Latest news with #AffordableCareActMarketplace
The Hill
02-07-2025
- Health
- The Hill
Mayors sue over Trump administration rules restricting ObamaCare enrollment
A coalition of U.S. city mayors is suing the Trump administration over a recently finalized rule that limits enrollment in Affordable Care Act Marketplace plans. In June, the Trump administration finalized the 'Marketplace Integrity and Affordability' rule, which shortens the open enrollment period for ACA plans to Nov. 1 to Dec. 15. Customers normally have until Jan. 15 to enroll. The rule also increases the maximum annual cost-sharing limitation and enacts stricter income verifications. The changes take effect beginning in 2027. The cities of Chicago, Columbus and Baltimore have filed a lawsuit against the Department of Health and Human Services, challenging the rule. They are joined by the advocacy groups Doctors for America and Main Street Alliance. The group is being represented in the case by the legal organization Democracy Forward. In their suit, they claim that the physicians who are part of Doctors for America will be harmed by this rule as more of their patients will become uninsured, and they will receive less than full reimbursement for patients without coverage. They are alleging the rule is in violation of the Administrative Procedure Act. 'Defendants failed to provide adequate reasons for, and failed to adequately respond to comments about, the following provisions, such that they are arbitrary and capricious under the APA, and Defendants failed to observe required procedure in adopting these provisions,' the lawsuit states. The plaintiffs are asking that the rule be found in violation and the law be blocked from being implemented. 'This unlawful rule will force families off their health insurance and raise costs on millions of Americans. This does nothing to help people – and instead harms Americans' health and safety across our country,' Skye Perryman, Democracy Forward president and CEO said in a statement.
CNBC
01-07-2025
- Health
- CNBC
Medicaid cuts in Trump's 'big beautiful' bill will leave millions uninsured, threaten rural hospitals
President Donald Trump's "big, beautiful bill" would make sweeping changes to U.S. health care, leaving millions of vulnerable Americans without health insurance and threatening the hospitals and centers that provide care to them. The Senate on Tuesday voted 51-50 to pass the controversial spending measure after a marathon overnight voting session on amendments. But the bill will face another major test in the House, where Republicans have a razor-thin majority and some members have already raised objections to the legislation. Recent changes to the bill would cut roughly $1.1 trillion in health-care spending over the next decade, according to new estimates from the nonpartisan Congressional Budget Office. More than $1 trillion of those cuts would come from Medicaid, a joint federal and state health insurance program for disabled and low-income Americans. The funding cuts go beyond coverage: the loss of that funding could gut many rural hospitals that disproportionately rely on federal spending. The CBO estimates that the current version of the bill would result in 11.8 million people losing health insurance by 2034, with the majority of those people losing Medicaid coverage. But the implications could be even bigger. Trump's bill combined with separate policy changes could result in an estimated 17 million people losing health insurance, said Robin Rudowitz, director of the program on Medicaid and the uninsured at health policy research organization KFF, in an interview. She said those other changes include new regulations that would dramatically limit access to Affordable Care Act Marketplace coverage and expiring enhanced ACA tax credits. "If all of this comes to pass, it would represent the biggest roll back of health insurance coverage ever due to federal policy changes," Cynthia Cox, KFF's director of the program on the ACA, said in an analysis published on Tuesday. Approximately 72 million Americans are currently enrolled in Medicaid, about one-fifth of the total U.S. population, according to government data. Medicaid is the primary payer for the majority of nursing home residents, and pays for around 40% of all births. The Trump administration and its allies insist the cuts in the bill aim to eliminate waste, fraud and abuse. Democrats have said they break the president's repeated promises not to touch the Medicaid program. Medicaid has been one of the most divisive issues throughout negotiations in both chambers, and some House Republicans have expressed reservations about how deep the cuts are. "I get that they want to cut fraud, but taking a swipe across the top is not going to solve the issue," Jennifer Mensik Kennedy, president of the American Nurses Association, said in an interview. She said the cuts could shutter hospitals and health centers in rural areas and lead to job losses for health-care staff like nurses. The cuts in the bill come from several different provisions, but the lion's share of Medicare savings will come from two changes. One would establish a new, strict national work requirement for certain Medicaid beneficiaries ages 19 to 64. It would require childless adults without disabilities and parents of children older than 14 to work, volunteer or attend school for at least 80 hours a month to keep their insurance coverage, unless they qualify for an exception. Current law prohibits basing Medicaid eligibility on work requirements or work reporting