Some States Roll Back ‘Retroactive Medicaid,’ A Buffer For The Poor — And For Hospitals
From Kaiser Health News, let's take a look at the latest regarding Medicaid.
If you’re poor, uninsured and fall seriously ill, in most states if you qualify for Medicaid — but weren’t enrolled at the time — the program will pay your medical bills going back three months. It protects hospitals, too, from having to absorb the costs of caring for these patients.
But a growing number of states are rescinding this benefit known as “retroactive eligibility.” On Nov. 1, Iowa joined three states that have eliminated retroactive coverage for some groups of Medicaid patients since the Affordable Care Act passed. Each state had to secure approval by the federal government.
Retroactive eligibility has been a feature of Medicaid for decades, reflecting the program’s emphasis on providing a safety net for poor, disabled and other vulnerable people. In contrast to private insurance, determining Medicaid eligibility can be complex and the application process daunting, advocates say. A patient’s medical condition also may keep families from applying promptly for coverage.
All four states — Arkansas, Indiana and New Hampshire, in addition to Iowa — have expanded Medicaid under the health law, which allowed states to include adults with incomes up to 138 percent of the federal poverty level, or about $16,000 for one person. So, in theory, most adults are required to have insurance under the ACA. In practice, each state still has a significant number of uninsured, ranging from 5 to 8 percent of the population.
The retroactive coverage “can compensate for the sorts of errors and lapses that can so easily occur on the part of both the applicant and the government bureaucracy” that delay applications, said Gordon Bonnyman, staff attorney at the Tennessee Justice Center, a public interest law firm that represents low-income and uninsured residents.
State and federal officials say eliminating the retroactive coverage helps encourage people to sign up for and maintain coverage when they’re healthy rather than waiting until they’re sick to enroll. It also fits into federal officials’ efforts to make Medicaid, the federal-state program that provides health care for low-income adults and children, more like private insurance.
But consumer advocates and health care providers say the shift will saddle patients with hefty medical bills and leave hospitals to absorb more uncompensated care when patients can’t pay. Some worry this could be the start of a trend.
In Iowa, the change applies to just about anyone coming into Medicaid — except for pregnant women and children under age 1. The change will affect up to 40,000 residents annually and save the program more than $36 million a year.
“We’re making it a lot more likely that Medicaid-eligible members are going to incur significant medical debt,” said Mary Nelle Trefz, health policy associate at the Child & Family Policy Center in Des Moines, whose organization opposed the change.
When someone has a traumatic health event, the initial focus is to get them stabilized, not figure out how to pay for it, said MaryBeth Musumeci, associate director of the Program on Medicaid and the Uninsured at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)
Patients may neglect to apply immediately for Medicaid, leaving them financially responsible for days or months of care they received before they got in their application, even though they may have been eligible for Medicaid all along.
That’s not the only issue, advocates say. Unlike the commercial insurance market where re-enrollment through someone’s employer is routine, Medicaid requires that beneficiaries’ eligibility be reassesed every year.
“People fall through the cracks,” said Andrea Callow, associate director of Medicaid initiatives at Families USA, a consumer advocacy group.
In addition, complications can arise for people who might need Medicaid coverage for long-term care services. “The criteria are complicated. For a layperson to find those criteria and figure out if they’re eligible” is challenging and they may need extra time, said Musumeci. Once patients have secured coverage, they may already have accrued hefty expenses.
Maybe so, but some people argue that a 90-day retroactive eligibility guarantee is counterproductive.
“We’re trying to get people to behave more responsibly, not less responsibly,” said Gail Wilensky, an economist who oversaw the Medicaid and Medicare programs in the early 1990s under President George H.W. Bush. “That is not the signal you’re sending” with three months of retroactive eligibility. A 30-day time frame is more reasonable, Wilensky said.
In contrast to Iowa, the waivers in Arkansas, Indiana and New Hamsphire generally apply only to adults who gained coverage under the law’s Medicaid expansion. (Indiana’s waiver also applies to other groups.)
Kentucky has a request pending that, like Iowa, would eliminate retroactive Medicaid eligibility except for pregnant women and children under 1, according to KFF.
Under federal law, officials can waive some Medicaid coverage rules to give states flexibility to experiment with different approaches to providing services. And retroactive eligibility waivers in Medicaid are hardly new. A few states like Tennessee have had them in place for years. Tennessee officials eliminated retroactive eligibility for all Medicaid beneficiaries in 1994 when the state significantly expanded coverage under TennCare, as Medicaid is known there. At the time, the state even allowed uninsured people to buy into the program who wouldn’t otherwise qualify based on income, said Bonnyman.
