Tuesday, March 14

When Does Making a Choice Seem Like No Choice At All?

When You're 60, Sick, and Trying To Get Good Healthcare Coverage.

At least that's what the CBO (Congressional Budget Office) says in the report it just issued on the AHCA, which is the acronym for the American Health Care Act, or 'Trumpcare' if we are to follow the Republican naming conventions. 'Trumpcare' is supposed to replace 'Obamacare', as Trump still insists on calling it. It was actually named the Affordable Care Act, which was one of the main focuses of the plan. We keep hearing that the new plan is going to be better, but what I wonder is, better for who?

Judge for yourself....

We finally have some numbers on what the Republicans’ proposed replacement for the Affordable Care Act is going to do to health insurance coverage and costs. The estimate, from the Congressional Budget Office, says that 24 million of us will lose coverage, and the rest of us will probably see our deductibles go up.
You can read the full report here. The CBO only looks at big picture questions, like what happens to the deficit and how many people will lose coverage each year. It’s not a crystal ball that can tell you what happens to the particular plan that you’re on now. But with this information, we can make some good guesses.
By the way, this bill is still very far away from becoming law, although Republicans in Congress are trying to hurry it along. It hasn’t yet had a vote by the full House of Representatives, and after that it would need to go to the Senate. President Trump would be able to veto it after that if he wanted to keep his campaign promises to “have coverage for everybody” and enact “no cuts to...Medicaid.”
This bill is also only the first stage of a three-point plan. Later, Congress will consider cutting essential benefits like maternity care, so insured people get even less for their money. But that’s all in the future—let’s look at the legislation that’s in front of Congress right now.
Will I Lose Insurance Coverage?
You might. If the bill is passed, 24 million people will lose coverage by 2026.
Right now, about 10 percent of people are uninsured. If the ACA stays in place, that number will hold steady. If the American Health Care Act replaces it, the total people uninsured in this country will go up to 19 percent. That’s even higher than pre-ACA numbers.
The CBO figures the people who lose coverage will include:
  • 4 million people who stop buying insurance this year because the tax penalty won’t be enforced. If you currently only have insurance because you’re afraid of the penalty, this is you.
  • 14 million people who would otherwise be eligible for Medicaid.These include a lot of low income adults in the 31 states that participated in the Medicaid expansion. Medicaid also provides care for kids, people with disabilities, and seniors in long term care. Medicaid cuts and caps begin in 2020.
  • 2 million people (each year) who had a gap in coverage and would have to pay a 30 percent penalty for a year when they buy coverage again. The penalty makes people want to keep coverage when they have it, so an initial 1 million will avoid dropping coverage at first.
  • Plus a bunch of people who say “no thanks” when premiums get too high. Older people face serious premium hikes; younger people won’t be as hard hit, but other changes mean insurance won’t be as good a deal for them.
A lot of the uninsured will be people who buy their insurance on the exchanges or who use Medicaid, but the CBO also estimates that some employers will stop offering insurance as a benefit—affecting perhaps 2 million people, who could still choose to buy a plan on their own. On the bright side, your employer might take the money they save and put it into different benefits or give you a small raise.
Will My Premiums Get More or Less Expensive?
First the one, then the other—if you’re young. For older folks, premiums will go up and up.
At first, premiums on the individual market will go up by 15 to 20 percent. With the tax penalty repealed, the young, healthy folks who choose to go without insurance won’t be paying into insurance plans. That means premiums have to go up for the people who stay.
By 2026, premiums will end up slightly cheaper, on average, than they would be if we continued under the ACA. (The CBO did not compare these to what premiums cost today, so it might still be more than what you’re currently paying.)
Currently, the ACA helps people buy insurance by paying part of your premium if you fall below a certain income level (400 percent of the federal poverty line, or about $24,000 this year). The amount of help you get is tied to your income level and to the cost of insurance in your area.But there’s a catch. Premiums will be cheaper because insurance will cover less. You’re not getting the same coverage for less money, you’re just getting less coverage. As we’ll see below, you’ll be on the hook for more costs through high deductibles and cost sharing.
The AHCA’s plan to help people afford insurance is to drop those and offer a tax credit that is larger for older people. But at the same time, they allow insurers to charge old folks five times as much as younger customers. The new tax credit barely makes a dent in those expected premiums.
Here’s an example: in 2026, under the ACA, a single person who makes $26,500 would pay $1,700 in premiums each year, no matter their age. Under the AHCA, if it passes, a 21-year-old would pay $1,450 (hey, not bad) but a 60-year-old would pay $14,600. That’s more than half of their very small income. If that person had a gap in coverage, the penalty would bring the total to 77 percent of their income, leaving just $6000 for everything else that person has to pay for in their life. Including their deductible.
Will My Deductible Still Be Sky-High?
Actually, it will probably get even worse. Right now, the cheapest insurance plans must cover at least 60 percent of their customers’ costs. Those are the “bronze” plans, and the other tiers cover more: 70 percent for silver, 80 for gold, 90 for platinum. If an insurer wants to participate in the Marketplace, it must offer a silver and a gold plan.
The AHCA takes away those requirements, so an insurer could decide to only offer low coverage plans. The CBO guesses that plans that cover less than bronze would be rare. It also estimates that plans that cover more than bronze will be rare, because those plans would attract sicker people that would rack up higher medical costs, so insurers might not be able to make them profitable.
High deductibles are a very simple way to make insurance cheaper (to entice people to buy it) but they also make insurance less helpful. If a plan only covers 60 percent of costs, on average, a lot of people will be maxing out their deductibles, and perhaps paying coinsurance and copays, too. The ACA currently provides subsidies for these “cost sharing” measures to certain low income folks. Those subsidies are going away, so the deductibles will sting even more.
Will I Still Be Able to Purchase Coverage If I Want It?
The good news is that the CBO sees the insurance market as stable—no “death spiral” resulting in the failure of the industry—under both the ACA and its replacement. So, insurance will still be around. A few employers will drop insurance as a benefit, as we mentioned, but you can still buy your own.
It may be harder to compare plans, though. Without the plan tiers, it will be harder to tell which plan is a better deal than another. And there will no longer be a requirement for plans to sell their insurance on the exchange websites like healthcare.gov, which was a handy one-stop shop.
Your choice of plans will probably change. There will probably be plenty of lower coverage plans available, which are the cheapest kind. But if you want to buy high coverage insurance (with, for example, small deductibles), there’s no guarantee that insurers will offer any.
You may also simply be unable to afford insurance if you are older, if you have a low income, or if you live in an area where insurance tends to be very expensive. The ACA’s subsidies helped in those situation, but those will be gone if the new law passes. You will, in a sense, have the “choice” to go without insurance or to buy a low coverage plan, but without a lot of cash you won’t really have a choice to buy insurance at all.

