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DOD: Periodic health assessment to include mental health portion

“Everyone across the DoD, active-duty wise, is accomplishing the mental health assessment for any of their PHAs that started on that date and after,” said Maj. Gretchen Haywood, Aerospace and Operational Medicine Flight commander.

Article source: http://www.daytondailynews.com/news/dod-periodic-health-assessment-include-mental-health-portion/LL6RNvpr9U3N56xu2cdU1L/

Weekend: Mental Health Moment

By NANCY STEPHANI
The opiate epidemic in our country, state and community is depressing. But there are reasons to hope. I attended a neurology conference several months ago where medical experts were optimistic.
We are Americans. We conquered polio. We have a handle on the AIDS crisis, and we will get the better of the current opiate epidemic.
There are some wonderful books that explain the current problem and how we got here. “Dreamland,” by Sam Quinones, explains how we got here and why the issue is so difficult to combat. “Hillbilly Elegy,” by J.D. Vance, tells a personal story and connects the current crisis to ACE scores — Adverse Childhood Experiences. The higher an ACE score, the more likely a person is to suffer from addiction and a host of other health and social issues.
Watch for more about this in next week’s column.
Finally, Dr. Daniel Sumrok, director of addiction sciences at the University of Tennessee College of Medicine, describes addiction as “compulsive comfort-seeking behavior.” Harvard researcher and clinician Bessel van der Kolk, M.D., also discusses in research articles how victims of trauma tend to be drawn to and experience additional trauma.
This gives treatment more options to explore. I in no way intend to justify drug abuse, but understanding addiction and where it comes from is a necessary step in treatment and eradication. All of us have ways to comfort ourselves; some healthy, and others not so healthy. Some of us have a drink, a cigarette, a chocolate milkshake, go running or take a bicycle ride, and cook comfort food. Most of us who have been around children are familiar with a favorite blanket, special pillow, pacifier for sleep and comfort, rocking chairs, etc.
Looking at addiction as maladaptive, compulsive (read that automatic and not thoughtful) comfort-seeking behavior makes sense. Family members and friends can begin to understand and not get angry or be so intolerant. This can lead to conversations about healthy coping skills and past hurtful events. Treatment providers can reframe new healthy and adaptive behaviors and explore past trauma. And people who engage in compulsive comfort-seeking behaviors can perhaps stop and look at their lives and make healthier choices.
Many of our court systems have gotten a big part of the message. Treatment courts focus on relationships and behavior in a more conversational setting model and support healthier coping skills and communication. Therapists who utilize the latest treatment strategies to address past trauma help those struggling with addiction to stop the self-medicating and comfort-seeking behavior, or at least stop and think about their actions. Families, friends and even employers are more understanding of individual struggles.
Together, we can beat these awful diseases called addiction.
Stephani, coordinator of emergency services at Century Health, is a licensed independent social worker supervisor. She is on professional staff at Ohio State University at Lima. If you have a mental health question, please write to: Mental Health Moment, The Courier, P.O. Box 609, Findlay 45839.




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Article source: http://thecourier.com/local-news/2017/08/13/weekend-mental-health-moment-183/

Goldman Sachs breaks down how Amazon can jump into health care

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Jeff Bezos

Amazon is speeding its efforts to crack the health care market, hiring a number of high-profile executives, testing Echo technology in top hospitals and creating a secret “1492″ team dedicated to health-technology opportunities like telemedicine and electronic medical records.

Goldman Sachs is now out with a 30-page report from five research analysts on Amazon’s likely ambitions in the $560 prescription drug market. The note cites CNBC’s reporting on the 1492 group and Amazon’s hiring of a general manager to lead its pharmacy unit.

Here are some of the key insights from the report:

  • Rather than replacing pharmacies right away, Amazon might start by partnering with a pharmacy benefits manager (PBM), which acts as an intermediary between payers, like health insurers, and the rest of the health system. That would provide “access to patient data and the potential to cross-sell related products.”
  • Amazon could ultimately improve price transparency for the consumer and reduce out-of-pocket drug costs. But it would likely start by speeding up the drug delivery process and facilitating at-home delivery.
  • Amazon could also become an online pharmacy, retail and online pharmacy, integrated PBM and online pharmacy, or handle drug distribution to pharmacies.
  • One potential — and overlooked — challenge for Amazon might be the so-called “age gap.” Amazon’s customers tend to be younger and healthier than people who typically take prescription drugs.
  • Amazon could move into digital health by using the Echo in clinical settings and developing tools for telemedicine and remote patient monitoring. “Imagine seeing a virtual doctor on your Amazon app, having it prescribe you a certain medication, and then tapping a ‘buy now’ button — all without leaving your home.”





