It’s not too late to sign up for Obamacare- But if you wait much longer you could face a fine

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 Note to HealthBeat readers: I have recently begun writing posts about healthcare and healthcare reform for Consumer Reports. Below, an excerpt from my latest post. M.M

It’s still not too late to sign up for insurance in your state’s marketplace. Open enrollment for Obamacare continues until Feb. 15. Meet that deadline, and you will be insured on March 1, with no penalty.

And if the plan you purchased in 2014 was automatically renewed on Jan. 1, you can still change your mind, comparison shop, and pick a new policy in February. There are lots of good reasons to shop around, as plans change from year to year.

Even better news: It’s not too late to apply for a tax credit that can help slash premiums. This year, nearly 9 out of 10 people who purchased insurance in state marketplaces have qualified for financial assistance. Last year, tax credits cut the average premium by 76 percent—to just $82 per month. Almost half of those who received subsidies wound up paying $50 or less. See if you might qualify for a subsidy.

Who has to pay fines?

Even if you don’t have insurance in January and February, you won’t have to pay a fine as long as you have health insurance in place by March 1.

How much will you owe?  Compare penalties to premiums in your zip code

Turbotax has created an online calculator that tallies the fine if you don’t buy insurance by Feb. 15.

To compare the fine to the cost of coverage, after subsidies, use the Kaiser Family Foundation’ premium calculator.

You will find links to both when you read the rest of this post on Consumer Reports.org.

 

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OBAMACARE ENROLLMENT (part 2) Who Will Remain Opposed to Obamacare in 2015? “Zero-Sum Thinking”

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In 2015, I predict that Obamacare enrollment will soar, matching 2014’s success.

This may seem counter-intuitive. After all, in recent months, the public’s perception of Obamacare seems to have soured. The Henry J. Kaiser Foundation’s health care tracking poll for July reveals that 53% of those surveyed last month said they view the Affordable Care Act unfavorably—a jump of 8 percentage points since June.  July’s results mark the first time since January, that more than half of all Americans opposed the health reform law

Is this because people who have enrolled in the Exchanges are unhappy with the insurance they purchased?

No.

      Most People Who Signed Up for  Obamacare Are Happy

Just one month earlier a Kaiser Foundation poll showed that “71%” of those who have enrolled in insurance plans that comply with Obamacare’s rules “rate their coverage as excellent or good overall,” and “more than half (55%) say it is an excellent or good value for what they pay for it.”

This is in part because in the Exchanges, middle-income as well as low-income customers qualify for government assistance to help cover premiums. As a result, 87% of customers have received subsidies that come in the form of tax credits. 

Nearly six out of ten of Obamacare’s new customers were previously uninsured, Kaiser reports, while the remainder are “plan-switchers” – people who previously had individual market coverage and switched to new coverage after Jan. 1.  This group includes people who had their old policies cancelled as the ACA’s requirements kicked in, as well as people who switched for other reasons, including the availability of premium subsidies.

No surprise, customers who were forced to switch to a plan that meets Obamacare regulations are not as pleased as those who were previously uninsured. Yet nearly half of the “switchers” acknowledge that after using the tax credit, their new, more comprehensive Obamacare plan costs less than their old policy. This means that they are getting more for less. And I would predict that as they use their new policies ( and discover, for example, that preventive care is free)  many will become more enthusiastic.

Here is  the bottom line: “As a whole,” Kaiser observes, “enrollees are more likely than the public overall to have a favorable view of the ACA: they are roughly evenly split between positive and negative views (47% favorable vs. 43% unfavorable). By contrast, views among the general public are more negative than positive (38% favorable vs. 46% unfavorable.)

In other words, people who have had direct experience with Obamacare are more likely to support it. Those who have only read about reform are more likely to be opposed

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Border Crisis: Fictions v. Facts (Part 2 of “Children from Central America”)

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Despite extensive media coverage, there is probably much that you don’t know about the history of the border crisis—and what we can or should do in response. Too often the headlines are designed to stir passions, rather than inform.

At the end of next week, Congress will leave for its five-week August Recess. Between now and then legislators will be debating the issues, and no doubt many of your friends will be taking positions.

Here are the facts you need when weighing what you hear–whether on television or at a neighbor’s barbecue.