“There was no reason for anybody to be uninsured except undocumented immigrants,” said Bonnyman. “It didn’t seem to have the potential for harm.”
But state officials revamped that program after serious financial problems. Eligibility for TennCare has become more restrictive again.
Other states that waived retroactive coverage for at least some Medicaid groups include Delaware, Maryland, Massachusetts and Utah, according to the Kaiser Family Foundation.
Bonnyman said his group frequently works with Medicaid beneficiaries who have medical bills they can’t afford that accumulated during the months before they applied for Medicaid.
“If you’re a moderate- to low-income working family, one or two days in the hospital is enough to ruin you financially,” he said.
You can read the original article here.
Source:
Andrews M. (14 November 2017). "Some States Roll Back ‘Retroactive Medicaid,’ A Buffer For The Poor — And For Hospitals" [Web blog post]. Retrieved from address https://khn.org/news/some-states-roll-back-retroactive-medicaid-a-buffer-for-the-poor-and-for-hospitals/
Understanding your Letter 226-J
Letter 226-J is the initial letter issued to Applicable Large Employers (ALEs) to notify them that they may be liable for an Employer Shared Responsibility Payment (ESRP). The determination of whether an ALE may be liable for an ESRP and the amount of the proposed ESRP in Letter 226-J are based on information from Forms 1094-C and 1095-C filed by the ALE and the individual income tax returns filed by the ALE’s employees.
What you need to do
- Read your letter and attachments carefully. These documents explain the ESRP process and how the information received affects the computation.
- The letter fully explains the steps to take if you agree or disagree with the proposed ESRP computation.
- Complete the response form (Form 14764) indicating your agreement or disagreement with the letter.
- If you disagree with the proposed ESRP liability, you must provide a full explanation of your disagreement and/or indicate changes needed on Form 14765 (PTC Listing). Return all documents as instructed in the letter by the response date.
- If you agree with the proposed ESRP liability, follow the instructions to sign the response form and return with full payment in the envelope provided.
You may want to
- Review the information reported on Forms 1094-C and 1095-C for the applicable year to confirm that the information filed with the IRS was accurate because the IRS uses that information to compute the ESRP.
- Keep a copy of the letter and any documents you submit.
- Contact us using the information provided in the letter if you have any questions or need additional time to respond.
- Send us a Form 2848 (Power of Attorney and Declaration of Representative) to allow someone to contact us on your behalf. Note that the Form 2848 must state specifically the year and that it is for the Section 4980H Shared Responsibility Payment.
Answers to Common Questions
Why did I receive this letter?
The IRS used the information you provided on Forms 1094/5-C and determined that you are potentially liable for an ESRP.
Where did the IRS get the information used to compute the ESRP?
The IRS used form 1094/5-C filed by the ALE and the individual income tax returns of your full-time employees to identify if they were allowed a premium tax credit.
Is this letter a bill?
No, the letter is the initial proposal of the ESRP
What do I need to do?
Review the letter and attachments carefully and complete the response form by the date provided.
What do I do if the information is wrong or I disagree?
Follow the instructions in the letter to provide corrected information for consideration by the IRS. The IRS will reply with an acknowledgement letter informing you of their final determination.
Do I have appeal rights?
Yes, the acknowledgement letter that you receive will spell out all your rights, including your right to appeal.
General Information
For more info visit ACA information center for Applicable Large Employers
Here’s an excerpt from the 226J letter, and a link to the official sample.
Source:
IRS (9 November 2017). "Understanding your Letter 226-J" [Web blog post]. Retrieved from address https://www.irs.gov/individuals/understanding-your-letter-226-j
Oranges and Pumpkin All-In-One?
Orange Pumpkin Loaf
Ingredients:
- 1 large orange
- 1/3 cup butter, softened -market pantry salted butter preferred
- 1 1/3 cups white sugar -market pantry granulated sugar preferred
- 2 eggs
- 1 cup canned pumpkin
- 1/3 cup water
- 2 cups all-purpose flour -market pantry all-purpose flour preferred
- 1 teaspoon baking soda
- ½ teaspoon baking powder
- ¾ teaspoon salt
- ½ teaspoon ground cinnamon
- ½ teaspoon ground cloves
- ½ cup chopped walnuts
- ½ cup chopped raisins
Directions:
- Preheat oven to 350 degrees. Grease a 9×5 inch loaf pan.
- Cut orange into wedges, and remove seeds. Place orange, peel and all, in a food processor. Pulse until finely chopped; set aside.
