Category Archives for Healthcare

CBO Numbers Says GOP Health Plan Benefits Young, Healthy…Not Seniors

Published in the Woonsocket Call on May 28, 2017

Weeks ago, the Trump Administration and GOP House leadership mended fences with GOP moderates and conservatives to hammer out a new version of the introduced legislation, the American Health Care Act (AHCA) of 2017 and replace the Affordable Care Act, called Obamacare Care. The GOP health care proposal with its last-minute changes passed on May 4 by a razor-thin vote of 217-213, a slim margin of four votes. All 193 Democrats opposed passage, along with 20 Republican lawmakers.

With passage, AHCA moved to the Senate for deliberation. Senators considered the House passed health care bill “Dead on Arrival.” But, Senate Majority Leader Mitch McConnell (R-Ky.) quickly appointed 13 Republican Senators to hammer out their chamber’s health care bill. Political observers doubt whether McConnell has enough votes to pass legislation this year.

Democratic lawmakers and critics of the House’s passed AHCA legislative proposal expressed outrage that House Speaker Paul Ryan (R-WI) called for a vote, not even waiting for the nonpartisan Congressional Budget Office (CBO) to provide an updated financial analysis of the new version of AHCA. The CBO’s cost analysis of the original bill, pulled moments before a scheduled vote on March 24, 2017, found that the GOP health care bill estimated that if passed 24 million or more Americans could be uninsured by 2026.

Now the long-awaited CBO new numbers are finally in for the House GOP passed health care bill.

According to the CBO analysis released on May 24, 2017, 23 million people will lose health insurance in the next decade under the House GOP’s recently passed health care proposal. The CBO analysis concludes that the AHCA benefits the young and healthy at the expense of older and sicker Americans. The report indicates that “near seniors” (aged 50-64) will be hit particularly hard by the GOP healthcare bill. Specifically, net insurance premium costs for low-income seniors would rise by 700 to 847 percent over the next 10 years under House-passed bill. A 64-year-old with an income of $26,500 per year who paid $1,700 annually for an Obamacare policy would now pay a whopping $13,600 under the Republican plan.

Aging Groups Rally Against Flawed GOP Fix to Nation’s Health Coverage

Aging advocates says that CBO’s analysis of the newer version of AHCA again brings to the forefront the flaws of the GOP’s health care coverage fix.

In a statement, AARP Executive Vice President Nancy LeaMond says the new CBO analysis serves as another example that the House legislation would make harmful changes to the nation’s current health care system. The bill would also hurt older Americans by decreasing the solvency of Medicare, hiking costs for those who can least afford them, eroding seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies, she said.

“AARP reiterates our strong opposition to the harmful bill passed by the House and calls on the Senate to take action by starting a bill from scratch. The CBO analysis found that premiums would go up to unaffordable levels by inflicting an Age Tax and removing current protections for people with common conditions including diabetes and weight gain. Putting a greater financial burden on older Americans is not the way to solve the problems in our health care system,” says LeaMond.

“The CBO report was no surprise to those of us who are looking out for the best interests of older Americans. The GOP leadership was so focused on passing repeal and replace legislation that they failed their due diligence by ignoring an ominous flaw: their bill will drive up seniors’ out-of-pocket costs by repealing subsidies that help defray the cost of premiums,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement.

The report also confirms that the House bill will only compound the problems faced by near seniors with pre-existing conditions. While an amendment by Rep. Fred Upton (R-MI) adds $8 billion over five years to fund high-risk pools for patients with pre-existing conditions, that will not be nearly enough to offset the extra costs to seniors, warns Richtman.

According to CBO, “People who are less healthy (including those with pre-existing or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all.”

Seniors who rely on Medicaid will suffer under the GOP’s passed health care bill, said Richtman, noting that the CBO report calculates that the AHCA slashes Medicaid spending by $834 billion. Medicaid currently helps pay for long term care for millions of seniors nationwide.

The CBO estimates that some 14 million Medicaid recipients would lose coverage under the AHCA – or not be able to attain it in the first place – within the next 10 years. In fact, more than half of the increase in uninsured Americans under the AHCA would come from this vulnerable population. In addition, changes to the ACA’s individual market reforms will increase the number of uninsured Americans age 50 to 64 from just over 10 percent under current law to nearly 30 percent, says Richtman.

Richtman charges that the GOP healthcare bill also weakens Medicare by repealing a tax on high wage earners, which would decrease the solvency of the Medicare Part A Trust Fund by three years. Accelerating the exhaustion of the Part A trust fund would likely lead to cuts in Medicare, including privatizing the program, that would be detrimental to current and future beneficiaries.

