#it is Not ok for a service that exists to provide financial aid for medical reasons to demand that u 'prove' it by paying out of pocket

[there-goes-trouble]

Okay in case you need help for any reason (USA)

If other forms of financial aid aren't coming through, try 211--one phone call can save you hours of headache while you're already in a tough spot:

Separately, while there are still public funds for it, you can be tested for COVID & FLU by a nurse from home in just abt every state:

Online resource for people who hate calling:

Food for Women Infants and Children:

Health & Human Services for medical help:

More medical help:

⬆️got a hospital bill for a procedure that you did not consent to expressly?⬆️

Help for homeowners about to lose their home (involves placing a lien on property):

This is for finding natal care related to living in a post-roe v. wade world:

There is so much pride in using resources our government might provide if you qualify because why shouldn't you get help? Tough spots happen, thats why these programs exist. & that's pretty cool.

[agayconcept]

.

[go-redgirl]

Trump's Proposed Economic Rescue Package Could Approach $1 Trillion

WASHINGTON (AP) — In a massive federal effort, President Donald Trump asked Congress to speed emergency checks to Americans, enlisted the military for MASH-like hospitals and implored ordinary people — particularly socially active millennials — to do their part by staying home to stop the spread of the coronavirus.

His proposed economic package alone could approach $1 trillion, a rescue initiative not seen since the Great Recession. Trump wants checks sent to the public within two weeks and is urging Congress to pass the eye-popping stimulus package in a matter of days.

As analysts warn the country is surely entering a recession, the government is grappling with an enormous political undertaking with echoes of the 2008 financial crisis.

At the Capitol on Tuesday, Senate Majority Leader Mitch McConnell vowed the Senate would not adjourn until the work was done.

“Obviously, we need to act,” McConnell said. “We’re not leaving town until we have constructed and passed another bill.”

But first, McConnell said, the Senate will vote on a House-passed package of sick pay, emergency food and free testing, putting it back on track for Trump’s signature — despite Republican objections. “Gag, and vote for it anyway,” he advised colleagues.

It was a signal of what the GOP leader called the “herculean” task ahead.

Overnight, the White House sent lawmakers a $46 billion emergency funding request to boost medical care for military service members and veterans, fund production of vaccines and medicines, build 13 quarantine centers at the southern border for migrants, make federal buildings safer, and reimburse Amtrak for $500 million in anticipated revenue losses, among other purposes.

The Trump request also reverses cuts to the Centers for Disease Control and National Institutes of Health that Trump proposed in his February budget for next year and would create a $3 billion fund for unanticipated needs.

Senators gathered at an otherwise shut-down Capitol as Americans across the country were implored to heed advice and avoid crowds. Young adults, in particular, are being urged to quit going out because even seemingly healthy people can be spreading the virus that causes the COVID-19 illness.

Even so, presidential primary elections unfolded in Florida, Illinois and Arizona. Ohio’s was called off hours before the polls were set to open.

After a savage drop at the start of the week, the stock market rose as Trump and aides sketched out elements of the economic rescue package at a briefing. Economists doubted that would be enough to stop millions of jobs losses, even if in the short term.

Bigger than the $700 billion 2008 bank bailout or the nearly $800 billion 2009 recovery act, the White House proposal aims to provide a massive tax cut for wage-earners, $50 billion for the airline industry and $250 billion for small businesses. Two people familiar with he package described it to The Associated Press on the condition of anonymity because they weren’t authorized to speak publicly.

The amount that would be sent out in checks Americans is not yet disclosed. The White House said it liked GOP Sen. Mitt Romney’s idea for $1,000 checks, though not necessarily at that sum and not for wealthier people.

“This is a very unique situation,” said Treasury Secretary Steve Mnuchin, exiting a private briefing of Senate Republicans. “We’ve put a proposal on that table that would attract a trillion dollars into the economy.”

One GOP leader, Sen. John Thune of South Dakota, told reporters afterward it “could be” up to $1 trillion.

Senate Democrats produced their own $750 billion proposal, which includes $400 billion to shore up hospitals and other emergency operations in response to the global pandemic and $350 billion to bolster the safety net with unemployment checks and other aid to Americans.

“The aid has to be workers first,” said Senate Minority Leader Chuck Schumer, not what happened in 2008, when the big banks took precedence. Schumer also said it’s time to call out the National Guard to provide security as communities reel from the crisis.

The slow-moving Congress is being asked to approve the far-reaching economic rescue as it tries to rise to the occasion of these fast times.

A roster of America’s big and small industries — airlines, hotels, retailers and even casinos — lined up for hoped-for aid.

For most people, the new coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia.

The vast majority of people recover from the new virus. According to the World Health Organization, people with mild illness recover in about two weeks, while those with more severe illness may take three to six weeks to recover.

Still, health officials are urging Americans to stay home to prevent an onslaught of cases that could overwhelm hospitals as happened in Italy, among the countries hardest hit.

As Congress considered aid, the Pentagon on Tuesday said it would provide 5 million respirator masks and 2,000 specialized ventilators to federal health authorities. And Medicare was immediately expanding coverage for telemedicine nationwide to help seniors with health problems stay home to avoid infection.

More than two dozen Senate Democrats urged Trump to invoke the Korean War-era Defense Production Act to increase production of masks, ventilators and respirators, as well as expand hospital capacity to combat the coronavirus. Federal officials said the administration is working with the Army Corps of Engineers to see about erecting temporary hospitals, as is done in the military, to handle an expected surge of cases.

Schumer compared the government response needed to a wartime mobilization.

House Speaker Nancy Pelosi, who marshaled the earlier package through a bipartisan vote last week, fielded a call from Mnuchin on Tuesday morning and another from Federal Reserve Chairman Jerome Powell in the afternoon, encouraged by the Fed chairman’s perspective that Congress could think big with interest rates at nearly zero.

In the call with Mnuchin, she and Rep. Peter DeFazio, D-Ore., chairman of the House Transportation committee, “emphasized that protecting workers’ paychecks and benefits was their top priority, and that immediate action was needed,” said Pelosi spokesman Drew Hammill on Twitter.

The debate is sure to revive the sharp divisions over the costly bank bailout and economic recovery of the Obama and Bush eras.

Much about the proposed checks is not known, such as whether the amount would vary by the income of the recipient or whether everyone would get the same sum. Mnuchin said “it’s clear we don’t need to send people who make $1 million a year checks, OK?”

Economists from both parties endorsed mailing checks of at least $1,000 to all American households as the quickest way to offset the sharp slowdown in economic activity.

“We need to pay people to stay at home,” said Heidi Shierholz, a senior policy analyst at the Economic Policy Institute, a liberal think-tank. The group predicted that without a huge stimulus package, the U.S. economy could lose three million jobs by this summer.

Still, some GOP senators were skeptical about the massive aid on the table. “I’m going to be very leery of doing something like in 2008,” said Indiana Republican Sen. Mike Braun.

“Right now, the plan around here is basically to just to start shoveling money out of a helicopter,” said Sen. Ben Sasse, R-Neb. “This is a bad idea. … We don’t need a policy where Washington, D.C., handpicks winners and losers.”

Despite federal guidelines against so many people gathering, senators had no choice but to convene. Legislating cannot be done from home.

But late Tuesday, another lawmaker, Sen. Cory Gardner, R-Colo., announced he would self-quarantine after contact with a constituent who later tested positive for coronavirus.

___

[stephenmccull]

Is Your Living Room the Future of Hospital Care?

Major hospital systems are betting big money that the future of hospital care looks a lot like the inside of patients’ homes.

This story also ran on Fortune. It can be republished for free.

Hospital-level care at home — some of it provided over the internet — is poised to grow after more than a decade as a niche offering, boosted both by hospitals eager to ease overcrowding during the pandemic and growing interest by insurers who want to slow health care spending. But a host of challenges remain, from deciding how much to pay for such services to which kinds of patients can safely benefit.

Under the model, patients with certain medical conditions, such as pneumonia or heart failure — even moderate covid — are offered high-acuity care in their homes, with 24/7 remote monitoring and daily visits by medical providers.

In the latest sign that the idea is catching on, two big players — Kaiser Permanente and the Mayo Clinic — announced plans this month to collectively invest $100 million into Medically Home, a Boston-based company that provides such services to scale up and expand their programs. The two organizations estimate that 30% of patients currently admitted to hospitals nationally have conditions eligible for in-home care. (KHN is not affiliated with Kaiser Permanente.)

Several other well-known hospital systems launched programs last summer. They join about two dozen already offering the service, including Johns Hopkins Medicine in Baltimore, Presbyterian Healthcare Services in New Mexico and Massachusetts General Hospital.

But hospitals have other financial considerations that are also part of the calculation. Systems that have built sparkling new in-patient facilities in the past decade, floating bonds and taking out loans to finance them, need patients filling costly inpatient beds to repay lenders and recoup investments.

And “hospitals that have surplus capacity, whether because they have newly built beds or shrinking populations or are losing business to competitors, are not going to be eager about this,” said Dr. Jeff Levin-Scherz, co-leader of the North American Health Management practice at consultancy Willis Towers Watson.

Medicare gave the idea a boost in November when it agreed to pay for such care, to help keep non-covid patients out of the hospital during the pandemic. Since then, more than 100 hospitals have been approved by Medicare to participate, although not all are in place yet.

Tasting opportunity, Amazon and a coalition of industry groups in March announced plans to lobby for changes in federal and state rules to allow broader access to a wide range of in-home medical services.

“We’re seeing tremendous momentum,” said Dr. Bruce Leff, a Johns Hopkins Medical School geriatrician who has studied and advocated for the hospital-at-home approach since he helped establish one of the nation’s first programs in the mid-1990s.

Leff and other proponents say various studies show in-home care is just as safe and may produce better outcomes than being in the hospital, and it saves money by limiting the need to expand hospitals, reducing hospital readmissions and helping patients avoid nursing home stays. Some estimates put the projected savings at 30% over traditional hospital care. But ongoing programs are a long way from making a dent in the nation’s $1.2 trillion hospital tab.

While the goal is to shift 10% or more of hospital patients to home settings, existing programs handle far fewer cases, sometimes serving only a handful of patients.

“In a lot of ways, this remains aspirational; this is the early innings,” said Dean Ungar, who follows the insurance and hospital industries as a vice president and senior credit officer at Moody’s Investors Service. Still, he predicted that “hospitals will increasingly be reserved for acute care [such as surgeries and ICUs].”

Challenges to scaling up include maintaining the current good safety profile in the face of rapid growth and finding enough medical staff — especially nurses, paramedics and technicians — who travel to patients’ homes.

The attraction for insurers is clear: If they can pay for care in a lower-cost setting than the hospital, with good outcomes, they save money.

For hospitals, “the financials of it are, frankly, a little tough,” said Levin-Scherz.

Those most attracted to hospital-at-home programs run at or near capacity and want to free up beds.

Even so, Gerard Anderson, a health policy professor at Johns Hopkins University Bloomberg School of Public Health, said hospitals likely see the potential, long term, for “huge profit margins” through “saving a lot of capital and personnel expense by having the work done at home.”

But Anderson worries that broad expansion of hospital-at-home efforts could exacerbate health care inequities.

“It’s realistic in middle- and upper-middle-class households,” Anderson said. “My concern is in impoverished areas. They may not have the infrastructure to handle it.”

Suburban and rural areas — and even some lower-income urban areas — can have spotty or nonexistent internet access. How will that affect the ability of those areas to participate, to communicate with physicians and other hospital staff members miles away? Proponents outline solutions, from providing patients with “hot spot” devices that provide internet service, along with backup power and instant communication via walkie-talkie-type handsets and computer tablets.

Social factors play a big part, too. Those who live alone may find it harder to qualify if they need a lot of help, while those in crowded households may not have enough room or privacy.

Another possible wrinkle: Not all patients have the necessary human support, such as someone to help an ill patient with the bathroom, meals or even answering the door.

That’s why both patients and their caregivers should get a detailed explanation of the day-to-day responsibilities before agreeing to participate, said Alexandra Drane, CEO of Archangels, a for-profit group that works with employers and provides resources for unpaid caregivers.

“I love the concept for a resourced household where someone can take this job on,” said Drane. “But there’s a lot of situations where that’s not possible. What If I have a full-time job and two children, when am I supposed to do this?”

The programs all say they aim to reduce the burden on families. Some provide aides to help with bathing or other home care issues and provide food. None expects family members to perform medical procedures. The programs supply monitoring and communication equipment and a hospital bed, if needed.

“We see the patient in their home setting,” said Morre Dean, president of Adventist Health’s hospital at home program, which serves a broad area of California and part of Oregon. “What is in their refrigerator? What is their living situation? Can we impact that? We aren’t reliant on the family to deliver care.”

Patients are typically visited in their homes daily by various health workers. Physicians make home visits in some programs, but most employ doctors to oversee care from remote “command centers,” talking with patients via various electronic gadgets.

All of that was delivered to James Clifford’s home in Bakersfield, California, after he opted to participate in the Adventist program so he could leave the hospital and finish treatment for an infection at home. It required coordination — his wife had to be at their house for the set-up team even as she was scheduled to pick him up — but “once it was set up, it worked well.”

At home, he needed treatment with antibiotics every eight hours for several days and “one nurse came at 2 a.m.,” said Clifford, 70. “It woke up my wife, but that’s OK. We had peace of mind by my being at home.”

Adventist launched its program a year ago, but it hasn’t achieved the scale needed to save money yet, said Dean. Ultimately, he envisions the hospital-at-home option as “our biggest hospital in Adventist Health,” with 500 to 1,500 patients in the program at a time.

Medicare’s payment decision gave momentum to such goals. But the natural experiment it created with its funding ends when the pandemic is declared over. Because of the emergency, Medicare paid the same as it would for in-hospital care, based on each patient’s diagnosis. Will hospitals be as enthusiastic if that is not the case in the future? Commercial insurers are unlikely to pay unless they see lower rates, since there are already concerns about overuse.

“From a societal perspective, it’s great if these programs replace expensive inpatient care,” said Levin-Scherz at Towers. But, he said, it would be a negative if the programs sought to grow by admitting patients who otherwise would not have gone into the hospital at all and could have been treated with lower-cost outpatient services.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

USE OUR CONTENT

This story can be republished for free (details).

Is Your Living Room the Future of Hospital Care? published first on https://smartdrinkingweb.weebly.com/

[gordonwilliamsweb]

Is Your Living Room the Future of Hospital Care?

Major hospital systems are betting big money that the future of hospital care looks a lot like the inside of patients’ homes.

This story also ran on Fortune. It can be republished for free.

Hospital-level care at home — some of it provided over the internet — is poised to grow after more than a decade as a niche offering, boosted both by hospitals eager to ease overcrowding during the pandemic and growing interest by insurers who want to slow health care spending. But a host of challenges remain, from deciding how much to pay for such services to which kinds of patients can safely benefit.

Under the model, patients with certain medical conditions, such as pneumonia or heart failure — even moderate covid — are offered high-acuity care in their homes, with 24/7 remote monitoring and daily visits by medical providers.

In the latest sign that the idea is catching on, two big players — Kaiser Permanente and the Mayo Clinic — announced plans this month to collectively invest $100 million into Medically Home, a Boston-based company that provides such services to scale up and expand their programs. The two organizations estimate that 30% of patients currently admitted to hospitals nationally have conditions eligible for in-home care. (KHN is not affiliated with Kaiser Permanente.)

Several other well-known hospital systems launched programs last summer. They join about two dozen already offering the service, including Johns Hopkins Medicine in Baltimore, Presbyterian Healthcare Services in New Mexico and Massachusetts General Hospital.