- In a large bowl, cream butter and sugar until smooth. Beat in the eggs one at a time, then stir in the pumpkin, water, and the ground orange. Mix together flour, baking soda, baking powder, cinnamon, and cloves. Stir into batter just until moistened. Stir in nuts and raisins. Spoon into the prepared loaf pan.
- Bake for 1 hour in the preheated oven, or until a toothpick inserted near the center comes out clean. Let stand 10 minutes, then remove from pan, and cool on a wire rack.
Do I Really Need Life Insurance?
At Saxon, we care greatly about others taking responsibility for their livelihood by applying for and obtaining life insurance. If you're not quite convinced you need to speak with one of our life insurance specialists, then take a glance at this article. Life insurance can help anyone - from single millennials to adults with mouths to feed. Don't let money or excuses keep you from protecting everything you've worked so hard for.
Let’s face it. Most people put off buying life insurance for any number of reasons—if they even understand it. Take a look at this list—do any of them sound like you?
1. It’s too expensive. In the ever-burgeoning budget of a young family, things like day care and car payments and possibly student loans eat up a good chunk of the money each month, and a lot of people think that life insurance is just outside those “necessities” when money’s tight. Life insurance is often not nearly as expensive as you might think, especially when you can get a good policy for less than the cost of a daily cup of coffee at the local café. If money’s tight now, what if something happens to you? Here’s more information about the true cost of life insurance.
2. That’s that stuff for babies and old people, right? People of a certain age remember Ed McMahon telling them their grandparents couldn’t be turned down for any reason and figure that’s the target demographic for life insurance. You might have been offered a small permanent insurance policy for your newborn, attractively presented with a cherubic infant on the envelope. The truth of the matter is that these are very specific insurance products—just as there are many insurance products for adults in their working years.
3. I’m strong and healthy! You eat right, you stay active, and everyone admires how grounded and centered you are. You passed your last physical with flying colors! That’s GREAT! But you’re neither immortal nor indestructible. It’s not even that something could happen to you—though it could—so much as when you’re at your strongest and healthiest, there’s no better time to get a policy to protect your loved ones. If you fall seriously ill or suffer significant injury later, it will make it tough to get that kind of policy, if any at all.
4. I have life insurance through my job. Many people are offered life insurance as part of their employee benefit coverage –and often, it’s the first time they encounter life insurance and have no idea that a $50,000 policy, or one or two times their salary, isn’t as much as they think it is. It sounds like a lot of money (and it is!), until you figure that it has to cover some or all the expenses for your loved ones in your absence. Plus, if you leave the job, it’s typically the type of insurance that doesn’t “move on” with you.
5. I don’t have kids. Sure, kids are a big reason why some people get life insurance, but that’s not the only reason for needing protection. If there is anyone in your life who would suffer financially from your loss—your spouse or live-in partner, a sibling, even your parents—a life insurance policy goes a long way in making sure everyone’s still OK even if something happens to you.
6. Life insurance—it’s on my list … eventually. There’s no deadline on life insurance, no mandate from the government on purchasing it. Your parents may have never talked to you about its importance, and it’s certainly not the most invigorating topic for conversation. But don’t let your “eventually” turn into your loved ones’ “if only.”
Don't wait to protect your livelihood. Have a chat with a specialist at Saxon Financial today by visiting this link.
Learn about the different types of life insurance here.
You can read the original article here.
Source:
Life Happens (n.d.). "Do I Really Need Life Insurance?" [Web blog post]. Retrieved from address https://www.lifehappens.org/insurance-overview/life-insurance/who-needs-life-insurance-reasons-dont-buy/
3 ways Congress can meaningfully reform 401(k)s
This article from Employee Benefit Advisor's Alexander Assaley drives home three points on improving 401(k)s - (1) improve coverage, (2) update antiquated testing results, and (3) expand limits while maintaining choices. How do you, as an employer, feel about these points?
In both the House and Senate’s tax bills there are no significant changes made to 401(k), 403(b) and IRA retirement accounts — for now. Congress has preserved the majority of tax benefits. However, we are only getting started, and there is still room for improvement. The drafted bills will look different, perhaps significantly so, before getting finalized into law.
Bloomberg/file photo
As our elected officials debate and negotiate tax legislation, I’d like to offer some input and advice on key characteristics and design structures that we should be advocating for with respect to retirement plans, and how advisers and benefits professionals can work to continually improve the private retirement system:
1) Improving coverage. One of the chief complaints from 401(k) critics is that many workers in this country don’t have access to a plan. Various research indicates that somewhere between 50%–65% of employees have access to a 401(k) or 403(b) and the remaining don’t.
