Tag Archives: Health Policy

66% of Americans are stressed about health insurance costs: 3 things to know

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

https://www.beckershospitalreview.com/payer-issues/66-of-americans-are-stressed-about-health-insurance-costs-3-things-to-know.html

Image result for stress over health insurance

Across all income levels, two-thirds of U.S. adults cite health insurance costs as a stressor, according to a report from the American Psychological Association.

APA’s report, “Stress in America: Uncertainty About Health Care,” examines responses from 3,440 adults who completed an online survey by The Harris Poll from Aug. 2 to Aug. 31, 2017.

Here are three things to know from the report.

1. Sixty-three percent of adults said uncertainty about their future health and the health of others is a stressor.

2. Personal health concerns or health problems affecting family members reflect a “very” or “somewhat” significant source of stress for 60 percent of respondents.

3. On a 10-point scale, where 1 is “little or no stress” and 10 is “a great deal of stress,” uninsured respondents reported average stress levels of 5.6. This is compared to insured adults, who reported average stress levels of 4.7.

After Months In Limbo For Children’s Health Insurance, Huge Relief Over Deal

Posted on by • Posted in Uncategorized • Tagged , , , • Leave a comment

https://www.npr.org/sections/health-shots/2018/01/23/580062690/after-months-in-limbo-for-childrens-health-insurance-huge-relief-over-deal?utm_campaign=KHN:%20First%20Edition&utm_source=hs_email&utm_medium=email&utm_content=60184347&_hsenc=p2ANqtz–pQlDPcJILKr6yp-eSvZFNnb5kBt7mE8ZMX0o6x19FCrM34maHyPdMJLgF5dUWUMK9ub4UDcZis67bQkFv3w-i_lnhbQ&_hsmi=60184347

When parts of the federal government ground to halt this past weekend, Linda Nablo, who oversees the Children’s Health Insurance Program in Virginia, had two letters drafted and ready to go out to the families of 68,000 children insured through the program, depending on what happened.

One said the federal government had failed to extend CHIP after funding expired in September and the stopgap funding had run out. The program would be shutting down and families would lose their insurance.

The other letter said they didn’t need to worry anymore because federal funding had finally come through and the program’s future was assured.

Since Monday’s deal to end the shutdown included a six-year reauthorization of CHIP, enrolled families in Virginia will get that second letter. The program will go on and no children will lose their health insurance.

Taking Stock Of Costs

After months of uncertainty, Nablo said she’s relieved. “Hugely relieved. It’s over and the program is safe, and we can all go back to our normal jobs,” she laughed.

Preparations to shut down the program in Virginia down began over the summer, even before funding expired. Staff spent untold hours getting ready to end the program, retooling enrollment systems, changing contracts and more.

“Those aren’t huge dollar amounts,” Nablo said. “I think the cost more is in the worry from parents.”

CHIP covers children in low-income families — most can’t afford private insurance and their children might have had to go uninsured. Nationally, about 9 million children get health coverage through CHIP.

An Unprecedented Situation

In its 20-year history, CHIP had always been uncontroversial, even popular in both parties. Its funding needs to be periodically renewed, and it always had been taken care of well in advance of the money running out.

CHIP is a match program — states and the federal government split the cost. When states made their budgets for this year, they assumed federal funding for CHIP would be there, so they were blindsided by the funding gap.

Every state’s calculus for how long they could run on leftover money was different. In Texas, Hurricane Harvey threw off that state’s projections. Because of the disaster, it waived fees for CHIP and enrollment spiked, so it had less money coming in and more going out.

A handful of states — including Virginia — sent out letters warning families their coverage was in jeopardy because of the uncertainty in Congress.

“One state — Connecticut — did freeze enrollment between the week of Christmas and New Year’s,” said Joan Alker of the Georgetown University Center For Children and Families, which monitored CHIP funding closelyduring the last few months.

Virginia’s Nablo said there might be other, more subtle, costs from all the uncertainty.

“I can’t quantify it, but I am sure there are states that held off on things like mounting an outreach program to encourage people to enroll because they didn’t know if the program was going to be there for them,” she said. “There may have been states that were thinking of implementing some efficiencies or innovations, but didn’t because — again — is the program going to be there?”

Six Years Of Certainty

Alker is happy with the CHIP deal Congress passed. She does point out it’s the same one they agreed on in September, so she’s not sure why it took a shutdown to finally get it through.

