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Podcasts

- Jen’s Lore Corner – Tathamet and the Burning Hells – Episode 016
  September 2, 2019Jen's Lore Corner / PodcastsWelcome to Jen’s Lore Corner, a podcast about the lore of the Diablo video game series. This podcast started as a segment on the Shattered Soulstone podcast. I decided to re-release those segments in their own podcast. New content started with Episode 010. In this episode, I talk about the lore that explains how The Burning Hells were formed, and how the Prime Evils and Lesser Evils came to be. Before I started this episode, I wrote a blog post about the Demons in Diablo III. It provides a brief summary of how the demons, and the angels, were created. In this episode, I mention the animated video called Wrath. Jen’s Lore Corner – Tathamet and the Burning Hells is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/content.blubrry.com/bookofjen/JLC016.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS...
- A Festival of Blogging – Episode 051
  August 1, 2019Podcasts / Words of JenIn this episode, I read a piece of my writing that is about #Blaugust2019. It is a challenge, of sorts, designed to inspire bloggers to start making regular posts on their blogs. It is also good for those who want to start a blog. I read “A Festival of Blogging” on episode 051 of Words of Jen. If you enjoyed this episode please consider supporting me on PayPal.me. Thank you! https://media.blubrry.com/bookofjen/p/content.blubrry.com/bookofjen/woj051.mp3Podcast: Play in new window | DownloadSubscribe: Android | RSS...

Diablo III

- Diablo IV: By Three They Come
  November 10, 2019Diablo III / Diablo LoreDiablo IV takes place many years after the events in the Diablo III: Reaper of Souls expansion. Millions have been slaughtered. Some people (who are part demon and part angel) are still there – trying to survive. It is only a matter of time before an opportunistic and powerful being steps in to take control of it. Diablo IV: By Three They Come was released at BlizzCon 2019. It provides an intense, and terrifying, look at what to expect in Diablo IV. (At the time I am writing this blog post, Diablo IV has not yet been released.) Watch the video before reading through this blog post. It contains spoilers of what is in the video. At the beginning of the video, we hear the voice of someone who sounds like he is praying. It’s hard to make out the words, but it sounds like a chant. Part of it sounds like: “The Eternal Light protects me.” The camera pans over what looks like an old church or cathedral. It is decrepit and looks to have been abandoned long ago. Four men run across the floor – away from demons that are chasing them. They have no time to notice the pattern on the floor. The Book of Adria includes several, similar, patterns. She used them to mark the souls of the Lesser Evils and Prime Evils, and to trap them all in the Black Soulstone. None of those designs match the one in the video, though. In her book, Adria mentions that blood is needed for these rituals. That shouldn’t be a surprise to anyone who played through Diablo III and fought Adria. To get to her, the player must go through an area and fight monsters that are made from Adria’s blood. The room she is in has a giant pool of blood in it. Three of the four men in the video look rough. We quickly learn that they are there for gold. The other man is very injured and being half-carried by the man who appears to be the leader of the party. “Blessed Akarat, by eternal light protects me, by divine… ” the injured man says. His voice matches the one at the beginning of the video. The leader tells him that “all the gold we want” is behind that door. The religious man says that he came here for knowledge. Akarat the Prophet is an influential figure on one of the oldest religions in Sanctuary. The Book of Cain says that Akarat was “a wandering ascetic from the rugged mountain land of Xiansai, north of Kehjistan.” In short, Akarat had a vision with a “spectacular flash of light and energy cascading across the sky”. Akarat attributed his vision to an angel named Yaerius, or “son of light”. Akarat wrote that humans are “bound together in a spectrum of cosmic radiance that was the foundation of existence itself.” At some point, Akarat “disappeared into the jungles of Kehijstan, content that he had spread his message to as many others as he could”. Later, the name Zakarum was used to describe those who followed the ideal of Zakara (or the “inner light”). Akarat didn’t name this religion himself – his followers did after he disappeared. From this, we know that the religious man in the video is a follower of the Zakarum faith. He calls upon Akarat to bless him, believing that he is about to die. He appears to be bleeding heavily, and may be aware that monsters are chasing them. It is reasonable for him to think he is about to die. I have no idea what kind of demons are chasing these men. I suspect that players will encounter whatever those things are in Diablo IV. The three rough looking men start to fight the demons, and the religious man is tasked with getting them through the door. To do so, he needs to read the carvings. He stumbles onto the door and says: “Oh, light, help me,” and starts reading it out loud. “By three they come. By three thy way opens.” He reads part of a sentence about blood, but kind of mumbles it. Looking down, he sees drops of his own blood falling onto a detailed carving on the floor. It rolls to a circle that has the shape of a hand. There are two others like it. “Blood is the key!” he yells. He explains to two of the rough looking guys: “It says, the blood of the willing goes…” The Barbarian slams his hand onto one of the circles and starts bleeding. The smaller thief-looking guy does the same. The religious man puts his hand on the original circle, and they manage to open the door. The three men don’t understand they are enacting a ritual. The door opens, and the three bleeding men rush through. The religious man wants to help the leader, but the thief holds him back. “He’s dead already.” The Barbarian breaks the chain that holds up the door, and it slams shut. The three men enter an area with three pillars, and another detailed symbol carved into the floor. The thief throws the religious man into one of the pillars, and demands that he read it. “By three they come. By three thy way opens. By… the blood of the… willing. Hail!… Hail the… the creator! Hail the daughter of…” The religious man stops, “Oh no. No, no no.” The thief wants to know where to find the coin. He’s clearly on there for the gold. “This is forbidden,” the religious man says. “This is a summoning! I cannot speak this!” The thief hits him, and the Barbarian pushes him against one of the pillars, yelling that they came here for treasure. “What is this place?” the Barbarian demands. The religious man says he doesn’t know. “Maybe it’s a temple. Or a tomb, or…” “It’s a gate” a mysterious voice says. They are in what remains of the Temple of the Triune. To make a long story short, the Temple of the Triune (also called the Cult of the Three) was formed by the Prime Evils on Sanctuary for the purpose of enslaving humanity. People thought they were worshiping three benevolent gods. Dialon was the spirit of determination, represented by a ram. Bala was the spirit of creation, represented by a leaf. Mefis was the spirit of love, represented by a red circle. But, that was all a lie. The people were unwittingly worshiping the Prime Evils. “Dialon” was really Al’Diablos – Diablo – Lord of Terror. “Bala” was Tor’Baalos – Baal – Lord of Destruction. “Mefis” was Dul’Mephistos, – Mephisto – Lord of Hatred. When the Temple of the Triune started, it was led by Lucion, son of Mephisto. Later, Lilith, daughter of Mephisto, disguised herself as Lucion and took over Season 18 in Diablo III was live during BlizzCon 2019. It was called “The Season of the Triune“. It included the Power of the Triune buff, which appeared as three circles. The Triune of Love (Power) gave players a damage bonus. The Triune of Determination (Resource Reduction) gave players a 50% discount on resources spent. The Triune of Creation (Cooldown reduction) enabled skills that were on cooldown to come off cooldown faster. Little did we know it, but the entire theme of Season 18 was softly hinting at what players could expect from Diablo IV. After the mysterious voice speaks, the thief gets quickly pulled away. The camera gives us a view from above, as the Barbarian stands on top of the very detailed design that is carved in the floor between the three pillars. Things get really disturbing from here. The thief is pulled into the air, bleeding, his bones broken. “…and blood is the key,” the mysterious voice says. The leader, who is dead, appears behind the Barbarian. The Barbarian tries to fight him, but ends up thrown to the top of a second pillar, head down. So, now we have two of the three rough looking guys trapped upside down on pillars. The third dead, but walking around. The religious man is on the floor where the Barbarian dropped him. The circles in the floor start to move as the dead leader walks toward him. The religious man starts praying to Akarat again, as his companions are torn apart. “From the Abyss,” the mysterious voice says, “We seek thy salvation”. Let me back up a minute here, for a quick history lesson about Sanctuary. It was created by Inarius, a renegade angel and Lilith, a renegade demon. (I’m leaving out a whole lot of details.) The two recruited additional angels and demons who also wanted to opt-out of the Eternal Conflict. Lilith and Inarius had a child they named Linarian (which is a combination of the name Inarius and the name Lilith). Linarian was the first Nephalem. Other angels and demons had children together, who were also Nephalem. According to Diablo Wiki Inarius eventually realized that the Nephalem were too powerful. He saw this as a big mistake, and considered whether to kill them or spare them. Lilith decided to kill the other angels and demons, to prevent them from deciding to harm the Nephalem. When Inarius found out what she did, he was horrified. He couldn’t bring himself to kill Lilith, so he banished her into the Void, which is also called the Black Abyss. It is an endless empty realm where individuals can be trapped. “From the Abyss, we seek thy salvation. By three, they come. By three, thy way opens. By the blood of the willing.” The dead leader walks to the center of the carving on the floor, and his appearance changes. “We call thee home,” the person says. But, who is this guy? Who is he trying to summon from the Abyss? And why does he want to do that? Let’s back up, again. Linarian, son of Inarius and Lilith, gathered other members of the first generation of Nephalem. After discovering what Lilith did, Inarius went out and started slaughtering the Nephalem. Linarius was not on good terms with either of his parents, and changed his name to Rathma. He became the first necromancer. Long story short, the remaining Nephalem were getting weaker with each generation. Lilith escaped from the Abyss and returned to Sanctuary – and ended up taking over the Temple of the Triune. Inarius banished her into the Abyss again. He also banished his son, Rathma, into the same Abyss where Lilith was. My interpretation of this is that mother and son were stuck in the same place at the same time. Perhaps they bonded with each other? Back to the video! A dead man enters the room and uses powers to put two of his former companions up on pillars. That body changes as the mysterious voice speaks, and reveals the necromancer that was controlling the dead body. That necromancer must be Rathma! No one else on Sanctuary would know where Lilith was or how to bring her back. The religious man floats towards Rathma, and frantically starts praying. “The Eternal Light protects me.” Rathma says: “There is no light here. You came to the darkness, for knowledge”. He memorizes the religious man, calms him, and uses him to finish the summoning. “Yes,” the religious man says. Rathma responds, “And all the knowledge you seek is here. Surrender. Speak the words. Call her home.” The religious man speaks, as he floats to the top of the third pillar. “By three, they come. By three, thy way opens. By the blood of the willing. We call thee home.” His blood joins that of the other two men. He gets a vision of Lilith’s face. “Hail! Daughter of Hatred,” the religious man says, as the video shows Lilith forming in a portal made of the blood of the men on the pillars. The religious man gets a vision of Inarius, chained up in Hell, where Mephisto (Lilith’s father) is torturing him, forever. He gets a third vision, this time of men in hooded robes facing forward. Behind them is what I think looks like the skull of a horned demon. It might be the the symbol that the Triune used to represent Diablo. It also looks a lot like the skull Lilith is holding in the statue that was revealed at BlizzCon 2019. “Creator of Sanctuary,” the religious man says, sounding absolutely terrified. Lilith is starting to come out of the blood portal. Another vision appears, this one showing fire, buildings that are falling apart, and people that have been attached to tall pikes. It’s not quite a crucifixion scene, but those people are probably dead. The one nearest the viewer has arrows stuck into him. Is this a vision of what Inarius did to the Nephalem he murdered? Or, is this a vision of what Lilith is planning to do to the people who are currently living on Sanctuary? I have no idea. “Hail…. Lilith,” the religious man says, with his dying breath, as he watches Lilith reach out of the blood portal to take the hand of Rathma. As Lilith steps out of the blood portal, Rathma says: “Blessed mother, save us.” Lilith, covered in blood, has returned to Sanctuary. Her son bows before her. One of the reasons why I think guy is Rathma is because he is the only person who could realistically refer to Lilith as “Blessed Mother”. He is, quite literally, her son. The other reason is because Rathma is a necromancer. What do necromancers want to do? They want to restore the balance between light and dark, good and evil. Sanctuary is in ruins, after what Malthael and his minions did to it. Rathma needs someone powerful to restore the balance. Lilith seems like the perfect choice, since Lilith has an established history of trying her best to protect the Nephalem. This makes me wonder. What if Lilith isn’t the “big bad” of Diablo IV after all? What if she is there to save not only Sanctuary itself, but the current generations of Nephalem? Diablo IV: By Three They Come is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- Lore of the Prime Evils and Lesser Evils
  October 30, 2019Diablo III / Diablo LoreThe lore of the Diablo series of video games and books makes it clear that there are Demons that originate in the Burning Hells. While many are minions, there are seven of them that are noteworthy. The three Prime Evils and the four Lesser Evils are constantly battling with each other in an effort to take over more land and minions. Each one wants to become the most powerful Lord of the Burning Hells. Here is a brief look at who each of these very important demons are. There are two easy ways to learn about the Prime Evils and Lesser Evils. One way is to read the early portions of Book of Cain. The other is to pick up the journals, narrated by Deckard Cain, as you travel through the story mode of Diablo III. There is a Journal in Diablo III titled “The Seven Lords of Hell”. It is narrated by Deckard Cain. It says: It is with some reluctance that I write on the seven Lords of Hell, for they are the greatest of the demons, and even whispering their names seems to poison the air around me. They are divided into the Lesser Evils (Belial, Azmodan, Duriel, and Andariel) and the Prime Evils (Mephisto, Baal, and Diablo). I’ll start with the Lesser Evils. Duriel, the Lord of Pain, is said to be the “brother” of Andariel, the Maiden of Anguish. The two might be twins or siblings. But, even if they aren’t actually related to each other, what one does pairs nicely with the work of the other. In the Book of Cain, it says that Duriel is the brother of Andariel. He is also known as the Maggot King (because his body resembles that of a maggot). He loves to torture those who end up in his lair, and will start to torture himself if there is no one else around. Duriel is described by Deckard Cain in an in-game journal. It says: Duriel is the twin of Andariel. I believe that they conspired together to assist Diablo in releasing Mephisto and Baal, though they had both supported the Lesser Evils in the past. The Lord of Pain was found guarding Baal’s prison – the tomb of Tal Rasha – when he was slain by heroes. Episode number 005 of Jen’s Lore Corner has more information about Duriel. Andariel, the Maiden of Anguish, is described in the Book of Cain as the “so-called twin” of Duriel. She is the only female Lesser Evil. Andariel enjoys causing emotional agony, which she considers to be more “pure” than physical pain. The Book of Cain says that Andariel sustains herself on the anguish of others. As such, she cannot stand being isolated. Those who become victims of Andariel can become so damaged by feelings of guilt, regret, and self-loathing, that they willingly hand themselves over to Duriel. The journal about Andariel in Diablo III is also narrated by Deckard Cain. It says: Andariel was the only female Evil. She aided the Lesser Evils for many years, but eventually she lost faith in their plots. Two