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Daily Archives: August 29, 2013

What is the hemoglobin A1c test

The hemoglobin A1c test is a common blood test used to determine how well patients are managing their diabetes. It is also called the HbA1c, glycohemoglobin, or glycated hemoglobin test. The test is commonly used to screen for type 1 and 2 diabetes. The HbA1c test shows the patient’s average blood sugar levels for the past two or three months. It measures how much of the hemoglobin is glycated (coated in sugar). Hemoglobin is a protein-based substance within red blood cells that carries oxygen from the lungs to the rest of the body…

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HHS Directs Medicare Advantage Plans To Offer Equal Coverage To Same-Sex Couples; IRS Issues Related Guidance On Tax Filing

In what the department described as its “first guidance” in the wake of the Supreme Court striking down the Defense of Marriage Act, HHS said that all Medicare Advantage enrollees, including same-sex couples, will have equal access to coverage in a nursing home.

Health and Human Services Secretary Kathleen Sebelius said in an HHS press release, “Today’s announcement is the first of many steps that we will be taking over the coming months to clarify the effects of the Supreme Court’s decision and to ensure that gay and lesbian married couples are treated equally under the law.”

Advocate: HHS Offers Benefits, Joint Placement to Married LGBT Seniors on Medicare
The federal Department of Health and Human Services announced today that legally married LGBT seniors on Medicare will be eligible for equal benefits and joint placement in nursing homes around the country. In the wake of the Supreme Court’s landmark ruling in June striking down a key section of the so-called Defense of Marriage Act, HHS Secretary Kathleen Sebelius said today’s announcement is just the first in a series of changes forthcoming in how the department deals with married LGBT people (Brydum, 8/ǽ).

The Internal Revenue Service made a similar announcement today regarding tax filing by same-sex couples:

Washington Post: IRS To Treat Same-Sex Marriages Equally For Tax Purposes
The Treasury Department and Internal Revenue Service announced on Thursday that they would treat legal same-sex marriages the same as heterosexual marriages for federal tax purposes. The new policy, which comes in response to a June Supreme Court ruling that overturned a key portion of the Defense of Marriage Act, allows same-sex spouses to file tax returns as married couples regardless of whether they live in jurisdictions that recognize gay unions (Hicks, 8/29).

NBC News: Married Gay Couples To Receive Federal Tax Benefits: Treasury
The U.S. Treasury and Internal Revenue Service announcement comes on the heels of the landmark Supreme Court ruling in June that said same-sex couples are entitled to federal benefits. The ruling struck down the 1996 law blocking federal recognition of gay marriage. The ruling applies to filing status, personal and dependency exemptions, standard deduction, employee benefits, IRAs, earned income tax credits and child tax credits, according to the Treasury Department and IRS statement (8/29).

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Group Health Omits Abortion Coverage From Plans Sold On State Exchange

Group Health Cooperative will not cover abortion in its individual health-insurance plans being offered through the marketplace put in place by the Affordable Care Act, but says women who buy them will be able to access the service without paying more.

Group Health said it made the decision not to include the coverage because of murky regulations about how it would have to account for federal money in plans that offered abortion.

But the HMO (health-maintenance organization) has long supported women’s reproductive options, officials said, and so it will provide access.

Group Health’s workaround did not satisfy abortion-rights and women’s-rights groups, who reacted angrily to the decision not to cover abortion.

“Group Health asserts that abortion care will be made available to patients in Group Health clinics, but the lack of coverage in the plan creates confusion and presents a barrier to access, while showing an alarming disregard for women,” NARAL Pro-Choice Washington, Legal Voice and Planned Parenthood Votes Northwest said in a statement.

Group Health said it made the decision earlier this year in the face of confusing regulations about how insurers should handle abortion premiums and costs.

The Affordable Care Act requires insurers that cover elective abortion to segregate premiums and expenditures because federal law bars abortion services from being funded by the federal premium subsidies for plans offered through state marketplaces known as exchanges.

“At the time Group Health filed our products, we lacked further regulatory guidance,” Group Health said in a statement. “Group Health determined that in order to ensure full compliance with all requirements, it was advisable to not include pregnancy termination services in our individual products offered through the exchange for 2014.”

Of those plans that have passed muster with state insurance officials, only Group Health’s did not include abortion coverage.

At least 31 plans will be sold inside the exchange, including Group Health’s four, and other companies are now appealing rejections.

BridgeSpan Health Company, Premera Blue Cross and its subsidiary, Lifewise Health Plan of Washington, all said their plans offered abortion coverage, with the exception of eight Premera plans that are among BlueCross/Blue Shield Association multistate plans forbidden by federal law to include abortion coverage.

Stephanie Marquis, spokeswoman for the state Office of the Insurance Commissioner, said revisions flew back and forth earlier this year over Group Health’s plans for the exchange.

