Would States Eliminate Key Benefits if AHCA Waivers are Enacted?
If lower premiums were a possibility, would states actually enact waivers to exclude certain essential health benefits? Check out this article from the Kaiser Family Foundation to learn more about the possible result of giving states the power to use waivers when it comes to healthcare coverage.
As the debate over amending health insurance market rules continues, proponents of changing the law have proposed reducing the health benefits provided by non-group plans as a potential way to lower premiums in the market. The Affordable Care Act (ACA) prescribes 10 categories of essential health benefits that non-group and small-group policies must cover, and provides in most cases that the scope of these benefits should be similar to those in employer group health plans, which cover most non-elderly Americans. The American Health Care Act (AHCA), which passed the House of Representatives on May 5, would permit states to seek waivers to amend the required benefits if doing so would achieve one of several purposes, including lowering premiums.1 We look below at the benefits covered by non-group plans before the ACA as a possible indication of how states could respond to the waiver authority under the AHCA.
Background
The lack of coverage for benefits such as maternity and mental health care in many nongroup plans, which was a frequent point of criticism when the ACA was debated, was one (but not the only) reason why non-group coverage was less expensive before the ACA was enacted. In the pre-ACA market, certain benefits were excluded to make coverage more affordable and to guard against potential adverse selection by applicants with more predictable, chronic health care needs. Even with the ability to medically screen applicants for non-group policies, some insurers excluded coverage for conditions such as mental health and substance abuse care unless states required that they be covered.
States determined coverage requirements for health insurance policies prior to the ACA. A few states defined a standard benefit package to be offered by insurers in the nongroup market. Most states adopted some mandates to cover or offer specific benefits or benefit categories – such as requirements for policies to cover maternity benefits or mental health treatments. In addition to deciding which categories of benefits must be included or offered, states might also specify a minimum level or scope of coverage; for example, a few states required that mental health benefits have similar cost sharing and limits as other outpatient services (sometimes called parity).
Pre-ACA non-group plans varied considerably in scope and comprehensiveness of coverage, with some plans limiting benefit categories or putting caps on benefits, while others offered more comprehensive options. For example, some plans did not cover prescriptions, others covered only generic medications or covered a broader range of medications subject to an annual cap, while still others covered a more complete range of medications. This diversity was possible because insurers generally were able to decline applicants with pre-existing conditions, and could require their existing customers to pass screening if they wanted to upgrade to more comprehensive benefits. This prevented applicants from selecting the level of coverage they wanted based on their known health conditions, but also prevented many people from being able to obtain non-group coverage at all.
To look more closely at the benefits provided in pre-ACA non-group plans, we analyzed data submitted by insurers for display on HealthCare.gov for the last quarter of 2013. Beginning in 2010, insurers submitted information about their non-group plans to be displayed on HealthCare.gov; the data includes information on benefits, coverage levels for each benefit, benefit limits, premiums and cost sharing parameters, and enrollment. We focus here on the benefits and benefit limits. We use data from 2013 because it is the most current year prior to when the ACA’s major insurance market changes went into effect, provides more benefit categories than some earlier years, and has more information about benefit limits for each category. We note, however, that the ACA prohibition on annual dollar limits took effect shortly after enactment and was phased in between 2010 and 2013, so these types of limits would likely not be reflected often in data we received. This means that our analysis likely misses some of the limits (for example, dollar limits on prescriptions) that existed in nongroup policies before the ACA was enacted. We limit the analysis to plans where insurers report enrollment in the product upon which the plan is based. Our methods are described in more detail in the appendix.
Results
The data include 8,343 unique plans across 50 states and the District of Columbia. We looked at the percentage of plans that included coverage for major benefit categories. Not surprisingly, all of the plans covered basic benefits such as inpatient hospital services, inpatient physician and surgical services, emergency room services, and imaging services, while virtually all (99%) covered outpatient physician/surgical services, primary care visits, home health care services, and inpatient and outpatient rehabilitation services.
Certain other benefits, however, were covered much less often (Figure 1). Large shares of plans did not provide coverage for inpatient or outpatient mental/behavioral health care services (38% each), inpatient or outpatient substance abuse disorder services (45% each), and delivery and inpatient care for maternity care (75%).2 In addition, 6% of plans did not provide coverage for generic drugs, 11% did not provide coverage for preferred brand drugs, 17% did not provide coverage for non-preferred brand drugs, and 13% did not provide coverage for specialty drugs.
Even when coverage was provided, some policies had meaningful limits or restrictions for certain benefits. Mental/behavioral health care is a case in point. Among plans with coverage for outpatient mental/behavioral health services, 23% limited benefits for some or all mental/behavioral services to fewer than 30 visits or sessions over a defined period (often a year) and 12% limited it to 12 or fewer. A small share (about 5%) of plans providing coverage for outpatient mental/behavioral health services provided benefits only for conditions defined as severe mental disorders or biologically-based illnesses or applied limits (such as visit limits) if the illness was not defined as severe or biologically based. The definitions of these terms varied by state.3
Similarly, for plans covering outpatient substance abuse disorder services, 22% limited the benefit to fewer than 30 visits or sessions; 12% limited it to 12 or fewer. In many of these plans, visits for either mental health or substance abuse care were combined to apply toward the same limit.
Among the relatively few plans that provided coverage for delivery and inpatient maternity care, a small share (3%) applied separate deductibles of at least $5,000 for maternity services and some plans (6%) applied a separate waiting period of at least year before benefits were available. A few plans restricted benefits to enrollees enrolled in family coverage or required that the enrollee’s spouse also be enrolled.
Discussion
The ACA raised the range of benefits provided by non-group policies such that the benefits now offered by non-group plans are comparable to those offered in employer group plans. The desire to lower non-group premiums, however, has led policymakers to consider allowing states to roll back the essential health benefits prescribed by the ACA.
Among the pre-ACA policies we reviewed, virtually all included benefits for certain services: hospital, physician, surgical, emergencies, imaging, and rehabilitation. Other services were covered less often, including prescription drugs, mental/behavioral health care, substance abuse disorder care, and coverage for pregnancy and delivery. This latter group of services all have some element of predictability or persistency that make them more subject to adverse selection. For example, many people use drug therapies over long periods and would be much more likely to select policies covering prescriptions than people who do not regularly use prescription drugs. If states were to drop any of these services from the list of essential health benefits for non-group plans, access to them could be significantly reduced.