decades ago, she chose to help Diablo during his resurgence and seized the Citadel of the Sightless Eye. Ultimately, she perished at the hands of brave heroes. Episode 004 of Jen’s Lore Corner has more information about Andariel. Azmodan is The Lord of Sin. The Book of Cain says that Azmodan is a “clever manipulator who trades in vice and corruption. He is passionate and plotting, both to very dangerous degrees. He is by far the most charismatic and seductive of all the Evils.” If you’ve played through enough of Diablo III to encounter a battle with Azmodan, that description may sound strange. Azmodan is rotund, has legs that sort of look like they belong on a scorpion, and too many eyes. I’m going to assume that some demons find those characteristics to be “hot”. The voice actor who plays Azmodan in Diablo III is David Sobolov. The voice he gave Azmodan is very charismatic. This is especially noticeable when players pick up journals where Azmodan is narrating a letter that he sent to Cydaea. The Book of Cain notes that Azmodan’s Lair in the Burning Hells is the most densely populated. It is “a warped arena of myriad sins, of both great joy and despair, a place where garish perversions are indulged to the extreme.” An in-game Journal titled: “Azmodan, The Lord of Sin” is also narrated by Deckard Cain. It says: The Valrous manuscript lists Azmodan as the best battlefield commander of all demons, having defeated the angels many times in the Eternal Conflict across Pandemonium and the Prime Evils in the demonic civil war. If the Lord of Sin ever assaults our realm, we truly have much to fear. Belial is the Lord of Lies. In the Book of Cain, he is described as “a trickster and master deceiver”. The part about Belial goes on to say: “Belial advocates the notion that perception is reality, and it is his sole purpose to dominate reality. He does not lie for the sake of lying, rather, he deceives with the overall intent of controlling others’ perceptions of what is real.” Belial lives for that moment when his victim realizes that they’ve been deceived. He enjoys watching the victim express the shock of having been betrayed. In the Book of Cain, Deckard Cain cites his sources that indicate that if you walked into Belial’s lair, it would appear to be a paradise. But, then you find that the fruit that looked good to eat was rotten inside. There are sudden drop-offs that lead to bottomless pits. It is a place of illusion where nothing is as good as it first appeared to be. Players can find an in-game Journal in Diablo III titled: “Belial, The Lord of Lies”. It is narrated by Deckard Cain. It says: Belial, Lord of Lies, is the most elusive of the seven Evils and is a master of deceit. It is said that he manipulated Azmodan into revolt against the Prime Evils. This began the Burning Hells civil war, which ended with the Dark Exile of the Prime Evils to our mortal realm. Players discover that the child Emperor Hakan II is really Belial in disguise. How that happened is a story for another time. It becomes obvious when you fight Belial and he, eventually, turns into his final form. Let’s move on to the Prime Evils. Mephisto is the Lord of Hatred. The Book of Cain says: “To Mephisto, hatred is a tool, though one he wields with the utmost precision. The Lord of Hatred despises all, but he loathes angels above all else. And so the inhabitants of Sanctuary are seen by him as weapons to be forged in his likeness, to be aimed one day at the High Heavens.” It also says that Mephisto is “adept at playing his brothers against each other. Diablo and Baal chafe at his manipulations, but more often than not they comply, most likely because Mephisto provides them with ample opportunities to pursue their ambitions.” Mephisto has a son named Lucion and a daughter named Lilith. Both of his children are demons. Mephisto hates them, too. There is a Journal in Diablo III titled: “Mephisto, The Lord of Hatred.” It is narrated by Deckard Cain. It says The evil of Mephisto, Lord of Hatred, was so pervasive that even after he had been defeated and entombed in a soulstone, his demonic essence oozed upwards into Travincal and corrupted the Zakarum priests. Though he fell to the same heroes who killed his brothers, I fear for us should he ever return. Tor’Baalos, known as Baal, is the Lord of Destruction. According to the Book of Cain, Baal “revels in the utter annihilation of not only the world around him, but also all those who inhabit it.” Baal never gets tired of the Eternal Conflict between the Demons and the Angels, mostly because he it gives him plenty of opportunities for destruction. He uses both strategy and deception to achieve his goals. The Book of Cain also says: “By all accounts, Baal’s realm in the Burning Hells is a frenzy of constant destruction wherein he breeds demons only for the sheer gratification of destroying them. It is said that he has built some of the mightiest structures in the Hells, perfection bastions of impenetrable strength, only to see them pulverized in unique and different ways.” Baal’s Realm of Destruction is where the Hellforge is located. Great weapons are forged within it. Hellforged weapons are infused with the elements of the Lords of Hell. In other words, Baal’s realm is constantly fluctuating between creation and destruction. Players can find a Journal titled: “Baal, the Lord of Destruction” in Diablo III. It is narrated by Deckard Cain. It says: Baal was the most brash and reckless of the Prime Evils. After the Dark Exile, he was contained within the Horadrim Tal Rasha and entombed. Centuries later, Diablo freed Baal, who then corrupted the Worldstone to devastating effect for the barbarians who lived near Mount Arreat. The heroes killed Baal shortly afterward. Diablo, also called Al’Diabolos, is the youngest of the three Greater Evils. He is the Lord of Terror, and his realm is called the Realm of Terror. The Book of Cain has a lot to say about Diablo. “Diablo is calm, cunning, and patient, and best understood when we view all his actions as attempts to instill terror in those around him. Consider the components of terror: a mix of fear, shock, and utter hopelessness. Perhaps Diablo’s most insidious power is the ability to cast his influence deep in the minds of his victims and latch upon their greatest, most crippling fears, then to apply that knowledge and, in doing so, use a person’s own worst fears against them.” Diablo sees himself as an artist of terror. He knows that conquest comes when enemies panic and turn their backs to their fears, rather than face them. But, Diablo doesn’t acquire satisfaction from the conquest itself. Instead, he feeds on the terror that preceeds the conquest. The fear a victim feels is, to Diablo, a greater reward than the pain they suffer when actually tortured. There is an in-game Journal titled: “Diablo, The Lord of Terror”. It is narrated by Deckard Cain. It says: Diablo was the youngest of the Prime Evils, but I found him the most dangerous, for his power over terror left him incapable of feeling fear. Though he had easily possessed and corrupted many humans, Diablo’s essence was finally trapped in a soulstone and banished to the unfathomable Abyss twenty years ago. Lore of the Prime Evils and Lesser Evils is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

Book Reviews

- The Care and Feeding of Exotic Pets – by Diana Wagman
  October 8, 2019Book Reviews / horrorDespite the title, The Care and Feeding of Exotic Pets, is not a book about how to provide care and comfort to an unorthodox choice of pet. You won’t find this one in your local pet store! Instead, it is an intense, creepy, novel about a woman who is kidnapped by a man who owns a gigantic iguana. Diana Wagman does an excellent job of getting into her characters heads, frightening the reader, and building the intensity of the story as it goes on. I want to take a minute to talk about the cover art. At first glance, the white letters of the title (and the name of the author) pop out. It took a bit longer to see the huge, green, iguana, ominously curling around the title. Winnie is thirty-eight-years old, divorced, and sort of lost. Her husband, Jonathan, left her for a younger woman. Winnie and their daughter Lacy, still live in the home Lacy grew up in. But, things are different now. Jonathan is a somewhat-famous TV game show host. He left Winnie for a twenty-something woman who was a contestant on the show. Jonathan and Winnie are still in touch, in part because they are sharing custody of their daughter. Lacy is a teenager who has become rebellious, and is starting to get in trouble at school. Winnie believes Lacy has started smoking. Winnie wants to still be married. She wanted to grow old with someone. The life she is living now doesn’t feel right to her. As such, she has gone from being a person who kept a tidy home to one who has lost interest in doing laundry. After dropping Lacy at school, Winnie takes her car to the shop for repairs. She is dressed in a tennis outfit (that needs washing). She waits outside for the vehicle that is supposed to take her to where she can obtain a rental car. After getting one, she has plans to go to her tennis lesson. Winnie’s thoughts are a mile away. A car pulls up and stops in front of her. She gets in, without thinking much about it. Slowly, she learns that the man driving the car has no connection to the repair shop or the rental company. This is where the tension starts building. The man who kidnapped Winnie is very troubled. He owns a gigantic, male iguana, which lives in his kitchen. The iguana is ready to mate, and is uncomfortable and irritable. The entire house is kept at a stiflingly hot temperature, for the iguana’s benefit. How can Winnie escape? I spent much of the book wondering if the iguana would eat Winnie. The story gives readers little clues, slowly, that make connections that were not immediately apparent. I’m not going to tell you how it ends. What I will says is this book is intense, and scary, and includes violence. Diana Wagman did an excellent job of making the characters, even the unlikable ones, very real. The Care and Feeding of Exotic Pets – by Diana Wagman is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- Where’d You Go, Bernadette – by Maria Semple
  September 13, 2019Book Reviews / fictionBernadette is a quirky, unbalanced, architect who hasn’t worked in a while. Her husband, Elgin, works for Microsoft. They live in Seattle with their wonderful daughter, Bee. Bee comes home from school with a stellar report card and asks her parents for a trip to Antarctica (a promised reward for good grades). Bernadette disappears shortly before the trip. This leaves her family wondering: “Where’d you go, Bernadette?” I am aware that this book has been made into a movie, but I haven’t watched it yet. Everything I put into this book review is from what I read. The thing I liked the most about this book is the format that the story was presented in. Almost everything is a letter, note, email, or other type of information written by one of the characters and sent to another. The rest comes to the reader from the viewpoint of Bee. My best guess is that there may be other books written this way. But, this one felt unique because it included such a wide variety of things that the reader gets to take a look it. The reader learns about the various characters – their personalities, motivations, desires – by “snooping” on things they wrote that were intended to be private. Another advantage of using this technique of storytelling is that the reader never had to guess which character’s head they were in, or who was speaking. Just look at the bottom of the note, where someone signed their name! The reader isn’t the only one reading things they weren’t meant to see. As the book goes on, it is revealed that the little pieces of writing that connect to either Bernadette or Elgin are a collection that Bee is pouring over. She wants to try and solve the mystery of where her mother went, in the hopes of finding her. Without giving away too much of the story, I can say that part of it is about Bernadette’s past as an architect. She was brilliant, and had an eclectic style that often incorporated salvaged pieces. But then, something happened that she never quite got over. Elgin is described as a “guru” at Microsoft. He’s a bit distant, and tends to focus a lot on his work. As such, he comes across as either oblivious or simply uninterested in socializing with coworkers. Put this together with Bernadette’s agoraphobia, and it kind of explains why the two of them have become disconnected from each other. There is a hysterically funny scene involving a mudslide (and I know that sounds terrible). No one is physically harmed, but there is plenty of property damage. It is the culmination of a “fight” between Bernadette and a character that I found to be unlikable. I believe the reader is supposed to have that reaction to that specific character. There are beautiful descriptions of Antarctica, as seen from a cruise ship. Maria Semple paints a vivid picture, and I felt like I could “see” the different colors of the snow, ice, and sky as I read through that part of the book. As I already mentions, I have not watched the movie that was based on this book. I cannot help but wonder what the visuals in the movie are like. In many ways, this book is about characters who are too wrapped up in themselves to properly form relationships with others. They all have their own reasons for being like that. There is an underlying theme of broken trust and an attempt to repair it. By the end of the book, the mystery of where Bernadette went, and why she went there, is revealed. I found it to be a satisfying ending. The book is funny, and strange, and is has the most delightful way of giving the reader little pieces of the mystery of Bernadette’s disappearance to stitch together. Some of the characters grow, and in doing so, are able to see where they have made mistakes. It leaves the reader with the reassurance that, despite what happened, relationships can sometimes be repaired if everyone involved chooses to work on them. Where’s You Go, Bernadette – by Maria Semple is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

World of Warcraft

- WoW Classic: Rites and Ceremonies
  October 19, 2019World of Warcraft / World of Warcraft ClassicVaca and Neverlast set out to work on some quests that involved rites, ceremonies, and fighting unbridled capitalism. We didn’t complete all of these quests in the same day, but were able to turn in ones we finished last time around. Lorekeeper Raintotem gave us a quest called A Sacred Burial. I found it interesting that it just so happened to be raining when we met an NPC (non-player character) named Raintotem. Lorekeeper Raintotem: Only the most valiant Tauren are laid to rest at Red Rocks, our sacred burial ground. It is an honor bestowed upon the great warriors who helped found and defend Thunder Bluff and those who have given their lives for the greater good of their tribes and chieftains. But it appears a foul menace has made its way onto our holy land. A band of Bristleback Interlopers is ravaging the grave site and I am too old and past my prime to drive them away. They must be driven off with force, Vaca. To complete this quest, players must kill 8 Bristleback Interlopers at Red Rocks. Completing this quest was not very difficult. There were other players working on it at the same time that we were. As you can see in the screenshot above, a random Hunter targeted this particular Bristleback we were fighting. It is nice when players just naturally work together. We found the Ancestral Spirit at Red Rocks and turned in the quest. Ancestral Spirit: You have shown great diligence in your yearning to pass the Rites of the Earthmother, Vaca. We, the Ancestral Spirits, represent the mighty Tauren who gave their lives bravely to found and protect our great city of Thunder Bluff. I hereby pass the duty of that protection over to you. You have passed the Rite of Wisdom, young warrior. Enter Thunder Bluff with pride. Ancestral Spirit: You will now be revered within our great city. Any tauren worthy of completing the Rites of the Earthmother earns that honor. For your final quest, seek out our noble leader, Cairne Bloodhoof, who dwells atop the highest mesa in Thunder Bluff. We returned to Lorekeeper Raintotem to turn in the A Sacred Burial quest. Lorekeeper Raintotem: Well done. You have sent those foul Bristlebacks a clear message. They will think twice before attempting to meddle in this holy spot again. We were hiding out on a hillside, after doing the “corpse run”, when Vaca hit level 9. Neverlast was right behind her, at Level 8. There were too many wild creatures in this area, and we couldn’t take them all down by ourselves. Veren Tallstrider, in Thunder Bluff, has a quest called Gathering Leather. It is a good one to take if you happened to have picked up Skinning. All you need to do is skin the animals you kill (or the dead animals other players – who don’t skin – left behind). Eventually, you gather up enough leather for Veren Tallstrider. Veren Tallstrider: Greetings, young one. You have a gleam in your eye; I can tell you are eager to venture back to the plains for the hunt. May you bring honor to your clan! I work with the skins of beasts, fashioning them into clothes and armor for the people of Thunder Bluff. If you hunt beasts and bring me their skins, then I will fashion something for you. To complete this quest, a player must bering 12 pieces of Light Leather to Veren Tallstrider. Vaca and Neverlast found High