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On The House Floor, Shea-Porter Pushes Amendment To Require Insurance Coverage Of Opioid Use Disorder Treatment

As Congress Debates Health Care Legislation, Congresswoman Highlights New Hampshire Heroin, Fentanyl, and Prescription Opioid Crisis 

WASHINGTON, DC Congresswoman Carol Shea-Porter (NH-01) today offered and the House voted on a Motion to Recommit that would require association health plans to provide coverage for substance use disorder treatment. As Congress this week considers the American Health Care Act, which would cause 24 million Americans to lose their coverage, Shea-Porter called on her colleagues to work together to improve access to quality, affordable health care.

“Today, Members of Congress can say to my constituents in New Hampshire and their constituents across this great nation: we hear you. We know your sons and daughters, your nieces and nephews, your neighbors and friends are struggling, and we have your back,” said Shea-Porter. “We believe all Americans deserve good health insurance they can count on when they need it most. We aren’t going to pull the rug out from under people who are about to turn their lives around.”

Shea-Porter’s remarks highlighted the fact that much-needed treatment facilities, such as Hope on Haven Hill in Rochester, which she recently visited, have been able to open because more Americans now have insurance that covers treatment thanks to the Affordable Care Act and its Medicaid expansion. 

177 Democrats and 2 Republicans voted for Shea-Porter’s motion.

SHEA-PORTER’S FULL HOUSE FLOOR REMARKS

“I rise today on behalf of the families and communities across this nation that are confronting a public health threat of our time: the heroin, fentanyl, and prescription opioid crisis. 

“This motion would simply ensure that the health insurance plans that today’s bill would permit must still cover substance use disorder treatment, including for opioids, as an essential health benefit.

“Under current law, we require insurers to cover this treatment. Before the Affordable Care Act, many insurers either didn’t cover treatment at all or imposed onerous requirements that blocked people from getting needed care.

“H.R.1101 would roll back that guarantee. It would allow association health plans to return to the kind of skimpy coverage that left so many people struggling with an opioid disorder in dire straits at critical moments. We know there’s often a narrow window of opportunity — after an overdose, for example — for someone to commit to treatment, and these are the moments when being able to make a single phone call can make all the difference. 

“This week’s debate about health care is extremely important. Will we decide to work together to improve the American people’s access to quality, affordable health care or weaken benefits and kick 24 million or more of our constituents off their plans? We all need to speak up on behalf of those whose lives have been turned around because they can now access care.

“As I talk to families, medical professionals, and law enforcement officials in my district, I hear stories that highlight the dramatic impact that improved access to coverage has had in making treatment a real option for people with substance use disorder.

“This week, we see that base of coverage is under serious threat. In fact, experts estimate that repealing the Affordable Care Act’s coverage provisions would cause about 2.8 million Americans with a substance use disorder to lose some or all of their coverage.

“And the quality of that coverage is also at risk. Thanks to the Affordable Care Act, insurance now must cover treatment for behavioral health and substance use disorder, just the same as it would cover any other medical service. These parity protections mean insurers must cover treatment for substance use disorder with comparable cost-sharing — no more surprises, like annual visit limits, higher copays, or frequent pre-authorization requirements and medical necessity reviews.

“Badly needed facilities are opening because plans now cover these services. I recently visited a recovery home for pregnant women and new mothers that was able to open its doors this year in my hometown only because it could rely on Medicaid expansion. Legislation like H.R.1101 would cause fewer people to have this coverage, meaning fewer facilities can open.

“Many of you know that my home state of New Hampshire is on the front lines of the heroin, fentanyl, and prescription opioid crisis. Our communities are struggling, and helping people get treatment is key to turning the tide. I have met the people who couldn’t be in a recovery facility without Medicaid expansion. 

“Today, Members of Congress can say to my constituents in New Hampshire and their constituents across this great nation: we hear you. We know your sons and daughters, your nieces and nephews, your neighbors and friends are struggling, and we have your back. We believe all Americans deserve good health insurance they can count on when they need it most. We aren’t going to pull the rug out from under people who are about to turn their lives around.

“I urge my colleagues to support this motion, which would not delay passage of the underlying bill. Thank you.”

New Hampshire Congressional Delegation Strongly Opposes GOP Repeal Of ACA

This week, Republicans released their new plan to repeal the Affordable Care Act, and replace it with something much worse.

“House Republicans should be ashamed of their new bill to repeal the Affordable Care Act, which would hurt New Hampshire workers and families by ending Medicaid expansion, driving up premiums, leaving fewer people with coverage than before the law passed, and setting us back in the fight against the heroin, fentanyl, and opioid epidemic,” said Congresswoman Carol Shea-Porter. “Despite months of pleas from their own constituents, who are terrified about losing their coverage, House Republicans have written a bill that shows total disregard for the people they are supposed to represent and instead bows to special interests. Unbelievably, after almost eight years, House Republicans still refuse to say how much their plan would cost and how many people it would force off their coverage – Republican leadership is trying to jam their bill through before the nonpartisan Congressional Budget Office even has the chance to score it. Instead of House Republicans’ backroom approach, the American people deserve an honest bipartisan debate on a bill that doesn’t erase the Affordable Care Act’s progress in driving the uninsured rate to the lowest on record, but instead makes needed fixes and improvements to our health care system to ensure all Granite Staters have access to affordable, quality healthcare.”

Congresswoman Kuster said the ACA is “not perfect” but “their proposal would increase costs, limit access, and cover fewer Americans” in her statement.

“It’s clear why Republicans in the House felt it necessary to keep this Affordable Care Act repeal plan hidden behind lock and key. Their proposal would increase costs, limit access, and cover fewer Americans. The Affordable Care Act is not perfect, and I’m willing to work with Republicans and Democrats to improve the law, but not at the expense of the healthcare of thousands of Granite Staters and millions of Americans nationwide,” said Congresswoman Annie Kuster. 