The difficulty is that insurers would be very reluctant to offer some of these services unless they were required in all policies because people who need these benefits would disproportionately select policies covering them. In the pre-ACA market, insurers were able to offer products with different levels of benefits because they generally were able to control who could purchase them by medically screening new applicants. Even existing customers faced medical screening if they wanted to change to a more comprehensive policy at renewal. Through these practices, insurers were able to avoid the situation where people could choose cheaper policies when they were healthy and upgrade to better benefits when their health worsened. The proposed AHCA market rules, however, would not guard against this type of adverse selection, because people with pre-existing health conditions would be able to select any policy offered at a standard premium rate, and change their selection annually without incurring a penalty, as long as they maintained continuous coverage. This means that the range of benefits provided by insurers in states with essential health benefit waivers would likely be more limited than what insurers offered in the pre-ACA non-group market. Benefit choice might be particularly limited in states that specify only a few benefits as essential.
It is hard to imagine that insurers would cover certain benefits if they were not required. For example, some insurers before the ACA did not offer mental health benefits unless required by a state, even when they could medically screen all of the applicants. And given the current problems with substance abuse in many communities, insurers would be reluctant to include coverage to treat them unless required. Offering these benefits as an option (for example, including them in some policies but not in others), would result in very high premiums for optional benefits because people who know they need them would be much more likely to choose them.
The AHCA presents state policymakers with a dilemma: they can reduce the essential health benefits to allow less expensive insurance options for their residents, but doing so may eliminate access to certain benefits for people who want and need them.
See original article Here.
Source:
Claxton, G., Pollitz, K., Semanskee, A., Levitt, L. (14 June 2017) Would States Eliminate Key Benefits if AHCA Waivers are Enacted? [Web Blog Post] Retrieved from address https://www.kff.org/health-reform/issue-brief/would-states-eliminate-key-benefits-if-ahca-waivers-are-enacted/
Rising Health Care Costs Threatening Employees’ Financial Goals
Did you know that the rising costs of healthcare could be having a negative effect on your employees' financial goals? Check out this great read by Marlene Y. Satter from Benefits Pro on how your employees' finances are being impacted by the costs of healthcare.
Employees are under financial stress — big time. In fact, 56 percent of them are stressed about their financial situation, and more than half of them say it’s taking a toll on both their ability to focus and their productivity on the job.
That’s according to the latest Bank of America Merrill Lynch Workplace Benefits Report, which finds that not only are 53 percent of stressed employees having trouble concentrating on their work, the cost of health care is a big shadow cast over workers’ financial situations. And that’s already an issue, with 43 percent of employees owning up to spending 3 or more hours a week while at the office dealing with personal financial matters.
As more employees find themselves shelling out more from their own pockets to pay health care bills — 69 percent of workers said so in 2015, but 79 percent said so in 2016 — it’s no surprise to hear that health care costs are up 10 percent since 2015. No wonder they’re stressed; salaries certainly haven’t risen to match.
Those rising health care costs are taking a bite out of most employees’ other financial goals — among workers who have experienced increasing health care costs, 56 percent are having to save less toward other objectives.
Women in particular are abandoning more discretionary spending and debt management to cover health care costs than men, with 72 percent chucking spending on recreation or entertainment, compared with 59 percent of men; 63 percent saving less for retirement, compared with 62 percent of men; and 50 percent paying down less debt, compared with 46 percent of men.
And the more expensive health care becomes, the more employees appear to appreciate employer-provided health coverage — with workers ranking health benefits as their top employer benefit (40 percent), followed by their 401(k) plan (31 percent).
Even among employees who class themselves as optimists about their financial futures, worries about health care and its cost are weighing them down. And as might be expected, money woes weigh more on women than men, even — or perhaps especially — when it comes to health care. While 52 percent of men say that becoming seriously ill and unable to work is a major concern (even larger for men than having to work longer than they planned), 58 percent of women fear illness and subsequent absence from the workplace.
And more than half of employees say that financial stress is negatively affecting their physical health. Different generations feel the effects more, with 51 percent of boomers, 56 percent of Gen Xers and 68 percent of millennials saying money worries are literally making them sick. Employers need to be aware of this and take steps to deal with it, particularly since it translates into a toll not just on workers but on the employer’s bottom line — via higher absenteeism rates and higher health care costs.
See the original article Here.
Source:
Satter M. (2017 June 1). Rising health care costs threatening employees' financial goals [Web blog post]. Retrieved from address https://www.benefitspro.com/2017/06/01/rising-health-care-costs-threatening-employees-fin
Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse Most Often Uncovered by Non-Group Health Plans
What would happen to the non-group insurance market under the American Health Care Act (AHCA)? Read this article from the Kaiser Family Foundation to learn more.
Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the Affordable Care Act (ACA) essential health benefits requirement took effect, finds a new Kaiser Family Foundation analysis.
Other major benefits most often left uncovered before the ACA include substance abuse disorder services (inpatient and outpatient services each not covered by 45% of 2013 non-group plans) and mental/behavioral health services (inpatient and outpatient services each uncovered by 38% of the plans).
Additionally, some plans that covered maternity, substance abuse or mental health care services included meaningful limits or restrictions, the analysis finds.
Since 2014, the ACA has required non-group plans to cover 10 categories of essential health benefits comparable to those offered in employer group plans. The new analysis offers a window into how insurers could respond if the essential health benefits requirement is rolled back, a change being considered by Congressional leaders and allowed through state waivers by the House-passed American Health Care Act as a potential way for lowering premiums.
Without the requirement, however, insurers in the non-group market would likely be reluctant to offer coverage for some expensive services that have an element of predictability and persistence, as people who needed these benefits would disproportionately select policies covering them. Unlike in the pre-ACA market, insurers would not be able to exclude from coverage altogether people with pre-existing conditions.
The new analysis finds that all 2013 non-group plans covered basic benefits, such as inpatient hospital services, inpatient physician and surgical services, and emergency room services. Some plans didn’t provide various levels of prescription drug coverage, however.
The analysis uses data insurers provided for the Health Plan Finder on HealthCare.gov for the last quarter of 2013. Certain provisions of the ACA, such as the prohibition of annual and lifetime dollar limits on benefits, had already begun to be phased in by that point, so the data does not reflect all of the types of limitations in non-group policies prior to the ACA.