rules, according to KFF. The new work requirement in the bill won't kick in until 2026. It is projected to save about $325 billion over a decade, the CBO said. An analysis published last week by the UC Berkeley Labor Center said that the work requirement would cause the most people to lose insurance and "poses an especially draconian barrier to older adults." The center said there is a steady drop-off in employment after age 50 due to factors "outside [people's] control," including deteriorating health, age discrimination and increasing responsibility to provide care for aging family members. "These same factors make older adults particularly vulnerable to coverage loss under Medicaid work requirements," the analysis said. People living in rural communities, such as seasonal farmers, may also struggle to find employment for parts of the year, said Mensik Kennedy of the American Nurses Association. AARP, an advocacy group focusing on issues affecting those 50 and older in the U.S., sent a letter over the weekend to Senate Majority Leader John Thune, R-S.D., and Senate Minority Leader Chuck Schumer, D-N.Y., opposing another provision that would disqualify people who fail to meet Medicaid work requirements from receiving premium tax credits to purchase coverage through the ACA Marketplaces. "This creates a steep coverage cliff for those in their 50s and early 60s – particularly for those nearing retirement or working part-time – who may be left with no affordable coverage option at all," the group said. Another driving source of Medicaid savings will come from a provision that will cap and gradually reduce the tax that states can impose on hospitals, health plans and other medical providers. Those provider taxes are designed to help fund state Medicaid programs, with the federal government matching a portion of the state's spending. Some members of the Trump administration and conservative lawmakers argue that it is a loophole for states to receive disproportionately more federal funds than they contribute. The bill's restrictions on provider taxes and another strategy called state-directed payments would cut spending by a combined $375 billion, according to the CBO report. But some GOP senators and experts raised concerns that capping provider taxes would threaten a critical funding stream for rural hospitals, which could force them and other health centers to close. Mensik Kennedy said health-care providers in rural reas, particularly critical access hospitals, rely more on Medicaid funding to support them compared to those in urban areas. "You're going to see closures of rural hospitals that are the backbone of their community and were already struggling financially. You're going to see half a million job losses," Mensik Kennedy said. She said pregnant women in rural areas could be forced to drive 30, 40 or 60 miles to deliver a baby, while emergency medical services could have to drive an hour to reach a patient having a heart attack. Patients in rural communities already have higher rates of chronic illnesses and mortality since they have limited access to care, according to the Centers for Disease Control and Prevention. Senate Republicans have added a $25 billion fund to the bill to help rural hospitals stay open in the face of Medicaid cuts. But Mensik Kennedy said that fund is "putting a bucket of water on the house fire," adding that it is not enough to offset the cuts from the cap on provider taxes and other provisions. Cuts in overall Medicaid funding for rural hospitals would exceed 20% in more than half of states, according to a report from the the National Rural Health Association. Senate Republicans handed a win to drugmakers after they added back a provision into the bill that would exempt more medicines from the Inflation Reduction Act's Medicare drug price negotiations. Under the bill, medicines used to treat multiple rare diseases will be exempt from those price talks between Medicare and manufacturers. The Senate initially left out that provision, called the ORPHAN Cures Act, in its first draft of the bill last month. The pharmaceutical industry argues that excluding those drugs from the negotiations will encourage more investments in treatments for rare conditions. Currently, only drugs that treat a single rare disease or condition can be exempted from price talks. "The ORPHAN Cures Act will enable more options for Americans living with rare disease," the trade group Biotechnology Innovation Organization wrote in a post on X last week. The group also said only 5% of rare diseases have an approved treatment, while the economic toll of rare conditions in the U.S. surpassed $997 billion in 2019. But on Tuesday, drug pricing group Patients For Affordable Drugs Now called on the House to remove the ORPHAN Cures Act from the bill and allow Medicare drug price negotiations to deliver more savings to patients. The decision to include it in the legislation "moves us in the wrong direction, undermining hard-fought progress to lower drug prices," Merith Basey, executive director of the group, said in a statement. "Pharma lobbyists will stop at nothing to maintain industry profits, and when a majority of the Senate caves to their interests, it's a reminder to Americans why they're paying the highest drug prices in the world. Simply put: it's because Congress allows it," Basey said. She called it a "completely unnecessary $5 billion giveaway" to the pharmaceutical industry, referring to CBO estimates for how much the ORPHAN Cures Act would cost taxpayers over the next decade.