Chieftain Cairne Bloodhoof. We needed to turn in a quest to him. Cairne Bloodhoof: Hail, young warrior. I see you found your way to my doorstep. I found this amusing because Vaca and Neverlast are, quite literally, standing on Cairne Bloodhoof’s doorstep. He immediately gave us another quest to work on. Cairne Bloodhoof: You have passed the Rites of the Earthmother and earned your place in Thunder Bluff. But in order to maintain the spot that you strived so hard to achieve, you must continue to prove your worth to your people. We are hunters, Vaca. Down below in Mulgore there is a mighty Kodo named Arra’chea. Show me your skills in the ways of tracking and hunting by bringing me the Horn of Arra’chea. At some point, I picked up both Skinning and Leatherworking. I thought that I needed both in order to skin things. But, that’s not how it works. All I needed was Skinning. I decided to unlearn Leatherworking (since I did not actually need it.) Vhan: No part of the animals we hunt is wasted. Vhan is a Journeyman Tailor. He was able to train Vaca in the art of Tailoring. My reason for wanting to pick up Tailoring was because I wanted to learn how to make linen bags. I figured those would probably sell on the Auction House. One of the first things I learned in Classic WoW was how scarce bags are. While in Thunder Bluff, we took a quest from Eyahn Eagletalon called Preparation For Ceremony. Eyahn Eagletalon: Vaca, my brother soon stands before Chief Bloodhoof, and it is my honor to make his headdress for him. I want to ask a favor of you while I finish tanning these leather straps. There is not enough time for me to find enough feathers, and I was wondering, would you gather more for me? You can find the feathers of the correct size from the harpies residing far to the north and northwest of Thunder Bluff. I need only 6 azure and 6 bronze feathers to complete the design. The screenshot above is a good example of the progress that my friend and I had made in WoW Classic (so far). My Warrior, Vaca, is fighting a Swoop and a Cougar by herself – with no trouble at all. This is a vast improvement from earlier, when one Swoop by itself was a challenge. My friend’s Druid, Neverlast, had enough time to go pick some flowers and then return to heal Vaca up a bit. It was nice to reach the point where we were more powerful than the local wildlife. Vaca is using the appropriately named Beatstick to kill this Flatland Cougar. If I remember correctly, she got it from a Goblin. I found it extremely amusing for my Warrior to use a weapon that was so perfectly named! We stopped to let a herd of marching Kodos pass by. They aren’t very aggressive – unless you get too close. We found Morin Cloudstalker on the road, right where we left him. This time, we were able to turn in The Ravaged Caravan quest that he gave us. Doing so allowed us to get more bag space back as we handed over the Venture Co. Documents. Morin Cloudstalker gave us two new quests to work on: The Venture Co. and Supervisor Fizsprocket. Morin Cloudstalker: This explains the buildup of Venture Co. employees and equipment we’ve seen in Mulgore. Those goblins… their company is expanding too quickly for their own good. It’s how they say, show a goblin something, and you can hear the scales in the background. Greedy little things, they are. Unfortunately for their business enterprise, we Tauren cannot allow them to conduct their operations in our lands. Go to their mine northeast of the ravaged caravan and send them a message. To complete this quest, we need to kill 14 Venture Co. Workers and 6 Venture Co. Supervisors. Personally, I find it comforting that Taurens aren’t big fans of unbridled capitalism. Vaca and Neverlast have been given the task of preventing the Venture Co. from “expanding too quickly for their own good.” Morin Cloudstalker: According to the documents you salvaged from the caravan, The Venture Co. created many plans to attempt to drive us from our lands here, so that they could have free reign to plunder our lands. The depths that they would sink to accomplish their goals disgusts and appalls me. I want the mastermind behind their plans killed. His name is Supervisor Fizsprocket, and you will find him at the Venture Co. mine east of the ravaged caravan. Bring me his clipboard, we shall see if we find out anything useful. To complete this quest, we must kill Supervisor Fizsprocket, obtain his clipboard, and bring it back to Morin Cloudstalker. Put the text of these two quests together, along with what we have learned of the Tauren lifestyle so far, and it tells a story. The land here is valued and looked after by the Tauren. They take only what they need, and use as much of a slain animal as possible. They send out people to cleanse water wells. A big company run by Goblins (that is growing too quickly) has decided to take away the Tauren’s land. The greedy Goblins want to basically mine the land for everything they can take from it, leaving behind nothing at all. The company wants to accomplish this by driving the Tauren from their lands. It sounds awfully similar to what actually happened to the First Nations people across the United States (and, I presume, other locations as well). The corporate colonizers are up to no good. My friend and I aren’t powerful enough in the real world to stop big corporations from being evil. It is going to feel good to get a chance to make things right on Azeroth. But first, we needed to finish the quest that required us to use the Winterhoof Cleansing Totem to cleanse Winterhoof Water Well. Mull Thunderhorn, in Bloodhoof Village, is the Tauren who gave us that quest. Neverlast hit level 9 as we turned in the quest. Mull Thunderhorn: News of your deed reached me moments ago – – already the beasts near the well drink from it eagerly. You have done a great thing for the land, Vaca. And you have done a great thing for the Tauren people. Let’s have a moment of appreciation for whatever Tauren used their skills to create these absolutely pathetic looking human target dummies! They are comically wonderful. These dummies aren’t pretty, but they seem functional. Clearly, some Tauren Hunter came by and shot a few precious arrows into them before Vaca and Neverlast arrived. Ruul Eagletalon gave us the Dangers of the Windfury quest. We were ready to turn it in. I wonder if he is the brother of Eyahn Eagletalon, who gave us a quest to find harpy feathers that he could use to make a headdress for his brother. For whatever reason, I failed to take any screenshots of us actually fighting the Harpies. I think we were too busy trying not to die. That said, we did manage to collect 8 Windfury Talons (each) and complete the quest. Little did we know that there would be more Harpy quests coming up! WoW Classic: Rites and Ceremonies is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- WoW Classic: Bag Space
  October 5, 2019World of Warcraft / World of Warcraft ClassicThere are times when the differences between WoW Classic and Retail WoW are glaringly obvious. In Retail WoW, it is fairly easy to obtain bags that are big enough to almost everything you need. Not so in WoW Classic! The quests that Vaca (my Tauren Warrior) and Neverlast (my friend’s Tauren Druid) we working on required more bag space than we had. There is a Fishing Trainer named Uthan Stillwater at Stonebull Lake. It makes sense for a Fishing Trainer to be located near a lake. My friend and I both decided to take up Fishing because it would mean we could sell the fish and make some money. Doing so gave Vaca just enough experience to hit Level 7! I think Neverlast was already Level 7. In retail World of Warcraft, players don’t need to actually equip a fishing pole in order to go fishing. In WoW Classic, that’s not the case! Players cannot fish without equipping a fishing pole. That’s one more item you need to carry around in your (limited) bag space. Where can a player obtain a fishing pole? Not from Uthan Stillwater the Fishing Trainer. As you can see, there is no … fishing supply vendor, for lack of a better term, standing anywhere near the Fishing Trainer. Instead, players have to go back to the nearest town (which is not far away), and go find the NPC (non-player character) who sells fishing poles. If I remember correctly, my friend and I were both laughing about that. We completed a quest called Mazaranache from Maur Raincaller in Bloodhoof village. This screenshot above is from when when we had finally finished it and were able to turn it in. The quest itself wasn’t difficult to do. It took more time than one might imagine. For whatever reason, many of the creatures that live on Azeroth that are missing vital body parts. We joked about the reason this might be happening. Maybe Vaca hit a Flatland Cougar with her weapon, and crushed the Femur that she and Neverlast were supposed to collect. We couldn’t find a reasonable explanation for why a Swoop didn’t have a Gizzard, or a Prairie Wolf was walking around without having a heart inside it. I think we concluded that these creatures couldn’t possibly be long for this world, so maybe killing them was an act of kindness? Getting back to the point I was intending to make before getting sidetracked, this quest requires players to collect and carry four different quest items in their bags. Our bags had a maximum of six slots each. The Mazzaranache quest items, a fishing pole, and a skinning knife fill up an entire bag. Next, we worked on the Sharing the Land quest. To do this, players need to go to a certain area in Mulgore, and kill 10 Palemane Tanners, 8 Palemane Skinners, and 5 Palemane Poachers. This quest didn’t require players to fill their bags with quest items. All you had to do was kill off the right number of the right kind of enemies – and you’re done. They were dropping copper, and occasionally some useful items. So, my bags quickly filled up again. That said, this was fun. The biggest reason why I wanted to play a Warrior was to slaughter everything in my path. These little guys respawned at what felt like a really quick rate. There were plenty for us, and the random group of players who were also working on this quest, to kill. Unfortunately, when those other players moved on, the quick respawn rate remained just as quick. We did the “corpse run” back to our bodies, as you do. All we needed was a couple more of one type of Palemane, and we we would be done. We were able to turn in the Poison Water quest and get some more quest items out of our bags. This one has players collecting 6 Prairie Wolf Paws and 4 Plainstrider Talons. It was nice to get those out of our bags. In return, we received a cleansing totem to take to the well. We got two quest items out of our bag, giving us two empty slots. The cleansing totem immediately takes up one slot. None of this is meant as a complaint. I remember “Vanilla” having the same issues with bag space. There are two potential solutions. Go back to town and sell stuff as soon as your bags are full. Or, drop some junk along the way in favor of holding on to items that are useful (or that you can sell). This is just something to get used to in Classic WoW. I can see where some people, who either never played “Vanilla”, or who strongly prefer how the current “retail” game functions, will find this situation very frustrating. If you take the time to stop and look around, you can find a lot of beauty in WoW Classic. I think this is something people forget about as they push to finish as many quests as possible. I find it peaceful to take my WoW character into beautiful places that I could not travel to “in real life” due to all my allergies and chronic illnesses. There is also something to be said about enjoying a nice view after dealing with the tedium of trying to balance limited bag space. WoW Classic: Bag Space is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

Out of Spoons (Chronic Illness)

- Telemedicine Worked for Me
  August 5, 2019Out of Spoons / Spoonie WritingPhoto by pina messina on Unsplash I have chronic illnesses and often get sick. Some of my chronic illnesses are autoimmune diseases. This isn’t anything new – I’ve been like this for as long as I can remember. In July, the sinus infection that I had been trying to fight off started winning the battle. By the time I realized that I needed to see a doctor – everything was closed. What could I do? The solution to my problem was telemedicine. I had been fighting this sinus infection for a few weeks, hoping it would go away. This is little more than procrastination, because I almost never am able to fight off a sinus infection without help. Typically, I get two sinus infections a year. This is an improvement from when I used to work in daycare, and as a teacher, when I would get four or more sinus infections a year. The result is that I’m acutely aware of the signs and symptoms that my body is trying to fight a sinus infection. There are many reasons why I did not immediately go see a doctor right away. I’ve been in and out of doctor’s offices more this year than in previous years, and didn’t want to sit around in a waiting room, again, for an indeterminate amount of time. My doctor is at what I call “the clinic for the poor people” and is booked so far ahead that I knew it would be impossible to be seen by that doctor right away. Once, I called for an appointment and was able to get an appointment with a different doctor – who has since left the clinic. The thing that made me realize that I was having great difficulty fighting off this sinus infection was the fever that developed. It showed up really fast while I was up late and trying to get some writing done. According to WebMD, a German doctor in the 19th century set the standard for human body temperature at 98.6 F, but more recent studies says the baseline for most people is closer to 98.2 F. Mine is generally around 96-point-something. The thermometer showed a body temperature of around 98.8 F, and kept getting higher after that. It was around three in the morning, so I decided to get some sleep to see if that helped. When I woke up, the fever was still there, and it felt like my sinuses were on fire. It was a Saturday, and the emergency clinic I was considering going to was closed. Sinus infections can get really serious if left untreated. I was so sick that I opted-out of playing Dungeons & Dragons with my friends that day. I was overly warm, in pain, and not thinking very clearly. What to do? The answer was telemedicine, something I had never tried before. The American Academy of Family Physicians (AAFP) describes telemedicine as: “telemedicine is the practice of medicine using technology to deliver care at a distance. A physician in one location uses a telecommunications infrastructure to deliver care to a patient at a distant site.” The AAFP supports expanded use of telemedicine as an appropriate and efficient means of improving health, when conducted within the context of appropriate standards of care. My health insurance is an individual plan that I got from the Marketplace. In other words, I have “Obamacare”. I am poor, so I get a subsidy to help me pay for my health insurance premiums. One of the “perks” of the health plan I have is telemedicine. They sent me emails about it, recommending I fill out an online form before I got sick. They sent me flyers about it, which I promptly recycled, because I never imagined I would need telemedicine. The first thing that needed to be done was to fill out an online form about my health and symptoms. My husband filled it out for me because I wasn’t coherent enough to do it myself. There were several options for the doctor to contact me, and I selected a phone call. The doctor was a very nice woman, with an Indian accent, who sounded like she was working in a noisy place. She asked about my symptoms, and offered advice about getting some rest and recommendations about what foods to consume and which to avoid while I was sick. Some of her suggestions were foods I am allergic to, because she didn’t have a full list of my allergens. That’s not her fault. The doctor asked if I was allergic to antibiotics. No, I’m not. Then, she rattled off a list of antibiotics and asked if I knew which one worked best for me. Yes, I did! The doctor sent a prescription to the pharmacy of my choice, and my husband went to get pick it up. Telemedicine worked really well for me. It was fast, efficient, and the doctor was very attentive. I didn’t have to sit in a waiting room and potentially infect everyone else who was there. The antibiotic I received was the generic form of the one I selected. It cost $1.83. The cost of speaking with a telemedicine doctor turned out to be $5.00. If I had been able to see a doctor at a clinic that day, the copay would have been $75.00. I will be using telemedicine again the next time I get a sinus infection. A telemedicine doctor cannot treat everything. There was a list of what it can be used for, and sinus infections are on that list. Telemedicine Worked for Me is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued