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From Alaska To Florida, States Respond To Opioid Crisis With Emergency Declarations

Overdoses from heroin and other opioids have led six states to declare public health emergencies.

Marianne Williams/Getty Images


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Marianne Williams/Getty Images

Overdoses from heroin and other opioids have led six states to declare public health emergencies.

Marianne Williams/Getty Images

Public health officials and others concerned about the nation’s opioid crisis are hailing President Trump’s decision to declare it a national emergency. A Presidential commission on opioids said in its interim report that an emergency declaration would allow the administration to take immediate action and send a message to Congress that more funding is needed.

But while the Trump administration prepares the presidential order, governors in six states have already declared emergencies to deal with opioids. They range from Alaska and Arizona in the West to Florida, Virginia, Maryland and Massachusetts in the East.

In Maryland, where 550 overdose deaths were reported in just the first three months of this year, Gov. Larry Hogan declared opioids a public health emergency in March.

“It’s a call to order and a call to action,” says Clay Stamp, head of Maryland’s Opioid Operational Command Center. Stamp comes to the job with a background as an emergency manager and compares this effort to the state’s response to a hurricane.

“We need all the right people in the room to make sure we can make a decision in time to move people out of harm’s way, shelter them and everything else,” he says. “This is no different.”

Since declaring an emergency, Maryland has tightened practices for those prescribing opioids and received a waiver to allow Medicaid to pay for residential drug treatment.

Massachusetts was the first state to declare opioids a public health emergency in 2014. Then-Gov. Deval Patrick acted on the recommendations of a special task force, says Michael Barnett, an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health.

The recommendations were “to open up funding for the Department of Public Health — for instance, to open up more treatment beds, to create funding and make it easier for … first responders to use naloxone, which reverses opioid overdoses in the field,” he says.

Making naloxone freely available and putting it in the hands of more people has helped save lives. That has been one of the most immediate impacts of emergency declarations in states that have issued them.

Arizona Gov. Doug Ducey declared a public health emergency in June. Will Humble, executive director for the Arizona Public Health Association says with that declaration, the state began gathering badly needed data on the crisis.

“Who it’s hitting, where it’s hitting, who is doing the prescribing, what portion of it are fentanyl and heroin and what portion are prescribed pills,” he says. “And, as you get that more complete information, it allows you to craft better public policy.”

In Florida, the emergency declaration issued in May enabled Gov. Rick Scott to quickly allocate some $27 million in federal funds for drug treatment and prevention.

Palm Beach County, Fla., saw nearly 600 fatal overdoses last year, mostly related to opioids. Alton Taylor, executive director of the county’s Drug Abuse Foundation says although the emergency declaration was welcome, Palm Beach County and the rest of the state still don’t have enough publicly-funded beds available to treat people with opioid addictions.

“Today as I’m talking to you, we have over 200 people on a waiting list,” he says. “These are people where we’ve done a clinical assessment of them and determined them to be in need of that service.”

Despite the emergency declaration, Florida, unlike some other states, hasn’t tapped Medicaid to help pay for drug treatment. Taylor says he’s hopeful President Trump’s emergency declaration, when finalized, will free up more money to treat people in recovery from opioid addictions.

Article source: http://www.npr.org/sections/health-shots/2017/08/11/542836709/from-alaska-to-florida-states-respond-to-opioid-crisis-with-emergency-declaratio

Diplomats in Cuba suffered "health attacks," Tillerson says

HAVANA — Secretary of State Rex Tillerson says that U.S. diplomats in Havana have been the victims of “health attacks” that left them with hearing loss – the most definitive U.S. statement yet on a series of mysterious incidents that have longtime observers puzzled. 

In the fall of 2016, a series of U.S. diplomats began suffering unexplained losses of hearing, according to officials with knowledge of the case. Some of the diplomats’ symptoms were so severe they were forced to cancel their tours early and return to the United States, officials said. The State Department said Wednesday that there had been “incidents which have caused a variety of physical symptoms.”

Tillerson said Friday that “we hold the Cuban authorities responsible for finding out who is carrying out these health attacks.”

The Cuban government flatly rejected the allegations on Wednesday, saying in a lengthy statement that “Cuba has never permitted, nor will permit, that Cuban territory be used for any action against accredited diplomatic officials or their families, with no exception.”

A source familiar with the incidents told CBS News that as many as eight or nine U.S. government employees had their assignments cut short due to the severity of the symptoms, but others affected remain on the island after being “encouraged not to leave.” 

Sources said Thursday that similar reports of headaches and hearing loss are coming from people within the Canadian embassy in Cuba. In the home of one top Canadian official, everyone in the residence including Cuban employees were taken to CIMEQ hospital where top government leaders are treated– for examination by an ENT specialist. The Cuban employees were then sent home for the day and Canadian security was brought in for a thorough sweep of the house.

