Care Act went into effect.</p></div></div></div><p>Some never bought a policy. But 20 percent went to the trouble of signing up on<a href="https://www.healthcare.gov/">HealthCare.gov</a>, or one of the state insurance exchanges, and even made payments. Then, those 2 million people let their insurance lapse.</p><p>NPR asked visitors to our Facebook page to&nbsp;<a href="https://www.facebook.com/NPR/photos/pb.10643211755.-2207520000.1446142660./10153909585316756/?type=3&amp;theater">tell us why</a>.</p><p>Many, like Laura Patterson, dropped their coverage when they got good news on the job front.</p><p>&quot;I was a seminary student working part time at a church and I needed health insurance,&quot; she says. &quot;I enrolled for the first half of the year in a plan that I knew, even if I just had a fairly minor accident, I wouldn&#39;t be able to pay all the bills. When I graduated from seminary and got a full-time job as a pastor, I had really great coverage through my church, so I dropped my ACA plan.&quot;</p><p>Others say they dropped their Obamacare health coverage because they found the plans too confusing, too expensive or not worth it.</p><p>Brendan Skwire tells NPR his insurance was too pricey. &quot;Basically, my premiums doubled when my income imploded,&quot; he says. &quot;I simply couldn&#39;t afford to pay the bill.&quot;</p><p>Several people say they were dropped from their health plan&#39;s rolls without warning. Elaine Marie was one of many who tell us they never knew their insurers were seeking more information from them.</p><p>&quot;I was dropped from my plan last year for &#39;not providing additional income information,&#39; &quot; Marie says. &quot;I check my mail regularly, and did not receive notice in the mail, or via email, or through the secure exchange system email.&quot;</p><p>Meanwhile, Vic Higgs of New York says the premiums and copays required in her current Obamacare plan are too expensive, relative to the small amount of medical care she uses each month. She plans to drop the plan in January.</p><p>&quot;I only visit two doctors a year, and only receive one monthly prescription that &mdash; prior to having insurance &mdash; cost me 80 bucks a month,&quot; Higgs writes. &quot;I think paying directly for the doctor visits and prescriptions is cheaper right now than having insurance.&quot;</p><p>As open enrollment begins this Sunday, these are some of the people Uncle Sam is going to try to re-enlist in the health care exchanges.</p><p>In the two years since the Affordable Care Act went into effect, most people eligible who actually wanted health insurance and could afford it have been enrolled.</p><p>The remaining patients who lack insurance will be harder to lure &mdash; and harder to keep, says&nbsp;<a href="http://www.hhs.gov/about/leadership/secretary/sylvia-mathews-burwell/index.html">Sylvia Burwell</a>, secretary of the department of health and human services.</p><p>Burwell says people in this group tend to be young, and live barely above the poverty line. About a third are members of minority groups, and most are men.</p><p>&quot;The remaining uninsured just get harder and harder to reach,&quot; says&nbsp;<a href="http://kff.org/person/larry-levitt/">Larry Levitt</a>, a health reform and insurance markets analyst at the Kaiser Family Foundation.</p><p>There&#39;s little information showing where people go when they leave the exchanges. A<a href="http://news.coveredca.com/2015/10/covered-california-surpasses-two.html">study</a>&nbsp;of the California market found only 15 percent quit and remained uninsured. Levitt says the national figures are probably about the same.</p><p>So what&#39;s the government to do? HHS is trying a variety of strategies.</p><p>The agency plans to use email,&nbsp;<a href="https://www.healthcare.gov/subscribe/">text messages</a>,&nbsp;<a href="https://www.facebook.com/Healthcare.gov/">Facebook</a>&nbsp;and online ads to convince the holdouts to get insurance. It&#39;s also launching some new Web tools that will allow people to&nbsp;<a href="https://www.healthcare.gov/lower-costs/">compare health plans</a>&nbsp;more easily and estimate their cost.</p><p>A new app lets consumers input details of their medical needs, including the names of doctors and medications, to find appropriate plans. The app also allows them to estimate how many visits they expect to have, and prescriptions they expect to use, as well as estimate how much they&#39;re going to spend out of pocket, beyond of their monthly premiums.</p><p>And for the first time, HHS will talk about penalties. People who don&#39;t buy a policy of some sort will face a&nbsp;<a href="https://www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/">$695 charge</a>&nbsp;per adult at tax time next year.</p><p>The agency will get lots of help from private groups in enrolling patients this year. For example, the nonprofit group Enroll America has staff in 14 states and works with community organizations across the country.</p><p>&quot;We do a lot of work with faith leaders across the country,&quot; says&nbsp;<a href="https://www.enrollamerica.org/about-us/who-we-are/anne-filipic/">Anne Filipic</a>, the group&#39;s president. &quot;We work with community colleges and small business owners. We work with restaurant associations and taxi cab associations. Perhaps we&#39;ll go to church on Sunday, and we&#39;ll actually stand up in front of the congregation and share with them the information.&quot;</p><p>Enroll America will be offering its own&nbsp;<a href="https://www.enrollamerica.org/get-covered-america/get-covered-calculator/">Web app</a>&nbsp;to help with the comparison of health plans.</p><p>The hope is that extra clarity will reduce unexpected costs and help keep people like Dave Egbert and his partner Rich Davis motivated to get insured and stay that way.</p><p>Egbert, of Huron, S.D., also contacted NPR via Facebook. He says he and Davis each dropped their coverage because the fees for doctor visits and tests added up unexpectedly. They could pay the premiums, Egbert says, but the overall costs were too much.</p><p>&quot;I couldn&#39;t afford to actually&nbsp;use&nbsp;the health insurance,&quot; he says.\</p><p>&mdash; <a href="http://www.npr.org/sections/health-shots/2015/10/30/452909204/obamacare-deploys-new-apps-allies-to-convince-the-uninsured?ft=nprml&amp;f=452909204" target="_blank"><em>via NPR</em></a></p></p> Fri, 30 Oct 2015 14:38:00 -0500 http://www.wbez.org/news/obamacare-fans-out-new-apps-allies-persuade-uninsured-113577 Jeb Bush has a plan to replace Obamacare; here's what's in it http://www.wbez.org/news/jeb-bush-has-plan-replace-obamacare-heres-whats-it-113341 <p><div style="text-align: center;"><img alt="" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/Jeb%20Bush%20is%20the%20latest%20Republican%20to%20offer%20an%20alternative%20to%20Obamacare..jpg" style="height: 465px; width: 620px;" title="Jeb Bush is the latest Republican to offer an alternative to Obamacare. (Sean Rayford/Getty Images)" /></div><div><p>Republicans in Congress and on the campaign trail call for an Obamacare repeal all the time. Plans to replace it are rarer, though. Obamacare is a fantastically complicated policy, and overhauling the health care system would likewise be a complicated business, affecting not only government spending and the economy, but people&#39;s very lives on an intensely personal level.