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29 апреля, 01:26

Paying Money You Owe Isn't A 'Bailout,' Mr. President

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); Merriam-Webster defines the word “bailout” as “a rescue from financial distress.” The concept is pretty simple: Someone does something that results in a bad outcome, and someone else helps them out of the jam. The word itself refers to bailing water out of a leaky boat, so the metaphor fits. In the midst of the financial crisis that happened in the last decade, President George W. Bush and Congress bailed out the giant banks that caused the problem, concluding that this distasteful action was better than the alternative, which could have been a worldwide collapse of the financial system and a depression that would’ve made the Great Recession look like a boom time. President Barack Obama bailed out the auto industry. And President George H.W. Bush bailed out failing savings and loan institutions back in the 1980s. People don’t like these government bailouts. They really, really don’t like them. The idea that a business made decisions so bad that the only way to prevent a catastrophe is for taxpayers to fix it doesn’t sit right with Americans. That’s why “bailout” is a go-to insult politicians like to use to to describe things they don’t like. This pejorative has been especially popular with Republicans in recent years. Take President Donald Trump, seen here using the term to describe a part of the Affordable Care Act.  Democrats are trying to bail out insurance companies from disastrous #ObamaCare, and Puerto Rico with your tax dollars. Sad!— Donald J. Trump (@realDonaldTrump) April 26, 2017 The Democrats want to shut government if we don't bail out Puerto Rico and give billions to their insurance companies for OCare failure. NO!— Donald J. Trump (@realDonaldTrump) April 27, 2017 Democrats jeopardizing the safety of our troops to bail out their donors from insurance companies. It is time to put #AmericaFirst — Donald J. Trump (@realDonaldTrump) April 27, 2017 Trump and members of his administration, along with a few GOP lawmakers, recently have started talking like this. It’s nonsense. So what’s Trump referring to here? It’s a once-obscure, difficult-to-explain element of the Affordable Care Act called cost-sharing reductions. Right now, it’s about the most fraught subject in health policy. Trump is threatening to cut off the money that makes cost-sharing reductions work, which would deal instant damage to the Affordable Care Act’s health insurance system and the people who rely on it. This threat might sound familiar to anyone who has followed Trump’s lengthy history of not paying his business partners. Remember Merriam-Webster: A bailout is an action taken after something bad has occurred to help the party that did the bad thing, or at least is suffering from that bad thing. What a bailout isn’t is when someone pays a bill for services rendered, or when the federal government carries out a program as written. (This isn’t the first time Republicans have called an existing part of the regular structure of Obamacare a “bailout.” It wasn’t true before, either.) As most people know, the Affordable Care Act offers tax credits to low- and middle-income households that reduce the monthly premiums for health insurance policies purchased via the law’s exchange marketplaces. But the lowest-income enrollees are eligible for a second kind of financial assistance ― those cost-sharing reductions, sometimes called CSRs. Here’s how they work: A person goes to the exchange and shops for coverage. If their income is low enough — up to 2.5 times the federal poverty level, which is $30,015 a year — their plans will come with lower deductibles and copayments. It’s a huge benefit for these enrollees who can, for example, take a deductible in the thousands of dollars and shrink it to just hundreds. More than 7 million people ― 58 percent of Obamacare enrollees ― received these subsidies this year. Health insurance companies are required by the law to reduce these out-of-pocket costs and to pay the difference to the hospitals, doctors and other medical providers who treat their customers. Then the federal government pays the insurers back. That last part is what Trump controls. No matter what he does, the insurers must lower these costs for their policyholders. But if Trump refuses to pay the companies back, some states would allow them to cancel their customers’ policies and leave the market altogether this year. And the companies that do continue to sell insurance through the exchanges would dramatically hike premiums next year to make up for the lost money. The White House went so far as saying they’d halt the payments next month, but backed down Wednesday. Paying this money is not a “bailout.” These health insurance companies didn’t screw up and come to Uncle Sam with their hands out. They entered into contracts with the government to sell certain kinds of health insurance under a certain set of rules, and one of those rules is they’d get the money they’re owed. Acting in bad faith with a business partner is part of Trump’s modus operandi, but it doesn’t really fly when it’s the federal government doing the reneging. That’s a big reason why a slew of health care and business groups are urging Trump and Congress to stop messing around and pay the money. Here’s a partial list of the organizations making this plea: the American Medical Association; the American Hospital Association; the Federation of American Hospitals; America’s Health Insurance Plans; the Blue Cross and Blue Shield Association; the American Benefits Council (a group of large businesses); and the U.S. Chamber of Commerce. The nation’s governors are worried, too. The National Governors Association — which represents all 50 governors from both political parties — asked Congress to fix this. It’s not often that every single governor agrees about something, and this is one of those times. The power to blow up the health insurance market is in Trump’s hands because of a lawsuit House Republicans filed against the Obama administration in 2014. Lawmakers argued that Obama was making these cost-sharing reduction payments to insurers in violation of the law, because Congress authorized them, but didn’t approve the specific spending. A federal court ruled in favor of House Republicans last year, but allowed the Obama administration to continue making the payments while the case worked its way through appeals. When Trump became president, his administration became the defendant in the case, and along with House Republicans, asked the appeals court to delay proceedings on the lawsuit while the two parties figure out what to do. In the meantime, the money keeps flowing to the insurance companies — but no one knows for how long, because Trump keeps saying he might cut them off. The result, as Molina Healthcare CEO Mario Molina explained to HuffPost this week, would be millions more uninsured, fewer choices for consumers because some insurers would refuse to sell plans under these circumstances, and much higher premiums for the insurance that remained. Put all that together, and it’s the American people who are going to need a bailout. Politics hurt too much? Sign up for HuffPost Hill, a humorous evening roundup featuring scoops from HuffPost’s reporting team and juicy miscellanea from around the web. -- 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.