After months of investigation, U.S. officials concluded that the American diplomats had been exposed to an advanced device that operated outside the range of audible sound and had been deployed either inside or outside their residences. It was not immediately clear if the device was a weapon used in a deliberate attack, or had some other purpose.

The U.S. officials weren’t authorized to discuss the investigation publicly and spoke on condition of anonymity.

The Wednesday night statement from the Cuban Foreign Ministry said it had been informed of the incidents on Feb. 17 and had launched an “exhaustive, high-priority, urgent investigation at the behest of the highest level of the Cuban government.

State Department spokeswoman Heather Nauert said the U.S. retaliated by expelling two Cuban diplomats from their embassy in Washington on May 23. She did not say how many U.S. diplomats were affected or confirm they had suffered hearing loss, saying only that they had “a variety of physical symptoms.”

Cuba’s government called the decision to expel the two Cuban diplomats “unjustified and baseless.”

Intelligence experts told CBS News it could also have been a routine intimidation campaign taken to another level.  

“This could be new technology that had a side effect that no one had expected,”  said Vince Houghton, an intelligence historian and curator at the International Spy Museum. “On the other hand, it could have been designed … to harass, to make people feel uncomfortable.”  

Article source: http://www.cbsnews.com/news/diplomats-in-cuba-suffered-health-attacks-tillerson-says/

Mysterious Health Issues Drove US Diplomats From Cuba

Ms. Nauert told reporters that last fall some diplomats and staff members at the embassy in Havana began reporting “a variety of physical symptoms.” She did not elaborate, but said that the issues were not life-threatening and that the officials had since been screened and treated.

“We can’t blame any one individual or country at this point yet,” she said on Thursday.

American officials told The Associated Press that the symptoms were primarily severe hearing loss, possibly caused by a covert sonic device.

The Cuban Ministry of Foreign Affairs said on Wednesday that it learned of the health issues on Feb. 17, and opened a “comprehensive, priority and urgent investigation” and formed a committee to investigate. The ministry also increased security around the American Embassy and diplomatic residences.

“Cuba is universally considered as a safe destination for both visitors and foreign diplomats, including Americans,” the ministry said in the statement.

Ms. Nauert said no cases involving private American citizens had been reported.

“The safety and security of American citizens at home and abroad is our top priority,” Ms. Nauert told reporters on Wednesday when the news broke. “We’re taking that situation seriously.”

On Thursday, a spokeswoman for Canada’s Foreign Ministry, Brianne Maxwell, confirmed that some Canadian officials in Cuba had also been affected.

“We are aware of unusual symptoms affecting Canadian and U.S. diplomatic personnel and their families in Havana,” Ms. Maxwell said in an email. “The government is actively working — including with U.S. and Cuban authorities — to ascertain the cause.”

She said officials did not believe there was any threat to Canadian tourists or other visitors to Cuba.


Continue reading the main story

Article source: https://www.nytimes.com/2017/08/10/world/americas/mysterious-health-issues-drove-us-diplomats-from-cuba.html

On Health Care, Who Needs Congress?

Now 41 major corporations that represent over six million workers and retirees have joined together to reform the private-sector health care system. Our companies are diverse, representing pretty much every sector of the economy. Known as the Health Transformation Alliance, we’re troubled by the number of middlemen who drive up the price of care, and by the soaring costs of prescription drugs.

The members of the alliance spend $25 billion on health care and, as a result, have a lot of data that helps us identify trends. By studying where the money goes and its impact on patient health, we can see what treatments, which doctors and hospitals, and which medical networks get the best results. Data analysis from IBM is turning what used to be a blizzard of paperwork into a road map for the future.

There are things data can tell us that individuals have a hard time learning on their own. For example, if data tell us that 50 percent of patients who visit a particular hospital suffer a relapse for a particular medical condition while only 25 percent of patients who visit a crosstown hospital have a relapse for the same illness, we want our employees to know that — and if possible, to use the hospital with the better results. The data can save lives.

Prescription drugs also save lives, but they’re expensive, often in ways hidden from employers and employees alike. This year, the alliance companies changed how we do business with pharmacy benefit managers, the companies that provide prescription drugs for our employees.

Rather than having individual companies contract with benefit managers, we worked with CVS and OptumRx on an approach under which we gain more access to drug companies’ pricing structures, strengthening our position in cost negotiations. That results in lower prices for the same medicines and allows the alliance members to achieve considerable savings. We also are working to ensure that formularies, the lists of prescription medicines covered by insurers, are the right ones for patients, not just the most profitable ones. This can increase the use of lower-cost generic drugs.