  July 3, 2019health insurance / Out of SpoonsThis blog post is a continuation of everything significant that happened with Obamacare, Medicare, Medicaid, and access to reproductive health care in the United States in 2019. Part Three left off at the end of June of 2019. This blog picks up in July of 2019. You may want to go back and take a look at the efforts that the Trump administration and the GOP made to destroy people’s access to health care in 2017 and in 2018. The purpose of this series of blog posts is to make it incredibly easy find information about what happened to health care access during the Trump administration. July 1, 2019: The Hill posted an article titled: “Overnight Health Care: Panel of judges set for ObamaCare case | Trump officials delay ‘ conscience protection’ rule | Theranos founder to go on trial for fraud next summer”. It was written by Peter Sullivan. From the article: Panel of judges set for big ObamaCare court case next weekThe three-judge panel on the Fifth Circuit Court of Appeals that will hear the lawsuit seeking to overturn the Affordable Care Act was revealed on Monday.The judges for the July 9 arguments are Carolyn King, Jennifer Elrod and Kurt Englehardt. King was appointed by President Jimmy Carter, while Elrod and Englehardt were appointed by President George W. Bush. That means there are two Republican-appointed judges to one Democratic-appointed judge.Most legal experts in both parties view the lawsuit’s legal argument challenging the health care law as extremely weak and think that eventually ObamaCare will be upheld. But there are still a lot of question marks around the case, especially after the court last week asked whether the blue states arguing to uphold the health law even have the legal standing to be involved……Trump administration delays implementation of ‘conscience protection’ ruleThe Department of Health and Human Services (HHS) is delaying the implementation of its “conscience protection” rule until November to give the administration more time to deal with a lawsuit over the policy.HHS announced in a court filing Saturday that the rule, which was originally scheduled to take effect July 22, would not be implemented until Nov. 22 at the earliest.A coalition of Democratic-led states filed a lawsuit against the administration in May saying the policy, which would allow health care providers to refuse to provide services on the basis of their religious beliefs, is unconstitutional……Background: President Trump announced the policy in May, which proponents say would protect health care workers and institutions from having to violate their religious or moral beliefs by participating in abortions, providing contraception sterilization, or performing other procedures… July 1, 2019: NPR posted an article titled: “Court Order Delay Of Trump Administration’s Health Care ‘Conscience Rights’ Rule”. It was written by Selena Simmons-Duffin. From the article: The federal government’s rule designed to support health workers who opt out of providing care that violates their moral or religious beliefs will not go into effect in July as scheduled. The effective date has been delayed by four months, according to court orders.The “Protecting Statutory Conscience Rights in Health Care” rule was originally issued in May by the Department of Health and Human Services’ Office for Civil Rights. It aligns with that office’s religious freedom priorities and would put new emphasis on existing laws that give health care workers the ability to file a complaint with that office if they are forced to participate in medical care that violates their conscience – such as abortion, gender confirmation surgery, and assisted suicide.As NPR reported, the rule also expands the type of workers who are able to file this kind of complaint to billing staff and receptionists and anyone else who in any way “assist[s] in the performance” of a procedure……Several groups sued the federal government over the rule immediately after it was issued. New York state led a coalition of 23 cities and states in one suit, and three jurisdictions in California also sued, including California state and San Francisco. Yet another plaintiff, Santa Clara County in California’s Bay Area, made the case that the rule put patient safety at risk, since it gave health workers the right to opt out of providing care without prior notice – potentially even in an emergency……Santa Clara and several other plaintiffs had filed for a preliminary injunction to prevent the rule from going into effect while the legal process played out……The new effective date is Nov. 22 – the federal judge in the California cases make that official over the weekend, and in the New York case, the federal judge certified the change on Monday… July 1, 2019: CNBC posted an article titled: “Nancy Pelosi’s latest Medicare proposal would pass drug discounts to all consumers”. It was written by Berkeley Lovelace, Jr. From the article: House Speaker Nancy Pelosi’s latest draft of legislation allowing Medicare to negotiate lower drug prices would also apply those discounts to private health plans across the U.S., according to a senior Democratic aide.The Department of Health and Human Services is currently prohibited from negotiating drug prices on behalf of Medicare – the federal government’s health insurance plan for the elderly. Pelosi has been working for months on a plan that would give HHS that power, which private health insurers already have. The most recent draft of the legislation proposes to extend those cost savings to private insurance plans, the aide said, asking not to be identified because the legislation is still being drafted and could change.Kaiser Health News first reported the news……It’s unknown if Pelosi’s plan would apply to all drugs. But according to Kaiser, it would authorize HHS to negotiate the prices of the 250 most expensive drugs. July 1, 2019: The American Medical Association (AMA) posted news titled: “Supreme Court to Medicare: Seek feedback before changing rules”. It was written by Contributing News Writer American Medical Association Tanya Albert Henry. From the news: A recent U.S. Supreme Court ruling ensures that Centers for Medicare & Medicaid (CMS) officials must tell the public about proposed changes to Medicare benefits – even if they seem minor – and give physicians and other stakeholders a chance to comment on modifications’ potential impact.Physicians are cheering the ruling, as the outcome is one the Litigation Center of the American Medical Association and State Medical Societies advocated for in a friend of the court brief filed in the case before the high court on behalf of the AMA and the Medical Society of the District of Columbia. Physicians told justices that “even ‘seemingly minor’ modifications in reimbursement determinations give rise to extreme financial consequences for providers and ultimately their patients.”The majority opinion, written by Justice Neil Gorsuch, opens by saying that in “one way or another, Medicare touches the lives of nearly all Americans,” noting that it provides health insurance for nearly one-fifth of the nation’s population. In explaining its reasoning for requiring the Department of Health and Human Services (HHS) to seek input, the court echoes arguments that the Litigation Center brief made about the importance of a notice-and-comment period for physicians, patients, and other stakeholders… July 1, 2019: University of Wisconsin-Madison News posted an article titled: “Wisconsin Medicaid expansion lowered antidiabetic drug costs 70%”. It was written by Katie Gerhards. From the article: …A new study by a team of University of Wisconsin-Madison researchers shows that Wisconsin Medicaid’s 2004 coverage expansion had a tremendous impact on making antidiabetic drugs more affordable for one of the state’s populations that needs them the most: childless adults with low income.Although Wisconsin did not participate in the Affordable Care Act Medicaid expansion, legislators approved a limited expansion through a Section 1115 Medicaid Demonstration Waiver. Effective 2014, this waiver expands coverage for childless adults earning up to 100% of the federal poverty level.Previously, this group had been covered by the BadgerCare Plus Core Plan, with covered fewer medications and had higher copays for generic and brand-name drugs. Transitioning from the Core Plan to the more comprehensive Standard Plan dropped out-of-pocket costs for antidiabetic medication by an average of 70 percent per childless adult, or $36.59 per year.The expanded coverage also correlated with a 4 percent increase in childless adults using antidiabetic medications, such as insulin and oral medications like metformin. That increase is largely driven by a growing number of people using medication, suggesting affordability might have been an obstacle before the coverage expansion… July 1, 2019: IndyStar posted an article titled: “State calls new rules ‘Gateway to Work.’ Activists call them a ‘poverty trap.'” It was written by Shari Rudavsky. From the article: …The requirements began Monday. People covered under the Healthy Indiana Plan are expected to work at least 20 hours per month. That number will slowly climb until July 2020, when Medicaid recipients will need to show that they have worked, volunteered, studied, or acted as a caregiver for 80 hours each month.State officials have said the Gateway to Work program will encourage low-income Hoosiers to find employment and improve lives. They said the program will support Hoosiers as they transition to employment at the same time it requires them to have “some skin in the game.”Those who oppose the work requirements point to Arkansas, where an estimated 17,000 people have lost health insurance since work requirements went int effect in June 2018.But officials for the Family and Social Services Administration have said the road map for Indiana looks nothing like the one overseen in Little Rock. They have estimated that about 20 percent of those currently on the Healthy Indiana Plan, or about 85,000 people, will be affected by the work requirement.At the start, FSSA officials have said they will operate under “an economy of trust” and allow HIP recipients to log their work hours without requiring outside documentation.Still, activists say they fear the new requirements will lead those in need to lose precious coverage, coverage that many value……Even if the system works as well as it can be expected, some recipients could still find it challenging to meet the requirement that they log on monthly to prove their eligibility, said Donna Neidnagel, a Brown County resident who spoke Monday.Only about a third of people who are full-time residents in Brown County have access to the internet. Many people live in areas where cellphones have no reception… July 1, 2019: Crain’s Chicago Business posted an article titled: “Illinois hiring hundreds to reduce Medicaid backlogs”. It was written by Stephanie Goldberg. From the article: Illinois is hiring hundreds of frontline workers to resolve major delays of its Medicaid application and renewal process.The Illinois Department of Healthcare and Family Services, which oversee Medicaid, and the Illinois Department of Human Services are working together to fill the vacancies, the departments said in a statement today. The first positions are expected to be filled this week.The Medicaid redetermination process, which reviews eligibility for the state’s nearly 3 million Medicaid beneficiaries, can lead to lapses in coverage. Such gaps are hard on patients, especially those managing chronic conditions, and health systems that don’t get reimbursed for medical services when claims are denied by health plans.Backlogs, which have increased in recent years, are considered delays of 45 days or more for initial applications and 60 days or more for renewals, the statement says……A recently passed a bipartisan Medicaid reform package also aims to reduce the backlogs. July 1, 2019: The Independent posted an article titled: “Iowa sued for blocking Medicaid from funding reassignment surgery”. It was written by Lily Puckett. From the article: The ACLU of Iowa has filed a lawsuit challenging a new state law that prohibits the use of Medicaid funding for gender reassignment surgery.Governor Kim Reynolds signed a bill on 3 May that included language amending the Iowa’s Civil Rights Act so that the state is not required to pay for gender reassignment surgery. On Friday, The ACLU sued Mr Reynolds, the state and the Iowa Department of Human Services on behalf of One Iowa, a group that advocates for transgender rights, and two transgender Iowans who qualify for Medicaid and whose doctors say they need the surgery to treat gender dysphoria.The lawsuit filed in the state court asks a judge to declare the measure invalid because it’s unconstitutional and order the state to halt enforcement. It claims the law violates inalienable rights to liberty, safety and happiness and equal protection sections of article 1 of the Iowa Constitution……In March, the Supreme Court ruled that the Iowa Department of Human Services cannot block Medicaid from paying for gender reassignment surgery for two transgender women whose doctors recommended the procedure.Republicans in the Iowa Legislature passed the law being challenged as part of a last minute addition to a human services budget bill responding to that ruling… July 2, 2019: Politico posted an article titled: “GOP states seek delay in Obamacare case”. It was written by Dan Diamond. From the article: REPUBLICAN STATES REQUEST OBAMACARE TRIAL DELAYThe GOP-led states seeking to overturn Obamacare requested on Monday that they get an additional 20 days to file a supplemental brief and that the opening argument set for next week to be delayed to “a date of the Court’s choosing” after the filing.In a letter to the clerk of the 5th U.S. Circuit of Appeals, attorney Kyle Hawkins said these “important” questions “merit a thorough response” that represents the views of all the states. “As of today, it appears unlikely that any such response will be completed by the Court’s July 3 deadline.”……ORAL ARGUMENTS SET IN CONSCIENCE-RULE LAWSUITPlaintiffs suing to stop HHS’s rule to strengthen conscience rights will have their day in court on Oct. 30, a federal judge in California ordered on Monday.The Trump administration’s rule, which would expand protections for religious-workers to deny health services, was to take effect on July 22, but U.S. District Court Judge William Alsup this weekend postponed the rule’s effect until Nov. 22. HHS was sued by San Francisco city attorney Dennis Herrera, California Attorney General Xavier Becerra and the Democratic-led states……REPRODUCTIVE RIGHTS GROUPS PUSH BACK ON FDAA coalition of 75 reproductive rights organizations and physicians sent an open letter to FDA calling for the agency and other government officials to remove barriers for patients to access abortion pills. The pills are supplied by a Dutch pharmacist through the website AidAccess.Org, but in March the FDA ordered the site in a warning letter to stop selling unapproved versions of two drugs – mifepristone and misoprostol – to U.S. consumers.The groups, including Planned Parenthood and National Organization for Women, argued that the medicines have been proven safe and effective and if laws and regulations “were based on science – not politics” they would be readily available… July 2, 2019: Aid Access.org posted “Open Letter – Medication Abortion Access Should Be Based on Science Not Politics”. From the open letter: In October of 2018, the international group AidAccess.org, led by Dr. Rebecca Gomperts, began offering mifepristone and misoprostol, commonly known as medication abortion pills, by mail, to patients in the United States. After an online medical consultation with a patient, Dr. Gomperts writes a prescription and a pharmacy fills the prescription and ships pills to the patient. According to analysis conducted by a research team at the University of Texas at Austin, in its first year of operation, AidAccess.org received over 21,000 requests for abortion pills, without any advertising or outreach.The two-medication combination that AidAccess.org is providing has been demonstrated to be safe and effective in extensive research and is the same combination approved for use in the United States by the Food and Drug Administration (FDA). Yet, despite the strong safety record of medication abortion, in March 2019 the FDA sent warning letters to AidAccess.org and Dr. Rebecca Gomperts, stating that they are violating the Federal Food, Drug, and Cosmetic Act by offering mifepristone and misoprostol directly to U.S. consumers seeking to end a pregnancy. The agency demanded that AidAccess.org immediately cease offering these medications to people in the United States.If the laws and regulations that determine the terms of abortion access in the United States were based on science – not politics – medication abortion would be widely available in the United States without medically unnecessary restrictions on distribution. Abortion with quality pills delivered by mail directly to one’s home with instructions for use in multiple languages and access to medical counseling and back-up, if needed, should be one of an array of abortion options available, ensuring everyone who needs to end a pregnancy has the freedom and control to do so in a way that best fits their lives. However, due to the politics of abortion, medication abortion has been over-regulated by the FDA, and pushed further out of reach for many by state restrictions.The high demand for medication abortion by mail should come as no surprise. Access to abortion is under direct threat today, with near-total bans on abortion care recently signed into law in Alabama, Georgia, Kentucky, Mississippi, and Ohio. This is happening in a context in which abortion is already inaccessible for many: 90% of U.S. counties have no abortion clinic. In addition to having to travel a long distance to the nearest abortion clinic, many people have to endure legally-mandated waiting periods. These medically unnecessary waiting periods create