“The amended American Health Care Act is an assault on the health care of all seniors,” says Richtman. “We can only hope that the Senate will take the CBO’s new figures into consideration – and reverse the provisions that are so demonstrably harmful to our nation’s seniors.”

GOP Defends its Health Care Coverage Fix

As expected, with the release of CBO’s new numbers, the GOP moved quickly to dispute the federal agency’s findings. Republican National Committee Chairwoman Ronna McDaniel stated “The CBO has a history of being way off in their predictions, often giving a different forecast from actual reality.”

Even former House Speaker Newt Gingrich (R-GA) got into the verbal fray, blasting the new CBO analysis on FOX Business’ Lou Dobbs Tonight, calling for “the abolishment of the federal agency.” Gingrich called CBO “a dishonest bureaucratic organization,” suggesting that money might be saved by hiring “outside professional firms, get three to five major scores on bills.”

The Battle on Health Care Reform Moves to the Upper Chamber

On May 22, 2017, more than 75 national organizations recently sent a letter to Senate Majority Leader Mitch McConnell and Ranking Minority Leader Chuck Schumer, calling on the Senators to reject AHCA and to engage in “a transparent, bipartisan dialogue on needed reforms to enhance health care access and affordability.” The correspondence gave notice that these organizations strongly opposed provisions in the AHCA that undermined Medicare’s financing and risk access to essential care for Medicare and Medicaid recipients.

The correspondence cosigners noted that Obamacare imposed a small tax increase on the highest earners that helped” put Medicare on stronger financial footing. The GOP health care bill’s repeal of this tax would result in lost revenues, causing the Medicare Hospital Insurance (Part A) Trust Fund to become insolvent two years earlier than anticipated. The correspondence also expresses alarm that Congress would knowingly vote to undercut the Trust Fund.

The correspondence also charges that the GOP’s AHCA advances devastating Medicaid cuts—per-capita caps—that threaten access to needed care for the 11 million people with Medicare who also depend on Medicaid. One in five people with Medicare rely on Medicaid to cover vital long-term home care and nursing home services, to help afford their Medicare premiums and cost-sharing, and more.

“Federal cuts to Medicaid…would drive states to make hard choices, likely leading states to scale back benefits, impose waiting lists, implement unaffordable financial obligations, or otherwise restrict access to services,” says the correspondence.

Joe Baker, president of the Medicare Rights Center, said, “A Medicaid cut is a Medicare cut. One in five people with Medicare rely on Medicaid to access home and community-based services and nursing home care that they would otherwise go without. Medicaid is also the lifeline that helps millions of older adults and people with disabilities afford their Medicare premiums and cost-sharing. Per-capita caps are not a viable path forward to support our aging nation; the Senate must start from scratch.”

Adds, Kevin Prindiville, executive director of Justice in Aging. “The AHCA risks the health and financial security of millions of older adults in our families and communities. Slashing the program’s funding by over $800 billion eliminates Medicaid’s 50-year guarantee that older adults can count on Medicaid when they need it the most. We call on the Senate to protect seniors and Medicaid.”

“Simply put, this legislation is not a health care bill,” says Judith Stein, executive director of the Center for Medicare Advocacy. “A health care bill would strengthen coverage and delivery programs. AHCA gratuitously weakens Medicare, decimates Medicaid, and guts insurance for 24 million people. We urge the Senate to reject this charade and develop a real health care bill that improves coverage and enhances the Affordable Care Act.”

House GOP Leadership Puts its Health Care Proposal on Fast-Track

Published in Woonsocket Call on March 12, 2017

After years of calling for the dismantling of Obama’s signature health care law, the 2010 Affordable Care Act (ACA), dubbed Obamacare, an emboldened GOP controlling both the White House and two chambers of Congress, began legislative efforts to substantially change the way the federal government subsidizes health coverage for millions of Americans and puts the brakes on Medicaid expansion that extended coverage to millions more.

On March 6, House Speaker Paul Ryan (R-Wis), with the blessing of President Donald Trump, began his legislative efforts to enact the House GOP’s 123 page health care proposal, the new American Health Care Act (AHCA). Democratic lawmakers and aging groups charge that the AHCA lacks a fiscal estimate from the bipartisan Congressional Budget Office as to how many people will lose their health insurance coverage as a result of the bill or how much it will cost.”