“The plan would cut Medicaid spending and phase out the expansion, which has helped thousands of people in New Hampshire access health insurance and has increased treatment and recovery services for those struggling with substance use disorders. Repealing health care subsidies would drive up costs for seniors and less healthy individuals, and provisions to defund providers such as Planned Parenthood do nothing to increase access to care. This is a huge giveaway to the wealthiest Americans, and the plan appallingly even includes a tax break for insurance CEOs making more than half a million dollars. I urge my colleagues on the other side of the aisle to rethink this misguided approach and instead come to the table in good faith to help improve the system for all Americans,” Kuster added. 

The Alliance for Retired Americans called the bill “another tax giveaway” to the wealthiest Americans and would “gut” the Medicare Trust Fund.

“After seven years Republicans have finally shown us what their repeal of Obamacare looks like. It would be a disaster for older and working Americans and for our health care system,” said Richard Fiesta, Executive Director of the Alliance for Retired Americans. “The bill repeals the increase in the Medicare payroll tax for high earners. That will reduce the solvency of the Medicare Trust Fund by 4 years, from 2029 to 2025. This is an insult to the fifty-seven million Medicare beneficiaries who have earned their guaranteed Medicare benefits, and many millions more who contribute to Medicare expecting it to be there when they retire.   

“The bill also cuts federal funding for Medicaid by $560 billion over 10 years. Cuts of this magnitude will force states to make deep cuts in the number of people who receive benefits, or the amount of health care provided. Over 70 million beneficiaries rely on Medicaid, including almost 6 million seniors who depend on it for their nursing home and home care services. The GOP’s message is, ‘Sorry, you’re out of luck.’

“Republicans have topped this off by changing the age rating for older Americans from 3:1 to 5:1, or even greater in some states. Enabling insurers to charge older Americans that much more will greatly increase costs for people over the age of 50,” Fiesta concluded. 

Senator Jeanne Shaheen said the bill would hurt middle class families in New Hampshire and across the U.S.

“This repeal bill would be nothing short of a disaster for healthcare coverage in New Hampshire and a devastating blow to our efforts to combat the opioid epidemic,” said Shaheen. “This is clearly a broken promise by President Trump and Republican leadership who assured the American public that nobody would be kicked off of their healthcare coverage. It’s unconscionable that this bill would decimate the Medicaid program and eliminate healthcare subsidies for the middle class while the wealthy get another tax break and insurance company CEOs get a pay bump. The bill also defunds Planned Parenthood, jeopardizing vital preventative and reproductive care for thousands of women in New Hampshire. It took Republican leadership seven years to come up with this repeal bill.  This proposal clearly demonstrates why Republican leadership should keep the Affordable Care Act and finally commit to working across the aisle to improve it.” 

Senator Maggie Hassan spoke out against the new House bill that would repeal the Affordable Care Act and New Hampshire’s bipartisan Medicaid expansion plan, force older Americans and middle class families to pay more while providing tax breaks for insurance CEOs and the wealthiest Americans, force drastic cuts to New Hampshire’s traditional Medicaid program for children, seniors and people with disabilities, and defund Planned Parenthood.

At a press conference in the Capitol with Senators Chuck Schumer (D-NY), Patty Murray (D-WA), Ron Wyden (D-OR) and Chris Murphy (D-CT), Senator Hassan specifically highlighted the devastating impact that the House bill would have on New Hampshire’s bipartisan Medicaid expansion plan and efforts to combat the heroin, fentanyl and opioid crisis.

“Make no mistake – this so-called replacement plan would end Medicaid expansion, which experts have said is the most important tool available to fight the substance use crisis. The House Republican plan also hurts children, seniors and people with disabilities with drastic federal cuts to the traditional Medicaid program. It would force states to either cut services our citizens need or to raise taxes,” said Senator Hassan.

Senator Hassan added, “Repealing Medicaid expansion would severely hurt the ability of those on the front lines to save lives and turn the tide of this deadly substance abuse epidemic. Substance use treatment providers have been clear that if Medicaid expansion is repealed, they will have to significantly cut back on the help that they can provide to those in need. To pull the rug out from millions of people across the country who are seeking a lifeline from the throes of addiction is the height of irresponsibility. And we cannot – and we will not – let it happen.”

Granite State Rumblings: The Dire Consequences Of ACA Repeal In NH

Last week we took a broad look at what repeal of the Affordable Care Act could mean for Medicaid and CHIP. This week let’s dig a little further into what the repeal would mean to children.

Repeal of the ACA would have particularly dire consequences for the 4.4 million children who would become uninsured. Health insurance for children has long-term positive outcomes, such as reductions in infant mortality and childhood deaths, improved health, and reduced disability. But there are subtler effects, too: expanding health coverage for low-income children improves high school and postsecondary success, and also employment over the long haul. Plus, children’s life chances are improved when parents are able to get the care they need, like treatment for depression (which is widespread among low-income mothers of young children). In states that have expanded Medicaid under the ACA, many more parents have health insurance, making access to treatment for behavioral health or substance use disorders more available, which helps parents’ own health and improves outcomes for their children.  ~ Source: CLASP ~