further challenges for people who have to take time away from work or school or arrange for childcare. These hurdles may increase the cost of an abortion, which averages $500 in the first trimester and only becomes more expensive as pregnancy progresses. In 35 states and the District of Columbia, Medicaid does not cover abortion care except in rare cases, making abortion financially inaccessible for low-income people. These restrictions are about control and limiting options, not safety or health……The risk for a person self-managing an abortion with pills in the United States today is not medical but legal. Since the year 2000, there have been at least 21 known arrests in the United States of people for ending their own pregnancy or helping someone who has made the decision to do so. Some have gone to jail, but even those who have not have had their lives turned upside down by investigations and in some cases have suffered economic and social harm caused by negative media exposure. The threat of investigation, arrest, or punishment is particularly of concern for those who live under heightened government surveillance, including many in immigrant communities. Five states currently have laws on the books that criminalizes self-managed abortion. The fact that these laws are generally outdated and likely unconstitutional does not mean they are inert: they have been used in the last decade to arrest, investigate, and prosecute people who ended or who were suspected of ending their own pregnancies. And in states without such laws, prosecutors who wish to punish people for abortion have used laws that were never intended to apply to self-managed abortion to target people who have ended, or are suspected of ending, their own pregnancies.The anti-abortion politicians and activists who propose restrictions are attempting to legislate legal abortion out of existence. They are well aware that the FDA’s restrictions and actions are a key element in the success of their own efforts to make abortion inaccessible… The letter included a list of organizations who signed on to the letter, as well as a list of individual medical professionals. Here are the organizations: Abortion Access FrontAbortion Care NetworkACCESS Women’s Health JusticeAdvocates for YouthAll-OptionsCarolina Abortion FundCatholics for ChoiceChicago Abortion FundCivil Liberties and Public Policy ProgramClarinda Regional Health CenterFeminist Women’s Health CenterForward TogetherGateway Women’s Access FundIf/When/How: Lawyering for Reproductive JusticeIn Our Own Voice: National Black Women’s Reproductive Justice AgendaIpasLegal VoiceMaine Family PlanningMariposa FundMedical Students for ChoiceMidwest Access CoalitionNARAL Pro-Choice ArizonaNARAL Pro-Choice ColoradoNational Abortion FederationNational Asian Pacific American Women’s Forum (NAPAWF)National Latina Institute for Reproductive HealthNational Institute for Reproductive HealthNew Voices for Reproductive JusticeNurses for Sexual and Reproductive HealthPendergrast ConsultingPhysicians for Reproductive HealthPlan CPlanned Parenthood Federation of AmericaProgress FloridaPublic Leadership InstituteReligious Coalition for Reproductive ChoiceSisterLove, Inc.SisterReachSurge Reproductive JusticeURGE: Unite for Reproductive & Gender EqualityWest Virginia FreeWhole Woman’s Health / Whole Woman’s Health AllianceWomen on Web July 1, 2019: CBS News posted an article titled: “American Medical Association sues North Dakota over abortion laws”. It was written by Emily Tillett. From the article: The American Medical Association (AMA), which often shies away from weighing in on overtly political matters, is suing the state of North Dakota over medical practices, which the AMA says directly “contradict reality and science”. In a lawsuit filed last week, the AMA is challenging the constitutionality of two laws in particular that direct doctors and medical care teams to provide patients with “false, misleading, and non-medical” information about reproductive health. The AMA, in a joint filing with the Center for Reproductive Rights (CRR), argues that the laws violate the First Amendment rights of physicians by forcing them to convey false information and non-medical statements with which they disagree……The state laws represent some father most restrictive abortion laws in the country. One law, H.B. 1336, which is set to take effect Aug. 1, compels doctors to tell their patients that medication-induced abortions can be reverse. Under this law, doctors must also give patients government-scripted information on where to find a medical professional who will provide an experimental and unethical treatment to “reverse” an abortion.The measure targets drug-induced abortions that require two drugs to be taken separately to complete the abortion. Abortion providers are supposed to tell women undergoing this kind of procedure that they might be able to stop the abortion if they’ve only taken the first drug.The AMA said that medical advice was “patently false”……The AMA is also challenging an existing North Dakota law that forces to tell patients that abortion terminates “the life of a whole, separate, unique, living human being.” The medical group argues that the law requires physicians to impart “ideological, government-mandated messages that are false or misleading” to their patients……The lawsuit argus that just last term, the U.S. Supreme Court held in National Institute of Family & Life Advocates v. Xavier Becerra that the government cannot regulate the speech of medical professionals to advance controversial ideas or to discriminate based on the content and/or viewpoint of the speaker… July 2, 2019: Statesman posted an article titled: “Court denies Texas bid to delay Affordable Care Act arguments”. It was written by Chuck Lindell. From the article: Keeping a legal challenge to the Affordable Care Act on a fast track, a federal appeals court Tuesday rejected a request to delay next week’s oral arguments made by Texas and 19 the states seeking to overturn the law.The Republican attorneys general, including Ken Paxton of Texas, said they needed more time to research and respond to questions – recently posed by the 5th U.S. Circuit Court of Appeals’ three-judge panel – that could end the appeal and provide a victory for opponents of the law.With that response due Wednesday, Texas Solicitor General Kyle Hawkins, the top appellate lawyer in Paxton’s agency, asked for 20 additional days to submit the brief, with oral arguments to be reset for sometime afterward.The appeals court rejected the request but pushed the deadline back two days, giving all sides until 5 p.m. Friday to submit the requested briefs.The delay was opposed by Democratic-led states and the U.S. House, which are fighting to preserve the Affordable Care Act after a federal judge in Texas – based on a lawsuit filed by Paxton – ruled in 2018 that the law was unconstitutional……The law, sometimes known as Obamacare, remains in effect during the appeal… July 2, 2019: WITF posted an article titled: “Pennsylvania’s own insurance exchange coming next year”. It was written by Marc Levy. From the article: Pennsylvania is moving to replace the federally operated Healthcare.gov with its own website to sell Affordable Care Act-compliant policies in a bid to get more people into it and lower their costs.Gov. Tom Wolf signed legislation Tuesday after it passed the Legislature unanimously last week. The administration unveiled the legislation in June after lining up support from a wide range of business and consumer advocacy groups, as well as leadership in the Republican-controlled Legislature.Pennsylvania let the federal government know of its intent and is preparing to submit its plans, called a “blueprint,” in the coming weeks.Wolf’s administration expects to take over some of the marketing and outreach efforts for Healthcare.gov next year before it unveils its new website next year for enrollment in the 2021 insurance year.It says it expects it can lower premiums by 5% to 10% for the 400,000 people who buy policies in the marketplace. Wolf’s insurance commissioner, Jessica Altman, said the savings can especially help the roughly 80,000 people who buy policies through Healthcare.gov, but whose incomes are too high to qualify for a federal tax subsidy… July 2, 2019: KTVA The Voice of Alaska posted an article titled: “Alaskans lose Medicaid dental benefits after Dunleavy budget cuts”. It was written by Lauren Maxwell. From the article: After Gov. Mike Dunleavy vetoed $50 million from the state’s Medicaid budget last week, some Alaskans are already starting to feel the effects.A large chunk of those cuts – $27 million – eliminates dental benefits for adults on Medicaid that in 2018 included approximately 30,000 Alaskans.On Monday, Anchorage Dental Group began calling its Medicaid patients to tell them their dental benefits were gone. Office Manager Candace Fleming said that included some patients whose treatment wasn’t finished yet……The cuts eliminate all services including preventive care like cleanings and fillings – the kind of things that Dr. James Hyer said can keep small problems from getting worse……The State said services to children on Medicaid are not impacted by the budget cuts and that adults who need emergency care for immediate relief of pain or acute infection will still be covered. July 2, 2019: Planned Parenthood posted a press release titled: “Ninth Circus Provides Emergency Relief for Millions of Title X Patients”. From the press release: The U.S. Court of Appeals for the Ninth Circuit has blocked the Trump-Pence administration’s dangerous Title X gag rule. The court’s order provides much-needed emergency relief to millions of people who access birth control and other reproductive health services through the program.Title X is the nation’s program for affordable birth control and reproductive health care, which serves four million people each year. Trump’s gag rule makes it illegal for health care providers in the Title X program to refer patients for abortion, and also blocks access to care at Planned Parenthood by imposing cost-prohibitive and unnecessary “physical separation” requirements. Title X helps millions of people struggling to make ends meet – the majority of whom are people of color, Hispanic, or Latino – access birth control, cancer screenings, STI testing, and other essential reproductive health care. Providers who serve nearly half of the patients who get care through Title X have made it clear that the rule would force them out of the program – the administration is putting health care at risk for patients across the country by pushing this rule to go into effect… July 2, 2019: Center for Reproductive Rights posted a press release titled: “Trump Administration Postpones Denial of Care Rule”. From the press release: In response to the Trump administration’s announcement that the Denial of Care Rule will no longer go into effect on July 22, the Center for Reproductive Rights, Lambda Legal, Americans United for Separation of Church and State, and the County of Santa Clara issued the following statement:“As we know from the firsthand accounts of our plaintiffs – health care providers who are on the front lines every day caring for patients – discrimination in health care is dangerous and lives are truly at stake. Confronted with these facts and the flurry of lawsuits showing how the Denial of Care Rule would irreparably harm health care providers and patients across the country, the Trump administration agreed to delay implementation. The Rule invites health care workers to discriminate based on religious or moral objections, targeting LGBTQ people and women seeking reproductive health care. The Rule is unconstitutional and we are ready to take on the Trump administration in this fight.”On Saturday, June 29, the U.S. Department of Health and Human Services (HHS) stipulated that it will delay the implementation of Denial of Care Rule. A court order put the delay of the rule into effect yesterday. The rule will no longer take effect on July 22 as originally planned; instead the rule will be delayed at least until November 22……The new regulation, issued in May by HHS, invites anyone employed by a health care provider – including doctors, nurses, EMTs, administrators, janitors, and clerical staff – to deny medical treatment and services to patients because of personal religious or moral beliefs. Health care facilities that do not comply risk losing federal funding. If allowed to go into effect, the Rule will cause mass confusion among health care providers and is completely infeasible to implement. As a result, some health care facilities – most of which receive federal funding through HHS – may do away with reproductive and LGBTQ services altogether, leaving millions without access to health care.In the lawsuit, the civil rights organizations argue that the rule is unconstitutional because it advances specific beliefs in violation of the First Amendment; violates patients’ rights to privacy, liberty, and equal dignity as guaranteed by the Fifth Amendment; and chills patients’ speech and expression in violation of the First Amendment, all to the detriment of patients’ health and well-being. The lawsuit also asserts that HHS violated the federal Administrative Procedure Act in creating the rule by arbitrarily and capriciously failing to consider the impact on patients and the health care system. July 3, 2019: The Hill posted an article titled: “Judge blocks Ohio’s ‘heartbeat’ abortion law”. It was written by Jessie Hellmann. From the article: A federal judge on Wednesday temporarily blocked an Ohio law that would have banned abortions after six weeks of pregnancy.The law, which bans abortions after a fetal heartbeat is detected, was signed earlier this year by Gov. Mike DeWine (R) and challenged by the American Civil Liberties Union (ACLU) and Planned Parenthood.It was slated to take effect this month, but U.S. District Judge Michael Barrett issued a preliminary injunction, blocking the law from taking effect while it is challenged in court……Barrett wrote in his ruling that the law places an “undue burden” on a woman’s right to obtain an abortion before the fetus is viable, violating Supreme Court precedent.The law would have been one of the strictest in the nation with no exemptions for cases of rape or incest… The case is called Preterm-Cleveland, et. al. vs. David Yost, et. al. It is available online. Here are some parts of U.S. District Judge Michael Barrett’s ruling: …In a nutshell, S.B. 23 bans abortion care at and after approximately six weeks in pregnancy. And, in so doing, according to Plaintiffs – a collection of reproductive clinics and physicians providing abortion care – violates women’s right to privacy as guaranteed by the Fourteenth Amendment……At six weeks LMP, many women are unaware that they are pregnant… Typically the menstrual cycle is approximately four weeks long, but varies based on the individual. Assuming a woman has consistently regular periods, she would be considered four weeks pregnant as measured from her LMP when her missed period occurs. Those who have irregular periods – caused by common medical conditions, contraceptive use, age or breastfeeding – or those who experience bleeding during early pregnancy that could be mistaken for a period may not realize that they missed a period…. But assuming a patient does know she is pregnant, there are certain logistical obstacles to obtaining abortion care before six weeks in pregnancy… She will need to schedule an appointment, make sure of payment, arrange for transportation, time off of work and possibly childcare during appointments… A minor patient, unless emancipated, also must obtain written parental consent or a court order… And all patients, regardless of age, must make two in-person trips – at least 24 hours apart – to the clinic before they can obtain an abortion… These reasons explain why the majority of abortions in Ohio – approximately 90% – take place at or after six weeks LMP. … S.B. 23, therefore, will prohibit almost all abortion care in Ohio……The Court concludes, based on current United States Supreme Court precedent, that Plaintiffs are certain to succeed on the merits of their claim that S.B. 23 is unconstitutional on its face……Plaintiffs argue that their patients will suffer serious and irreparable harm in the absence of a preliminary injunction, because allowing the Act to take effect will prevent Ohio women from exercising their constitutional right to reproductive freedom as protected by the Fourteenth Amendment… Inasmuch as this Court has determined that S.B. 23 places an “undue burden” on a woman’s right to choose a pre-viability abortion, and thus violates her right to privacy guaranteed by the Fourteenth Amendment, we further determine that its enforcement would, per se, inflect irreparable harm……[Planned Parenthood of Southeastern Pa. v] Casey acknowledged the State’s “legitimate interest from the outset of the pregnancy in protecting the … life of the fetus that may become a child.”