See original article Here.
Source:
(14 June 2017) Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse, Most Often Uncovered by Non-Group Health Plans. [Web Blog Post]. Retrieved from address https://www.kff.org/health-reform/press-release/analysis-before-aca-benefits-rules-care-for-maternity-mental-health-substance-abuse-most-often-uncovered-by-non-group-health-plans/
High-Deductible Health Plans Promote Increased Wellness Program Participation
Are you looking for a new way to increase participation in your wellness program? Take a look at this interesting article by Nick Otto from Employee Benefit News on how offering high-deductible health plans can be a great way to boost enrollment into your wellness program.
Employer-provided healthcare continues to be the most common access to health insurance in the U.S., and as employers continue to look for ways to cut costs, consumer-driven high-deductible health plans continue to grow with the added benefit of increased employee engagement in healthcare choices.
Fourteen percent of the U.S. population was enrolled in a CDHP and 14% was enrolled in an HDHP, a slight increase for both from the previous year, according to the 2016 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey.
And the number of workers who were in a CDHPs or HDHPs was more likely than those in a traditional plan to exhibit cost-conscious behaviors, according to a recent report from the non-partisan Employee Benefit Research Institute.
“This survey found that high deductibles are associated with new behaviors [that are] often encouraged by employers and insurers,” says Paul Fronstin, director of EBRI’s Health Research and Education Program and co-author of the report.
The theory behind CDHPs and HDHPs is that the cost-sharing structure is a tool that will be more likely to engage individuals in their health care, compared with people enrolled in more traditional coverage, the study suggests.
And with the employees taking a bigger interest in their healthcare planning, employers are noticing their wellness programs taking a bigger role.
The study focused on three types of wellness programs: a health-risk assessment, a health-promotion program to address a specific health issue, and a biometric screening.
“CDHP enrollees and HDHP enrollees were more likely than traditional-plan enrollees to report that they tried to find cost information. They are also more likely to participate in wellness programs.” Adds Fronstin.
Specifically, 45% of CDHP enrollees reported that their employer offered a health risk assessment, compared with 34% of traditional-plan enrollees and 30% of HDHP enrollees. When asked about the availability of health-promotion programs, 53% of CDHP enrollees, 32% of HDHP enrollees and 41% of traditional-plan enrollees reported that their employer offered such a program.
Additionally, when asked about biometric-screening programs, 45% of CDHP enrollees reported that their employer offered such a program, compared with 36% among traditional-plan enrollees and 33% among HDHP enrollees.
CDHP and HDHP enrollees were also more likely than traditional-plan enrollees to report that their employer offered a cash incentive or reward for participating in a biometric screening program. Seventy percent of CDHP and 67% of HDHP enrollees reported a cash incentive or reward for a biometric screening, compared with 51% among traditional-plan enrollees.
While these numbers represent self-reported awareness of available health and wellness programs and cannot be cross-referenced with objective data from employers and insurers, it is significant that, across the board, CDHP enrollees are aware and participate at higher rates in wellness programs, the author notes.
Another trend the study found was the increased interest in health savings accounts.
Among individuals enrolled in CDHPs, 56% opened an HSA, 19% were in an HRA, and 25% were enrolled in an HSA-eligible health plan but had not opened an HSA.
It’s more common for employers to contribute to HSAs than in the past, and the dollar amount is also increasing, EBRI says. Seventy-eight percent of CDHP enrollees reported that their employer contributed to the account in 2016, up from 67% in 2014.
Additionally, 20% of CDHP enrollees reported an employer contribution of at least $2,000 in 2016, up from 10% in 2014.
See the original article Here.
Source:
Otto N. (2017 June 1). High-deductible health plans promote increased wellness program participation [Web blog post]. Retrieved from address https://www.benefitnews.com/news/high-deductible-health-plans-promote-increased-wellness-program-participation
An Update on Health Care and Tax Reform
Make sure you are staying up-to-date with all the recent changes happening in healthcare. Here is a great article by Joseph Minarik from the Committee for Economic Development to help you stay informed with everything going on with the new healthcare legislation.
The status of what may be the Administration’s two highest legislative priorities, health care reform and tax reform, remains uncertain.
The overwhelming consensus in Washington is that the Administration and the Congress have virtually no alternative but to either complete or abandon health care reform before taking up tax reform. That is because both an Administration health care reform (to “repeal and replace” Obamacare, more formally known as the Affordable Care Act, or ACA), and any Administration tax reform, can be enacted only under reconciliation procedures in the Senate (which prevent a filibuster that would require 60 votes to break). By budget process rules, there can be only one reconciliation process in progress at one time. The current process was designed expressly for health care reform. The health care reform process cannot continue if tax reform is begun.
A decision to abandon health care reform would be extremely painful to the many Republicans in Congress who made repealing Obamacare their signature campaign promise. This would certainly be an admission of failure in the current environment, with Republicans controlling the White House and both chambers of the Congress. But that delays and reduces the time available to complete any attempted tax reform. Of course, the relevant policy players can have tax reform conversations among themselves, but that is not the same as actually engaging in a public debate over actual legislative language.
So the current debate over health care legislation is time-sensitive. And passing the House health care bill, the American Health Care Act (AHCA), was extraordinarily difficult. The Senate cannot pass the AHCA, and their passing any similar bill would likely be even more difficult than was the process in the House.
To begin, Democrats will provide zero votes to “repeal” what they hold as the signature achievement of the Obama Administration. Republicans have 52 votes in the Senate, and thus, even under the reconciliation procedure, can afford to lose only two votes. (The Vice President would be called on to break a 50-50 tie.) Thus, the Senate Republicans’ margin for error is extremely small, and the ideological spread of their membership is probably wider than is that of their caucus on the House side.
And under these daunting arithmetic constraints, the Senate health bill must thread several very small substantive needles.
The bill will be under very tight fiscal constraints. The Republicans want the health bill to reduce the deficit, so that the money it saves can be used to pay for tax reform. This is expected even after the repeal of many of the taxes and fees and some of the spending cuts that Obamacare used to finance itself.
The programmatic expectations on the bill will be considerable. Opinion surveys showed “Obamacare” to be highly unpopular. But when not identified with the bill, many of Obamacare’s key features were found to be resoundingly popular – even among Republicans, and even in the very same surveys. One such feature was eliminating discrimination against persons with pre-existing conditions. At the same time, one of the highest House Republican priorities was reducing premiums. The House Republicans could find no alternative way to reduce premiums but to water down the protections for those with pre-existing conditions, in some instances through provisions that were less than totally transparent. The Senate Republicans are likely to be less accepting of such provisions.