Beginning Jan. 1, these drug reforms alone are projected to save participating companies, their workers and, in some cases, retirees at least $600 million over three years — while achieving the same or better results. Even for large companies, that’s a lot of money. It’s also an inducement for more companies to join our effort. The more that join, the more reforms we can achieve.

We and our employees spend more than $5 billion each year on four procedures and ailments: knee replacements, hip replacements, back pain and diabetes. These common problems account for 20 percent of the money our companies spend on treatment. Starting next year, we will create new medical networks in three major cities that will focus on delivering better results for these ailments and procedures at better prices. Our new networks are likely to compete with some doctors and hospitals that don’t have as good a treatment record. The health care arena needs more competition, and we will encourage it.

The rising number of companies joining our alliance means corporations recognize that the status quo is not acceptable. Private sector health care must change. We are doing our part to make that happen.

Robert Andrews, a former Democratic congressman from New Jersey, is chief executive of the Health Transformation Alliance.

A version of this op-ed appears in print on August 11, 2017, on Page A21 of the New York edition with the headline: How Bosses Can Fix Health Care.


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Article source: https://www.nytimes.com/2017/08/11/opinion/corporate-america-health-care-congress.html

Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts

KEY FINDINGS:
  • The August Kaiser Health Tracking Poll finds that the majority of the public (60 percent) say it is a “good thing” that the Senate did not pass the bill that would have repealed and replaced the ACA. Since then, President Trump has suggested Congress not take on other issues, like tax reform, until it passes a replacement plan for the ACA, but six in ten Americans (62 percent) disagree with this approach, while one-third (34 percent) agree with it.
  • A majority of the public (57 percent) want to see Republicans in Congress work with Democrats to make improvements to the 2010 health care law, while smaller shares say they want to see Republicans in Congress continue working on their own plan to repeal and replace the ACA (21 percent) or move on from health care to work on other priorities (21 percent). However, about half of Republicans and Trump supporters would like to see Republicans in Congress keep working on a plan to repeal the ACA.
  • A large share of Americans (78 percent) think President Trump and his administration should do what they can to make the current health care law work while few (17 percent) say they should do what they can to make the law fail so they can replace it later. About half of Republicans and supporters of President Trump say the Trump administration should do what they can to make the law work (52 percent and 51 percent, respectively) while about four in ten say they should do what they can to make the law fail (40 percent and 39 percent, respectively). Moving forward, a majority of the public (60 percent) says President Trump and Republicans in Congress are responsible for any problems with the ACA.
  • Since Congress began debating repeal and replace legislation, there has been news about instability in the ACA marketplaces. The majority of the public are unaware that health insurance companies choosing not to sell insurance plans in certain marketplaces or health insurance companies charging higher premiums in certain marketplaces only affect those who purchase their own insurance on these marketplaces (67 percent and 80 percent, respectively). In fact, the majority of Americans think that health insurance companies charging higher premiums in certain marketplaces will have a negative impact on them and their family, while fewer (31 percent) say it will have no impact.
  • A majority of the public disapprove of stopping outreach efforts for the ACA marketplaces so fewer people sign up for insurance (80 percent) and disapprove of the Trump administration no longer enforcing the individual mandate (65 percent). While most Republicans and Trump supporters disapprove of stopping outreach efforts, a majority of Republicans (66 percent) and Trump supporters (65 percent) approve of the Trump administration no longer enforcing the individual mandate.
  • The majority of Americans (63 percent) do not think President Trump should use negotiating tactics that could disrupt insurance markets and cause people who buy their own insurance to lose health coverage, while three in ten (31 percent) support using whatever tactics necessary to encourage Democrats to start negotiating on a replacement plan. The majority of Republicans (58 percent) and President Trump supporters (59 percent) support these negotiating tactics while most Democrats, independents, and those who disapprove of President Trump do not (81 percent, 65 percent, 81 percent).
  • This month’s survey continues to find that more of the public holds a favorable view of the ACA than an unfavorable one (52 percent vs. 39 percent). This marks an overall increase in favorability of nine percentage points since the 2016 presidential election as well as an increase of favorability among Democrats, independents, and Republicans.

Attitudes Towards Recent “Repeal and Replace” Efforts

In the early morning hours of July 28, 2017, the U.S. Senate voted on their latest version of a plan to repeal and replace the 2010 Affordable Care Act (ACA). Known as “skinny repeal,” this plan was unable to garner majority support– thus temporarily halting Congress’ ACA repeal efforts. The August Kaiser Health Tracking Poll, fielded the week following the failed Senate vote, finds that a majority of the public (60 percent) say it is a “good thing” that the U.S. Senate did not pass a bill aimed at repealing and replacing the ACA, while about one-third (35 percent) say this is a “bad thing.” However, views vary considerably by partisanship with a majority of Democrats (85 percent), independents (62 percent), and individuals who say they disapprove of President Trump (81 percent) saying it is a “good thing” that the Senate did not pass a bill compared to a majority of Republicans (64 percent) and individuals who say they approve of President Trump (65 percent) saying it is a “bad thing” that the Senate did not pass a bill.