</p><p>This week, presidential candidate and former Florida Gov. Jeb Bush released his own detailed proposal for repealing and replacing the Affordable Care Act. In a&nbsp;<a href="http://www.c-span.org/video/?328700-1/former-governor-jeb-bush-rfl-health-care-policy-address">speech</a>&nbsp;and an&nbsp;<a href="http://www.unionleader.com/article/20151013/OPINION02/151019793&amp;source=RSS">op-ed in the New Hampshire Union Leader</a>, Bush announced his plan is aimed at cutting health care costs. Here&#39;s what his plan would do.</p><p><strong>What are the basics of Bush&#39;s plan?</strong></p><p>Bush&#39;s speech and op-ed decry the &quot;skyrocketing premium costs&quot; he says Obamacare created and argue for giving more power to the states. With those as his major guiding principles, here are the highlights of his plan:</p><ul><li><p>Repeal Obamacare, providing its 17 million participants a &quot;transition plan&quot; away from the program.</p></li><li><p>Give people tax credits to buy catastrophic health care plans.</p></li><li><p>Replace the so-called &quot;Cadillac Tax,&quot; albeit with a&nbsp;<a href="http://www.nytimes.com/2015/10/14/upshot/jeb-bush-has-found-a-part-of-obamacare-to-love.html?rref=upshot">policy</a>&nbsp;similarly imposing higher taxes on expensive health plans.</p></li><li><p>Allow some businesses to contribute toward their workers&#39; health insurance, in lieu of providing that coverage themselves.</p></li><li><p>Eliminate the&nbsp;<a href="https://www.cms.gov/cciio/resources/data-resources/ehb.html">benefits</a>&nbsp;the ACA requires health plans to provide.</p></li><li><p>Increase the maximum amount that people can contribute to their health savings accounts from $3,350 to $6,650.</p></li><li><p>Cap federal health spending to states, creating what appears to be a&nbsp;<a href="http://www.vox.com/2014/7/25/5930699/block-grants-explained">block grant-like</a>Medicaid program.</p></li></ul><p><strong>Would it lower health care costs?</strong></p><p>Bush&#39;s plan would make it cheaper to buy your own insurance, says one expert, but there would be trade-offs &mdash; lower costs could mean fewer benefits.</p><p>&quot;I have no doubt that premiums in the individual market would be lower under Bush&#39;s plan, mainly because there would be less regulation of the benefits those plans have to offer,&quot; said Larry Leavitt, co-executive director of the Kaiser Family Foundation&#39;s Program for the Study of Health Reform and Private Insurance.</p><p>Bush&#39;s plan&nbsp;<a href="http://www.nytimes.com/2015/10/14/us/politics/jeb-bush-offers-health-plan-that-would-undo-affordable-care-act.html">gets rid of</a>&nbsp;the requirement that plans cover certain things (Obamacare&#39;s &quot;essential health benefits&quot;), like maternal care and mental health. Rather, it encourages so-called &quot;catastrophic&quot; health insurance plans &mdash; bare-bones plans that protect people in expensive emergency situations. Those plans tend to not only have lower premiums but also higher deductibles.</p><p>&quot;Bush emphasizes high-deductible plans and [health savings accounts] and wants to encourage those plans. High deductibles do discourage people from using services and lead to lower health spending overall,&quot; Leavitt said.</p><p>The plan also would relax Obamacare&#39;s guaranteed coverage for pre-existing conditions. Instead, it would only guarantee it for people with &quot;continuous coverage.&quot; Defenders say this would stop people from getting coverage only when they are sick, but detractors say this makes it too easy to not be covered, as financial hardship or employment changes can easily interrupt coverage. That provision could likewise lower costs by lowering the number of chronically ill people in risk pools.</p><p>Altogether, the plan looks like it could easily lower health care spending.</p><p>&quot;Do I believe that his plan will cost less than the current status quo under the Affordable Care Act? I believe the answer is yes,&quot; said Mark Fendrick, a professor at University of Michigan&#39;s medical school and public health school.</p><p>But there are a lot of &quot;buts&quot; to tack on here. For one, there&#39;s still a lot we don&#39;t know &mdash; for example, how much the plan might cut spending on low-income Americans&#39; health care, as well as how much those new tax credits would cost compared to what&#39;s in place right now.</p><p>Another thing to consider is where that cost-cutting comes from &mdash; is lower-cost health insurance always better, or is it at some point detrimental to customers?</p><p>&nbsp;</p><blockquote class="twitter-tweet" lang="en"><p dir="ltr" lang="en">Today in NH, I announced my plan to repeal &amp; replace Obamacare. Read about it here: <a href="http://t.co/E3JsN4Aqas">http://t.co/E3JsN4Aqas</a> <a href="http://t.co/6ymKRXI1Vs">pic.twitter.com/6ymKRXI1Vs</a></p>&mdash; Jeb Bush (@JebBush) <a href="https://twitter.com/JebBush/status/653959139153063936">October 13, 2015</a></blockquote><script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script><p>&nbsp;</p><p>Bush&#39;s policies would curb cost growth to an extent, said Sabrina Corlette, senior research fellow at Georgetown&#39;s Health Policy Institute, but she added a caveat: &quot;I would note that they do so on the backs of consumers, rather than tackling some of the more thorny issues such as how we pay providers and suppliers.&quot;</p><p>Moreover, Fendrick said, focusing too intently on costs might be wrongheaded.</p><p>&quot;I did not go to medical school to learn how to save people money,&quot; he said. &quot;So when the first question always is whether we should save money on health care or not, that is largely irrelevant to the bigger question of whether this would make people healthier or not. ... My answer is probably not.&quot;</p><p><strong>OK, so would it make people healthier?</strong></p><p>The unsatisfying answer is that it&#39;s impossible to know. But here&#39;s what we do know: One thing is that the plan would remove Obamacare&#39;s mandate that people get coverage. Removing that, as well as requirements that businesses provide coverage, could easily leave many fewer people insured.</p><p>But does less coverage mean worse health? There&#39;s some evidence of this, but it&#39;s not entirely clear-cut.</p><p>One&nbsp;<a href="http://www.ncbi.nlm.nih.gov/pubmed/18815523">2008 meta-analysis</a>, for example, found that health care access increased self-reported health, the use of preventive services, and lowered mortality.