The House Republican AHCA sought to attract younger, healthier households to purchase insurance (without the mandate that their Members abhor) by raising the relative premiums of older enrollees. That is unlikely to sit well in the Senate – or at least well enough with a margin of only two votes.
Next on what could be a very long list of concerns is the repeal of Obamacare’s Medicaid expansion. There are 20 Republican Senators who represent states that have expanded Obamacare. As much as some Republicans opposed the Medicaid expansion, the same Senators are unwilling to impose a sudden reduction in their states’ federal funding to repeal it. Many of those Republicans also do not want to remove health care coverage from the working families who were covered by the expansion.
In the broadest terms, Republican Senators will not want to take away a benefit that has been given to the citizens of their states – even though those Senators may have on a principled basis opposed granting that benefit in the first place. But achieving everything that they want to achieve in this bill, subject to a rigorous budget constraint, may prove impossible.
And then, assuming the Senate manages to pass a bill, it will then have to reconcile its very different bill with that of the House. It is always possible that many House and Senate Republicans will decide to sacrifice their preferences to that the Administration can have its first-year victory to set a positive tone (and avoid a highly negative one). But the first instinct of a Member of Congress is almost always self-preservation, and the fondest hope and expectation is that the next election will see the triumph of his or her ideological view and thus the ability to achieve all of the goals that cannot be obtained in the present because of the service of doctrinal purity.
Whether health care reform succeeds or not, the President and the Congress are sure to find that tax reform is every bit as complex as is health care reform. Again, they will begin with the tightest budget constraint, along with a lengthy list of priorities. They already have discussed tax cuts for large businesses and small businesses, public corporations and LLCs, and of course a massive tax cut for the middle class. How all of that happens without widening the already excessive and growing budget deficit is a true puzzle. At present, the House Ways & Means Committee chair continues to maintain that he will put forward a revenue-neutral bill by relying on the so-called “border-adjustment tax” which CED has discussed in a recent policy brief, and which has proven highly unpopular in the Senate. This makes the prospects even more murky.
If all of this fails, which it may or may not, the Administration and the Congress will find themselves at the end of the year with no particular legislative achievement. There is some possibility that they would respond to that conundrum by following the path of least resistance and proposing a large net tax cut, forcing the political opposition to vote against it and thus cross many taxpayers. But that, of course, would worsen the already troubling budget outlook.
See the original article Here.
Source:
Minarik J. (2017 May 17). An update on health care and tax reform [Web blog post]. Retrieved from address https://www.ced.org/blog/entry/an-update-on-health-care-and-tax-reform
7 Morning Rituals To Make Your Day 8 Times More Productive
Are you looking for a way to make your morning more productive? Take a look at this great article by Karen Reed from Positive Health Wellness and check out these 7 great tips for boosting your productivity in the morning.
“You will never change your life until you change something you do daily. The secret of your success is found in your daily routine. ” — John C. Maxwell
Rituals make you who you are. The morning ritual is rediscovering productivity at the start of the day. You need not wake at the crack of dawn to have a productive start to your day. Instead, you need to take a close look at how you start your day and figure out how to get more from it. One way to do that is establishing a morning ritual.
What Is Morning Ritual?
A morning ritual is something you do daily as part of your morning.It must be a right blend of both physical activities and mental activities.If you start your day with a few simple tasks, it helps you to begin a cycle of results that will increase your vigor to be productive through your day.
The morning ritual gives you a chance to center yourself and embrace your day instead of fleeing from it. It will help you to enjoy the luxury of time you’ve given yourself by rising at an appropriate time.
Why Creating A Morning Ritual Will Make You More Successful?
Establishing healthy habits and morning routine are critical for a lifetime of success. Your morning routine sets the right tone for the whole day. If you do each day right, you’ll do life right. If you don’t have a good morning routine, you may feel overwhelmed and disorganized.
The first step to work smarter and not harder is that you need to create healthy habits. The personal ritual that you set up for yourself will put you in the right mindset and offset any morning procrastination.
The other reason to create a morning routine is to avoid mental fatigue. We have only certain amount of energy and willpower when we wake up each morning. It slowly gets drained away with decisions. It is especially true if you have hundreds of small decisions to make in the morning that means nothing, but will affect how you make decisions for the rest of the day.
So try to have the first hour of your day vary as little as possible with routine. Knowing how the first few minutes of your day looks like, is powerful and it helps you to feel “in control” and “non-reactive.” This action, in turn, reduces anxiety and ensures that you’re more productive throughout the day.
Steps To Put Your Morning Ritual Into Place
- Write down a list of things you do every morning and what you like to add.
- Estimate the time it’ll indeed take to do everything on your list.
- Adjust your wake-up time to fit in your new ritual.
- Familiarize your list each morning for at least 2-3 days before making adjustments.
- Once you’ve got used to your changes, start enjoying your morning rituals.
You could work on “Habit Stalking” to craft yourself a good morning routine that works for you. Habit Stalking is a way to build a new practice into your life by stalking it on top of something that you’re currently doing.
Avoid designing something long and complicated when you’re starting off. Start with an easily manageable chunk of time. You can start with a five or 10-minute ritual and move your way up. Just take your time to build a balanced morning schedule. There’s nothing like starting your day off fabulous both mentally and physically.
Benefits Of Having A Morning Ritual
- A morning routine helps you to feel more grounded and embodied.
- It helps you to slow down and tune into your intuition.
- Enables you to batch your energy sources and self-care in a defined amount of time.
- Makes you less reactive and more intentional as you start your work day.
- Helps you feel more productive without feeling fragmented.
- Promotes more space and pause to make choices that nourish you.
- It syncs with your natural feminine rhythms and those of nature.
- It optimizes your decision making power for creative and productive work.
7 Morning Rituals You Should Adapt
Here are seven tips to build your morning routine that will help to become the best version of yourself and will make you take on your day confident and energized.