27 апреля, 21:30

An Insurance CEO Explains The Dangerous Game Trump Is Playing With Obamacare

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); President Donald Trump has been threatening to stop making payments to health insurance companies that cover low-income people under Obamacare. Doing so would seriously jeopardize the entire insurance market in ways that could be felt immediately by poor households and the insurers that provide their health benefits. Although the Trump administration said on Wednesday it wouldn’t cut off these funds ― called cost-sharing reduction payments or CSRs ― immediately, the president still sees them as a cudgel to use against Democrats in Congress. Trump believes the public will blame the party that created Obamacare if he seriously damages the health insurance system, rather than him and his Republican Party. It’s an enormously complex policy and business issue with the potential for devastating consequences. The problem dates back three years to a lawsuit House Republicans filed against President Barack Obama’s administration, challenging the legality of the way the federal government paid insurers with low-income customers. Last year, Obama lost that lawsuit and appealed, and the funding remains in jeopardy because Congress hasn’t authorized the spending in the meantime. More than 7 million people ― 58 percent of Obamacare enrollees ― received these subsidies this year. To help readers better understand what this all means and why it matters, HuffPost interviewed Mario Molina, a physician and the CEO of Molina Healthcare, an insurance company that has more than 1 million customers in nine states with policies from the Affordable Care Act’s exchanges. The following is a transcript of that conversation. This stuff is complicated. Can you to explain to a layperson what these cost-sharing reduction payments are and why they’re important? Molina: The cost-sharing reductions are payments that are made to health plans to help cover copays and deductibles for low-income patients who get their health insurance through the exchange. And the way it works is that, let’s say you have a $50 copay. Depending on your income, it may be reduced to $15 with the health plan picking up the balance, which then gets paid to the doctor or the provider that you’re seeing. The plan is paid by the government, and then any money that is not used for copays and deductibles we must then return. So it’s really not a premium payment so much as it is a reimbursement for subsidies that reduce the out-of-pocket costs to the insured individual. Why are we talking about this? What’s the problem right now? Why is there a question about whether these payments are going to be made? The first issue is that many people with low-to-moderate incomes rely on these to help make their insurance more affordable. One of the things that Americans have complained about is the high cost of the copays and deductibles in this program. So this is designed to help them to be able to access doctors in a way that’s more affordable. The reason that we’re talking about it and why the funding is in question is that there’s an argument between the administration ― the Obama administration, it started out with ― and the Republicans in Congress as to how it would be paid for. The Obama administration felt that it was built into their budget. Congress thought that it was not. So there’s a fight. It’s a little bit like if I hired someone to paint my house, and then my wife and I argued about who’s going to write the check: Is it coming out of my account or her account? We still owe the painter the money. He did the work. But we’re arguing about whose bank account this is going to come out of. That’s the issue right now. So we’re looking for Congress to acknowledge that they’re going to pay for it and to fund the program. Right now, the administration continues to pay for it while this is in dispute. This could result in millions of Americans losing their insurance coverage this year. Mario Molina, CEO of Molina Healthcare What happens immediately if the administration halts these payments or drops the appeal of the lawsuit that the previous administration lost on this question? Many people in the insurance industry believe that if the government doesn’t fund this and doesn’t pay the insurance plans, that they will have breached their contract with the insurance plans, and this could result in millions of Americans losing their insurance coverage this year. What are the bigger, longer-term implications for the entire individual health insurance market ― both for the exchanges and people who buy directly ― if these payments go away, starting with 2018’s market? The Kaiser Family Foundation has estimated that, without these cost-sharing reductions, premiums will rise by an average of about 20 percent. [Note: The estimate is 19 percent.] So health care will be more expensive in 2018, and many of the insurance companies will drop out because of the uncertainty about the program. Beneficiaries or people seeking insurance could find fewer choices, higher costs ― all because Congress did not fund the program. How is your company preparing for these eventualities in this climate of uncertainty for what you may do next year, and are there ways the end of these payments would affect Molina differently from other health insurance companies? What we’re doing to prepare for next year is to develop our premium rates. And we really have to look at this two ways. One is if the CSR is funded and one if it is not. The second question is: Do we even stay in the program at all? And if they’re not funded for 2017, I imagine that we’ll drop out of the program altogether. It affects all companies, some maybe to a greater extent than others, depending on how many of your members are getting these subsidies. For us, it’s over 70 percent. For some companies, it may be as high as 90 percent. So, the greater the percentage of your members who get these subsidies, the bigger the impact it will be on your health plan. And for us, we simply couldn’t sustain the losses. For us, it would be losses of hundreds of millions of dollars without these payments. Beneficiaries or people seeking insurance could find fewer choices, higher costs ― all because Congress did not fund the program. Mario Molina, CEO of Molina Healthcare At this moment, what is your message to the administration and to the Congress about what they should do and when? My advice to the president and to the Congress is that they should fund the CSRs, which they’re currently paying anyway, for 2017 and 2018 to create stability in the individual insurance market. This will allow them time to come up with some rational changes to the Affordable Care Act to make it more sustainable for the long term. What they really need to do, though, is to buy themselves some time and some stability to have a bipartisan debate about what should be done about the insurance market in the United States. What happens next, and what will you be looking for in the very near term, in the coming weeks or couple of months? Molina: In the coming weeks, I think the most important priority is to fund these cost-sharing reductions to make sure that people who rely on them continue to have access to health insurance. Longer term, I think that the country needs to address the high cost of health care, which is what drives the high cost of insurance. We often hear that the ACA and the individual market is failing. It’s not. And if the funding continues, I think that it will do well in 2017 and 2018. But Congress needs to ensure that the funding is there. This transcript has been edited for clarity. Politics hurt too much? Sign up for HuffPost Hill, a humorous evening roundup featuring scoops from HuffPost’s reporting team and juicy miscellanea from around the web. -- 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.

27 апреля, 21:30

An Insurance CEO Explains The Dangerous Game Trump Is Playing With Obamacare

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); President Donald Trump has been threatening to stop making payments to health insurance companies that cover low-income people under Obamacare. Doing so would seriously jeopardize the entire insurance market in ways that could be felt immediately by poor households and the insurers that provide their health benefits. Although the Trump administration said on Wednesday it wouldn’t cut off these funds ― called cost-sharing reduction payments or CSRs ― immediately, the president still sees them as a cudgel to use against Democrats in Congress. Trump believes the public will blame the party that created Obamacare if he seriously damages the health insurance system, rather than him and his Republican Party. It’s an enormously complex policy and business issue with the potential for devastating consequences. The problem dates back three years to a lawsuit House Republicans filed against President Barack Obama’s administration, challenging the legality of the way the federal government paid insurers with low-income customers. Last year, Obama lost that lawsuit and appealed, and the funding remains in jeopardy because Congress hasn’t authorized the spending in the meantime. More than 7 million people ― 58 percent of Obamacare enrollees ― received these subsidies this year. To help readers better understand what this all means and why it matters, HuffPost interviewed Mario Molina, a physician and the CEO of Molina Healthcare, an insurance company that has more than 1 million customers in nine states with policies from the Affordable Care Act’s exchanges. The following is a transcript of that conversation. This stuff is complicated. Can you to explain to a layperson what these cost-sharing reduction payments are and why they’re important? Molina: The cost-sharing reductions are payments that are made to health plans to help cover copays and deductibles for low-income patients who get their health insurance through the exchange. And the way it works is that, let’s say you have a $50 copay. Depending on your income, it may be reduced to $15 with the health plan picking up the balance, which then gets paid to the doctor or the provider that you’re seeing. The plan is paid by the government, and then any money that is not used for copays and deductibles we must then return. So it’s really not a premium payment so much as it is a reimbursement for subsidies that reduce the out-of-pocket costs to the insured individual. Why are we talking about this? What’s the problem right now? Why is there a question about whether these payments are going to be made? The first issue is that many people with low-to-moderate incomes rely on these to help make their insurance more affordable. One of the things that Americans have complained about is the high cost of the copays and deductibles in this program. So this is designed to help them to be able to access doctors in a way that’s more affordable. The reason that we’re talking about it and why the funding is in question is that there’s an argument between the administration ― the Obama administration, it started out with ― and the Republicans in Congress as to how it would be paid for. The Obama administration felt that it was built into their budget. Congress thought that it was not. So there’s a fight. It’s a little bit like if I hired someone to paint my house, and then my wife and I argued about who’s going to write the check: Is it coming out of my account or her account? We still owe the painter the money. He did the work. But we’re arguing about whose bank account this is going to come out of. That’s the issue right now. So we’re looking for Congress to acknowledge that they’re going to pay for it and to fund the program. Right now, the administration continues to pay for it while this is in dispute. This could result in millions of Americans losing their insurance coverage this year. Mario Molina, CEO of Molina Healthcare What happens immediately if the administration halts these payments or drops the appeal of the lawsuit that the previous administration lost on this question? Many people in the insurance industry believe that if the government doesn’t fund this and doesn’t pay the insurance plans, that they will have breached their contract with the insurance plans, and this could result in millions of Americans losing their insurance coverage this year. What are the bigger, longer-term implications for the entire individual health insurance market ― both for the exchanges and people who buy directly ― if these payments go away, starting with 2018’s market? The Kaiser Family Foundation has estimated that, without these cost-sharing reductions, premiums will rise by an average of about 20 percent. [Note: The estimate is 19 percent.] So health care will be more expensive in 2018, and many of the insurance companies will drop out because of the uncertainty about the program. Beneficiaries or people seeking insurance could find fewer choices, higher costs ― all because Congress did not fund the program. How is your company preparing for these eventualities in this climate of uncertainty for what you may do next year, and are there ways the end of these payments would affect Molina differently from other health insurance companies? What we’re doing to prepare for next year is to develop our premium rates. And we really have to look at this two ways. One is if the CSR is funded and one if it is not. The second question is: Do we even stay in the program at all? And if they’re not funded for 2017, I imagine that we’ll drop out of the program altogether. It affects all companies, some maybe to a greater extent than others, depending on how many of your members are getting these subsidies. For us, it’s over 70 percent. For some companies, it may be as high as 90 percent. So, the greater the percentage of your members who get these subsidies, the bigger the impact it will be on your health plan. And for us, we simply couldn’t sustain the losses. For us, it would be losses of hundreds of millions of dollars without these payments. Beneficiaries or people seeking insurance could find fewer choices, higher costs ― all because Congress did not fund the program. Mario Molina, CEO of Molina Healthcare At this moment, what is your message to the administration and to the Congress about what they should do and when? My advice to the president and to the Congress is that they should fund the CSRs, which they’re currently paying anyway, for 2017 and 2018 to create stability in the individual insurance market. This will allow them time to come up with some rational changes to the Affordable Care Act to make it more sustainable for the long term. What they really need to do, though, is to buy themselves some time and some stability to have a bipartisan debate about what should be done about the insurance market in the United States. What happens next, and what will you be looking for in the very near term, in the coming weeks or couple of months? Molina: In the coming weeks, I think the most important priority is to fund these cost-sharing reductions to make sure that people who rely on them continue to have access to health insurance. Longer term, I think that the country needs to address the high cost of health care, which is what drives the high cost of insurance. We often hear that the ACA and the individual market is failing. It’s not. And if the funding continues, I think that it will do well in 2017 and 2018. But Congress needs to ensure that the funding is there. This transcript has been edited for clarity. Politics hurt too much? Sign up for HuffPost Hill, a humorous evening roundup featuring scoops from HuffPost’s reporting team and juicy miscellanea from around the web. -- 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.