… But that acknowledgement was preceded with the recognition that “[b]efore viability, the State’s interests are not strong enough to support a prohibition of abortion or the imposition of a substantial obstacle to the woman’s effective right to elect the procedure”…. An injunction will preserve the status quo that has been in place for more than 40 years since Roe was decided, and some 25 years since Casey followed… CONCLUSIONFor the foregoing reasons, Plaintiffs’ Motion for Preliminary Injunction … is GRANTED. Specifically, all Defendants, their officers, agents, servants, employees, and attorneys, and those persons in active concert or participation with them who receive actual notice of this Order, are preliminarily enjoined from enforcing or complying with S.B. 23 pending further Order of this Court… July 3, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Judge Blocks Ohio’s Near Total Abortion Ban in ACLU Case”. From the press release: A federal judge temporarily blocked an Ohio law that would have banned abortion as early as six weeks into pregnancy, before most women know they are pregnant. The American Civil Liberties Union (ACLU), the ACLU of Ohio, and Planned Parenthood brought the lawsuit on behalf of Preterm-Cleveland and other abortion clinics in the state. Senate Bill 23 was signed by Governor DeWine and was scheduled take effect this month.Ohio is one of more than seven states that have considered similar legislation so far this year. In addition to Ohio, the ACLU has challenged similar abortion bans in Kentucky and Georgia, a near total ban in Alabama, and an 18-week ban in Arkansas, among other litigation. Courts have already blocked identical measures in Kentucky and Mississippi. None of the bans are in effect, and abortion remains legal in all 50 states… July 3, 2019: Politico posted an article titled: “Appeals court takes up fresh challenge to Trump abortion ‘gag rule'”. It was written by Rachel Roubein and Renuka Rayasam. From the article: The full 9th U.S. Circuit Court of Appeals on Wednesday said it would take up a fresh challenge to the Trump administration’s overhaul of the federal family planning program just weeks after three of its Republican-appointed judges said the policy change can take effect nationwide while several legal challenges play out.The appeals court froze the administration’s rule revamping the Title X program while it hears the case, according to Brigitte Amiri, deputy director at the ACLU’s Reproductive Freedom Project.The court’s order marks the latest turn in a battle over the administration’s changes to the program, which seek to steer federal dollars away from providers such as Planned Parenthood that offer abortions and abortion referrals. Critics have dubbed the Trump policy a “gag rule”.The order covers several challenges to the rules, but it’s unclear whether they will be heard together or separately… July 3, 2019: The American Civil Liberties Union posted a press release titled: “Court Blocks Trump Administration’s Attempt to Gut Family Planning Program in Response to ACLU Lawsuit”. From the press release: The Ninth Circuit Court of Appeals restored a preliminary injunction today in the ACLU’s case against the Trump Administration’s efforts to roll back Title X, the nation’s family planning program. The decision blocks the implementation of the rule, which would have undermined the health care needs of four million low-income people each year, while the cases argued… July 3, 2019: Center for Reproductive Rights posted a press release titled: “Judge refuses to block Title X Rule in Maine, jeopardizing healthcare access for thousands of Mainers”. From the press release: U.S. District Court Judge Lance Walker today denied the Center for Reproductive Rights’ request to block the Trump Administration’s Domestic Gag Rule from going into effect in the state of Maine, jeopardizing the future of Maine Family Planning’s clinics across the state.In June 2019, on behalf of Maine Family Planning (MFP), the Center for Reproductive Rights made an emergency request to re-block the rule after a federal appeals court overrode lower court decisions that had previously blocked the rule from going into effect nationwide.Maine Family Planning is the state’s sole Title X grantee and the largest reproductive health care organization in Maine. With this ruling, 85% of abortion clinics in the state of Maine are in jeopardy…The Domestic Gag Rule Will:Force healthcare providers that receive federal funding like MFP to stop performing abortions, even though no federal funds are used to finance abortion.Prohibit doctors at these facilities from making referrals to abortion providers, even when the patient has already decided to have an abortion and directly asks for a referral.Force doctors to give all pregnant patients prenatal referrals, even when the patient doesn’t want one.Give Title X funding to non-medical organizations known as “crisis pregnancy centers,” which are designed to look like medical clinics but aim to deter women from getting abortions… July 3, 2019: The U.S. Court of Appeals for the Ninth Circuit posted its order on the case called State of California v. Alex M. Azar. It was written by Chief Justice Sidney R. Thomas. Upon the vote of a majority of nonrecused active judges, it is ordered that these cases be reheard en banc pursuant to Federal Rule of Appellate Procedure 35 (a) and Circuit Rule 35-3. The three-judge panel Order on Motions for Stay Pending Appeal in these cases shall not be cited as precedent by or to any court of the Ninth Circuit. Judges Graber, Christen, and Owens did not participate in the deliberations or vote in these cases. July 3, 2019: Delaware Online posted an article titled: “For the first time, Highmark looks to lower its Obamacare marketplace rates”. It was written by Meredith Newman. From the article: For the first time, Highmark BlueCross Blue Shield of Delaware is asking the state to decrease its Obamacare marketplace rates.Highmark, the only insurer on the Delaware Affordable Care Act marketplace, has proposed decreasing rates by 5.8 percent in 2020, officials said. This is expected affect about 20,000 residents.Previously, the insurer has increased rates in the double digits. Last year, rates increased by 3 percent, This decrease would only apply to Delawareans who are enrolled on the ACA marketplace, not those who have Medicaid, Medicare and private insurance… July 3, 2019: Oklahoma’s News 4 posted an article titled: “Oklahoma Medicaid Office: Update address or lose benefits”. From the article: Oklahoma’s Medicaid agency is warning its SoonerCare members to keep their current address on file with the agency or risk losing their health care benefits.The Oklahoma Health Care Authority sent out a public reminder Wednesday of the new rule that was signed by Gov. Kevin Stitt last week. The agency says it intends to launch outreach efforts through social media and through outbound phone calls to SoonerCare recipients after hours and on weekends.Agency officials say the rule is needed to comply with federal guidelines. But advocates for the poor have criticized the policy, saying low-income people move more frequently and that many members will be wrongfully cut from the programs… July 3, 2019: RappNews posted an article titled: “Free Clinic changes business model to accommodate expanded Medicaid program”. From the article: As of January 1, an additional 400,000 Virginians gained access to quality, low-cost health insurance through the state’s expanded Medicaid program.The enduring mission of the Fauquier Free Clinic (FFC) is to provide eligible residents of Fauqier and Rappahannock counties with access to comprehensive medical, dental and mental health care. This year, the clinic’s business model underwent extensive changes to accommodate new and existing patients when Medicaid expanded its services for low-income adults throughout Virginia……In Fauquier County alone, 1,700 to 1,800 people have become eligible for Medicaid insurance benefits. In Rappahannock County, 300 to 400 people are now eligible. Throughout the state of Virginia, eligibility has been granted to around 400,000 people.“Medicaid expansion was a great opportunity for the Commonwealth and Fauquier County to provide health insurance coverage for those most in need,” said FFC board member Gregory Bengston. “Changing our business model to ensure that clinic patients who were now Medicaid-eligible had continued access to health care services was a huge accomplishment”… July 3, 2019: The Middletown Press posted an article titled: “Appeals court puts Trump abortion restrictions on hold again”. It was written by Gene Johnson. From the article: Trump administration rules that impose additional hurdles for low-income women seeking abortions are on hold once again.The 9th Circuit Court of Appeals in San Francisco on Wednesday vacated a unanimous ruling from a three-judge panel and said a slate of 11 judges will reconsider lawsuits brought by more than 20 states and several civil rights and health organizations challenging the rules.Critics say the rules would force many clinics to find new locations, undergo expensive remodels or shut down……With [the three-judge panel’s decision] vacated, the injunction issued by the lower court judges are once again in effect. It’s not clear when new court arguments will be held.“We are profoundly grateful the preliminary injunction is back in place,” said Clare Coleman, president of the National Family Planning and Reproductive Health Association, which is involved in the cases… July 3, 2019: Senator Dick Durbin (Democrat – Illinois) posted a press release on his official website titled: “Durbin Calls On Congress To Protect And Strengthen The ACA, Not Undermine It”. From the press release: With health care advocates once again under attack, U.S. Senator Dick Durbin (D-IL) today stood with advocates and individuals who have been helped by the Affordable Care Act (ACA) to address the Trump Administration’s latest lawsuit seeking to dismantle the health law and call on Congress to strengthen the ACA, not undermine it. Next week, oral arguments will be head on Texas v United States – a lawsuit over the constitutionality of the entire ACA. If the Trump Administration and 20 Republican state Attorneys General (AGs) succeed, the ACA could be struck down, leaving tens of millions of Americans without health care or protections for pre-existing conditions.“Thanks to the Affordable Care Act, 20 million Americans gained health insurance, including more than one million people in Illinois,” said Durbin. “All of its important and life-saving protections will be gone if President Trump gets his way starting next week in court. I stand ready to work with my colleagues in Congress to protect and strengthen the Affordable Care Act.”After President Trump’s failed attempt to repeal the ACA two years ago, he turned to the courts to sabotage the health law. Last February, 20 Republican AGs filed a lawsuit over the constitutionality of the ACA – arguing that because the individual mandate penalty was zeroed out in the 2017 Republican tax law, the rest of the ACA should also be struck down.In December, a District Court judge in Texas sided with the Republican plaintiffs, and the case will go to the 5th U.S. Circuit Court of Appeals in New Orleans next week. If the Trump Administration and Republican AGs succeed, the entirety of the ACA could be struck down, meaning: Protections for people with pre-existing conditions would be eliminatedMillions would be kicked off MedicaidIndividual insurance markets and premium assistance would be eliminatedSeniors on Medicare would face increased prescription drug costsWomen could be charged more than men for health careYoung people would no longer have access to their parents’ insurance plan up to age 26Annual and lifetime caps on benefits could returnThere would no longer be guaranteed coverage for preventative screening and contraception services without deductibles or copaymentsThere would no longer be guaranteed coverage for mental health or addiction treatment services Since the ACA was signed into law in 2010, the uninsured rate in Illinois has fallen by 49 percent. More than one million uninsured Illinoisans now have health insurance thanks to Medicaid expansion and tax credits to purchase Exchange plans, and 90,000 young adults have health insurance by staying on their parents’ plans until age 26. Further, the approximately 5 million Illinois residents with pre-existing conditions now have protections against discrimination from insurance companies, and Illinois seniors have saved an average of more than $1,000 on their prescription drugs due to the ACA’s closing of the Medicare “donut hole” coverage gap.Last month the House of Representatives passed bi-partisan legislation, Protecting Americans with Pre-Existing Conditions Act, to prevent President Trump from allowing health insurance companies to discriminate against people with pre-existing conditions, yet Senate Majority Leader Mitch McConnell (R-KY) has refused to call up this legislation for a vote. The House has also advanced legislation to crack down on junk health plans and restore funding for insurance sign-ups and outreach. July 3, 2019: Kaiser Family Foundation posted information titled: “Explaining Texas v. U.S: A Guide to the 5th Circuit Appeal in the Case Challenging the ACA”. It was written by MaryBeth Musumeci. I highly recommend you read it want to understand more about that case. In this blog post, I will include only the “Looking Ahead” portion of the information. Oral argument is scheduled for 1:00 p.m. on July 9th, with 45 minutes to be shard among the state intervener-defendants and the House, and 45 minutes to be shared among the state plaintiffs, individual plaintiffs, and federal government. The case will be heard by a panel of three judges, including Judge Carolyn Dineen King (appointed by President Carter), Judge Jennifer Walker Elrod (appointed by President George W. Bush), and Judge Kurt D. Engelhardt (appointed by President Trump). There is no deadline by which the court must issue a decision, but it could come as early as fall 2019.If the court finds that the individual mandate is unconstitutional and invalidates only that provision, the practical result will be essential the same as the ACA exists today, as amended by the TCJA, without an enforceable mandate. If the court adopts the position that the federal government took during the trial court proceedings and invalidates the individual mandate as well as the protections for people with pre-existing conditions, then the federal funding for premium subsidies and the Medicaid expansion would stand, and it would be up to the states whether to reinstate the insurance programs.The most far-reaching consequences, affecting nearly every American in some way, will occur if the court decides that the entire ACA must be overturned. The number of non-elderly individuals who are uninsured decreased by 19.1 million from 2010 to 2017, as the ACA went into effect. The ACA made significant changes to the individual market, including requiring protections for people with pre-existing conditions, creating insurance marketplaces, and authorizing premium subsidies for people with low and modest incomes. The ACA also made other sweeping changes throughout the health care system including expanding Medicaid eligibility for low-income adults; requiring private insurance, Medicare, and Medicaid expansion coverage of preventative services with no cost sharing; phasing out the Medicare prescription drug “doughnut hole” coverage gap’ reducing the growth of Medicare payments to health care providers and insurers; establishing new national initiatives to promote public health, care quality, and delivery system reforms; and authorizing a variety of tax increases to finance these changes. All of these provisions could be overturned if the trial court’s decision is upheld, and it would be enormously complex to disentangle them from the overall health care system… July 5, 2019: The Jamestown Sun posted an article titled: “Number of abortions continues to slide in North Dakota”. It was written by John Hageman. From the article: The number of induced abortions performed in North Dakota slid for the fourth straight year in 2018, marking the lowest figure since recordkeeping began almost four decades ago, according to new state data.There were 1,141 induced abortions recorded in North Dakota last year, down slightly from 1,155 in 2017, according to state Department of Health reports. The agency began tracking abortion statistics in 1981.The state hit a record number of abortions in 1982 with 3,076.Tammi Kromenaker, the director of the state’s sole abortion clinic, the Red River Women’s Clinic in Fargo, cited Medicaid expansion and the Affordable Care Act’s contraceptive mandate, which the Trump administration has tried to roll back.