“Unfortunately, they made the change to take that benefit away from women, and we can’t require them to include it,” she said. “It’s an unfortunate decision for consumers.”

Group Health spokesman Ed Boyle said women who buy plans in the exchange may still access abortions services because Group Health is not only an insurer but a medical provider.

Although women who buy those plans and seek abortions won’t be covered by their insurance, Boyle said, they will not be at risk financially: “In 2014 our members who enroll through the exchange can be assured they will have access to pregnancy termination services through Group Health medical centers, with no greater financial burden than as if this was a covered benefit,” Boyle said.

Boyle said now that federal and state regulators have clarified rules regarding federal subsidies, Group Health intends to add the benefits to plans sold through the exchange in 2015, and is committed to “providing women access to the full spectrum of reproductive health services that are safe, affordable and accessible.”

Women’s-rights groups said the HMO’s decision was “inconsistent with Group Health’s own record on reproductive rights,” which has been twice affirmed by leadership and consumer members of the consumer-governed cooperative, the groups said.

Rachel Berkson, executive director of NARAL, said it was “particularly galling to see one of the most progressive, pro-women health-care providers in our state placing limits on abortion coverage.”

It’s not clear there will be limits. But Lisa Stone, executive director of Legal Voice, said she was worried that without coverage specified in the policies, women might face administrative burdens or, if they need inpatient care in a non-Group Health hospital, additional charges.

This is the kind of issue anticipated by backers of the Reproductive Parity Act (RPA), a bill that failed to gain approval in the Legislature this year. The bill would have ensured abortion coverage after the federal law took effect. Late in the session, despite backing from both sides of the aisle, Senate Health Care Committee Chairwoman Randi Becker, R-Eatonville, refused to schedule a vote.

Said Elaine Rose, CEO of Planned Parenthood Votes Northwest: “The need for the RPA has never been more apparent. Women can’t trust insurance carriers to protect all of their pregnancy options.”

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Wireless fitness monitor 'can help heart surgery recovery'

A simple wireless “off-the-shelf” fitness monitor could help the recovery of patients who have had heart surgery, according to a study to be published in The Annals of Thoracic Surgery. Researchers from the Mayo Clinic in Rochester, MN, analyzed a number of patients over the age of 50 who had undergone elective heart surgery. This included coronary artery bypass grafting, valve repair replacement or both. All patients lived at home, were ambulatory before surgery, and were expected to be in hospital for 5-7 days after the procedures…

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Parkinson's severity linked to brain inflammation

A new study found markers of inflammation in the cerebrospinal fluid that protects the brain and spine from injury, linking these markers to symptoms like fatigue, depression and anxiety in patients with Parkinson’s disease. Researchers say the findings may lead to new ways of treating the complex riddle of Parkinson’s…

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Mental and substance use disorders 'leading cause of non-fatal illness'

Researchers say that combined, mental and substance use disorders were the leading cause of non-fatal illness worldwide in 2010, according to a study published in the The Lancet. The study, conducted by researchers from Australia and the US, analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010). The researchers looked at 20 mental and substance use disorders included in GBD 썚, then systematically reviewed the patterns, causes and effects of the disorders…

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Small Businesses Passing Health Cost Increases On To Workers; Employers Blame Health Law For Shrinking Benefits

Businesses are still trying to sort out many of the issues that come with the implementation of the Affordable Care Act.

The Washington Post: As Rates Soar, Small Business Owners Pass Along More Health Care Costs To Employees
Health insurance costs for small business owners have been rising for more than a decade, and some are concerned the health care law will drive their premiums higher at an even faster clip. Many appear to be coping by passing some of the costs along to their employees (Harrison, 8/28).

CNN Employers Play Obamacare Blame Game
No more health benefits for spouses. Higher deductibles for employees. More cost-sharing. Employers are citing increased costs imposed by the Affordable Care Act — as Obamacare is formally known — as part of the reason they are pulling back on benefits. … UPS and UVa said they are dropping coverage for employees’ spouses that have access to benefits elsewhere. Delta said in a letter to administration officials that it will have to pass along some of the rising costs to its employees. While there’s no doubt Obamacare comes with increased costs for employers, health reform can only be blamed for a piece of the price hike, experts say (Luhby, 8/29).

CBS News Health Care Is A Priority For Employers In 2014
Not only are companies concerned about health care plans, but they are concerned about actual employee health as well: 60 percent of HR executives cite “lowering overall healthcare costs” and “improving overall employee health” as top priorities for 20Ǯ. This shows a continuation of the trend for companies [to] develop and implement “wellness” programs. Thirty four percent of companies are looking to increase participation in already existing healthcare plans (Lucas, 8/28).

San Jose Mercury News/Digital First Media: How 13 Major Companies Have Responded To Obamacare
What effects will Obamacare have on business? With the health insurance exchanges set to launch on Oct. 1, the fight over whether the law is good or bad for business continues. There’s still not solid information on either side, but some big-name businesses have weighed in, either through words or actions (Beckwith, 8/28).