  •  Are you aware that since President Obama took office, it has become harder for illegal immigrants to cross our Southwestern border? This is something Fox News doesn’t usually mention.
  •  Did you know that even if we deport the tens of thousands of children who have come here since last October, many refugee experts agree they’ll try again—and that other children will follow them? In other words, they say, deportation will not serve as a deterrent. These kids are running for their lives.
  • Are you aware that in the past the U.S. has backed military coups and paramilitary death squads in Central America? As democratically-elected governments toppled, constitutional order collapsed, and the gangs took over the streets.  Does this mean that we are in part responsible for the exodus of kids fleeing violence at home? That is a difficult question, but definitely worth thinking about.
  • Did you know that the most powerful gangs originated in Los Angeles?  In the 1990s, we began deporting these thugs (via ConAir), and dumped them back in countries ill-equipped to police them.
  • Had you heard that the kids coming in today are not trying to avoid border patrols? They are rafting, swimming, and walking into the U.S. in broad daylight. So the problem is not that we don’t have enough border patrols to “secure the border. “ The new immigrants are eager to turn themselves over to border officials. Why? In 2008, former President George W. Bush signed the “William Wilberforce Trafficking Victims Protection Reauthorization Act.” This bipartisan measure mandates that the border patrols cannot simply send unaccompanied minors from Central America back to their home countries. The U.S. government must try to find responsible relatives in the U. S. and place the children with them (or in foster homes) while they await a hearing before an immigrant court judge.

Understanding this law–and why it passed so easily in 2008—is key to understanding the legal and moral quandary that President Obama and Congress now face.

  • Finally, how many Americans are aware that, despite high unemployment rates in the U.S., we face a labor shortage? We need more immigrants willing to pick crops, work construction, and provide long-term care for baby-boomers.

Canada’s population also is aging, and Canada  is welcoming them l —part of that  country’s embrace of multiculturalism. We are not. Are we missing something?

All in all, this crisis is far more complicated than most reports acknowledge.

Before you decide where you stand on the issue, you might want to consider the media myths vs. the facts below.

                                        On President Obama’s Role

Fiction:  President Obama’s lax immigration policies have encouraged children to stream into this country.

Fact: As marauding gangs have taken over cities in Honduras, El Salvador and Guatemala, children have been fleeing, not only to the U.S. , but to Nicaragua, Panama, Mexico, Cost Rica and Belize.

 From 2008 to 2013, the UN High Commission on Refugees (UNHCR) has documented a 712% increase in the number of Central Americans applying for asylum in those five countries.

Clearly President Obama’s policies on immigration did not drive their decision to seek safe haven in Panama or Costa Rica.

Fiction: Reports of violence in Central America have been greatly overblown. These children are coming to the U.S. in search of jobs, social services and better living conditions.

Fact: Street gangs in Honduras, Guatemala and El Salvador torture and execute young boys who refuse to join. As I explained in part 1 of this post gang members also pick out young girls who they want to be their “girl-friends”—which means they will be raped by one or more members of the gang. Neither their families nor the police can protect them. This is why they run.

According to the U.S. State Department, Guatemala now has one of the highest violent crime rates in Latin America. El Salvador reports the second-highest murder rate in Latin America, and Honduras ranks #1, world-wide.

There, child murders are up 77% from just a year ago.

Finally, note that Nicaragua, which is the poorest nation in mainland Latin America (and the second poorest in the Western Hemisphere, after Haiti)  has seen a 238% increase in asylum applications from Central Americans in the last year. This serves as strong evidence that desperate children and families are not seeking “economic opportunities.”

There are no opportunities in Nicaragua. They are fleeing the mayhem at home.

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Children from Central America Surge Across Our Border: Congress Must Now Decide Whether to Change the Immigration Law that George W. Bush Signed in 2008

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If you think fertilized eggs are people but refugee kids aren’t, you’re going to have to stop pretending your concerns are religious– Syd’s SoapBox

News reports have been filled with conflicting theories explaining why tens of thousands of unaccompanied children from Honduras, El Salvador and Guatemala, have been streaming into the U.S.  Some observers say that their parents are sending them here, so that they can take advantage of the social services and free education available in the U.S. Others argue that they are not coming here willingly, but that they have been forced to flee gang violence in their home countries that ranges from murder to rape. Still others charge that President Obama’s lax immigration policy has drawn these migrants to the U.S.

Unfortunately many of the reports circulating in the media and the blogosphere are not backed up by evidence.  Even worse, the American Immigration Council  (AIC) says, “some are intentionally aimed at derailing the eventual overhaul of our broken immigration system.” 