10 Reasons Why Repealing the ACA Would Harm Kids

  1. If health reform were repealed, insurers would go back to denying coverage for children with pre-existing conditions. Parents of children with cancer, children born with a birth defect, children with asthma, special-needs kids, among others, would once again be unable to get coverage for their kids without the Affordable Care Act.
  2. Insurers would return to the practice of placing lifetime limits on coverage so that if a child is fortunate enough to beat leukemia when they are 8 they would be uninsurable if they face another serious illness later in life.
  3. Dependent children through age 26 would not be guaranteed access to coverage on their parents’ policy, leaving scores of young adults, including recent high school and college grads, back among the ranks of the uninsured.
  4. Insurers would not have to cover vision care services or eyeglasses for children even if it is impossible for a child to be successful in school if they can’t see
  5. Insurers also would not be required to cover dental care, a horrible return to the days when lack of coverage could cause a child to die from an infected tooth that could have been addressed for about 100.
  6. Repealing health reform would jeopardize the future of the successful Children’s Health Insurance Program (CHIP), a federal-state program that offers low or no-cost coverage for families who earn too much to qualify for Medicaid but not enough to buy their own coverage. CHIP and Medicaid were crucial for families during the recession, ensuring that coverage for kids remained stable despite the downturn in the economy.
  7. Children with terminal illnesses would be returned to the days when they would not be able to get compassionate end-of-life hospice care unless they agreed to forgo looking for a cure for their illness.
  8. Insurers would be allowed to resume the practice of charging co-payments for preventive health services, including essential well-baby and well-child visits, and vaccinations, creating financial disincentives for parents to get care for their children that keeps them healthy.
  9. Children in foster care would no longer qualify for Medicaid beyond age 18. This provision parallels the one enabling young adults to remain on their parents’ health plans until they turn 26.
  10. Efforts to eliminate bureaucratic red tape and streamline enrollment processes for children who are already eligible but not enrolled in public health coverage would suffer if health reform was repealed. Nearly two-thirds of children who are uninsured actually qualify for coverage but face significant barriers that make it difficult for them to sign-up or re-enroll for coverage.

As we explained last week, through the Affordable Care Act, Medicaid and the Children’s Health Insurance Program (CHIP) have worked in unison to dramatically cut the ranks of the uninsured across the country. CHIP has provided coverage to the almost eight million children whose families currently or once lived in the coverage gap. 

Because of the options available under the ACA the percentage of uninsured children has dropped from 14.9 percent in 1997 to just 4.8 percent in 2015 — a 68 percent reduction. That is impressive! 

Medicaid and CHIP have also been an option for many parents who can participate in a health insurance option through their employers, but because of costs associated with employer based coverage have turned instead to these programs.

Michelle Andrews with Kaiser Health News, a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation wrote about this in a recent article.

Many Parents With Job-Based Coverage Still Turn To Medicaid, CHIP To Insure Kids

By Michelle Andrews, December 9, 2016

Lower income parents who have health insurance through their employers are increasingly likely to forgo family coverage and enroll their kids in Medicaid or the Children’s Health Insurance Program (CHIP) instead, a new study found. Working families’ growing reliance on these programs is something lawmakers should keep in mind when they consider whether to renew financing for the CHIP program in 2017, the study’s lead author said.

“These aren’t just safety net programs for uninsured families,” said Douglas Strane, a clinical research associate at PolicyLab at the Children’s Hospital of Philadelphia and the lead author of the study, which appeared in the December issue of Health Affairs. “If CHIP isn’t renewed, we could place substantial pressure on working families.”

Medicaid is the state-federal program that provides health coverage for low-income adults and children. CHIP provides health insurance for children in families whose incomes are modest but too high to qualify for Medicaid. In 2016, only three states — Arizona, Idaho and North Dakota — limited Medicaid/CHIP coverage to children whose families have incomes less than 200 percent of the federal poverty level ($40,320 for a family of three). In contrast, 19 states offered coverage to children with family incomes greater than 300 percent of the federal poverty level ($60,480 for a three-person family), according to the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

Medicaid/CHIP out-of-pocket costs vary by state, but coverage is generally significantly less expensive than employer coverage.

Health Affairs study analyzed data from the Medical Expenditure Panel Survey between 2008 and 2013 for families with incomes between 100 and 400 percent of the federal poverty level in which at least one parent had employer-sponsored coverage. The study predated the opening of the health law’s marketplaces, but the researchers said that because these families had employer-based coverage options, they would likely not qualify for less expensive coverage on the exchanges.

Over the course of the study, nearly all the families in which a parent was offered coverage accepted it for the parent, and about three-quarters of children in the sample were covered by their parents’ employer-sponsored plan, on average.

But the proportion of kids who lacked employer-sponsored coverage even though at least one parent had it grew from 22.5 percent in 2008 to 25 percent in 2013, the study found. Likewise, the percentage of children who were on Medicaid or CHIP even though at least one parent had coverage through an employer increased 3.1 percentage points, to 15.2 percent, over the course of the study.

Premium increases for employer-sponsored coverage may put a family plan out of reach for low- and moderate-income families, said Strane. Between 2006 and 2016 premiums rose 58 percent for family coverage, according to the Kaiser Family Foundation’s 2016 annual survey of employer-sponsored coverage. This year, families pay $5,277 for coverage on average, 29 percent of the total cost of the plan. Workers’ share of the premium grew 78 percent over the past decade, outpacing the growth in premiums, according to the KFF study.

“They did the math and likely figured CHIP was going to save them money,” said Strane.

There is a lot at stake for children and families as the plan to repeal the Affordable Care Act moves forward. And we need your help!

Personal stories are the most powerful tools we have in our fight to protect access to affordable, high-quality healthcare for all children and their families. By telling your story in support of CHIP, Medicaid and the consumer protections gained under the Affordable Care Act, you help put a face to how kids and families will be impacted by the threat to repeal the Affordable Care Act and dismantle Medicaid and CHIP.

Every Child Matters in NH and Maine are collecting stories from those who have benefitted from Medicaid and CHIP.

Please share this link and help us collect real life stories that we will share with our members of Congress and the new Administration in Washington. We have the data; now we need your story!

Impact of the Affordable Care Act in New Hampshire

Thousands of Granite Staters have gained coverage, and hundreds of thousands more have had their coverage substantially improved.

