Tagged Uninsured

The Health Law’s Two Americas: Those Who Qualified For Help And Those Who Didn’t

For those who were able to get federal subsidies, the health law was a blessing. The ones who didn’t were left feeling angry and short-changed.

The Associated Press: Health Law Created Winners And Losers When Buying Insurance
Michael Schwarz is a self-employed business owner who buys his own health insurance. Subsidized coverage through “Obamacare” offers protection from life’s unpredictable changes and freedom to pursue his vocation, he says. Brett Dorsch is also self-employed and buys his own health insurance. But he gets no financial break from the Affordable Care Act. “To me, it’s just been a big lie,” Dorsch says, forcing him to pay more for less coverage. (Alonso-Zaldivar, 2/22)

Kaiser Health News: GOP Fix To Insurance Markets Could Spike Premiums For Older Customers
Dale Marsh has not been enamored with his health insurance since the Affordable Care Act took effect. Premiums for Marsh, 53, and his wife, Tammy, rose, their deductibles grew, and they gave up access to their regular doctors to keep costs down. This year, facing monthly premiums of $1,131 — a 47 percent increase from four years before — they decided to go without coverage. “It’s useless insurance,” said Marsh, who owns a software company with Tammy, 52, in Graford, Texas. “We’re praying for the best, that neither one of us need insurance, that we don’t have to go the hospital.” Yet, a new premium spike may be in store for those in their 50s and 60s. (Rau and Appleby, 2/22)

In other news, worries about repeal persist —

The Associated Press: ‘It Saved My Life’: Talk Of Obamacare Repeal Worries Addicts
While the Affordable Care Act has brought health coverage to millions of Americans, the effects have been profound, even lifesaving, for some of those caught up in the nation’s opioid-addiction crisis. In Kentucky, which has been ravaged worse than almost any other state by fentanyl, heroin and other drugs, Tyler Witten went into rehab at Medicaid’s expense after the state expanded the program under a provision of the act. Until then, he had been addicted to painkillers for more than a decade. “It saved my life,” he said. (Beam and Johnson, 2/22)

The Philadelphia Inquirer: Advocates: Repealing Obamacare Would Cost N.J. Jobs And Lives
The generally left-leaning groups detailed county-by-county effects in an effort to get residents to put pressure on representatives at town hall meetings during this week’s congressional recess. Some lawmakers who have not scheduled meetings are discovering that gatherings have been planned in their absence. With more than $4 billion a year in direct federal funding at stake, the ripple effect of rescinding the law would kill 86,000 jobs, according to an analysis by New Jersey Policy Perspective. About 800,000 residents would lose health insurance without the ACA’s Medicaid expansion and subsidies for coverage purchased on the federal exchange. Plus, 212,000 seniors who fall into Medicare’s “doughnut hole” would each lose an average $1,241 in prescription assistance. (Sapatkin, 2/21)

Asbury Park Press: Group: Obamacare Repeal Costs Jersey Shore Over $500M
The Jersey Shore would lose more than $500 million a year in federal funding and 11,000 jobs if Obamacare is repealed without a replacement, according to a study released by consumer advocates on Tuesday. While replacement proposals on the table would soften the blow, they would leave New Jersey and consumers with less financial help for health care and possibly insurance policies that don’t cover as much, they said. (Diamond, 2/21)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

A Not-So-Fun Recess: Hostile Crowds Confront GOP Lawmakers Over Repeal Plans

“With all due respect, sir, you’re the man that talked about the death panels. We’re going to create one great big death panel in this country,” the vice chairman of the Iowa Democratic Party’s Rural Caucus said at Sen. Chuck Grassley’s town hall meeting. Across the country, lawmakers are facing agitated and concerned voters during their weeklong recess.