This coverage gap primarily extends to part-time and “gig” workers, as well as small businesses with less than 30 employees. Retirement plan advisers and practitioners need to create forward-thinking solutions to provide these employees with access to employer-sponsored and tax qualified retirement plans.
Most of all, we can shrink the coverage gap if we get small businesses to establish plans. Both data and anecdotal evidence find that the biggest drivers for small businesses to create and offer retirement plans are 1) tax benefits to the owners and executives; and 2) simple, easy to use programs with minimal liability. This is where some of the tax policy or other reforms could really help.
2) Updating antiquated testing rules. While we often cite the $18,500 (or $24,500 for those eligible to make catch-up contributions) employee deferral limits for retirement plans in 2018, the practical nature is that a lot of highly compensated employees, HCEs, (including small business owners) are limited to contributing at much lower levels due to various non-discrimination tests.
While the spirit of non-discrimination testing is just — ensuring business owners and executives aren’t structuring their plans to limit or prevent their employees from benefiting, or inequitably benefiting owners and their family members — the current structure significantly dis-incentivizes the small business owner from offering a plan in the first place because they can’t maximize their benefit.
Let me be clear, we are big proponents of matching and profit sharing contributions, and want to see employers help their employees get on track for retirement too; however, the current safe harbor provisions with immediate, or short vesting schedules, along with cumbersome testing requirements, often cause too big of a hurdle for the small business owners to commit and therefore, short changes their employees with no plan at all.
I would love to see tax reform improve safe harbor provisions and/or testing components that might make it easier for business owners and HCEs save up to the limit without concerns of failed testing or hefty safe harbor contributions. Practically speaking, these workers need to save more in order to meet their retirement income needs, since Social Security will make up a small percentage of their income replacement, and the 401(k) is the best place to make it happen.
3) Expanding limits and maintaining choice. Just before Congressional Republicans announced their tax bill, a group of Senate Democrats unveiled a plan which would actually raise limits for 401(k) plans. While our research aligns with many other studies that the vast majority of savers don’t reach the annual limits, we would be in favor of expanding the limits — even if it only allowed for Roth-type contributions above the $18,500 (or $24,500) limits.
Additionally, we think an employee’s ability to select either Roth or pre-tax contributions is critical. While the tax preferential treatment of defined contribution plans is just one component that makes these vehicles so valuable, it has definitely emerged and remained as the “branding tool” that encourages so many workers to get into the plan in the first place.
Source:
Assaley A. (10 November 2017). "3 ways Congress can meaningfully reform 401(k)s" [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/opinion/3-ways-congress-can-meaningfully-reform-401-k-s
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The Latest: House passes sweeping GOP tax overhaul
WASHINGTON (AP) — The Latest on House consideration of the tax overhaul (all times local):
1:50 p.m.
The House has passed a sweeping Republican tax bill cutting taxes for corporations and many people. It puts GOP leaders closer to delivering to President Donald Trump a crucial legislative achievement after nearly a year of failures.
The House voted 227-205 along party lines to approve the bill, which would bring the biggest revamp of the U.S. tax system in three decades.
Most of the House bill’s reductions would go to business. Both the Senate and House would slash the 35 percent corporate tax rate to 20 percent and reduce levies on millions of partnerships and certain corporations, including many small businesses.
Personal income tax rates for many would be reduced through some deductions, and credits would be reduced or eliminated. But projected federal deficits would grow by $1.5 trillion over the coming decade.
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12:15 p.m.
Democrats are using new projections by Congress’ nonpartisan tax analysts to call the Senate Republican tax bill a boon to the wealthy that boosts middle-income families’ taxes.
The Joint Committee on Taxation estimated that starting in 2021, many families earning less than $30,000 would have tax increases under the bill. By 2027, families earning up to $75,000 would face higher levies, while those earning more would get tax cuts.
Republicans say the new calculations reflect two provisions in the bill.
The Senate measure ends personal income tax cuts beginning in 2026 because Republicans needed to reduce the bill’s costs to obey the chamber’s budget rules.
It also abolishes the requirement under former President Barack Obama’s health care law that people buy insurance. That means fewer people getting federally subsidized coverage — which analysts consider a tax boost.
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11:35 a.m.
President Donald Trump has arrived at the Capitol to encourage House Republicans who are about to push a $1.5 trillion tax package through their chamber.
The closed-door meeting comes as GOP leaders hope that by Christmas, they will give Trump and themselves their first legislative triumph this year.
House approval was expected later Thursday of the plan to slash corporate tax rates and reduce personal income tax rates while eliminating some deductions and credits.