According to rating agency S&P Global Ratings, between 6 million and 10 million people could lose health insurance coverage if the GOP’s health care proposal to “repeal and replace” Obamacare passes. Specifically, there would be a decline in enrollment in the individual health insurance plan market of between 2 million and 4 million people. There would also be a decline of between 4 million and 6 million people in the nation’s Medicaid system after 2020 to 2024, says the recently released analysis.

GOP Health Proposal on Fast-Track

Just hours after AHCA was introduced early in the week, the House Energy and Commerce Committee and Ways and Means Committee began holding markups on their specific portions of the GOP’s health care proposal. After deliberating for almost 18 hours the Ways and Means approved its portion by a vote of 23-16, along party lines. After a marathon 27-hour markup session, the AHCA proposal was approved by the second House panel, Energy and Commerce Committee, by voted 31 to 23, by party line, too. Next week, the House Budget and Rules committees is expected to take up the GOP health care proposal, with a full House floor scheduled for the week of March 20. It has been reported that Ryan hopes to have a bill to President Trump for signature before April recess.

“Obamacare is rapidly collapsing. Skyrocketing premiums, soaring deductibles, and dwindling choices are not what the people were promised seven years ago. It’s time to turn a page and rescue our health care system from this disastrous law,” said House Speaker Ryan in a statement released when AHCA was thrown into the legislative hopper.

Ryan asserted that the GOP health care proposal would “drive down costs, encourage competition, and give every American access to quality, affordable health insurance. It protects young adults, patients with pre-existing conditions, and provides a stable transition so that no one has the rug pulled out from under them.”

The GOP health care proposal would keep two of the most popular provisions of Obama’s ACA, specifically providing health care coverage to people with pre-existing conditions (though insurers would be allowed to charge higher premiums to individuals with lapsed health care coverage) and allowing children to stay on their parents’ health plans until the age of 26.

But, the GOP’s efforts to repeal and replace Obama Care has brought aging groups together to put the brakes on House passage.

Aging Groups Come Out Swinging

Seniors’ advocates object to the ACHA’s impact on federal programs that provide both healthcare and long-term care to retirees. The bill rescinds an 0.9% tax on upper income earners’ wages, which had been used to extend the solvency of Medicare until 2028. Removing the tax decreases Medicare’s solvency by four years, which could lead to benefit cuts down the road. Advocates also decry the age-rating provisions in the repeal bill, which would allow insurers to charge older Americans up to five times as much for premiums as younger enrollees pay. The $4,000 tax credits for near seniors (aged 50-64) which replace Obamacare subsidies won’t make a dent in the premiums that this age group will pay under the GOP plan. Older Americans who can’t afford insurance will then arrive at the threshold of Medicare less healthy, putting additional strain on the system.

“This legislation is a triple whammy for seniors. It’s bad for Medicare beneficiaries, bad for near seniors, and bad for the Medicare program,” says Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare.”

Richmond is especially alarmed that the AHCA also makes radical changes to the Medicaid program. The bill cuts $370 billion from Medicaid over 10 years by imposing “per capita caps,” meaning that states will get a fixed federal payment per beneficiary instead of the guaranteed match they now receive. Those fixed payments will not be able to keep pace with rising healthcare costs, leaving the states with significant shortfalls. “Millions of seniors rely on Medicaid for skilled nursing care, both in the home and at community-based facilities. The cut in federal payments will compel states to remove seniors from Medicaid rolls or radically reduce benefits, forcing them and their families into poverty.”

Following the release of the GOP’s AHCA, the Washington, D.C.-based AARP, the nation’s largest advocacy group representing over 37 million members, came out swinging. The GOP legislative proposal would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors, warned AARP Executive Vice President Nancy LeaMond in a statement.

“Before people even reach retirement age, big insurance companies would be allowed to charge them an age tax that adds up to thousands of dollars more per year. Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs, noted LeaMond.

LeaMond charged, “On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal. “Finally, Medicaid cuts could impact people of all ages and put at risk the health of 17.4 million children and adults with disabilities and seniors by eliminating much needed services that allow individuals to live independently in their homes and communities.”

“Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable,” says LeaMond, noting that her nonprofit aging group will work with either political party to hammer out a health plan that “puts Americans’ health care first, not the special interests.”

Adds Judith Stein, executive director of the Center for Medicare Advocacy in a statement, “the proposed AHCA would also gut key financing mechanisms of the Affordable Care Act that would amount to tax cuts for the wealthy – by some estimates, by hundreds of billions of dollars. Regrettably, these tax cuts include provisions that would jeopardize Medicare’s financial stability. “We fear such cuts will lead to renewed calls to ‘save’ Medicare by privatizing it for future generations,” says Stein.