Meditation
Meditation helps you to start your day on a positive note. It helps you to be more at peace with yourself. Research has shown that meditation can enhance your:
- Attention
- Creativity
- Working memory
- Emotional regulation
- Immune function
- Cognitive performance
- Self-control
- Healthy habits
- While reducing stress
Researchers from the Carnegie Mellon University have found that meditation reduces Interleukin-6 an inflammatory health biomarker found in highly stressed individuals. If you begin your day with meditation, it calms your “busy mind syndrome,” which results if you don’t activate your mental spam filter.
Meditating helps to filter out the internal and external noise and negative self-talk that can sabotage your otherwise sharp, clear, perpetual acuity. Meditating as a morning ritual helps you to tame your emotions and keeps your emotional brain in check.
A study published in the American Journal of Psychiatry says that patients who were suffering from an anxiety disorder or panic disorder underwent three months of meditation and relaxation training. And at the end of the three-month period, their panic attacks had substantially reduced.
Meditation also improves empathy and positive relationships. It enhances feelings of competence about one’s life and promotes environmental mastery, ego resilience, and purpose in life.
What a beautiful way to start your day, filling your soul,mind, and body from the “Higher Power” to embark on your day’s journey.
Gratitude
Robert Emmons, the world’s leading scientific expert on gratitude,writes, “it’s an affirmation of goodness. We affirm that there are good things in the world, gifts, and benefits we’ve received.”
In the second part of gratitude, he says, “we recognize that the sources of this goodness are outside of ourselves. … We acknowledge that other people—or even higher powers, if you’re of a spiritual mindset—gave us many gifts, big and small, to help us achieve the goodness in our lives.”
After you’ve completed your meditation just take a few minutes and be thankful for all the positive things that happened to you. You might be grateful for an unexpected visit from an old friend, a beautiful encounter with a kind stranger, or a new opportunity that shines your way.
Practicing gratitude as a morning ritual can have tremendous benefits for your overall health. Being grateful increases your self-esteem makes you more optimistic and less materialistic and self-centered. It increases your happiness, makes you more relaxed, resilient and less envious.
Gratitude increases your energy, longevity, improves your sleep quality and immunity. It boosts your career growth by increasing your goal achievement, productivity and decision making. It results in better management and improved networking.
Your social relationships get a boost by being grateful. It results in healthier marriage, more friendships and deeper relationships. The real power of gratitude is that it helps you to pick out and focus on what is working in your life –what is in tune with your being as a whole. If you have time, you can also practice gratitude journaling.
Writing Down Your Tasks
Journaling your important tasks is a practical ritual. It helps you to focus your day and life on what is essential. It helps you to prioritize and manage your time better.
Start the ritual by identifying and writing down one to three essential tasks you need to complete during that day. They may be the tasks that support your long-term goals that are related to your purpose, passion or the general direction of life.
You can also write down mundane tasks which David Allen, productivity speaker and author of Getting Things Done calls “core dump.”this involves writing down every project, task, and activity you need to address.
You can write down every “to do” item you can think of. It clears the space in your head for more important topics.
Morning Pages is a technique developed by Julia Cameron, author of The Artist’s Way. It involves writing approximately 750 words of conscious writing. If you follow this practice as a morning ritual, it clears your head for the day’s most important thinking.
Writing down your tasks helps you to process your emotions, gives a record of your past, gains you a sense of achievement, helps you think big and makes you more committed.
Positive Affirmations
Barrie Davenport writes in live bold and bloom that affirmations are a form of auto suggestion. If you practice it deliberately and repeatedly, they reinforce chemical pathways in the brain and strengthen neural connections.
If you practice positive thought patterns or affirmations regularly, you create neuroplasticity in the area of the brain that processes what you’re thinking about.
Some of the positive affirmations you can say are:
- I awake in the morning feeling happy and enthusiastic about my day.
- I can tap into the wellspring of inner happiness anytime I wish.
- I have healthy boundaries with my partner
- Success is my natural state,and I expect to be successful in all of my endeavors.
- I am energetic and enthusiastic. Confidence is my second nature.
- I always attract only the best of the circumstances and the best positive people in my life.
- I choose to be proud of myself.
- I am talented.
- I am attractive and beautiful.
- Every cell in my body quivers with energy and good health.
- I breathe in peace. I breathe out chaos and disorder.
Exercise
Morning is a great time for exercise. It’s quiet and peaceful in the morning.You can go for a mindful run and have little interruptions. Even a simple 5-minute exercise workout will wake up your muscles and get them ready for the day ahead.
A quick morning exercise jumpstarts your cells.You could jog, walk, dance, do yoga- anything to get your blood flowing. The options are endless. If you’re on a weight-loss mission, a brisk morning walk is a key to shedding a few pounds.
According to researchers from Northumbria University, people can burn up to twenty percent more body fat by exercising in the morning when they are on an empty stomach.
Researchers say that the morning light helps synchronize your body clock. Researchers, from Northwestern University’s Feinberg School of Medicine in Chicago, say that light is the most potent agent to harmonize your internal body clock that regulates the circadian rhythms. This aspect, in turn,controls energy balance. It is not rocket science to understand that including exercise as a morning ritual keeps you productive and energetic the whole day.
Listen To Uplifting Music
Music uplifts your physical and mental health in numerous ways. When you combine music and your exercise together,you get stunning results. Researchers found that participants pedaled faster when riding stationary bicycles while listening to music. Listening to pumping music helps you to run faster, and increases your workout endurance.
Music makes you feel happier because it enhances blood vessel function. It reduces stress levels and relieves depression. It improves your cognitive performance and helps you perform better in high-pressure situations. If you’re hard pressed for time, just combine this ritual while doing your morning exercise or while driving to work.
Detoxify With Lemon Water
Drinking warm water first thing in the morning helps flush the digestive system and rehydrates the body. Drinking lemon water acts as a natural flush and cleanses your liver. Lemon juice enhances stomach acid production and bile production. It results in a clean liver and lymph system.
Lemon contains vitamin C and potassium. When you drink lemon water first thing in the morning, it helps your body to absorb these vitamins and provides a little immune boost. Vitamin C is good for your adrenals and contributes to reducing your stress levels.
Since lemon water flushes your body, you enjoy a cleaner skin. The vitamin C helps in collagen production and makes your skin smooth and healthy. If you drink lemon water first thing in the morning, it will help you maintain a healthy weight.
Conclusion
You are what you frequently do everyday. If you include special routines in your daily schedule, you can turn your life around for the better. The main thing about rituals is that you can start your own and train yourself through practice.