26 апреля, 21:05

The GOP Has Its Finger On The Grenade That Would Blow Up Obamacare

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); President Donald Trump could be just weeks away from fulfilling his threat to explode the Obamacare market by halting crucial payments to health insurance companies, and House Speaker Paul Ryan (R-Wis.) has declared he’s not planning to do anything about it. During a telephone call Tuesday evening, White House Office of Management and Budget Director Mick Mulvaney told House Minority Leader Nancy Pelosi (D-Calif.) that the Trump administration may withhold next month’s distribution of cost-sharing reduction payments, or CSRs, according to a House Democratic aide who asked not to be identified. Those payments reimburse insurers who serve the lowest-income people who get coverage from the Affordable Care Act’s health insurance exchanges. Democrats have been pushing to make sure those payments continue ― either by having the Trump administration continue to dispense them, by relying on its own authority to do so, or by having Congress appropriate the money directly. An obvious vehicle for the latter would be the omnibus spending bill, now under consideration in Congress, that is supposed to fund government operations past April 30. “Pelosi reiterated the Democratic negotiators’ position that CSR payments must be included in the omnibus. Mulvaney indicated that, while the Trump administration had continued the CSR payments, they had not yet decided whether they would make the May payment,” the aide wrote in an email. A spokesperson for the Office of Management and Budget disputed some parts of this account, but did not deny Mulvaney’s comments about the possibility of stopping insurer payments after May. And in written statement, Mulvaney made clear the administration was not eager to see the subsidies as part of the omnibus spending bill ― calling them “an 11th hour bailout of Obamacare.” Over on Capitol Hill, Ryan confirmed that the omnibus spending bill won’t include the funding. “Obviously CSRs, we’re not doing that. That is not in an appropriation bill. That is something separate that the administration does,” Ryan said. The consequences of halting these payments to health insurance companies could be devastating for people who buy coverage on their own, rather than through employers. Insurers would face higher costs, and in many states they could respond by cancelling coverage for the rest of 2017. Even to the extent insurers decided to stay in the markets, this year or next, they would have to raise premiums for 2018 by an average of 19 percent, according a projection by the Henry J. Kaiser Family Foundation. The possibility doesn’t appear to be hypothetical. On an earnings call Wednesday morning, Anthem Blue Cross Blue Shield, the nation’s second-biggest insurer and largest player on the health insurance exchanges, said it expected to raise rates by 20 percent ― or maybe pull out of markets altogether ― if CSR funding stopped. That’s why the insurance lobby, other health care interest groups and business organizations like the U.S. Chamber of Commerce have made maintaining this funding a key priority. Trump repeatedly has threatened to allow the Obamacare insurance markets to wither under his watch either through inaction or by halting federal payments to health insurance companies. He’s made the threats both before and after last month’s collapse of the House Republican effort to repeal the Affordable Care Act and enact a measure that would cover 24 million fewer people. Trump’s odd gambit is that voters will blame Democrats ― the party that enacted the Affordable Care Act ― rather than Republicans ― the party that controls the entire federal government now ― for the fallout from his actions. Polls have repeatedly indicated the opposite ― that voters will hold Trump and the Republicans responsible for what happens to health insurance. But amid House Republican indecision about health care reform overall and the messy process of keeping the federal government from shutting down despite GOP control of Congress and the White House, Mulvaney’s and Ryan’s statements indicate that threat could become a reality soon. Cost-sharing reduction payments have been a critical part of the Affordable Care Act since its benefits took effect in 2014, not a post-facto provision added to the law to “bail out” insurance companies as Mulvaney implied. Under the Affordable Care Act, the poorest enrollees into private health plans purchased through the exchanges receive two forms of assistance. The first are the tax credits that reduce monthly insurance premiums, which are available to people who earn up to four times the federal poverty level, or $48,240 a year for a single person. Those whose incomes are below 250 percent of poverty, or $30,150 for a single person also are eligible for cost-sharing reductions that make out-of-pocket costs like deductibles and co-payments lower, as well. Health insurance companies are required by the law to reduce these out-of-pocket costs for qualified customers, and then the federal government is obliged to reimburse them for the lost money. Insurers would still have to cut cost-sharing for enrollees even if the government payments weren’t made, and absorb the losses that would result. The reason the money may stop flowing and that Trump has the authority to unilaterally end them stems from a 2014 lawsuit House Republicans filed against former President Barack Obama’s administration. The House GOP argued that Obama unlawfully made these payments without Congress authorizing the spending. While the Affordable Care Act sets out the obligations on insurers to provide lower cost-sharing to eligible customers and the process by which the government pays them back, Republicans maintain Congress still needs to appropriate the actual dollars. Last year, a federal judge ruled for the GOP, prompting the Obama administration to appeal. The judge agreed to stay the decision, allowing the federal government to continue making payments as the case works its way up through the courts. When Trump became president, his administration became the defendant in the case. The Trump administration and House Republicans obtained delays from the appeals court while they decided how to proceed. Like Obama, Trump has continued to make the payments in the meantime, but has always had the power to end them at any point. That point may come next month. Congress could have appropriated the funding earlier and resolved the dispute in that fashion. At several points in the last few weeks, prominent Republicans indicated they were inclined to go along ― perhaps as part of the spending bill that Democrats and Republicans are now negotiating. But Ryan made clear Wednesday that’s not currently on the table, as far as he’s concerned. Matt Fuller contributed reporting. Politics hurt too much? Sign up for HuffPost Hill, a humorous evening roundup featuring scoops from HuffPost’s reporting team and juicy miscellanea from around the web. -- 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.

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26 апреля, 18:22

Ryan: Spending bill won't include Obamacare payments

House Speaker Paul Ryan said the spending bill to keep the federal government running won’t include funding for Obamacare’s cost-sharing subsidies. “CSRs, we’re not doing that," Ryan said Wednesday, referring to the subsidy program that helps reduce out-of-pocket health costs for low-income Obamacare customers. "That is not in an appropriation bill, that’s something separate that the administration does.” Lawmakers are "very, very close on everything else" in the spending bill, Ryan said during a press conference. Government funding is set to run out after Friday. Insurers, state regulators and health care groups have urged Congress to continue funding Obamacare's cost-sharing subsidies, warning the law's insurance marketplaces could collapse without them. The House, which complained the Obama administration illegally funded the subsidies, successfully sued to block the program. But the subsidies continue to flow while the case is on appeal. If Congress refuses to fund the subsidies, the Trump administration must decide by next month whether to fight the House lawsuit or let the payments end. Trump has often suggested he will use these subsidies as leverage with Democrats on repealing and replacing Obamacare. Ryan also did not say when the House may reschedule a vote on an updated Obamacare repeal bill, which would allow states to opt out of major Obamacare rules under certain conditions.

26 апреля, 17:43

White House to continue Obamacare payments, removing shutdown threat

Lawmakers are expected to pass a one-week funding extension in order to finalize a deal.

Выбор редакции
25 апреля, 00:33

ADPVoice: 3 Boxes To Check When You Set Up Your Organization's CSR Program

Corporate social responsibility used to be considered a nice-to-have feature for organizations looking to boost their brand recognition and appease certain stakeholders.