But hospitals have other financial considerations that are also part of the calculation. Systems that have built sparkling new in-patient facilities in the past decade, floating bonds and taking out loans to finance them, need patients filling costly inpatient beds to repay lenders and recoup investments.

And “hospitals that have surplus capacity, whether because they have newly built beds or shrinking populations or are losing business to competitors, are not going to be eager about this,” said Dr. Jeff Levin-Scherz, co-leader of the North American Health Management practice at consultancy Willis Towers Watson.

Medicare gave the idea a boost in November when it agreed to pay for such care, to help keep non-covid patients out of the hospital during the pandemic. Since then, more than 100 hospitals have been approved by Medicare to participate, although not all are in place yet.

Tasting opportunity, Amazon and a coalition of industry groups in March announced plans to lobby for changes in federal and state rules to allow broader access to a wide range of in-home medical services.

“We’re seeing tremendous momentum,” said Dr. Bruce Leff, a Johns Hopkins Medical School geriatrician who has studied and advocated for the hospital-at-home approach since he helped establish one of the nation’s first programs in the mid-1990s.

Leff and other proponents say various studies show in-home care is just as safe and may produce better outcomes than being in the hospital, and it saves money by limiting the need to expand hospitals, reducing hospital readmissions and helping patients avoid nursing home stays. Some estimates put the projected savings at 30% over traditional hospital care. But ongoing programs are a long way from making a dent in the nation’s $1.2 trillion hospital tab.

While the goal is to shift 10% or more of hospital patients to home settings, existing programs handle far fewer cases, sometimes serving only a handful of patients.

“In a lot of ways, this remains aspirational; this is the early innings,” said Dean Ungar, who follows the insurance and hospital industries as a vice president and senior credit officer at Moody’s Investors Service. Still, he predicted that “hospitals will increasingly be reserved for acute care [such as surgeries and ICUs].”

Challenges to scaling up include maintaining the current good safety profile in the face of rapid growth and finding enough medical staff — especially nurses, paramedics and technicians — who travel to patients’ homes.

The attraction for insurers is clear: If they can pay for care in a lower-cost setting than the hospital, with good outcomes, they save money.

For hospitals, “the financials of it are, frankly, a little tough,” said Levin-Scherz.

Those most attracted to hospital-at-home programs run at or near capacity and want to free up beds.

Even so, Gerard Anderson, a health policy professor at Johns Hopkins University Bloomberg School of Public Health, said hospitals likely see the potential, long term, for “huge profit margins” through “saving a lot of capital and personnel expense by having the work done at home.”

But Anderson worries that broad expansion of hospital-at-home efforts could exacerbate health care inequities.

“It’s realistic in middle- and upper-middle-class households,” Anderson said. “My concern is in impoverished areas. They may not have the infrastructure to handle it.”

Suburban and rural areas — and even some lower-income urban areas — can have spotty or nonexistent internet access. How will that affect the ability of those areas to participate, to communicate with physicians and other hospital staff members miles away? Proponents outline solutions, from providing patients with “hot spot” devices that provide internet service, along with backup power and instant communication via walkie-talkie-type handsets and computer tablets.

Social factors play a big part, too. Those who live alone may find it harder to qualify if they need a lot of help, while those in crowded households may not have enough room or privacy.

Another possible wrinkle: Not all patients have the necessary human support, such as someone to help an ill patient with the bathroom, meals or even answering the door.

That’s why both patients and their caregivers should get a detailed explanation of the day-to-day responsibilities before agreeing to participate, said Alexandra Drane, CEO of Archangels, a for-profit group that works with employers and provides resources for unpaid caregivers.

“I love the concept for a resourced household where someone can take this job on,” said Drane. “But there’s a lot of situations where that’s not possible. What If I have a full-time job and two children, when am I supposed to do this?”

The programs all say they aim to reduce the burden on families. Some provide aides to help with bathing or other home care issues and provide food. None expects family members to perform medical procedures. The programs supply monitoring and communication equipment and a hospital bed, if needed.

“We see the patient in their home setting,” said Morre Dean, president of Adventist Health’s hospital at home program, which serves a broad area of California and part of Oregon. “What is in their refrigerator? What is their living situation? Can we impact that? We aren’t reliant on the family to deliver care.”

Patients are typically visited in their homes daily by various health workers. Physicians make home visits in some programs, but most employ doctors to oversee care from remote “command centers,” talking with patients via various electronic gadgets.

All of that was delivered to James Clifford’s home in Bakersfield, California, after he opted to participate in the Adventist program so he could leave the hospital and finish treatment for an infection at home. It required coordination — his wife had to be at their house for the set-up team even as she was scheduled to pick him up — but “once it was set up, it worked well.”

At home, he needed treatment with antibiotics every eight hours for several days and “one nurse came at 2 a.m.,” said Clifford, 70. “It woke up my wife, but that’s OK. We had peace of mind by my being at home.”

Adventist launched its program a year ago, but it hasn’t achieved the scale needed to save money yet, said Dean. Ultimately, he envisions the hospital-at-home option as “our biggest hospital in Adventist Health,” with 500 to 1,500 patients in the program at a time.

Medicare’s payment decision gave momentum to such goals. But the natural experiment it created with its funding ends when the pandemic is declared over. Because of the emergency, Medicare paid the same as it would for in-hospital care, based on each patient’s diagnosis. Will hospitals be as enthusiastic if that is not the case in the future? Commercial insurers are unlikely to pay unless they see lower rates, since there are already concerns about overuse.

“From a societal perspective, it’s great if these programs replace expensive inpatient care,” said Levin-Scherz at Towers. But, he said, it would be a negative if the programs sought to grow by admitting patients who otherwise would not have gone into the hospital at all and could have been treated with lower-cost outpatient services.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

USE OUR CONTENT

This story can be republished for free (details).

Is Your Living Room the Future of Hospital Care? published first on https://nootropicspowdersupplier.tumblr.com/

[supremekalmllc]

New Post has been published on https://supremekalm.com/cannabis-coronavirus-and-federal-disaster-assistance/

Cannabis, Coronavirus and Federal Disaster Assistance

Coronavirus has been great for cannabis sales. In most states with approved cannabis programs, both medical and adult use marijuana sales have been designated “essential services” by state and local governments. With this support, the supply chain has weathered the COVID-19 pandemic better than many industries. Still, the pandemic continues unabated and cannabis businesses are far from secure.

Over the past month, the federal government has attempted to throttle the sputtering economy with varying forms of stimulus. Some of the efforts have been undertaken by the Federal Reserve (slashing the federal funds rate; debt purchase commitments) and some by the Internal Revenue Service (pushing out deadlines). But Congress and the President have taken matters further. In this post, I’ll summarize the three “phases” of Congressional stimulus, and their implications for cannabis businesses.

Before diving in, it’s important to draw a bright line between forms of cannabis defined as “hemp” and “marijuana” under federal law. In the 2018 Farm Bill, hemp was removed from the definition of “marijuana” under the federal Controlled Substances Act. Although heavily regulated, hemp is no longer controlled in the classic sense. For this reason, qualified hemp businesses should be entitled to the same stimulus relief as businesses in most other industries. Marijuana businesses will generally be excluded, except that these businesses will incur related obligations with respect to employees as set forth below.

Phase One – Coronavirus Preparedness and Response Supplemental Appropriations Act (HR 6074)

This bill became law on March 6 and focused primarily on domestic and international public health measures. However, it also contained a $20 million grant to the Small Business Administration (SBA) Disaster Relief Fund. On March 11, President Trump instructed the SBA “to exercise available authority to provide capital and liquidity to firms affected by the coronavirus.” The capital would take the form of $50 billion of low-interest loans. Unfortunately for marijuana businesses, SBA was quick to point out that:

Because federal law prohibits the sale and distribution of cannabis, the SBA does not provide financial assistance to businesses that are illegal under federal law. Businesses that aren’t eligible include marijuana growers and dispensers, businesses that sell cannabis products, etc., even if the business is legal under local or state law.

This is not a new SBA position. In 2018, SBA issued a Policy Statement defining “Direct Marijuana Business” and “Indirect Marijuana Business.” The Policy Statement explained that those two categories of businesses are not eligible SBA borrowers. Although the SBA spokesperson did not reference this Policy in the above quote, it is fair to assume the Policy Statement remains in place for HR 6074 and related stimulus.

In response to being left out in the cold, cannabis organizations and trade groups like NORML and NCIA have written their letters to Congress. Those letters will likely go nowhere (as usual). Qualified hemp businesses, on the other hand, stand to benefit from the SBA loans. Criteria for those loans can be found here.

Phase Two – Families First Coronavirus Response Act (HR 6201)

HR 6201 was introduced on March 11 and became law one week later, on March 18. It takes effect April 1 (this Wednesday) and sunsets December 3, 2020. The law includes provisions for insurance coverage of coronavirus testing, nutrition assistance, paid sick leave, expansion of the Federal and Medical Leave Act, and unemployment benefits. The final three items are most relevant to cannabis businesses.

Regarding paid sick leave, all businesses (including cannabis businesses) with fewer than 500 employees must provide up to 80 hours (10 days) of paid sick leave if an employee cannot work for a coronavirus-related absence. This includes caring for someone with coronavirus, caring for children because of school or day-care closures, etc. It’s important to note that this is additional paid sick leave over whatever the business may already provide under policy or applicable law. Paid leave is at the employee’s full wage, but is capped at $511/day if the employee is sick or must self-quarantine, or $200/day if the employee must care for others.

HR 6201 also expands the federal Family Medical Leave Act (FMLA). All employers, including cannabis employers, must provide up to 12 weeks of paid FMLA leave to employees who must stay home (and cannot work from home) because of school or daycare closures. The first 2 weeks (10 days) are unpaid, though the employee may get paid sick leave either under this law or under existing sick/PTO policies. The next 10 weeks are paid at 2/3 of employee’s regular wage, capped at $200/day.

With respect to unemployment insurance, HR 6201 includes $1 billion in funding for state-administered unemployment insurance programs. It’s important to note that these funds are transferred from the federal government to the state governments. As such, individual states have the authority to decide for themselves which industries are legally eligible to receive benefits. Cannabis company workers in many states may therefore seek and receive benefits (provided the state is on board and provided the company has been property paying its unemployment insurance).

The IRS will reimburse employers for 100% of the cost of paid sick leave, either through payroll tax credits and/or direct payment refunds. IRS guidance is silent on whether marijuana businesses would be eligible for this relief, but given the plain language of Internal Revenue Code § 280E, it seems unlikely. As with everything else, hemp businesses should be OK.

Phase Three – Coronavirus Aid, Relief, and Economic Security Act (S 3548)

The CARES Act is massive. Enacted on March 27, it provides $2 trillion in stimulus, including cash payments to individuals, $500 billion in corporate aid, $100 billion to health-care providers, $150 billion to state and local governments and $349 billion in small business loans. The bailout likely does nothing for marijuana businesses given its structure, but should help qualified hemp operators.

Under the CARES Act, small businesses can receive loans to cover payroll expenses, health care benefits, employee salaries, rent, utilities and interest on mortgage debt. To qualify for these “Paycheck Protection Program” loans, businesses must employ 500 employees or less, including all full-time and part-time employees. Nearly all U.S. hemp businesses fall into this category. For a full summary of the Paycheck Protection Program loans, go here.

Interestingly, and unlike with typical SBA loans, Paycheck Protection Program borrowers do not need to provide security or personal guarantees. These loans are also forgivable in many circumstances. Because the CARES Act delegates lending authority to banks and credit unions, potentially eligible hemp businesses should reach out to their banks and credit unions directly (although loan interest rates, maturity dates, and other terms will be set by the Treasury Department).

With respect to marijuana businesses, federal law still prohibits bank involvement except as contemplated by the ancient Financial Crimes Enforcement Network guidance (FIN-2014-G001). In generally, financial institutions remain hesitant to service the industry—especially in any capacity beyond basic merchant services—given anti-money laundering concerns and Bank Secrecy Act requirements. Marijuana businesses may technically qualify to receive federal assistance under the Paycheck Protection Program, but it seems unlikely those loans would be administered. I would love to be wrong about this.

The post Cannabis, Coronavirus and Federal Disaster Assistance appeared first on Harris Bricken.

[forensiceyes]

Cannabis, Coronavirus and Federal Disaster Assistance

Coronavirus has been great for cannabis sales. In most states with approved cannabis programs, both medical and adult use marijuana sales have been designated “essential services” by state and local governments. With this support, the supply chain has weathered the COVID-19 pandemic better than many industries. Still, the pandemic continues unabated and cannabis businesses are far from secure.

Over the past month, the federal government has attempted to throttle the sputtering economy with varying forms of stimulus. Some of the efforts have been undertaken by the Federal Reserve (slashing the federal funds rate; debt purchase commitments) and some by the Internal Revenue Service (pushing out deadlines). But Congress and the President have taken matters further. In this post, I’ll summarize the three “phases” of Congressional stimulus, and their implications for cannabis businesses.

Before diving in, it’s important to draw a bright line between forms of cannabis defined as “hemp” and “marijuana” under federal law. In the 2018 Farm Bill, hemp was removed from the definition of “marijuana” under the federal Controlled Substances Act. Although heavily regulated, hemp is no longer controlled in the classic sense. For this reason, qualified hemp businesses should be entitled to the same stimulus relief as businesses in most other industries. Marijuana businesses will generally be excluded, except that these businesses will incur related obligations with respect to employees as set forth below.

Phase One – Coronavirus Preparedness and Response Supplemental Appropriations Act (HR 6074)

This bill became law on March 6 and focused primarily on domestic and international public health measures. However, it also contained a $20 million grant to the Small Business Administration (SBA) Disaster Relief Fund. On March 11, President Trump instructed the SBA “to exercise available authority to provide capital and liquidity to firms affected by the coronavirus.” The capital would take the form of $50 billion of low-interest loans. Unfortunately for marijuana businesses, SBA was quick to point out that:

Because federal law prohibits the sale and distribution of cannabis, the SBA does not provide financial assistance to businesses that are illegal under federal law. Businesses that aren’t eligible include marijuana growers and dispensers, businesses that sell cannabis products, etc., even if the business is legal under local or state law.

This is not a new SBA position. In 2018, SBA issued a Policy Statement defining “Direct Marijuana Business” and “Indirect Marijuana Business.” The Policy Statement explained that those two categories of businesses are not eligible SBA borrowers. Although the SBA spokesperson did not reference this Policy in the above quote, it is fair to assume the Policy Statement remains in place for HR 6074 and related stimulus.

In response to being left out in the cold, cannabis organizations and trade groups like NORML and NCIA have written their letters to Congress. Those letters will likely go nowhere (as usual). Qualified hemp businesses, on the other hand, stand to benefit from the SBA loans. Criteria for those loans can be found here.

Phase Two – Families First Coronavirus Response Act (HR 6201)

HR 6201 was introduced on March 11 and became law one week later, on March 18. It takes effect April 1 (this Wednesday) and sunsets December 3, 2020. The law includes provisions for insurance coverage of coronavirus testing, nutrition assistance, paid sick leave, expansion of the Federal and Medical Leave Act, and unemployment benefits. The final three items are most relevant to cannabis businesses.

Regarding paid sick leave, all businesses (including cannabis businesses) with fewer than 500 employees must provide up to 80 hours (10 days) of paid sick leave if an employee cannot work for a coronavirus-related absence. This includes caring for someone with coronavirus, caring for children because of school or day-care closures, etc. It’s important to note that this is additional paid sick leave over whatever the business may already provide under policy or applicable law. Paid leave is at the employee’s full wage, but is capped at $511/day if the employee is sick or must self-quarantine, or $200/day if the employee must care for others.