The deal keeps the federal investment in the program at its current level for two fiscal years. After that, the amount that states have to pay for the program will increase.

“At least states now have time to plan for that,” Alker said. “Overall, it really was a fair and reasonable compromise.”

She is puzzled, though, as to why it was only a six-year extension when the Congressional Budget Office estimated extending CHIP for 10 years would save the federal government $6 billion.

“The six-year [extension] is a small saver — it saves just under a billion dollars,” Alker said. “Now there’s nothing preventing Congress from coming back as they move ahead with the bigger budget deal — they could come back and extend CHIP for four more years and grab those savings.”

Impact On Children’s Uninsured Rate

Alker does worry that the months of uncertainty around CHIP may have already caused children to drop out of the program, increasing the uninsured rate among children. That should become clear in the fall, when the Georgetown Center For Children and Families does its annual assessment of the children’s uninsured rate.

If that trend develops nationally, it hasn’t been the case in Virginia, where CHIP enrollment went up this past fall.

“We actually saw a boost in enrollment,” Nablo said. “I can’t really quite explain it.”

Maybe, she said, it was all the attention the unprecedented funding crisis brought to CHIP. A silver lining, perhaps, to many months of anxiety.

 

Health Affairs 2017: Editor’s Picks

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

http://web.healthaffairs.org/acton/rif/17576/s-04f8-1801/-/l-00e1:5b3a/l-00e1/showPreparedMessage?sid=TV2:WbEgD1Dn4

 

For the third year in a row, Alan Weil, Health Affairs Editor-in-Chief, shares his own “Top Ten” favorite articles for 2017. His list of articles, in alphabetical order by first author, covers a broad range of topics. Many of these articles analyze the effects of a specific policy; others raise the profile of issues that deserve more attention. Some articles had unexpected findings. Their shared attribute is that the authors chose to focus on interesting and important questions. To read more details about the findings, please visit Alan’s blog post.

  1. ‘Go Back To California’: When Providers Fail Transgender Patients by Laura Arrowsmith | September 2017

  2. Iowa’s Medicaid Expansion Promoted Healthy Behaviors But Was Challenging To Implement And Attracted Few Participants by Natoshia M. Askelson, Brad Wright, Suzanne Bentler, Elizabeth T. Momany, and Peter Damiano | May 2017

  3. Los Angeles Safety-Net Program eConsult System Was Rapidly Adopted And Decreased Wait Times To See Specialists by Michael L. Barnett, Hal F. Yee, Jr., Ateev Mehrotra, and Paul Giboney | March 2017

  4. Lower-Income Countries That Face The Most Rapid Shift In Noncommunicable Disease Burden Are Also The Least Prepared by Thomas J. Bollyky, Tara Templin, Matthew Cohen, and Joseph L. Dieleman | November 2017
  5. Women In The United States Experience High Rates Of Coverage ‘Churn’ In Months Before And After Childbirth by Jamie R. Daw, Laura A. Hatfield, Katherine Swartz, and Benjamin D. Sommers | April 2017

  6. Impact Of Ambulance Diversion: Black Patients With Acute Myocardial Infarction Had Higher Mortality Than Whites by Renee Y. Hsia, Nandita Sarkar, and Yu-Chu Shen | June 2017

  7. Substantial Physician Turnover And Beneficiary ‘Churn’ In A Large Medicare Pioneer ACO by John Hsu, Christine Vogeli, Mary Price, Richard Brand, Michael E. Chernew, Namita Mohta, Sreekanth K. Chaguturu, Eric Weil, and Timothy G. Ferris | April 2017

  8. Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine by Noa Krawczyk, Caroline E. Picher, Kenneth A. Feder, and Brendan Saloner | December 2017

  9. A National Profile Of End-Of-Life Caregiving In The United Statesby Katherine A. Ornstein, Amy S. Kelley, Evan Bollens-Lund, and Jennifer L. Wolff | July 2017

  10. Market Share Matters: Evidence Of Insurer And Provider Bargaining Over Prices by Eric T. Roberts, Michael E. Chernew, and J. Michael McWilliams | January 2017

Study: Americans using less health care, but paying more for it

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

Study: Americans using less health care, but paying more for it

Study: Americans using less health care, but paying more for it

 

Health-care spending has increased because prices are rising, not because Americans are using more health care, according to a new study released Tuesday.