</p><p>But a recent,&nbsp;<a href="http://www.nejm.org/doi/full/10.1056/NEJMsa1212321#t=articleResults">well-known study</a>&nbsp;of Medicaid in Oregon was more mixed &mdash; going on Medicaid was associated with lower rates of depression and better self-reported health (as well as increased financial stability) but no statistical difference in blood pressure or cholesterol. People sought out more diabetes treatment, but improvements in their health also weren&#39;t significant.</p><p>Meanwhile, higher-deductible plans seem to reduce health care usage, as a&nbsp;<a href="http://www.nber.org/papers/w21632?utm_campaign=ntw&amp;utm_medium=email&amp;utm_source=ntw">recent study</a>&nbsp;found. That might be good, in the sense that it might reduce unnecessary doctor visits, but it might reduce necessary ones as well.</p><p>That&#39;s a lot of information, so here&#39;s the upshot: Reasonable people could disagree on this. Leavitt, for his part, stressed that the link between insurance and outcomes is murky. Fendrick, meanwhile, thinks health outcomes would likely be worse under Bush&#39;s plan.</p><p>But here&#39;s one more important point: This question wouldn&#39;t even affect many Americans whose employers would simply continue providing coverage. Rather, Bush&#39;s plan would disproportionately affect lower-income people, according to several nonpartisan experts who spoke to NPR.</p><p>Aside from potentially cutting Medicaid benefits, the size of Bush&#39;s tax credits is adjusted based on age, not income, according to the New York Times.</p><p>&quot;This is not a wise path if one&#39;s priority is to protect Americans facing the greatest economic and health risks,&quot; said Harold Pollack, professor at the University of Chicago&#39;s School of Social Service Administration, in an email.</p><p><strong>What don&#39;t we know?</strong></p><p>Bush&#39;s plan does lay out a lot of information, but a few important parts aren&#39;t specifically explained. For example, it says there would be a &quot;transition plan&quot; for the 17 million people currently covered by Obamacare, but it doesn&#39;t explain what that plan looks like.</p><p>&quot;It would be a huge transition from Obamacare to a plan like this, which would be a huge disruption,&quot; Leavitt said. &quot;If this were to become a reality, there would be a lot more details required about how that transition would work.&quot;</p><p>There&#39;s also the cost. The Bush campaign says it believes the plan would reduce the deficit. But there aren&#39;t enough specifics here to really know what that might look like.</p><p>We do know that repealing Obamacare could be expensive. The Congressional Budget Office&nbsp;<a href="http://www.politico.com/story/2015/06/obamacare-repeal-congressional-budget-office-deficit-119228">estimated earlier this year</a>&nbsp;that repealing the Affordable Care Act would add $353 billion to the deficit. Bush&#39;s plan would mitigate some of these effects, like with his replacement for the Cadillac Tax, but it&#39;s unclear to what degree, as well as how the rest of his plan&#39;s costs and cost-cutting would balance out.</p><p><strong>What is Jeb Bush saying with this plan?</strong></p><p>Wanting to repeal Obamacare doesn&#39;t itself set Bush apart from other Republicans &mdash; calls for Obamacare repeal have been constant since the law passed in 2010.</p><blockquote class="twitter-tweet" lang="en"><p dir="ltr" lang="en">.<a href="https://twitter.com/HillaryClinton">@HillaryClinton</a>&nbsp;and&nbsp;<a href="https://twitter.com/BernieSanders">@BernieSanders</a>&nbsp;would double-down on Obamacare &amp; its failures. My plan:&nbsp;<a href="http://t.co/BZgQcM6YXE">http://t.co/BZgQcM6YXE</a>&nbsp;<a href="http://t.co/HVio8lkrQD">pic.twitter.com/HVio8lkrQD</a></p>&mdash; Jeb Bush (@JebBush)&nbsp;<a href="https://twitter.com/JebBush/status/654028797214371841">October 13, 2015</a></blockquote><p>But the plan does send a couple of political messages about Bush. One is in setting his priorities. Opponents may attack Bush for the plan&#39;s potential effects on lower-income Americans, but it does accomplish other, decidedly conservative economic goals.</p><p>&quot;It&#39;s important to see these replacements not as doing everything the ACA did but as fulfilling other policy aims: less regulation, cutting taxes and reducing federal spending,&quot; Leavitt said.</p><p>Moreover, Bush seems to be staking out a position as the substantive, policy-wonk GOP contender. His detailed repeal-and-replace plan, on top of his other recent tax and energy proposals, for example, could help cement that identity.</p></div><p>&mdash;<a href="http://www.npr.org/sections/itsallpolitics/2015/10/14/448570670/jeb-bush-has-a-plan-to-replace-obamacare-heres-whats-in-it"><em> via NPR</em></a></p></p> Wed, 14 Oct 2015 12:25:00 -0500 http://www.wbez.org/news/jeb-bush-has-plan-replace-obamacare-heres-whats-it-113341 Morning Shift: Same-sex marriage debate heats up in corporate America http://www.wbez.org/programs/morning-shift-tony-sarabia/2014-04-10/morning-shift-same-sex-marriage-debate-heats <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/Cover Flickr Andrea Goh.jpg" alt="" /><p><p>After controversies with Honey Maid and Mozilla, we examine how companies are handling the same-sex marriage issue. We also take a look at some of the challenges in overcoming health care disparities. Plus, the Leonard Cohen inspired music of Greg Ashley.</p><div class="storify"><iframe allowtransparency="true" frameborder="no" height="750" src="//storify.com/WBEZ/morning-shift-same-sex-marriage-debate-heats-up-in/embed?header=false&amp;border=false" width="100%"></iframe><script src="//storify.com/WBEZ/morning-shift-same-sex-marriage-debate-heats-up-in.js?header=false&border=false"></script><noscript>[<a href="//storify.com/WBEZ/morning-shift-same-sex-marriage-debate-heats-up-in" target="_blank">View the story "Morning Shift: Same-sex marriage debate heats up in corporate America" on Storify</a>]</noscript></div></p> Thu, 10 Apr 2014 08:15:00 -0500 http://www.wbez.org/programs/morning-shift-tony-sarabia/2014-04-10/morning-shift-same-sex-marriage-debate-heats Adjunct professors demand inclusion in health care reforms http://www.wbez.org/news/adjunct-professors-demand-inclusion-health-care-reforms-106034 <p><p>Starting in January 2014, large employers will be required to give health benefits to people who work at least 30 hours a week. The provision of the federal Affordable Care Act applies to anyone with more than 50 full-time employees &ndash; including all of Illinois&#39; community colleges.</p><p>Now some adjunct professors are worried they&rsquo;ll have their hours cut by colleges who don&rsquo;t want to shell out the cash come January.