Miami Herald
28-05-2025
- Business
- Miami Herald
What to do when your spouse loses their job
If you depend on your spouse's job to help cover your day-to-day expenses and save for the future, it can be hard to hear that they've been let go at work. And you may not be sure what to do when your spouse loses their job. Once you've gotten over the shock, there are steps you can take together to get through this shakeup. Here's a comprehensive rundown from Freedom Debt Relief of what to do when your spouse loses their job. Key Takeaways: When your spouse loses their job, it can have a financial and an emotional out health insurance and unemployment benefits for ways to cut spending, and to support your spouse in their job search. The First Things To Do When Your Spouse Loses Their Job Supporting your spouse when they lose their job can make a tough situation easier. Your spouse may need at least a few days to get over the shock and regroup. Give your spouse some space to wallow, and encourage them when they're feeling down. But also focus on these moves. Figure out health insurance If you relied on your spouse's job for health insurance, you need to figure out another way to get coverage. If you're working, see if you and your spouse can get onto your employer-sponsored plan. If that's not an option, consider COBRA (a law that lets you continue employer-sponsored coverage, if you pick up the employer's part of the cost) or more affordable solutions like the Affordable Care Act Marketplace. You can also find out if you qualify for Medicaid. Sign up for unemployment benefits Do this right away because there's often a mandatory waiting period after you file before benefits kick in. Unemployment benefits won't replace your spouse's paycheck in full when they lose their job, but they can replace a portion. You're generally eligible for unemployment benefits when you lose a job through no fault of your own. Benefits are usually paid weekly, and the amount you get depends on your state and your former salary. Find out about severance It may be that your spouse is entitled to a severance package, which could put some money in your pockets while they begin a job search. Encourage your spouse to talk to their human resources department for details. Find out whether your spouse can cash out unused sick or vacation time If your spouse accrued sick or vacation days that they didn't use by the time they were laid off, they may be eligible to get paid for that time. This, too, is a question for the human resources department. Get on a budget It's important to maximize your joint income when a spouse loses their job. Create a budget and aim to find expenses you can cut back on temporarily. You may be able to pause subscriptions, a gym membership, or even your mortgage payments if you're in the midst of a financial hardship. Assess your savings If you have an emergency fund with enough money to cover a few months of bills, see if that can take some of the pressure off while your spouse regroups. You should still get onto a budget and trim expenses, but it's helpful to know how long your savings can sustain you. Know your rights If you think your partner was discriminated against in the course of losing their job, there may be something you can do. Check with your state's Department of Labor or search online for legal aid groups. You can also contact employment attorneys. Many offer a free consultation in which they offer an opinion on whether you should move forward with a case against the employer. Priorities to Focus On During the Job Search When you get upsetting news, it can be tough to deal with at first. But after the reality of unemployment has set in and a few weeks have passed, consider doing the following. Get a handle on your debt While debt management with a loss of income is hard, it's not impossible. If you can no longer make your debt payments, contact your creditors and lenders to find out what options are available. They may allow you to make partial payments or defer your payments, especially if you've always paid on time. You can also potentially avoid adding to your debt by dipping into your emergency fund or picking up a side gig to pay for basic expenses. Support your spouse's job hunt There are a few ways you can help your spouse while they look for a new job. Be a sounding board for resume updates. Keep your eye out on sites like Indeed, LinkedIn, and Monster for positions that you think may pique their interest, or