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Topic: Anyone ElseTerrified about Repeal of ACA Bill

Forum: Employment, Insurance, and Other Financial Issues —

Employment, insurance, and financial concerns are common. Meet others here to discuss and for support.

Posted on: Jul 15, 2017 10:35AM

sfar wrote:

Just wondering how people are coping with the constant threat to our health care coverage due to our pre-existing conditions. I've always believed that you need to take action when you're feeling stressed and threatened and this health insurance issue is driving me crazy. I have contacted my senators but both of them are on the same page with me. When I tried to contact the moderate "on the fence" GOPs, they don't accept email from people outside of their state. It just seems so out of our control right now and I hate that feeling. Any thoughts or ideas?




Dx 2/24/2016, IDC, Right, 2cm, Stage IIA, Grade 3, 0/1 nodes, ER+/PR+, HER2+ (FISH) Surgery 3/29/2016 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 4/19/2016 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 4/20/2016 Herceptin (trastuzumab) Radiation Therapy 9/11/2016 Whole-breast: Breast Hormonal Therapy 10/16/2016 Arimidex (anastrozole)
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Jun 17, 2019 12:39PM Lumpie wrote:

Trump Wants to Neutralize Democrats on Health Care. Republicans Say Let It Go.

By Peter Baker, Michael Tackett and Linda Qiu

  • June 16, 2019

Mr. Trump has promised to replace President Barack Obama's health care law with "something terrific" that costs less and covers more without ever actually producing such a plan.

Now he is vowing to issue the plan within a month or two, reviving a campaign promise with broad consequences for next year's contest. If he follows through, it could help shape a presidential race that Democrats would like to focus largely on health care.

The hard economic reality of fashioning a plan that lives up to the promises Mr. Trump has made would invariably involve trade-offs unpopular with many voters.....many remain skeptical that Mr. Trump will produce the plan he is now promising to unveil ....

https://www.nytimes.com/2019/06/16/us/politics/trump-health-care-democrats-2020.html?action=click&module=Well&pgtype=Homepage&section=Politics

{The New York times allows access to a limited number of articles per month without subscription.}

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 17, 2019 12:55PM pupmom wrote:

And we're supposed to believe a pathological liar because.....?

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, Right, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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Jun 17, 2019 07:11PM edwards750 wrote:

There are plenty of those around in Washington these days.

Diane

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Jun 18, 2019 06:21AM Salamandra wrote:

Lots of politicians are people with real values, no less honest than any of us, trying to make a difference. When we paint them all with a broad brush, we provide cover for those who are exploitative grifters, make it seem 'normal', deter people from voting and participating, and deter good people from running for office. I think it does real harm.

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/18/2018 Lumpectomy; Lymph node removal: Sentinel Radiation Therapy 12/3/2018 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 18, 2019 08:31AM pupmom wrote:

Well, I was specifically referring to ONE politician, making wild promises he's made over and over about having the most awesome medical plan ever. Yet, somehow that plan never materializes.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, Right, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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Jun 18, 2019 12:02PM edwards750 wrote:

I knew that.


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Jun 18, 2019 04:11PM Meow13 wrote:

Yes, I for one would like him out preferably behind bars.

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Jun 18, 2019 04:15PM pupmom wrote:

Same here Meow

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, Right, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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Jun 18, 2019 05:00PM Salamandra wrote:

Yes. I was more responding to the post of edwards750. I agree.

Dx at 39. 1.8cm. Oncotype 9. Dx 9/19/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 10/18/2018 Lumpectomy; Lymph node removal: Sentinel Radiation Therapy 12/3/2018 Whole-breast: Breast Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jun 18, 2019 09:52PM Lumpie wrote:

At the risk of sounding jaded.... I know I don't have to tell you all that it's just so terrifying that one person... or a few people... could be so callous as to publicly advocate taking people's healthcare away when they are in ill health.... and that there might not be any consequences. It makes me question what kind of world we are living in. Maybe I am in la la land expecting better of people. One of the major proposals out there from a think tank is to control healthcare costs by rigorously capping lifetime spending on healthcare and putting those who are too expensive on hospice. It's creepy. Isn't there a famous futuristic dystopian novel about something like that? Except there it was old people rather than sick people....?