The U.S. Department of Health and Human Services released an extensive compilation of state-level data illustrating the substantial improvements in health care for all Americans over the last six years. The data show that the uninsured rate in New Hampshire has fallen by 43 percent since the Affordable Care Act (ACA) was enacted in 2010, translating into 63,000 Granite Staters gaining coverage. And, in addition to residents who would otherwise be uninsured, hundreds of thousands more Granite Staters with employer, Medicaid, individual market, or Medicare coverage have also benefited from new protections as a result of the law.

“As our nation debates changes to the health care system, it’s important to take stock of where we are today compared to where we were before the Affordable Care Act,” said Secretary Sylvia M. Burwell. “Whether New Hampshirites get coverage through an employer, Medicaid, the individual market, or Medicare, they have better health coverage and care today as a result of the ACA. Millions of Americans with all types of coverage have a stake in the future of health reform. We need to build on our progress and continue to improve health care access, quality, and affordability, not move our system backward.”

Highlights of the data release include:

Employer Coverage: 853,000 people in New Hampshire are covered through employer-sponsored health plans. Since the ACA was enacted in 2010, this group has seen:

  • An end to annual and lifetime limits: Before the ACA, 545,000 Granite Staters with employer or individual market coverage had a lifetime limit on their insurance policy. That meant their coverage could end exactly when they needed it most. The ACA prohibits annual and lifetime limits on policies, so all New Hampshirites with employer plans now have coverage that’s there when they need it.
  • Young adults covered until age 26: An estimated 9,000 young adults in New Hampshire have benefited from the ACA provision that allows kids to stay on their parents’ health insurance up to age 26.
  • Free preventive care: Under the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no extra cost to consumers. This provision benefits 690,524 people in New Hampshire, most of whom have employer coverage.
  • Slower premium growth: The average premium for New Hampshire families with employer coverage grew 4.8 percent per year from 2010-2015, compared with 7.3 percent over the previous decade. Assuming New Hampshire premiums grew in line with the national average in 2016, family premiums in New Hampshire are $3,300 lower today than if growth had matched the pre-ACA decade.
  • Better value through the 80/20 rule: Because of the ACA, health insurance companies must spend at least 80 cents of each premium dollar on health care or care improvements, rather than administrative costs like salaries or marketing, or else give consumers a refund. Granite Staters with employer coverage have received $2,264,293 in insurance refunds since 2012.

Medicaid: 189,429 people in New Hampshire are covered by Medicaid or the Children’s Health Insurance Program, including 94,622 children and 20,839 seniors and people with disabilities covered by both Medicaid and Medicare. The ACA expanded Medicaid eligibility and strengthened the program for those already eligible.

  • 22,000 Granite Staters have gained coverage through Medicaid: An estimated 22,000 New Hampshire residents have health insurance today because New Hampshire expanded Medicaid under the ACA. Coverage improves access to care, financial security, and health, resulting in an estimated 3,000 more Granite Staters getting all needed care, 3,200 fewer Granite Staters struggling to pay medical bills, and 30 avoided deaths each year.
  • Thousands of Granite Staters with a mental illness or substance use disorder are getting care: Thanks to expansion and improved access to treatment, an estimated 2,000 fewer Granite Staters are experiencing symptoms of depression.
  • New Hampshire is saving millions in uncompensated care costs: Instead of spending $20 million on uncompensated care, which increases costs for everyone, New Hampshire is getting $210 million in federal support to provide low-income adults with much needed coverage.
  • Children, people with disabilities, and seniors can more easily access Medicaid coverage: The ACA streamlined Medicaid eligibility processes, eliminating hurdles so that vulnerable Granite Staters could more easily access and maintain coverage.
  • New Hampshire is improving behavioral health: Under the ACA, CMS is helping New Hampshire link payments with improved outcomes for beneficiaries with co-morbid conditions; customize expansions/ enhancements to specific populations; and spread integration efforts to new areas of the state.

Individual market: 49,114 people in New Hampshire have coverage through the Marketplace. Individual market coverage is dramatically better compared to before the ACA:

  • No discrimination based on pre-existing conditions: Up to 597,050 people in New Hampshire have a pre-existing health condition. Before the ACA, these Granite Staters could have been denied coverage or charged an exorbitant price if they needed individual market coverage. Now, health insurance companies cannot refuse coverage or charge people more because of pre-existing conditions.
  • Tax credits available to help pay for coverage: Before the ACA, only those with employer coverage generally got tax benefits to help pay for health insurance. Now, 31,151 moderate- and middle-income Granite State resudents receive tax credits averaging $261 per month to help them get covered through HealthCare.gov.
  • Women pay the same as men: Before the ACA, women were often charged more than men just because of their gender. That is now illegal thanks to the ACA, protecting roughly half the people of New Hampshire.
  • Greater transparency and choice: Before the ACA, it was virtually impossible for consumers to effectively compare insurance plan prices and shop for the best value. Under the ACA, New Hampshire has received $9 million in federal funding to provide a more transparent marketplace where consumers can easily compare plans, choosing among 32 plans on average.

Medicare: 275,803 people in New Hampshire are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:

  • Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, 21,026 New Hampshire seniors are saving $22 million on drugs in 2015, an average of $1,047 per beneficiary.
  • Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 176,282 New Hampshire seniors, or 74 percent of all New Hampshire seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.
  • Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for New Hampshire Medicare beneficiaries dropped 3 percent between 2010 and 2015, which translates into 152 times New Hampshire Medicare beneficiaries avoided an unnecessary return to the hospital in 2015. 
  • More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. 8 Accountable Care Organizations (ACOs) in New Hampshire now offer Medicare beneficiaries the opportunity to receive higher quality, more coordinated care.

Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on December 13, 2016

From our friends at the Campaign for a Family Friendly Economy: 

The future of our state depends on lawmakers acting now to enact policies that help New Hampshire become the best state to live, work and raise a family.