The Senate Finance Committee is aiming to pass its separate version by week’s end. But some GOP senators want changes.
Republicans say the final measure will bestow lower levies on millions of Americans and spur economic growth by reducing business taxes. Democrats say the measure is disproportionately tilted toward corporations and the wealthy.
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10:45 a.m.
Republicans drove a $1.5 trillion tax overhaul toward House passage Thursday. But Senate GOP dissenters also emerged in a sign that party leaders have problems to resolve before Congress can give President Donald Trump his first legislative triumph.
Trump was heading to the Capitol for a pep rally with House Republicans, shortly before the chamber was expected to approve the measure over solid Democratic opposition. There were just a handful of GOP opponents in the House, unhappy because the measure sharply curbs deductions for state and local taxes, but all agreed that passage seemed certain.
Like a similar package nearing approval by the GOP-led Senate Finance Committee, most of the House measure’s reductions would go to business. Personal income tax rates for many would be reduced, but some deductions and credits would be reduced or eliminated. Federal deficits would grow by $1.5 trillion over the coming decade.
You can read the original article here.
Source:
Associate Press (16 November 2017). "The Latest: House passes sweeping GOP tax overhaul" [Web blog post]. Retrieved from address https://apnews.com/b3297c1e443b40049beebcd832aaadc8?utm_campaign=SocialFlow&utm_source=Twitter&utm_medium=AP
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CenterStage: Fee-Based vs Commission-Based Advisors: What You Should Know
“After almost 30 years of working in the business, the most important question to ask,” Garry Rutledge, AIF®, a Fee Based Advisor with Saxon, explained, “is do you trust that person to make decisions in your best interest or in theirs?”
In this month’s CenterStage article, we sat down with Garry to get the lowdown on what to expect from both fee-based financial advisors and commission-based advisors.
When Is a Commission-Based Advisor a Better Choice than a Fee-Based Advisor?
A commission-based advisor receives compensation for transactional business, usually at the point of sale, with a small annual fee to encourage advisor engagement. A client rarely knows the commission amount until the transaction is completed.
Garry mentioned, “those who purchase investments for the long term are better off choosing a commission-based advisor, who won’t pursue the client for information and bombard you with advice.”
Also, if you are a do-it-yourselfer when it comes to investing, a commission-based advisor is a great fit for you.
When Is a Fee-Based Advisor a Better Choice than a Commission-Based Advisor?
A fee-based advisor tends to value relationship’s over transactions. This results in, typically, a more involved and hands on process, because positive results increase the value of client’s portfolio. A fee-based advisor takes a consultative approach to managing client’s assets and is more likely to offer a broader scope of advice than compared to a commission based advisor.
A fee-based advisor works for the relationship resulting in little or no bias to an investment or its sponsor, as it relates to compensation, vs a commission-based advisor who may consider the compensation when making a decision when weighing similar products.
What Are You Paying Your Financial Advisor?
There are three means of advisor compensation:
- Commission for products or transactions
- A percentage of assets an advisor manages
- A hybrid between method 1 and 2
It’s imperative to know which method your advisor utilizes. This knowledge allows you to determine if you are receiving advice commensurate with the value provided. A Commissioned advisor, after making a sale, generally has no interest in what the outcome is because they have received compensation vs a fee based advisor who must build trust with clients to maintain a meaningful relationship.
Garry very rarely utilizes the hybrid model when working with clients. However, in keeping with his philosophy of doing right by his clients, there are times when he must employ this model. Garry points out, “at times, an alternative investment that is a complimentary piece of a client’s portfolio is not available on a fee basis, in which circumstance dictates that I receive a commission. In full disclosure, my clients realize when this happens and exactly what their charge will be.”
As a means of building relationships, Garry has and is focused on sustaining the fee based practice he has built and continues to build through client referrals. Garry’s fees range from 1% to .5%, depending on the assets and complexity of a client case. With this knowledge, clients know what their expenses will be up front.
The length of his client relationships is a testament that fee based advising is successful in building a solid financial advisory firm.
In the end, the client must determine what works for them, as far as how they will compensate the advisor. If a client wants to be transactional, commission is the way to proceed; but if an ongoing relationship is a requirement, a fee-based advisor is the best path for them.
More About Garry
Garry joined Saxon in August of 2006 and his focus has been the strategic management of client assets with tax minimization and capital preservation as the foundation of his planning strategy.
Since graduating from Wright State University in 1988 with a degree in Finance, Garry has worked for two respected firms. Garry holds Series 7 & 63 securities licenses, and his Life & Health license, along with achieving the professional AIF (Accredited Independent Fiduciary) designation.