</p><p>Dennis Polkow joined a group of protesters Friday outside the Westin Hotel, where Illinois community college leaders were holding a weekend gathering. After working at Oakton Community College for 13 years, he&rsquo;s teaching 3 classes this semester and making less than 12 thousand dollars, he says, with no benefits<b style="font-weight: normal;"><span style="font-size: 16px; font-family: Arial; vertical-align: baseline; white-space: pre-wrap;">. </span></b>Like many other adjuncts, Polkow often juggles jobs at several colleges to make ends meet.</p><p>He said when he heard about the health care bill, &ldquo;I thought, hallelujah, affordable health care act. I&rsquo;ll be able to get affordable health care. Instead it&rsquo;s like...cut, cut, cut, cut, cut.&rdquo;</p><p>Polkow&rsquo;s one of the people who&rsquo;d be covered under Obamacare. But this February he found out Oakton may limit adjunct course loads in preparation for the health care law to kick in.</p><p>The college caught flack from faculty over memos that circulated about limiting adjunct course hours, and now Oakton Community College President Peg Lee says nothing&rsquo;s been decided.</p><p>&ldquo;We don&rsquo;t even know how to define the number of hours,&rdquo; she said Friday.</p><p>Adjuncts are paid by the course hour rather than by hours worked, and federal guidelines for calculating who will get coverage are still under review. Lee says whatever the calculations, community colleges are already strapped for cash. Governor Quinn&rsquo;s 2014 budget slashes higher education by five percent, and Lee says Oakton&rsquo;s still waiting on state reimbursement checks from last year. Sequestration cuts could also limit the numbers of students bringing federal aid into the community college system.</p><p>&ldquo;As much as I believe in universal health care and a single payer, we can&rsquo;t be that universal health care and single payer provider,&rdquo; Lee said. &ldquo;We just don&rsquo;t have the money.&rdquo;<img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/RS7114_051-scr.JPG" style="height: 187px; width: 280px; float: right;" title="Peg Lee (WBEZ/Lewis Wallace)" /></p><p>It&rsquo;s unclear whether most community colleges will adopt the practice of cutting adjunct hours to avoid Obamacare costs.</p><p>&ldquo;We&rsquo;re learning what the rules are and how they impact employees and employers, and the decisions that need to be made,&rdquo; said Mike Monaghan, director of the Illinois Community College Trustees Association. &ldquo;We have lots more work to do.&rdquo;</p><p>Still, he said the adjuncts&rsquo; concerns are legitimate.</p><p>&ldquo;Everybody has reason to be concerned, whether you&rsquo;re an employee or an employer,&rdquo; Monaghan said. &ldquo;Any additional expense puts pressure on declining budgets.&rdquo;</p><p>Cuts are already in place at Joliet Junior College (JJC).&nbsp;In anticipation of the health care reforms, the administration has placed a cap of six course hours per semester on all adjuncts&rsquo; schedules beginning this summer. At the protest Friday, JJC adjuncts&rsquo; union president Al Kennedy spoke quietly but urgently&nbsp;about the effect of the cuts on some union members.</p><p>&ldquo;Are they going to be able to pay their rent for their apartment? Are they gonna be able to put food on the table for the kids? They&rsquo;re just beside themselves,&rdquo; he said.</p><p>JJC stands by the decision, saying that planning for a law they still have so little information about is a balancing act.</p><p><img alt="" class="image-original_image" src="http://llnw.wbez.org/styles/original_image/llo/insert-images/RS7116_019-scr.JPG" style="height: 201px; width: 300px; float: left;" title="Steven Brody (WBEZ/Lewis Wallace)" />&ldquo;I think this is just one of the sort of byproducts of this law,&rdquo; said JJC spokesperson Kelly Rohder.</p><p>But to protester Steven Brody, also an Oakton adjunct, this is about &nbsp;more than a fight over health care.</p><p>&ldquo;This is simply the first reaction of every one of these colleges to having to finally come to grips with the fact that they overutilize and underpay their adjunct faculty,&rdquo; he said.</p><p><a href="http://www.academicworkforce.org/CAW_portrait_2012.pdf" target="_blank">A recent study</a> found that three quarters of college classes nationwide are taught by part-time or adjunct instructors, a dramatic shift from the 1970s when the majority of classes were taught by tenured faculty. Average pay for adjunct professors adds up to just over $20,000 a year for eight courses total, and most of the positions don&rsquo;t come with health insurance.</p><p><em>Follow <a href="https://twitter.com/LewisPants" target="_blank">Lewis Wallace on Twitter</a>.</em></p></p> Mon, 11 Mar 2013 16:44:00 -0500 http://www.wbez.org/news/adjunct-professors-demand-inclusion-health-care-reforms-106034 The NRA has a say even in your health care http://www.wbez.org/blogs/achy-obejas/2012-12/nra-has-say-even-your-health-care-104566 <p><div class="image-insert-image "><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/RS2581_AP05031408767-guns%20Nam%20Y.%20Huh-scr.jpg" style="float: right; height: 300px; width: 300px;" title="AP file" />Did you think the National Rifle Association had reached its nadir when it suggested that, no matter the costs, we should put an armed guard in every school in the nation? Did you think it was a bit much that the group thought to inject itself in education policy by providing a whole gun training regimen for schools?</div><p><br />Here&rsquo;s another NRA policy that&rsquo;s right there with that flash of genius, that&#39;s far more intrusive, and one with which the group has had some success: The Firearm Owners Privacy Act -- <a href="http://www.myfloridahouse.gov/sections/Bills/billsdetail.aspx?BillId=44993">already passed in 2011 in Florida</a>, the nation&rsquo;s loony bin -- would seek to ban physicians from asking patients about gun ownership and possession.<br /><br />The act basically says that doctors can ask about smoking, drinking, drugs, physical abuse, caloric intake and any other health risk factor they can come up with, but not about firearm possession. Never mind that study after study shows that even <a href="http://www.bradycampaign.org/facts/gunviolence/gunsinthehome/">law-abiding gun owners have a higher risk of death by gunshot</a> if they keep their weapons at home.<br /><br />The idea behind it is so impractical that even the version signed by Florida Gov. Rick Scott comes with exemptions for EMTs and other emergency personnel.<br /><br />And want to know what&rsquo;s even scarier? There&rsquo;s <a href="http://www.dailykos.com/story/2012/12/19/1171950/-Guns-mental-health-and-Obamacare#">a section in the Affordable Care Act</a>, AKA Obamacare, that mirrors the Firearm Owners Act. The ACA provision doesn&rsquo;t out-and-out prohibit doctors from asking about guns -- a useful question when dealing with minors, or potentially homicidal or suicidal patients -- but it discourages them from doing so. The provision, under the ACA&rsquo;s Title X, even goes so far as to forbid doctors from collecting any data that concerns gun ownership.