The report from the Health Care Cost Institute (HCCI) showed that total health-care spending grew by 4.6 percent per person from 2015 to 2016 even as utilization of services remained steady, or declined in some cases.

As a result, health-care spending per person reached a new high of $5,407 in 2016.

“It is time to have a national conversation on the role of price increases in the growth of health care spending,” said Niall Brennan, president of the HCCI.

“Despite the progress made in recent years on value-based care, the reality is that working Americans are using less care but paying more for it every year. Rising prices, especially for prescription drugs, surgery, and emergency department visits, have been primary drivers of faster growth in recent years.”

The study focused on people under the age of 65 with employer-sponsored health insurance.

Spending on brand named prescription drugs grew by 110 percent between 2012 and 2016, but utilization dropped 38 percent.

According to the report, the average price for an emergency room visit went up 31.5 percent between 2012 and 2016, but the number of visits only increased slightly.

The average price for surgical admissions increased by 30 percent between that five-year period, but there was a 16 percent drop in utilization.

 

Under Obamacare, Out-Of-Pocket Costs Dropped But Premiums Rose, Study Finds

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

http://www.wbur.org/commonhealth/2018/01/23/obamacare-household-spending

Isabel Diaz Tinoco (left) and Jose Luis Tinoco speak with Otto Hernandez, an insurance agent from Sunshine Life and Health Advisors, as they shop for insurance under the Affordable Care Act at a store setup in the Mall of Americas on Nov. 1, 2017 in Miami, Fla. The open enrollment period to sign up for a health plan under the Affordable Care Act runs until Dec. 15. (Joe Raedle/Getty Images)

Passing the Affordable Care Act was always much more about extending coverage than cutting costs. Still, as the landmark law faces one challenge after another, new data are giving a better picture of how the law has played out. That includes a new study that looks at how Obamacare affected household medical spending.

The short answer: On average, Obamacare did not affect household medical spending very much — but it definitely did cut costs for poorer people more than it did for people with more money. Here’s our discussion on Radio Boston, edited:

Host Meghna Chakrabarti: So what did this study find?

Carey Goldberg: The study was looking for how Obamacare was affecting our medical spending. As with everything with Obamacare, it’s complicated. But here we go: In a nationally representative sample of over 80,000 adults, overall, in the first couple of years after Obamacare really kicked in — 2014 and ’15 — out-of-pocket payments dropped by an average of $74.

And by out-of-pocket payments, you mean co-pays and payments you have to make because you haven’t hit your deductible yet.

Right, or procedures that aren’t covered. And meanwhile, the insurance premiums that households paid rose by an average of $232. So it’s a funny little coincidental parallel — out-of-pocket payments dropped by 12 percent, but premium payments rose by 12 percent.

But I’d imagine the effects really varied depending on a household’s income level?

They did. The ACA was meant mainly to help households with lower incomes, and it did. The study found that 6.5 percent of the population became newly insured after the ACA kicked in, and overall, the ACA predominantly helped lower-income people.

Here’s Dr. Anna Goldman, from Cambridge Health Alliance and Harvard Medical School, the lead author on the study: ‘The big picture is that the ACA did make real progress by reducing out-of-pocket spending, especially for poor and low-income households. But even in light of this progress, many American households still continue to face burdensome medical costs.’

On those ‘burdensome costs,’ this study also looked at what’s called ‘high-burden spending,’ which is defined as paying more than 5 or 10 percent of your income on out-of-pocket medical expenses. Premiums can be considered ‘high burden,’ too — that cut-off is if you’re paying more than 9.5 percent of your income.

So if I’m earning 20,000 a year, and I’m hit with out of pocket medical expenses of over $,1,000, that would be considered ‘high-burden’ or a premium that runs me close to $ 2,000 a year.

Right. So on these ‘high burden medical expenses, the good news is that out-of-pocket, high-burden spending fell by 20 percent overall — and it especially dropped for poor people. The not-so-good news for better-off folks is that among middle-income households, there was a 28 percent increase in high-burden spending on premiums.

Because premiums have been getting steeper and steeper. Does this study suggest the ACA is to blame?

No. Dr. Goldman says a better way to look at it is that while the ACA did help with out-of-pocket costs, it didn’t stem from the rise in premiums that was already underway.

I have to admit this is a little underwhelming. We have devoted so much attention and so much political wrangling to Obamacare over the last years, and this study is telling us that at least in the first couple of years, and in terms of household costs, it’s been something of a wash.