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Sunday, March 12

Another Blot On An Otherwise Still Beautiful City

How many towns have something like this buried in their 'closet'?

     I marvel sometimes at just how many small towns (and big cities) have something like this buried deep in their community memory.  I was never even aware that these kinds of secrets existed until Ving Rhames did such an awesome job in the movie  'Rosewood'. (The town in FL where the hunting down and massacring of blacks took place because of one married white woman who didn't want her husband to find out she'd cheated on him, so she lied and said she'd been raped and beat up by a black man,) That was probably the beginning of my search for long-buried secrets, and little known black facts that I could use to educate my brothers and sisters about what we've been up against all these many years, and what we're STILL fighting to get away from.  This one was named The Parchman Ordeal, and it happened in Natchez, MS.

Beautiful Natchez, MS

Parchman Ordeal: Natchez, Miss., Apologizes for Shipping Hundreds of Innocent Black People to State Penitentiary

   Fifty years ago, police in Natchez, Miss., rounded up hundreds of innocent, civil rights protesters 

  and shipped them off to the Mississippi State Penitentiary at Parchman. Last week, the city's mayor 
  and Board of Aldermen publicly apologized for the grave injustice, the Natchez Democrat reports.
In anticipation of the national spotlight that will illuminate the city next year during its tricentennial celebration, the board decided that it was time to make amends and did so in a public resolution.
In October 1965, approximately 700 black citizens who congregated at a local auditorium were arrested for organizing a march in protest of racist voter disenfranchisement. The ordinance cited in the mass arrest was later determined to be unconstitutional, according to Darrell White, director of the Natchez Museum of African American History and Culture. But that didn't matter to the good old boys.
Two hundred of those arrested were shipped off to Parchman, a prison notorious for its inhumane conditions, where they were subjected to mistreatment and abuse. According to the Democrat, the protesters never went before a judge or had their day in court.
White and Galen Mark LaFrancis are in the process of filming a documentary to shed light on the Parchman Ordeal, which, along with other Natchez stories—like the 1967 Ku Klux Klan slaying of Wharlest Jackson—has flown below the nation's radar.
Community activist Dr. Betty Cade, who spearheaded the efforts, told the paper that the public apology "is the first step in getting this out in the open and letting us heal" as the city, once the second-largest slave-trading post in the United States and the largest in the state of Mississippi, heads into its 300th year.
Mayor Larry L. "Butch" Brown agrees.
"The city of Natchez must stare down its shame for the mistreatment of hundreds of innocent, black Natchezians," read Brown during a reconciliation banquet at a local church. " … for 50 years, the city has failed to acknowledge publicly the disgrace of the Parchman Ordeal. The city failed its citizens and failed the principles of this nation.
"Even though it has been a long time coming," Brown continued, "it is not too late to recognize and apologize to those true heroes of Natchez who bravely endured degradation in advancing the cause of equality before the law."  
Let's be clear: A public apology may be great P.R., it may even be well-intentioned, but it is not justice.
I was born and raised in Natchez, Miss. (full disclosure: I consider Mayor Brown a family friend), and this I know to be true: An apology is not nearly enough. "We're sorry" does not rectify the generations of white privilege that are evident in every crevice of this town, or the accepted system of white supremacy that leaves that privilege relatively unchallenged.
It's 2015. We are long past the stage of "first steps."
I think about the plantation economic structure in Natchez and how much the tourism industry is fueled by the blood and broken bones of slaves. This is a town where symbols of that "peculiar institution," including a restaurant shaped like a giant mammy—affectionately called "Black Mammy's" by those racist locals who see nothing wrong with it—is considered a local treasure, and Civil War re-enactments and Confederate flags are considered a part of its charm.
Natchez is home to dozens of gorgeous, immaculately preserved antebellum homes—built by enslaved Africans—that bring tourists from around the world to gaze in awe at a city "where the Old South still lives." It is a city that unapologetically celebrates and profits from a time period when black people in this country were considered less than chattel.