HR 6201 also expands the federal Family Medical Leave Act (FMLA). All employers, including cannabis employers, must provide up to 12 weeks of paid FMLA leave to employees who must stay home (and cannot work from home) because of school or daycare closures. The first 2 weeks (10 days) are unpaid, though the employee may get paid sick leave either under this law or under existing sick/PTO policies. The next 10 weeks are paid at 2/3 of employee’s regular wage, capped at $200/day.

With respect to unemployment insurance, HR 6201 includes $1 billion in funding for state-administered unemployment insurance programs. It’s important to note that these funds are transferred from the federal government to the state governments. As such, individual states have the authority to decide for themselves which industries are legally eligible to receive benefits. Cannabis company workers in many states may therefore seek and receive benefits (provided the state is on board and provided the company has been property paying its unemployment insurance).

The IRS will reimburse employers for 100% of the cost of paid sick leave, either through payroll tax credits and/or direct payment refunds. IRS guidance is silent on whether marijuana businesses would be eligible for this relief, but given the plain language of Internal Revenue Code § 280E, it seems unlikely. As with everything else, hemp businesses should be OK.

Phase Three – Coronavirus Aid, Relief, and Economic Security Act (S 3548)

The CARES Act is massive. Enacted on March 27, it provides $2 trillion in stimulus, including cash payments to individuals, $500 billion in corporate aid, $100 billion to health-care providers, $150 billion to state and local governments and $349 billion in small business loans. The bailout likely does nothing for marijuana businesses given its structure, but should help qualified hemp operators.

Under the CARES Act, small businesses can receive loans to cover payroll expenses, health care benefits, employee salaries, rent, utilities and interest on mortgage debt. To qualify for these “Paycheck Protection Program” loans, businesses must employ 500 employees or less, including all full-time and part-time employees. Nearly all U.S. hemp businesses fall into this category. For a full summary of the Paycheck Protection Program loans, go here.

Interestingly, and unlike with typical SBA loans, Paycheck Protection Program borrowers do not need to provide security or personal guarantees. These loans are also forgivable in many circumstances. Because the CARES Act delegates lending authority to banks and credit unions, potentially eligible hemp businesses should reach out to their banks and credit unions directly (although loan interest rates, maturity dates, and other terms will be set by the Treasury Department).

With respect to marijuana businesses, federal law still prohibits bank involvement except as contemplated by the ancient Financial Crimes Enforcement Network guidance (FIN-2014-G001). In generally, financial institutions remain hesitant to service the industry—especially in any capacity beyond basic merchant services—given anti-money laundering concerns and Bank Secrecy Act requirements. Marijuana businesses may technically qualify to receive federal assistance under the Paycheck Protection Program, but it seems unlikely those loans would be administered. I would love to be wrong about this.

The post Cannabis, Coronavirus and Federal Disaster Assistance appeared first on Harris Bricken.

Cannabis, Coronavirus and Federal Disaster Assistance posted first on http://ronenkurzfeld.blogspot.com

[financialthreesixfive-blog]

White House Seeks To End EV Federal Tax Credit

Can't say we're surprised by this.

After recently's announcement by General Motors that they would be closing 5 plants and ceasing a few of their cars including the Chevy Volt, President Trump went to Twitter to react to the news. His reaction was both expected, however likewise a little puzzling, as his message didn't appear to truly make sense.

President Trump's Tweet:

Really dissatisfied with General Motors and their CEO, Mary Barra, for closing plants in Ohio, Michigan and Maryland. Absolutely nothing being closed in Mexico & & China. The U.S. saved General Motors, and this is the THANKS we get! We are now looking at cutting all @GM subsidies, including ... for electrical cars. General Motors made a huge China wager years ago when they constructed plants there (and in Mexico)-- do not believe that bet is going to pay off. I am here to protect America's Workers!The confusing

part is the danger of eliminating aids "for electrical automobiles" as a penalty to GM for plant closures and prospective layoffs. General Motors is on the edge of exceeding the 200,000 th electric lorry offered, and will most likely pass it prior to completion of this year. GM will start their tax credit draw-down in the Second quarter of 2019, at which time the tax credit is cut in half to a maximum of $3,750. Then, in the 4th quarter, it is halved once again to $1,875 for 2 quarters before it's gone completely.

The Chevrolet Volt, along with other low-selling lorries, will be stopped as GM shutters plants and restructures.So, in less than four months, GM, in addition to Tesla who currently surpassed their limit, will be at a competitive downside against all of the other OEMs with concerns to their electric lorries. The electric lorries from the companies will receive the full tax credit ($ 7,500) while GM and Tesla's consumers receive half ($ 3,750) of the full credit for 6 months, and after that one-quarter ($ 1,875) for another six months. No other company is anticipated to strike their 200,000 th electric automobile threshold for at least another 2 years.

For that reason, if the Trump administration were to get rid of the electric automobile tax credit, it would in fact assist GM (and Tesla) be more competitive, not punish them, as the President implied.

today, White House primary financial advisor Larry Kudlow stated the Trump administration will look for to end aids for electric cars and trucks and likewise for renewable resource sources.

As a matter of our policy, we wish to end all of those aids, Kudlow stated. And by the method, other aids that were imposed throughout the Obama administration, we are ending, whether it's for renewables therefore forth.Kudlow acknowledged

that it may not be too easy to do this, and stated he doesn't anticipate to end electric car subsidies for another year or more, probably in 2020 or 2021.

One questions if GM's plant closure announcement simply provided the President a reason to attack the EV Federal tax credit, something he's never actually supported, and it truly had nothing to do with GM. That would in fact make more sense since GM will no longer benefit from it by the time the White House does move to have it removed.

Back in June, a polar opposite proposition was made in your house of Representatives. Democrat Peter Welch of Vermont presented a costs to eliminate the 200,000 car trigger, extend tax credits for all car manufacturers for 10 years, and develop a time of purchase rebate ( H.R. 6274 ). There's been extremely little to report on this, and offered the current remarks from the White Home, we find it tough to imagine it ever being approved.

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most recent> earliest most voted Can we do this without yet another photo of Trump! He is constantly in our faces anyhow.

" >Vote Up 5 -2 Vote Down Reply yah, it's actually horrible to have to become aware of this jackass every day for several years on end. At least do not show his awful mug.wc_not_clicked" > Vote Up 3 -2 Vote Down Reply I completely comprehend. I didn't have an excellent photo of the White House or Kudlow that we have rights to utilize, so I needed to use Trump.

"> Vote Up 3 0 Vote Down ReplyVote Up 0 0wc-vote-link wc-down wc-separate wc_vote wc_not_clicked" > Vote Downwc-cta-button "title=" Reply "> Reply Well, it would not hurt Tesla much or GM. It might even offer EV sales a short term boost. I also don't know how it can end this" law "sooner.

Not without court challenges or with Congressional approval. It might be part of settlement with Congress on something else, but there is no other way they can end it without Congress.

"> Vote Up 7 0

Vote Downclass= "wc-reply-button wc-cta-button "title =" Reply" > Reply Yes, becuase that's how

you help your country gain advanced mfg and innovation jobs and knowledge, by ceding it to nations like China with strong EV rewards and mandates./ s What a dipstick. I understood tRUMP and Swamp Drainers would try and" MAGA" the Federal Tax Credit disappear. Our POTUS Don McDeath says:" Out, damned spot! out, I state!" Somebody, anyone, please aid by getting a proverbial banana, and packing it up, and/or down either, and/or both, of those deplorable Orange tailpipes.

How about change it so that it just uses to EVs developed in the United States? Motivate car manufacturers to construct here.

"> Vote Up 2 0 Vote Down Reply WH proposing to end rewards in between 2020 & 2021. These incentives produced in Bush W period ... and will end for Tesla and GM by 2020. In other news, Thump reducing tariffs on imports from China to near absolutely no %. With GMs operations in CHINA being a joint partnership; there's

really nothing from stopping a partner from offering in United States of America. Still not seeing how any of this penalizes GM? Removing the incentives IMHO would really belief GM and Tesla as it would Level playing field. Clients would not have a benefit to go shopping other EV brands.

Anyhow in a couple weeks, it will be 2019 ... a new year and a new set of players in Congress. We guaranteed to see a A few more tantrum's ... but tough to state if/when any EV reward programs will be modified.

Of note ... Congress has yet to sign off on NAFTA associated renegotiated. There are numerous balls in play ... some will score, some will be kicked out of play.

"> Vote Upwc-positive" > 3 0 Vote Down Reply M Hovis EVs are here to remain, but transitional subsidies can speed or slow their adoption. Tradition business have to ride a fine line of making revenues on their old technologies while staying up to date with the EV disturbance. When it comes to US markets, it would be sensible to remember what happened to the big three the last time they built the car they wanted us to have actually opposed to the cars and truck that people wanted. When it comes to Trump, whatever he does is in support of oil. All the hate and crazytown is to distract from oil. If we had his income tax return we would understand all we need to learn about his dealings with the very oil-rich Russia and oil business. Tom, is best that his motions do not hurt GM rather assists them. While Trump is assaulting EV subsidies, how about the oil aids? The subsidies covering the billions of dollars in climate disasters. Don't buy that? How about the billions of dollars spent on asthma attacks, work days lost, etc from particulate matter entering the bloodstream from the burning of nonrenewable fuel sources. Or how about the military aids spent for protecting foreign oil. It's really not United States oil or foreign oil, it's BP,...

title ="Learn more"" > Learn more"wc_not_clicked" > Vote Up 4 -1Vote DownReply Vote Up 3 -1 Vote Down Reply Up here in the excellent white north we invoked the cumulative facepalm when Trump was chosen and

rolled on the floor laughing ever considering that. Then we elected Doug Ford and now I sympathize while staying in disbelief over how such a thing might take place. OK, back to the post ... How does it make any sense that punishing GM will help American tasks?!?!?!?!?!?!class ="wc-vote-link wc-up wc-separate wc_vote wc_not_clicked" > Vote Up5 -1 Vote Down Reply Vote Up 00 Vote Down

Reply Lou Grinzo Wait-- what makes you think that ANYTHING he says or does has any goal other than to assist himself? The function of this declaration is to [1] get attention and [2] rile up his base by irritating his non-base. Keep in mind, his base just requires to see "the other people" mad for them to be happy.

Vote Up 0 0 Vote Down Reply >

Vote Up 3 -1> Vote Down Reply It just makes good sense to his supporters becuase he does not speak in complete sentences or completed thoughts. They fill out the meaning based on their own biases. He "speaks their reality" because they fill it in.

"> Vote Up 2

0Vote Down Reply

2 years away. That's like 18 Trump years. There will be 100s more manufactured crises in between once in a while. Vote Up 4 0 Vote Down Reply 1 hour ago It seems to me that the best method to make America Great Again would be to focus on assisting United States companies be competitive in emerging innovations. There are a lot of examples of innovations that were developed (or substantially established) here, such as solar cells, Lithium-ion batteries, computing, carbon fiber, networking switches, ... yet our monetary system/business environment doesn't offer the time and capitol it requires to establish these innovations. It appears the drive for quarterly earnings basically eliminates investment in these companies practically the time the existing development programs such as DARPA stop funding (and you are basically out of luck if there isn't a defense/medical application).

No matter what you consider Tesla, you need to admit that without them the US would be a transport and energy 3rd world nation and do not believe the Boeing (or the Russians) was going to invest in reusable rockets. The truly unfortunate thing is their capability to raise cash is probably mostly tied to Musk's personality and celebrity status.

"> Vote Up 3 0 Vote Down Reply Tesla is ready anyway and GM is not interested and thats why they closed Volt. Others will just discontinue their designs which is great given that they are not interested anyway in selling the plugins. I am expecting numerous car manufacturers to reduce the rate which will look attractive. There is a difference in between a Leaf rate of $30,000-- $7,500 = $22,500 and a MSRP of $22,500. With this decrease, individuals may compare Leaf to Altima and realize that its more affordable and buy more. Provided Nissan offers Leaf.

Vote Up 0 0 Vote Down Reply In other news, water is damp. One well-known saying is" Every nation gets the federal government it should have."

I actually do not understand what we did to deserve this one! Vote Up 00wc_not_clicked" > Vote Down Reply

[cyberdelusionphilosopher-blog]

Fort Branch Indiana Cheap car insurance quotes zip 47648

"Fort Branch Indiana Cheap car insurance quotes zip 47648

Fort Branch Indiana Cheap car insurance quotes zip 47648

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I just moved from Richmond VA to Greensboro NC. My car insurance is in Richmond VA and and my car is registered up there. I'm only going to stay in North Carolina for about 8 months. I want to know if I can switch my car insurance to North Carolina with out having to register my car and switching my license plates over to North Carolina. Car insurance is a hell of alot high up in Richmond than here and I want to save some much needed money. Anyone know if I can make the insurance switch with out having to register my car and switching my tags over to North Carolina? Please respond with only legit answers.

""In NYS can I make auto payments on a car in my name, and have the insurance in my boyfriends name?""

Will the car dealer have a problem with the insurance being in his name because I am only 20 and been driving for a year so my insurance rate is alot higher than his but the car is for him, so its not like I am going to be driving it I am just putting the loan in my name to build my credit. Is that against the law??""

I have my driving test soon need insurance help im 17 could go on mums insurance but lowest quote is 1500?

and thats with a box in the car but lowest quote without box in lowest quote 3500 and lowest quote on my own insurance 4000 her car is a 1.4 54 plate fiesta on my own it would be a banger old car

What is cheaper in car insurance...?

An old fiat punto or a new fiat punto

Buying a car in NJ from a Private seller but want Georgia Insurance?

I have a Georgia License and am currently away at College in New Jersey (My family has a house here and in Georgia). I want to buy my first car, but insurance in NJ is extremely expensive. How do I get Georgia insurance, Registration, and my Georgia address to show on the vehicle Title? When I purchase the car from the private seller, how will I be able to get my car home with no plates?? Is there a way to get temporary plates in New Jersey and Temporary Registration? Will I need to get a New Jersey License? HELP !!! Can someone give me a step by step walkthrough of what I have to do to get the Georgia Insurance? Thank you !""

Would this be legal ? start own car insurance company and insure self.?

We were talking about the price of car insurance at work today about how the cost is becoming ridiculous. I came up with this idea its entirely hypothetical but it got me wondering if it was possible. Just say i started and registered a insurance business. I offered 3rd party only insurance to my close friends and family people that i know personally are careful drivers.Say 50 people get a years cover for just 100 and i insure my self for free. Now i know what you might be thinking what happens if some one has a bump? Well i have 5000 in the business account so it should cover minor repairs however and hear comes the is it legal part if someone puts in a large claim that i cannot cover.Say my grandma writes off some rich mans Bentley. I just declare the company bankrupt ! Thinking about it its not to different to what the bankers have been doing .

What affordable health insurance would you recommend for my uninsured 21 year old daughter?

She works full time but her employer charges an outrageous amount of money for health insurance. I know there are many many young people who don't have health insurance, mostly because of the cost of high insurance premiums. But my daughter really needs it cause she has some health issues that will stay with her for a lifetime.""

Where can I get non-owners insurance in New Jersey?

I dont own a car, but I rent about once a week, and would rather not have to take out liability insurance each time.""

Fort Branch Indiana Cheap car insurance quotes zip 47648

Fort Branch Indiana Cheap car insurance quotes zip 47648

Car insurance for 18 year old female with '97 Dodge Dakota?