According to the Center for Medicare Advocacy’s statement, the proposed GOP legislative proposal would dismantle key structural supports of ACA, including eliminating the employer coverage mandate and the individual mandate to obtain health coverage, and instead would impose a 30 percent penalty for lapses in coverage. Instead of the ACA’s subsidies that make health coverage more affordable for millions, the new legislation would offer age-based tax credits ranging from about $2,000 to $4,000 – likely insufficient to pay for meaningful insurance coverage.

The Medicare Advocacy Group also warns that older Americans needing health insurance coverage before becoming Medicare eligible would also be hit hard by the proposed AHCA. The ACA’s protection of older adults that prevents insurance companies from charging no more than three times the premium amount charged of younger individuals (a 3:1 ratio) would be replaced by a higher 5:1 ratio – this dramatically increasing the premium amount insurance companies can charge older adults. Critics call this change an “age tax.”

Finally, the Republican’s AHCA would also phase out ACA’s expansion of Medicaid starting in 2020, structurally reforming virtually the entire Medicaid program (including Medicaid expansion). These changes would have a devastating impact on providing health care by capping federal Medicaid payments to each state to a limited, preset amount per person (often referred to as a “Per Capita Cap”).

Could Political Backlash Happen with Passage of AHCA?

Last Thursday, Ryan, with sleeves rolled up, urged GOP lawmakers to back AHCA, promising tweaks to address Republican conservatives’ concerns. At the 23 minute news conference, Ryan said: “This is the closest we’ve been to repealing and replacing Obamacare and it’s the closest we will ever get to repealing and replacing Obamacare.” It is either voting for the House bill, or let ACA survive, he said.

President Trump also chimed in to the AHCA debate, too, by calling for the controversial health care proposal’s enactment in an afternoon tweet. “Despite what you hear in the press, health care is coming along great. We are talking to many groups and it will end in a beautiful picture!,” he tweeted.

As the Congressional April recess approaches opposition to AHCA is building as physician, nurse and hospital groups warn that the legislative proposal’s enactment will take health care coverage away from millions of Americans. While Democratic and progressive organizations oppose ACA’s passage, too, a growing number of GOP lawmakers and conservative groups, from the Cato Institute, Americans for Prosperity and Tea Party Patriots, are expressing their concerns.

Days ago, Andrev Ostrovskv, chief medical officer for Medicaid at the Baltimore, Maryland-based Centers for Medicare and Medicaid based, risking the wrath of Trump’s political appointees in his federal agency, tweeted his displeasure and opposition. “Despite political messaging from others at HHS [Health and Human Services], I align with the experts from @aafp @AmerAcadPeds @AmerMedicalAssn in opposition to #AHCA,” he tweeted. Dr. Ostrovskv’s agency oversees the administering of Obamacare.

Even if the GOP House Leadership are able to address conservative lawmaker concerns, one being AHCA does not require an earlier halt to Medicaid expansion enrollment, the GOP’s health care proposal appears to have a rocky road to travel in the upper chamber. Senate. Republications, having just a 52-48 slim majority, can only lose two votes.

Says Senator Tom Cotton (R-Arkansas) in a tweet to House GOP Leadership: “ House health-care bill can’t pass Senate w/o major changes. To my friends in House: pause, start over. Get it right, don’t get it fast.”

With the popularity of Obamacare the GOP’s death wish to repeal and replace the law may well be hazardous to the Republican Party’s political health. We’ll find out for sure in the mid-term elections.

Save the Roses and Try These Tips: Six Ways to Improving Communication at Home

Published in the Woonsocket Call on February 5, 2017

Effective Communication at home with your husband, wife, or partner is key to maintaining a meaningful, healthy, environment and thriving family. With Valentine’s Day fast approaching, Author Donna Mac, a well-known corporate trainer, based in South Eastern, Massachusetts, with 25 years of experience in the broadcasting industry, translates effective corporate communication into tips for use in enhancing communication with your loved ones.

According to Mac, sexual infidelity, commonly linked to divorce, is not the leading cause for couples separating. The corporate communications expert notes that a recent article in Psychology Today says that whether a partner’s communication “lifts you up or brings you down” is the single largest predictor of divorce.

So, mastering your communication skills may be the best Valentine’s Day gift you can give, much better than a dozen roses. Mac, founder & president of Rehoboth, MA-based DMacVoice Communications, explains her Six Pillars Of Effective Communication which can bring healthy energy into an ailing relationship and bring you closer together with your loved one.