that might be something new to consider. Reach out to your professional and social network to drum up leads. Most importantly, help keep your spouse's spirits high, and reassure them that they will eventually land a job. Stay mentally and physically healthy It's important to keep your spirits-and your spouse's-up when they lose their job. Having no routine could be tough on your spouse, so try to find ways to get them moving and out of the house. That could mean going for a walk together every evening when you get home from work, or finding an online yoga class. Tap career resources Your spouse may be eligible for employment and training programs offered by your city or state. Or there may be free courses online that can help your spouse boost their skills. Help them look into their options so they don't feel like they're going through this alone. Strategies for Getting Through a Long Job Search You can hope that your spouse will find a job pretty quickly after losing one. But that may not happen. Many employers have lengthy interview processes that can take months to complete. And also, it's important for your spouse to find a new job that's a good fit. But if your spouse's job hunt seems to have stalled, you can do the following. Help your spouse change industries If your spouse hasn't been able to find work in their field, it may be time for them to consider expanding their horizons and changing industries. Find out which industries are in high demand, and discuss those options. If your spouse expresses interest in one of them, there may be training and education programs to enroll in. Try to frame your spouse's career change as an exciting opportunity, as opposed to something they're doing out of necessity. Rethink near-term financial goals You may have had plans to remodel or buy a home, pay off your car, or start a college fund for your children this year. Your spouse's unemployment may force you to temporarily rethink your financial plans. But remind yourselves that you're not giving up on your goals-you're just shifting them a bit due to circumstances outside your control. See if you're eligible for government benefits If your household income has taken a big hit, you may be eligible for certain benefits you weren't entitled to before. These could include Medicaid and SNAP. Research whether moving might help If your spouse is having a hard time finding work where you live, it may be time to consider a move. Or you may decide to move to lower your costs while your spouse is in the midst of a career transition. Research different parts of the country together to see what options you have. Be creative about income If it's been a while since your spouse collected a paycheck and their unemployment benefits are running out, find creative ways to boost your income. Rent out an in-law unit you don't use; sell stuff you no longer want or need; get a part-time job; and do whatever else you can think of to make some extra money. And remember: This too shall pass. Be a sounding board Being unemployed long-term can be tough, but your support can get your spouse through it. Commit to being a sounding board throughout their job search. Celebrate their wins, like getting interviews, and let them vent when they're down, like when they're passed over for another candidate. Consider debt relief If the loss of your spouse's job has made your debt situation worse, it may be time to explore options for debt relief. A debt relief company can help explain your choices, and help you find a solution that can put you on the path to a better financial future. Frequently Asked Questions Will losing a job hurt my credit score? The loss of a job won't directly affect your credit score, since employment isn't a factor in calculating it. But the loss of income you experience could cause you to fall behind on your debts. That, in turn, could result in a lower credit score. Can I pause my debt payments if I've lost my job? That's up to your lenders and credit card issuers. Contact them and let them know your situation. They may agree to pausing your payments for a time without reporting you to the credit bureaus as delinquent on your debt. Should I take out a loan if I've lost my job to cover my expenses? It can be tricky to qualify for a loan if you don't have an income. Plus, you might struggle to pay the loan back if you aren't working. This story was produced by Freedom Debt Relief and reviewed and distributed by Stacker. © Stacker Media, LLC.