“The (ACA) continuing to cover birth control, with no deductible and no co-pay, that is huge for so many families,” Kromenaker said Friday, July 5, noting that North Dakota is following a national trend in seeing abortion decline……The Red River Women’s Clinic recently joined the American Medical Association in filing a federal lawsuit against two North Dakota abortion laws they say will force doctors to misinform their patients and violate their medical ethics. That includes requiring physicians to inform patients it may be possible to revers a drug-induced abortion… July 5, 2019: San Francisco Chronicle posted an article titled: “California offers doctors student-loan help to treat underserved patients”. It was written by Elizabeth Aguilera. From the article: It’s a trade aimed at getting more doctors to treat poorer patients: California says it will help repay the student loans of 247 selected doctors in exchange for their promise that at least 30% of their caseload will be people enrolled in Medi-Cal.The $60 million student loan repayment, CalHealthCares, is funded by the state tobacco tax that voters increased three years ago.It’s all a part of California’s effort to increase the number of doctors who accept Medi-Cal, the state’s Medicaid health insurer of low-income residents, which has been plagued by shortages – due both to the state’s paltry rates for doctors in its provider network and to the substantial increase in the number of residents on Medi-Cal. California has one of the lowest Medicaid reimbursement rates in the country, and patients wait months, or longer, to see specialists.More than 1,300 doctors and medical residents applied for the benefit which provides up to $300,000 over five years, and those selected were chosen based on their commitment to treat the underserved, their geographic location and their specialities……Research indicates that debt is a major concern for physicians nationwide: a 2017 server by an affiliate of the American Medical Association found that half owed $200,000 or more in medical school loans……This is the first doctor group to receive funding from the $340 million fund created by Prop. 56 tobacco tax revenue. The state expects there will be at least five more rounds of awards.Later this summer, the state will announce awards for dentists who applied to participate in the loan repayment program for serving Denti-Cal patients. Information about that lawsuit can be found on the American Medical Association website. July 5, 2019: Idaho Press posted an article titled: Idaho seeks public comment on 2nd Medicaid waiver, for same purpose as 1st. It was written by Betsy Z. Russell. From the article: The Idaho Department of Health and Welfare is taking public comment on a new Medicaid expansion waiver, less than a week after the comment period on a related waiver closed.Both applications deal with people who earn between 100 percent and 138 percent of the federal poverty level. The intent is to give them the option to buy subsidized private health insurance through the state exchange, rather than shift to Medicaid. The agency announced the new waiver Wednesday, saying the move stems from conversations with the federal Centers for Medicare and Medicaid Services……The move stems from actions taken by the Idaho Legislature during the 2019 session. Rather than implement straight Medicaid expansion, as approved by voters, Republican lawmakers adopted a series of conditions and restrictions on the program. One of the conditions was that people in the 100 percent to 138 percent income category be given the choice to remain in the state exchange.Under current federal rules, people who qualify for Medicaid aren’t eligible for the tax credits that will help lower the cost of private insurance through the state exchange. Consequently, Idaho will need federal approval to enact the Legislature’s will… July 5, 2019: The Philadelphia Inquirer posted an article titled: “Medicaid enrollment growth driven by families working for large employers, CHOP study finds.” It was written by Sarah Gantz. From the article: Enrollment in Medicaid and CHIP, the Children’s Health Insurance Program, among children whose parents work full time and earn more than 100 percent of the federal poverty level grew significantly between 2008 and 2016, according to a new study by researchers at the Children’s Hospital of Philadelphia published this month in Health Affairs.Researchers found the growth was largely driven by families working for large private employers, where health insurance is a standard benefit – but an increasingly unaffordable one.Employer-sponsored health insurance is still the most common type of health plan for adults under 65 and their children. But employees are spending more and more out of pocket as their wages remain stagnant.As companies are strained by rising health-care costs, they are shifting more of the burden to their employees. Across the country, employees’ average share of a premium for family coverage increased 57 percent between 2008 and 2016, to $5,277, according to the Kaiser Family Foundation. Deductibles rose from $1,344 to $2,147 for a family during that period.A study by the Commonwealth Fund found that nearly 24 million people with employer health plans spend at least 10 percent of their income on premiums, out-of-pocket costs, or both.Meanwhile, Medicaid offers low-cost coverage and possibly more comprehensive benefits for eligible families who are finding that they can’t afford their employer health coverage, said David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia and a co-author of the Health Affairs study… July 8, 2019: The Texas Tribune posted an article titled: “Texas is going to court to end Obamacare. It hasn’t produced a plan to replace it.” It was written by Emma Platoff and Edgar Walters. From the article: Last year, after a federal judge in Texas declared the entirety of the Affordable Care Act unconstitutional, throwing into question millions of Americans’ health coverage, the state’s Republican leaders promised they would come up with a plan to replace it.But on Tuesday, a legislative session that seemed to have no room for issues other than property tax reform and school finance, Texas will ask a federal appeals court in New Orleans to end the law in its entirety – without offering a replacement plan.The conservative crusade against portions of the act, known as Obamacare, has spanned a decade. But Texas’ latest lawsuit, filed in February 2018, became an existential threat to the law after U.S. District Judge Reed O’Connor ruled in December that it is unconstitutional in its entirety. At stake: subsidized health coverage of roughly 1 million Texans, sweeping protections for patients with preexisting conditions, young adults staying on their parents’ insurance plans until age 26, and a host of low-cost benefits available to all people with health insurance, including those covered through their employers. Texas already has the highest uninsured rate in the nation……Attorneys for the state of Texas argue the health law cannot stand since the Republican-led Congress in 2017 zeroed out Obamacare’s individual mandate – a penalty imposed on people who choose to remain uninsured. Democrats had favored the penalty as a way to induce more people to purchase health insurance, with the goal of reaching near-universal coverage. Without it, Texas argues, the whole law must fall.But the state’s Republican leaders have offered few ideas about what should replace Obamacare, a law that touches practically every aspect of health care regulations and includes several popular protections for patients. Gov. Greg Abbott – a vocal critic of the law – pledged in December that if the law remained struck down on appeal, “Texas will be ready with replacement health care insurance that includes coverage for pre-existing conditions.”Since then, he’s been quiet on the issue, including during this year’s 140-day Texas legislative session… July 8, 2019: Planned Parenthood posted a press release titled: “Congress Blocks D.C. Abortion Ban in Spending Bill”. From the press release: The House of Representatives voted 224-196 to pass a spending bill that survived Republican efforts to include a provision to block District of Columbia residents with low incomes from accessing safe, legal abortion. The provision has been included in previous spending bills and in current law, and the fact that the House FY 2020 Financial Services and General Government Appropriations bill expands access to safe, legal abortion is in part due to the historic number of reproductive health champions in Congress. Unfortunately, the bill retains language in current law that prohibits federal employees and their dependents from purchasing insurance plans that cover abortion… July 8, 2019: Center for Reproductive Rights posted a press release titled: “Statement on Commission of Unalienable Rights”. From the press release: On Monday, July 8, Secretary Pompeo announced the creation of a Commission on Unalienable Rights, chaired by Professor Mary Ann Glendon, to advice on “human rights grounded in our nation’s founding principles” based on documents like the Declaration of Independence and the 1948 Universal Declaration of Human Rights (UDHR), for a term of two years.The following is a statement by Stephanie Schmid, U.S. Foreign Policy Council at the Center for Reproductive Rights, about the Commission:“The Commission is nothing less than a subterfuge for undermining reproductive rights and the rights of marginalized communities including LGBTQ persons.“Contrary to its asserted purpose, there is no need to redefine or develop foundational principles on human rights. There is a clear and unequivocal consensus by U.N. human rights treaty bodies and independent experts that reproductive rights are human rights, grounded in the right to life, health, equality, non-discrimination and freedom from cruel, inhuman, and degrading treatment, among other rights.“This new Commission is part of a comprehensive effort by this Administration to erase sexual and reproductive health and rights from global discourse. The State Department has deleted reporting on reproductive rights from its annual Country Reports on Human Rights Practices and the Center for Reproductive Rights currently has two lawsuits pending in the United States District Court for the District of Columbia challenging these cuts. In addition, this Administration has insisted on the elimination of sexual and reproductive health and rights protections from U.N. resolutions, sending a clear message that the United States does not care about the plight of women and girls, nor established international law.“We are also alarmed by reports that the State Department has not engaged in Congressional consultation in advance of creating this Commission and similar reports that there was no consultation or input from career human rights experts working in the State Department’s Bureau of Democracy, Human Rights, and Labor (DRL). Indeed, this Commission appears to be an attempt to circumvent the State Department’s foreign policy and human rights experts in an effort to pick and choose which rights the United States will respect and promote. This redundant and duplicative Commission is a waste of tax-payer resources, which the House of Representatives recognized when it passed H.R. 2740 which included a provision explicitly prohibiting funds being allocated to this Commission.“This unnecessary Commission will further compound the Administration’s disengagement, deprioritization, and rollback of human rights and further cede the United States’ leadership in advancing the full spectrum of human rights protections within the United States and globally.” July 8, 2019: Planned Parenthood posted a press release titled: “State Department Attempts to Redefine Human Rights In Order to Violate Them”. From the press release: Today, the U.S. Department of State rolled out the Commission on Unalienable Rights, with the stated objective of “promotion of individual liberty, human equality, and democracy through foreign policy.” As outlined by Secretary Pompeo, the intent of the commission is to redefine human rights according to what he calls “America’s founding principles.” The commission is stacked with advisors who have long records arguing against reproductive rights – including access to safe, legal abortion – and against rights for LGBTQ communities, including Chair Mary Ann Glendon, a prominent anti-abortion activist.Statement from Dr. Leana Wen, President, Planned Parenthood Global:“The Trump-Pence administration’s new sham commission should be seen for what it really is: an attempt to narrowly redefine human rights in order to violate them. At at time when this administration is attacking reproductive rights, rolling back LGBTQ rights, and detaining children and families under horrific conditions, this commission is nothing more than a thinly veiled attempt to unconscionably exclude specific groups from legal protections. The U.S. should be leading the charge to protect and defend human rights, not undermining them for political gain.” July 8, 2019: Xavier Becerra tweeted: “The entire #ACA is at risk. In less than 24 hours, my team will be in court defending healthcare for millions of Americans just like Anna and her family. #ProtectOurCare”. The tweet includes a thread of tweets by Anna. July 9, 2019: New York Attorney General Letitia James tweeted: “!! Today we’re in court to defend the #ACA & #ProtectOurCare because the health & safety of millions of Americans is at risk. Access to quality & affordable healthcare is a basic right. Rolling back the clock is dangerous & irresponsible. We’re ready to fight.” July 9, 2019: CNBC posted an article titled: “Health-care stocks fall ahead of court arguments over constitutionality of Obamacare”. It was written by Berkeley Lovelace Jr. From the article: Health-care stocks fell Tuesday ahead of a legal showdown between the Trump administration, a group of Republican-led states and more than a dozen Democratic state attorneys generals over the constitutionality of the Affordable Care Act before the U.S. 5th Circuit Court of Appeals in New Orleans……Shares of insurers UnitedHealth, Cigna and Humana were down more than 1% in early afternoon trading. Shares of HCA Healthcare, the largest for-profit U.S. hospital operator, and Tenet Healthcare were down 2% and 3%, respectively. Community Health Systems was falling by more than 7%… July 9, 2019: Planned Parenthood posted a press release titled: Court Hears Challenge to Affordable Care Act, Risking Health Care for Millions”. From the press release: The U.S. Court of Appeals for the 5th Circuit will hear oral arguments in Texas v. U.S., a case that seeks to strike the Affordable Care Act (ACA) in its entirety, putting access to health care for millions at risk. Under the ACA, 20 million people gained health care coverage and more than 62 million women have gained coverage for preventable services with no out-of-pocket costs, including birth control, STI screenings, breast cancer screenings, and Pap tests……Gutting the ACA would threaten the health and financial security of millions of people:More than 62 million women now have access to no-copay preventative services, including birth control, STI screenings, and life-saving preventative services such as breast cancer screenings and Pap tests.Under the ACA, women of color are able to access better preventative care, a step forward in leveling the playing field for communities the have faced years of discriminatory policies that result in poor health outcomes.Financial assistance to purchase health insurance could be eliminated, threatening millions’ access to private insurance coverage, and coverage for the 12 million people who receive coverage under the ACA’s expansion of Medicaid is also threatened.Prior to the ACA, routine women’s health conditions were considered pre-existing conditions, including pregnancy.The Affordable Care Act eliminate “gender rating,” ensuring women do not pay an estimated $1 billion more annually than men for the same health care. July 9, 2019: Representative Joe Kennedy III tweeted: “This is what the Trump Admin is arguing in court today: – Health care is a privilege – Preexisting conditions can be disqualifying – Low-income patients can’t be treated – Addiction treatment can’t be covered – This nation is too weak to care for all its citizens #ProtectOurCare.” July 9, 2019: CBS News posted an article titled: “Judges have tough questions for Obamacare backers”. From the article: The fate of former President Obama’s signature health care law, and its coverage and insurance protections for millions of Americans, was again being argued before a panel of judges – this time a federal appeals court in New Orleans.Attorneys for states hoping to save President Obama’s health care law were hit with some intense and occasionally skeptical questioning from appellate judges in a New Orleans federal court.The main issue in Tuesday’s hearing was whether Congress rendered the entire Affordable Care Act unconstitutional when it zeroed out the tax imposed people who don’t buy health insurance.The law’s supporters say Congress clearly didn’t want “Obamacare” dismantled when it eliminated the tax in 2017. And they said the tax elimination doesn’t destroy the whole law.But appellate judges Kurt Engelhardt and Jennifer Walker Elrod both noted the law still says people must buy insurance. They questioned whether that command now violates the Constitution. Engelhardt also suggested Congress, not the courts, should choose which parts of the law should be salvaged… July 9, 2019: Senator Patty Murray tweeted: “ICYMI: Here’s what is at risk today because of the lawsuit being brought by Representatives to undermine families’ health care:” The tweet includes a link to a Seattle Times opinion piece from June of 2019. July 9, 2019: Politico posted an article titled: “Appeals court skeptical Obamacare can survive”. It was written by Paul Demko. From the article: A panel of federal appeals judges aggressively questioned whether Obamacare can survive during Tuesday afternoon oral arguments in a case that could upend the 2010 health care law.Two Republican appointees on the three-judge panel frequently interrupted attorneys to question whether the Affordable Care Act’s individual mandate is unconstitutional and if not whether the entire law could stand without it. The ACA’s future appeared murky after two hours of oral arguments at the 5th Circuit Court of Appeals, but it’s not clear if the judges were ready to uphold a federal judge’s earlier decision invalidating the law……Appellate Judge Jennifer Elrod, a George W. Bush appointee, on Tuesday posited that lawmakers – who failed to agree on an Obamacare replacement plan two years ago – deliberately eliminated the mandate penalty because they knew the rest of the law would have to fall. She said perhaps lawmakers thought, “Aha, this is the silver bullet that’s going to undo Obamacare.”Attorneys for the 20 Democratic-led states that are defending the law, as well as the Democratic-controlled House, countered that Congress clearly intended for the rest of the law to survive when it eliminated the mandate penalty.