<br /><br />A judge issued <a href="http://www.miamiherald.com/2012/07/02/2879089/miami-federal-judge-sides-with.html">a permanent injunction against Florida&#39;s bill</a> last July, saying, among other things, that the law was so vague it violated doctor&rsquo;s First Amendment rights to free speech.<br /><br />But the Obamacare provision -- which was <a href="http://www.redstate.com/briansikma/2012/06/28/how-the-nra-helped-obamacare/">written with the NRA&rsquo;s blessing</a> -- stands. In other words, even when the NRA loses a state statute in the courts, it has something to build on down the road based on federal law.<br /><br />That&rsquo;s why <a href="http://smartgunlaws.org/">six other states</a> -- Alabama, Minnesota (c&rsquo;mon!), North Carolina, Oklahoma, Tennessee and West Virginia -- have tried to pass their own versions of the Firearm Owners Privacy Act.<br /><br />Supporters of Firearm Owners Privacy Act argue that the law basically <a href="http://www.sunshinestatenews.com/story/florida-appeal-flawed-decision-overturning-docs-vs-glocks-law">allows doctors to drop patients who are gun owners </a>-- as if doctors had a particular prejudice rather than a concern about the health consequences of gun ownership.<br /><br />&quot;What is curious about this law &mdash; and what makes it different from so many other laws involving practitioners&rsquo; speech &mdash; is that it aims to restrict a practitioner&rsquo;s ability to provide truthful, non-misleading information to a patient, whether relevant or not at the time of the consult with the patient,&rdquo; wrote U.S. District Judge Marcia Cooke in her ruling on the Florida version.<br /><br />In other words, Judge Cooke put a stop to a law that would have kept physicians from asking questions about guns and how it might impact the health -- perhaps even <em>life</em> -- of their patients.<br /><br />But the NRA would like doctors to let that info be.</p><p>And by working with the NRA on the ACA to keep gun nuts from upending the entire law, the White House has provided the very platform for this nasty bit of murderous legalese to keep popping up, like varmints in a midway shooting game.</p></p> Wed, 26 Dec 2012 12:21:00 -0600 http://www.wbez.org/blogs/achy-obejas/2012-12/nra-has-say-even-your-health-care-104566 Politicians respond to Supreme Court ruling of President Obama's health care law http://www.wbez.org/blogs/bez/2012-06/politicians-respond-supreme-court-ruling-president-obamas-health-care-law-100497 <p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/7441740662_5f33882e60_z.jpg" style="float: left; width: 300px; height: 200px; " title="Protesters outside the Supreme Court as the ACA ruling came down Thursday morning. (Flickr/Talk Radio News Service)" />As the Supreme Court ruling on the Affordable Care Act came down Thursday morning, politicians in Illinois and across America began to release their responses. Below are some of their statements, culled from Twitter, email and phone interviews conducted by WBEZ.</p><p>&quot;I gave (President Barack Obama) my advice. I told him many times, I said the political cost of doing this, and thank God, for the rest of the country, he didn&#39;t listen to me.&quot;&nbsp;<strong><a href="https://twitter.com/RahmEmanuel/status/218371515417243649">-- Chicago Mayor Rahm Emanuel</a></strong></p><p>&quot;We&#39;re going to do whatever we can to do to repeal this law, because as Governor Romney said, this law is terrible for America.&quot;</p><p>&ldquo;I want to start over. I want to get rid of the whole thing. And then I want Republicans and Democrats to sit down and work on the things we all agree on, which are tort reform, expanding health savings accounts, letting Americans cross state lines to buy insurance. Look, Obamacare goes in the exact opposite direction.&rdquo;&nbsp;<strong>-- Representative Joe Walsh (R-IL-8th)</strong></p><p>&ldquo;Today is a historic day when the Supreme Court declared that the Affordable Care Act and the&nbsp;health security it brings is the law of the land. With President Obama&rsquo;s leadership, Congress&nbsp;enacted the most significant law in half a century. The law ends insurance industry abuses in&nbsp;the health system, improves Medicare and Medicaid for seniors and the disabled, and covers&nbsp;millions of uninsured Americans. Today, Republicans need to finally put to rest the relentless,&nbsp;partisan attacks against a landmark law that is already working to provide affordable,&nbsp;high-quality care....Today is a day for celebration. Tomorrow we will get back to work ensuring that every&nbsp;American can take advantage of the benefits of Obamacare and have access to affordable,&nbsp;comprehensive and high quality health care. &rdquo; <strong>-- Representative Jan Schakowsky (D-IL)</strong></p><p>&quot;While I respect the Court&rsquo;s decision, the health care law threatens our economic recovery by raising taxes, imposing new regulations and creating a drag on the economy. Congress should repeal the health care law and replace it with common sense, centrist reforms that give Americans the right to buy insurance across state lines and expand coverage without raising taxes, while blocking the government from coming between patients and their doctors.&quot; <strong>-- Senator Mark Kirk (R-IL)</strong></p><p>&quot;I am pleased to see that the Supreme Court has validated the important benefits of this law and look forward to its full implementation #hcr&quot; (<a href="http://twitter.com/RepBobbyRush/status/218347873954308099">Twitter</a>)</p><p>&ldquo;Today the United States Supreme Court told the American People that they do indeed have a right to quality health care. I am pleased that the most important part of the Affordable Care Act, the individual mandate that makes the entire program possible, has been ruled constitutional.&nbsp;</p><p>Now the fight begins to make sure that these benefits are not taken away.&nbsp; Please know that I will continue to fight in behalf of the residents of the First Congressional District and our nation.&quot;<strong>&nbsp;</strong><strong>-- Representative&nbsp;Bobby Rush&nbsp;(D-IL)</strong></p><p>&ldquo;Unfortunately, the court&rsquo;s ruling will have tragic consequences that will spread well beyond the issue of mandatory insurance and health care services. It will drive up health care costs and put yet another financial burden on our already struggling small businesses. We in Illinois will be exploring avenues available for implementing this sweeping law and still providing the greatest options and lowest cost for our families and businesses.