The New York Times: At Town Halls, Doses Of Fury And A Bottle Of Tums
Representative Marsha Blackburn may have expected to draw a friendly crowd by scheduling a town hall-style meeting in a Tennessee community that had voted overwhelmingly for President Trump, but she instead faced a hurricane-strength blast of disapproval on Tuesday. Ms. Blackburn, an eight-term Republican, was sharply questioned about a wide range of issues that have unsettled Mr. Trump’s first month in office, including health care, the environment, education and the president’s links to Russia. (Gabriel, Kaplan, Alvarez and Huetteman, 2/21)

The Associated Press: GOP Members Of Congress Meet With Protests At Town Halls
A month into Trump’s presidency, protests continue over his immigration policies, Cabinet selections and the GOP’s push to repeal the Affordable Care Act, without all the specifics on how to replace it. At the town halls, protesters are probing their lawmakers to see if they will veer from some of Trump’s more controversial decisions, and if they will promise coverage for those currently served by the Affordable Care Act. Trump took to Twitter on Tuesday to address the town halls. “The so-called angry crowds in home districts of some Republicans are actually, in numerous cases, planned out by liberal activists. Sad!” he tweeted. (Matisse, 2/21)

The Associated Press: US Senate Leader: Winners Make Policy, Losers Go Home
Nearly 1,000 people jeered Senate Majority Leader Mitch McConnell as he drove to a speech Tuesday where he told local business leaders that “winners make policy and the losers go home.” … Several people stood and booed as McConnell finished his remarks, including answering a few questions about the Affordable Care Act and regulations on the financial industry imposed by the legislation known as Dodd-Frank. McConnell was largely unfazed by those he called “the people outside,” saying he was “proud” of them for expressing their views. (Beam, 2/21)

Politico: This Time, Grassley Hears Pro-Obamacare Voices
What a difference eight years makes. More than 100 Iowans on Tuesday packed into a small farm town community center by 7:45 a.m. to urge Sen. Chuck Grassley not to repeal Obamacare, and to air their opposition to President Donald Trump’s agenda, his Cabinet nominees and his Supreme Court pick. (Haberkorn, 2/21)

Politico: GOP Lessons From The Latest Round Of Brutal Town Halls
An overflow crowd here was eager to take on Rep. Dave Brat, the conservative Republican who just weeks earlier needled liberal protesters in his district and groused about all the women “in my grill” over GOP plans to repeal and replace Obamacare. But with a plain-spoken approach — and a format that didn’t revolve around live-fire questions from the combative crowd — Brat offered his colleagues a potential blueprint for defusing tense constituent town halls that have bedeviled his Republican colleagues as they’ve been swarmed by protesters. (Cheney, 2/21)

CNN: Brat Faces Raucous Crowd At Town Hall
Rep. Dave Brat faced a raucous crowd Tuesday night at a town hall here in the outer edge of his district, where a majority of the room interrupted him with angry shouts and jeers. The Virginia Republican took at least 34 questions for over an hour and at times appeared to enjoy the back-and-forth. “I don’t mind boisterousness. I’m having fun,” Brat said toward the end, swinging his arm in the air as people continued to shout at him. “I like having debate, spirited conversation — if you can have a conversation.” (Killough, 2/21)

WAVY (Hampton Roads, Va.): Boisterous Crowd Voices Concerns At Rep. Taylor’s First Town Hall In Va. Beach
Representative Scott Taylor (R-VA) held a packed town hall meeting at Kempsville High School in Virginia Beach Monday night. 10 On Your Side’s Joe Fisher reports the crowd was at capacity with about 750 people inside. Hundreds more were turned away at the door because they couldn’t fit in the school’s auditorium. … Taylor also said he supports the repeal of the Affordable Care Act and the implementation of a new policy that doesn’t discriminate against people with pre-existing conditions. “The vast majority of people are getting crushed by Obamacare,” he said. “What’s responsible I believe, is dissecting, having a discussion, and finding the best thing.” (Satchell, 2/21)

KTVH (Helena, Mont.): Hundreds Gather In Helena To Ask Daines To Hold Town Hall
U.S. Sen. Steve Daines was scheduled to speak before the Montana House Tuesday, but several hours before the address, his office announced it had been rescheduled to Wednesday. Despite that change, hundreds of protesters still gathered on the State Capitol steps in Helena in hopes of getting the senator’s attention. … Celeste Thompson, a home care worker, said she has health care because of the federal Affordable Care Act. She asked for more information on how Republicans in Congress plan to replace the ACA if it is repealed. “Our lives and so many others depend on access to health care,” Thompson said. “If the Affordable Care Act is repealed, that access will be stripped away from us.” (Ambarian, 2/21)