Join us Thursday, January 26 in Concord to make our voices heard. RSVP today to attend the Family Friendly Economy State House Day.

Together, we will make sure that our lawmakers act this year to establish paid family and medical leave insurance and make investments in child care so working families can make ends meet while caring for their families. 

Our day of activities will include a breakfast training, small group meetings with legislators, and a press conference to get our message out far and wide. Your voice is critical to our success.

Ahead of January 26, we’ll work with you to schedule a meeting in Concord with your legislator so you can share with them why it’s critical to your family’s future that they act to increase investment in quality child care and establish a family and medical leave insurance program in New Hampshire.

Your legislator needs to hear from you. Join us at our Family Friendly Economy State House Day. RSVP now to be a critical part of creating a brighter future for New Hampshire’s workforce!

Our state’s economic prosperity depends on keeping parents in the workforce and providing for the next generation – our children can’t wait. We must speak out. 

Thanks for your support,

Amanda Sears
Director, Campaign for a Family Friendly Economy

There are a few upcoming events in 2017 that I want to be sure are on your radar. 

Family Friendly Economy State House Day: January 26th 9am-1pm, Concord State House (114 N Main Street). You can find more information about it HERE.

The NH Children’s Trust 6th Annual Strengthening Families Summit is set for Tuesday, March 28th. You can find more information about it HERE.

Granite State Rumblings (Part 2): The Relationship Between Healthcare And Healthy Development

GROWING UP GRANITE

(This is part two of this week’s Granite State Rumblings. Part 1 can be found here)

CLASP and Georgetown University Center for Children and Families (CCF) released a new report on the important but often-overlooked link between adult health care coverage and children’s healthy development – specifically, the connection between health care coverage and identifying and treating maternal depression, so that children can thrive.  Because of the powerful connection between mothers’ mental health and children’s wellbeing and long-term success, Medicaid expansion is a critical tool to help children and should be front and center for child-focused advocates and policymakers.

We are especially excited about this report because of the complementary expertise of our two organizations – CCF on health and CLASP on child care and early childhood development.  Thank you to our co-authors Stephanie Schmit and Alisa Chester for their hard work synthesizing the research about child development, Medicaid expansion, and maternal depression.  The report, Medicaid Expansion Promotes Children’s Development and Family Success by Treating Maternal Depression, distills the research to support four key conclusions.

  • Untreated maternal depression is a major public health problem that affects large numbers of women, especially low-income women and their children. More than half (55 percent) of poor infants have a mother who is experiencing some level of depressive symptoms. Maternal depression has been shown to undercut children’s healthy development and stymie families’ efforts to escape poverty. Maternal depression can affect children’s cognitive, socio-emotional, and behavioral development, as well as academic achievement and employment opportunities throughout their lifetime.
  • While safe and effective treatments exist, low-income and uninsured women are far less likely to get treatment. More than one-third (37 percent) of low-income mothers with young children who have had a major depressive disorder do not receive any treatment. The cost of mental health care is a major barrier to care, particularly for uninsured mothers.
  • States that used the Affordable Care Act (ACA) to expand Medicaid coverage for low-income parents have new opportunities to ensure that women are enrolled and receiving coverage. In the 19 states that have not expanded Medicaid, half a million mothers fall into a coverage gap. They earn too much to qualify for Medicaid coverage but earn too little to qualify for premium assistance through the ACA’s health insurance marketplace. The Medicaid income eligibility threshold for parents in most non-expansion states is extremely low. (See chart).
  • Mothers without health insurance face significant financial barriers to getting the care they need to treat maternal depression.  As research cited in the report demonstrates, expanding Medicaid coverage to more low-income adults (including mothers) would remove those barriers and help increase access to screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and families’ economic security. Access to Medicaid has been shown to reduce the incidence of depression by increasing access to mental health services and diminishing financial barriers to care. For example, new research indicates that Medicaid expansion has not only resulted in improved access to medical benefits but has also resulted in improved access to behavioral health treatment for newly eligible enrollees.

The report concludes that Medicaid expansion for low-income mothers can greatly improve women’s access to treatment for depression, which is vital to children’s healthy development.

Extending Medicaid coverage to more low-income mothers would help increase screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and family economic security.

If more states were to accept Medicaid expansion funding, more mothers would gain access to maternal depression screening and treatment and more children would have improved opportunities to reach their full potential.

Planned Parenthood Votes Launches Digital Ad Campaign Targeting Ayotte Around RNC

Ayotte TrumpConcord, NH –– Planned Parenthood Votes launched a digital ad campaign during the Republican Convention, targeting Kelly Ayotte to highlight how dangerous she and Donald Trump are for women and families in this country. The digital campaign includes the launch of a microsite –– Toxic Trump –– and a digital ad buy that will run in New Hampshire and hold Ayotte accountable for her support for Trump to be the next president.

Kayla Montgomery, Advocacy and Organizing Manager of Planned Parenthood New Hampshire Action Fund, said:

“Kelly Ayotte may be skipping the RNC convention, but voters in New Hampshire know exactly where she stands on women’s health – which is right next to the dangerous Trump/Pence ticket. They might not be together this week, but their agenda on blocking access to reproductive health care and banning abortion is in lock step. While Donald Trump has been promoting a dangerous agenda on the campaign trail, Kelly Ayotte has been legislating it in the Senate for years. New Hampshire can’t afford another 6 years of Kelly Ayotte.”

According to Planned Parenthood Votes, Ayotte wants to ban abortion and block access to Planned Parenthood health centers, just like Trump does. The ad buy will hold Ayotte accountable for her support of Trump and her votes to block access to care at Planned Parenthood health centers. The buy includes graphics and videos that will run on Facebook and Twitter.