Six Pillars of Effective Communication

“The first pillar in becoming a more effective communicator,” says Mac, noting this “is tied to ‘knowing and owning who you are.’ That means your strengths and vulnerabilities. You must be comfortable with who you are and understand that you have a right to communicate what you are thinking and feeling.” She cautions us to be careful to always communicate as calmly and respectfully as possible. Don’t wait to communicate until emotions build up to the point where that is not possible.

“Also, get a sense for whether you are you an extrovert or an introvert”. Mac notes that this will influence how you interact with your partner. According to Mac, communication tends to flows more easily for extroverts. Introverts need more time to process before they speak, but they are usually better listeners.

She also cautions against being a passive, or even a passive-aggressive communicator. Both of these styles are non-productive but they are easy to fall into. Often times it feels easier to be a passive communicator because being an effective communicator take courage and work. “These days, it’s easy to hide behind our computer screens,” she says.

The second Pillar calls for the need to understand your partner. “Understand how your personality and communication style differs from that of your loved one,” suggests Mac, who says that there are differences as well as varying points of view in every relationship. “When you disagree, be open to the possibility that either of you may be “right” or “wrong” or a bit of both. Be open to learning something new. It is also important to make it easy for your partner to share his or her vulnerabilities and ask for your help. “Create a safe space for communications by allowing and encouraging your partner to communicate often and to be authentic,” she adds.

To use a phrase from her book, you can continue to “understand your audience” over the years by listening intently and often.

Pillar three encourages you to “master the content of the conversation” you are about to have. She stresses the need to be clear on what it is you would like to say especially if you have to have a challenging conversation.

Mac says, “You may need to practice how you are going to broach an extremely difficult topic. Do your best to speak in a way that is compelling but concise and has the best interest of both of you. Instead of accusing your partner of something, talk about the way that issue has affected you. Remember, they might not know if you don’t’ tell them. Also, try not to ramble. Instead, state your case with clarity and the most positive energy you can muster. If their actions are unacceptable, know where your boundaries lie and clearly and calmly state them.”

Put Yourself Into Their Shoes

Pillar four calls for you to “anticipate questions and reactions” to conversations.” Mac recommends, while you want to make sure you get your point across, ensure that you’ve taken time to put yourself into your partner’s shoes. “Life isn’t easy for anyone. But if you take time to think about and anticipate how they may feel or react to your topic you won’t be so quick to react emotionally and with harsh words and energy.

By anticipating reaction you will be able become more proactive in your relationship, she says, noting that, “your partner will appreciate it.”

“Remember, effective communication in a trusted relationship takes time, thought and occasional discomfort,” says Mac.

Pillar five suggests that you “speak to serve” in your conversations. “When you ‘serve’ the person you’re speaking with, you are taking time to make sure that the conversation is not “all about you”. It’s for the benefit of you, for them and for the greater good of the relationship or even the entire family!” says Mac. “When you serve while speaking, you are making sure that understanding is taking place. If you’re not sure that it is, you might want to say something like, “is this making sense to you?”

Finally, Pillar six calls for you to “detach from the outcome” of the conversation. “If you follow the first 5 Pillars of Effective Communication you will be well on your way to becoming a highly effective communicator. But you aren’t quite there yet!” states Mac. It is very important that you don’t try to control your partner’s reaction.

Instead of concerning yourself with perfection, remain flexible and detached, knowing that total agreement is never possible. Plus, it’s really unimportant. What is important is the health and strength of your relationship and two powerful voices, even if they don’t always see eye to eye,” she adds.

Don’t Try to Change Others, Change Yourself

Mac suggests that if you want to become an effective communicator, don’t focus on changing the other person. We have no control over other people, only ourselves. “So work on changing what you can change in your communication style so that you can communicate in compelling and influential ways”.

While Mac’s Six Pillars Of Effective Communication can be directed to couples, look at the recommendations and try replacing “romantic” partner with “business” partner or someone you’re collaborating with at work. And replace “the entire family” with “the entire department or company in Pillar five.

“These communication tips are universal and are the foundation for healthy professional AND personal relationships. The are not easy to integrate into our lives, but the more you use them, the quicker they’ll become part of who you are and how you communicate.”

Donna Mac is author of Guide to a RICHER LIFE–Know Your Worth, Find Your Voice & Speak Your Mind and The Six Pillars of Effective Communication. She is also a keynote speaker and private coach. For more details, go to http://www.dmacvoice.com.