I have been fact-checking those reports for more than two weeks.  Below, a summary of you need to know as we debate this tangled story.

The AIC recently released a report, based on documented interviews with more than 350 children from El Salvador which states that  “crime, gang threats, or violence appear to be the strongest determinants for childrens’ decisions to emigrate.

Typically, the gangs try to recruit children. If they refuse, they and/or family members are shot. 

The United Nations High Commissioner for Refugees (UNHCR) offers charts showing how that in 2012, the murder rate in Honduras in was a whopping 30 percent higher than UN estimates of the civilian casualty rate at the height of the Iraq war. The charts  also reveal that, statistically speaking, Honduras, Guatemala and El Salvador are twice as dangerous for civilians as Iraq was.

Writing on Vox, Amanda Taub explains why minors are in special danger: “Children are uniquely vulnerable to gang violence. The street gangs known as “maras” — M-18 and Mara Salvatrucha, or MS-13 — target kids for forced recruitment, usually in their early teenage years, but sometimes as young as kindergarten. They also forcibly recruit girls as “girlfriends,” a euphemistic term for a non-consensual relationship that involves rape by one or more gang members.”  

This is what 15-year-old Maritza told the UNCHR when it interviewed hundreds of the fleeing children: “One member of the gang  “liked” me. Another gang member told my uncle that he should get me out of there because the guy who liked me was going to do me harm. In El Salvador they take young girls, rape them and throw them in plastic bags.”

Maritza’s uncle knew that neither he nor the police could protect her. “My uncle told me it wasn’t safe for me to stay there. They told him that on April 3, and I left on April 7.”
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Polarized Politics Led To Cantor’s Defeat– and Cochran’s Victory. Why the “Uncommitted Center” Is So Important (Cantor part 2)

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Please scroll down for Part 1 of this post. 

When House Majority leader Eric Cantor lost his seat to ultra-conservative David Brat, the Washington Post’s Ruth Marcus summed up the majority view among political pundits: “The episode offers a disturbing commentary about the poisonous, polarized state of American politics.”  

I cannot agree. I don’t think “polarization” is toxic.  To the contrary, as the poet William Blake once wrote “Without Contraries, No Progress.”  Conflict can clarify issues, and help us move forward.  Indeed, the clash of opinions is a time-honored way of testing their validity.

Do you remember the 1990s, a decade when it became difficult to tell the difference between Democrats and Republicans? While Republicans headed toward the far right, Democrats moved right of center. During his second term, Bill Clinton started to sound all too much like Ronald Reagan, as he set out to “reform welfare,” forcing single mothers to go to work, even though we weren’t offering them affordable day care. After leaving the White House, Clinton reclaimed his position as a stand-up liberal, but at the time, the distinction between Democrats and Republicans was badly blurred.

Today, the difference between the two parties is clear.  I wouldn’t say that Democrats are ultra-liberal, but conservatives have moved so far to the right that Democrats had no choice but to take a stand on critical issues including: global warming, gun control, the need to raise the minimum wage, and universal access to health care.

By contrast, in the 1990s, Congressional Democrats were “lukewarm” on health care reform. As  Paul Starr reports in his newest book, Remedy and Reaction, Senate Finance Committee chairman, Daniel Patrick Moynihan, Democrat of New York, actually stood up to say, “We don’t have a health care crisis.”

But by  2010,  the crisis was obvious, and Democrats came together. Pelosi and Harry Reid marshaled the votes, and Congress passed legislation which, while far from perfect, is solidly progressive: Low-income and middle-income Americans receive the subsidies they need; insurers can no longer discriminate against people suffering from pre-existing conditions, and preventive care–including contraception–is free.There is much more work to be done, but at last, we have begun.

Since then, Congressional Democrats have not had the votes to pass much-needed legislation in other areas.

But at least President Obama is no longer the compulsive compromiser that he appeared to be during his first term in office. I see this as progress.  As I have argued in the past, on some issues compromise is not an option.  Too much is at stake. 

On the ground,voters are as divided as their elected representatives.  Politically active Democrats have begun to move  left of center while Republican voters have become more conservative. The Pew Research report that I discussed in the first part of this post reveals that a decade ago, only 10% of politically engaged Republicans took a conservative stance on almost all issues. Today, 33% express consistently conservative views. At the other end of the political spectrum, almost forty  percent of committed Democrats are consistent liberals, up from just 8% in 1994. The overall share of Americans who express consistently conservative or constantly liberal opinions has doubled over the past two decades from 10% to 21%. .