I feel the same way. What Dr. Goldman, the lead researcher, commented about that is, look, the ACA was the biggest reform of the health care system since 1965, and to get passed it had to involve a lot of political compromise:

‘It was nowhere near as radical as it could have been,’ she said. ‘I think that a single-payer plan, for example, which many Democrats on the more progressive side of the party were advocating for, would have been much more effective in reducing medical spending by all American households, certainly for people in poor and low-income households — no co-payments, no deductibles, no premiums.”

This isn’t news either, but a single-payer system apparently in this country has not been in the realm of the politically possible.

I would think the ACA as it is right now isn’t even within the realm of political possibility at the moment. The individual mandate is already out.

It’s on its way out. Although not here in Massachusetts, we should note. But what this study also tells us is that as the individual mandate and other aspects of the ACA get phased out, it will be largely the poorer people who will mostly lose out.

In the study’s conclusions the authors write that without the individual mandate, the numbers of people without insurance will go back up again, as will out-of-pocket costs, and premiums will likely rise, too, because healthier people won’t be buying insurance.

The final sentence of the paper says that international experience shows that a universal, comprehensive national health insurance program would be the most effective way to reduce household spending on medical expenses and the gaps between rich and poor.

 

Sick and Alone: High-Need, Socially Isolated Adults Have More Problems, but Less Support

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , • Leave a comment

http://www.commonwealthfund.org/publications/blog/2018/jan/sick-and-alone-socially-isolated-adults

Image result for Sick and Alone: High-Need, Socially Isolated Adults Have More Problems, but Less Support

High-need adults — those with two or more chronic medical conditions and physical or cognitive limitations — are more likely to feel socially isolated than those who do not have these health issues, according to a previous Commonwealth Fund analysis.1 The higher rate of isolation among high-need adults is particularly concerning since previous research has shown isolation and loneliness can exacerbate health problems, increase mortality, and cost Medicare more.

To explore how isolation affects high-need adults, we analyzed data from the Commonwealth Fund Survey of High-Need Patients conducted from June to September 2016. We found that high-need adults who are socially isolated (defined as people who report often feeling a lack of companionship, left out, or isolated from others) are more likely to have mental, emotional, and financial issues. They are also less likely to receive timely, good-quality care than high-need adults who do not report feeling alone.

Reviews published in Health Affairs and BMC Public Health of several interventions targeting social isolation have shown that increased access to social supports can improve patient physical and mental health outcomes and lower costs. Providers working with high-need adults should consider the impact of isolation on their patients, and connect those who feel alone to evidence-based support groups or social services.

High-need, isolated adults are more likely to:

  • Have mental health issues. Approximately three of four high-need, socially isolated adults currently have or have previously received a mental health diagnosis or report experiencing emotional distress in the past year.
  • Worry about their condition and being a burden to loved ones. High-need, isolated adults are also more likely to be somewhat or very concerned about being a burden to family or friends (70% versus 52%) and are three times more likely to lack confidence in their ability to manage their health than high-need adults who are not isolated (34% versus 11%).
  • Be financially vulnerable. Forty percent of high-need, isolated adults have incomes below $15,000 a year, and 80 percent worry about having enough money to pay bills or afford nutritious meals. They are also more likely than those who are not isolated to avoid taking medications or filling a prescription because of cost.
  • Experience barriers to health care. High-need patients need good access to quality care to manage their health issues. However, high-need adults who are isolated are more likely to report trouble getting care after hours or on weekends without using the emergency room (65% versus 51%). They also, not surprisingly, were more likely to report using the emergency room two or more times in the past two years (54% versus 42%). This is consistent with research that has shown that social isolation is associated with increased preventable hospitalizations. Additionally, they were significantly more likely than high-need adults who are not isolated to delay care. Finding a way to get to medical appointments appears to be a major barrier: nearly three times as many high-need, isolated adults delayed care because of a lack of transportation.
  • Report poorer quality of care and communication with providers. When high-need, isolated adults do access care, it is often of lower quality. They are significantly less likely than those who do not feel isolated to report that their provider was always or usually well informed about their medical history (76% versus 90%), involved them in decisions (72% versus 88%), or listened carefully to them (76% versus 90%). Only half reported that all three statements were always or usually true (50% versus 66%). This may be a missed opportunity, as patient-centered communication has been shown to reduce costs and improve outcomes for complex patients.