Be conscious because routines work both in positive and negative ways. So be smart and choose the right ones. If you follow the ones that we’ve discussed above, we are positive that these morning rituals will bring only good things to your life.
See the original article Here.
Source:
Reed K. (2017 June 11). 7 morning rituals to make your day 8 times more productive [Web blog post]. Retrieved from address https://www.positivehealthwellness.com/fitness/7-morning-rituals-to-make-your-day-8-times-more-productive/
Retirement Calculator Seen as Critical Tool
Did you know that the most impactful tool for employee financial wellness is a retirement calculator? Find out more in this article by Bruce Shutan from Employee Benefit News on why you should have a retirement calculator included in your employee benefits program.
In analyzing the financial behaviors of 67,089 U.S. employee financial wellness assessments, Financial Finesse concluded that the most impactful action was for employers to offer a retirement calculator. The 2016 Year in Review Report also suggested that they promote it to the hilt with the help of their brokers and advisers.
“Running that projection is driving other behavior,” such as changes in cash flow or higher retirement plan contributions over time, explains Cynthia Meyer, a financial planner with Financial Finesse and author of the report.
She says advisers can help spotlight the use of a retirement calculator in an educational workshop or enrollment meeting where they can detail examples or case studies involving the potential effect of this handy tool.
The report uncovered a few bright spots. More employees ran a retirement projection, which jumped to 49% in 2016 from 35% in 2015. In addition, about 60% of these employees discovered they were on track to retire comfortably while about 40% discovered they were underfunded and needed to make changes.
Another positive development was that repeat usage of workplace financial wellness programs appears to be gaining momentum. The number of employees who have done annual workplace assessments of their finances multiple times has climbed steadily since 2013 when it was just 6% to 15% in 2014, 16% in 2015 and 29% in 2016.
However, problems persist. Virtually all demographic groups were still found to have insufficient savings for a comfortable retirement. For example, while 92% of the employees studied participate in an employer-sponsored retirement plan, just 77% contribute enough to earn the full employer match.
Still, Meyer notes that packaging financial wellness content with a good retirement plan is becoming a standard practice as the movement toward a more holistic view of employee finances gains traction.
Aon Hewitt’s 2017 Hot Topics in Retirement and Financial Wellbeing survey found that 59% of employers are very likely and another 33% are moderately likely to focus on the financial wellbeing of workers in ways that extend beyond retirement decisions. Moreover, 86% of employers are very or moderately likely to communicate to their workforces the link between health and wealth.
Rob Austin, director of retirement research at Aon Hewitt, says this is an indication of “just how much I think employers still care about their employees.” It certainly bodes well for brokers and advisers who can expect to be busy in the coming years helping their clients create a strategy and build out a plan that appeals to each workforce, he believes.
Aon Hewitt’s survey, whose 238 respondents represent nearly 9 million employees, noted several other key trends. They include employers enhancing both the accumulation and decumulation phases for their defined contribution plan participants, and defined benefit plan sponsors revisiting ways they’re removing risk from their plan.
See the original article Here.
Source:
Shutan Bruce (2017 May 29). Retirement calculator seen as critical tool [Web blog post]. Retrieved from address https://www.benefitnews.com/news/retirement-calculator-seen-as-critical-tool?brief=00000152-14a7-d1cc-a5fa-7cffccf00000
Here's What The GOP Bill Would (And Wouldn't) Change About Women's Health Care
What will change about women's healthcare and what will stay the same? Danielle Kurtzleben explores the potential changes in the following article for NPR.
The Affordable Care Act changed women's health care in some big ways: It stopped insurance companies from charging women extra, forced insurers to cover maternity care and contraceptives and allowed many women to get those contraceptives (as well as a variety of preventive services, like Pap smears and mammograms) at zero cost.
Now Republicans have the opportunity to repeal that law, also known as Obamacare. But that doesn't mean all those things will go away. In fact, many will remain.
Confused? Here's a rundown of how this bill would change some women-specific areas of health care, what it wouldn't change, and what we don't know so far.
What would change:
Abortion coverage
There are restrictions on abortion under current law — the Hyde Amendment prohibits federal subsidies from being spent on abortions, except in the case of pregnancies that are the result of rape or incest or that threaten the life of the mother. So while health care plans can cover abortions, those being paid for with subsidies "must follow particular administrative requirements to ensure that no federal funds go toward abortion," as the Guttmacher Institute, which supports abortion rights, explains.
But the GOP bill tightens this. It says that the tax credits at the center of the plan cannot be spent at all on any health care plan that covers abortion (aside from the Hyde Amendment's exceptions).
So while health care plans can cover abortion, very few people may be able to purchase those sorts of plans, as they wouldn't be able to use their tax credits on them. That could make it much more expensive and difficult to obtain an abortion under this law than under current law.
Planned Parenthood funding
This bill partially "defunds" Planned Parenthood, meaning it would cut back on the federal funding that can be used for services at the clinics. Fully 43 percent of Planned Parenthood's revenue in fiscal year 2015 — more than $550 million — came from government grants and reimbursements.
Right now, under Obamacare, federal funds can be spent at Planned Parenthood, but they can't be used for abortion — again, a result of the Hyde Amendment and again, with the three Hyde Amendment exceptions. But this bill goes further, saying that people couldn't use Medicaid at Planned Parenthood.
To be clear, it's not that there's a funding stream going directly from the government to Planned Parenthood that Congress can just turn off. Rather, the program reimburses Planned Parenthood for the care it provides to Medicaid recipients. So this bill would mean that Medicaid recipients who currently receive care at an organization that provides abortions would have to find a new provider (whom Medicaid would then reimburse).
Abortion is a small part of what Planned Parenthood does: The organizations says it accounted for 3.4 percent of all services provided in the year ending in September 2014. (Of course, some patients receive more than one service; Planned Parenthood had around 2.5 million patients in that year. Assuming one abortion per patient, that's roughly 13 percent of all patients receiving abortions.)
Together, providing contraception and the testing for and treatment of sexually transmitted diseases made up three-quarters of the services the organization provided in one year.
That means low-income women (that is, women on Medicaid) could be among the most heavily affected by this bill, as it may force them to find other providers for reproductive health services.
Of the other government money that goes to Planned Parenthood, most of it comes from Title X. That federal program, created under President Richard Nixon, provides family planning services to people beyond Medicaid, like low-income women who are not Medicaid-eligible. Earlier this year, Republicans started the process of stripping that funding.
