Fewer Americans Without Health Plans Since Obamacare Debut

https://www.bloomberg.com/news/articles/2018-08-29/fewer-americans-without-health-insurance-since-obamacare-debut

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Fewer Americans lack health insurance — but the gap remains wide, especially in some pro-Trump states.

The number of uninsured declined to 28.3 million in the first quarter, down from 29.3 last year — and 48.6 million in 2010, the year the Affordable Care Act was signed into law by then-President Barack Obama, according to data from the federal Centers for Disease Control and Prevention.

The distribution, however, is uneven with data for south central states — Arkansas, Louisiana, Oklahoma and Texas — showing almost a quarter of adults lacking health care coverage. President Donald Trump, who has opposed Obamacare, won those four states in the 2016 presidential election.

The CDC data also show:

  • Even with the reduction, one in eight Americans between 18 to 64 remained uninsured.
  • Of those with insurance, about one in five were covered by public plans and seven in ten were covered by private plans. Children fared better, with more than 95 percent covered by public or private plans.
  • About one in four Hispanics lacked coverage while 14.1 percent of non-Hispanic blacks, 8.9 percent of non-Hispanic whites and 6.1 percent of non-Hispanic Asians lacked coverage.
  • The number of people under age 65 covered under the Health Insurance Marketplace declined by about 1 million to 9.7 million.
  • The number of adults who lacked health insurance for more than one year declined from 32 million in 2010 to 14.9 million in the first quarter of this year.

 

 

 

 

The uninsured rate remains plateaued

https://www.cdc.gov/nchs/data/nhis/earlyrelease/Insur201808.pdf?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosvitals&stream=top-stories

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The Centers for Disease Control and Prevention is out with its latest health insurance coverage data this morning, and the nation’s uninsured rate isn’t really changing a whole lot.

By the numbers: As of March 2018, 8.8% of all Americans, or about 28.3 million people, had no health insurance.

  • Those numbers are almost identical to the CDC’s 2017 report, when 28.1 million people were uninsured as of March 2017.
  • It’s also worth noting that 47% of people younger than 65 are in a high-deductible plan, up from 42.3% recorded at the same point last year.

The big picture: The federal and state exchanges established by the ACA are treading water when it comes to enrollment, and no new states have expanded Medicaid. (Notably, Maine Gov. Paul LePage is still resisting his state’s voter-approved Medicaid expansion.)

The bottom line: Don’t expect the uninsured rate to fluctuate a lot until more states expand Medicaid or the ACA exchanges get more federal support.

Looking ahead: The U.S. Census Bureau will unveil its 2017 health insurance numbers on Sept. 12.

 

 

Suicide rates rise sharply across the United States, new report shows

https://www.washingtonpost.com/news/to-your-health/wp/2018/06/07/u-s-suicide-rates-rise-sharply-across-the-country-new-report-shows/?noredirect=on&utm_term=.2e83fb652ffe

 

Suicide rates rose in all but one state between 1999 and 2016, with increases seen across age, gender, race and ethnicity, according to a report released Thursday by the Centers for Disease Control and Prevention. In more than half of all deaths in 27 states, the people had no known mental health condition when they ended their lives.

In North Dakota, the rate jumped more than 57 percent. In the most recent period studied (2014 to 2016), the rate was highest in Montana, at 29.2 per 100,000 residents, compared with the national average of 13.4 per 100,000.

Only Nevada recorded a decline — of 1 percent — for the overall period, although its rate remained higher than the national average.

Increasingly, suicide is being viewed not only as a mental health problem but a public health one. Nearly 45,000 suicides occurred in the United States in 2016 — more than twice the number of homicides — making it the 10th-leading cause of death. Among people ages 15 to 34, suicide is the second-leading cause of death.

The most common method used across all groups was firearms.

“The data are disturbing,” said Anne Schuchat, the CDC’s principal deputy director. “The widespread nature of the increase, in every state but one, really suggests that this is a national problem hitting most communities.”

It is hitting many places especially hard. In half of the states, suicide among people age 10 and older increased more than 30 percent.Percent change in annual suicide rate* by state, from 1999-2001 to 2014-2016 (Centers for Disease Control and Prevention)

“At what point is it a crisis?” asked Nadine Kaslow, a past president of the American Psychological Association. “Suicide is a public health crisis when you look at the numbers, and they keep going up. It’s up everywhere. And we know that the rates are actually higher than what’s reported. But homicides still get more attention.”