I turn 18 in August and plan on getting my license right after my birthday, but my grandmother has offered to buy me a 1997 Dodge Dakota before I even get my license. Questions I want to ask are: How much is insurance on one of those vehicles? What will be the insurance once I get my license in August? I'm just looking for an estimate so I can figure out how much of my paycheck would be going towards it or even if I could possibly afford the thing. Thanks in advance! =) P.S. I'm an A+, homeschooled, female student if that makes any difference.""

Toronto best cheap auto insurance?

Toronto best cheap auto insurance?

Cheapest car insurance for 18 year old ?

H there, once again i ask for thy help!!!>.. < ... so here i just bought a 2002 VAUXHALL CORSA 1.2 SXI BLACK, 1000 pounds, 90k Miles, im on a provisional license, hoping to pass by january. I will do aorund 6k a year miles. car will be used to get to uni, work and commute for shoping. thanks""

How much would insurance go up for a newer used car?

I drive a 1988 Lincoln Mark VII. I wanted to know how much more my insurance would go up if I got a 1996 Buick Regal?

What is a cheap car insurance company?

I am currently 18 years old. I am getting my licence on June 16th 2010. My car is under my dads name and currently it is uninsured, he wants me to insure the car under MY name because he will not be driving it anymore. What is the CHEAPEST insurance company for someone like me? I have to get the car insured before June 16th so that i can take my licence test. Thanks in advance.""

PLEASE ANSWER!!!!!!!! discounts on insurance?

SO IM 18 YEARS OLD, I HAVE MY LICENSE... AND I WANT TO GET A CAR SOON. PREFERBALY AN 2006 ACURA RSX COUPE (i know coupes are alot more expensive...) but i was wondering if i can get ...show more""

Using Canadian insurance in California?

I am currently living in Ontario and i plan on going to Los angeles, CA to visit a friend by myself. I plan on renting a car (There are car companies that allow 18 year old driver). My parents put me in the car insurance so I am basically covered. I think. I know that its the law to get liability insurance. Would the insurance here count as a liability insurance?""

Can I get one day car insurance?

Hello, I have a car that has a problem and need to take it to my mechanic but I got a new car so have no insurance on it anymore. I have State Farm and was wondering if I can get a one day insurance to drive it to the mechanic and about how much that would be, it's an oldie '91 but I will not risk driving it without insurance....thank you.....""

I'm looking for affordable health insurance.?

I'm 31 and I have a pre-existing condition (open heart surgery 2004). I take coumadin daily and get my blood checked every month at Jacksonville Heart Center. I'm looking to take another job with much better pay. The only problem is they don't offer health insurance yet. I've been quoted at $180-$190 a month that do accept pre-existing conditions. Is there anyone cheaper that is not just some fly by night company?

Is ICBC Prejudiced against young drivers a 120$ a month insurance rate cars?

I am a young drivers just starting out and I drive just like anyone else, I don't consider my actions dangerous why is it though I must pay premium prices if I drive well. These rates only adjust after driving for a longer time. it can be that of statistics ? I know that amount a month for insurance alone is exorbitant and when I ask older drivers some say they pay around 50$ a month. Are there other licensures in BC for licensing for driving a car, perhaps much cheaper than ICBC ?""

Democrats: So will there be fine for not having health insurance or not?

When I asked this question just yesterday, Democrats assured me there wouldn't be ANY fine for not having health insurance - it was an OPTION.""

Will my insurance go up if i get my first speeding ticket?

I live in Louisiana and have farm bureau. I dont pay for my insurance so i was wondering if i should tell my mom since she will see if it went up. Please Help!!!

Motorcycle insurance?

Anyone know where I can get cheap bike Insurance I'm looking for basic coverage on a 650cc Yamaha Maixm I just got my licence in May. I live in Ontario Canada.

Where is the best place to get cheap car insurance for young drivers?

Where is the best place to get cheap car insurance for young drivers?

""Car accident, not at fault, but no insurance, other driver has no license. what to do?""

my parents got into a car accident with another driver. however, it wasn't their fault. in addition, my parents don't have insurance for that car because they just go it about 2 months ago (used.) but we have 2 other vehicles that are insured. does that mean that our car is technically under the policy? The other driver, who was at fault, HAS NO LICENSE but has an identification card, and has insurance. (her license is probably suspended) what are my parent's options?""

Insurance Coverage?

HI I was in accident about 5 Month ago..I was seen by a doctors but I stopped going becuase I didn't have that much pain. Now I started having all this pain on my legs..so My question is, if I go see a doctor now, does my insurance covers it. Thank you for your advice..""

MotorBike Insurance For CBT...?

i was just wondering if i bought a Honda CBR 125r and i got a provisional license ad done the CBT would i need insurance to ride on the roads for 2 years or would i not need insurance until i could save up money for lessons, theory and practical test....???""

Are dual sport bikes cheaper on insurance?

Well me being only 17 and only having a minumum wage job. I heard it was cheaper to own a bike. Don't get the wrong impression, I can afford a car and insurance. It's it cost too much money. I have less thsn 100$ every MONTH to myself. I should habe over 650. So anyways. I want to get a bike. Since i'll only be commuting. Social,work,school. Is it worth it. And if so what kind of bike shoukd I get. I'm 6.3 and big. Woukd a 250cc be a good start?""

Proof of insurance for a road test?

i have a road test and the dmv requires a proof of insurance i don't have insurance so does the person im supposed to go with, only my dad has an insurance on the car but he will be away on that day. Can i just go to the dmv and show them my dad's insurance without him being there?""

Why is motorcycle insurance so expensive?

I figure that if I finance a new motorcycle, I will have to get collision. So I go and get a quote from Progressive on an Aprilia SL 750. Just liability = ~70$ a month. Liability Comprehensive Collision = ~$650 a month. $650 a month = the cost of the bike in one year. 18 year old male with one prior minor moving violation""

Got a question about changing my car color and insurance...?

So this past summer I was so close into painting my car into White! But my mom was hating on it, and she told me that if i had changed the color of my car we would had to contact the insurance people... Telling them that the car is getting a color Changed Them having to change some info on the car And the worst part... The insurances goes up? (btw... my car's color is black) So you guys out there... Please help answering my question! would my insurance go up if I change my car's color? I haven't paint the car yet.. maybe till' the spring time since its almost winter time!!! Thanks!""

""Car insurance strange quotes, why?""

Back in August, I got a quote on a car, it worked out as 900 for the year.(I'm only 17), and since then I've been getting regular quotes, and can't help but notice how much it's gone up. In only 2 months, it's gone up from 900 to 1900. I haven't changed a thing, and if you've used confused.com you'll know that you can just re-quote, which is what I've been doing. Anybody know why it's gone up so much. By the way it goes up about 40 a day at the moment. Could it be because it's the end of the month, or the end of the year? Thanks to any answers in advance.""

HELP! best auto insurance for new driver?

Hi, i am a new driver. got my licens in 2011 but due to college i wasnt able to drive around much. after graduation i decided to buy a car and look for insurance. and after reading insurance company reviews ... its kinda scaring the crap out of me. it seems that they are all interested in you buying their service but once you get into an accident you are on your own. i know internet reviews can be bias, so I kinda want to know which auto insurance company would you recommend. here is my basic info: am 23 years old, college graduate, live in a relatively decent neighborhood in southern California, had my license since 2011, and the car am looking into buying is either a new 2013 Toyota corolla or a Nissan sentra. oh and i have never had auto insurance, am not sure if i was covered in my mom's previous insurance but chances are nope. one more thing what kind of coverage would you recommend? and deductible? oh lol and which car would you recommend Nissan sentra or Toyota corolla? and any buying car tips ? thanks you so much for your help, I will defintly be choosing a best answer :)""

""I'm 21 with the Gerber Life Insurance policy plan, should I continue?""

I got a mail indicating that I am not the owner of this policy (my parents started this for me when I was young). So I have a few questions, now that I am 21, do I have 10,000$ worth of life insurance for the rest of my life (without having to continue paying?) Why would I want to continue paying if this is just here as insurance in case for my burial costs.. isn't 10k enough for that? If I stop paying will I still have this 10,000 dollars in life insurance, or am I being forced to pay in order to keep it?""

What is a cheap car insurance for me...i am 16 years old?

need the cheapest one

Fort Branch Indiana Cheap car insurance quotes zip 47648

Fort Branch Indiana Cheap car insurance quotes zip 47648

How to win the claim case from the other car insurance company?

ok. So few days ago, I got into a car accident. I was driving down the highway simply just going straight. All of a sudden, this SUV crashed into me from my left lane and knocked off my side-view mirror & left some marks on my left front door. At that time of the being, I was so shocked because all I did was just go straight & I guess the car next to mine was trying to make a lane change but he wasn't fast enough to advance me. so instead, he bumped into me and realized what he's done then went back to his lane. after the accident, we both exited out from the highway & parked our cars on the side road because that's where the other car led me. I was driving alone at that time & I was so scared because it was my first time getting into this kind of an accident. I quickly tried calling 911 & told the 911 lady to send me a police. But she just asked if there was any injury & I said no then she just told me to exchange the insurance. How rude of her. Not to be mean, but I was little scared of the mexicans b/c the area I was in at the moment was really ghetto. so then I took some photos of the damages and exchanged the insurance company. The guy kept telling me in bad English that he was ahead of me so it's my fault. and I told him that I didn't even move & he was the one changed the lane without even checking to see if it was clear. but he couldn't really speak english well or he didn't even want to listen to me. so I left like that with my sideview mirror dangling next to me. *sigh* this isn't the end of the story yet. I claimed his insurance company which ive never heard of. They said that he's telling them I was the one who hit their car. which made NO SENSE. I even have a picture of their car bumper's mark on my side of the car door which proves that there's no way I hit their car and left a mark on mine and broke my own side view mirror and left THEM no damages. His car was clear with one inch scratch on the side which was made when he hit my car after bumping into me with his bumper and quickly turning back into his own lane. I can't even believe how he can lie about this kind of stuff. I feel so mad that there're ppl like him existing!!! It's so frustrating to see the liar defending himself. His Insurance company didn't even try to look at my car & told me that they are sorry & they can not help me b/c their customer said he didn't do it. What should I do in this situation? I have no witness, there wasn't any police there at the time because they wouldn't send me any which is SO WRONG of them to do. I want to sue 911 people. grr. How can I possibly prove them that I have no faults and they should repair my damn side view mirror?!?!?! What can I do?""

""Car insurance,if im fully?""

If im fully comp on my own insurance, could i buy another car and not pay any more premiums.""

I desperately need auto insurance. i got my license like 6 months ago and i need cheap insurance?

as u guys probably kno, insurance for teens is ridiculously high!!.. the cheapest i got it was liek 215 a month.. but thats like.. no coverage. do any of u kno a good company or a good alternative way to legally have insurance which is not necessarily a monthly payment? (my friend told me about insuring mye license but im not too clear on how that works)""

Car insurance cheaper at 17 or mid 20's?

im 17 in January and getting my driving lessons for my birthday - when and if I pass I'm not getting a car till I'm in my 20's. will the insurance be cheaper when I'm mid 20's than it would be at 17?

What wold be the cheapest and best insurance?

I'm 19 and a full time college student and I live in Wisconsin. I have a work study job at school as well as a full time job in the summer. I live with my grandma because I was technically abandoned by my mom while in high school and she is unemployed so I don't think she has insurance. I wrestle in college and earlier this year I sustained a concussion and a few days afterward I got rear ended which made the symptoms a lot worse. Theyre insurance is paying for some of the bills but not all. So what insurance should I try to pursue.

I need to get rid of my car because the payments are way to high and insurance sucks?

I bought a 2003 Toyota Avalon a little more than a year ago from a dealer. I put 7000 dollars as a down payment and now am paying 240 a month for 60 months. Its getting kind of hard to pay off the car now with all of the costs going up. The total price of the car was 15000 and I got a bumper to bumper warranty for 5 years/100,000 miles when I bought it at 35,000 miles. The car now has 54.000 miles. How do I trade it in for a car that would cost me less than 200 a month Thanks""

Car insurance total loss?

I own a 1997 dodge intrepid std 4 dr sedan 6cyl gasoline 3.3 liter 4 speed in fair conditions cd player no rust with 197,242 miles. My car was was in a hail and tornado damage where the hood has a dent and the driver and passanger side have dent and the trunk. I have full coverage insurance and they telling me that my car was total last i love my car and i spent alot of money fixing it and it drives great no problem. So I was trying to get some help from some one that could tell me how much is my car worth so they wont give me less money and if they offer me less what could I do. I am not trying to bew greedy but i do love my car and spent alot of money on it. I would rather get it fix . PLEASEEEEEEEEEEEEEEE HELP ME""

Cheapest place to insure a peugeot 106 1.1 or a peugeot 106 quiksilver?

Im getting pissed off with the prices of inurance for my car the cheapest i can get it is 3200 fully comp (third party is more money for some reason?!?) and ive tryed all these compare websites and they are utter bollocks i might aswell not have passed my bastard driving test with these prices, i may have to wait another year for my insurance to go down. Btw im 19 year old and have been passed 4 month, can anyone help me im sick of ******* looking at insurance websites, thanks""

Car insurance question! CRAP...?

i got my first speeding ticket today. i was going 41 in a 30 and a conniving cop was at the bottom of this hill i was driving on and pulled me over right as i was slowing down for a stop sign. will this first ticket effect my car insurance rate? i have had my license for 2 years and have had a perfect record so far.

Car insurance not at fault?

I recieved a letter from my auto insurance who finished their investigation regarding my claim (minor accident @parking lot of a store with another vehicle) and according to them I am 0% at fault. The other party's auto insurance is still conducting their investigation. If the other party finds me at fault then what happens next? The reason why I ask is I got laid off my job in February & I do not have the funds to pay and it's been hard to find a job that pays a decent rate to help me live here in northern California. Your assistance greatly appreciated. Thank you.

""How much would a $1,000,000 liability insurance policy cost?

I'm planning events at several different venues and this is required. Each event is 4 hours.

""Would any car insurance(allstate,geico) insure an international student who doesn't have a PA licence?

I have my country licence and an international driving permit. I would like to buy a car in Pennsylvania as I am staying for about a year in this country. I would like to know will car insurance companies insure me?

Cost of 2005 bmw 745li insurance?

im 16 ill be gettin mine when im 17 whats the average insurance cost for a 2005 bmw 745li

Auto Insurance when buying New Vehicle?

What is procedure on obtaining Auto Insurance when you buy a new vehicle and have no present insurance account setup? Does dealer offer temporary insurance until you can get quotes from a few companies?

What is the best website to compare car insurance rates?

I've been searching for the past few days and can't seem to find anything that actually compares quotes even though a lot of websites say they do. Anyone know of a great website that can help?

Why want the Republicans work with the Democrats to get a good health care system in the U.S.?

Is it because the Republicans are behind big business?

What is the definition of basic legal cover for car insurance?

Like if my car insurance company tells me that when driving other peoples cars, I have basic legal cover Is this any different than third party cover? Like say I'm driving someone elses car how much am I covered With my insurance it doesnt need to be an emergency for me to be covered driving someone elses car, just wondering how much I'm covered Because I was told that that level of cover is less than third party cover Thanks""

How much is your car insurance?

Not to sound stalkerish at all lol I'm just a lil confused on car insurance and want to know what about average is. So can you please put how old you are, what car you drive, and how much you pay... Thanks ALOT it means alot to me :)""

Is it true that if you buy a brand new car the car insurance will be much more than a second hand car?