Montana Public Radio: Protesters Give Sen Daines An Earful At The State Capitol
Just before U.S. Senator Steve Daines was scheduled to give a speech in front of Montana lawmakers Tuesday afternoon, a crowd of protesters gathered on the Capitol steps. The event was organized by a Facebook group called “Bring The Town Hall to Steve Daines”. … About an hour and a half before Senator Daines was scheduled to arrive at the Capitol Tuesday to address Montana’s House of Representatives, he postponed his speech, pushing it to Wednesday. Staff with Senator Daines’ office say he pushed his speech back a day to work with his schedule, saying Daines had several other reasons to be in Helena on Wednesday. (Cates-Carney, 2/21)

Arkansas Online: Cotton Hears Medicare Concerns
A group of Arkansas senior citizens told U.S. Sen. Tom Cotton on Tuesday that they like their Medicare Advantage plans, but a few expressed concerns about higher spending caps and rising medication costs. Cotton, a Republican from Dardanelle, told the group that he supports the federally-funded program and will defend it on Capitol Hill. Nonetheless, the overall health care system needs changes, he said, promising to work to improve it. (Lockwood, 2/22)

CQ Roll Call: Health Coverage Questions Persist For Republicans
As Republican lawmakers face questions from constituents and colleagues about their plans to repeal and replace the 2010 health care law, they’re finding few answers, including what kind of legislation could pass the Senate. Republicans do not need Democratic support to undo parts of the law, since they will move the legislation through the budget reconciliation process that requires a simple majority in the Senate. But with only 52 Republican senators, the GOP plan will need support from the party’s conservatives and moderates, and it’s not clear what could get everyone on board. (Bowman, 2/22)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: Surprise Medical Bill Measure Progresses In Ariz. Legislature; Conn. Claims One Of The Lowest Rates Of Uninsurance Naitonally

Outlets report on news from Arizona, Connecticut, California, Missouri, Minnesota, Ohio, Georgia and Washington, D.C.

Arizona Republic: Arizona Lawmakers Propose Relief For Consumers From Unexpected Medical Bills
Health-care consumers who have been stung by surprise medical bills might soon find some relief from an unexpected source: the Arizona Legislature. The problem occurs when a consumer seeks care after checking to be sure a doctor, clinic or hospital is part of their insurance company’s network — only to be billed later by out-of-network providers such as anesthesiologists or surgical assistants who were part of the chain of care. That can sometimes result in a whopping medical tab, with the consumer caught between an insurance company that doesn’t want to pay more and a medical provider who refuses to accept less. (Alltucker, 2/15)

The CT Mirror: CT Uninsured Rate Among Lowest In The Country, Report Says
Connecticut had one of the lowest rates of uninsured residents in the country last year, according to estimates from a federal survey released this week. The estimates from the National Health Interview Survey, released by the National Center for Health Statistics, pegged Connecticut’s uninsured rate at 3.5 percent – but the authors warned that that figure should be used with caution because the potential for error “does not meet standards of reliability or precision.” (Levin Becker, 2/16)

KQED: California Prisons Fight To Reduce Dangerous ‘Valley Fever’ Infections Among Inmates
When the wind kicks up in the town of Coalinga, dust devils whirl over almond orchards and pumpjacks. You can even see the narrow brown funnels from the grounds of Pleasant Valley State Prison, on the outskirts of town.But at the prison itself, there’s hardly any dust. That’s evidence of years of work by the California Department of Corrections and Rehabilitation to reduce and control the San Joaquin Valley’s ubiquitous wind-borne dust. The dust carries the spores of the debilitating fungal disease known as coccidioidomycosis, or “valley fever.” (Klein, 2/15)

St. Louis Public Radio: Refugee Restrictions Disrupt Work Of St. Louis Disease Researchers 
President Donald Trump’s executive order last month reduced the cap of refugees allowed into the United States from 110,000 to 50,000. That means that fewer refugees will be resettled into areas like St. Louis. But the cap also is curtailing disease research across the country. To understand diseases that are widespread in poor, war-torn countries, scientists study refugees from those nations that are infected with those diseases. (Chen, 2/15)

The Star Tribune: Resident Dies After Eden Prairie Caregiver Forgot To Plug In Heart Pump
A distracted aide at an Eden Prairie assisted-living center failed to plug in a resident’s heart pump at bedtime, and the man didn’t live through the night, according to a state investigation released Wednesday. The state Health Department found the facility, Aging Joyfully, at fault in the July 10 death because it had no procedure to ensure the pump would keep operating when switched every night from batteries to electricity from an outlet. (Walsh, 2/15)