17 апреля, 23:06

Republicans Prepare To Lose On A Government Funding Bill

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); WASHINGTON ― Republicans may hold the House, the Senate and the White House, but when it comes to the upcoming omnibus spending bill, it’s Democrats who look in control. There are still a number of tricky issues to settle, and there are plenty of ways a deal could blow up, but when Congress returns next week just a few days before an April 28 government funding deadline, the emerging bill seems likely to please Democrats and anger conservatives. It’s the first real instance where Republicans and President Donald Trump need Democratic votes to enact their agenda ― short of once again blowing up Senate rules ― and that leverage has Democrats blocking many Republican priorities. In the GOP dream world, Republicans would defund Planned Parenthood, restrict money for so-called sanctuary cities, fund Trump’s border wall, potentially blow up Obamacare, and provide significantly more for defense while starving other domestic programs that Democrats prefer. But it seems Republicans will get hardly any of that, save for a defense boost that lawmakers on both sides essentially consider pro forma at this point. Conservatives inside and outside Congress may soon rightfully ask: How is this deal any different than a bill Republicans would get if Hillary Clinton were president and Democrats controlled Congress? The difficulty for Republicans is that they need eight votes in the Senate to pass an omnibus spending bill, which will fund the government until October. Needing eight Democratic votes in the Senate is basically akin to needing all Democrats, as Senate Minority Leader Chuck Schumer (D-N.Y.) will have to sign off on the bill. And if Schumer has to give the deal his blessing, it’s tough for Republicans to get much. One flashpoint is the border wall. Trump and Republicans want at least some money toward the construction of a wall along the U.S.-Mexico border, but according to aides with knowledge of the negotiations, Democrats aren’t willing to give much ― if anything. Instead, Democrats are offering money for border security, most of which would have to be offset in some way. Trump may get some funding for a physical wall, but it would hardly be enough to even start construction. It may be just enough that both sides would be able to claim some form of victory ― Democrats on functionally blocking the wall, Republicans on at least getting more for border security, and, maybe Pyrrhically, for a physical barrier. The other issue where Republicans and Democrats could both say they won is the most obvious negotiating point: funding levels. Almost every lawmaker concedes they are going to blow through the Budget Control Act spending caps Congress set in 2011. The question is by how much and for what priorities. Republicans would like to add substantial money to defense. But the traditional agreement between Republicans and Democrats in Washington has been that, for every dollar of defense spending above the caps, non-defense priorities get a dollar too. How that spending breakdown gets divvied up is still under negotiation, but with the bill already tilting toward Democrats, GOP leadership knows they are going to lose conservatives anyway. That means they have to make up the difference with Democrats. The common paradox on these spending bills is that the more Democrats win on policy, the more they win on spending. If conservatives are going to vote no anyway over objections on issues like Planned Parenthood or the border wall, it’s Democrats who have to carry the bill to passage in the House and Senate. At this point, Republicans ― in the House, at least ― look to be playing for a “majority of the majority,” which has mostly eluded Republicans over the last several years on these large spending deals. Perhaps the best sign of just where a deal stands is that Democrats told The Huffington Post that negotiations were going well, whereas conservatives sounded hopeless about supporting the measure. Still, passing an omnibus bill with nearly unanimous Democratic support and just a little help from Republicans could be so unpalatable for Trump that he vetoes the legislation. Aides have pointed out that the White House has mostly stayed out of the negotiations to this point, with the exception of Office of Management and Budget director Mick Mulvaney seeming to indicate recently that the administration wanted to cut funding for sanctuary cities. But that demand looks to be more bluster than reality. Aides have also pointed out that, mechanically, it may be difficult to actually cut funds for cities that tend not to deport undocumented immigrants. (No one seems to have a good legislative definition of a sanctuary city.) The White House understands that failure to fund the government looks far worse for Republicans ― who control every lever of the federal government ― than it does for Democrats. And the last thing the GOP needs amid its inability to pass a health care bill is another reminder that they have difficulty governing. Voters may get a reminder anyway, as the few legislative days before a government shutdown on April 29 could lead Congress to pass a short-term continuing resolution for, say, one week. Concerns about governing have already led Republicans to back off a fight that Trump raised when he suggested Republicans could try to blow up the Obamacare insurance markets and force Democrats to negotiate by withholding the subsidies that help low-income consumers purchase Obamacare plans. Trying to dismantle Obamacare through a government funding bill, however ― à la Republicans in 2013 ― puts the GOP in a public relations crisis where they likely take the blame for a shutdown, as well as the collapse of the 2010 health care law. Instead, GOP aides told HuffPost, Republicans would probably fund those so-called cost-sharing reductions and try to tackle health care through their own bill. The money for those CSRs would likely be tied to additional defense money. The promise of a health care bill in the offing is also helping to tamp down a fight over defunding Planned Parenthood. Speaker Paul Ryan (R-Wis.) said recently he saw a reconciliation health care bill, which is subject to simple majorities in the House and Senate, as the proper place to have that fight over Planned Parenthood. Republicans still haven’t given up hope that they can accomplish their health care priorities through that sort of bill. Just as they haven’t given up hope on funding a border wall through a supplemental spending bill, just as they haven’t given up on even more defense spending beyond an omnibus in a defense supplemental. But if they can’t get hardly anything in a must-pass bill now, why would Republicans think they can get more in other bills? “Senator Schumer will shut down the government before he gives concessions on Planned Parenthood or the border wall, and for Republicans to believe that some future must-pass bill will make Democrats cave is just wishful thinking,” one Republican member told HuffPost. -- 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.

15 апреля, 00:07

Procrastinating on April 14, 2017

**Over at [Equitable Growth](http://EquitableGrowth.org): Must- and Should-Reads:** * _Notes: Working, Earning, and Learning In the Age of Intelligent Machines | Equitable Growth_ * **Nick Bunker**: _A new way to look at how U.S. firms affect their workers’ pay now and in the future | Equitable Growth_ * **Josh Marshall**: _Trump Threatens to Torch More Republicans_: "the President is threatening... CSR payments to sabotage the Obamacare exchanges and... force Democrats to the bargaining table... * **Barry Eichengreen and Brad DeLong** (2013): _New Preface to Charles Kindleberger, "The World in Depression 1929-1939"_: "Anyone fortunate enough to live in New England in 1970-1985 or so and possessed of even a limited interest in international financial and monetary history... * **Dani Rodrik**: _A Foreword to Kari Polanyi Levitt_: "I first encountered Karl Polanyi as an undergraduate, in a course on comparative politics... ---- **Interesting Reads:** * **Justin Fox**: _The De-Electrification of the U.S. Economy_: "The 'old thermoelectric power complex' was decidedly not on the cusp of a big boom in 1999..." * **Afaf Lutfi Sayyid-Marsot** (1984): _Egypt in the Reign of Muhammad Ali_ * **Carlos F.Diaz Alejandro** (1984): _Essays on the Economic History of the Argentine Republic_ * **Peter Evans** (1995): _Embedded Autonomy_ *...

14 апреля, 02:20

Democrats Say They Will Fight Trump Over Health Insurance Subsidies

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); Get ready for another big congressional fight over Obamacare. The flashpoint this time is a key funding stream for the program ― one that subsidizes insurers so they can offer low-income consumers plans with reduced out-of-pocket expenses. President Donald Trump suggested in a Wednesday Wall Street Journal interview that he and other Republicans might cut off the funds. Now Democrats are saying they’ll fight this by demanding that Congress include the money as part of a spending bill that is supposed to keep the government running past April. Senate Minority Leader Chuck Schumer (D-N.Y.) “will be pushing hard for it as part of the negotiations,” a senior Democratic leadership aide told The Huffington Post. An aide to House Minority Leader Nancy Pelosi (D-Calif.) said that the issue is her “top priority” in the negotiations. The politics of the emerging conflict are complicated and unpredictable, and one possible outcome is an impasse that prevents the spending bill from passing. In other words, another government shutdown over Obamacare could be in the offing. But the stakes in the fight are higher than normal, because withholding the money could throw insurance markets into disarray ― potentially unraveling insurance coverage for millions of people. In the Journal interview, Trump said he hoped that would motivate Democrats to negotiate with him over repeal. Democrats, predictably, are having none of it. They say they are happy to talk about modifying the health care law ― but only if Republicans agree to leave the bulk of the coverage expansion in place, and only if Trump stops trying to sabotage the law. The payments in question ― so-called cost-sharing reductions, or CSRs ― reimburse insurers for providing more generous coverage to consumers with incomes below 250 percent of the poverty line. That’s $61,500 for a family of four. The 2010 Affordable Care Act instructs the federal government to make these payments, but it does not actually appropriate the money. The Obama administration paid the money anyway, saying it had legal authority to do so. House Republicans then launched a lawsuit over the payments. Last year, a federal district court ruled the payments unconstitutional but also stayed the decision, assuming the Obama administration would appeal ― which it did. As long as the decision is stayed, the federal government can continue to pay the money. But the Trump administration hasn’t indicated whether it will keep the Obama administration appeal going. That’s rattled insurers, who are busy calculating rates for next year ― and, in some cases, deciding whether to keep offering exchange coverage at all. If the money were to vanish, insurers couldn’t simply stop offering the plans with the reduced cost-sharing. Instead, they’d be required by law to keep offering them ― and to account for the extra expense by raising premiums for everyone. Doing so would likely mean raising premiums for the typical plan by 19 percent, according to an analysis by the Henry J. Kaiser Family Foundation. Realistically, many of the insurers ― still recovering from losses they incurred in the Affordable Care Act’s early years and uncertain about the program’s future ― would drop out altogether. An increasingly vocal chorus of interest groups, including everybody from the American Medical Association to the U.S. Chamber of Commerce, have been calling on the president and Congress to address the issue ― ideally, with a permanent solution. One way to do that would be to appropriate the money for the next few years, or maybe indefinitely. The coming spending bill would be an obvious place to try that, because, unlike most of the bills that go through the House these days, it will probably end up passing with a combination of Democratic and Republican votes ― over the objections of the most conservative members. Lawmakers wouldn’t even have to find offsetting revenue or spending cuts, because the official budget baseline, from the Congressional Budget Office, anticipates the money (roughly $7 to $8 billion for next year) being spent. Key House Republicans have already said they would like the money to keep flowing, their objections to Obamacare notwithstanding. “I will do everything I can to make sure the cost-sharing reduction payments get made, especially this year, where they were promised by the federal government under the contracts,” Rep. Greg Walden (R-Ore.), chairman of the Energy and Commerce Committee, told Bloomberg News last month. “That’s an obligation not only to insurers but also to the people who took on those plans. We cannot leave them high and dry.” But that was before Trump made his statements about withholding the subsidies ― and it’s not clear what House Republicans will do if Trump decides to oppose the funding strongly. “We continue to work with the Trump administration to evaluate the options in front of us,” AshLee Strong, spokeswoman for House Speaker Paul Ryan (R-Wis.), said on Thursday. CORRECTION: Chuck Schumer is the Senate minority leader, not the majority leader. -- 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.