Why?? I'm going to buy the very first car for me (a mazda 3 hatchpack 2006 or 2008..) and I want it to be new cause I can afford any price. But my dad keeps telling me not to buy a new car cause i won't be having good bennefits from it..such as the car insurance. It will be higher than a second hand car's...around 1000 euros every year. Also the car insurance must be full if it's a new car and I should have it on 1/3 cause its cheaper. So if it's a new car I can't have it on 1/3. What do you think I should do? I really want that car and that's why I want it to be new..cause it's the one I've always wanted!

Does filing a claim raise auto insurance rate?

My car was vandalized while I slept. Luckily my car shut itself off when it did not recognize the key. I filed a claim with the insurance. I had comprehensive coverage. When it was time to renew, my rates increased. What is the point of having insurance if you are discouraged from filing a claim? I thought if it was not my fault, my rates do not increase?""

Why are insurance companies getting blamed for dropping coverage?

when it was because of the regulations in the patient protection and affordable care act that ended these plans?

I'm about to be 19. Where should I look for health insurance?

in California I work 2 part time jobs, neither give health insurance and my parents don't get health insurance from their jobs. It's currently Summer break but I will be going to school in the Fall. I asked for help from my bank (Wells Fargo) but my mom said I could find much better prices. Any advice would be appreciated, I need it by tomorrow.""

How can i make my car insurance cheaper?

im finding it more expensive this year than in 2010 to buy my car insurance and yet that was closer to the claims i've had to include (one in july for an sp30 speeding and the other for a none fault accident in my unoccupied vehicle in october). i dont understand this at all and its really bugging me as im finding it hard to get a decent quote. my car also has a rear spoiler which was there when i bought it which is also causing me hassle. is there anything i can do to get the best quote for my car, i'm going insane lol. im in the uk also""

Did you agree over a decade ago when California made police asking for auto insurance illegal?

For a few years, police were not allowed to ask for auto insurance from motorists. Much of the argument in favor of that law was that it discriminated against poor Mexicans. It was overturned eventually as auto insurance violations/irresponsibility became epidemic. How does this relate to the current law in Arizona? How does it relate to the mandatory health insurance law?""

""Insurance company refuse insure my house, what can I do?""

Hi I bought a house at a auction for 30000 last week. The house is empty (vacated). But the house is locked up and no internal view before the auction, I cannot access this house before the contract is done, it may take 20 days or more. So by law this property is mine, I need building insure for it. When I try to apply for insure after the auction, the insurance company refuse to insure this house. They said: I understand the property is vacant at present.Insurance is difficult whilst vacant . 1. First, is it ture, vacated house cannot be insured? 2. what can I now? Thanks in front""

Fort Branch Indiana Cheap car insurance quotes zip 47648

Fort Branch Indiana Cheap car insurance quotes zip 47648

https://www.linkedin.com/pulse/full-coverage-auto-insurance-farm-bureau-quote-jacob-foster/"

[ongames]

This Is What Obamacare's Critics Won't Admit Or Simply Don't Understand

THOUSAND OAKS, California ― Maryann Hammers is likely to die from ovarian cancer someday. But she hopes someday won’t come anytime soon.

Hammers, 61, received the diagnosis in late 2013, and doctors told her that it was stage 3-C, which meant that she could live for many years with the right treatment and a little luck. So far, she’s had both. She’s in remission for the second time, and her last course of chemotherapy ended a year and a half ago. But recent blood tests detected elevated levels of a protein associated with tumors, she explained when we met a few weeks ago. “Maybe it’s a fluke,” she said. “I hope so. I kinda feel like the clock is ticking.”

If the cancer is back, Hammers said, she may need surgery similar to her two previous operations — “gigantic surgeries, gutted like a fish and hospitalized for many days.” Chemotherapy would likely come next, plus medication, hospitalization, and home care. But Hammers considers herself lucky because she’s been able to get treatment at City of Hope, a highly respected Southern California cancer research and treatment center, and luckier still that she’s been able to pay for the treatment with insurance — an Anthem Blue Cross policy she bought through Covered California, the exchange her state created under the Affordable Care Act.

To hear President Donald Trump, House Speaker Paul Ryan and other Republicans tell it, Obamacare has been a disaster, even for those who obtained coverage through the law. Hammers has a very different perspective. She’s a freelance writer and editor, which means she has no employer-provided insurance. In the old days, if she’d gone shopping for a policy with her cancer diagnosis, she would have struggled to find a carrier willing to sell her one.

I'm terrified. ... Do you know how easy it is to use a million dollars when you're getting cancer treatment? Maryann Hammers, Thousand Oaks, California

And it’s not just the pre-existing condition guarantee, which even critics like Trump say they support, that Hammers has found so valuable. The Affordable Care Act requires insurers to cover a wide range of services and treatments — which, in her case, has included multiple shots of Neulasta, a medication that boosts white blood cell counts and typically costs several thousand dollars per injection. The law also prohibits annual or lifetime limits on benefits, which, as a long-term cancer patient, she would be a prime candidate to exceed. 

Policies with such robust coverage inevitably cost thousands of dollars a year, more than Hammers could afford on her own — particularly since battling the disease has cut into her work hours. But the law’s generous tax credits discount the premiums and help with the out-of-pocket costs, too. “Without the Affordable Care Act, I honestly do not know what I would have done,” she said.

The coverage Hammers has today still isn’t as good as what she had years ago, when she worked for a company that provided benefits. But it’s better than what she had in the years right before the cancer diagnosis, when she was buying insurance on her own. The latter plan covered fewer services and came with out-of-pocket costs high enough to discourage her from getting checkups. Obamacare’s introduction of free preventive screenings led her to schedule a long-overdue colonoscopy. During routine preparation for that procedure, a physician first felt a lump in her abdomen.  

Sometimes Hammers wonders whether, with less sporadic doctor visits, the cancer might have been caught a little sooner. “But I couldn’t afford a fat doctor’s bill. And I thought I was super healthy.”

These days, something else looms even larger in her mind — the possibility that Trump and the Republican Congress will repeal the health care law without an adequate replacement, or maybe with no replacement at all.  

“I’m terrified — isn’t that crazy?” Hammers said. “My biggest source of stress right now isn’t the fact that I have incurable cancer. It���s the prospect of losing my insurance.”

What American Health Care Used To Look Like

To appreciate the significance of stories like Hammers’ and what they say about the Affordable Care Act, it helps to remember what used to happen to people like her before the law took effect. By 2009, when President Barack Obama took office, roughly 1 in 6 Americans had no health care insurance, and even the insured could still face crippling medical bills. As a reporter covering health care during those years, I met these people. Some of their stories stand out, even now, because they capture the old system at its callous, capricious worst.

Gary Rotzler, a quality engineer at a defense contractor in upstate New York, lost his family coverage in the early 1990s when he lost his job. He ended up uninsured for two years, while he juggled stints as an independent contractor. His wife, Betsy, made do without doctor visits even after she started feeling some strange pains. By the time she got a checkup, she had advanced breast cancer. Desperate efforts at treatment failed. After she died, Gary, a father of three, had to declare bankruptcy because of all the unpaid medical bills.

Jacqueline Ruess, a widow in south Florida, thought she was insured. But then she needed expensive tests when her physicians suspected she had cancer. Although the tests were negative, the insurer refused to pay the bills because, it said, a brief episode of a routine gynecological problem in her past qualified as a pre-existing condition.

Tony Montenegro, an immigrant from El Salvador living in Los Angeles, was uninsured and working as a security guard, until untreated diabetes left him legally blind.

Marijon Binder, an impoverished former nun in Chicago, was sued by a Catholic hospital over medical expenses she couldn’t pay.

And Russ Doren, a schoolteacher in a Denver suburb, believed he had good insurance until the bills for his wife’s inpatient treatment at a psychiatric hospital hit the limit for mental health coverage. The hospital released her, despite worries that she was not ready. A few days later, she took her own life.

The Affordable Care Act of 2010 was an effort to address these kinds of problems — to carry on the crusade for universal coverage that Harry Truman had launched some 60 years before. But precisely because Obama and his allies were determined to succeed where predecessors had failed, they made a series of concessions that necessarily limited the law’s ambition.

They expanded Medicaid and regulated private insurance rather than start a whole new government-run program. They dialed back demands for lower prices from drugmakers, hospitals and other health care industries. And they agreed to tight budget constraints for the program as a whole, rather than risk a revolt among more conservative Democrats. These decisions meant that health insurance would ultimately be more expensive and the new system’s financial assistance would be less generous.

Still, projections showed that the law would bring coverage to millions while giving policymakers tools they could use to reduce medical costs over time. When the Senate passed its version of the legislation in December 2009, then-Sen. Tom Harkin (D-Iowa) described the program as a “starter home” with a solid foundation and room for expansion.

Where Obamacare Failed And Where It Succeeded

Seven years later, Trump and the Affordable Care Act’s other critics insist that the program has been a boondoggle — that the Obamacare starter home needs demolition. Some of their objections are philosophical, and some, like the persistent belief that the law set up “death panels,” are fantastical. But others focus on the law’s actual consequences.

High on that list of consequences are the higher premiums and out-of-pocket costs that some people face. The new rules, like coverage of pre-existing conditions, have made policies more expensive, and Obamacare’s financial aid frequently doesn’t offset the increases. A “rate shock” wave hit suddenly in the fall of 2013, when insurers unveiled their newly upgraded plans and in many cases canceled old ones — infuriating customers who remembered Obama’s promise that “if you like your plan, you can keep it,” while alienating even some of those sympathetic to what Obama and the Democrats were trying to do.

I’ve interviewed plenty of these people, too. A few weeks ago, I spoke with Faisuly Scheurer, a real estate agent from Blowing Rock, North Carolina. She and her husband, who works in the restaurant business, were excited about the health care law because they’d struggled to find decent, affordable insurance. They make about $60,000 a year, before taxes, with two kids and college tuition looming in the not-distant future, she said.

In late 2013, they checked out their options and learned that, after tax credits, coverage would cost $360 a month. Scheurer said she remembers thinking, “OK, that is really tight. But if the benefits are good, we are going to have to skimp on other things to make it work.” Then she learned about the deductible, which was nearly $13,000 per year. “My disappointment was indescribable.”

The Scheurer family ultimately decided to remain uninsured. They’re not the only ones, and that has weakened the system as a whole. The people eschewing coverage tend to be relatively healthy, since they’re most willing to take the risk of no coverage. That’s created big problems for insurers, which need the premiums from healthy folks to offset the high medical bills of people with serious conditions.

Many insurers have reacted by raising premiums or pulling out of some places entirely, leaving dysfunctional markets in North Carolina and a handful of other states. Just this week, Humana, which had already scaled back its offerings, announced that it was pulling out of the Affordable Care Act exchanges altogether. At least for the moment, 16 counties in Tennessee don’t have a single insurer committed to offering coverage in 2018.

Trump, Ryan and other Republicans pounced on the Humana news, citing it as more proof of a “failed system” and the need for repeal. That’s pretty typical of how the political conversation about the Affordable Care Act has proceeded for the last seven years. The focus is on everything that’s gone wrong with Obamacare, with scant attention to what’s gone right.

And yet the list of what’s gone right is long.

In states like California and Michigan, the newly regulated markets appear to be working as the law’s architects intended, except for some rural areas that insurers have never served that well. Middle-class people in those states have better, more affordable options.

It looks like more insurers are figuring out how to make their products work and how to successfully compete for business. Customers have turned out to be more price-sensitive than insurers originally anticipated. In general, the carriers that struggle are large national companies without much experience selling directly to consumers, rather than through employers.

Last year’s big premium increases followed two years in which average premiums were far below projections, a sign that carriers simply started their pricing too low. Even now, on average, the premiums people pay for exchange insurance are on a par with, or even a bit cheaper than, equivalent employer policies — and that’s before the tax credits.

The majority of people who are buying insurance on their own or get their coverage through Medicaid are satisfied with it, according to separate surveys by the Commonwealth Fund and the Henry J. Kaiser Family Foundation. The level of satisfaction with the new coverage still trails that involving employer-provided insurance, and it has declined over time. But it’s clearly in positive territory 

And then there’s the fact that the number of people without health insurance is the lowest that government or private surveys have ever recorded. When confronted with questions about the people who gained coverage because of the law, Republicans often say something about sparing those people from disruption ― and then argue that even those who obtained insurance through the law are suffering and no better off. This claim is wildly inconsistent with the experience of people like Maryann Hammers ― and, more important, it’s wildly inconsistent with the best available research.

People are struggling less with medical bills, have easier access to primary care and medication, and report that they’re in better health, according to a study that appeared in the Journal of the American Medical Association in 2015. The number of people forgoing care because of costs or being “very worried” about paying for a catastrophic medical bill dropped substantially among the newly insured, Kaiser Foundation researchers found last year when they focused on people in California.

A bunch of other studies have turned up similar evidence, All of them gibe with a landmark report on the effects of Massachusetts’ 2006 insurance expansion, which was a prototype for the national legislation. Residents of that state experienced better health outcomes and less financial stress, according to the study published in the Annals of Internal Medicine.

“Though it’s had no shortage of controversies and stumbles, there’s really no denying that the ACA has created historic gains in insurance coverage,” said Larry Levitt, a senior vice president at the Kaiser Foundation. “With better coverage that has fewer holes, access to health care has improved and many have better protection from crushing medical bills.”

What Repeal Would Really Mean

Reasonable people can disagree about whether these achievements justify Obamacare’s costs, which include not only higher premiums for the young and healthy but also hefty new taxes on the wealthiest Americans. That’s a debate about values and priorities as much as facts.

What’s not in dispute, or shouldn’t be, is the stark choice on the political agenda right now.

Democratic lawmakers still argue for the principle that Truman laid out in 1948: “health security for all, regardless of residence, station, or race.” They think the Affordable Care Act means the U.S. is closer to that goal and that the next step should be to bolster the law ― by using government power to force down the price of drugs, hospital services and other forms of medical care, while providing more generous government assistance to people who still find premiums and out-of-pocket costs too onerous. Basically, they want people like Faisuly Scheurer to end up with the same security that people like Maryann Hammers already have.

Some Republicans talk as if they share these goals. Trump has probably been the most outspoken on this point, promising to deliver “great health care at lower cost” and vowing that “everybody would be covered.” But other Republicans reject the whole concept of health care as a right. Although it’s theoretically possible to draw up a conservative health plan that would improve access and affordability, these aren’t the kinds of plans that Republicans have in mind. 

There’s a face to this law, there’s a face to people that are going to be affected by it. Angela Eilers, Yorba Linda, California

Their schemes envision substantially less government spending on health care, which would mean lower taxes for the wealthy but also less financial assistance for everybody else. Republicans would make insurance cheaper, but only by allowing it to cover fewer services and saddling beneficiaries with even higher out-of-pocket costs. The result would be some mix of more exposure to medical bills and more people without coverage. If Republicans repeal the Affordable Care Act without replacing it ― a real possibility, given profound divisions within the GOP over how to craft a plan ― 32 million more people could go uninsured, according to the Congressional Budget Office.

That would mean real suffering, primarily among those Americans who benefit most from the law now ― the ones with serious medical problems, or too little income to pay for insurance on their own, or both.

Jay Stout, a 20-year-old in Wilmington, North Carolina, is one of those people. He was in good health until a head-on car collision nearly severed his arm and landed him in the hospital for more than a month. Surgeries and rehabilitation would have cost him hundreds of thousands of dollars that, as a community college student working part-time as a busboy, he could never have paid — if not for the Blue Cross plan that his mother had bought through the Affordable Care Act. When we spoke a few weeks ago, he told me the insurance has been “irreplaceable” and that losing it “would be totally devastating.”