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jun 18, 2019 11:12PM april1964 wrote:

Logan’s Run ....?


oncotype 18 Dx LCIS/DCIS/IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Jun 19, 2019 12:34AM Meow13 wrote:

I was sickened to hear Mitch McConnell not understanding the importance of healthcare for our 911 first responders.

Some suggesting New York state should be responsible for them!

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Jun 19, 2019 06:01AM DogMomRunner wrote:

That's because McConnell's financial backers don't care about them. If there was a financial benefit to keeping the poor healthy then McConnell (and others would be all over it).

You ain't run far enough to say My legs have failed You ain't gone far enough You ain't worked hard enough You ain't run far enough to say It ain't gonna get any better. Nathaniel Rateliff Dx 4/24/2019, DCIS/IDC, Left, 1cm, Stage IA, Grade 3, 0/8 nodes, ER-/PR-, HER2+ (FISH) Surgery 5/17/2019 Lumpectomy: Left; Lymph node removal: Left, Sentinel Targeted Therapy 6/6/2019 Herceptin (trastuzumab) Chemotherapy 6/6/2019 Taxol (paclitaxel) Radiation Therapy 9/22/2019 Whole-breast: Breast
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Jun 19, 2019 01:06PM Artista964 wrote:

Hopeful Mitch gets voted out. Scumbag. I think he's up for reelection soon.

Dxd at 50. Went thru it all on my own by choice. Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, PR+, HER2- Surgery 8/5/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/3/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jul 3, 2019 05:36PM Lumpie wrote:

The Declining Middle Class and the Use of Healthcare in the United States

"If you... believe you fit into the middle class in the United States, it is important to read this. According to the Wall Street Journal, the mix of who is getting crushed by healthcare expenses is changing rapidly.

"...a Kaiser study found healthcare deductibles for individual workers had risen 67% between 2010 and 2015. An analysis of millions of insurance claims found patient cost-sharing during the years between 2004 and 2014 was driven by a 256% jump in deductible payments."

https://www.elitecme.com/resource-center/nursing/the-declining-middle-class-and-the-use-of-healthcare-in-the-united-states/?utm_campaign=NW%20Enewsletter&utm_source=hs_automation&utm_medium=email&utm_content=74325109&_hsenc=p2ANqtz-_Fm82MKEIwqgaV4E1huUCIGYqGrmLM0MmyYoVY0mMHjt7VhNZrELjF7lOKIDAvlJMKhj-aS65kKOgG3ZYVD_B3X3myPA&_hsmi=74325109


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 3, 2019 10:30PM JoE777 wrote:

Trump's attorneys are before courts as we speak to declare the affordable care act unconstitutional to strike it down with no intention to replace it. If this thread is going to become a propaganda conduit for the Republican healthcare plan(if you get sick, die), I'll be leaving the thread.
Dx 2/2012, IDC, Left, 2cm, Stage IIA, metastasized to bone, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 4/3/2012 Lumpectomy: Left; Lymph node removal: Sentinel Hormonal Therapy 1/7/2018 Femara (letrozole) Dx 2/2018, IDC, Stage IV, metastasized to bone/lungs, Grade 1, ER+/PR+, HER2- Targeted Therapy Kisqali Chemotherapy Other Radiation Therapy External: Bone Hormonal Therapy Aromasin (exemestane), Femara (letrozole) Radiation Therapy Whole-breast: Breast, Lymph nodes
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Jul 4, 2019 12:42PM Lumpie wrote:

Nancy Pelosi's latest Medicare proposal would pass drug discounts to all consumers JUL 1 2019
  • House Speaker Nancy Pelosi is working on a proposal that would give the U.S. Department of Health and Human Services the power to negotiate lower drug costs for Medicare.
  • The legislation would also extend the drug discounts to private insurance plans, according to a senior Democratic aide.
  • Currently, pharmacy benefit managers negotiate drug benefits for private insurance plans and employers.

