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House GOP sues White House over health care law

WASHINGTON — House Republicans filed suit against the Obama administration Friday, making good on a promise by House Speaker John Boehner to challenge President Obama’s use of executive authority to implement the Affordable Care Act.

“Time after time, the president has chosen to ignore the will of the American people and rewrite federal law on his own without a vote of Congress,” Boehner said in a statement, “If this president can get away with making his own laws, future presidents will have the ability to as well. The House has an obligation to stand up for the Constitution, and that is exactly why we are pursuing this course of action.”

The suit — filed against the secretaries of Health and Human Services and the Treasury — focuses on two unilateral actions by the executive branch: the president’s decision to twice waive the mandated deadline for larger employers to provide health insurance to employees; and a decision to pay insurance companies through a Treasury Department account that was not authorized by Congress.

The employer mandate requires companies with 50 or more employees working at least 30 hours weekly to offer health care coverage or pay fines. Businesses with fewer than 50 workers are exempt. The requirement was initially set to take effect this year. Now, companies with 50 to 99 employees have until 2016 to comply while bigger companies have until next year.

The lawsuit, filed in federal district court in Washington, comes a day after Obama announced a round of executive orders on immigration that will allow up to 5 million undocumented immigrants to apply for legal status. Some Republicans have suggested they could sue the president over that action as well, but it will require a separate vote. The House voted to authorize the health care lawsuit in July.

House Republicans have held dozens of votes to repeal all or part of the law since they took control of the U.S. House in 2011.

Democrats counter that the lawsuit is part of their ongoing effort to dismantle the law. “Americans are tired of watching Congress focus all its energy on trying to undo the patient protections and cost saving measures of the Affordable Care Act,” said House Minority Whip Steny Hoyer, D-Md., in a statement in which he called the suit an “exercise in futility and frivolity.”

House Minority Leader Nancy Pelosi, D-Calif., accused Republicans of “prioritizing the special interests and the howls of impeachment-hungry extremists before the needs of the nation.”

Jonathan Turley, a law professor at George Washington University, will represent the U.S. House before the courts. At least two law firms declined to take up the case before Turley agreed. The case was assigned to Judge Rosemary M. Collyer, who was appointed to her post by President George W. Bush in 2003.

Contributing: Associated Press

Article source: http://www.usatoday.com/story/news/politics/2014/11/21/house-gop-lawsuit-obama/19336165/

Health Enrollment Counting Error Shows Where System Is Still Broken

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Article source: http://www.nytimes.com/2014/11/21/upshot/health-enrollment-counting-error-shows-where-system-is-still-broken.html

House Republicans Sue Obama Administration Over Health Law

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Article source: http://www.nytimes.com/2014/11/22/us/politics/obamacare-lawsuit-filed-by-republicans.html

Obama’s Immigration Plan Could Shield Five Million

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Article source: http://www.nytimes.com/2014/11/20/us/politics/obamacare-unlikely-for-undocumented-immigrants.html

Health insurance costs have nowhere to go but up

Its open-enrollment time for employers and their employees, the time when employees must choose a health insurance plan or confirm they’ll remain on their current coverage for 2015. This is also the time when folks are eligible to purchase an individual health insurance plan on HealthCare.gov or one of the various state-based exchanges. For those plans, you have until Dec. 15 to purchase your 2015 health insurance.

Regardless of where you get your health insurance, one thing is for sure: Your premiums for 2015 and the next several years are set to rise significantly.

Folks are used to the fact that health insurance costs always seem to go up. They’ve done so for the last 14 years, with the highest annual increase of about 14 percent and the lowest at about 3 percent. But the increases for 2015 are staggering, ranging from 20 percent to over 60 percent.

And consumers need to plan for more rate hikes over the next several years, especially those who have coverage through their employer. One of the biggest causes behind these increases is the Affordable Care Act (ACA), so called because it was supposed to provide more affordable health insurance for all.

According to a brief from the American Academy of Actuaries, several factors appear to be pushing health insurance premium up in 2015 and in future years. They include:

Risk pool composition: The ACA prohibits insurers from charging different premiums to individuals based on their health status. So, when more people with higher claims (older, sicker, etc.) enroll in new health insurance plans and don’t get offset with a sufficient increase in those with fewer claims (younger, healthier, etc.), insurers project more claims and subsequently raise premiums.