You can contact Garry via email, phone, or connect with him on LinkedIn.
These are the opinions of Garry Rutledge and not necessarily those of Cambridge; they are for informal purposes only, and should not be construed or acted upon as individualized investment advice. All investing involves risk. Depending on the types of investments, there may be varying degrees of risk. Investors should be prepared to bear loss, including total loss of principal.
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Trump picks former Lilly drug executive as health secretary
We're sure you've seen it trending. Here is the latest on Alex Azar of Eli Lilly & Co - President Trump's nominee for head of the Department of Health and Human Services.
(Bloomberg) – President Donald Trump named former Eli Lilly & Co. executive Alex Azar to lead the Department of Health and Human Services after agency’s past chief resigned amid blowback over his taxpayer-funded private jet travel.
“Happy to announce, I am nominating Alex Azar to be the next HHS Secretary. He will be a star for better healthcare and lower drug prices!” Trump tweeted Monday.
If confirmed, Azar will take over the administration’s management of the Affordable Care Act. Trump and Congressional Republicans have called to repeal the health law, and the administration has taken steps to destabilize it, such as cutting funding for some programs and refusing to pay subsidies to health insurers. He’ll also be a key figure on drug costs.
Bloomberg/file photo
Trump has been highly critical of the drug industry, saying that pharmaceutical companies are “getting away with murder” and threatening to use the federal government’s buying power to bring down prices.
Drug Costs
However he’s taken no concrete action yet to do much on prices, and the former drug executive’s appointment may continue the trend of strong talk but little action, said Spencer Perlman, director of health-care research at Veda Partners, a policy analysis firm.
“It is very unlikely the administration will take aggressive regulatory actions to control prescription drug prices,” Perlman said in a note to clients Monday. “The administration’s tepid response to drug pricing has not matched the president’s heated rhetoric.”
Dan Mendelson, president of Avalere Health, a consulting firm, also didn’t think Azar represented a change in direction on pharmaceutical policy. “His appointment will not change the president’s rhetoric,” Mendelson said in a phone interview.
Before his time at Lilly, Azar served as deputy secretary at HHS under President George W. Bush. One former Obama administration official said that experience could help him at the agency.
“While we certainly differ in a number of important policy areas, I have reason to hope he would make a good HHS secretary,” said Andy Slavitt, who ran the Centers for Medicare and Medicaid Services under the last administration and who has been a frequent critic of efforts to derail Obamacare. Slavitt said he hoped Azar would “avoid repeating this mistakes of his predecessor over-politicizing Americans’ access to health care.”
Running Obamacare
Azar, who ran Indianapolis-based Lilly’s U.S. operations until earlier this year, has been an advocate for more state flexibility under Obamacare. That matches up with what Republicans have pushed for, such as in a seemingly stalled bipartisan bill to fund insurer subsidies that help lower-income people with health costs.
As secretary, Azar would have broad authority over the program.
“I’m not one to say many good things about Obamacare, but one of the nice things in it is it does give a tremendous amount authority to the secretary,” Azar said during an interview with Bloomberg TV in June. “There are still changes that can be made to make it work a little better than it has been.”
There are signs that the law is gaining popular support despite the repeal efforts. In recent state elections in Virginia, Democrats won a competitive governors race that saw health care emerge as a top issue. In Maine, residents voted to expand Medicaid under the Affordable Care Act. Early enrollment in Obamacare plans earlier this month was also up considerably compared to last year.
Trump’s first HHS secretary, Tom Price, resigned in September after his extensive use of private and military jets at taxpayer expense was revealed. Azar must be approved by the Senate.
Senate Confirmation
Senator Orrin Hatch, who heads the Senate Finance Committee that will review Azar’s nomination, called on Trump’s pick to help “right the wrongs of this deeply flawed law.”
“For too long, hardworking, middle-class families have been forced to bear the brunt of Obamacare’s failures in the form of higher premiums and fewer choices,” Hatch said in a statement.
Ron Wyden, the senior Democrat on the panel, said he would closely scrutinize Azar’s record.
“At every turn, the president has broken his promises to American families to lower health care costs, expand access, and bring down the high price of prescription drugs,” Wyden said in a statement.
Azar left Lilly in January, several months after another senior executive was named to succeed then-CEO John Lechleiter. A lawyer by training, Azar previously clerked for Antonin Scalia on the Supreme Court.
You can read the original article here.