Figure 1: Two-Thirds of Republicans and Trump Supporters Say It Was a Bad Thing the Senate Didn’t Pass ACA Repeal Legislation

The majority of those who view the Senate not passing an ACA replacement bill as a “good thing” say they feel this way because they do not want the 2010 health care law repealed (34 percent of the public overall) while a smaller share (23 percent of the public overall) say they feel this way because, while they support efforts to repeal and replace the ACA, they had specific concerns about the particular bill the Senate was debating.

And while most Republicans and supporters of President Trump say it is a “bad thing” that the Senate did not pass ACA repeal legislation, for those that say it is a “good thing” more Republicans say they had concerns about the Senate’s particular legislation (21 percent) than say they do not want the ACA repealed (6 percent). This is also true among supporters of President Trump (19 percent vs. 6 percent).

Figure 2: More Republicans and Trump Supporters Say Senate Bill Failure is a Good Thing Due to Policy Rather than Against Repeal Efforts

Who Do People Blame or Credit for the Senate Bill Failing to Pass?

Among those who say it is a “good thing” that the Senate was unable to pass ACA repeal and replace legislation, similar shares say the general public who voiced concerns about the bill (40 percent) and the Republicans in Congress who voted against the bill (35 percent) deserve most of the credit for the bill failing to pass. This is followed by a smaller share (14 percent) who say Democrats in Congress deserve the most credit.

Figure 3: Four in Ten Credit the Public for the Senate Bill Not Passing, Similar Share Blame the Democrats

On the other hand, among those who say it is a “bad thing” that the Senate did not pass a bill to repeal the ACA, over a third place the blame on Democrats in Congress (37 percent). About three in ten (29 percent) place the blame on Republicans in Congress while fewer (15 percent) say President Trump deserves most of the blame for the bill failing to pass.

Half of the Public Are “Relieved” or “Happy” The Senate Did Not Repeal and Replace the ACA

More Americans say they are “relieved” (51 percent) or “happy” (47 percent) that the Senate did not pass a bill repealing and replacing the ACA, than say they are “disappointed” (38 percent) or “angry” (19 percent).

Figure 4: Half of Public Are Happy/Relieved that Senate Failed to Pass the Repeal Legislation; Fewer Say They Are Disappointed/Angry

Although two-thirds of Republicans and Trump supporters say they feel “disappointed” about the Senate failing to pass a bill to repeal and replace the ACA, smaller shares (30 percent and 37 percent, respectively) report feeling “angry” about the failure to pass the health care bill.

Figure 5: Two-Thirds of Republicans and Trump Supporters Say They Are Disappointed that Senate Failed to Pass Repeal; Fewer Are Angry

Majority Say President Trump and Republicans in Congress Are Responsible for the ACA Moving Forward

With the future of any other replacement plans uncertain, the majority (60 percent) of the public say that because President Trump and Republicans in Congress are now in control of the government, they are responsible for any problems with the ACA moving forward, compared to about three in ten Americans (28 percent) who say that because President Obama and Democrats in Congress passed the law, they are responsible for any problems with it. Partisan divisiveness continues with majorities of Republicans and supporters of President Trump who say President Obama and Democrats are responsible for any problems with it moving forward, while large shares of Democrats, independents, and those who do not approve of President Trump say President Trump and Republicans in Congress are responsible for the law moving forward.

Figure 6: Most Say President Trump and Republicans Are Responsible for ACA Moving Forward

Moving Past Repealing The Affordable Care Act

This month’s survey continues to find that more of the public holds a favorable view of the ACA than an unfavorable one (52 percent vs. 39 percent). This marks an overall increase in favorability since Congress began debating ACA replacement plans and a nine percentage point shift since the 2016 presidential election.

Figure 7: More of the Public Have Favorable Views than Unfavorable Views of ACA

The shift in attitudes since the 2016 presidential election is found regardless of party identification. For example, the share of Republicans who have a favorable view of the ACA has increased from 12 percent in November 2016 to 21 percent in August 2017. This is similar to the increase in favorability among independents (11 percentage points) and Democrats (7 percentage points) over the same time period.

