District Court Ruling Against the ACA Would End Popular Benefits

Right before Christmas a U.S. District Court Judge in Texas ruled the

Affordable Care Act, also called Obamacare, was unconstitutional. What’s more

the judge didn’t just throw out the controversial provision that nearly every

American is required to carry health insurance, he tossed out the entire law with

its myriad provisions.

Not long ago, the news site ProPublica published an important story about employers who, in their quest for a younger and cheaper workforce, were pushing out “older” workers – often those in their early 50s. Crunching data from the Urban Institute, reporters found that 28 percent of stable, long-time employees sustain at least one damaging layoff between turning 50 and leaving the workforce for retirement.

Having good insurance doesn’t always mean that you won’t be caught with a huge surprise medical bill you didn’t expect and won’t know where to turn.  But politics and self-interest on the part of insurers and health care providers have gotten in the way of a workable solution.

The Food and Drug Administration just announced it would once again try to regulate tobacco products.  

This time the target of the agency’s regulatory hand is what it believes is the growing menace of flavored e-cigarettes and other tobacco products used by young people who’ve turned to vaping and smoking. The FDA said about 3.6 million kids under age 18 now admit they use e-cigarettes. 

It’s open enrollment time for medical insurance, and for people having to shop in the individual insurance market; the choices are as confusing as ever.

Television ads splashed over the airwaves as the midterm electioneering came to a close didn’t help much. By the end of the campaign it was hard to find any candidate – Democrat or Republican – who didn’t want to cover people with preexisting health conditions. 

Karen R., a 70-year-old Medicare beneficiary living in a mid-size town in Indiana, contacted me recently about her Part D drug coverage. She and her husband both have traditional Medicare, a Medigap policy, and what’s called a stand-alone plan for their drugs. For a long time, her stand-alone plan offered through Humana worked well for them. Her out-of-pocket costs for most drugs was only $8.

Making decisions about Medicare coverage has never been easy. Over the years the task has become more complicated as Congress has moved to privatize the system.

Open enrollment, the time for evaluating your coverage and making changes if you can, opens Oct. 15 and runs through Dec. 7 this year.  This is the first of two columns that address decisions people about to become eligible for Medicare and those already on the program will have to make.

Anyone buying health insurance this fall faces a daunting task: having to choose among multiple, often-complex options that offer widely varying degrees of protection.

“Lowering Your Blood Pressure Could Stave Off Dementia,” heralded the headline from Bloomberg, which was not alone in delivering the “good” news.

Time advised, “There May Finally Be Something You Can Do to Lower Your Risk of Dementia.” 

Reuters’ headline was even more definitive.  “Lowering Blood Pressure Cuts Risk of Memory Decline: US Study.”

Readers can be forgiven if they rushed to their doctors to discuss more aggressive blood pressure treatment.  Who wouldn’t want to escape the scourge of dementia? But alas, most of the news stories beneath the headlines were as misleading as the headlines themselves. 

Two years ago in this space I told the story of a Mississippi woman Katherine Green who got caught in the unsavory business practices of the air ambulance industry that has trapped many more Americans since then. Green, a college history professor, chose to fight the company that transported her late husband to a Jackson hospital after he suffered a fatal fall in their home.

A new health insurance option awaits consumers this fall. Proponents say it will offer lower premiums and relief from increasingly expensive Obamacare policies sold in the so-called individual market.  That’s the place where people who don’t have employer or government-sponsored insurance turn when they need coverage.

Recent studies about health care in America show troubling trends, especially in states with large rural and relatively low-income populations. 

While the United States continues to spend far more than any other developed country on health care on a per capita basis and as a percentage of gross domestic product (GDP), many states, especially in the south and Midwest, are losing ground in key areas that pertain to life expectancy.

The headline in the Wall Street Journal seemed to sum up the president’s plans for dealing with America’s high drug prices. “Drug Industry Relieved By Price Proposal,” it read and then described the president’s blueprint as falling short of  “more far-reaching ideas.” Since the plan contained no major threat to the status quo, it’s no wonder it boosted pharmaceutical stocks.