&rdquo; <strong>-- State Senator Bill Brady (R-IL)</strong></p><p>&ldquo;This decision means that we can move forward to address the unsustainable increase in health care costs and expand the protection of health insurance coverage to over 30 million Americans &ndash; including millions in Illinois.&rdquo;</p><p>&ldquo;Those who opposed any change in the law and dismissed the constitutionality of this measure were rejected by the actions of Congress and the opinion of the Chief Justice.&rdquo;</p><p>&ldquo;It is also noteworthy that after two controversial, activist decisions in Bush v. Gore and Citizens United, the Chief Justice, in both the Arizona immigration law and the Affordable Care Act cases, appears to be working to reestablish the political neutrality of this court. That is a positive development.&rdquo; <strong>--&nbsp;Senator Dick Durbin (D-IL)</strong></p><p>&quot;Constitutionality should not be mistaken for good public policy. Although the Supreme Court today ruled that ObamaCare is constitutional, that does not change the fact that it will drive up the cost of health care, add to our already exploding debt and hurt job creation, including within our vibrant medical device manufacturing sector.</p><p>&quot;Standing outside the Supreme Court in our Nation&#39;s Capitol today as the ruling was handed down I was reminded of the passion this legislation has ignited among an overwhelming and consistent majority of Hoosiers who have rejected ObamaCare from the very start.</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/7461564836_c384cb2342_z.jpg" style="float: right; width: 300px; height: 215px; " title="A scene from the Supreme Court following their ruling to uphold the ACA. (Flickr/SEIU International)" />&quot;The stakes are too high. Our economy, our future, depends on us electing Mitt Romney this November.&quot; <strong>--&nbsp;Indiana Republican Party State Chairman Eric Holcomb&nbsp;</strong></p><p>&ldquo;While this ruling speaks to the constitutionality of the ACA, the real question is whether the 2010 law makes for good public policy.&nbsp;The American people missed a golden opportunity with health care reform when Congress rushed it through on a partisan basis. I believe that properly confronting the big issues and challenges in this country requires input from both sides and bipartisan support. There are positive provisions in the ACA that should remain as law, but there is more we can do to increase quality and access to care, while reining in skyrocketing costs to the health care system.&nbsp; As health care reform continues to take shape, I am committed to working in a bipartisan way to find positive solutions to the rising costs of health care.&rdquo;&nbsp;--&nbsp;<strong>Representative Robert Dold (R-IL)</strong></p><p>&ldquo;I applaud today&rsquo;s decision by the United States Supreme Court upholding the Affordable Care Act. &nbsp;</p><p>&ldquo;In accordance with this historic ruling, the Cook County Health and Hospitals System will continue to seek a 1115 Medicaid Waiver from the work Centers for Medicare and Medicaid Services. This waiver, if approved by the federal government, would permit CCHHS to receive federal reimbursement for the costs of treatment provided to the tens of thousands of our patients who currently have no medical coverage but will gain access to Medicaid on January 1, 2014.</p><p>&ldquo;CCHHS is the foundation of the safety-net health network in northeastern Illinois. Today&rsquo;s decision by the Supreme Court will allow our system to proactively prepare for Affordable Care Act implementation in 2014.&rdquo; <strong>-- Cook County Board President Toni Preckwinkle</strong></p><p>&quot;There&#39;s still so much more that needs to be done but for most families this insures that them the rug is not going to be pulled out from underneath them.&quot; <strong>-- Representative Mike Quigley (D-IL)</strong></p><p>&ldquo;With or without the unpopular health mandate, the cost of care continues to rise, and it&rsquo;s up to Republicans and Democrats alike to work across the aisle on solutions. I&rsquo;m disappointed that the Court did not put a stop to the government overreach.&nbsp; But Washington still has a responsibility to fix polices that are raising costs, hurting job creation, siphoning millions from Medicare, and placing an added layer of bureaucracy between patients and their doctors. &nbsp;&nbsp;<br /><br />&ldquo;Under the Administration&rsquo;s law, too many families will lose the plans they have, and small businesses are afraid to hire new employees. We should go back to work on effective, bipartisan reforms that Democrat leaders ignored, like Association Health Plans for small businesses, allowing consumers to buy insurance across state lines, and medical malpractice reform. At the same time, we can and should maintain coverage for pre-existing conditions and young adults under 26.&rdquo; <strong>-- Representative Judy Biggert (R-IL)</strong></p></p> Thu, 28 Jun 2012 11:27:00 -0500 http://www.wbez.org/blogs/bez/2012-06/politicians-respond-supreme-court-ruling-president-obamas-health-care-law-100497 Supreme Court upholds requirement that most Americans have health insurance http://www.wbez.org/news/supreme-court-upholds-requirement-most-americans-have-health-insurance-100489 <p><p><em>Update Thursday June 28 10:05 a.m.&nbsp;</em></p><p><a href="http://www.wbez.org/node/100489#Ruling"><em>Read the full text of the decision.</em></a></p><p>The&nbsp;Supreme&nbsp;Court&nbsp;on Thursday upheld the individual insurance requirement at the heart of President Barack Obama&#39;s historic health care overhaul.</p><p>The decision means the huge overhaul, still only partly in effect, will proceed and pick up momentum over the next several years, affecting the way that countless Americans receive and pay for their personal medical care. The ruling also hands Obama a campaign-season victory in rejecting arguments that Congress went too far in requiring most Americans to have health insurance or pay a penalty.</p><p>Breaking with the&nbsp;court&#39;s&nbsp;other conservative justices, Chief Justice John Roberts announced the judgment that allows the law to go forward with its aim of covering more than 30 million uninsured Americans.</p><p>The justices rejected two of the administration&#39;s three arguments in support of the insurance requirement. But the&nbsp;court&nbsp;said the mandate can be construed as a tax. &quot;Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness,&quot; Roberts said.</p><p>The&nbsp;court&nbsp;found problems with the law&#39;s expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states&#39; entire Medicaid allotment if they don&#39;t take part in the law&#39;s extension.</p><p>The&nbsp;court&#39;s&nbsp;four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.</p><p>Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.</p><p>&quot;The act before us here exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting states all Medicaid funding,&quot; the dissenters said in a joint statement.