Figure 8: Partisans Showing Gradual Increases in ACA Favorability Over Past Year

Next Steps For The ACA

The most recent Kaiser Health Tracking Poll finds that after the U.S. Senate was unable to pass a plan to repeal and replace the ACA, the majority of the public (57 percent) wants to see Republicans in Congress work with Democrats to make improvements to the 2010 health care law but not repeal it. Far fewer want to see Republicans in Congress continue working on their own plan to repeal and replace the ACA (21 percent) or move on from health care to work on other priorities (21 percent). About half of Republicans (49 percent) and Trump supporters (46 percent) want Republicans in Congress to continue working on their own plan to repeal and replace the ACA, but about a third of each say they would like to see Republicans work with Democrats on improvements to the ACA.

Figure 9: Most Want Republicans and Democrats to Work Together to Improve ACA

Six in ten Americans (62 percent) disagree with President Trump’s strategy of Congress not taking on other issues, like tax reform, until it passes a replacement plan for the ACA while one-third (34 percent) of the public agree with this approach. Republicans and Trump supporters are more divided in their opinion on this strategy with similar shares saying they agree and disagree with the approach.

Figure 10: Most Disagree With Strategy of Congress Continuing to Work on ACA Replacement Plan Before Moving on to Other Issues

Most Want to See President Trump and Republicans Make the Current Health Care Law Work

Regardless of their opinions of the ACA, the majority of the public want to see the 2010 health care law work. Eight in ten (78 percent) Americans think President Trump and his administration should do what they can to make the current health care law work while fewer (17 percent) say President Trump and his adminstration should do what they can to make the law fail so they can replace it later. About half of Republicans and supporters of President Trump say the Trump administration should do what they can to make the law work (52 percent and 51 percent, respectively) while about four in ten say they should do what they can to make the law fail (40 percent and 39 percent, respectively).

Figure 11: More Say President Trump’s Administration Should Make the ACA Work than Say They Should Make the ACA Fail

This month’s survey also includes questions about specific actions that the Trump administration can take to make the ACA fail and finds that the majority of the public disapproves of the Trump Administration stopping outreach efforts for the ACA marketplaces so fewer people sign up for insurance (80 percent) and no longer enforcing the individual mandate, the requirement that all individuals have insurance or pay a fine (65 percent). While most Republicans and Trump supporters disapprove of President Trump stopping outreach efforts so fewer people sign up for insurance, which experts say could weaken the marketplaces, a majority of Republicans (66 percent) and Trump supporters (65 percent) approve of the Trump administration no longer enforcing the individual mandate.

Figure 12: While Most Disapprove of Actions to Weaken the ACA, Republicans Approve of No Longer Enforcing Individual Mandate

The Future of the ACA Marketplaces

About 10.3 million people have health insurance that they purchased through the ACA exchanges or marketplaces, where people who don’t get insurance through their employer can shop for insurance and compare prices and benefits.1 Seven in ten (69 percent) say it is more important for President Trump and Republicans’ next steps on health care to include fixing the remaining problems with the ACA in order to help the marketplaces work better, compared to three in ten (29 percent) who say it is more important for them to continue plans to repeal and replace the ACA.

The majority of Republicans (61 percent) and Trump supporters (63 percent) say it is more important for President Trump and Republicans to continue plans to repeal and replace the ACA, while the vast majority of Democrats (90 percent) and seven in ten independents (69 percent) want them to fix the ACA’s remaining problems to help the marketplaces work better.

Figure 13: Partisan Differences in Views of President Trump and Republicans’ Next Steps on Health Care

Uncertainty Remains on Who is Impacted by Issues in the ACA Marketplaces

Since Congress began debating repeal and replace legislation, there has been news about instability in the ACA marketplaces which has led some insurance companies to charge higher premiums in certain marketplaces.  Six in ten Americans think that health insurance companies charging higher premiums in certain marketplaces will have a negative impact on them and their family, while fewer (31 percent) say it will have no impact.

Figure 14: Most Say Insurance Companies Charging Higher Premiums in the ACA Marketplaces Will Negatively Impact Them

There has also been news about insurance companies no longer selling coverage in the individual insurance marketplaces and currently, it’s estimated that 17 counties (9,595 enrollees) are currently at risk to have no insurer on the ACA marketplaces in 2018.2 The majority of the public (54 percent) say health insurance companies choosing not to sell insurance plans in certain marketplaces will have no impact on them and their family. Yet, despite the limited number of counties that may not have an insurer in their marketplaces as well as this not affecting those with employer sponsored insurance where most people obtain health insurance, about four in ten (38 percent) of the public believe that health insurance companies choosing to not sell insurance plans in certain marketplaces will have a negative impact on them and their families.