Reinsurance fund reductions: The ACA created a reinsurance program to provide payments to insurance plans to help offset the costs of enrolling individuals with higher claims. Funding for this program comes from additional fees on all health insurance plans, including employer-sponsored plans. Those fees are set to decline and eventually discontinue, which points to further rate hikes.

Rising cost of medical services: This increase, the so called medical trend, results from an ever-worsening demand-supply imbalance. Beyond general inflationary pressures, an aging population is causing a rapidly growing utilization of health care, and the supply of medical services to meet this demand surge appears insufficient.

The ACA also mandated additional benefits and covered services as well extra fees charged to health insurers, which are passed down in the form of higher premiums.

Knowing that rising health insurance costs in 2015 and for the next several years is nearly a sure thing, regardless of the ACA, what can you really do about it?

In my next column, I’ll lay out several strategies you can use to manage these ever-rising costs.

Article source: http://www.cbsnews.com/news/why-your-health-insurance-costs-will-keep-rising/

Seven senior executives leave Metro Health ahead of partnership with …

WYOMING, MI – Seven key members of Metro Health’s leadership team – including the chief operating officer who started in May – are no longer working for the hospital, officials confirmed.

In preparation for an affiliation with Community Health Systems, a for-profit system based in Tennessee, Metro Health has done some restructuring at senior leadership levels, spokeswoman Ellen Bristol said in a written statement.

“Consequently, we received resignations from some individuals,” she said.

Bristol said it is not Metro’s policy to comment on personnel issues, but she confirmed that the following are no longer employed by Metro Health:

• Svetlana Dembitskaya, chief operating officer

• Dr. David Duffey, chief medical officer and executive vice president

• Tim Susterich, chief financial officer

• Ingrid Cheslek, executive vice president of patient care services and chief nursing officer

• Christine Lawrence, vice president of compliance

• Helen Berghoef, vice president of ancillary and emergency services

• Erika Duncan, vice president of human resources

Metro has named three doctors to serve as interim chief medical officers: Jeff Postlewaite, Todd Hartgerink and William Cunningham.

Mary Marks has been named the interim chief nursing officer.

Metro Health is pursuing a strategic partnership with CHS that officials said would lead to the sale of 70 percent of Metro to CHS. An affiliation between Metro Health, a nonprofit hospital, and CHS, a for-profit system, would be subject to review by state regulators.

Mike Faas, the chief executive officer of Metro, told the Grand Valley Metro Council in February that it was conducting a due diligence period of exploration before reporting its findings to state regulators for approval.

At that time, Faas said Metro administrators and CHS would have an equal representation for decisions that affect West Michigan.

Faas added that last year was Metro’s most successful in terms of growing its footprint, employing more medical professionals and building the amount of cash on hand at about $120 million. A partnership with CHS would rid Metro of $160 million of debt with “no financial handcuffs once we do the deal,” Faas said.

“Metro Health is continuing to work with Community Health Systems (CHS) towards an affiliation,” Bristol said. “Metro Health is not aware of any issues that would prevent this affiliation from happening and, as a result, is actively taking steps in preparation for its partnership with CHS.”

She added that the organizational changes would not affect patient care.

“We continue to keep our vision focused on what we can do now and how we can prepare for Metro Health’s future,” she said. “The plans we have put in place to affiliate with CHS bring us closer to becoming part of the largest healthcare system in America.

Here is a look at some of the executives who have left Metro:

Dembitskaya: When she was named the chief operating officer in May, Metro noted that she had more than 15 years of experience in health care leadership. She was responsible for the hospital’s day-to-day operations, overseeing the operating budget, more than 2,500 physicians and employees and the 12 neighborhood outpaitent centers.

Dembitskaya has served as COO of medicine at Mount Sinai Health System in New York, executive director of the Harvard University Beth Israel Deaconess Medical Center – Cardiovascular Institute in Boston, and as director of operation and finance for the Department of Internal Medicine – Nephrology at the University of Michigan Health System.

Duffey: He was named chief medical officer in August 2012. Previously, he served as the chairman and medical director of quality, safety and clinical innovation at Spectrum Health Medical Group and the division chief of pediatric hospitalists at Helen DeVos Children’s Hospital.

