From Al Tompkins | Poynter <[email protected]>
Subject Millions with ACA insurance may dodge a huge price increase
Date July 29, 2022 9:59 AM
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Plus, the exploding number of U.S. monkeypox cases — and could floating abortion clinics become a thing? Email not displaying correctly?
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** Millions with ACA health insurance may be spared huge price increases
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How quickly things can change when Congress is trying to shuffle out of D.C. for a month in a midterm election year and huge issues are stacking up like airplanes on a tarmac.

The legislation that was once known as “Build Back Better” on Thursday became the “Inflation Reduction Act.” This new complex package of tax increases, subsidies for people who get insurance through the Affordable Healthcare Act and tax increases on corporations will come before a Senate vote next week.

One week ago today, ([link removed]) I told you that in a matter of weeks, millions of Americans who get their health insurance through the Affordable Care Act’s insurance marketplace will be getting a letter in the mail telling them that their health insurance costs, in some cases, will double. In even more cases, the premiums will rise by more than $100 a month.

That would happen if Congress does not extend the insurance subsidies in place now. The subsidies expire at the end of the year. Until Wednesday evening, it appeared the subsidies might become a heated midterm election issue. But Senator Joe Manchin, D-W.Va., who a week ago wavered in his tie-breaking support for extending the subsidies, now agrees that the nation should extend the federal subsidies for Affordable Care Act premiums, first enacted by the American Rescue Plan for three years. ([link removed]) That does not make the subsidies permanent, but that is another issue for another Congress.

It is difficult to overstate how important this is, despite so little news coverage of this issue. Bloomberg points out: ([link removed])

The framework’s ACA subsidy extension comes as the share of Americans who rely on the ACA continues to grow. A new report ([link removed]) the CDC published this morning shows the share of Americans without health coverage continued to fall in the first quarter to 8%, or 26.4 million people— down from 9.5%, or 30.8 million, in the first quarter of 2021. In April, HHS reported ([link removed]) that total enrollment for Medicaid expansion, ACA marketplace coverage, and the Basic Health Program reached an all-time high of over 35 million people in early 2022, Sara Hansard reports ([link removed]) .

The Kaiser Family Foundation provides ([link removed]) a deep dive into this issue including probable increases if the subsidies are not extended (though it appears now they will be.) But journalists, remember that just as we have witnessed this week, in a midterm election year, things change quickly and sometimes in a heated way. Stay alert.


** The ‘Inflation Reduction Act’ promises to lower some drug prices eventually
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Without a doubt, lawmakers who vote for President Joe Biden’s plan will crow that they voted to lower drug prices. If the bill passes and becomes law, not much will change for most people for years. A major part of that claim will be embodied by saving $288 billion through prescription drug pricing reforms. The reforms include two major measures including allowing Medicare to negotiate drug prices and capping out-of-pocket costs to $2,000.

As I said, drug prices are not going to drop fast, even under the new plan before the Senate. It is a six-year process that begins next year, then the cap on out-of-pocket prescriptions for Medicare kicks in in 2025. Then, 10 or 15 drugs at a time, Medicare will negotiate with drug companies for lower prescription prices for some costly drugs. The Kaiser Family Foundation explains the timeline:
(Kaiser Family Foundation)


** Legislation that would address climate change gets new life
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Manchin also now says he will support legislation that Senate Majority Leader Chuck Schumer says is the most “pro-climate legislation that has ever been passed by Congress.” While passage is not assured, The New York Times explains just some of what it would do:

The bill aims to tackle global warming by using billions of dollars in tax incentives to ramp up wind, solar, geothermal, battery and other clean energy industries over the next decade.

Companies would receive financial incentives to keep open nuclear plants that might have closed, or to capture emissions from industrial facilities and bury them underground before they can warm the planet. Car buyers with incomes below a certain level would receive a $7,500 tax credit to purchase a new electric vehicle and $4,000 for a used one. Americans would receive rebates to install heat pumps and make their homes more energy-efficient.

Senate Democrats estimated that the legislation would enable the United States to cut greenhouse gas emissions to 40 percent below 2005 levels by 2030, putting the nation within striking distance of the aggressive climate goals laid out by Mr. Biden last year.


** Why epidemiologists say the CDC’s guidance to isolate for five days after a positive COVID-19 test is wrong
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Two new studies (that have yet to go through peer review) say the CDC’s guideline ([link removed]) that you should isolate for five days after testing positive for COVID-19 are wrong. One of the studies, from Massachusetts General Hospital, says there is nothing magical about five days of isolation. Some people are infectiouseight days after testing positive. ([link removed])

The key, these researchers say ([link removed]) , is to stay isolated until you test negative, as Biden did this week.

NPR explained: ([link removed])

"We don't have anything that says definitely you are contagious or definitely you're not," says Dr. Emily Landon ([link removed]) , an infectious disease specialist at UChicago Medicine. "The best thing we have are these rapid antigen tests."

A study ([link removed]) co-authored by Landon followed health care workers at the University of Chicago who had been infected but were feeling mostly better and went to get tested after five days. They found that more than half of them still tested positive on antigen tests after six days.

Unlike PCR tests, which search for genetic material from the virus, rapid antigen tests work by looking for the proteins that are packed inside the virus. A positive test generally correlates with the presence of infectious virus. Scientists can determine that by taking samples from someone who's been infected and trying to grow the virus in a lab — what's known as a viral culture.

Generally, most people who get infected are not still testing positive on an antigen test 10 days after symptom onset.

"If you have enough virus in your system to be turning one of these tests positive, that means your body probably hasn't yet fully cleared the infection," says Hay.


** U.S. leads world in monkeypox cases, which exploded in number this week
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Look at this map ([link removed]) of documented monkeypox ([link removed]) cases and it may remind you of the CDC COVID-19 maps, where the United States leads the world in new cases. The U.S. has more than 4,600 monkeypox cases, while Spain has 3,700. Nobody else is close.
(CDC)

A month ago, the U.S. had 244 cases. We have had a 1,900% case increase in a month.

The U.S. Food and Drug Administration cleared more than 786,000 doses of monkeypox vaccines to be distributed nationwide through health departments and more are on the way.


** Floating abortion clinics?
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It was not that long ago that entrepreneurs thought up a way to get around state laws that banned casino gambling. They put the casinos on barges and called them boats and declared themselves outside of state, or in some cases, federal jurisdiction. Now a physician has the idea for a floating abortion clinic in the Gulf of Mexico. Yahoo News has the details. ([link removed])

There already is a Dutch charity called Women on Waves ([link removed]) that sails offshore to countries where abortions are illegal. The group also uses what it calls abortion drones ([link removed]) to ferry abortions pills into countries where the drugs are illegal.


** Struggle to pay for basic expenses
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The latest Pulse survey from the U.S. Census shows that week by week, Americans are starting to fall behind paying their bills and affording basic expenses.

Here is a comparison of two survey periods:
(Bloomberg-based on U.S. Census survey)
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