Выбор редакции
13 апреля, 15:00

Three Ways CSR Can Attract Mature Millennials To Your Business

CSR is more than just altruism on a grand scale.

Выбор редакции
13 апреля, 08:26

Trump Threatens to Torch More Republicans

**Should-Read**: Point 1: Pro-tip: saying in advance that you do not want to actually put the threat in your bargaining position into effect means that you already have a different bargaining position than you think you do. Point 2: In return for getting Trump to agree to continue CSR payments, Democrats should be willing to let Trump demand and then support Medicare's offering its network as an insurance plan on all the health exchanges: **Josh Marshall**: _Trump Threatens to Torch More Republicans_: "the President is threatening... CSR payments to sabotage the Obamacare exchanges and... force Democrats to the bargaining table... >...“I don’t want people to get hurt,” said President Trump. “What I think should happen—and will happen—is the Democrats will start calling me and negotiating.”... **Should-Read**: Point 1: Pro-tip: saying in advance that you do not want to actually put the threat in your bargaining position into effect means that you already have a different bargaining position than you think you do. Point 2: In return for getting Trump to agree to continue CSR payments, Democrats should be willing to let Trump demand and then support Medicare's offering its network as an insurance plan on all the health exchanges: **Josh...

13 апреля, 05:38

Trump Threatens Coverage Of Millions If Democrats Won't Negotiate On ACA Repeal

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); President Donald Trump is contemplating a new strategy to get repeal of the Affordable Care Act through Congress: threatening to torpedo insurance for millions of Americans unless Democrats agree to negotiate with him. In an interview with the Wall Street Journal that appeared on Wednesday, Trump made a warning. If Democrats won’t talk repeal, the president said, Republicans might decide to cut off some subsidies now flowing to health insurers offering coverage through Obamacare’s exchanges. “I don’t want people to get hurt,” Trump said, sounding a bit like a mobster describing a protection racket. “What I think should happen — and will happen — is the Democrats will start calling me and negotiating.” Those subsidies are a really big deal. Without them, insurers would have to jack up premiums ― by an average of 19 percent for typical policies, according to a Henry J. Kaiser Family Foundation study. That increase would be above and beyond any other increases in the works. Many insurers would probably exit the markets altogether. If ACA cost-sharing subsidies end, premiums would rise 19%. Or, more likely, insurers would just exit the market.https://t.co/nL5WrP7f6r pic.twitter.com/xExhhdmMS7— Larry Levitt (@larry_levitt) April 12, 2017 The payments are called cost-sharing reductions, or CSRs. They reimburse insurers for the expense of providing special insurance plans, with lower out-of-pocket costs, to customers with incomes below 250 percent of the poverty line, or $61,500 for a family of four. The health care law calls on the federal government to pay insurers the CSRs but it does not actually appropriate money for that purpose. The Obama administration had disbursed the money anyway, and devised a legal argument to justify the move. House Republicans sued, claiming the spending was unconstitutional, and last year a U.S. district court judge agreed with them. The judge stayed the decision, allowing the Obama administration to file an appeal, and in the interim the federal government has continued to disburse the CSRs. But with the Obama administration gone, it’s up to the Trump administration and its allies to keep the money flowing. The Trump administration could do so, at least temporarily, by pressing ahead with the appeal or simply seeking a delay in the case. Or it could work with Congress on a more permanent solution ― namely, passing legislation that would appropriate the money for a limited time or indefinitely. Trump is spooking insurers ― and they were spooked already Until Wednesday, the administration hadn’t said much, except that it would continue funding CSRs as long as it was required to do so by law. Several Republicans in Congress went a bit further, and said they thought the federal government should keep disbursing the funds as long as the law was in place ― although they stopped short of saying exactly how they intended to make that happen. In the Journal interview, Trump for the first time shed light on his own thinking: You know that if we follow that lawsuit, we’re not supposed to pay money toward Obamacare — you know, Obama just paid the money because he couldn’t get approved — the approval from Congress. Well, Congress hasn’t approved it, so if Congress doesn’t approve it, or if I don’t approve it, that would mean that Obamacare doesn’t have enough money so it dies immediately as opposed to over a period of time. So, Congress is going to have to approve it [the insurance payments]. Will they approve it? I don’t know, I’m not sure, 50-50. If they approve it, then I will have to approve it. Otherwise, those payments don’t get made and Obamacare is gone, just gone. Politico subsequently quoted a senior official confirming that “POTUS wants to use [the subsidies] as leverage. When Obamacare fails on its own, the Dems will want to come to the table.” That prediction may be a bit fanciful. House Minority Leader Nancy Pelosi (D-Calif.) called Trump’s statement “appalling” and accused him of trying to “manufacture a crisis.”  Her Senate counterpart, Minority Leader Chuck Schumer (D-N.Y.), said, “Our position remains unchanged: drop repeal, stop undermining our health care system, and we will certainly sit down and talk about ways to improve the Affordable Care Act.” Nor is it clear whether Trump is prepared to carry out his threat. He ended up backing down from the last Obamacare-related ultimatum he made ― a demand, in March, that House Republicans vote on repeal legislation. But simply making the threat is sure to unnerve the nation’s insurers, at a time when they are figuring out what premiums to charge for the coverage they sell through the Affordable Care Act’s exchanges ― and, in some cases, whether to withdraw from those exchanges altogether. The law’s private insurance exchanges have been a fragile enterprise from the get-go, with insurers struggling to make money and premiums rising quickly in some states ― in part because many people have found the coverage too expensive to afford, and in part because Republicans at the state and federal level have done their best to undermine the program. In 2014, for example, conservatives attacked the law’s “risk corridors,” a standard feature of public-private insurance programs designed to insulate carriers from huge losses. The conservatives prevailed, which meant the program paid out only a fraction of the money it owed ― saddling insurers with huge losses. The difficulty of making money on Obamacare led some insurers, particularly the big national carriers, to pull back from the market, and today roughly one in five people buying through the exchanges can choose from just one carrier. Critics of the law, like Trump and House Speaker Paul Ryan (R-Wis.), have for years cited stories like these as proof the law was “exploding” and in need of repeal. But the state of the program varies a lot from state to state, and in California, Florida and Maryland, just to name a few, the program is working well ― with multiple insurers and prices that are actually cheap relative to the cost of comparable employer plans. There is also strong evidence that last year’s price hikes ― the ones that Trump kept talking about during his presidential campaign ― were mostly a one-time correction of the premiums insurers initially set too low. Just last week, a report from S&P Global Market Intelligence found that nonprofit Blue Cross plans, a staple of the exchanges, were seeing improved margins ― and on track for profitability within a few years. But that report also made a warning that analysts and insurance officials had been making for months: Future success depended on steady management and nurturing. And that’s not what the Affordable Care Act has gotten since January, when the Trump administration took over. Trump has already undermined the law in other ways  At various times, it looked like the Trump administration might be taking its stewardship of the law seriously ― and trying to keep insurance markets stable even as it sought to repeal the law. The Department of Health and Human Services issued new regulations, tweaking enrollment procedures in ways insurers had long recommended, and gave a green light to states trying to use special waivers from the law’s requirements in order to help struggling insurers. But Trump’s very first act as president was to sign an executive order instructing agencies to ease the law’s regulatory burden ― an order that seemed to signal, among other things, that his administration would not aggressively enforce the law’s individual mandate penalty, which encourages healthy people to buy coverage before they get sick. Sure enough, within a few weeks the Internal Revenue Service announced it was canceling plans to tighten up mandate enforcement. More ominously still, the Trump administration in January abruptly canceled some advertising that was supposed to run at the end of open enrollment. The advertising, which the Obama administration had planned, was supposed to nudge people waiting until the last minute to sign up for a plan. But without the ads ― and amid all the talk of repeal ― signups in the last two weeks fell well below last year’s levels, even though enrollment had been running slightly ahead of the 2016 pace through January. The possibility that Trump might not implement the law aggressively ― to say nothing of the possibility that the law might be repealed altogether ― has been on the minds of insurers for weeks, as they try to figure out their plans for 2018 and beyond. And they have made clear that one issue, in particular, would weigh heavily on their minds: the future of those reimbursements for offering plans with low out-of-pocket costs. “You cannot understate how big a deal they are” to insurers, Sean Mullin, a senior director at the health care consulting firm Leavitt Partners, told The Huffington Post earlier this week. On Wednesday, just hours before the Journal interview appeared, a group of eight influential trade groups ― including not just America’s Health Insurance Plans and the American Medical Association, but also the U.S. Chamber of Commerce ― wrote a letter to Trump saying “The most critical action to help stabilize the individual market for 2017 and 2018 is to remove uncertainty about continued funding for cost sharing reductions (CSRs).” Following the publication of Trump’s comments, Kristine Grow, AHIP spokesperson, told HuffPost that “We must remember that when we talk about CSRs, we are talking about a subsidy that 7 million people rely on ― to get coverage, and to be able to see their doctor.” In the Journal interview, Trump said he thought his threat would bring Democrats to the table because “they own Obamacare” ― but acknowledged that “the longer I’m behind this desk and you have Obamacare, the more I would own it.” Recent polls suggest that transformation has already taken place. In a new Kaiser Foundation poll that appeared last week, 61 percent said they would blame Trump and the Republicans for problems with the health care law, while just 31 percent said they’d blame Obama and the Democrats. -- 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.