San Jose Mercury News: Sunnyvale School Grocery Program Provides Weekend Meals To Students 
For many parents, San Miguel Elementary School is not just a place to fill their children’s minds but their stomachs as well. Since 2015 the school has participated in the Weekend School Food Program organized by Sunnyvale Community Services in partnership with the Sunnyvale School District. The program allows parents and other residents to pick up 32 pounds of donated food twice a month on Fridays. (Kezra, 2/15)

The Washington Post: ‘Urgent Care On Wheels’: Fire Departments Rescuing Patients From Costly ER Trips
In the 15 minutes after firefighters and a nurse knocked at Thelma Lee’s Maryland townhouse, they checked her blood pressure, told her what foods would keep her blood sugar from skyrocketing and set up an appointment — and a ride — to visit her primary-care physician. They also changed the battery in her chirping fire alarm and put a scale in her bathroom so she could monitor her weight. Then they rolled out in an SUV to their next house call. (Bui and Williams, 2/15)

San Jose Mercury News: Palo Alto Marsh To Get Mosquito Control Treatment
Palo Alto’s flood basin and nearby areas will be sprayed Thursday, Feb. 23 with a pesticide in an effort to reduce the growth of salt marsh mosquitoes, which are known for being “very vicious biters.” Russ Parman, assistant manager of the Santa Clara County Vector Control District, said the day-biting salt marsh mosquitoes are not known to transmit diseases such as West Nile or Zika. Officials are concerned, however, that treatment delays caused by winter storms will result in a “big cohort of mosquitoes,” Parman said. (Lee, 2/15)

Cleveland Plain Dealer: 4th Ohio Child Dies Of Flu-Related Illness: What You Need To Know 
A 7-year-old Columbiana County boy who died on Saturday of flu-related illness marked the fourth such death in the state so far this flu season, coming only two days after the death of a Rocky River 6 year old. Eva Harris of Rocky River died February 9th after being admitted to the Cleveland Clinic with a high fever two days earlier. The Columbiana County child was the second from that county to die of flu-related illness since the January 25th death of a 6-year-old Salem boy. (Zeltner, 2/15)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

For California’s Smallest Businesses, Obamacare Opened The Door

If Republicans in Congress scrap the Affordable Care Act, Carmina Bautista-Ortiz might have to go back to Mexico for health care. But she’d rather spend the time running the printing shop she and her husband own in Jurupa Valley, a city about 50 miles east of Los Angeles.

For at least 10 years, before the Affordable Care Act made it possible for them to get insurance, Bautista-Ortiz and her husband Roger had been uninsurable — she because of a heart condition known as tachycardia, he because of high cholesterol.

Bautista-Ortiz crossed the border to get tests and specialty care for her rapid heartbeat. Her husband was slapped with a $20,000 hospital bill, which Carmina spent two years negotiating down until the hospital dismissed the debt.

Three years ago, the couple was finally able to buy subsidized health coverage through the state’s Obamacare exchange, Covered California, and Bautista-Ortiz said they now spend less time worrying about how to get care.

“Our health is … basically the most important thing that we have,” said Bautista-Ortiz. “If you’re not feeling well, you’re not going to do your job the right way.”

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Under Republican-led plans to repeal the Affordable Care Act, hundreds of thousands of self-employed people in California are at risk of losing their ability to buy affordable insurance. Some business owners welcome the rollback of the law, but the smallest of California businesses — entrepreneurs and contract workers who buy insurance on their own through Covered California — have the most to lose under a repeal.

That worries small business advocates who favor the Affordable Care Act. They say putting health care coverage out of reach of the self-employed could threaten Americans’ entrepreneurial spirit and burden people who create jobs and take on financial risk.

“When you’re providing a benefit that allows folks to take that risk with a little more of a safety net … that allows more entrepreneurs to take the plunge,” said Mark Herbert, California Director for Small Business Majority, an advocacy organization that opposes repeal.

Nationally, California has one of the highest rates of small business owners who get their coverage through a health insurance exchange — 16 percent — according to a U.S. Department of the Treasury analysis of 2014 data. And Covered California officials say nearly a quarter of enrollees — 377,000 people — declared themselves “self-employed” as of December. Enrollees receive an average of $440 a month in tax credits to help offset insurance premium costs, a spokesperson for the exchange said.

Herbert said rolling back subsidized health care and the no-exclusion policy for preexisting conditions could lead entrepreneurs to abandon their endeavors for more secure jobs, or prevent them from setting up shop in the first place.