Still, improvements to the infrastructure of black neighborhoods remain minimal; increases in job and business opportunities for people of color remain scarce; educated and skilled educators in an underperforming school district aren't given the resources they need to provide high-quality and globally competitive education for students of color, while private resources are funneled into predominantly white private schools; and limited access to affordable, high-quality, comprehensive health care is evidence of why Mississippi is dangerous for black people in more ways than one.
Despite popular opinion, I don't say these things because I hate Natchez; I say these things because I know it has the potential to be so much better. I say them because my father, two grandfathers and grandmother, who all at different points served on the Board of Aldermen, would say the same thing.
An apology is merely symbolic. Now let's talk about substance.
If the city's robust tourism industry—an industry built on the backs of enslaved Africans and their descendants—is to continue operation, then a percentage of the profits should go toward the redevelopment of a once-thriving black community, an endeavor that engaged community leaders have already undertaken with some success.
If that sounds like reparations, it's because it is. And that's a public conversation worth having—beginning with financial settlements for the individuals wrongfully arrested, abused and denied due process during the Parchman Ordeal.
The apology may allow some members in local government to celebrate the city's tricentennial with a clear conscience, but this city's debt to humanity is not paid. No symbolic gesture of reconciliation for past injustice—no matter how overdue or warranted—is enough, not when systemic injustice is considered business as usual.
  I'll save my applause until there's a resolution on what the local government plans to   
 do about that.  
                         by  Kirsten West Savali 

And I, for one, will be watching for updates on this story, watching to see just what the local government does plan to do about it.

Wednesday, March 1

Nothing Deep Today, I'm On a Rant!!

What Has Happened to Customer Service?

It's been allowed to grow old and die, that's what's happened to it! Somehow the old way of doing things, of caring for the people who pay your bills everyday, THE CUSTOMERS, has gone the way of the dodo bird and tight short shorts on male basketball players. No one cares anymore, no one is being taught manners, or chivalry or given a book by Emily Post! What does this say for the people of this world?

This is what set me off today:

I don't normally do a product or service review unless I've really really liked something, but I'm making an exception today. This Early Bird Books has me so angry; the page had 5 books marked as free, with Amazon, Barnes & Noble,  iTunes, and Open Road Media listed as places to purchase them from. YES, I said purchase!!
Banner from Early Bird Books website
(Click on the caption if you'd like to visit the page for yourself.)

Let me clarify something. My preferred method of reading nowadays is on my Kindle HDX 7, so I exclusively use Amazon when ordering books. Of the 5 books listed, one (1) was available for free, the other four (4) had prices listed!!! I did not check the other retailers, so perhaps the books are free somewhere else, but all the title says is "Free Ebooks to Download Today".  There is no qualifying statement, or explanation given that might shed some light on the situation I found myself in after doing all the clicking through to see if I could get what they were offering.  After staring at the title of the site about 50 times, something caught my attention; above the books is the title , and the Share buttons and blah blah blah, but there is also the date. The date on it is February 24, 2017!! That should  make me feel better, right? Okay they probably WERE free back then! It doesn't make it better though, for me it makes it worse. What happened to the customer service that should have been taking care of stuff like this? To me it says that the site has not been updated, no one has even bothered to remove the old content, so no one gives a hoot about any prospective customers or even the returning customers who might want to see something new!! 

What kind of shady outfit is this that cares so little for the people who use its site? 

Has anyone else had any experience with them?