12 апреля, 22:55

Right Now The Big Threat To Obamacare Isn’t Repeal. It’s Sabotage.

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); President Donald Trump and his congressional allies could still wreak havoc with the Affordable Care Act’s private insurance markets, even though the effort at full repeal has stalled. They could do so through some combination of neglect and sabotage ― and it could all start more quickly than most people realize. Right now, insurance companies that sell individual policies through the law’s exchanges are trying to figure out what premiums to charge next year and, in some cases, whether to keep selling on the exchanges at all. They’re making these decisions without key information, because the Trump administration has sent mixed signals about its intent to enforce the law and to continue paying critical subsidies to insurers. In just the last week or so, industry officials have started to raise a fuss, warning that they need some clarity ― either from the administration or Congress ― on how Obamacare is going to work in 2018, assuming it remains on the books. But the insurers aren’t getting much of a public response. This has made them even more anxious, increasing the chances that they’ll raise premiums a lot more than they would have otherwise ― or abandon the markets altogether. Trump, House Speaker Paul Ryan (R-Wis.) and other high-profile critics of Obamacare have been arguing for years that its private insurance markets are collapsing. The reality is that they’ve been working fine in some states and struggling in others, with signs of gradual improvement overall, as a recent report from S&P Global Market Intelligence showed. But that had a lot to do with aggressive management under President Barack Obama. Now the Republicans are in charge. They can turn their predictions of collapse into a self-fulfilling prophecy, threatening insurance for a significant portion of the people who depend on the law for coverage. All The Uncertainty Is Upsetting Insurers The most pressing issue today is the future of so-called cost-sharing reductions, or CSRs. Under the Affordable Care Act, insurers that sell directly to individuals through the exchanges must offer special plans, with lower out-of-pocket costs, to customers with incomes up to 250 percent of the poverty line. That’s $61,500 for a family of four, by this year’s standards.  The money to reimburse insurers for the extra cost of these plans comes from the federal government ― or, at least, that’s what the law’s architects intended. But in yet another example of its poor drafting, the statute does not appropriate the money for this expense explicitly. The Obama administration paid the money anyway, claiming it had the authority to do so. House Republicans disagreed, sued and won in U.S. district court last year ― throwing the future of those payments into doubt.  The Obama administration appealed the decision and the district judge stayed it, so the money could keep flowing to the insurers while the case proceeded. But now it’s the Trump administration defending the CSRs, and it hasn’t said whether it will pursue that appeal. It has simply said it will make the payments as long as the case is active ― a vow that insurers consider pretty close to meaningless, since the administration could decide to drop the appeal at any time. “Plans need more certainty,” Kristine Grow, spokeswoman for America’s Health Insurance Plans, said this week, following administration statements that left its position on the lawsuit ambiguous. The CSR issue is “huge,” according to Sean Mullin, a senior director at the health care consulting firm Leavitt Partners. “You cannot understate how big a deal they are” to insurers, he told The Huffington Post. The danger is immediate. If the administration were to pull back the appeal, then the district court ruling would take effect right away and the federal government would stop writing those checks. Insurers would have a huge problem because they would still be legally obligated to provide those plans with the low out-of-pocket costs. They’d have two choices: Swallow the losses or drop such coverage midyear, which is something that most states would allow them to do under those circumstances. We are already feeling repercussions. Frankly it’s an easier decision for a health plan not to play next year because of the lack of clarity. Sean Mullin, senior director at Leavitt Partners “We can’t absorb ― this year it will probably be $400 million ― we simply can’t absorb that kind of loss if they decide not to fund the CSRs for 2017,” Mario Molina, chief executive officer of Molina Insurance, told HuffPost last week. “So if they don’t fund the CSRs for this year, we would consider that a breach of contract. We would notify our members of a 30-day intention to cancel their contracts and then probably sue the federal government for the money.” Insurers also face a dilemma over what to do for 2018. They’re setting premiums for next year right now. If they can’t count on that extra federal funding, they’ll have to raise premiums for their standard, silver-level plans by an average of 19 percent, according to a new analysis from the Henry J. Kaiser Family Foundation. Keep in mind that would be 19 percent just to make up for the loss of the CSR subsidies. That hike wouldn’t cover the usual 4 to 7 percent in rising medical costs every year, nor would it account for other sources of uncertainty ― of which there are suddenly many, thanks to some confusing signals from the Trump administration. Early on, the Trump administration proposed some regulatory tweaks to the Obamacare enrollment process, like making it harder for people to get coverage midyear because of a divorce, lost job or other special qualifying event. Insurers had long sought those changes, because they feared consumers were gaming the system, and took that proposal as a sign the administration wanted to keep the program functioning even as it sought repeal. The administration has also signaled to states that it would help them develop “reinsurance” programs, which subsidize insurers for their most expensive beneficiaries, in order to keep premiums from rising too high. On the other hand, Trump’s very first act as president was to sign an executive order instructing federal agencies to find ways of reducing the regulatory burden of the Affordable Care Act. That sounded a lot like an instruction to ease up on the individual mandate, or at least the financial penalty designed to encourage healthy people to sign up for coverage. A few weeks later, the Internal Revenue Service announced that it was canceling an Obama-era plan that would have made it more difficult for people to evade the penalty. In January, the Trump administration also canceled some advertising that the Obama administration had planned for the end of the open enrollment period. “We aren’t going to continue spending millions of taxpayers’ dollars promoting a failed government program,” a Trump official said. The number of signups over the final two weeks of enrollment ended up substantially lower than it had been the previous year. Republicans have a history of trying to undermine the Affordable Care Act. Three years ago, Sen. Marco Rubio (R-Fla.) led a conservative crusade that succeeded in killing a provision of the law that was supposed to insulate insurers from big losses. Now, with the threat of outright repeal still looming and Trump musing that Republicans would benefit politically from an Obamacare implosion, insurers are understandably nervous about how the program will be managed in 2018 and beyond ― and how consumers will react to the tumult. “We and our members are a bit confused most days,” said Ceci Connolly, president of the Alliance of Community Health Plans. Mullin thinks the uncertainty is already influencing insurer behavior. “I would say we are already feeling repercussions,” he said. “Frankly it’s an easier decision for a health plan not to play next year because of the lack of clarity.”  What Insurers Need To Hear And When They Need To Hear It It’s no secret what the insurers feel like they need. Priority number one is getting a commitment on the CSR subsidies, ideally more than vague reassurances from the administration. What insurers really want is some kind of action from Congress ― an appropriation, whether short- or long-term, so that insurers know the money will be there for the next few years. Congress has to pass a spending bill to keep the government operating past the end of April. An appropriation for the cost-sharing reductions could be added to it. Timing is critical, given that insurers’ planning for 2018 is already underway. Molina said his company needs a commitment by the end of month. “The vehicle [for funding CSRs] doesn’t really matter,” Molina said. “What matters to us is that they continue to meet their contractual obligations and pay that money. … If President Trump and the Republicans in the House want to stabilize the marketplace, they need to continue funding them.” After that, insurers are calling for more concrete assurances that the Trump administration is seeking to manage the Affordable Care Act successfully. That could mean clearer statements about enforcement of the individual mandate. It could also mean something much more basic, like filling some key Department of Health and Human Services posts ― those officials who, in theory, would be overseeing the marketplaces and working with insurers to make sure they stay in the program. One such position is the chief executive officer of the federal marketplace that 37 states use. That job has been vacant ever since Kevin Counihan, the Obama administration’s appointee, left in January.  “Running a marketplace for 37 states requires active management and leadership that can speak for the new administration,” said Jon Kingsdale, who ran the Massachusetts state exchange and is now a senior strategy adviser at the Wakely Consulting Group. “Temporary and junior holdovers from the last administration simply carry no heft with issuers, brokers and others that [the agency] must work with day in and day out.” Of course, the president and HHS Secretary Tom Price might be happy to see the Affordable Care Act struggle, figuring they can blame any new complications or even a full-blown crisis on the Democrats ― and then use those circumstances as the pretext for repeal. The Affordable Care Act’s rising popularity and the backlash against this year’s repeal effort suggest Republicans are wrong about that. In a new Kaiser Foundation poll, voters said by a 2-to-1 margin that they would hold Trump and the Republicans, not Obama and the Democrats, responsible for future problems with the law. It’s safe to assume more outspoken insurance executives, like Molina, would encourage that perception. “If they stand back through inaction and allow the marketplace to collapse,” Molina said, “the trail leads right back to their door.” He’s probably right. The last few weeks have made clear that Obamacare, for all of its problems, provides financial security and access to medical care that Americans value. If Republicans preside over the program’s unraveling, they are likely to face the voters’ wrath ― although not before causing a great deal of human misery. -- 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.