Source:
Employee Benefit Advisors (13 November 2017). "Trump picks former Lilly drug executive as health secretary" [Web blog post]. Retrieved from address https://www.employeebenefitadviser.com/articles/trump-picks-former-lilly-drug-executive-as-health-secretary?tag=00000151-16d0-def7-a1db-97f024b50000
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10 surprisingly great places to retire in the U.S.
At Saxon, we care about retirement and offering you the best plans. In this article, we take a look at Forbes's list of the top 10 places to retire. Do any of these places sound peaceful to you?
Probably the biggest retirement decision you’ll face (after: Can I ever?) is: Where should I retire? To help, U.S. News has just come out with its first Best Places to Retire in the United States ranking of the 100 largest metropolitan areas. Some of its Top 10 spots will surely surprise you and you may also wonder why certain parts of the country failed to make the cut.
Credit: Shutterstock
“This is a much more comprehensive analysis than we’ve done in the past,” said Emily Brandon, U.S. News senior editor for retirement. “Before, we’ve done themed lists like 10 Places to Retire on Social Security Alone and 10 Retirement Spots With Year-Round Nice Weather.”
How U.S. News Ranked the Best Places to Retire
This time, U.S. News first asked people 45 and older to indicate the “attributes of a retirement destination that are most important to them” and collected responses from 841 of them. “What people told us was most important to them in a place to retire was 'being affordable' but also, they wanted to feel happy there,” said Brandon.
The Top 10
The Top 10 best places to retire in America, according to U.S. News:
- Sarasota, Fla.
- Lancaster, Pa.
- San Antonio, Texas
- Grand Rapids, Mich.
- El Paso, Texas
- McAllen, Texas
- Daytona Beach, Fla.
- Pittsburgh, Pa.
- Austin, Texas
- Washington, D.C.
“Most of the places scored well on some measures, but not on others,” said Brandon.
That’s a fact. Sarasota had high scores for Happiness, Desirability and Retiree Taxes and decent ones in the other categories. McAllen didn’t fare well in the Job Market category and Washington, D.C. got a low ranking for Housing Affordability. El Paso and Grand Rapids were weak in the Desirability category.
Why Places Scored Well and Didn't
The reason four Texas metro areas made it into the Top 10? “Affordable housing, low taxes and above-average levels of happiness,” said Brandon.
The three winners in the Middle Atlantic states (Lancaster, Pittsburgh and Washington, D.C.) had high rankings because of happy residents and access to high quality health care, Brandon noted.
You may have noticed that the Top 10 largely consists of small- and mid-size cities and no California or New York City-area metros. “I think a lot of that has to do with housing prices,” said Brandon. “Almost no California places scored high in the list largely because housing prices are out of reach for many people with low- or even mid-range incomes.” California home prices are 150% above the U..S. average, overall. The highest-ranked California metro area in the U.S. News list is San Diego, which came in at No. 21.
What About the Weather?
Somewhat strangely, the U.S. News ranking didn’t factor in weather at all.
“We had some discussion about whether to include weather,” said Brandon. “It’s tricky because not everyone has the same preferences when it comes to weather. Some people want four seasons. Some find snowy winters terrible.” The upshot: the rankers left out this variable.
How the U.S. News List Compares With Other Rankings
The U.S. News list is markedly different from other recent Best Places to Retire rankings from Forbes and WalletHub.
The 25 places Forbes chose, after looking at 550 communities, were in big and small cities and skewed toward warm and moderate climates; its top places included Clemson, S.C., Port Charlotte, Fla. and Green Valley, Ariz. None of its 25 were in the U.S. News Top 10.
WalletHub looked at the retiree-friendliness of the 150 largest U.S. cities across 40 metrics and its top picks were mostly large ones. Three cities in Florida topped the list: Orlando, Tampa and Miami. Austin was the only one in both WalletHub’s Top 10 and U.S. News’.
What the Rankings Can't Rank
You won’t want to move to any place in retirement just because it’s on a Best Places list, of course. And no ranking can account for a key retirement location criteria for many people: proximity to family members.
Still, Best Places to Retire rankings can be a useful part of your research as long as you closely read their methodology, so you understand what the raters were rating.
“These types of surveys can be a great starting point in deciding where to retire,” said Brandon. “It all comes down to your personal preferences. Your criteria for what makes a best place to retire may be different than for others.”
You can read the original article here.