</p><p>Republican campaign strategists said presidential candidate Mitt Romney will use the&nbsp;court&#39;sruling to continue campaigning against &quot;Obamacare&quot; and attacking the president&#39;s signature health care program as a tax increase.</p><p>&quot;Obama might have his law, but the GOP has a cause,&quot; said veteran campaign adviser Terry Holt. &quot;This promises to galvanize Republican support around a repeal of what could well be called the largest tax increase in American history.&quot;</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/Illinois%20dentists%20AP.jpg" style="float: right; width: 300px; height: 192px; " title="Dentists attend to a patient at the Chicago Family Health Center in Chicago. (AP/M. Spencer Green, File)" /><strong>Illinois reacts: Quinn &quot;thrilled&quot; with health care ruiling</strong></p><p>Illinois&nbsp;officials must decide how to implement key provisions of President Barack Obama&#39;s health care overhaul now that the U.S. Supreme Court upheld the law&#39;s individual insurance requirement.</p><p>That includes developing an online insurance marketplace where people and small businesses can comparison shop for insurance beginning in 2014.</p><p>Gov. Pat Quinn&#39;s administration wouldn&#39;t answer questions about&nbsp;Illinois&#39; plans, but aides say he&#39;s &quot;thrilled&quot; by the ruling.</p><p>A lawmaker who led work on implementing the state&#39;s insurance exchange has said&nbsp;Illinoiswon&#39;t be able to meet a Nov. 16 deadline to get it set up.</p><p>Democratic Rep. Frank Mautino told The Associated Press this week that&nbsp;Illinois&nbsp;must consider a federal-state partnership to meet the requirement.</p><p>Illinois&nbsp;officials estimate about 800,000 now-uninsured residents would get public or private health insurance.</p><p><strong>Republicans plan to continue campaigning against health care law&nbsp;</strong></p><div class="image-insert-image "><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/SCOTUS1.jpg" style="height: 200px; width: 300px; float: left;" title="Demonstrators protest outside of the Supreme Court this week. (Flickr/Talk Radio News Service Lingjing Bao)" />Republican campaign strategists say Mitt Romney will use today&#39;s Supreme&nbsp;Court&nbsp;ruling to continue campaigning against &quot;Obamacare.&quot; They say he will be attacking the president&#39;s signature health care program as a tax increase.</div><p>Veteran Republican campaign adviser Terry Holt says, &quot;Obama might have his law, but the GOP has a cause.&quot; He says the decision will rally Republican support for an appeal of what Holt says &quot;could well be called the largest tax increase in American history.&quot;</p><p>Romney has said this week that if the law were to be upheld, Americans would need to elect a president who would repeal it.</p><p>House Speaker John Boehner says the&nbsp;Supreme&nbsp;Court&nbsp;ruling shows the need to repeal the law.&nbsp;The Ohio Republican says in a statement that the law is hurting the economy by increasing health care costs and making it difficult for small businesses to hire.</p><p>He says the&nbsp;court&#39;s&nbsp;ruling demands repeal of the entire law.</p><p>Boehner say Americans want a common-sense approach to health care. He says Republicans are ready to work with a president who&#39;s willing to listen to the people and &quot;will not repeat the mistakes that gave our country &#39;Obamacare.&#39;&quot;</p><p><strong>What&#39;s next?</strong></p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/health%20care%20protests%20Flickr%20Talk%20Radio%20News%20Service.jpg" style="float: right; width: 300px; height: 200px; " title="(Flickr/Talk Radio News Service)" />The 2010 health care law will continue phasing in as planned. It&#39;s expected to bring coverage to about 30 million uninsured people, so that more than nine in ten eligible Americans will be covered.</p><p>Some parts are already in effect: Young adults can stay on their parents&#39; insurance up to age 26. Insurers can&#39;t deny coverage to children with health problems. Limits on how much policies will pay out to each person over a lifetime are eliminated. Hundreds of older people already are saving money through improved Medicare prescription benefits. And co-payments for preventive care for all ages have been eliminated.</p><p>Starting in 2014, almost everyone will be required to be insured or pay a fine. There are subsidies to help people who can&#39;t afford coverage. Most employers will face fines if they don&#39;t offer coverage for their workers. Newly created insurance markets will make it easier for individuals and small businesses to buy affordable coverage. And Medicaid will be expanded to cover more low-income people.</p><p>Insurers will be prohibited from denying coverage to people with medical problems or charging those people more. They won&#39;t be able to charge women more, either. During the transition to 2014, a special program for people with pre-existing health problems helps these people get coverage.</p><p>An assortment of tax increases, health industry fees and Medicare cuts will help pay for the changes.</p><p><strong>Is the issue settled?</strong></p><p>Not necessarily. Although the&nbsp;court&nbsp;found it constitutional, the health care law still could be changed by Congress. Romney and Republican congressional candidates are campaigning on promises to repeal it if elected in November.</p><p>Some parts of the law are popular, but others &mdash; especially the mandate that virtually everyone have insurance coverage &mdash; are not.</p><p>Also, an estimated 26 million people will remain without health coverage once the law is fully implemented, including illegal immigrants, people who don&#39;t sign up and elect to face the fine instead, and those who can&#39;t afford it even with the subsidies.</p><p>* * * *&nbsp;</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/health%20care%20protests%20AP.jpg" style="float: left; width: 310px; height: 207px; margin: 5px;" title="A Tea Party supporter protests against President Barack Obama's health care law outside the Supreme Court Thursday, morning. Saving its biggest case for last, the Supreme Court is expected to announce ruling shortly. (AP/David Goldman)" /><em>Update June 28 8:31 a.m.</em></p><p><strong>Political uncertainty weighed heavy before ruiling</strong></p><p>&quot;My guess is they&#39;re not sleeping real well at the White House tonight,&quot; presumptive Republican presidential nominee Mitt Romney told supporters Wednesday in northern Virginia.</p><p>Anticipation of Thursday&#39;s decision could be equally unnerving for Romney, whose opposition to the&nbsp;law&nbsp;has become a central pillar of his campaign.</p><p>Neither candidate has any direct influence over the ruling. The court could uphold the health&nbsp;care&nbsp;law, strike it down or deem the requirement that most Americans carry&nbsp;health insurance unconstitutional while retaining other aspects of the&nbsp;law.