Meenakshi Bewtra had never had a serious health problem until her first year at the University of Pennsylvania medical school, when she developed severe gastrointestinal problems — the kind that forced her into the hospital for two months and drove her to drop out of school. Her insurance lapsed, which meant that her GI issues became a pre-existing condition. She eventually found coverage and today she’s a professor of medicine at Penn, where she moonlights as an advocate for universal health insurance.

“For the first time, I truly understood what comprehensive health insurance meant,” Bewtra said, remembering what it was like to become fully covered. “I did not have to worry about how many times I saw a doctor, or how many lab tests I had to get, or having to ration out medications.”

Angela Eilers, who lives in Yorba Linda, California, isn’t worrying about her own health. It’s her daughter Myka who has a congenital heart condition called pulmonary stenosis, which makes it more difficult for the heart to pump blood to the lungs. The little girl has required multiple surgeries and will need intensive medical treatment throughout her childhood.

In 2012, Angela’s husband, Todd, was laid off from his job at an investment firm. Since going without insurance was not an option, they took advantage of COBRA to stay on his old company’s health plan. It was expensive, and Eilers recalled panicking over the possibility they might not be able to pay the premiums. “I remember sitting at the table, thinking of plans. What would be our plan? One of them was … giving up our parents rights to my mom, because she has really good health insurance.”

Eventually her husband started his own consulting business, and that gave them the income to keep up with premiums until 2014 — when they were able to obtain coverage through the Affordable Care Act. Today they have a gold plan, one of the most generous available, for which they pay around $20,000 a year. Even though they make too much to qualify for financial assistance, they’re grateful for the coverage. Seven-year-old Myka has already run up more than a half-million dollars in medical bills. In the old days, before Obamacare, they would have worried about hitting their plan’s lifetime limit on benefits. 

The family’s coverage has become more expensive over the years. They wish the price were lower, but they’re also not complaining about that. “I’m thankful that the letter was a premium hike, rather than ‘Sorry, we are not going to cover your daughter anymore,’” Angela Eilers said.

When she thinks about the possibility of Obamacare repeal, she wonders if Trump and the Republicans understand what that would really mean. “There’s a face to this law, there’s a face to people that are going to be affected by it,” Eilers said. “It’s not me, it’s not him, it’s her. She’s only 7. And through no fault of her own, why should she suffer? And she’s not the only one.”

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This Is What Obamacare's Critics Won't Admit Or Simply Don't Understand published first on http://ift.tt/2lnpciY

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This Is What Obamacare's Critics Won't Admit Or Simply Don't Understand

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THOUSAND OAKS, California ― Maryann Hammers is likely to die from ovarian cancer someday. But she hopes someday won’t come anytime soon.

Hammers, 61, received the diagnosis in late 2013, and doctors told her that it was stage 3-C, which meant that she could live for many years with the right treatment and a little luck. So far, she’s had both. She’s in remission for the second time, and her last course of chemotherapy ended a year and a half ago. But recent blood tests detected elevated levels of a protein associated with tumors, she explained when we met a few weeks ago. “Maybe it’s a fluke,” she said. “I hope so. I kinda feel like the clock is ticking.”

If the cancer is back, Hammers said, she may need surgery similar to her two previous operations — “gigantic surgeries, gutted like a fish and hospitalized for many days.” Chemotherapy would likely come next, plus medication, hospitalization, and home care. But Hammers considers herself lucky because she’s been able to get treatment at City of Hope, a highly respected Southern California cancer research and treatment center, and luckier still that she’s been able to pay for the treatment with insurance — an Anthem Blue Cross policy she bought through Covered California, the exchange her state created under the Affordable Care Act.

To hear President Donald Trump, House Speaker Paul Ryan and other Republicans tell it, Obamacare has been a disaster, even for those who obtained coverage through the law. Hammers has a very different perspective. She’s a freelance writer and editor, which means she has no employer-provided insurance. In the old days, if she’d gone shopping for a policy with her cancer diagnosis, she would have struggled to find a carrier willing to sell her one.

I'm terrified. ... Do you know how easy it is to use a million dollars when you're getting cancer treatment? Maryann Hammers, Thousand Oaks, California

And it’s not just the pre-existing condition guarantee, which even critics like Trump say they support, that Hammers has found so valuable. The Affordable Care Act requires insurers to cover a wide range of services and treatments — which, in her case, has included multiple shots of Neulasta, a medication that boosts white blood cell counts and typically costs several thousand dollars per injection. The law also prohibits annual or lifetime limits on benefits, which, as a long-term cancer patient, she would be a prime candidate to exceed. 

Policies with such robust coverage inevitably cost thousands of dollars a year, more than Hammers could afford on her own — particularly since battling the disease has cut into her work hours. But the law’s generous tax credits discount the premiums and help with the out-of-pocket costs, too. “Without the Affordable Care Act, I honestly do not know what I would have done,” she said.

The coverage Hammers has today still isn’t as good as what she had years ago, when she worked for a company that provided benefits. But it’s better than what she had in the years right before the cancer diagnosis, when she was buying insurance on her own. The latter plan covered fewer services and came with out-of-pocket costs high enough to discourage her from getting checkups. Obamacare’s introduction of free preventive screenings led her to schedule a long-overdue colonoscopy. During routine preparation for that procedure, a physician first felt a lump in her abdomen.  

Sometimes Hammers wonders whether, with less sporadic doctor visits, the cancer might have been caught a little sooner. “But I couldn’t afford a fat doctor’s bill. And I thought I was super healthy.”

These days, something else looms even larger in her mind — the possibility that Trump and the Republican Congress will repeal the health care law without an adequate replacement, or maybe with no replacement at all.  

“I’m terrified — isn’t that crazy?” Hammers said. “My biggest source of stress right now isn’t the fact that I have incurable cancer. It’s the prospect of losing my insurance.”

What American Health Care Used To Look Like

To appreciate the significance of stories like Hammers’ and what they say about the Affordable Care Act, it helps to remember what used to happen to people like her before the law took effect. By 2009, when President Barack Obama took office, roughly 1 in 6 Americans had no health care insurance, and even the insured could still face crippling medical bills. As a reporter covering health care during those years, I met these people. Some of their stories stand out, even now, because they capture the old system at its callous, capricious worst.

Gary Rotzler, a quality engineer at a defense contractor in upstate New York, lost his family coverage in the early 1990s when he lost his job. He ended up uninsured for two years, while he juggled stints as an independent contractor. His wife, Betsy, made do without doctor visits even after she started feeling some strange pains. By the time she got a checkup, she had advanced breast cancer. Desperate efforts at treatment failed. After she died, Gary, a father of three, had to declare bankruptcy because of all the unpaid medical bills.

Jacqueline Ruess, a widow in south Florida, thought she was insured. But then she needed expensive tests when her physicians suspected she had cancer. Although the tests were negative, the insurer refused to pay the bills because, it said, a brief episode of a routine gynecological problem in her past qualified as a pre-existing condition.

Tony Montenegro, an immigrant from El Salvador living in Los Angeles, was uninsured and working as a security guard, until untreated diabetes left him legally blind.

Marijon Binder, an impoverished former nun in Chicago, was sued by a Catholic hospital over medical expenses she couldn’t pay.

And Russ Doren, a schoolteacher in a Denver suburb, believed he had good insurance until the bills for his wife’s inpatient treatment at a psychiatric hospital hit the limit for mental health coverage. The hospital released her, despite worries that she was not ready. A few days later, she took her own life.

The Affordable Care Act of 2010 was an effort to address these kinds of problems — to carry on the crusade for universal coverage that Harry Truman had launched some 60 years before. But precisely because Obama and his allies were determined to succeed where predecessors had failed, they made a series of concessions that necessarily limited the law’s ambition.

They expanded Medicaid and regulated private insurance rather than start a whole new government-run program. They dialed back demands for lower prices from drugmakers, hospitals and other health care industries. And they agreed to tight budget constraints for the program as a whole, rather than risk a revolt among more conservative Democrats. These decisions meant that health insurance would ultimately be more expensive and the new system’s financial assistance would be less generous.

Still, projections showed that the law would bring coverage to millions while giving policymakers tools they could use to reduce medical costs over time. When the Senate passed its version of the legislation in December 2009, then-Sen. Tom Harkin (D-Iowa) described the program as a “starter home” with a solid foundation and room for expansion.

Where Obamacare Failed And Where It Succeeded

Seven years later, Trump and the Affordable Care Act’s other critics insist that the program has been a boondoggle — that the Obamacare starter home needs demolition. Some of their objections are philosophical, and some, like the persistent belief that the law set up “death panels,” are fantastical. But others focus on the law’s actual consequences.

High on that list of consequences are the higher premiums and out-of-pocket costs that some people face. The new rules, like coverage of pre-existing conditions, have made policies more expensive, and Obamacare’s financial aid frequently doesn’t offset the increases. A “rate shock” wave hit suddenly in the fall of 2013, when insurers unveiled their newly upgraded plans and in many cases canceled old ones — infuriating customers who remembered Obama’s promise that “if you like your plan, you can keep it,” while alienating even some of those sympathetic to what Obama and the Democrats were trying to do.

I’ve interviewed plenty of these people, too. A few weeks ago, I spoke with Faisuly Scheurer, a real estate agent from Blowing Rock, North Carolina. She and her husband, who works in the restaurant business, were excited about the health care law because they’d struggled to find decent, affordable insurance. They make about $60,000 a year, before taxes, with two kids and college tuition looming in the not-distant future, she said.

In late 2013, they checked out their options and learned that, after tax credits, coverage would cost $360 a month. Scheurer said she remembers thinking, “OK, that is really tight. But if the benefits are good, we are going to have to skimp on other things to make it work.” Then she learned about the deductible, which was nearly $13,000 per year. “My disappointment was indescribable.”

The Scheurer family ultimately decided to remain uninsured. They’re not the only ones, and that has weakened the system as a whole. The people eschewing coverage tend to be relatively healthy, since they’re most willing to take the risk of no coverage. That’s created big problems for insurers, which need the premiums from healthy folks to offset the high medical bills of people with serious conditions.

Many insurers have reacted by raising premiums or pulling out of some places entirely, leaving dysfunctional markets in North Carolina and a handful of other states. Just this week, Humana, which had already scaled back its offerings, announced that it was pulling out of the Affordable Care Act exchanges altogether. At least for the moment, 16 counties in Tennessee don’t have a single insurer committed to offering coverage in 2018.

Trump, Ryan and other Republicans pounced on the Humana news, citing it as more proof of a “failed system” and the need for repeal. That’s pretty typical of how the political conversation about the Affordable Care Act has proceeded for the last seven years. The focus is on everything that’s gone wrong with Obamacare, with scant attention to what’s gone right.

And yet the list of what’s gone right is long.

In states like California and Michigan, the newly regulated markets appear to be working as the law’s architects intended, except for some rural areas that insurers have never served that well. Middle-class people in those states have better, more affordable options.

It looks like more insurers are figuring out how to make their products work and how to successfully compete for business. Customers have turned out to be more price-sensitive than insurers originally anticipated. In general, the carriers that struggle are large national companies without much experience selling directly to consumers, rather than through employers.

Last year’s big premium increases followed two years in which average premiums were far below projections, a sign that carriers simply started their pricing too low. Even now, on average, the premiums people pay for exchange insurance are on a par with, or even a bit cheaper than, equivalent employer policies — and that’s before the tax credits.

The majority of people who are buying insurance on their own or get their coverage through Medicaid are satisfied with it, according to separate surveys by the Commonwealth Fund and the Henry J. Kaiser Family Foundation. The level of satisfaction with the new coverage still trails that involving employer-provided insurance, and it has declined over time. But it’s clearly in positive territory 

And then there’s the fact that the number of people without health insurance is the lowest that government or private surveys have ever recorded. When confronted with questions about the people who gained coverage because of the law, Republicans often say something about sparing those people from disruption ― and then argue that even those who obtained insurance through the law are suffering and no better off. This claim is wildly inconsistent with the experience of people like Maryann Hammers ― and, more important, it’s wildly inconsistent with the best available research.

People are struggling less with medical bills, have easier access to primary care and medication, and report that they’re in better health, according to a study that appeared in the Journal of the American Medical Association in 2015. The number of people forgoing care because of costs or being “very worried” about paying for a catastrophic medical bill dropped substantially among the newly insured, Kaiser Foundation researchers found last year when they focused on people in California.

A bunch of other studies have turned up similar evidence, All of them gibe with a landmark report on the effects of Massachusetts’ 2006 insurance expansion, which was a prototype for the national legislation. Residents of that state experienced better health outcomes and less financial stress, according to the study published in the Annals of Internal Medicine.

“Though it’s had no shortage of controversies and stumbles, there’s really no denying that the ACA has created historic gains in insurance coverage,” said Larry Levitt, a senior vice president at the Kaiser Foundation. “With better coverage that has fewer holes, access to health care has improved and many have better protection from crushing medical bills.”

What Repeal Would Really Mean

Reasonable people can disagree about whether these achievements justify Obamacare’s costs, which include not only higher premiums for the young and healthy but also hefty new taxes on the wealthiest Americans. That’s a debate about values and priorities as much as facts.

What’s not in dispute, or shouldn’t be, is the stark choice on the political agenda right now.

Democratic lawmakers still argue for the principle that Truman laid out in 1948: “health security for all, regardless of residence, station, or race.” They think the Affordable Care Act means the U.S. is closer to that goal and that the next step should be to bolster the law ― by using government power to force down the price of drugs, hospital services and other forms of medical care, while providing more generous government assistance to people who still find premiums and out-of-pocket costs too onerous. Basically, they want people like Faisuly Scheurer to end up with the same security that people like Maryann Hammers already have.

Some Republicans talk as if they share these goals. Trump has probably been the most outspoken on this point, promising to deliver “great health care at lower cost” and vowing that “everybody would be covered.” But other Republicans reject the whole concept of health care as a right. Although it’s theoretically possible to draw up a conservative health plan that would improve access and affordability, these aren’t the kinds of plans that Republicans have in mind. 

There’s a face to this law, there’s a face to people that are going to be affected by it. Angela Eilers, Yorba Linda, California

Their schemes envision substantially less government spending on health care, which would mean lower taxes for the wealthy but also less financial assistance for everybody else. Republicans would make insurance cheaper, but only by allowing it to cover fewer services and saddling beneficiaries with even higher out-of-pocket costs. The result would be some mix of more exposure to medical bills and more people without coverage. If Republicans repeal the Affordable Care Act without replacing it ― a real possibility, given profound divisions within the GOP over how to craft a plan ― 32 million more people could go uninsured, according to the Congressional Budget Office.

That would mean real suffering, primarily among those Americans who benefit most from the law now ― the ones with serious medical problems, or too little income to pay for insurance on their own, or both.

Jay Stout, a 20-year-old in Wilmington, North Carolina, is one of those people. He was in good health until a head-on car collision nearly severed his arm and landed him in the hospital for more than a month. Surgeries and rehabilitation would have cost him hundreds of thousands of dollars that, as a community college student working part-time as a busboy, he could never have paid — if not for the Blue Cross plan that his mother had bought through the Affordable Care Act. When we spoke a few weeks ago, he told me the insurance has been “irreplaceable” and that losing it “would be totally devastating.”

Meenakshi Bewtra had never had a serious health problem until her first year at the University of Pennsylvania medical school, when she developed severe gastrointestinal problems — the kind that forced her into the hospital for two months and drove her to drop out of school. Her insurance lapsed, which meant that her GI issues became a pre-existing condition. She eventually found coverage and today she’s a professor of medicine at Penn, where she moonlights as an advocate for universal health insurance.

“For the first time, I truly understood what comprehensive health insurance meant,” Bewtra said, remembering what it was like to become fully covered. “I did not have to worry about how many times I saw a doctor, or how many lab tests I had to get, or having to ration out medications.”