Figure 15: Half Think Health Insurance Companies Leaving the ACA Marketplaces Will Have No Impact on Them and Their Families

The majority of the public think both of these ACA marketplace issues will affect everyone who has health insurance and not just those who purchase their insurance on these marketplaces. Six in ten think health insurance companies choosing not to sell insurance plans in certain marketplaces will affect everyone who has health insurance while about one-fourth (26 percent) correctly say it only affects those who buy health insurance on their own. In addition, three-fourths (76 percent) of the public say that health insurance companies charging higher premiums in certain marketplaces will affect everyone who has health insurance while fewer (17 percent) correctly say it will affect only those who buy health insurance on their own.

Figure 16: Most Unaware ACA Marketplace Issues Only Affect Those Who Purchase Their Own Insurance

Majority Say President Trump Should Not Use Cost-Sharing Reduction Payments as Negotiating Strategy

Over the past several months President Trump has threatened to stop the payments to insurance companies that help cover the cost of health insurance for lower-income Americans (known commonly as CSR payments), in order to get Democrats to start working with Republicans on an ACA replacement plan.3 The majority of Americans (63 percent) do not think President Trump should use negotiating tactics that could disrupt insurance markets and cause people who buy their own insurance to lose health coverage, while three in ten (31 percent) support President Trump using whatever tactics necessary to encourage Democrats to start negotiating. The majority of Republicans (58 percent) and President Trump supporters (59 percent) support negotiating tactics while most Democrats, independents, and those who disapprove of President Trump do not (81 percent, 65 percent, 81 percent).

Figure 17: Partisan Differences on President Trump’s Negotiating Strategy

Methodology

Article source: http://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-august-2017-the-politics-of-aca-repeal-and-replace-efforts/

Study: Trump actions trigger health premium hikes for 2018

The Trump administration’s own actions are triggering double-digit premium increases on individual health insurance policies purchased by many consumers, a nonpartisan study has found.

The analysis released Thursday by the Kaiser Family Foundation found that mixed signals from President Donald Trump have created uncertainty “far outside the norm,” leading insurers to seek higher premium increases for 2018 than would otherwise have been the case.

The report comes with Republicans in Congress unable to deliver on their promise to repeal and replace the Obama-era Affordable Care Act. Trump, meanwhile, insists lawmakers try again. The president says “Obamacare” is collapsing, but he’s also threatened to give it a shove by stopping billions of dollars in payments to insurers. Some leading Republicans are considering fallback measures to stabilize markets.

Researchers from the Kaiser foundation looked at proposed premiums for a benchmark silver plan across major metropolitan areas in 20 states and Washington, D.C. Overall, they found that 15 of those cities will see increases of 10 percent or more next year.

The highest: a 49 percent jump in Wilmington, Delaware. The only decline: a 5 percent reduction in Providence, Rhode Island.

About 10 million people who buy policies through HealthCare.gov and state-run markets are potentially affected, as well as another 5 million to 7 million who purchase individual policies on their own.

Consumers in the government-sponsored markets can dodge the hit with the help of tax credits that most of them qualify for to help pay premiums. But off-marketplace customers pay full freight, and they face a second consecutive year of steep increases. Many are self-employed business owners.

The report also found that insurer participation in the ACA markets will be lower than at any time since “Obamacare” opened for business in 2014. The average: 4.6 insurers in the states studied, down from 5.7 insurers this year. In many cases insurers do not sell plans in every community in a state.

The researchers analyzed publicly available filings through which insurers justify their proposed premiums to state regulators. To be sure, insurers continue to struggle with sicker-than-expected customers and disappointing enrollment. And an ACA tax on the industry is expected to add 2 to 3 percentage points to premiums next year.

But on top of that, the researchers found the mixed signals from the administration account for some of the higher charges. Those could increase before enrollment starts Nov. 1.

“The vast majority of companies in states with detailed rate filings have included some language around the uncertainty, so it is likely that more companies will revise their premiums to reflect uncertainty in the absence of clear answers from Congress or the administration,” the report said. Once premiums are set, they’re generally in place for a whole year.

Insurers who assumed that Trump will make good on his threat to stop billions in payments to subsidize copays and deductibles requested additional premium increases ranging from 2 percent to 23 percent, the report found.

Insurers who assumed the IRS under Trump will not enforce unpopular fines on people who remain uninsured requested additional premium increases ranging from 1.2 percent to 20 percent.

“In many cases that means insurers are adding double-digit premium increases on top of what they otherwise would have requested,” said Cynthia Cox, a co-author of the Kaiser report. “In many cases, what we are seeing is an additional increase due to the political uncertainty.”

That doesn’t sound like what Trump promised when he assumed the presidency.

In a Washington Post interview ahead of his inauguration, Trump said, “We’re going to have insurance for everybody.”

“There was a philosophy in some circles that if you can’t pay for it, you don’t get it,” he added. “That’s not going to happen with us.”