Multiple polls show New Hampshire voters support safe and legal abortion:

  • American Values Atlas shows that New Hampshire is actually more in favor of access to safe and legal abortion than the national average.
  • Exit polls from 2012 show that New Hampshire is one of the most pro-choice states in the country.
  • A poll of 2016 Republican primary voters found that 49% percent describe themselves as “pro-choice” on the issue of abortion, while only 41% call themselves “pro-life.”

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Planned Parenthood Votes (123 William St, NY NY 10038) is an independent expenditure political committee registered with the Federal Election Commission. Planned Parenthood Votes activities are not authorized by any candidate or candidate’s committee.

Planned Parenthood New Hampshire Action Fund is an independent, nonpartisan, not-for-profit membership organization formed as the advocacy and political arm of Planned Parenthood of Northern New England in New Hampshire. The Action Fund engages in educational and electoral activity, including legislative education, grassroots organizing, and advocacy.

Unions Representing Healthcare Workers Petition for Workplace Safety

US_Dept_of_LaborWASHINGTON— Today, a coalition of unions—including the AFL-CIO; American Federation of Teachers; American Federation of State, County and Municipal Employees; American Federation of Government Employees; Communications Workers of America; International Brotherhood of Teamsters; Service Employees International Union; and the United Steelworkers—petitioned the U.S. Department of Labor to take a significant step toward safety by promulgating a comprehensive workplace violence prevention standard to protect all workers in healthcare and social service settings. Because we represent workers in the healthcare and social assistance sectors, we all know there is an immediate need to address the preventable and often tragic workplace-related assaults and associated injuries that occur too often in these settings.

The Bureau of Labor Statistics found that between 2005 and 2014, the rates of injuries that resulted in lost time for private sector healthcare and social assistance facilities increased by 64 percent and rates for private sector hospitals increased by 110 percent. And 52 percent of all the incidents of workplace violence reported to the BLS in 2014 came from the healthcare and social assistance workforce. These numbers highlight the urgent nature of having comprehensive standards for workplace violence prevention.

“Workers should never face violence in the workplace, but for healthcare workers it’s a too-common reality. We are calling on the Occupational Safety and Health Administration to create national employment standards so that workers have meaningful protections on the job. Our union and our rank-and-file activists have worked tirelessly for months raising these issues and now—in collaboration with unions that represent healthcare workers, including National Nurses United—to craft this proposal. We hope to see it enacted without delay,” said AFT President Randi Weingarten.

“Workplace violence is not part of the job. Our healthcare workers on the frontline of patient care in numerous hospitals and other settings need a strong federal OSHA standard to protect them from workplace violence and assaults,” said AFL-CIO President Richard Trumka.

“This rule is urgently needed to stop the appalling spiral of injuries and fatalities in healthcare and social services, and to protect our members, and all workers,” said Teamsters General President James. P. Hoffa.

“The American Federation of Government Employees represents more than 100,000 nurses, doctors and frontline healthcare providers across government. Their safety, and the safety of all healthcare workers, is critically important. We strongly urge the Department of Labor to adopt a national standard for reducing workplace violence across the healthcare system and ensuring safe working conditions for all healthcare providers.” said AFGE National President J. David Cox Sr.

“The intensification of violence against healthcare workers is alarming because it is preventable,” said United Steelworkers International President Leo W. Gerard. “Our union is proud to stand in solidarity calling for an enforceable OSHA standard to prevent workplace violence and protect all healthcare workers as they care for their patients.”

“Our members deserve to go to work every day and be safe. Our union strongly advocates OSHA develop a comprehensive workplace violence standard for healthcare and social assistance workers. Such a standard would provide needed protections from workplace violence and lead to improved working conditions for millions of U.S. workers,” said Chris Shelton, president, Communications Workers of America.

Granite State Rumblings: Americans Want A Candidate Who Will Invest In Children

Public Opinion Shows Voters Strongly Favor Investments in Children & Youth

A new poll commissioned by the Children’s Leadership Council finds that a strong majority (63 percent) of Americans want more funding for programs that support children and young people. More than three in five adults strongly favor expanded spending to improve education, health and nutrition.

In this election year, most adults say they are more likely to vote for a candidate who commits to investing in effective child and youth well-being policies, according to a new national poll conducted by Hart Research on behalf of the Children’s Leadership Council. More than three in five adults representing every age, race, income and education level across the country, want the next president and Congress to spend more on nutrition, health and education programs for children, according to the poll findings. By overwhelming margins, Americans say the nation’s children would be better off if government did more to support parents and families, and, that they would be more likely to vote for a candidate who would commit to policies that advance children’s well-being, if elected. This is especially true of Millennials, regardless of party.

“Support for the well-being of our nation’s children has no boundaries,” said Randi Schmidt, executive director of the Children’s Leadership Council. “Adults of all stripes, and from every corner of the country, are sending a strong message to presidential candidates and to Congress that our children must come first.”

Those surveyed responded with particular enthusiasm to candidate commitments related to reducing child abuse, child poverty and hunger. These are followed by policies related to child health care coverage, college affordability, child care, and education.

Millennials overwhelmingly support programs aimed at ensuring children’s well-being, according to the poll findings, with three in four millennials (74 percent) saying there should be greater investments in such programs.

Key findings:

Overall government investments in child well-being

  • Support for greater government investments in children is particularly high among Americans age 18- 34 (74%), African Americans (75%), Hispanics (74%), and parents with children under age 18 (71%).
  • Eighty-three percent of Democrats and more than half (58%) of Republicans say the next president and Congress should invest more when it comes to meeting the needs of children.
  • Parents of children under age 18 say that America’s children would be better off if government did more to support parents and families by making education, child care, nutrition and children’s healthcare more affordable. The majority of adults, both parents and nonparents, support this statement, with 75 percent of women, and 64 percent of men responding affirmatively.

Child Poverty and Hunger

  • Both parents and nonparents equally (80%) say they are more likely to support a candidate who prioritizes reducing child poverty and hunger.