It's unknown if Pelosi's plan would apply to all drugs. But according to Kaiser, it would authorize HHS to negotiate the prices of the 250 most expensive drugs.

https://www.cnbc.com/2019/07/01/pelosis-latest-medicare-proposal-would-pass-drug-discounts-to-all-consumers.html

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 4, 2019 01:06PM Lumpie wrote:

Why It's Still 1989 for Primary Care Time and financial pressures keep PCPs from keeping up
  • by Milton Packer, MD
  • July 03, 2019

{This article provides remarkable insight on the "nuts-and-bolts" challenges associated with providing good quality primary care in today's healthcare - and payment - environment.}

Without doubt, U.S. patients with many chronic illnesses are not receiving good quality medical care to reduce suffering and prolong life.

What happens if a physician tries to make a difference and spends a bit of extra time? Their schedule runs late. When a survey subsequently asks if their appointment started on time, patients say no. And thus, the physician's patient satisfaction scores suffer.

To get real medical attention these days, you need to have an illness that requires or is amenable to a procedure for which the physician is paid. The result: when compared with other countries, we have the most expensive healthcare in the world, but we have worse outcomes.

..finding someone to blame does not fix the problem.

Our healthcare delivery system for chronic illness is horribly ill, even for those with full access to healthcare. Financialization has hollowed out its core mission and has made it meaningless. Increasing access to a failing medical infrastructure may sound good, but it does not address our core issues.

Healthcare for patients with chronic illnesses in the U.S. is on life support. The medical community seems helpless to fix this problem -- presumably because the solution is political, not medical.

The most important crisis facing U.S. medicine is not access to healthcare. It is access to 21st century healthcare.

https://www.medpagetoday.com/blogs/revolutionandrevelation/80822?xid=nl_mpt_DHE_2019-07-04&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-07-04&utm_term=NL_Daily_DHE_Active

{Author provides disclosures.}

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 8, 2019 07:48PM april1964 wrote:

I didn’t read this yet ....

https://www.huffpost.com/entry/aca-obamacare-lawsu...

I’m on Obamacare and definitely would be effected if it is taken away


oncotype 18 Dx LCIS/DCIS/IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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Jul 8, 2019 07:54PM Artista964 wrote:

I doubt it'll pass especially since it's election year when they say supreme court would rule, spring/summer 2020.... 10 years is huge to pull the rug under 20 million people.

Dxd at 50. Went thru it all on my own by choice. Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, PR+, HER2- Surgery 8/5/2015 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/3/2016 Whole-breast: Breast, Lymph nodes Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jul 11, 2019 04:26PM Lumpie wrote:

What Can Be Done About 'Pay for Play'? Kevin Campbell, MD, calls for an overhaul of the U.S. pharmaceutical and device industries

Kevin Campbell, MD, takes a look at pharmaceutical industry influence on physician prescribing and lobbying on Congress, and says both are in need of a fix.

{Both video and article formats are available.}

https://www.medpagetoday.com/blogs/campbells-scoop/80928?xid=nl_mpt_DHE_2019-07-11&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-07-11&utm_term=NL_Daily_DHE_Active

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 11, 2019 08:27PM Lumpie wrote:

No Faith in 'Christian' Health Plan

No Faith in Healthcare Cost-Sharing Ministry

Customers paying thousands of dollars to a religiously affiliated healthcare cost-sharing ministry under Aliera Healthcare shouldn't have much faith that their medical bills will be paid.

The Houston Chronicle writes that this "obscure but growing type of coverage based on the biblical principle that the like-minded should help each other in times of need" comes with a catch -- it's not technically insurance. As such, it's not bound by laws under the Affordable Care Act that require coverage of pre-existing conditions or that insurers spend 80% of premiums on medical care. Authorities say the company spends just 20% of "member fees" on medical bills.

Aliera is under fire from regulators in multiple states for allegedly deceiving customers into thinking its product was legitimate insurance when it wasn't. One customer from Texas was stuck with a $130,000 bill for his wife's surgery -- though the company reversed its multiple prior denials and said it would pay the entire claim when the Chronicle's story published. Aliera also said in a statement that it would "vigorously defend against the false claims directed at our company."