People covered under Obama’s law “can expect to have great health care,” Trump said at the time. “It will be in a much simplified form. Much less expensive and much better.”

But the White House never produced the health care proposal Trump promised. And the GOP bills in Congress would have left millions more uninsured, a sobering side-effect that contributed to their political undoing.

The Trump administration sidestepped questions about its own role raised by the Kaiser study.

Spokeswoman Alleigh Marre said rising premiums and dwindling choices predate Trump.

“The Trump administration is committed to repealing and replacing Obamacare and will always be focused on putting patients, families, and doctors, not Washington, in charge of health care,” Marre said in a statement.

The ongoing political turmoil for people who buy individual health insurance stands in sharp contrast to relative calm and stability for the majority of Americans insured through workplace plans. The cost of employer-sponsored coverage is expected to rise around 5 or 6 percent next year, benefits consultants say.

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Associated Press Health Writer Tom Murphy in Indianapolis contributed to this report.

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Online:

Kaiser report – https://tinyurl.com/ya2yneqj

Article source: http://abcnews.go.com/Health/wireStory/study-trump-actions-trigger-health-premium-hikes-2018-49129908

Trump, McConnell Point Fingers Over Health Care Failure

President Trump speaks as Senate Majority Leader Mitch McConnell, R-Ky., looks on during a meeting with House and Senate leadership at the White House back in June.

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Pool/Getty Images

President Trump speaks as Senate Majority Leader Mitch McConnell, R-Ky., looks on during a meeting with House and Senate leadership at the White House back in June.

Pool/Getty Images

When it comes to health care legislation, the finger pointing between President Trump and Senate Majority Leader Mitch McConnell, R-Ky., is continuing almost two weeks after GOP efforts to repeal and replace the Affordable Care Act failed.

The top Republican in the Senate was the first to throw down the gauntlet this week, saying back home in Kentucky that it was Trump’s political inexperience that led to him setting “excessive expectations” over wanting to speedily repeal Obamacare.

McCain Votes No, Dealing Potential Death Blow To Republican Health Care Efforts

“Part of the reason I think that the storyline is that we haven’t done much is because, in part, the president and others have set these early timelines about things need to be done by a certain point,” McConnell said on Monday, according to ABC News.

“Our new president, of course, has not been in this line of work before. And I think he had excessive expectations about how quickly things happen in the democratic process,” the Senate majority leader continued. “So part of the reason I think people feel we’re underperforming is because too many artificial deadlines — unrelated to the reality of the complexity of legislating — may not have been fully understood.”

Unsurprisingly, that explanation didn’t sit well with the commander in chief, and he took to Twitter on Wednesday to fire back, asking “After 7 years of Repeal Replace, why not done?”

Dan Scavino, Trump’s social media director, had shared similar sentiments earlier from his personal account.

And Fox News Channel host Sean Hannity, a fervent Trump backer, called McConnell “weak” and “spineless.”

The escalating tension between the president and McConnell has the potential to jeopardize the rest of the Republican legislative agenda in the Senate when Congress returns to Washington, D.C., next month — a daunting list that includes a tax overhaul, raising the debt ceiling and more.

After Health Care Collapse, GOP Seeks Redemption With Tax Cuts

Another thing making the Trump-McConnell spat complicated — McConnell’s wife, Elaine Chao, is the president’s Secretary of Transportation.

But it wasn’t just the White House that was, at least initially, pressing for an ambitious legislative agenda.

“The two biggest issues we’re moving forward with in the first half of the year obviously are repeal and replacing Obamacare and tax reform,” McConnell said back in January at the GOP congressional retreat.

The latest jab from the president toward the majority leader comes just after Trump gave McConnell a political win on Tuesday night when the president threw his support behind Sen. Luther Strange, R-Ala., ahead of a primary next week in a special election race.

Strange, who was appointed to fill now-Attorney General Jeff Sessions’ seat, has the backing of McConnell, the majority leader’s super PAC and the National Republican Senatorial Committee.

The endorsement was a blow to Rep. Mo Brooks, who’s fighting to earn a spot in a runoff as a result of Tuesday’s voting — with both Brooks and Strange likely to finish behind Roy Moore, a controversial former Alabama Supreme Court justice best known for refusing to remove a Ten Commandments memorial from a state judicial building. Brooks was critical of Trump last year during the presidential campaign, pointing to his “serial adultery”, and, more recently, the congressman slammed the president for his “public waterboarding” of Sessions on Twitter.

On Wednesday though, in the wake of Trump’s own escalating feud with McConnell, Brooks tried to seize an opening, urging the president to reconsider his endorsement since Brooks wants to oust McConnell from GOP leadership.

Article source: http://www.npr.org/2017/08/09/542464074/trump-mcconnell-point-fingers-over-health-care-failure