Yahoo
30-04-2025
- Business
- Yahoo
‘It's been a long road;' Woman's health insurance nightmare comes to an end 18 months later
After 18 months of fighting, a woman told News Center 7 I-Team she is relieved because she's finally solved a health insurance nightmare. [DOWNLOAD: Free WHIO-TV News app for alerts as news breaks] In November, the I-Team first reported that the woman's health insurance company changed and then cancelled her coverage, without her permission. Lorie Delaney has spent a lot of time on the phone over the last year and a half fighting for her family. 'Frustrating, angry, overwhelming,' she said. This week, the call from the Affordable Care Act Marketplace was different. TRENDING STORIES: Babysitter wanted after 1-year-old suffers third-degree burns Uber driver wearing 'Retired Drug Dealer' shirt arrested after 24 grams of meth found in car Severe storms sends trees crashing into homes, powerlines across Miami Valley 'I told my husband, I said, 'I'm crying.' I said, 'but all tears of joy,'' Delaney said. In November, News Center 7 reported that Delaney and her husband, Randy, said a rogue insurance broker treated their healthcare like a pinball. Bouncing them around from one ACA insurance plan to another to make money. News Center 7 uncovered that it's happened to hundreds of thousands across the country who rely on the ACA. That rogue broker incorrectly adjusted the Delaneys' income several times, which can cause IRS penalties of thousands of dollars. 'We went ahead and paid the $14,421 federal tax bill that was due,' Lorie said. Before that, Lorie appealed, saying she thought her tax forms were incorrect because she was victimized by fraud within the ACA Marketplace. Just this week, she learned she won the appeal. She'll be getting corrected tax forms to file, and then about half of that 14,421 dollars. 'Like I said, they were happy tears that maybe we can finally close the door on this chapter and be done. So, it's been a long road,' Lorie said. Lorie said she's talked to a lawyer about joining the class action lawsuit. The class action lawsuit claims families who rely on the Affordable Care Act Marketplace for healthcare are victims of a multimillion-dollar health insurance fraud scheme. The companies named in the lawsuit have denied wrongdoing. [SIGN UP: WHIO-TV Daily Headlines Newsletter]
Yahoo
15-04-2025
- Health
- Yahoo
Illinois Gov. Pritzker and other Democrats sign letter protesting changes to healthcare
CHICAGO, Ill. (WTVO) — Illinois Gov. JB Pritzker has joined four other Democrat governors in signing a letter protesting the Trump administration's proposed changes to the Affordable Care Act Marketplace. The efforts are part of President Donald Trump's announced efforts to cut the federal budget and reduce the burden to taxpayers. The budget resolution adopted by the House in February calls for $880 billion in budget cuts for the House Energy and Commerce Committee, which oversees Medicare and Medicaid. While Trump has denied plans to cut Medicare or Medicaid, analysts say it would be impossible to reduce the committee's budget without those cuts. The proposed Marketplace Integrity and Affordability Proposed Rule would revise standards relating to past-due payments, exclude Deferred Action for Chilchood Arrivals (DACA) recipients from certain coverage, change work requirements for eligibility, and remove mandates for insurers to cover gender affirming or sex-trait modifications. 'It's a clear signal that, certainly, the federal government would not be looking to ensure that coverage is not discriminatory, as it has been doing before,' Katie Keith, director of the Center for Health Policy and the Law at Georgetown University. Analysts say the potential changes would shift Medicaid costs away from the federal government and to the states, which have to make up the difference. The federal government covers 90% of expansion states' Medicaid budgets, with nonexpansion states receiving a of 50%-77%. The governors contend that the proposed rules would result in higher insurance premiums and cause low-income residents to abandon healthcare coverage altogether. The letter, signed by Gov. Pritzker, Gov. Jared Polis of Colorado, Gov. Michelle Lujan Grisham of New Mexico, Gov. Wes Moore of Maryland, and Gov. Tina Kotek of Oregon, is addressed to Peter Nelson, Director of the Centers for Medicare & Medicaid Services. 'Any rule changes for the 2026 plan year, which will be filed for approval in late spring, create ahigh risk of destabilizing state health insurance markets, particularly as Congress contemplatesthe expiration of enhanced Affordable Care Act (ACA) tax credits and cuts to Medicaid,' the letter reads. The governors jointly argued against key concerns, such as restricting the state's ability to set open enrollment periods and determine eligibility for coverage, eliminating options for special enrollments, and changing premium adjustment calculations. 'Once again, it is clear that the Trump Administration will stop at nothing to restrict access to health insurance for Americans,' said Pritzker. 'This proposed rule will cause confusion, make it harder to enroll, and limit healthcare access for the most vulnerable Illinoisans.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