Lawrence: She was named vice president of compliance in February 2007 and, before that, was Metro’s director of legal services and risk management.

Susterich: He was named chief financial officer in February 2007. Before that, he served as Metro’s vice president of finance.

Sue Thoms covers health care for MLive/The Grand Rapids Press. Email her at sthoms1@mlive.com or follow her on Twitter, Facebook or Google+.

Article source: http://www.mlive.com/business/west-michigan/index.ssf/2014/11/seven_key_executives_leave_met.html

The Upshot|How Much Did Health Insurance Rates Go Up? It’s Complicated

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Article source: http://www.nytimes.com/2014/11/19/upshot/how-much-did-health-insurance-rates-go-up-its-complicated.html

Seen At 11: Health Experts Sound The Alarm On Possible Health Risks Of Leaf …

CBS New York (con’t)

Affordable Care Act Updates:
CBSNewYork.com/ACA

Health News Information:
CBSNewYork.com/Health

NEW YORK (CBSNewYork) – From the city to the suburbs, the hum of leaf blowers is a familiar sound.

But it’s not the noise that has people up in arms– it’s their potential health hazard.  They clear dust, debris, leaves and even snow quickly and efficiently, but some health experts ask at what price?

“We’re concerned about the health implications,” said Dr. Adrienne Weiss-Harrison, with the American Lung Association.

Dr. Weiss-Harrison points to studies showing that gas leaf blowers spread dangerous pollutants like ozone gas and carbon monoxide as well as stir up irritating allergens like mold and spores.

“Although they’re small devices, there are so many operating that they have a large impact,” Dr. Weiss-Harrison said.

As CBS2’s Maurice DuBois reported, it’s estimated that one gas leaf blower emits as much pollution as 17 cars in continuous use over the course of an hour.

Now, a growing number of towns in New York, New Jersey and Connecticut are imposing bans on their use.

“I don’t think there is anything to be gained by using leaf blowers,” Fred Chichester said.

Chichester, along with his wife Pat Kenschaft, are anti-leaf blower activists.

“This is just so destructive to human health, the environment,” Kenschaft said.

The couple helped pass a leaf blower ban in Montclair, N.J., that prohibits people from using the devices in warmer months when the heat compounds the negative effects.  But Chichester would like to take it a step further and limit the use of leaf blowers throughout the nation.

“I’d like to see us work toward a total ban of leaf blowers,” he said.

However, not everyone CBS2 talked to is on board with a complete ban, despite the potential health concerns.

“I smell more out of my own lawnmower than I do out of those guys,” one Montclair resident said.

“I see both sides of that issue,” another said.

“There has to be a compromise,” a third resident added.

“It’s so much more efficient than using a rake,” Executive Director of the New Jersey Landscape Contractors Association Jody Shilan said.

Shilan acknowledges the leaf blower concerns but says the bans could devastate the industry.

“It’s going to raise the cost significantly for homeowners that do have landscape contractors to take care of their property,” she said.

Shilan says the industry has been using gas powered leaf blowers for more than 20 years because of their efficiency. But as manufacturers design less toxic models, they will slowly make their way into landscapers’ hands.

“As an industry, we want to do what’s right for our communities but it’s something that will take time,” Shilan said.

In the meantime, the New Jersey Landscape Contractors Association says it can work with some seasonal bans and is training operators on how to use leaf blowers more efficiently and respectfully.

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Article source: http://newyork.cbslocal.com/2014/11/18/seen-at-11-health-experts-sound-the-alarm-on-possible-health-risks-of-leaf-blowers/

Obama’s Executive Order on Immigration Is Unlikely to Include Health Benefits

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Article source: http://www.nytimes.com/2014/11/20/us/politics/obamacare-unlikely-for-undocumented-immigrants.html

Zoetis to Buy Abbott’s Animal Health Assets for $255 Million

Zoetis Inc. has agreed to buy the animal health business of Abbott Laboratories for $255 million, less than a week after it surfaced that activist investor William Ackman has taken a roughly $2 billion stake in the company.

Abbott Animal Health’s products include anesthesia, fluid therapy, pain, oncology and diabetes monitoring. The acquisition will expand Zoetis’ diagnostics business as more pets are being treated for pain and…

Article source: http://online.wsj.com/articles/zoetis-to-buy-abbotts-animal-health-assets-for-255-million-1416231168