The opioid crisis is a major talking point on the national political stage. On the whitehouse.gov website, President Donald Trump says, “Together, we will face this challenge as a national family with conviction, with unity, and with a commitment to love and support our neighbors in times of dire need. Working together, we will defeat this opioid epidemic.”

We’ve heard relatively little from Washington in recent months about the Affordable Care Act, but that doesn’t mean our elected officials have forgotten about it or that its future is certain. Republican lawmakers still say the plan forces Americans to buy health insurance they may not want or need and that many may not be able to afford. Democrats say its benefits outweigh any downside. 

The electronic cigarette, or e-cigarette, has been touted – without proof – as a healthier alternative to traditional tobacco products and perhaps even a method of breaking the tobacco habit altogether. Now a new, related product with the brand name JUUL has entered the market and is especially appealing to teens.

Attached are documents that outline digital specs for different products, as well as a glossary of digital terms.

What happens in Idaho in the coming weeks undoubtedly will not stay in Idaho. What happens there could make a big difference in how much you pay for your health insurance – or whether you can even get insurance. 


Every time your doctor sends a medical claim to a medical insurance company or care management organization, you will receive an Explanation of Benefits – usually referred to as an EOB or EOB form. (The exception may be some prescriptions). 

One of the selling points for the tax bill President Trump signed into law a few weeks ago is that it will spur job growth because corporations will use money they otherwise would have paid in taxes to hire more workers. 

When people think about health issues, they often don’t think about their teeth. Dental health is rarely considered a priority, especially among those in rural areas where dental health care providers are not always easily accessible.

Open enrollment for the Affordable Care Act (aka: Obamacare) ends on Friday, Dec. 15, of this year. Previously, open enrollment lasted until the end of January, so the enrollment period for this year has been cut half. 

One of the benefits of the Affordable Care Act to Medicare beneficiaries has been the gradual closing of a big and costly gap called the “doughnut hole” in the prescription drug (Medicare Part D) program. By the end of 2020—if the ACA is not repealed or altered substantially by Congress—the doughnut hole will be completely closed.

As annual enrollment for Obamacare insurance approaches on November 1, the law itself and the people who have come to depend on it for health coverage are both facing an uncertain future.

What’s going to happen to healthcare now that Senate Republicans have failed to pass their bill, which would have replaced much of the Affordable Care Act? In particular, what’s going to happen to Medicaid, the government’s largest insurance program, which covers 74 million Americans? This is a good time to clarify what was at stake and may still be up for grabs in the months to come.

Hospitals May Get Accredited Even With Poor, Unsafe Care

Earlier this year an Illinois woman sent an email telling me of the poor care her husband received at a large Chicago hospital. After six weeks of fighting for his life, he died.

This fall the House of Representatives is likely to take up legislation passed by the Senate that gives terminally ill patients the right to try unproven, experimental drugs that are not yet on the market. Thirty-seven states have already passed similar legislation.

What should you expect now that the drive to repeal and replace the Affordable Care Act appears dead – at least for the moment?  Given how legislation gets made in Washington, I wouldn’t be surprised to see some elements of the repeal and replace bill surface again, possibly tacked onto what’s known as must-have legislation.  

The 2017 Colorado readership survey — conducted by Pulse Research in June 2017 — shows that newspaper media readership in Colorado is not fading out of existence, but in fact, Colorado has one of the strongest newspaper followings in the nation. This zip file contains an animated video, sli…

One thing I haven’t heard much in this latest healthcare debate is that the U.S. has the best health system in the world. That’s different from the last two times around.

When the nation debated the Clinton health plan in 1994 and the Affordable Care Act in 2009-2010, a huge talking point for politicians and special business interests opposed to reform was, “The American system is so good, why change it?”

As Obamacare approaches its fifth sign-up season, policyholders in many parts of the country are facing a marketplace with fewer choices and higher premiums. 

A New York Times analysis has found that 45 percent of U.S. counties probably will have either just one insurer or no insurers to choose from. That means some 3 million people in nearly 1,400 counties might have only one carrier and about 35,000 people could have none. 