“As a result,” Pew reports, “ideological overlap between the two parties has diminished. “Today, 92% of Republicans are to the right of the median Democrat, and 94% of Democrats are to the left of the median Republican.”. 

“Republicans and Democrats are more divided along ideological lines – and partisan antipathy is deeper and more extensive – than at any point in the last two decades. And a new survey of 10,000 adults nationwide finds that these divisions are greatest among those who are the most engaged and active in the political process.”

                                 Is Polarization A Threat to the Nation?

Most pundits are appalled.
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Cantor’s Defeat—What It Does Not Mean– Part 1

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Shocked by House Majority Leader Eric Cantor’s defeat in last week’s Virginia primary, many in the media have decided that this “earthquake” has re-shaped the political landscape.

Immigration reform is dead, they say, and tea party radicals are far stronger than many suspected.

Meanwhile, the alarmists warn, political polarization has divided the country, poisoning our democracy. On that last point they are half-right; Republican voters have moved to the far right, while politically active Democrats are beginning to shift toward the left.

But polarization is not necessarily a threat to the Republic.  Pointed debate can clarify the issues– and underline what is at stake, raising voter awareness. Conservatives are making it clear what they are willing to sacrifice for the sake of their ideology, and mainstream Americans are becoming alarmed. For example, David Brat, the far-right conservative who defeated Eric Cantor, says that he would like to slash social security by 2/3.  This is a statement that could bring out voters who normally would not vote in a mid-term election.

As I will argue in part 2 of this post, at this point, too many mainstream America are not paying attention to the issues. “I’m just not interested in politics,” they say. Or, “I’ve given up on politicians.” A democracy needs a passionate, engaged electorate. Indifference is what will poison the Republic.

Cantor’s Loss Does Not mean that “Immigration Reform is Dead”

The conventional wisdom says that, until recently, President Obama had been waiting for the House to act on immigration reform. Supposedly, Eric Cantor, the House Majority leader, was open to some sort of compromise on an overhaul of immigration law, and this is why he lost the primary.

Not so fast.

First, this is not all up to the House. Obama could use his executive authority to limit deportations.

Speaking at a fundraiser the day after the primary, President Obama said: “It’s interesting to listen to the pundits and the analysts and some of the conventional wisdom talks about how the politics of immigration reform seem impossible now. I fundamentally reject that.” 

An Army of Refugee Children Flood Our Borders–What Should We Do?

Even as the president spoke, thousands of children from Central America continued to surge across our border, seeking an escape from the violence and poverty of Central America.

Once minors get into the U.S., they typically turn to immigration agents for protection. Under a  law passed during the George W. Bush administration, children, unlike adults, cannot simply be deported.  They must be turned over to Health and Human Services, and protected while their case is decided. Some will go to court where Legal Aid lawyers will argue that they will be in danger if they return home. Others will be reunited with relatives in the U.S. Some will ultimately be deported–but this could take years.

On Fox Special Report with Bret Baier, political analyst Brit Hume paid tribute to these lone childrens” struggle and their courage: “The immigrant children illegally crossing American borders by the thousands have triggered a logistical, humanitarian and law enforcement crisis to which current US immigration policy has no satisfactory answer.

“It may be tempting to call for their deportation,” he added, “but that ignores an important consideration: what the minor children, most of them unaccompanied by adults, had to go through just to get here.

“Nearly all are from Guatamala, El Salvador and Honduras, three countries plagued by extraordinary levels of drug and gang violence. Honduras now has the highest per capita murder rate in the world.”

“I have seen some of these kids,” Hume told his audience. “A youth home where I serve on the board here in Virginia has taken in dozens of them.  They are remarkable kids from what I have seen of them.  They are well behaved. When meals are served some of them weep at the fact that they’re eating better than their families can back home.  They wait till all are served before they’ll eat. They turn up at prayer services.  . . .  They potentially could make an enormous contribution to this country if we can find a way to house them and care for them and let them stay”. (Hat-tip to Digby for calling attention to Hume’s impassioned speech.)

The flood of young refugees, crossing into this country daily– and overflowing holding centers—casts a spotlight on their plight, making it clear that illegal immigration is not a problem that we can ignore. We just don’t know what to do with these children.