One factor in the rising rate, say mental health professionals as well as economists, sociologists and epidemiologists, is the Great Recession that hit 10 years ago. A 2017 study in the journal Social Science and Medicine showed evidence that a rise in the foreclosure rate during that concussive downturn was associated with an overall, though marginal, increase in suicide rates. The increase was higher for white males than any other race or gender group, however.

“Research for many years and across social and health science fields has demonstrated a strong relationship between economic downturns and an increase in deaths due to suicide,” Sarah Burgard an associate professor of sociology at the University of Michigan, explained in an email on Thursday.

The dramatic rise in opioid addiction also can’t be overlooked, experts say, though untangling accidental from intentional deaths by overdose can be difficult. The CDC has calculated that suicides from opioid overdoses nearly doubled between 1999 and 2014, and data from a 2014 national survey showed that individuals addicted to prescription opioids had a 40 percent to 60 percent higher risk of suicidal ideation. Habitual users of opioids were twice as likely to attempt suicide as people who did not use them.

High suicide numbers in the United States are not a new phenomenon. In 1999, then-Surgeon General David Satcher issued a report on the state of mental health in the country and called suicide “a significant public health problem.” The latest data at that time showed about 30,000 suicides a year.

Kaslow is particularly concerned about what has emerged with suicide among women. The report’s findings came just two days after 55-year-old fashion designer Kate Spade took her own life in New York — action her husband attributed to the severe depression she had been battling.

“Historically, men had higher death rates than women,” Kaslow noted. “That’s equalizing not because men are [committing suicide] less but women are doing it more. That is very, very troublesome.”

National Institute of Mental Health director Joshua A. Gordon explains some of the latest research surrounding suicide rates in the U.S. 

Among the stark numbers in the CDC report was the one signaling a high number of suicides among people with no diagnosed  mental health condition. In the 27 states that use the National Violent Death Reporting System, 54 percent of suicides fell into this category.

But Joshua Gordon, director of the National Institute of Mental Health, said that statistic must be viewed in context.

“When you do a psychological autopsy and go and look carefully at medical records and talk to family members of the victims,” he said, “90 percent will have evidence of a mental health condition.” That indicates a large portion weren’t diagnosed, “which suggests to me that they’re not getting the help they need,” he said.

Cultural attitudes may play a part. Those without a known mental health condition, according to the report, were more likely to be male and belong to a racial or ethnic minority.

“The data supports what we know about that notion,” Gordon said. “Men and Hispanics especially are less likely to seek help.”

The problems most frequently associated with suicide, according to the study, are strained relationships; life stressors, often involving work or finances; substance use problems; physical health conditions; and recent or impending crises. The most important takeaway, mental health professionals say, is that suicide is an issue not only for the mentally ill but for anyone struggling with serious lifestyle problems.

“I think this gets back to what do we need to be teaching people — how to manage breakups, job stresses,” said Christine Moutier, medical director of the American Foundation for Suicide Prevention. “What are we doing as a nation to help people to manage these things? Because anybody can experience those stresses. Anybody.”People without known mental health conditions were more likely to be male and to die by firearm. (CDC)

The rates of suicide for all states and the District of Columbia were calculated using data from the National Vital Statistics System. Information about contributing circumstances for those who died by suicide was obtained via the National Violent Death Reporting System, which is relatively new and in place in only 27 states.

“If you think of [suicide] as other leading causes of death, like AIDS and cancer, with the public health approach, mortality rates decline,” Moutier said. “We know that same approach can work with suicide.”

 

 

‘What The Health?’ Campaign Promises Kept, Plus ‘Nerd Reports’

Podcast: KHN’s ‘What The Health?’ Campaign Promises Kept, Plus ‘Nerd Reports’

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President Donald Trump managed to fulfill — at least in part — two separate campaign promises this week.

To the delight of anti-abortion groups, the administration issued proposed rules that would make it difficult if not impossible for Planned Parenthood to continue to participate in Title X, the federal family-planning program. And Congress cleared for Trump’s signature a “right-to-try” bill aimed at making it easier for patients with terminal illnesses to obtain experimental medications.

Also this week, the National Center for Health Statistics and the Congressional Budget Office issued reports about Americans both with and without health insurance and the cost of subsidizing health insurance to the federal government.

And May’s “Bill of the Month” installment features some very expensive orthopedic screws.

This week’s panelists for KHN’s “What the Health?” are Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Sarah Kliff of Politico and Alice Ollstein of Talking Points Memo.