Implications

High-need adults appear to be especially vulnerable to the damaging effects of social isolation. The health care system, which is increasingly focused on improving care for high-need patients who account for nearly half of all health care spending, can play a role in identifying and addressing isolation among their patients.

Providers should assess high-need patients for social isolation, evaluate the impact it has on their health, mental health, and access to health care, and refer them as needed to appropriate supports. Connecting isolated adults to evidence-based, cost-effective programs, such as support groups and social services like transportation assistance, could not only improve outcomes for high-need patients themselves, but also has the potential to lower the cost of care for this population by reducing unnecessary hospitalizations.

 

 

340B Drug Program Sees Massive Changes on the Horizon

Posted on by • Posted in Uncategorized • Tagged , , , , , • Leave a comment

http://www.healthleadersmedia.com/health-plans/340b-drug-program-sees-massive-changes-horizon?spMailingID=12791316&spUserID=MTY3ODg4NTg1MzQ4S0&spJobID=1321984466&spReportId=MTMyMTk4NDQ2NgS2#

Image result for 340b drug pricing program

 

A proposal in the Senate aims to create savings for health providers while a new report details how to maximize the program’s pharmacy benefits.  

The 340B Drug Pricing Program represents ample healthcare and business opportunities to some, while others see it as a federal program in need of significant reforms to address outstanding cost concerns.

The program, which provides Medicare payments for outpatient drugs to hospitals serving high volumes of low-income patients, has garnered both praise and controversy in recent months. The program is viewed as crucial for rural hospitals attending to high Medicare populations, but also as a lightning rod for perceived governmental mismanagement.

Sage Growth Partners, a healthcare business consultant agency based in Baltimore, released a report Thursday titled, “Realizing the Full Power of 340B Pharmacy Benefits.” The report includes three distinct 340B models health systems can implement: do-it-yourself, contract pharmacy, or global managed services.

Dan D’Orazio, CEO of Sage Growth Partners, said while contract pharmacy models have been the most popular approach, businesses have to assess their own expectations and needs when getting involved with the 340B program.

“This report takes a look at how you decide to manage or operate one of these entities and whether you go it alone, find a commercial partner like a pharmacy or find a managed partner to help you do that,” D’Orazio told HealthLeaders Media. “There are different models to do that and I think they have different ramifications for profitability, patient care, coordination of care, and medication adherence.”

D’Orazio said recent reports have indicated the 340B program is “a little out of control” but said the public should not be scared, adding the program represents a “real opportunity” for health systems dealing with financial pressures. He also said the program’s rules are clear, though hospitals may need to engage with managed partners for experience and assistance with any lingering complexities.

Ire, attention center on 340B

Despite the enthusiasm to maximize 340B benefits, the program has sustained pointed criticism in recent months.

A recent Pacific Research Institute study found numerous cases of abuse and profiteering, ultimately urging Congress to reform the program. A report from the Department of Health and Human Services’ Office of Inspector General last month highlighted $4.4 billion in federal funds misspent on health care programs last year, including 340B.

Those interested in implementing the strategies detailed in the Sage Growth Partners’ report will have to account for legislative corrections, which could be on the way.

Sen. Bill Cassidy, R-La., introduced the HELP Act on Tuesday, which would create a moratorium on registering “new non-rural section 340B hospitals and associated sites.” In a press release, Cassidy stated his support for 340B while highlighting the need for improvement after documented instances of wasteful spending.

“But too often the program’s discounts are used to pad hospitals’ bottom lines instead of helping disadvantaged patients afford their treatments,” Cassidy said. “This bill will increase transparency and accountability and help ensure these discounts reach patients.”

The group 340B Health, which represents hospitals and health systems, issued a statement responding to Cassidy’s legislative proposal.

“We agree the 340B program is an important resource for hospitals and their patients, and support having a thoughtful conversation about transparency in the 340B program,” the statement read. “However, we are concerned by the proposals included in the HELP Act.

“If enacted, these changes would limit the ability of 340B hospitals to fulfill their mission to care for all Americans regardless of their ability to pay. The legislation would make changes to the rules on which hospitals can participate in 340B, which could reduce the number of hospitals that could qualify for the drug discounts. It would also impose significant new reporting requirements that would not shed any light on what hospitals do with their 340B savings to help patients.”

So far, the bill has not even advanced to a committee vote.