Angela Eilers, who lives in Yorba Linda, California, isn’t worrying about her own health. It’s her daughter Myka who has a congenital heart condition called pulmonary stenosis, which makes it more difficult for the heart to pump blood to the lungs. The little girl has required multiple surgeries and will need intensive medical treatment throughout her childhood.

In 2012, Angela’s husband, Todd, was laid off from his job at an investment firm. Since going without insurance was not an option, they took advantage of COBRA to stay on his old company’s health plan. It was expensive, and Eilers recalled panicking over the possibility they might not be able to pay the premiums. “I remember sitting at the table, thinking of plans. What would be our plan? One of them was … giving up our parents rights to my mom, because she has really good health insurance.”

Eventually her husband started his own consulting business, and that gave them the income to keep up with premiums until 2014 — when they were able to obtain coverage through the Affordable Care Act. Today they have a gold plan, one of the most generous available, for which they pay around $20,000 a year. Even though they make too much to qualify for financial assistance, they’re grateful for the coverage. Seven-year-old Myka has already run up more than a half-million dollars in medical bills. In the old days, before Obamacare, they would have worried about hitting their plan’s lifetime limit on benefits. 

The family’s coverage has become more expensive over the years. They wish the price were lower, but they’re also not complaining about that. “I’m thankful that the letter was a premium hike, rather than ‘Sorry, we are not going to cover your daughter anymore,’” Angela Eilers said.

When she thinks about the possibility of Obamacare repeal, she wonders if Trump and the Republicans understand what that would really mean. “There’s a face to this law, there’s a face to people that are going to be affected by it,” Eilers said. “It’s not me, it’s not him, it’s her. She’s only 7. And through no fault of her own, why should she suffer? And she’s not the only one.”

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.

from http://ift.tt/2lhKYWx from Blogger http://ift.tt/2lYrfLJ

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This Is What Obamacare's Critics Won't Admit Or Simply Don't Understand

THOUSAND OAKS, California ― Maryann Hammers is likely to die from ovarian cancer someday. But she hopes someday won’t come anytime soon.

Hammers, 61, received the diagnosis in late 2013, and doctors told her that it was stage 3-C, which meant that she could live for many years with the right treatment and a little luck. So far, she’s had both. She’s in remission for the second time, and her last course of chemotherapy ended a year and a half ago. But recent blood tests detected elevated levels of a protein associated with tumors, she explained when we met a few weeks ago. “Maybe it’s a fluke,” she said. “I hope so. I kinda feel like the clock is ticking.”

If the cancer is back, Hammers said, she may need surgery similar to her two previous operations — “gigantic surgeries, gutted like a fish and hospitalized for many days.” Chemotherapy would likely come next, plus medication, hospitalization, and home care. But Hammers considers herself lucky because she’s been able to get treatment at City of Hope, a highly respected Southern California cancer research and treatment center, and luckier still that she’s been able to pay for the treatment with insurance — an Anthem Blue Cross policy she bought through Covered California, the exchange her state created under the Affordable Care Act.

To hear President Donald Trump, House Speaker Paul Ryan and other Republicans tell it, Obamacare has been a disaster, even for those who obtained coverage through the law. Hammers has a very different perspective. She’s a freelance writer and editor, which means she has no employer-provided insurance. In the old days, if she’d gone shopping for a policy with her cancer diagnosis, she would have struggled to find a carrier willing to sell her one.

I'm terrified. ... Do you know how easy it is to use a million dollars when you're getting cancer treatment? Maryann Hammers, Thousand Oaks, California

And it’s not just the pre-existing condition guarantee, which even critics like Trump say they support, that Hammers has found so valuable. The Affordable Care Act requires insurers to cover a wide range of services and treatments — which, in her case, has included multiple shots of Neulasta, a medication that boosts white blood cell counts and typically costs several thousand dollars per injection. The law also prohibits annual or lifetime limits on benefits, which, as a long-term cancer patient, she would be a prime candidate to exceed. 

Policies with such robust coverage inevitably cost thousands of dollars a year, more than Hammers could afford on her own — particularly since battling the disease has cut into her work hours. But the law’s generous tax credits discount the premiums and help with the out-of-pocket costs, too. “Without the Affordable Care Act, I honestly do not know what I would have done,” she said.

The coverage Hammers has today still isn’t as good as what she had years ago, when she worked for a company that provided benefits. But it’s better than what she had in the years right before the cancer diagnosis, when she was buying insurance on her own. The latter plan covered fewer services and came with out-of-pocket costs high enough to discourage her from getting checkups. Obamacare’s introduction of free preventive screenings led her to schedule a long-overdue colonoscopy. During routine preparation for that procedure, a physician first felt a lump in her abdomen.  

Sometimes Hammers wonders whether, with less sporadic doctor visits, the cancer might have been caught a little sooner. “But I couldn’t afford a fat doctor’s bill. And I thought I was super healthy.”

These days, something else looms even larger in her mind — the possibility that Trump and the Republican Congress will repeal the health care law without an adequate replacement, or maybe with no replacement at all.  

“I’m terrified — isn’t that crazy?” Hammers said. “My biggest source of stress right now isn’t the fact that I have incurable cancer. It’s the prospect of losing my insurance.”

What American Health Care Used To Look Like

To appreciate the significance of stories like Hammers’ and what they say about the Affordable Care Act, it helps to remember what used to happen to people like her before the law took effect. By 2009, when President Barack Obama took office, roughly 1 in 6 Americans had no health care insurance, and even the insured could still face crippling medical bills. As a reporter covering health care during those years, I met these people. Some of their stories stand out, even now, because they capture the old system at its callous, capricious worst.

Gary Rotzler, a quality engineer at a defense contractor in upstate New York, lost his family coverage in the early 1990s when he lost his job. He ended up uninsured for two years, while he juggled stints as an independent contractor. His wife, Betsy, made do without doctor visits even after she started feeling some strange pains. By the time she got a checkup, she had advanced breast cancer. Desperate efforts at treatment failed. After she died, Gary, a father of three, had to declare bankruptcy because of all the unpaid medical bills.

Jacqueline Ruess, a widow in south Florida, thought she was insured. But then she needed expensive tests when her physicians suspected she had cancer. Although the tests were negative, the insurer refused to pay the bills because, it said, a brief episode of a routine gynecological problem in her past qualified as a pre-existing condition.

Tony Montenegro, an immigrant from El Salvador living in Los Angeles, was uninsured and working as a security guard, until untreated diabetes left him legally blind.

Marijon Binder, an impoverished former nun in Chicago, was sued by a Catholic hospital over medical expenses she couldn’t pay.

And Russ Doren, a schoolteacher in a Denver suburb, believed he had good insurance until the bills for his wife’s inpatient treatment at a psychiatric hospital hit the limit for mental health coverage. The hospital released her, despite worries that she was not ready. A few days later, she took her own life.

The Affordable Care Act of 2010 was an effort to address these kinds of problems — to carry on the crusade for universal coverage that Harry Truman had launched some 60 years before. But precisely because Obama and his allies were determined to succeed where predecessors had failed, they made a series of concessions that necessarily limited the law’s ambition.

They expanded Medicaid and regulated private insurance rather than start a whole new government-run program. They dialed back demands for lower prices from drugmakers, hospitals and other health care industries. And they agreed to tight budget constraints for the program as a whole, rather than risk a revolt among more conservative Democrats. These decisions meant that health insurance would ultimately be more expensive and the new system’s financial assistance would be less generous.

Still, projections showed that the law would bring coverage to millions while giving policymakers tools they could use to reduce medical costs over time. When the Senate passed its version of the legislation in December 2009, then-Sen. Tom Harkin (D-Iowa) described the program as a “starter home” with a solid foundation and room for expansion.

Where Obamacare Failed And Where It Succeeded

Seven years later, Trump and the Affordable Care Act’s other critics insist that the program has been a boondoggle — that the Obamacare starter home needs demolition. Some of their objections are philosophical, and some, like the persistent belief that the law set up “death panels,” are fantastical. But others focus on the law’s actual consequences.

High on that list of consequences are the higher premiums and out-of-pocket costs that some people face. The new rules, like coverage of pre-existing conditions, have made policies more expensive, and Obamacare’s financial aid frequently doesn’t offset the increases. A “rate shock” wave hit suddenly in the fall of 2013, when insurers unveiled their newly upgraded plans and in many cases canceled old ones — infuriating customers who remembered Obama’s promise that “if you like your plan, you can keep it,” while alienating even some of those sympathetic to what Obama and the Democrats were trying to do.

I’ve interviewed plenty of these people, too. A few weeks ago, I spoke with Faisuly Scheurer, a real estate agent from Blowing Rock, North Carolina. She and her husband, who works in the restaurant business, were excited about the health care law because they’d struggled to find decent, affordable insurance. They make about $60,000 a year, before taxes, with two kids and college tuition looming in the not-distant future, she said.

In late 2013, they checked out their options and learned that, after tax credits, coverage would cost $360 a month. Scheurer said she remembers thinking, “OK, that is really tight. But if the benefits are good, we are going to have to skimp on other things to make it work.” Then she learned about the deductible, which was nearly $13,000 per year. “My disappointment was indescribable.”

The Scheurer family ultimately decided to remain uninsured. They’re not the only ones, and that has weakened the system as a whole. The people eschewing coverage tend to be relatively healthy, since they’re most willing to take the risk of no coverage. That’s created big problems for insurers, which need the premiums from healthy folks to offset the high medical bills of people with serious conditions.

Many insurers have reacted by raising premiums or pulling out of some places entirely, leaving dysfunctional markets in North Carolina and a handful of other states. Just this week, Humana, which had already scaled back its offerings, announced that it was pulling out of the Affordable Care Act exchanges altogether. At least for the moment, 16 counties in Tennessee don’t have a single insurer committed to offering coverage in 2018.

Trump, Ryan and other Republicans pounced on the Humana news, citing it as more proof of a “failed system” and the need for repeal. That’s pretty typical of how the political conversation about the Affordable Care Act has proceeded for the last seven years. The focus is on everything that’s gone wrong with Obamacare, with scant attention to what’s gone right.

And yet the list of what’s gone right is long.

In states like California and Michigan, the newly regulated markets appear to be working as the law’s architects intended, except for some rural areas that insurers have never served that well. Middle-class people in those states have better, more affordable options.

It looks like more insurers are figuring out how to make their products work and how to successfully compete for business. Customers have turned out to be more price-sensitive than insurers originally anticipated. In general, the carriers that struggle are large national companies without much experience selling directly to consumers, rather than through employers.

Last year’s big premium increases followed two years in which average premiums were far below projections, a sign that carriers simply started their pricing too low. Even now, on average, the premiums people pay for exchange insurance are on a par with, or even a bit cheaper than, equivalent employer policies — and that’s before the tax credits.

The majority of people who are buying insurance on their own or get their coverage through Medicaid are satisfied with it, according to separate surveys by the Commonwealth Fund and the Henry J. Kaiser Family Foundation. The level of satisfaction with the new coverage still trails that involving employer-provided insurance, and it has declined over time. But it’s clearly in positive territory 

And then there’s the fact that the number of people without health insurance is the lowest that government or private surveys have ever recorded. When confronted with questions about the people who gained coverage because of the law, Republicans often say something about sparing those people from disruption ― and then argue that even those who obtained insurance through the law are suffering and no better off. This claim is wildly inconsistent with the experience of people like Maryann Hammers ― and, more important, it’s wildly inconsistent with the best available research.

People are struggling less with medical bills, have easier access to primary care and medication, and report that they’re in better health, according to a study that appeared in the Journal of the American Medical Association in 2015. The number of people forgoing care because of costs or being “very worried” about paying for a catastrophic medical bill dropped substantially among the newly insured, Kaiser Foundation researchers found last year when they focused on people in California.

A bunch of other studies have turned up similar evidence, All of them gibe with a landmark report on the effects of Massachusetts’ 2006 insurance expansion, which was a prototype for the national legislation. Residents of that state experienced better health outcomes and less financial stress, according to the study published in the Annals of Internal Medicine.

“Though it’s had no shortage of controversies and stumbles, there’s really no denying that the ACA has created historic gains in insurance coverage,” said Larry Levitt, a senior vice president at the Kaiser Foundation. “With better coverage that has fewer holes, access to health care has improved and many have better protection from crushing medical bills.”

What Repeal Would Really Mean

Reasonable people can disagree about whether these achievements justify Obamacare’s costs, which include not only higher premiums for the young and healthy but also hefty new taxes on the wealthiest Americans. That’s a debate about values and priorities as much as facts.

What’s not in dispute, or shouldn’t be, is the stark choice on the political agenda right now.

Democratic lawmakers still argue for the principle that Truman laid out in 1948: “health security for all, regardless of residence, station, or race.” They think the Affordable Care Act means the U.S. is closer to that goal and that the next step should be to bolster the law ― by using government power to force down the price of drugs, hospital services and other forms of medical care, while providing more generous government assistance to people who still find premiums and out-of-pocket costs too onerous. Basically, they want people like Faisuly Scheurer to end up with the same security that people like Maryann Hammers already have.

Some Republicans talk as if they share these goals. Trump has probably been the most outspoken on this point, promising to deliver “great health care at lower cost” and vowing that “everybody would be covered.” But other Republicans reject the whole concept of health care as a right. Although it’s theoretically possible to draw up a conservative health plan that would improve access and affordability, these aren’t the kinds of plans that Republicans have in mind. 

There’s a face to this law, there’s a face to people that are going to be affected by it. Angela Eilers, Yorba Linda, California

Their schemes envision substantially less government spending on health care, which would mean lower taxes for the wealthy but also less financial assistance for everybody else. Republicans would make insurance cheaper, but only by allowing it to cover fewer services and saddling beneficiaries with even higher out-of-pocket costs. The result would be some mix of more exposure to medical bills and more people without coverage. If Republicans repeal the Affordable Care Act without replacing it ― a real possibility, given profound divisions within the GOP over how to craft a plan ― 32 million more people could go uninsured, according to the Congressional Budget Office.

That would mean real suffering, primarily among those Americans who benefit most from the law now ― the ones with serious medical problems, or too little income to pay for insurance on their own, or both.

Jay Stout, a 20-year-old in Wilmington, North Carolina, is one of those people. He was in good health until a head-on car collision nearly severed his arm and landed him in the hospital for more than a month. Surgeries and rehabilitation would have cost him hundreds of thousands of dollars that, as a community college student working part-time as a busboy, he could never have paid — if not for the Blue Cross plan that his mother had bought through the Affordable Care Act. When we spoke a few weeks ago, he told me the insurance has been “irreplaceable” and that losing it “would be totally devastating.”

Meenakshi Bewtra had never had a serious health problem until her first year at the University of Pennsylvania medical school, when she developed severe gastrointestinal problems — the kind that forced her into the hospital for two months and drove her to drop out of school. Her insurance lapsed, which meant that her GI issues became a pre-existing condition. She eventually found coverage and today she’s a professor of medicine at Penn, where she moonlights as an advocate for universal health insurance.

“For the first time, I truly understood what comprehensive health insurance meant,” Bewtra said, remembering what it was like to become fully covered. “I did not have to worry about how many times I saw a doctor, or how many lab tests I had to get, or having to ration out medications.”

Angela Eilers, who lives in Yorba Linda, California, isn’t worrying about her own health. It’s her daughter Myka who has a congenital heart condition called pulmonary stenosis, which makes it more difficult for the heart to pump blood to the lungs. The little girl has required multiple surgeries and will need intensive medical treatment throughout her childhood.