12 апреля, 22:55

Right Now The Big Threat To Obamacare Isn’t Repeal. It’s Sabotage.

function onPlayerReadyVidible(e){'undefined'!=typeof HPTrack&&HPTrack.Vid.Vidible_track(e)}!function(e,i){if(e.vdb_Player){if('object'==typeof commercial_video){var a='',o='m.fwsitesection='+commercial_video.site_and_category;if(a+=o,commercial_video['package']){var c='&m.fwkeyvalues=sponsorship%3D'+commercial_video['package'];a+=c}e.setAttribute('vdb_params',a)}i(e.vdb_Player)}else{var t=arguments.callee;setTimeout(function(){t(e,i)},0)}}(document.getElementById('vidible_1'),onPlayerReadyVidible); President Donald Trump and his congressional allies could still wreak havoc with the Affordable Care Act’s private insurance markets, even though the effort at full repeal has stalled. They could do so through some combination of neglect and sabotage ― and it could all start more quickly than most people realize. Right now, insurance companies that sell individual policies through the law’s exchanges are trying to figure out what premiums to charge next year and, in some cases, whether to keep selling on the exchanges at all. They’re making these decisions without key information, because the Trump administration has sent mixed signals about its intent to enforce the law and to continue paying critical subsidies to insurers. In just the last week or so, industry officials have started to raise a fuss, warning that they need some clarity ― either from the administration or Congress ― on how Obamacare is going to work in 2018, assuming it remains on the books. In response, Republicans have offered little in the way of reassurance. In fact, on Wednesday, Trump said in a Wall Street Journal interview that insurers might end up losing a key subsidy they now receive unless Democrats sit down with him to negotiate over repeal. “I don’t want people to get hurt,” Trump said. “What I think should happen ― and will happen ― is the Democrats will start calling me and negotiating.”  Democrats aren’t likely to agree and, as always, it’s not clear how seriously to take Trump’s threat. But merely by making statements like these, Trump is rattling insurers. It increases the chances that they’ll raise premiums a lot more than they would have otherwise ― or abandon the markets altogether. Trump, House Speaker Paul Ryan (R-Wis.) and other high-profile critics of Obamacare have been arguing for years that its private insurance markets are collapsing. The reality is that they’ve been working fine in some states and struggling in others, with signs of gradual improvement overall, as a recent report from S&P Global Market Intelligence showed. But that had a lot to do with aggressive management under President Barack Obama. Now the Republicans are in charge. They can turn their predictions of collapse into a self-fulfilling prophecy, threatening insurance for a significant portion of the people who depend on the law for coverage. All The Uncertainty Is Upsetting Insurers The most pressing issue today is the future of those subsidies ― so-called cost-sharing reductions, or CSRs. Under the Affordable Care Act, insurers that sell directly to individuals through the exchanges must offer special plans, with lower out-of-pocket costs, to customers with incomes up to 250 percent of the poverty line. That’s $61,500 for a family of four, by this year’s standards.  The money to reimburse insurers for the extra cost of these plans comes from the federal government ― or, at least, that’s what the law’s architects intended. But in yet another example of its poor drafting, the statute does not appropriate the money for this expense explicitly. The Obama administration paid the money anyway, claiming it had the authority to do so. House Republicans disagreed, sued and won in U.S. district court last year ― throwing the future of those payments into doubt.  The Obama administration appealed the decision and the district judge stayed it, so the money could keep flowing to the insurers while the case proceeded. But now it’s the Trump administration defending the CSRs, and it hasn’t said whether it will pursue that appeal. It has simply said it will make the payments as long as the case is active ― a vow that insurers consider pretty close to meaningless, since the administration could decide to drop the appeal at any time. “Plans need more certainty,” Kristine Grow, spokeswoman for America’s Health Insurance Plans, said this week, following administration statements that left its position on the lawsuit ambiguous. The CSR issue is “huge,” according to Sean Mullin, a senior director at the health care consulting firm Leavitt Partners. “You cannot understate how big a deal they are” to insurers, he told The Huffington Post. The danger is immediate. If the administration were to pull back the appeal, then the district court ruling would take effect right away and the federal government would stop writing those checks. Insurers would have a huge problem because they would still be legally obligated to provide those plans with the low out-of-pocket costs. They’d have two choices: Swallow the losses or drop such coverage midyear, which is something that most states would allow them to do under those circumstances. We are already feeling repercussions. Frankly it’s an easier decision for a health plan not to play next year because of the lack of clarity. Sean Mullin, senior director at Leavitt Partners “We can’t absorb ― this year it will probably be $400 million ― we simply can’t absorb that kind of loss if they decide not to fund the CSRs for 2017,” Mario Molina, chief executive officer of Molina Insurance, told HuffPost last week. “So if they don’t fund the CSRs for this year, we would consider that a breach of contract. We would notify our members of a 30-day intention to cancel their contracts and then probably sue the federal government for the money.” Insurers also face a dilemma over what to do for 2018. They’re setting premiums for next year right now. If they can’t count on that extra federal funding, they’ll have to raise premiums for their standard, silver-level plans by an average of 19 percent, according to a new analysis from the Henry J. Kaiser Family Foundation. Keep in mind that would be 19 percent just to make up for the loss of the CSR subsidies. That hike wouldn’t cover the usual 4 to 7 percent in rising medical costs every year, nor would it account for other sources of uncertainty ― of which there are suddenly many, thanks to some confusing signals from the Trump administration. Early on, the Trump administration proposed some regulatory tweaks to the Obamacare enrollment process, like making it harder for people to get coverage midyear because of a divorce, lost job or other special qualifying event. Insurers had long sought those changes, because they feared consumers were gaming the system, and took that proposal as a sign the administration wanted to keep the program functioning even as it sought repeal. The administration has also signaled to states that it would help them develop “reinsurance” programs, which subsidize insurers for their most expensive beneficiaries, in order to keep premiums from rising too high. On the other hand, Trump’s very first act as president was to sign an executive order instructing federal agencies to find ways of reducing the regulatory burden of the Affordable Care Act. That sounded a lot like an instruction to ease up on the individual mandate, or at least the financial penalty designed to encourage healthy people to sign up for coverage. A few weeks later, the Internal Revenue Service announced that it was canceling an Obama-era plan that would have made it more difficult for people to evade the penalty. In January, the Trump administration also canceled some advertising that the Obama administration had planned for the end of the open enrollment period. “We aren’t going to continue spending millions of taxpayers’ dollars promoting a failed government program,” a Trump official said. The number of signups over the final two weeks of enrollment ended up substantially lower than it had been the previous year. Republicans have a history of trying to undermine the Affordable Care Act. Three years ago, Sen. Marco Rubio (R-Fla.) led a conservative crusade that succeeded in killing a provision of the law that was supposed to insulate insurers from big losses. Now, with the threat of outright repeal still looming and Trump musing that Republicans would benefit politically from an Obamacare implosion, insurers are understandably nervous about how the program will be managed in 2018 and beyond ― and how consumers will react to the tumult. “We and our members are a bit confused most days,” said Ceci Connolly, president of the Alliance of Community Health Plans. Mullin thinks the uncertainty is already influencing insurer behavior. “I would say we are already feeling repercussions,” he said. “Frankly it’s an easier decision for a health plan not to play next year because of the lack of clarity.”  What Insurers Need To Hear And When They Need To Hear It It’s no secret what the insurers feel like they need. Priority number one is getting a commitment on the CSR subsidies, ideally more than vague reassurances from the administration. What insurers really want is some kind of action from Congress ― an appropriation, whether short- or long-term, so that insurers know the money will be there for the next few years. Congress has to pass a spending bill to keep the government operating past the end of April. An appropriation for the cost-sharing reductions could be added to it. Timing is critical, given that insurers’ planning for 2018 is already underway. Molina said his company needs a commitment by the end of month. “The vehicle [for funding CSRs] doesn’t really matter,” Molina said. “What matters to us is that they continue to meet their contractual obligations and pay that money. … If President Trump and the Republicans in the House want to stabilize the marketplace, they need to continue funding them.” After that, insurers are calling for more concrete assurances that the Trump administration is seeking to manage the Affordable Care Act successfully. That could mean clearer statements about enforcement of the individual mandate. It could also mean something much more basic, like filling some key Department of Health and Human Services posts ― those officials who, in theory, would be overseeing the marketplaces and working with insurers to make sure they stay in the program. One such position is the chief executive officer of the federal marketplace that 37 states use. That job has been vacant ever since Kevin Counihan, the Obama administration’s appointee, left in January.  “Running a marketplace for 37 states requires active management and leadership that can speak for the new administration,” said Jon Kingsdale, who ran the Massachusetts state exchange and is now a senior strategy adviser at the Wakely Consulting Group. “Temporary and junior holdovers from the last administration simply carry no heft with issuers, brokers and others that [the agency] must work with day in and day out.” Of course, the president and HHS Secretary Tom Price might be happy to see the Affordable Care Act struggle, figuring they can blame any new complications or even a full-blown crisis on the Democrats ― and then use those circumstances as the pretext for repeal. The Affordable Care Act’s rising popularity and the backlash against this year’s repeal effort suggest Republicans are wrong about that. In a new Kaiser Foundation poll, voters said by a 2-to-1 margin that they would hold Trump and the Republicans, not Obama and the Democrats, responsible for future problems with the law. It’s safe to assume more outspoken insurance executives, like Molina, would encourage that perception. “If they stand back through inaction and allow the marketplace to collapse,” Molina said, “the trail leads right back to their door.” He’s probably right. The last few weeks have made clear that Obamacare, for all of its problems, provides financial security and access to medical care that Americans value. If Republicans preside over the program’s unraveling, they are likely to face the voters’ wrath ― although not before causing a great deal of human misery. This article has been updated with comments from Trump’s Wall Street Journal interview.  Sign up for the HuffPost Must Reads newsletter. Each Sunday, we will bring you the best original reporting, long form writing and breaking news from The Huffington Post and around the web, plus behind-the-scenes looks at how it’s all made. Click here to sign up! -- 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.