One Boy’s Story

“‘Where I live, parents are obligated to give a son to the gangs,'” Carols, a 17-year-old from Honduras told Bloomberg, while fighting back tears. An uncle who tried to defy the criminals paid with his life.

Another child showed Bloomberg his right hand: before he fled Honduras, a gang had accosted him on the street and amputated the tips of two fingers

“If you want to live, you have to leave your family,” a third 16-year-old confided.

“Carlos’ journey of 1,700 miles (2,700 kilometers) took about a month by bus and foot,” Bloomberg reports. When he arrived in northern Mexico, just a quarter mile from the border, he  explained that he hasn’t decided whether he’ll try to reach an uncle in Houston clandestinely or voluntarily surrender to border agents.

“’If I do that, they could deport me,” Carlos explained

“That could be fatal,” the reporter observed.
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The “Cholesterol Con”–Eggs

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In the past, I have written about the “cholesterol con” (part 1), the widespread  belief that high levels of “bad  (LDL)  cholesterol” can cause heart attacks. As I have explained (part 2), the myth has generated enormous profits for many commercial interests, including companies that peddle statins. (Please read both parts of the post.)   No surprise, manufacturers  have poured millions of dollars into perpetuating the myth, and  thus have succeed in convincing a great many Americans that they should avoid high-cholesterol foods–including eggs.

According to Harvard University’s Harvard Heart Letter, however, it is not the cholesterol in eggs or other food that’s a major culprit. It’s saturated and trans fats (which our bodies may convert to artery-clogging cholesterol).

Today, as my husband, son, daughter-in-law and I celebrated Father ‘s Day with a brunch that featured “perfect scrambled eggs” (here is the recipe), fresh fruit and mini-bagels, I regaled them what I had just learned by reading  “Heart Sisters.” (Okay, “regaled” is the wrong word. My son and husband are not quite as interested in healthcare topics as I am. But my daughter-in-law—who is from the South, has lovely manners, and a kind heart — is always extremely interested in what I have to say.)

On Heart Sisters, Carolyn Thomas (a Mayo-Clinic trained heart attack survivor) lays out what Harvard’s cardiologists tell us about the egg:

“Fact: Eggs are a good source of nutrients. One egg contains six grams of protein and some healthful unsaturated fats. Eggs are also a good source of choline, which has been linked with preserving memory, and lutein and zeaxanthin, which may protect against vision loss.

“Myth: Eating eggs is bad for your heart. The only large study to look at the impact on heart disease of eating up to six eggs per week (reported in the April 2008 issue of the American Journal of Clinical Nutrition) found no connection between the two. In people with diabetes, though, egg-a-day eaters were slightly more likely to have developed heart disease than diabetics who rarely ate eggs.  (Ed. note: Quelle surprise . . . this study was done on men only).

“Fact: Eggs do have a lot of cholesterol. The average large egg contains 212 milligrams of cholesterol. As foods go, that’s quite a bit, rivaled only by single servings of liver, shrimp, and duck meat. Your daily cholesterol maximum intake should be below 300 mg.

“Myth: All that cholesterol goes straight to your bloodstream and then into your arteries. Not so. For most people, only a small amount of the cholesterol in food passes into the blood. Saturated and trans fats have much bigger effects on blood cholesterol levels.

“So if you like eggs, the Harvard Heart Letter says that eating one a day should be okay, especially if you cut back on saturated and trans fats, plus dietary cholesterol from other sources such as red meat.

“Other ways to enjoy eggs without worrying about cholesterol include not eating the yolk, which contains all the egg’s cholesterol.” (Note: II personally like to have two eggs for breakfast poached, soft-boiled or fried in just a little butter two or three times a week. I eat mainly the whites just dipping them in the runny yolk. In this way, I consume just one yolk–MM.

Happy Father’s Day.

 

 

 

 

 

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Cantor’s Defeat–Wittiest One-Liners

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Eric Cantor’s shellacking has drawn much attention–perhaps two much commentary. (After all, this was just a primary.  I don’t think that it “Changes Everything.”)

That  said, here are my favorite comments on this event::

— “‘Brat Upsets Cantor’ . . . The headline sounds like a failed Bar Mitzvah” — Delaware Dem

—On Tuesday night, Ezra Klein wrote:“John Boehner must be having an emotionally complicated evening.”

 

 

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