“Uncertainty is very scary,” Herbert said. “There are enough variables and challenges that small business owners face,” said Herbert.

Other self-employed people say the looming repeal of Obamacare may not make them change careers, but it would change their relationship to health care.

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Charlie Murphy, a sewer pipe inspector in San Rafael, Calif., signed up for health insurance through Covered California last year. He recently lost 20 pounds after a doctor’s check-up. (Courtesy of Charlie Murphy)

Charlie Murphy, a sewer pipe inspector in Marin County, says if the hefty government subsidies that help him pay his monthly premium disappeared, he’d drop his coverage, or get a skeletal policy instead.

“My focus would be more [on] something catastrophic, than [a plan that supports] health maintenance,” said Murphy, 54, who pays a fraction of a monthly premium of roughly $500. The rest is subsidized with federal money.

When Murphy signed up for health care last year, he decided it was time for a check-up, the first in seven years. He barely interacted with doctors during the previous fifteen years, which he spent uninsured.

He was surprised to hear that his blood sugar and blood pressure were higher than they should be.

“I thought I was in better health than I was,” Murphy said.

The doctor’s visit — and a break up with a girlfriend — inspired Murphy to lose 20 pounds this past year. He cut down on smoking and drinking alcohol, and learned he can “survive without cookies and pie.”

He got some mental health treatment for anxiety, too, which improved his “outlook,” he said.

Although Obamacare may have made a notable impact on his health, he said he wouldn’t pay more for insurance or abandon his career to keep the same health care access he has now.

“I like working for myself, it’s nice … Driving around with the dog,” said Murphy, who performs site visits on homes for sale, inspecting sewage systems.

Just as each individual experiences the health care system differently, small business owners’ perspectives on Obamacare also vary widely and are influenced by ideological views and how much care costs.

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Sunder Ramani, owner of Westwind Media in Burbank, Calif., pays the health care premiums for roughly a dozen employees who opt into his employer-sponsored plans. He says premiums he have been steadily increasing in recent years. (Courtesy of Sunder Ramani)

Sunder Ramani, who owns Westwind Media, a post-production company in Burbank, Calif., offers small group coverage to roughly a dozen employees, even though he’s not legally required to. He pays 100 percent of their premiums.

“I’ve been paying higher and higher premiums, but for what appears to be packages that are less and less attractive,” said Ramani. He is a member of the California Leadership Council of the National Federation of Independent Business, a conservative small business association which opposes the Affordable Care Act and sued to overturn the law when it was first passed.

Ramani said if his business revenue hadn’t grown over the past several years, he might have shifted more of the health cost burden onto his employees. While Obamacare may not be solely responsible for health cost increases, Ramani said, the law didn’t bring them down as much as it could have.

In California, premiums in the small group market have been going up, but recent premium hikes have been smaller than in previous years, according to data from one of California’s two insurance regulators, the California Department of Managed Health Care. Premiums grew by almost 10 percent for small employer plans in 2011, whereas this year, they rose less than 6 percent, according to the data.

Businesses with 50 or more workers have greater legal responsibilities under the Affordable Care Act. The health reform law requires them to offer employees affordable coverage or pay a penalty.

That employer mandate has created an administrative “headache” for small business owners, say the insurance agents who help them comply with new required paperwork.

What’s more, the new requirement on employers hasn’t increased the rate of people with job-based coverage, because most employers of that size already offered employee health care before Obamacare, according to researchers at the Urban Institute.

But to the individuals who run the smallest of California’s enterprises, the law gave them benefits that didn’t exist before — the guaranteed availability of insurance, and the financial support to pay for it.

The promised repeal of the federal health law, as well as other policy changes under President Donald Trump, is complicating Carmina Bautista-Ortiz’s decisions to hire more employees or offer health care to the two she currently has.

Right now, those two employees, hired late last year, are responsible for their own health care. One is covered through her husband, and Carmina suggested to the other that he find a policy on the open market.

Bautista-Ortiz plans to look into a group health policy and help her employees pay for coverage. But right now, she says, those decisions are on hold.

She’s not sure how a repeal of Obamacare would affect her business yet, but she knows it will affect her personally.

“We’re ready for the worst, and hoping for the best,” she said.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Categories: California, California Healthline, Covered California, Insurance, Repeal And Replace Watch, Syndicate, The Health Law, Uninsured