Child Abuse and Family Violence

  • Seventy-five percent of all adults surveyed say reducing child abuse and family violence is an especially compelling reason to support a candidate. Among Republicans, this position resonates particularly well, with more than 2 in 3 (67%) of Republicans saying they would be more likely to vote for a candidate who stakes out such a position.

Children’s Healthcare

  • Children’s health care is the top issue among African Americans, with 83 percent of respondents saying they would be more likely to support candidates who commit to preserving and improving health care coverage. Sixty-seven percent of all adults also would be more likely to support a candidate who makes children’s health care a priority.

Affordable College

  • 76 percent of parents with children under 18 say they are more likely to vote for a candidate who commits to making college more affordable, making it the second-most compelling reason among the policies tested, to support a candidate.
  • 66 percent of all respondents say they are more likely to support a candidate who focuses on making college more affordable, while 82 percent of African Americans and 81 percent of Democrats say such a commitment would draw their support.
  • For unmarried moms, parents over 35, college-educated parents, and those making more $75,000 a year, making college affordability a priority is the top reason to support a candidate.
  • Across all geographic and democratic groups, millennials are even more likely than older adults to support an increase in investment for children and youth.

Child Care Assistance and Early Childhood Education

  • Expanding child care assistance and early childhood education garners the most support from African Americans (77%) and Democrats (73%). Both of these groups are most likely to be compelled to vote for a candidate who commits to other learning opportunities, including expanding afterschool programs and summer learning opportunities.

Hart Research conducted the online survey between March 31 – April 6 to understand national sentiment regarding public investments in children and the role of government in improving child well-being. There were 2,050 adults, including 595 parents of children under the age of 18 from across the country, who participated in the survey.

The Children’s Leadership Council is a coalition of leading policy and advocacy organizations, (which includes Every Child Matters), that are working every day to improve the health, education and well-being of children and youth in order to prepare them for school, work, and life.

For more information, visit the Children’s Leadership Council at childrensleadershipcouncil.org.

#TBT: That Time Chris Sununu Cast the Deciding Vote to Deny Critical Health Care For Thousands of NH Women

Concord, N.H. – As we mark the 43rd anniversary of the Supreme Court’s landmark Roe v. Wade decision protecting a woman’s right to make her own health decisions this week, the New Hampshire Democratic Party is throwing it back to that time Chris Sununu cast the deciding vote to defund Planned Parenthood.

In August, Chris Sununu voted to defund Planned Parenthood, even though Sununu himself said that women in his district have no other choice for the critical health services that Planned Parenthood provides.

But was it hard for Sununu to decide to cut access to health care for thousands of Granite State women? Apparently not. Sununu at the time said it was “a very easy vote for me to take.”

“Planned Parenthood defundamentalists like Chris Sununu are unbelievably out of touch with Granite State women,” said Holly Shulman, New Hampshire Democratic Party spokeswoman. “43 years after Roe v. Wade, Granite Staters of all political persuasions are overwhelmingly pro-choice and pro-Planned Parenthood. It’s clear that Chris Sununu is taking his cues from Marco Rubio who wants to ban abortion without exception and Ted Cruz who wants to nullify Roe v. Wade. The fact is Chris Sununu cares more about making a partisan political point than doing what’s right for New Hampshire.”

Bernie Sanders Releases Details and How He Plans To Pay For Medicare-For-All

Medicare-for-All Plan Detailed by Sanders, Improves Health Care and Cuts Costs

CHARLESTON, S.C. – U.S. Sen. Bernie Sanders on Sunday detailed a Medicare-for-all plan to provide better health care for all Americans at less cost.

“Universal health care is an idea that has been supported in the United States by Democratic presidents going back to Franklin Roosevelt and Harry Truman,” Sanders said. “It is time for our country to join every other major industrialized nation on earth and guarantee health care to all citizens as a right, not a privilege.”

The proposal would expand Medicare, the popular and successful health care program for seniors, and build on the success of the Affordable Care Act, which Sanders helped craft. Patients would be able to choose their own doctors and receive comprehensive care for everything from hospital stays to emergency room visits to primary and specialty care.

Sanders’ Medicare-for-all plan would save $6 trillion over the next 10 years compared to the current system, according to a detailed analysis by Gerald Friedman, an economist at University of Massachusetts at Amherst who is a leading expert on health care costs.

In a nation that now spends $3 trillion a year on health care – nearly $10,000 per person – Sanders’ plan would save consumers money by eliminating expensive and wasteful private health insurance. The plan would save taxpayers money by dramatically reducing overall health care costs and bringing down skyrocketing prescription drug prices which are far greater in the United States than in any other country.

The typical family earning $50,000 a year would save nearly $6,000 annually in health care costs, Friedman calculated. The average working family now pays $4,955 in premiums for private insurance and spends another $1,318 on deductibles for care that isn’t covered. Under Sanders’ plan, a family of four earning $50,000 would pay just $466 per year to the Medicare-for-all program.

Businesses would save more than $9,400 a year in health care costs under Sanders’ plan. The average annual cost to the employer for a worker with a family who makes $50,000 a year would go from $12,591 to just $3,100.

The shift to universal health care would be paid for with a 2.2 percent health care premium (calculated under the rules for federal income taxes); a 6.2 percent health care payroll tax paid by employers; an estate tax on the wealthiest Americans and changes in the tax code to make federal income tax rates more progressive.

Under the plan, individuals making $250,000 to $500,000 a year would be taxed at a rate of 37 percent. The top rate, 52 percent, would apply to those earning $10 million or more a year, a category that in 2013 included only the 13,000 wealthiest households in the United States.

Additional savings would be achieved from reducing outlays for taxpayer-supported health care expenditures.

Sanders laid out his health care plan and progressive tax reform proposals here in South Carolina where he and former Secretary of State Hillary Clinton and former Maryland Gov. Martin O’Malley were to take part on Sunday night in a nationally televised debate in their contest for the Democratic Party presidential nomination.