What wouldn't change (yet):
Republicans have stressed that this bill was just one of three parts, so it's hard to say definitively what wouldn't change at all as a result of their plan. But thus far, here's what is holding steady:
Maternity and contraceptive coverage
Because this was a reconciliation bill, it could cover fiscal-related topics only. It couldn't get into many of the particulars of what people's coverage will look like, meaning some things won't change.
The essential health benefits set out in Obamacare — a list of 10 types of services that all plans must cover — do not change for other policies. Maternity care is included in those benefits, as is contraception, so plans will have to continue to cover those. The GOP bill also doesn't change the Obamacare policy that gave women access to free contraception, as Vox's Emily Crockett reported.
In addition, maternity and contraception are still both "mandatory benefits" under Medicaid. That doesn't change in the GOP bill. (Confusingly, the bill does sunset essential health benefits for Medicaid recipients. But because there is overlap and these particular benefits remain "mandatory," they aren't going away.)
However, all of this won't necessarily remain unchanged. In response to a question about defunding Planned Parenthood this week, Health and Human Services Secretary Tom Price said that he didn't want to "violate anybody's conscience." When a reporter asked how this relates to birth control, Price did not give a definite answer.
"We're working through all of those issues," he said. "As you know, many of those were through the rule-making process, and we're working through that. So that's not a part of this piece of legislation right here."
So this is something that could easily change in the second "phase" of the health care plan, when rules are changed.
"Preventative services [the category that includes contraception] hasn't been touched, but we expect those to be touched probably via regulation," said Laurie Sobel, associate director for women's health policy at the Kaiser Family Foundation.
The end of gender rating
Prior to Obamacare, women were often charged more for the same health plans as men. The rationale was that women tend to use more health care services than men.
However, Obamacare banned the practice, and that ban seems unlikely to change, as the GOP cites nondiscrimination as one of the bill's selling points:
"Our proposal specifically prohibits any gender discrimination. Women will have equal access to the same affordable, quality health care options as men do under our proposal."
See original article Here.
Source:
Kurtzleben, D. (10 March 2017). Here's What The GOP Bill Would (And Wouldn't) Change About Women's Health Care. [Web Blog Post] Retrieved from address https://www.npr.org/2017/03/10/519461271/heres-what-the-gop-bill-would-and-wouldnt-change-for-womens-healthcare
GOP’s Health Bill Could Undercut Some Coverage In Job-Based Insurance
Thanks to the new legislation passed by Congress health care is on the verge of changing as we know it. Check out this interesting article by Michelle Andrews from Kaiser Health News on how these changes to healthcare will affect Americans who get their healthcare through an employer.
This week, I answer questions about how the Republican proposal to overhaul the health law could affect job-based insurance and what the penalties for not having continuous coverage mean. Perhaps anticipating a spell of uninsurance, another reader wondered if people can rely on the emergency department for routine care.
Q: Will employer-based health care be affected by the new Republican plan?
The American Health Care Act that recently passed the House would fundamentally change the individual insurance market, and it could significantly alter coverage for people who get coverage through their employers too.
The bill would allow states to opt out of some of the requirements of the Affordable Care Act, including no longer requiring plans sold on the individual market to cover 10 “essential health benefits,” such as hospitalization, drugs and maternity care.
Small businesses (generally companies with 50 or fewer employees) in those states would also be affected by the change.
Plans offered by large employers have never been required to cover the essential health benefits, so the bill wouldn’t change their obligations. Many of them, however, provide comprehensive coverage that includes many of these benefits.
But here’s where it gets tricky. The ACA placed caps on how much consumers can be required to pay out-of-pocket in deductibles, copays and coinsurance every year, and they apply to most plans, including large employer plans. In 2017, the spending limit is $7,150 for an individual plan and $14,300 for family coverage. Yet there’s a catch: The spending limits apply only to services covered by the essential health benefits. Insurers could charge people any amount for services deemed nonessential by the states.
Similarly, the law prohibits insurers from imposing lifetime or annual dollar limits on services — but only if those services are related to the essential health benefits.
In addition, if any single state weakened its essential health benefits requirements, it could affect large employer plans in every state, analysts say. That’s because these employers, who often operate in multiple states, are allowed to pick which state’s definition of essential health benefits they want to use in determining what counts toward consumer spending caps and annual and lifetime coverage limits.
“If you eliminate [the federal essential health benefits] requirement you could see a lot of state variation, and there could be an incentive for companies that are looking to save money to pick a state” with skimpier requirements, said Sarah Lueck, senior policy analyst at the Center on Budget and Policy Priorities.
Q: I keep hearing that nobody in the United States is ever refused medical care — that whether they can afford it or not a hospital can’t refuse them treatment. If this is the case, why couldn’t an uninsured person simply go to the front desk at the hospital and ask for treatment, which by law can’t be denied, such as, “I’m here for my annual physical, or for a screening colonoscopy”?
If you are having chest pains or you just sliced your hand open while carving a chicken, you can go to nearly any hospital with an emergency department, and — under the federal Emergency Medical Treatment and Active Labor Act (EMTALA) — the staff is obligated to conduct a medical exam to see if you need emergency care. If so, they must try to stabilize your condition, whether or not you have insurance.
The key word here is “emergency.” If you’re due for a colonoscopy to screen for cancer, unless you have symptoms such as severe pain or rectal bleeding, emergency department personnel wouldn’t likely order the exam, said Dr. Jesse Pines, a professor of emergency medicine and health policy at George Washington University, in Washington, D.C.
“It’s not the standard of care to do screening tests in the emergency department,” Pines said, noting in that situation the appropriate next step would be to refer you to a local gastroenterologist who could perform the exam.
Even though the law requires hospitals to evaluate anyone who comes in the door, being uninsured doesn’t let people off the hook financially. You’ll still likely get bills from the hospital and physicians for any care you receive, Pines said.
Q: The Republican proposal says people who don’t maintain “continuous coverage” would have to pay extra for their insurance. What does that mean?
Under the bill passed by the House, people who have a break in their health insurance coverage of more than 63 days in a year would be hit with a 30 percent premium surcharge for a year after buying a new plan on the individual market.
In contrast, under the ACA’s “individual mandate,” people are required to have health insurance or pay a fine equal to the greater of 2.5 percent of their income or $695 per adult. They’re allowed a break of no more than two continuous months every year before the penalty kicks in for the months they were without coverage.