Senate overwhelmingly agrees to short-term spending bill, ends government shutdown

Posted on by • Posted in Uncategorized • Tagged , , , , , , , • Leave a comment

https://www.fiercehealthcare.com/healthcare/senate-agrees-to-short-term-spending-bill-ends-government-shutdown?mkt_tok=eyJpIjoiWVdJd1pqQXdOekF3WkRSayIsInQiOiJ4UFpvSldiZ2oyelBmS1VNVEZFSFwvS2M1Ujh4cUZyWVl0WjBHeENYMXZLVzIrWXhac3dock56YVk0U291OGJaSk1EZStpVmtRZTh3Q005ZjExeGV1RFBxQk9mK2NNQ1F4dHVrOVRwS2Jtbk9SZVFTV2IxV01kejlzOHg3Wk52UVwvIn0%3D&mrkid=959610

hhs

The Senate agreed to a short-term spending bill Monday that effectively ended the government shutdown.

The 81-18 vote to approve the spending bill came after Majority Leader Sen. Mitch McConnell, R-Ky., promised Sunday to take up debate on immigration issues if the Senate hadn’t reached agreement on Deferred Action for Childhood Arrivals (DACA), which provides protections for young immigrants brought to the country by their parents without proper documentation.

The vote puts an end to the government shutdown, three days after it began at midnight Saturday when the Senate fell 10 votes short the 60 votes needed to approve a House-passed spending bill. However, the spending bill passed by the Senate is for three weeks, not the four that the House approved.

The failure to reach an earlier agreement on a spending bill that eventually led to the shutdown set a precedent as the Republican party controls the House, Senate and presidency. The White House said Saturday it would refuse to negotiate on immigration until funding was restored.

The shutdown temporarily put more than 40,000 employees who work for the Department of Health and Human Services and its related agencies and offices on furlough Monday morning. Under the HHS contingency plan the furloughs would:

  • limit disease surveillance by the Centers for Disease Control and Prevention,
  • stop work by the Office of the National Coordinator for Health Information Technology on standards coordination, and
  • halt implementation and testing required under the Health Information Technology for Economic and Clinical Health and 21st Century Cures (Cures) acts by the Office of the National Coordinator for Health Information Technology.

 

Senate votes to reopen government, averts major setback to health agencies

Posted on by • Posted in Uncategorized • Tagged , , , , , , , , , , , • Leave a comment

http://www.healthcarefinancenews.com/news/government-reopens-averts-major-setback-health-agencies?mkt_tok=eyJpIjoiTldRek16STVORGd5WXpnMiIsInQiOiJ4XC9LYmRhVVpueHBOS2o1OWhxMWsyd0xPbVREQ0F6R2ZoK05rVGl3VWZIbWNlOFNORVwvU1dkbkFvakJRUU15UUJMYnBtdzQ0MDFvcHBiZ0FneTF1UFdSSGRLdVRZMTNFcUl2SmhcL0paaEVidlVrTmdjemp3R3BycDJtamp2VjlaWSJ9

Debate on the Senate floor on Jan. 22. Credit: C-span

Here’s a look at HHS, ONC and CDC plans during a government shutdown.

The Senate voted on Monday to approve a temporary funding measure that keeps the government running through Feb. 8.

The vote came after the government had been shut down for two days with the U.S. Department of Health and Human Services contingency plans already kicking in as of Monday morning when about 50 percent of its staff stayed home on furlough.

The Office of the National Coordinator for Health Information Technology is not operating. However, the NIH is continuing care for current NIH Clinical Center patients.

A contingency staffing plan is keeping other operations going, including Medicare and Medicaid payments, though an extended shutdown could result in delays in claims processing, audits, and other administrative functions.

In the short term, the Medicare program will continue largely without disruption during a lapse in appropriations, according to HHS.

States will have sufficient funding for Medicaid through the second quarter.

The Centers for Medicare and Medicaid Services will maintain the staff necessary to make payments to eligible states from remaining Children’s Health Insurance Program (CHIP) carryover balances.

CMS is continuing key federal exchange activities, such as open enrollment verification.

Other ongoing HHS activities include substance abuse and mental health services for treatment referral and the suicide prevention lifeline.

The Administration for Children and Families and Temporary Assistance for Needy Families (TANF), along with child support and foster care services continues.

The Centers for Disease Control and Prevention is maintaining its 24/7 emergency operations center.