Recently I heard from a woman in rural Nebraska who told me about her 76-year old father, who in late April had a lemon-size cancerous mass removed from his brain. The man chose to have his chemotherapy and radiation treatments at a hospital close to his home instead of at one of the larger hospitals farther away. Not surprisingly he wanted family nearby.

Older Americans may be in for a rough ride if the changes Washington politicians are considering come to pass.  Because good, explanatory journalism is in short supply and TV shouting matches don’t tell you much, I decided to use this space to discuss some of the possible changes that could soon affect millions of people in their 60s and older.

Federal funding for meals on wheels is on the chopping block. The Trump administration budget blueprint released in March calls for the elimination of two federal block grants:  That’s money the federal government gives the states for social welfare programs, and those programs include home-delivered meals and meals served in senior centers.

Republican efforts to repeal and replace Obamacare are getting lots of media attention. But like most reporting on major issues, the coverage is about who’s up, who’s down, who wins, and who loses. Explanations of how proposals will affect people will get short shrift. 

Over the past few months, these columns have raised plenty of questions about Medicare, present and future, and I’ve received many responses to those questions from readers. Today’s column addresses some of readers’ concerns about Medicare, a complicated program. 

Q: Why do you refer to Social Security as social insurance?  This continues to baffle me just as those who continually refer to SS as a handout. It’s not a handout. That money has been taken out of every one of my paychecks since I was 16. This is my money.  TF

When you fill a prescription at your local pharmacy, you assume the medicine you receive is safe and won’t interact badly with other drugs you’re taking.

That’s not an unreasonable assumption, considering that pharmacists enjoy a positive reputation among the public. A recent Gallup poll found that pharmacists are among the most trusted professionals ranking second only to nurses.

In a recent column I reported on an effort in Ohio to bring price transparency to medical services. Ohio state representative Jim Butler had spearheaded passage of legislation that would require healthcare providers including doctors and hospitals to disclose prices for their services. The law was supposed to take effect last summer, but Gov. John Kasich, the Ohio Hospital Association, and other health groups that oppose transparency have stymied implementation. The governor’s budget for next year calls for repealing the law.

The failure of the Republican-led effort to repeal and replace Obamacare represents a big victory for all kinds of citizens and interest groups that analyzed the proposed legislation and said no dice. 

The day before House Speaker Paul Ryan decided not to take a vote on the American Health Care Act, a Quinnipiac Poll found that only 17 percent of American voters approved of the GOP’s legislation while 56 percent did not.

What’s going to happen to Medicare? 

That’s not an insignificant question given the political shift in Washington.  Now, with Republicans controlling the presidency and both houses of Congress, some ideas they’ve been pushing for years have a chance of passing. Those ideas would drastically change the way Medicare works for those already on it and those joining in the next few years.

Anyone facing a hospital stay for themselves or a family member should look at new data the government released right before Christmas showing that it  penalized 769 of the nation’s hospitals for having high rates of patient injuries. The monetary penalties – a reduction for the year in their reimbursement for treating Medicare patients – do bite. Larger teaching hospitals could lose as much as $1 million or more.

Lori Eng, a 62-year-old office manager who works in western Nebraska, sent an email not long ago telling me she was “terrified” she might loose her Obamacare health insurance.  The many horror stories passed along in the media had frightened her, and she wanted me to hear from someone who had benefitted from the law.

Will patients benefit from the passage of the 21st Century Cures Act? After listening to politicians and reading the headlines, most people might think it’s the best thing ever to come along for patients. 

Surprise medical bills spell big trouble for consumers, especially those who find themselves in an emergency room. Such “surprises” have surfaced as a major patient problem, but because of entrenched healthcare interests, a solution is not likely any time soon.

What You Need To Know About Choosing Health Insurance 

Even though the election is over and Republicans are in a position to repeal and replace Obamacare as they’ve been vowing to do for several years, that doesn’t mean you should avoid signing up for 2017 insurance coverage.

The fight in California over a ballot initiative that would begin to control the price of pharmaceuticals paid by state programs shows how difficult it is to “do something” about the high price of prescription drugs.

Get ready to make some decisions. Medicare open enrollment begins October 15 and runs through early December. It’s the time when seniors and disabled people can switch plans to cover gaps in Medicare’s coverage.