While some legitimate healthcare cost-sharing ministries do exist, "there are others that are taking advantage of this wild west of insurance we are living in now," said one expert on insurance reform.

https://www.medpagetoday.com/publichealthpolicy/ethics/80930?xid=nl_popmed_2019-07-11&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=PopMedicine_071119&utm_term=NL_Gen_Int_PopMedicine_Active

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 12, 2019 12:12PM Lumpie wrote:

White House Cedes Battle, but Not War, Against Drug Rebates HHS Secretary said he hopes Congress will consider taking action

The Trump administration isn't giving up on getting rid of drug rebates to pharmacy benefit managers or insurers to instead give negotiated discounts directly to consumers, Health and Human Services (HHS) Secretary Alex Azar said Thursday.

the administration confirmed that it was withdrawing a proposed rule that would have required drug company discounts -- with some exceptions -- to go directly to consumers. The rule, first proposed in February to apply to Medicare and Medicaid, would have required that any discounts received by pharmacy benefit managers as rebates be passed directly on to Medicare and Medicaid beneficiaries when they received their prescriptions.

The risk of a premium increase under the plan "was a known risk in our proposal and ..... while we support the concept of getting rid of rebates ... we're not going to put seniors at risk of their premiums going up." Congress might take this up; they have more tools....

Public Citizen's Health Research Group...{advocates}....advancing direct government drug pricing negotiation, stopping price spikes, and taking on the monopoly power of prescription drug corporations..."

https://www.medpagetoday.com/publichealthpolicy/medicare/80971?xid=nl_mpt_DHE_2019-07-12&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-07-12&utm_term=NL_Daily_DHE_Active

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 12, 2019 01:14PM Lumpie wrote:

The Centers for Medicare and Medicaid Services proposed a new payment model for radiation oncology. Here's what the American Society for Radiation Oncology has to say about it.

The aim of this model would be to test whether prospective episode-based payments to physician group practices (PGPs), hospital outpatient departments (HOPD), and freestanding radiation therapy centers for radiotherapy (RT) episodes of care would reduce Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries.

ASTRO has worked for many years to craft a viable payment model that would stabilize payments, drive adherence to nationally-recognized clinical guidelines and improve patient care. We appreciate the Administration's focus and commitment to ensuring radiation oncologists' ability to participate in an advanced APM."

https://innovation.cms.gov/initiatives/radiation-oncology-model/

https://www.astro.org/News-and-Publications/News-and-Media-Center/News-Releases/2019/APM-statement


"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 12, 2019 02:13PM - edited Jul 12, 2019 02:14PM by Lumpie

HOUSE PANEL ADVANCES SURPRISE BILL PACKAGE

A package of 10 healthcare-related bills, including funding for expiring public health programs and addressing surprise medical billing, was advanced out the House Energy and Commerce (HEC) Health subcommittee Thursday afternoon

https://www.healthleadersmedia.com/finance/house-panel-advances-surprise-bill-package

https://www.beckershospitalreview.com/finance/house-subcommittee-advances-no-surprises-act-3-quotes-from-lawmakers.html

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 20, 2019 04:43PM Lumpie wrote:

Trump officials tell one court Obamacare is failing and another it's thriving

Los Angeles Times

The Trump administration argues two different narratives about the ACA in different court cases. This article highlights how eliminating the individual mandate didn't severely affect insurance enrollment rates. "In an insurance market that guarantees access to people with pre-existing conditions, there need to be both carrots and sticks to encourage healthy people to sign up for coverage and keep the market stable. It turns out, if the carrot is large enough, the stick is less important."

https://www.latimes.com/politics/la-na-pol-trump-obamacare-lawsuit-20190708-story.html?mc_cid=d982dcbbc1&mc_eid=12d673e585

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 21, 2019 02:03PM Lumpie wrote:

New Judicial Advocacy Project to Help Ensure that Medicaid is Meeting the Goals and Needs of the People It Serves

With support from the Robert Wood Johnson Foundation, the National Health Law Program will execute a judicial advocacy strategy to protect rights conferred by Medicaid.