The CDC will continue to track the data on the flu, which has been virulent this season.

Gloves Off, Fists Up: Nurses Storm Capitol To Renew Single-Payer Fight

Posted on by • Posted in Uncategorized • Tagged , , • Leave a comment

Gloves Off, Fists Up: Nurses Storm Capitol To Renew Single-Payer Fight

The nurses are back with their gloves off — and not the disposable medical kind.

Despite a legislative setback last year — dealt by one of the state’s top Democrats, of all people — the powerful California Nurses Association stormed the state Capitol Wednesday to resume their campaign for single payer health care.

A few hundred of the union’s members and supporters, dressed in cherry-red sweatshirts and hats, crowded the north steps of the Capitol on Wednesday morning, pumping their fists and chanting “Everybody in! Nobody out!”

Hours before a marathon hearing on the issue began, they toted around mass-produced signs and bopped to an Afro-Latin-hip-hop band, all in support of a single-payer bill that Assembly Speaker Anthony Rendon described last year as “woefully incomplete.”

“The only thing that’s incomplete is the leadership,” declared Bonnie Castillo, a former critical-care nurse who is the union’s associate executive director.

Castillo, the first speaker, set a defiant tone for the raucous event, which took place just before an informational hearing on the bill that would replace private insurance with one government-administered or “single-payer” health care system in California.

A couple of hundred people chant in support of the single-payer bill, SB 562, sporting red and signs during a rally outside the state Capitol on Wednesday. (Ana B. Ibarra/California Healthline).

Bonnie Castillo, a registered nurse and associate executive director for the California Nurses Association, tells the crowd “the only thing that’s incomplete is the leadership,” while addressing concerns about single-payer bill SB 562 during a rally outside the Capitol. (Ana B. Ibarra/California Healthline)

The union has been the most ardent supporter of single-payer in the state. The nurses say the health care system they work for now leaves some people who can’t afford to pay sick, struggling and in debt.

They stand in stark contrast to others in the medical field, who have banded together to form a coalition opposing the single-payer bill, SB 562. The bill “would dismantle the health care marketplace and destabilize the state’s economy,” the group of physicians, dentists, nurse practitioners, community clinics and others said in a press release.

Rendon yanked the bill from further consideration last June, saying it did not address serious issues such as financing and cost controls.

In that instant, Rendon became the union’s No. 1 enemy. At the time, the union’s executive director, RoseAnn DeMoro, tweeted a picture of the iconic California grizzly bear being stabbed in the back with a knife emblazoned with Rendon’s name. Rendon said he was besieged by death threats.

 

During the hour-long rally under overcast skies and a foggy drizzle, the mere mention of his name elicited boos.

“We have the tenacity, the determination and the will to continue. We’re not stopping until we get this passed,” Catherine Kennedy, an intensive-care nurse in Sacramento and secretary for the organization, told a California Healthline reporter.

Catherine Kennedy, a registered nurse and secretary for the California Nurses Association, says the group has the tenacity and will to put up a fight for single-payer legislation. (Ana B. Ibarra/California Healthline)

The union says it has 100,000 members. The fact that most are women makes it much stronger, Kennedy said, especially at a time when women are feeling more empowered.

“Time’s up on that!” some yelled in front of the Capitol, echoing the #TimesUp movement that has gained momentum as women nationwide speak out about sexual harassment and other gender-related discrimination.

“Nurses are a female dominated profession. We will not be dismissed. We will not be ridiculed. We will not be put in our place,” Castillo tweeted shortly after she spoke.

Earlier this month, Rendon told reporters that the bill’s sponsors had not responded to his concerns — including how to pay for a single-payer system. “Absolutely nothing has happened with the bill,” he said. “The sponsors of the bill have sat on their hands and done nothing for the past six months.”

That comment is “insulting and disrespectful to all these people who have been knocking on doors … and participating in every committee hearing,” Castillo said after the rally.

Castillo added that the union commissioned an economic analysis of the proposal that was never robustly discussed in the legislature.

Inside the committee room, the hearing, which started at 1 p.m., stretched into the evening as nurses dominated the public comment period. Throughout the testimony, they scoffed and mock-coughed at comments they disagreed with.

They promised to be back with more noise, more rallies and more pressure until single-payer makes it through the legislature.

“The intent is to get us to shut up,” Castillo said, “but that’s not going to happen here.”