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Poor People In At Least 21 States To Face Medicaid Coverage Gap

McClatchy reports that in most states opting against the health law’s Medicaid expansion, millions will be stranded without insurance:  They will make too much to qualify for Medicaid, but too little to get subsidies to help buy coverage on the new insurance marketplaces. Other news organizations report on the Michigan Senate’s decision to move ahead with expansion, but not until April, and on the continuing debate in Ohio.

McClatchy Medicaid ‘Coverage Gap’ Looming For The Poor In 21 States
The law was supposed to provide health insurance for most Americans next year by expanding Medicaid in all states to people earning up to 138 percent of the federal poverty level. That’s about $15,900 for an individual in 2ው, or nearly $32,500 for a family of four. But when the Supreme Court ruled that states could opt out of the expansion, Republican-led states took advantage. Rather than expand their Medicaid programs, most kept their programs as is – open mainly to the poorest of the poor (Pugh, 8/28).

Detroit Free Press: Delay In Medicaid Expansion To Be Costly
Getting the expansion of Medicaid passed in the state Senate Tuesday night was a huge victory for Gov. Rick Snyder, state health officials and, ultimately, nearly 500,000 low-income Michiganders. But the failure of the Senate to vote to give the bill immediate effect, thus delaying the implementation of the law until April 1, could cost the state and individuals hoping to qualify for Medicaid coverage dearly (Gray, 8/29).

Stateline: Michigan Senate Narrowly Passes Medicaid Expansion
The Michigan Senate narrowly voted in favor of expanding Medicaid eligibility Tuesday night, extending Medicaid benefits to an additional 345,000 residents (according to the Kaiser Family Foundation and The Urban Institute) now without health insurance. The measure is expected to be approved by the House in early September and signed by Republican Gov. Rick Snyder, who lobbied forcefully for expansion. Under the legislation, beneficiaries would be required to pay a portion of their premiums (Ollove, 8/28).

Columbus Dispatch: Citing Depression, Maurice Clarett Joins Call To Boost Medicaid
Mental health advocates gathered at the Statehouse today to push for Medicaid expansion in Ohio. Among the supporters? Former Ohio State phenom running back Maurice Clarett. Clarett, part of the 2002 National Championship team, had numerous off-the-field troubles, including robbery and weapons convictions that put him in prison. He has since been treated for depression (Felser, 8ቹ).

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Political Cartoon: 'Snidely Whiplashed?'

Kaiser Health News provides a fresh take on health policy developments with “Snidely Whiplashed?” by Mike Luckovich.

Here’s today’s health policy haiku:

GET THE RAKES

It’s not yet autumn,
but fed regulations are
dropping like fall leaves.
-Anonymous

If you have a health policy haiku to share, please send it to us at http://www.kaiserhealthnews.org/ContactUs.aspx and let us know if you want to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

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New Health Law Rules Aimed At Protecting Insurance Marketplace Funds, Consumers

The regulations are designed to safeguard how federal funds will be used in online insurance marketplaces and to provide protections to consumers. News outlets also detail a number of health law implementation issues, including a study about how rate shock warnings might be “overblown.”

CNN: HHS Finalizes More Obamacare Policies
As part of its continued effort to solidify Affordable Care Act regulations before insurance exchanges open on October 1, the Department of Health and Human Services finalized a new rule on Wednesday clarifying how a number of issues will be handled in the new marketplaces. “The overarching goal is to safeguard federal funds and to protect consumers by ensuring that issuers, marketplaces, and other entities comply with federal standards meant to ensure consumers have access to quality, affordable health insurance,” the department said in a press release (Aigner-Treworgy, 8/28).

The Wall Street Journal: Prepaid Debit Cards Allowed As Health-Insurance Payment
The Obama administration said Wednesday it would require insurers to let uninsured Americans pay for health coverage this fall with prepaid debit cards rather than limit them to bank-account transfers, though it won’t require insurers to accept automatic monthly payments from credit or debit cards. Allowing prepaid cards is aimed at ensuring millions of lower-income Americans can sign up for coverage even if they don’t have checking accounts (Radnofsky, 8/28).

The Associated Press: 4 Tips For Savvy Health Care Shopping
Your employer and President Obama are imploring you to become a better health care consumer. They want everyone to take a more active role in their care because it’s vital to help slow the seemingly perpetual rise of health care expenses (Murphy, 8/28).

The Courier-Journal/USA Today: Study: Obamacare Rate Concerns ‘Overblown’
With Affordable Care Act set to begin in earnest next year, fears are mounting that insurance premiums will skyrocket when American workers re-enroll for health benefits through their jobs. But experts and a newly released study say those fears appear largely unfounded (Ungar, 8/29).

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