The National Health Law Program will work with Medicaid stakeholders, including advocates, providers, Medicaid beneficiaries, policymakers, and other legal experts, to (1) monitor legal developments in courts that will impact rights and benefits set forth in the Medicaid Act and regulations; (2) forecast opportunities to advance and protect health rights and benefits set forth in those laws; (3) submit amicus briefs in cases with a potential impact on Medicaid rights; and (4) connect with additional allies to support the work of the project.

This project rests on the theory that a comprehensive monitoring and response system directed at judicial threats to Medicaid, with a central focus on amicus curiae briefs in pivotal cases, will demonstrably increase the number of judges who are educated about the important Medicaid issues at stake. In addition, it will increase stakeholder knowledge about and involvement in the judicial process and Medicaid issues. The training component of the project will result in stakeholders who have the capacity to engage in the judicial process, either by drafting amicus briefs themselves (in the case of legal organizations) or by engaging legal representation to do so on their behalf. The ultimate goal is to increase the likelihood of judicial rulings that better reflect the complexities of Medicaid coverage -- how Medicaid works legally and what coverage means to the more than 70 million Americans who depend on Medicaid for their health care needs.

We are grateful to the Robert Wood Johnson Foundation for making this project possible and look forward to working with our existing partners and joining with new allies as we advance health rights and make progress toward our goal of health equity.

https://healthlaw.org/

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 21, 2019 02:42PM Lumpie wrote:

Stopping 'Pay-for-Delay' a Top Priority for Klobuchar Minnesota senator and Democratic presidential candidate outlines her health priorities

One of Sen. Amy Klobuchar's (D-Minn.) top priorities as president would be to stop "pay-for-delay" deals in which brand-name drugmakers pay generic firms to delay their entry into the market... a president can do that herself," Klobuchar, who is running for the Democratic presidential nomination, said at an event held at the National Press Club. "And I will apply for waiver from the ban on re-importing safe drugs from other countries ... and put forth a bill to require Medicare to negotiate prices for our seniors.

https://www.medpagetoday.com/washington-watch/electioncoverage/81051?xid=nl_mpt_DHE_2019-07-18&eun=g1278169d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202019-07-18&utm_term=NL_Daily_DHE_Active

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 21, 2019 10:41PM Lumpie wrote:

New CMS resources help states waive ACA requirements Most states have gotten or are seeking the waivers to establish a reinsurance program to reimburse insurers that are covering high claim costs.

The Centers for Medicare and Medicaid Services has released new resources to help states submit waivers to Affordable Care Act requirements.

The resources are to identify areas of flexibility and variations states can consider, such as combining multiple waiver concepts or coming up with their own.

Most states have gotten or are seeking the Section 1332 waivers to establish a reinsurance program to fully or partially reimburse insurers that are covering claims for high-risk beneficiaires. This reduces the price of premiums in those states.

States that have approved 1332 waivers are Maine, Wisconsin, Minnesota, New Jersey, Maryland, Oregon, Alaska and Hawaii, according to a Kaiser Family Foundation report.

States may waive seven ACA requirements, including: the individual and employer mandates to have health insurance; essential health benefits; limits on cost sharing for covered benefits; metal tiers of coverage; requirements for marketplaces to have a website, call center and a navigator program; and premium tax credits and cost-sharing reductions.

An ACA requirement that remains in place is preserving access to coverage for people with pre-existing conditions. Other guardrails mandate that the new plan provide coverage that is at least as comprehensive in covered benefits, at least as affordable and cover a comparable number of residents.

https://www.healthcarefinancenews.com/news/new-cms-resources-help-states-waive-aca-requirements

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride." Dx 2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC) Targeted Therapy 1/14/2016 Herceptin (trastuzumab) Chemotherapy 1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Dx 2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+ Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Right Surgery Lumpectomy: Right
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Jul 22, 2019 06:35AM MountainMia wrote:

But if no one can find the insurance ("requirements for marketplaces to have a website, call center and a navigator program") then all the rest of the coverage guarantees don't matter much.


The rain comes and the rain goes, but the mountain remains. I am the mountain.

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