Among the takeaways from this week’s podcast:

  • The Trump administration’s proposed rule to cut Title X reproductive health funding for groups that perform abortions was designed to meet demands from the president’s religious supporters, but it could backfire by mobilizing liberal voters.
  • The changes being considered might also open the door for some religious-based groups that don’t support abortion — or perhaps even contraception — to get federal Title X funding.
  • Conservatives’ campaign to get a “right-to-try” bill through Congress has been driven in large part by individual patient stories.
  • New data released by the Centers for Disease Control and Prevention this week shows the uninsured rate did not grow in 2017, despite a number of changes that the Trump administration made to the marketplace and federal promotion of it.

Plus, for “extra credit,” the panelists recommend their favorite health stories of the week they think you should read, too.

 

Despite Attacks on Obamacare, the Uninsured Rate Held Steady Last Year

The Uninsured Rate Held Steady

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The numbers suggest a surprising resilience of the health law.

Last year, Trump administration officials declared Obamacare “dead,” pulled enrollment ads offline, distributed social media videos critical of the law and sent signals that the law’s requirement to buy health insurance was no longer in effect.

But the number of Americans with health insurance stayed largely unchanged. The results of a big, government survey on health insurance status were published Tuesday, and they show that the uninsured rate remained basically flat at 9.1 percent in the first year of the Trump presidency.

The numbers suggest a surprising resilience of the health law, and its expansion of insurance coverage, even in the face of efforts that the law’s defenders call “sabotage.”

The new statistics come from the Centers for Disease Control and Prevention, which monitors the number of Americans with and without health insurance every quarter. Some smaller private surveys, from Gallup and the Commonwealth Fund had shown the uninsured rate rising last year. But the C.D.C. research includes a larger sample size, and is generally regarded as a more definitive study. Tuesday’s study contains data from the entire calendar year of 2017.

Among states that expanded their Medicaid programs under the Affordable Care Act, the uninsured rate actually fell last year. Among states that didn’t expand, it rose a little.

Overall, Obamacare has substantially reduced the number of Americans without insurance. According to the report, 19.3 million fewer people were living without health insurance in 2017 compared with 2010, when the Affordable Care Act passed Congress.

New health insurance options aren’t the only thing that has changed since the passage of the Affordable Care Act. A strengthening economy has nudged more Americans into the work force, increasing people’s access to health insurance at work.

Obamacare has shown other signs of hardiness. This year, the Trump administration slashed the program’s advertising budget by 90 percent, and withdrew key subsidies from insurance companies, leading to premium increases for some customers. But every market had at least one insurer that continued to offer plans on the Obamacare marketplaces, and sign-ups dipped only slightly.

That does not mean that the insurance trends will hold forever. There are several reasons the uninsured rate may rise in the future:

  • In the face of rising premiums, it is likely that some who do not qualify for federal subsidies have dropped coverage this year.

  • Several states are trying to set up work or other “community engagement” requirements for some Medicaid beneficiaries. A few will impose such rules this year. States requesting such changes estimate they will result in a declining number of residents covered by Medicaid.

  • The Trump administration is working on regulations to allow more loosely regulated insurance plans into the market. These plans could prove appealing to some people who are currently uninsured. But they could cause prices to rise for insurance plans with all of the Obamacare consumer protections, prompting other people to drop their coverage. According to an estimate from the Urban Institute, about 2.6 million fewer people may have comprehensive coverage next year.

  • The tax penalty for people who decline to obtain insurance will disappear entirely next year. That change alone is likely to cause several million fewer Americans to have insurance. Early filings by insurance carriers suggest the change will cause another round of big price increases. And economists at the Congressional Budget Office estimate that the policy’s disappearance will also cause fewer people eligible for government help from even investigating such options.

The combination of those changes is likely to mean some backsliding. But last year’s data suggest that Obamacare’s policies have helped create options that are appealing to many Americans who would have gone without insurance in the years before its passage.

 

 

 

 

Medical Research, Drug Treatment And Mental Health Are Winners In New Budget Bill

https://www.npr.org/sections/health-shots/2018/03/22/596116779/medical-research-drug-treatment-and-mental-health-are-winners-in-new-budget-bill?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202018-03-23%20Healthcare%20Dive%20%5Bissue:14589%5D&utm_term=Healthcare%20Dive

Sen. Susan Collins, R-Maine (center), is joined on Wednesday by Sen. Lindsey Graham (from left), R-S.C., Sen. Lisa Murkowski, R-Alaska, and Rep. Greg Walden, R-Ore. Collins was pushing for provisions in the budget bill aimed at lowering premiums for people purchasing health insurance in the Affordable Care Act’s marketplaces. That didn’t happen.