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10 апреля, 15:22

Cisco CSR 1000v: Обзор возможностей. Часть 1

За почти год с момента запуска проекта mClouds.ru мы получили интересный опыт в работе с различными техническими решениями. Сегодня мы хотим немного коснуться темы маршрутизации в сетях провайдеров облачных услуг и заодно рассказать вам почему для нас оказался очень интересным относительно новый продукт хорошо известной компании Cisco Systems, а именно — Cloud Services Router 1000v (CSR 1000v). Читать дальше →

30 марта, 20:23

Data Suggesting Virtue Signaling Marketing Doesn't Work

A survey was put out recently wherein Millennials were asked if, in light of the completely fabricated "Uber was racist" story (during Trump's travel ban), were you still going to use them?And surprise of surprises 95% of Millennials said "yes."This little tidbit may be of no great concern, but within it lays a whole bunch of implications for leftists and leftist strategies.1.  Virtue signaling doesn't work either to gain market share or getting your enemy to lose it.Lyft's disgusting cowardice in accusing Uber of being racist, in all reality should have backfired.  Of course it didn't, but it also didn't score Lyft a huge part of Uber's business.  We also saw this in Target's desperate attempt to be ahead of the SJW curve in letting whoever identify as whatever so you can use whichever bathrooms.  Target's sales have slumped ever since.2.  Most people, both right and left, are too fat and lazy to boycott.Boycotting is haaaaarrrrrd.  And the lazy Americans who've populate North America today don't want to drive the extra mile to get non-Star Buck coffee, and "gee shuck whillkers howdy, they just can't do without their Anti-American Apple product!"  It doesn't matter right or left, you can have a company like Bioware come out right and say "we are going to ass rape you full of leftist politics" and kids will line up to buy those video games.  So here there is good news for the CSR heads and other SJW's who are employed by corporate America.  They will still get their warm fuzzies and muh feelz championing what they were programmed to champion.  Won't do jack to your sales.  Either boosting or harming them.  So an entire generation of fake corporate skeeze can get their political jollies off using marketing and corporations to think they're doing something worthwhile.3.  Virtue signaling is solely for the virtue signaler.You would think that since virtue signaling has no effect companies would not engage in it.  Politics would be taken out of commercials and companies would...oh I don't know...just offer their fucking service or product without a sermon.But oh you poor simple minded fool.  Virtue signaling is going nowhere because it's solely for the virtue signaler.Understand virtue signalers and the people who virtue signal do so because they really have nothing else in value in life.  They are not your engineers or your truck drivers or your stay at home parent or your otherwise engaged and purposed person in life.  They are wasted lives wandering the US who have no real value or agency and use (predominantly) leftist politics as a substitute for meaning.  A surgeon who just spent 5 hours in surgery does not brag about how he goes green.  An airline pilot does not parade the fact he's for amnesty for illegal aliens.  And a CPA in the middle of busy season is too busy to flaunt her organic/free trade diet.  Real people with real jobs and real lives just don't have time for these fake religions.Unfortunately, millions of Americans are completely worthless, pointless people who have no real reason to live.  And they could go out and get a real job, or study STEM or raise a family,but that would take effort and that would be haaaaaarrrrrd.Ergo, why nearly all your virtue signalers are worthless people engaged in worthless professions.CSR heads.HR heads."Diversity consultants."Professors.Teachers.Non profit employees. Liberal arts majoring millennials.Liberal arts majoring soccer moms who live off of STEM majoring husbands as they compete against each other as to who shops more at Whole Foods.These people need something to point to in order to fool others and themselves that they're not parasites.  And the religions of the left, with their Nicene Creed like recitations about global warming, going green, anti-racism, etc. etc., fills that void of agency and purpose in life.So while virtue signaling may not work, and may prompt no one to change their behaviors, realize it's here to stay until the millions of worthless people die off.  Because, seriously, what else do they have to do in life?HHR4HM7ZPMV3

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30 марта, 19:01

Doubts on liquidity hit shares

Shanghai shares yesterday fell for the fourth straight day amid lingering concerns over liquidity.

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23 марта, 15:00

Western CSR Logic Won't Solve An Eastern Problem

To reach a global solution and create a better ecosystem for companies big and small, the East and the West must learn to see the world through each other’s eyes.

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16 марта, 19:00

Китайцы переходят на водородные трамваи

Китайская вагоностроительная компания CSR Sifang построит восемь трамваев с водородными топливными элементами для города Фошань в провинции Гуандун (КНР).

18 апреля 2015, 09:10

5 самых быстрых поездов в мире

Современные поезда быстрее машин. Но насколько быстрее? На самом деле, даже суперкарам за составами, получившими статус bullet-train, не угнаться. Соревнуются они между собой. И ради победы готовы даже взлететь.