</p><p>The announcement is expected to be followed almost immediately by a barrage of advertisements and fundraising appeals from Democrats and Republicans, all trying to cast the decision in the most advantageous light for their candidates.</p><p>The Obama campaign began trying to raise money off the ruling even before it was announced. In a Thursday morning fundraising email with the subject line &quot;Today&#39;s Decision,&quot; Obama campaign manager Jim Messina told supporters &quot;no matter what, today is an important day to have Barack Obama&#39;s back.&quot;</p><p>The Democratic Congressional Campaign Committee also issued a fundraising appeal for a &quot;health&nbsp;care&nbsp;rapid response fund,&quot; telling supporters by email Wednesday that, however the court rules, &quot;Democrats are in for a tough fight.&quot;</p><p>Secrecy has marked each campaign&#39;s planning for the critical moment.</p><p>Obama is scheduled to be in the Oval Office with Vice President Joe Biden when the ruling is announced. The president is certain to respond to the decision, but his specific plans to do so were unclear. Romney&#39;s campaign has refused to disclose the location of a Capitol Hill venue where he will face reporters shortly after the announcement.</p><p>It is clear, however, that the Supreme Court&#39;s ruling on Obama&#39;s sweeping federal health&nbsp;care&nbsp;law&nbsp;will shape the contours of the presidential campaign through the summer and fall. Both Obama and his Republican rival are primed to use the outcome &mdash; whatever it is &mdash; for political gain.</p><p>Obama has expressed confidence the court will uphold his signature legislative initiative. But he won&#39;t be shocked if a conservative majority overturns the most controversial provision, those familiar with his thinking say. Romney aides say the Republican candidate will get a political boost if the court strikes down the measure. But they don&#39;t want celebrations that could alienate voters who could lose&nbsp;health&nbsp;care&nbsp;benefits as a result of the decision.</p><p>The court&#39;s ruling could have a far-reaching impact on the nation&#39;s&nbsp;health&nbsp;care&nbsp;system. If thelaw&nbsp;is upheld, about 30 million of the 50 million uninsured Americans would get coverage in 2014 when a big expansion begins.</p><p>Overturning all or part of the&nbsp;law&nbsp;could leave as uninsured the more than 3 million young adults who gained coverage through a provision allowing them to stay on their parents&#39; insurance up to age 26, according to the&nbsp;Health&nbsp;and Human Services Department. Another 60,000 people who gained coverage through a plan for those with pre-existing conditions may not be able to get coverage elsewhere if the entire&nbsp;law&nbsp;is struck down.</p><p>Obama recently has avoided mentioning the impending court ruling directly, but during campaign events this week he has vigorously defended the&nbsp;health&nbsp;care&nbsp;overhaul as critical to the public&#39;s&nbsp;health&nbsp;and well-being.</p><p>&quot;I think it was the right thing to do. I know it was the right thing to do,&quot; he told supporters in Boston.</p><p>Romney, who as Massachusetts governor signed a&nbsp;health&nbsp;care&nbsp;law&nbsp;on which the Obama&#39;s federal&nbsp;law&nbsp;was modeled, has focused more than usual on the Supreme Court ruling this week. In campaign appearances in Virginia, New Jersey and New York, he offered supporters and donors a preview of his likely response to the decision and said Obama&#39;s first term would be essentially wasted if the&nbsp;law&nbsp;is overturned.</p><p>If the court upholds the&nbsp;law, Romney told supporters at a northern Virginia electronics manufacturer Wednesday, it&#39;s still bad policy. &quot;And that&#39;ll mean if I&#39;m elected president we&#39;re going to repeal it and replace it,&quot; he said.</p><p>And if the court strikes down the&nbsp;law, Romney said, &quot;They&#39;re going to be doing some of my work for me.&quot;</p><p>Obama advisers say the Supreme Court showed reasonableness earlier this week in a ruling on an Arizona immigration case, and they see it as a hopeful sign for how the court might rule on health&nbsp;care.</p><p>If the court upholds the&nbsp;law, Obama could get an election-year gust of wind at his back, with his vision and leadership validated. If the court strikes down the overhaul, the White House would seek to cast the decision as detrimental to millions of Americans by highlighting popular elements of the&nbsp;law&nbsp;that would disappear, such as preventive&nbsp;care&nbsp;and coverage for young adults on parents&#39; plans.</p><p>The Romney campaign has coordinated its response directly with the Republican National Committee and House Republicans, who have agreed not to &quot;spike the ball&quot; &mdash; as one Republican put it &mdash; should the&nbsp;law&nbsp;be struck down. His campaign worries that an over-celebratory tone may turn off voters affected by the decision.</p><p>Indeed, the stakes are high for both candidates. Polling suggests that most Americans oppose the&nbsp;law, but an overwhelming majority want Congress and the president to find a new remedy if it&#39;s struck down.</p><p>Romney so far has spent little time crafting a comprehensive plan to replace the overhaul. And the Obama campaign already has seized on Romney&#39;s opposition to the most popular provisions in the&nbsp;law. For example, Romney would not prevent&nbsp;health&nbsp;care&nbsp;companies from denying coverage to new customers with medical conditions. Nor would he force them to cover young adults on their parents&#39; plans through age 26.</p><p>Still, both sides will use it to raise money and motivate supporters. And outside groups are ready to unleash a flood of advertisements following the ruling, including a 16-state, $7 million ad buy from the conservative political action group Americans for Prosperity.</p><p>___</p><p>AP White House Correspondent Ben Feller contributed to this report.</p><p><a href="http://www.scribd.com/doc/98542447/Aca-Ruling" name="Ruling" style="margin: 12px auto 6px auto; font-family: Helvetica,Arial,Sans-serif; font-style: normal; font-variant: normal; font-weight: normal; font-size: 14px; line-height: normal; font-size-adjust: none; font-stretch: normal; -x-system-font: none; display: block; text-decoration: underline;" title="View Aca Ruling on Scribd">ACA Ruling</a><iframe class="scribd_iframe_embed" data-aspect-ratio="0.772727272727273" data-auto-height="false" frameborder="0" height="826" id="doc_31157" scrolling="no" src="http://www.scribd.com/embeds/98542447/content?start_page=1&amp;view_mode=list&amp;access_key=key-1t8qxe2glmz9trd6dmrq" width="620"></iframe></p></p> Thu, 28 Jun 2012 08:27:00 -0500 http://www.wbez.org/news/supreme-court-upholds-requirement-most-americans-have-health-insurance-100489