To read more about Sanders’ Medicare-for-all plan and his progressive tax proposals, click here.

To read Professor Gerald Friedman’s analysis of Sanders’ plan, click here.


UPDATED WITH STATEMENT FROM HILLARY CLINTON CAMPAIGN

Hillary for America spokesman Brian Fallon released the following statement:

“Senator Sanders has been changing a lot of positions in the last 24 hours because when his plans and record come under scrutiny, their very real flaws get exposed. After digging in his heels for weeks, he backpedaled on his vote to give sweeping immunity to gun manufacturers and dealers. And after weeks of denying the legitimacy of the questions Hillary Clinton raised about flaws in the health care legislation he’s introduced 9 times over 20 years, he proposed a new plan two hours before the debate. Hillary Clinton knows what it takes, and has what it takes, to protect the gains of the Affordable Care Act and secure quality, affordable health care for all Americans. When you’re running for President and you’re serious about getting results for the American people, details matter—and Senator Sanders is making them up as he goes along.”

After Billions of $$$ to Stockholders, UnitedHealth Claims Poverty Due To Obamacare

By LaurMG, used by CreativeCommons license via Wikimedia Commons

By LaurMG, used by CreativeCommons license via Wikimedia Commons

SMH.

Yesterday’s 24/7WallSt article about UnitedHealth said that an “earnings warning” issued by the corporation “could be a serious blow to at least part of ACA/Obamacare.”

UnitedHealth’s latest advice to investors is that the corporation now expects slightly lower 2015 profits.  (Can’t help noticing: that recalculation includes a write-off of “$275 million related to the advance recognition of 2016 losses.” Nevermind that we haven’t actually gotten to 2016 yet; UnitedHealth is already calculating losses.)

Apparently, that press release was worth the headline “UnitedHealth Warning Creates Huge Spillover, With Big Implications Ahead.”

Just a month ago, 27/7WallSt was writing happier news about UnitedHealth. Quarterly earnings per share were better than expected, and better than 2014. Premiums were up 9.87% over last year. The company was adding about 100,000 new subscribers a month (1.7 million new people a year). And for the first three quarters of 2015, things were so rosy that UnitedHealth spent $1.1 billion buying back its own stock.

Plus, UnitedHealth paid out another $1.3 billion to shareholders in dividends, just in the first three quarters of 2015.

So… $2.4 billion paid out to shareholders in the first nine months of this yearand now suddenly there’s supposed to be some sort of crisis?  Wow.

Back to 24/7WallSt: “What has been interesting to see here is that UnitedHealth actually has seen its shares soar under ACA/Obamacare.”  Yes, that’s what happened.  The Affordable Care Act passed in 2010.  Here’s what UnitedHealth’s stock price history looks like:UNH stock chart

Looks like UnitedHealth’s profits are up since Obamacare, too.  Here’s what their quarterly earnings-per-share history looks like:UNH EPS chartAm I the only one having a hard time seeing how this is a problem for UnitedHealth?

Back to 24/7WallSt. The headline from last month’s article: Are UnitedHealth Earnings Enough for Investors?

Hmmn.  Is investor greed the real crisis for Obamacare?

— — — —

insuranceYep, there’s more.

As of yesterday, the corporation’s new profit expectations “reflect a continuing deterioration in individual exchange-compliant product performance.”  Yep, they’re talking about policies sold to individuals through ACA exchanges, which apparently are not “performing” very well.  From the press release: “UnitedHealthcare has pulled back on its marketing efforts for individual exchange products in 2016. The Company is evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.”

In other words: individual policies aren’t “performing” very well, from the corporation’s perspective.  So UnitedHealthcare may stop selling them.

UnitedHealth is currently the largest health insurance provider in America. Other large health insurance providers – Anthem and Cigna, Humana and Aetna – have plans to merge, which “could shrink the number of major companies in the health insurance industry from five to just three. And that could mean fewer options and higher rates for consumers and the employers that provide health insurance.”

And according to yesterday’s 24/7WallSt article, UnitedHealth’s (newest) earnings forecast “could be used by the companies to support those pending health insurance mergers.”  Apparently on the theory that the four other insurers are too small to compete in the individual policy “product segment.”  (Even though Centene Corp. and Kaiser Permanente seem to be doing just fine.)

Am I the only one wondering why UnitedHealth’s latest earnings warning would justify the mergers of its largest competitors?  Given the corporation’s “soaring” stock price.  Given the corporation’s growth in earnings-per-share.  Given the fact that the UnitedHealth paid out $2.4 billion to shareholders just in the first nine months of this year…?

Am I the only who remembers that Obamacare was intended to rein in profiteering by insurance companies?

Remember what it was like, back then?  “In the midst of a deep economic recession, America’s health insurance companies increased their profits by 56 percent in 2009, a year that saw 2.7 million people lose their private coverage.  The nation’s five largest for-profit insurers closed 2009 with a combined profit of $12.2 billion.”

So, yeah, I suppose someone could “blame” Obamacare for UnitedHealth’s current financial situation.  And the fact that UnitedHealth’s per-share profit (EPS) is 75% higher now than it was in 2009.

But if anybody’s going to start passing blame around, now that “the 2016 presidential election has brought the health care argument up more times than can easily be counted”…

I think we should also be talking about whether Obamacare managed to stop the corporate profiteering, like it was supposed to.

— — — —

Can’t help noticing…

Yesterday’s headlines were fueled by the sudden drop in UnitedHealth’s stock price, which followed its revised earnings statement.

But that was yesterday.  So far today, the stock price has recovered more than half of yesterday’s decline.

Which still leaves the stock trading at about four times its price in 2009.

— — — —

Read more NHLN coverage of stock buybacks here.

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