The continuous coverage requirement is the Republicans’ preferred strategy to encourage people to get health insurance. But some analysts have questioned how effective it would be. They point out that, whereas the ACA penalizes people for not having insurance on an ongoing basis, the AHCA penalty kicks in only when people try to buy coverage after a break. It could actually discourage healthy people from getting back into the market unless they’re sick.
In addition, the AHCA penalty, which is based on a plan’s premium, would likely have a greater impact on older people, whose premiums are relatively higher, and those with lower incomes, said Sara Collins, a vice president at the Commonwealth Fund, who authored an analysis of the impact of the penalties.
See the original article Here.
Source:
Andrews M. (2017 May 23). GOP's health bill could undercut some coverage in job-based insurance[Web blog post]. Retrieved from address https://khn.org/news/gops-health-bill-could-undercut-some-coverage-in-job-based-insurance/
Ear To The Door: 5 Things Being Weighed In Secret Health Bill Also Weigh It Down
With Congress passing the American Health Care Act a few weeks, the legislation now shifts to the Senate for its final approval. Take a look at this article by Julie Rovner from Kaiser Health News and find out where we are at on the healthcare repeal process and which aspects of the AHCA legislation the Senate is bound to change.
Anyone following the debate over the “repeal and replace” of the Affordable Care Act knows the 13 Republican senators writing the bill are meeting behind closed doors.
While Senate Majority Leader Mitch McConnell (R-Ky.) continues to push for a vote before the July 4 Senate recess, Washington’s favorite parlor game has become guessing what is, or will be, in the Senate bill.
Spoiler: No one knows what the final Senate bill will look like — not even those writing it.
“It’s an iterative process,” Senate Majority Whip John Cornyn (R-Texas) told Politico, adding that senators in the room are sending options to the Congressional Budget Office to try to figure out in general how much they would cost. Those conversations between senators and the CBO — common for lawmakers working on major, complex pieces of legislation — sometimes prompt members to press through and other times to change course.
Although specifics, to the extent there are any, have largely stayed secret, some of the policies under consideration have slipped out, and pressure points of the debate are fairly clear. Anything can happen, but here’s what we know so far:
1. Medicaid expansion
The Republicans are determined to roll back the expansion of Medicaid under the Affordable Care Act. The question is, how to do it. The ACA called for an expansion of the Medicaid program for those with low incomes to everyone who earns less than 133 percent of poverty (around $16,000 a year for an individual), with the federal government footing much of the bill. The Supreme Court ruled in 2012 that the expansion was optional for states, but 31 have done so, providing new coverage to an estimated 14 million people.
The Republican bill passed by the House on May 4 would phase out the federal funding for those made eligible by the ACA over two years, beginning in 2020. But Republican moderates in the Senate want a much slower end to the additional federal aid. Several have suggested that they could accept a seven-year phaseout.
Keeping the federal expansion money flowing that long, however, would cut into the bill’s budget savings. That matters: In order to protect the Senate’s ability to pass the bill under budget rules that require only a simple majority rather than 60 votes, the bill’s savings must at least match those of the House version. Any extra money spent on Medicaid expansion would have to be cut elsewhere.
2. Medicaid caps
A related issue is whether and at what level to cap federal Medicaid spending. Medicaid currently covers more than 70 million low-income people. Medicaid covers half of all births and half of the nation’s bill for long-term care, including nursing home stays. Right now, the federal government matches whatever states spend at least 50-50, and provides more matching funds for less wealthy states.
The House bill would, for the first time, cap the amount the federal government provides to states for their Medicaid programs. The CBO estimated that the caps would put more of the financial burden for the program on states, who would respond by a combination of cutting payments to health care providers like doctors and hospitals, eliminating benefits for patients and restricting eligibility.
The Medicaid cap may or may not be included in the Senate bill, depending on whom you ask. However, sources with direct knowledge of the negotiations say the real sticking point is not whether or not to impose a cap — they want to do that. The hurdles: how to be fair to states that get less federal money and how fast the caps should rise.
Again, if the Senate proposal is more generous than the House’s version, it will be harder to meet the bill’s required budget targets.
3. Restrictions on abortion coverage and Planned Parenthood
The senators are actively considering two measures that would limit funding for abortions, though it is not clear if either would be allowed to remain in the bill according to the Senate’s rules. The Senate Parliamentarian, who must review the bill after the senators complete it but before it comes to the floor, will decide.
The House-passed bill would ban the use of federal tax credits to purchase private coverage that includes abortion as a benefit. This is a key demand for a large portion of the Republican base. But the Senate version of the bill must abide by strict rules that limit its content to provisions that directly impact the federal budget. In the past, abortion language in budget bills has been ruled out of order.
4. Reading between the lines
A related issue is whether House language to temporarily bar Planned Parenthood from participating in the Medicaid program will be allowed in the Senate.
While the Parliamentarian allowed identical language defunding Planned Parenthood to remain in a similar budget bill in 2015, it was not clear at the time that Planned Parenthood would have been the only provider affected by the language. Planned Parenthood backers say they will argue to the Parliamentarian that the budget impact of the language is “merely incidental” to the policy aim and therefore should not be allowed in the Senate bill.
5. Insurance market reforms
Senators are also struggling with provisions of the House-passed bill that would allow states to waive certain insurance requirements in the Affordable Care Act, including those laying out “essential” benefits that policies must cover, and those banning insurers from charging sicker people higher premiums. That language, as well as an amendment seeking to ensure more funding to help people with preexisting conditions, was instrumental in gaining enough votes for the bill to pass the House.
Eliminating insurance regulations imposed by the ACA are a top priority for conservatives. “Conservatives would like to clear the books of Obamacare’s most costly regulations and free the states to regulate their markets how they wish,” wrote Sen. Mike Lee (R-Utah), who is one of the 13 senators negotiating the details of the bill, in an op-ed in May.
However, budget experts suggest that none of the insurance market provisions is likely to clear the Parliamentarian hurdle as being primarily budget-related.
See the original article Here.
Source:
Rovner J. (2017 June 16). Ear to the door: 5 things being weighed in secret health bill also weigh it down [Web blog post]. Retrieved from address https://khn.org/news/ear-to-the-door-5-things-being-weighed-in-secret-health-bill-also-weigh-it-down/