 

The big budget deal reached this week in the House doesn’t include a long-sought-after provision to stabilize the Affordable Care Act marketplaces. But the $1.3 billion plan, set to fund the government through September, has lots of new money for medical research, addiction treatment and mental health care.

Here’s the rundown of what’s included in the 2,232-page spending bill, now in the hands of a Senate vote, based on summaries released by the House and Senate appropriations committees.

  • $78 billion in overall funding for the Department of Health and Human Services, a $10 billion increase
  • $3.6 billion to fight the opioid addiction crisis
    • This more than doubles the money allocated in fiscal 2017 and boosts funding for treatment and prevention, as well as helping to find alternatives for people suffering from pain.
  • $3.2 billion for mental health care
    • This is a 17 percent boost from last year and goes to treatment, prevention and research.
  • $37 billion for the National Institutes of Health
    • This is a $3 billion increase over fiscal 2017 and boosts spending on research into Alzheimer’s disease and a universal flu vaccine, among other things.

Lawmakers could not agree on language designed to stabilize the Affordable Care Act insurance markets and lower insurance premiums that Sens. Lamar Alexander, R-Tenn., and Susan Collins, R-Maine, have been fighting for since last fall. That bill would have reinstated the cost-sharing reduction payments, by which the government reimburses insurance companies that give the lowest-income customers a break on their copayments and deductibles.

Last year President Trump announced that the government would stop making the payments, a decision that drove the unsubsidized premiums on insurance policies higher.

Alexander says his proposal would restore those payments and cut premiums as much as 40 percent.

“Nothing is more important to Americans than health care, and nothing is more frightening than the prospect of not being able to afford health insurance, which is the case for a growing number of Americans,” he said at a news conference Wednesday.

But Democrats refused to support the provision because it also included language that would have barred any insurance policy sold on the ACA marketplaces from covering abortion.

 

 

 

Orthopedic Urgent Care Franchising is THE Opportunity of 2018

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Healthcare Executives, Physicians, and Healthpreneurs dealing with hospital spending cuts, reduced insurance reimbursements, and reduced market share are looking for solutions to earnings loss which is giving rise to the innovations in specialized focused urgent care.

The economic pressures coupled with the need for lifestyle balance cause many in the healthcare industry to look for alternatives and franchising is leading this nationwide healthcare overhaul.

With approximately 9,000 urgent care centers in the United States offering generalized care, OrthoNOW is the only franchised care center of its kind in the United States — a unique position to gain market share in this highly fragmented industry.

OrthoNOW’s focus is on sports medicine and the treatment and prevention of the full range of orthopedic injuries, all on a walk-in basis. Services include treatment of injuries to the hand, wrist, foot, ankle, knee, spine and shoulder, as well as preventative consultation and regimens by experts in orthopedics.

Strong interest in the brand is being fueled by CDC estimates that injuries have a $671 billion annual impact on the U.S. economy — orthopedic medicine contributes $48 billion to the GDP and urgent care centers produce an additional $30 billion in revenue. Further, 160 million patients seek out urgent care each year; 48 million of those patients will require orthopedic care who, without access to, are referred to the local emergency room only to be redirected to a specialist following a long and expensive visit.

“OrthoNOW offers an innovative turn-key solution with a comprehensive support system built in. Our corporate staff consists of veteran business, medical and franchise professionals who work closely with our franchisees and provide ongoing support. Thus, our operations are efficient and effective,” says Christine Dura, Chief Development Officer. “We have more than 1,000 territories available, and we are aggressively targeting proven multi-unit operators and Regional Developers who understand the power of scalability.”

Have you ever wondered how owning a proven franchise model in healthcare could change your financial future? OrthoNOW’s power-packed 30 minute webinar is the place to start. Get expert answers to your most pressing questions. Some will watch and miss the opportunity. Some may even try a solution on their own. Regardless, their proven model leads the charge in delivering the healthcare solutions many Americans need NOW.

Answer the call of millions of Americans in need of expert and affordable healthcare. Join OrthoNOW’s webinar on February 28, 2018, which covers the four big questions in franchising:

  • Am I the right fit?
  • What is my investment?
  • How much money can I make?
  • Why OrthoNOW?