In 2012, Angela’s husband, Todd, was laid off from his job at an investment firm. Since going without insurance was not an option, they took advantage of COBRA to stay on his old company’s health plan. It was expensive, and Eilers recalled panicking over the possibility they might not be able to pay the premiums. “I remember sitting at the table, thinking of plans. What would be our plan? One of them was … giving up our parents rights to my mom, because she has really good health insurance.”

Eventually her husband started his own consulting business, and that gave them the income to keep up with premiums until 2014 — when they were able to obtain coverage through the Affordable Care Act. Today they have a gold plan, one of the most generous available, for which they pay around $20,000 a year. Even though they make too much to qualify for financial assistance, they’re grateful for the coverage. Seven-year-old Myka has already run up more than a half-million dollars in medical bills. In the old days, before Obamacare, they would have worried about hitting their plan’s lifetime limit on benefits. 

The family’s coverage has become..

from DIYS http://ift.tt/2lVz2x4

[realestate63141]

This Is What Obamacare's Critics Won't Admit Or Simply Don't Understand

THOUSAND OAKS, California ― Maryann Hammers is likely to die from ovarian cancer someday. But she hopes someday won’t come anytime soon.

Hammers, 61, received the diagnosis in late 2013, and doctors told her that it was stage 3-C, which meant that she could live for many years with the right treatment and a little luck. So far, she’s had both. She’s in remission for the second time, and her last course of chemotherapy ended a year and a half ago. But recent blood tests detected elevated levels of a protein associated with tumors, she explained when we met a few weeks ago. “Maybe it’s a fluke,” she said. “I hope so. I kinda feel like the clock is ticking.”

If the cancer is back, Hammers said, she may need surgery similar to her two previous operations — “gigantic surgeries, gutted like a fish and hospitalized for many days.” Chemotherapy would likely come next, plus medication, hospitalization, and home care. But Hammers considers herself lucky because she’s been able to get treatment at City of Hope, a highly respected Southern California cancer research and treatment center, and luckier still that she’s been able to pay for the treatment with insurance — an Anthem Blue Cross policy she bought through Covered California, the exchange her state created under the Affordable Care Act.

To hear President Donald Trump, House Speaker Paul Ryan and other Republicans tell it, Obamacare has been a disaster, even for those who obtained coverage through the law. Hammers has a very different perspective. She’s a freelance writer and editor, which means she has no employer-provided insurance. In the old days, if she’d gone shopping for a policy with her cancer diagnosis, she would have struggled to find a carrier willing to sell her one.

I'm terrified. ... Do you know how easy it is to use a million dollars when you're getting cancer treatment? Maryann Hammers, Thousand Oaks, California

And it’s not just the pre-existing condition guarantee, which even critics like Trump say they support, that Hammers has found so valuable. The Affordable Care Act requires insurers to cover a wide range of services and treatments — which, in her case, has included multiple shots of Neulasta, a medication that boosts white blood cell counts and typically costs several thousand dollars per injection. The law also prohibits annual or lifetime limits on benefits, which, as a long-term cancer patient, she would be a prime candidate to exceed. 

Policies with such robust coverage inevitably cost thousands of dollars a year, more than Hammers could afford on her own — particularly since battling the disease has cut into her work hours. But the law’s generous tax credits discount the premiums and help with the out-of-pocket costs, too. “Without the Affordable Care Act, I honestly do not know what I would have done,” she said.

The coverage Hammers has today still isn’t as good as what she had years ago, when she worked for a company that provided benefits. But it’s better than what she had in the years right before the cancer diagnosis, when she was buying insurance on her own. The latter plan covered fewer services and came with out-of-pocket costs high enough to discourage her from getting checkups. Obamacare’s introduction of free preventive screenings led her to schedule a long-overdue colonoscopy. During routine preparation for that procedure, a physician first felt a lump in her abdomen.  

Sometimes Hammers wonders whether, with less sporadic doctor visits, the cancer might have been caught a little sooner. “But I couldn’t afford a fat doctor’s bill. And I thought I was super healthy.”

These days, something else looms even larger in her mind — the possibility that Trump and the Republican Congress will repeal the health care law without an adequate replacement, or maybe with no replacement at all.  

“I’m terrified — isn’t that crazy?” Hammers said. “My biggest source of stress right now isn’t the fact that I have incurable cancer. It’s the prospect of losing my insurance.”

What American Health Care Used To Look Like

To appreciate the significance of stories like Hammers’ and what they say about the Affordable Care Act, it helps to remember what used to happen to people like her before the law took effect. By 2009, when President Barack Obama took office, roughly 1 in 6 Americans had no health care insurance, and even the insured could still face crippling medical bills. As a reporter covering health care during those years, I met these people. Some of their stories stand out, even now, because they capture the old system at its callous, capricious worst.

Gary Rotzler, a quality engineer at a defense contractor in upstate New York, lost his family coverage in the early 1990s when he lost his job. He ended up uninsured for two years, while he juggled stints as an independent contractor. His wife, Betsy, made do without doctor visits even after she started feeling some strange pains. By the time she got a checkup, she had advanced breast cancer. Desperate efforts at treatment failed. After she died, Gary, a father of three, had to declare bankruptcy because of all the unpaid medical bills.

Jacqueline Ruess, a widow in south Florida, thought she was insured. But then she needed expensive tests when her physicians suspected she had cancer. Although the tests were negative, the insurer refused to pay the bills because, it said, a brief episode of a routine gynecological problem in her past qualified as a pre-existing condition.

Tony Montenegro, an immigrant from El Salvador living in Los Angeles, was uninsured and working as a security guard, until untreated diabetes left him legally blind.

Marijon Binder, an impoverished former nun in Chicago, was sued by a Catholic hospital over medical expenses she couldn’t pay.

And Russ Doren, a schoolteacher in a Denver suburb, believed he had good insurance until the bills for his wife’s inpatient treatment at a psychiatric hospital hit the limit for mental health coverage. The hospital released her, despite worries that she was not ready. A few days later, she took her own life.

The Affordable Care Act of 2010 was an effort to address these kinds of problems — to carry on the crusade for universal coverage that Harry Truman had launched some 60 years before. But precisely because Obama and his allies were determined to succeed where predecessors had failed, they made a series of concessions that necessarily limited the law’s ambition.

They expanded Medicaid and regulated private insurance rather than start a whole new government-run program. They dialed back demands for lower prices from drugmakers, hospitals and other health care industries. And they agreed to tight budget constraints for the program as a whole, rather than risk a revolt among more conservative Democrats. These decisions meant that health insurance would ultimately be more expensive and the new system’s financial assistance would be less generous.

Still, projections showed that the law would bring coverage to millions while giving policymakers tools they could use to reduce medical costs over time. When the Senate passed its version of the legislation in December 2009, then-Sen. Tom Harkin (D-Iowa) described the program as a “starter home” with a solid foundation and room for expansion.

Where Obamacare Failed And Where It Succeeded

Seven years later, Trump and the Affordable Care Act’s other critics insist that the program has been a boondoggle — that the Obamacare starter home needs demolition. Some of their objections are philosophical, and some, like the persistent belief that the law set up “death panels,” are fantastical. But others focus on the law’s actual consequences.

High on that list of consequences are the higher premiums and out-of-pocket costs that some people face. The new rules, like coverage of pre-existing conditions, have made policies more expensive, and Obamacare’s financial aid frequently doesn’t offset the increases. A “rate shock” wave hit suddenly in the fall of 2013, when insurers unveiled their newly upgraded plans and in many cases canceled old ones — infuriating customers who remembered Obama’s promise that “if you like your plan, you can keep it,” while alienating even some of those sympathetic to what Obama and the Democrats were trying to do.

I’ve interviewed plenty of these people, too. A few weeks ago, I spoke with Faisuly Scheurer, a real estate agent from Blowing Rock, North Carolina. She and her husband, who works in the restaurant business, were excited about the health care law because they’d struggled to find decent, affordable insurance. They make about $60,000 a year, before taxes, with two kids and college tuition looming in the not-distant future, she said.

In late 2013, they checked out their options and learned that, after tax credits, coverage would cost $360 a month. Scheurer said she remembers thinking, “OK, that is really tight. But if the benefits are good, we are going to have to skimp on other things to make it work.” Then she learned about the deductible, which was nearly $13,000 per year. “My disappointment was indescribable.”

The Scheurer family ultimately decided to remain uninsured. They’re not the only ones, and that has weakened the system as a whole. The people eschewing coverage tend to be relatively healthy, since they’re most willing to take the risk of no coverage. That’s created big problems for insurers, which need the premiums from healthy folks to offset the high medical bills of people with serious conditions.

Many insurers have reacted by raising premiums or pulling out of some places entirely, leaving dysfunctional markets in North Carolina and a handful of other states. Just this week, Humana, which had already scaled back its offerings, announced that it was pulling out of the Affordable Care Act exchanges altogether. At least for the moment, 16 counties in Tennessee don’t have a single insurer committed to offering coverage in 2018.

Trump, Ryan and other Republicans pounced on the Humana news, citing it as more proof of a “failed system” and the need for repeal. That’s pretty typical of how the political conversation about the Affordable Care Act has proceeded for the last seven years. The focus is on everything that’s gone wrong with Obamacare, with scant attention to what’s gone right.

And yet the list of what’s gone right is long.

In states like California and Michigan, the newly regulated markets appear to be working as the law’s architects intended, except for some rural areas that insurers have never served that well. Middle-class people in those states have better, more affordable options.

It looks like more insurers are figuring out how to make their products work and how to successfully compete for business. Customers have turned out to be more price-sensitive than insurers originally anticipated. In general, the carriers that struggle are large national companies without much experience selling directly to consumers, rather than through employers.

Last year’s big premium increases followed two years in which average premiums were far below projections, a sign that carriers simply started their pricing too low. Even now, on average, the premiums people pay for exchange insurance are on a par with, or even a bit cheaper than, equivalent employer policies — and that’s before the tax credits.

The majority of people who are buying insurance on their own or get their coverage through Medicaid are satisfied with it, according to separate surveys by the Commonwealth Fund and the Henry J. Kaiser Family Foundation. The level of satisfaction with the new coverage still trails that involving employer-provided insurance, and it has declined over time. But it’s clearly in positive territory 

And then there’s the fact that the number of people without health insurance is the lowest that government or private surveys have ever recorded. When confronted with questions about the people who gained coverage because of the law, Republicans often say something about sparing those people from disruption ― and then argue that even those who obtained insurance through the law are suffering and no better off. This claim is wildly inconsistent with the experience of people like Maryann Hammers ― and, more important, it’s wildly inconsistent with the best available research.

People are struggling less with medical bills, have easier access to primary care and medication, and report that they’re in better health, according to a study that appeared in the Journal of the American Medical Association in 2015. The number of people forgoing care because of costs or being “very worried” about paying for a catastrophic medical bill dropped substantially among the newly insured, Kaiser Foundation researchers found last year when they focused on people in California.

A bunch of other studies have turned up similar evidence, All of them gibe with a landmark report on the effects of Massachusetts’ 2006 insurance expansion, which was a prototype for the national legislation. Residents of that state experienced better health outcomes and less financial stress, according to the study published in the Annals of Internal Medicine.

“Though it’s had no shortage of controversies and stumbles, there’s really no denying that the ACA has created historic gains in insurance coverage,” said Larry Levitt, a senior vice president at the Kaiser Foundation. “With better coverage that has fewer holes, access to health care has improved and many have better protection from crushing medical bills.”

What Repeal Would Really Mean

Reasonable people can disagree about whether these achievements justify Obamacare’s costs, which include not only higher premiums for the young and healthy but also hefty new taxes on the wealthiest Americans. That’s a debate about values and priorities as much as facts.

What’s not in dispute, or shouldn’t be, is the stark choice on the political agenda right now.

Democratic lawmakers still argue for the principle that Truman laid out in 1948: “health security for all, regardless of residence, station, or race.” They think the Affordable Care Act means the U.S. is closer to that goal and that the next step should be to bolster the law ― by using government power to force down the price of drugs, hospital services and other forms of medical care, while providing more generous government assistance to people who still find premiums and out-of-pocket costs too onerous. Basically, they want people like Faisuly Scheurer to end up with the same security that people like Maryann Hammers already have.

Some Republicans talk as if they share these goals. Trump has probably been the most outspoken on this point, promising to deliver “great health care at lower cost” and vowing that “everybody would be covered.” But other Republicans reject the whole concept of health care as a right. Although it’s theoretically possible to draw up a conservative health plan that would improve access and affordability, these aren’t the kinds of plans that Republicans have in mind. 

There’s a face to this law, there’s a face to people that are going to be affected by it. Angela Eilers, Yorba Linda, California

Their schemes envision substantially less government spending on health care, which would mean lower taxes for the wealthy but also less financial assistance for everybody else. Republicans would make insurance cheaper, but only by allowing it to cover fewer services and saddling beneficiaries with even higher out-of-pocket costs. The result would be some mix of more exposure to medical bills and more people without coverage. If Republicans repeal the Affordable Care Act without replacing it ― a real possibility, given profound divisions within the GOP over how to craft a plan ― 32 million more people could go uninsured, according to the Congressional Budget Office.

That would mean real suffering, primarily among those Americans who benefit most from the law now ― the ones with serious medical problems, or too little income to pay for insurance on their own, or both.

Jay Stout, a 20-year-old in Wilmington, North Carolina, is one of those people. He was in good health until a head-on car collision nearly severed his arm and landed him in the hospital for more than a month. Surgeries and rehabilitation would have cost him hundreds of thousands of dollars that, as a community college student working part-time as a busboy, he could never have paid — if not for the Blue Cross plan that his mother had bought through the Affordable Care Act. When we spoke a few weeks ago, he told me the insurance has been “irreplaceable” and that losing it “would be totally devastating.”

Meenakshi Bewtra had never had a serious health problem until her first year at the University of Pennsylvania medical school, when she developed severe gastrointestinal problems — the kind that forced her into the hospital for two months and drove her to drop out of school. Her insurance lapsed, which meant that her GI issues became a pre-existing condition. She eventually found coverage and today she’s a professor of medicine at Penn, where she moonlights as an advocate for universal health insurance.

“For the first time, I truly understood what comprehensive health insurance meant,” Bewtra said, remembering what it was like to become fully covered. “I did not have to worry about how many times I saw a doctor, or how many lab tests I had to get, or having to ration out medications.”

Angela Eilers, who lives in Yorba Linda, California, isn’t worrying about her own health. It’s her daughter Myka who has a congenital heart condition called pulmonary stenosis, which makes it more difficult for the heart to pump blood to the lungs. The little girl has required multiple surgeries and will need intensive medical treatment throughout her childhood.

In 2012, Angela’s husband, Todd, was laid off from his job at an investment firm. Since going without insurance was not an option, they took advantage of COBRA to stay on his old company’s health plan. It was expensive, and Eilers recalled panicking over the possibility they might not be able to pay the premiums. “I remember sitting at the table, thinking of plans. What would be our plan? One of them was … giving up our parents rights to my mom, because she has really good health insurance.”

Eventually her husband started his own consulting business, and that gave them the income to keep up with premiums until 2014 — when they were able to obtain coverage through the Affordable Care Act. Today they have a gold plan, one of the most generous available, for which they pay around $20,000 a year. Even though they make too much to qualify for financial assistance, they’re grateful for the coverage. Seven-year-old Myka has already run up more than a half-million dollars in medical bills. In the old days, before Obamacare, they would have worried about hitting their plan’s lifetime limit on benefits. 

The family’s coverage has become..

from DIYS http://ift.tt/2lVz2x4