Source:
Eisenberg R. (2 October 2017). "U.S. News Offers A New Take On The Best Places In The U.S. To Retire" [Web blog post]. Retrieved from address https://www.forbes.com/sites/nextavenue/2017/10/02/u-s-news-offers-a-new-take-on-the-best-places-in-the-u-s-to-retire/#4d26f87c60ec
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How employers can better support the caregivers in their workforces
How can you provide the best support for the caregivers in your workforce? From Employee Benefit News, this article discusses the responsibilities caregiving employees juggle, and why it's so important for employers to take those responsibilities into consideration when creating a healthy and stable work environment.
As more employees self-identify as caregivers for family members and friends, employers are starting to address the needs of workers who struggle to balance work while caring for others.
The numbers are staggering. One in six U.S. employees identify as a caregiver for a family member or friend, according to research by Family Caregiver Alliance. An AARP study found that U.S. businesses lose more than $25 billion annually in lost productivity due to absenteeism among full-time working caregivers, and that figure grows an additional $3 billion when part-time workers with caregiving duties are accounted for.
“Of today’s 40 million family caregivers, 24 million are juggling caregiving responsibilities and employment. By recognizing and supporting their needs, employers can improve productivity and foster a stable and healthy workforce,” says Nancy LeaMond, chief advocacy and engagement officer for AARP.
With that in mind, Northeast Business Group on Health and AARP have released a resource guide for employers who wish to ease the burden of the caregivers among their workforce. According to Supporting Caregivers in the Workplace: A Practical Guide for Employers, the authors recommend that employers create a corporate culture of awareness, draft workplace policies, benefits and programs, obtain the support of top executives and implement new services throughout the work force.
The guide also suggests employers offer paid sick days that can also be used for the care of a relative; in-house stress-reduction programs such as yoga, meditation; massage discounts and online or in-person coaching to assist in developing a care plan. Employers are also urged to offer digital tools to help employees manage their caregiving duties and provide legal and financial counseling for employees.
Employees who are preoccupied with the care and wellbeing of a parent, sibling or child have an impact on the workplace in both their quality of work and in potential medical claims.
“Trying to balance those responsibilities however large or small does have ramifications for the folks who are doing the caregiving,” says Candace Sherman, interim CEO of NEBGH. She says caregivers often feel lonely and isolated due to the demands placed on them and they often experience depression and anxiety when dealing with their caregiving roles.
“They're often spending their outside-of-work time providing care as opposed to socializing and oftentimes they neglect their own mental and physical well-being in favor of making sure that whomever they're caring for has what they need,” says Sherman. “Ultimately, that shows up in healthcare claims down the road.”
Fighting the stigma
By creating a culture of awareness around caregiver needs and responsibilities, employers may shake the resistance employees feel when identifying as caregivers.
“We found that there's a bit of a stigma in terms of folks raising their hand and saying ‘I'm a caregiver and I'm having some trouble,’” says Sherman. She adds that this impulse is similar to employees’ overall reluctance to admitting that they have a mental health issue.
“Employee caregivers might worry that if their colleagues know they're caring for someone, their manager will think ‘I've got this great new assignment but this person's overburdened right now,’” she says. “Or maybe they're up for a promotion and they feel they won't be considered because people know that they have other responsibilities outside of work.”
The caregiving guide recommends employers “ensure that managers at all levels are aware of the company’s policies regarding flex-time, leave policies and other benefits that caregiving employees can access, and should encourage them to openly support employees using these benefits.”
The guide also recommends that providing paid leave to these employees “might be the single most important consideration for employers when thinking about creating a caregiving-friendly workplace.”
Benefit administrators appear to be getting the message. Respondents of a July 2017 survey of benefits executives and managers from roughly 130 companies said that if they could roll out “two new policies, programs or benefits tomorrow to support caregivers, they would expand leave policies and coaching, wellness or support services designed to support caregiver well-being.”
The burden is not just on employers to act to improve the workplace for caregivers, they have to come to terms with their duties and the impact it has on their personal and work lives, says Sherman. Caregivers are slow to identify themselves as such because of cultural and societal roles that engrain our sense of family responsibilities.
“We have all been there or we’re close to people who have been there in terms of caring for someone who's ill or elderly. We are ingrained to view it as we're caring people and this is just something that we do, so people don't self-identify as caregivers,” Sherman says.
She adds, “But if you're a caregiver and you're balancing those responsibilities, they can range from checking in with a family member a couple of times a week or making a run for groceries or medications to much more intensive duties that occupy several hours a day.”
You can read the original article here.
Source:
Albinus P. (5 November 2017). "How employers can better support the caregivers in their workforces" [Web Blog Post]. Retrieved from address https://www.benefitnews.com/news/how-to-meet-the-needs-of-caregiver-employees?feed=00000152-18a5-d58e-ad5a-99fd665c0000