“All the court has to do is lookout the text,” said Samuel Siegel, the attorney representing the Democratic-led states.The three-judge appellate panel is expected to rule in the coming months. They could back the lower court ruling invalidating all of Obamacare or overturn it entirely. The judges may also determine that the elimination of the individual mandate penalty only renders certain parts of the ACA unconstitutional, such as its protections for individuals with preexisting medical conditions. That was the Trump administration’s original stance on the lawsuit before recently embracing the lower court ruling against the entire ACA… June 9, 2019: California Governor Gavin Newsom tweeted: “The Trump administration is going to court today to try and overturn the ENTIRE Affordable Care Act. – 133 MILLION with pre-existing conditions could lose coverage. – 23 MILLION could lose their health insurance – 12 MILLION could lose Medicaid coverage” The tweet included a link to The New York Times from March of 2019. June 9, 2019: Former Vice-President Joe Biden tweeted: “Today, the Affordable Care Act is back in the courts – putting the health care of millions of Americans at risk. It’s clear some will stop at nothing to sabotage Obamacare and roll back the progress we’ve made.” The tweet included a link to The New York Times. July 9, 2019: The New York Times posted an article titled: “Appeals Court Seems Skeptical About Constitutionality of Obamacare Mandate”. It was written by Abby Goodnough. From the article: …In 90 minutes of oral arguments on whether a federal district judge in Texas was correct in striking down the Affordable Care Act in December, two appellate judges appointed by Republican presidents peppered lawyers with blunt questions while the third judge, appointed by President Jimmy Carter, remained silent.The two Republican appointees, Jennifer Walker Elrod, appointed by President George W. Bush in 2007, and Kurt Engelhardt, appointed by President Trump in 2018, seemed particularly skeptical of the Democratic defendants’ argument that Congress had fully intended to keep the rest of the law when it eliminated the penalty for going without insurance as part of its 2017 tax overhaul……The case, which could make its way to the Supreme Court ahead of those elections, threatens insurance protections for people with pre-existing medical conditions and many other sweeping changes the 2010 law has made throughout the health care system……The arguments did reveal some tensions between the Republican states that brought the case, led by Texas, and Mr. Trump’s Justice Department. For example, a lawyer for Texas took issue with a puzzling new Justice Department position – revealed in a May brief – that the ruling should apply to only the 18 plaintiff states, not nationwide. The Republican states would need to evaluate if they had “been the victims of a bait and switch,” said the Texas lawyer, Kyle D. Hawkins.In another wrinkle, August E. Flentje, a lawyer for the Justice Department, appeared reluctant to answer questions from Judge Elrod about how applying the ruling only to the plaintiff states would work. He was also vague about another new and surprising position the administration mentioned almost in passing in its May brief: that some pieces of the health law, though not its insurance provisions, should be preserved….…Over all, though, the panel spent the most time on the question of whether the rest of the law should fail if Judge O’Connor was correct in scrapping the insurance mandate – and Judge Elrod and Judge Engelhardt, based on their questioning, seemed to firmly believe he was. Judge Engelhardt asked Mr. Letter, the House lawyer, why Congress could not remedy the situation by writing a new health law or set of laws.“The could do this tomorrow, ” Judge Engelhardt said, leading Mr. Letter to dryly point out that Mr. Trump would need to sign off on new laws, too.“And obviously the president would sign this, right?” he asked sardonically. “No, obviously not.”..…Judge Engelhardt twice asked Mr. Letter why, if Congress fully intended to keep the rest of the health law when it eliminated the penalty for going without insurance in 2017, the Senate, which is controlled by Republicans, had not also sent a lawyer to make that case.“Why would the Senate not be here to say, ‘Oh, this is what we meant when we wrote this?” he asked. “They’re sort of the 800-pound gorilla that’s not in the room.”..…The appeals panel also spent a good chunk of the allotted 90 minutes asking questions on a third topic: whether the Democratic states and House of Representatives even have standing to appeal Judge O’Connor’s ruling……If the appeals court ultimately decides that neither the House nor the intervening Democratic states have standing, it could either let Judge O’Connor’s ruling stand or vacate it. In any event, the losing party will almost certainly appeal to the Supreme Court… July 9, 2019: Julián Castro tweeted: “The Trump administration is actively working to undermine our health care system and jeopardize the coverage of 130 million Americans with pre-existing conditions. We must #ProtectOurCare and work to expand, not restrict, access to quality health care.” The tweet included a link to The New York Times article above. July 9, 2019: Beto O’Rourke tweeted: “We will defend the ACA. We will protect the care of those whose lives depend on it. And we will fight for universal, guaranteed, high-quality health care so every person can see a doctor, afford their prescriptions, and to live to their full potential.” The tweet included a link to The New York Times article above. July 9, 2019: Governor Jay Inslee tweeted: “800,000 people who have healthcare coverage in WA state are at risk if the Affordable Care Act is struck down. The #ACA has saved lives, strengthened consumer and patient protections for everyone, and is keeping costs from growing unabated. #ProtectOurCare”. The tweet included a link to The New York Times article above. July 9, 2019: Pete Buttigieg tweeted: “Republicans are putting health care for over 20 million Americans in jeopardy with their latest attack on the Affordable Care Act. Instead of restricting access, we should be expanding health care with Medicare for All Who Want It.” The tweet includes a link to an NPR article. July 9, 2019: Elizabeth Warren tweeted: “The Trump administration is in court today in their never-ending crusade to destroy health care for millions of Americans. If they succeed, families like Chantel’s would go bankrupt. People would die. #ProtectOurCare.” The tweet includes a video featuring Chantel and her family. July 9, 2019: Nancy Pelosi tweeted: “Under the ACA, the 130 million Americans w/ pre-existing conditions cannot be discriminated against y their insurer. Their health care costs could skyrocket if the GOP’s Texas v. US lawsuit succeeds in throwing out years of progress on health care. #ProtectOurCare”. July 9, 2019: Speaker of the House Nancy Pelosi posted remarks on the official Speaker of the House website titled: “Pelosi Remarks at Press Conference on Day of Oral Arguments in GOP’s Texas v. U.S. Lawsuit to Destroy Health Care”. From the remarks: …Today, the Trump Administration is demanding that the court strike down every last provision of the ACA. Protecting protections for the over 130 million Americans with pre-existing conditions and their families, bans on lifetime and annual limits, as the Leader mentioned, that can have a very devastating impact financially, as well as health-wise, for a family. The Medicaid expansion in the ACA, very important to people born with a pre-existing condition, babies born with a pre-existing condition and families otherwise, savings for seniors on prescription drug cost, the premium assistance that makes health coverage affordable for millions of American families.As you all know, the Affordable Care Act extended benefits to 20 million people who did not have health care before and that was very important – a major achievement in itself, but that was not the full extent of the bill.130 million Americans have pre-existing conditions and they are affected by this law case. And, what’s interesting about it is during the campaign, across the country, Republicans were saying, “We’re for preserving the pre-existing medical conditions [protections]” and yet they vote over and over again to prevent it and now they’re taking it to court.And, the reason they think they have a chance in court is because of what they did on the horrible GOP Tax Scam bill, where they undermined the Affordable Care Act there. Every chance they get, they try to undermine the health and financial security of America’s working families.The ACA is a pillar of health and economic security, standing alongside Medicare, Medicaid, and Social Security. But the GOP is showing that they want to destroy the Affordable Care Act for America’s families……But more than 190 Republicans that day voted to be fully complicit in the Administration’s attempt to tear away health care protections. Families across the nation have called on Congress to ‘Protect Our Care’ and House Democrats are fighting for them……Democrats will continue to fight For The People to lower health care costs and the cost of prescription drugs and to protect people with pre-existing conditions… July 9, 2019: Representative Jerry Nadler tweeted: “Today the Trump Admin is arguing to strike down the entire ACA, turning their back on millions with preexisting conditions. @HouseJudiciary is committed to fighting this GOP assault, and will hold a hearing on the DOJ’s refusal to defend the ACA this month #ProtectOurCare”. The tweet included a link to an NPR tweet. July 9, 2019: Covered California posted a news release titled: “California’s Initiatives Will Lead to Hundreds of Thousands Gaining Health Care Coverage With Lower Premiums and New Financial Help”. From the news release: California’s individual market will see a preliminary rate change of 0.8 percent in 2020, which is the lowest change since Covered California’s launch, due to new state affordability initiatives designed to lower costs and encourage enrollment.An estimate 922,000 people – including many middle-income Californians – will be eligible from a first-in-the-nation expansion of financial help that builds on the Affordable Care Act and lowers the costs of their health care coverage.Covered California projects that lowering health care costs and reinstating the penalty on individuals who can afford coverage, yet choose to go without insurance, will result in 229,000 people becoming newly covered.All 11 health insurance companies return to the market in 2020, and a major national plan, Anthem Blue Cross, with expand – giving nearly all Californians a choice of two carriers, and 87 percent able to choose from three carriers or more.A Covered California analysis projects that an estimated 922,000 will be eligible for the new state subsidy program that will help lower the cost of their coverage in 2020. The consumers who are projected to benefit from the new state subsidies are:An estimated 235,000 middle-income Californians who previously did not qualify for financial help because they exceeded federal income requirements. They will be eligible to receive an average of $172 per household per month, which will help them save an average of 23 percent off their current premiums. Many of these consumers, particularly those who live in high-cost regions, will see significant savings and annual reductions in their health care premiums in the hundreds or even thousands of dollars.An estimated 663,000 Covered California enrollees who currently receive federal financial help. They will be eligible to receive an average of an additional $15 per household per month which will help them save an average of 5 percent on their current premiums.An estimated 23,000 Covered California enrollees whose annual household income falls below 138 percent of the federal poverty level (FPL), which is less than $17,237 for an individual and $35,535 for a family of four. They will see their premiums for the benchmark plan lowered to $1 per member, per month. July 9, 2019: Los Angeles Times posted an article titled: “With Obamacare in peril, California reins in rising health insurance premiums”. It was written by Barbara Feder Ostrov and Ana B. Ibarra. From the article: Premiums on California’s health insurance exchange will rise by an average of 0.8% next year, the lowest increase in the agency’s history, state officials announced Tuesday.Covered California Executive Director Peter Lee credited two new statewide initiatives for keeping the proposed rate hikes low: Next year, California will be the first state in the country to offer state-funded tax credits to middle-class enrollees, which will be paid for in part by a new tax penalty on Californians who don’t have health insurance……Covered California estimates that the state-based tax credits, in conjunction with the new state tax penalty, will result in 229,000 newly insured Californians.The average rate hike for 2020 is far lower than this year’s average increase of nearly 9% and the five-year average increase of 8.4%. Covered California began offering health plans in 2014 to individuals and families who purchase their own insurance as part of the state’s implementation of the Affordable Care Act, a.k.a. Obamacare……The new individual mandate for Californians starts in 2020. The penalty for not having insurance will mirror the one under the Affordable Care Act, which as $695 per adult (and $347.50 per child under 18) or 2.5% of annual household income, whichever is greater. That can amount to thousands of dollars a year.The revenue from the penalty, plus other state funds, will help pay for state-based tax credits for roughly 922,000 people who purchase insurance through Covered California. As part of the 2019-20 state budget signed by Gov. Gavin Newsom last month, the state will pledge $1.45 billion over the next three years for this effort.Under the deal, California will become the first state to offer financial aid to middle-income enrollees who make between 400% and 600% of the federal poverty level – many of whom have been struggling to pay their premiums. That’s between about $50,000 and $75,000 a year for an individual and between about $103,000 and $154,500 for a family of four.Under the Affordable Care Act, people who purchase plans through Covered California and other health insurance exchanges are eligible for federal tax credits only if they make between 138% and 400% of the federal poverty level. People who earn more than 400% of the federal poverty level get no federal aid… July 9, 2019: Concord Monitor posted an article titled: “Sununu to sign Democrat-backed safeguards to Obamacare provisions”. It was written by Ethan DeWitt. From the article: Gov. Chris Sununu is poised to sign a Democratic bill that would protect certain portions of the Affordable Care Act by codifying them into state law, his office said.On Tuesday, Democratic legislative leaders in Concord sent a bill to Sununu that would add a range of provisions into state statute, including a requirement that health insurance plans cover those with pre-existing conditions.The move comes as a New Orleans federal court takes up oral arguments over the constitutionality of the Affordable Care Act – a high stakes case that threatens funding as well as regulations within the law……Senate Bill 4 would add to state law a mandate that insurance plans also cover a range of “essential health benefits” such as coverage for emergency services, maternity care, and rehabilitative services. And it would prevent the re-emergence of lifetime caps on age or expenses for those on certain insurance plans.Those protections were introduced into federal law by the ACA in 2010 – also known as “Obamacare” – which has faced opposition and legal challenges by several Republican attorneys general and supported by the U.S. Department of Justice……For Sununu, support for the bill puts him odds with some in his party. While SB 4 passed the Senate nearly unanimously, it left the House on party lines, after House Republicans argued it would tie the state’s hands in the event the ACA did fall and big decisions needed to be made… July 9, 2019: The Catholic Health Association of the United States (CHA) posted a news release titled: “CHA Strongly Urges Upholding The ACA In Texas v. United States”. From the news release: CHA Strongly Urges Upholding the ACA in Texas v. United StatesStatement by Sr. Mary Haddad, RSM, President and Chief Executive Officer, Catholic Health Association of the United StatesAs the U.S. Court of Appeals for the Fifth Circuit considers the constitutionality of the Affordable Care Act (ACA), the Catholic Health Association of the United States (CHA) stands firmly with those defending the law. CHA joined with four hospital organizations earlier this year in filing a brief as amici curiae in support of the Intervenor-Defendants-Appellants in Texas v. United States.“We believe health care is a basic human right and the effort to eliminate access to affordable health care coverage for millions of Americans is unconscionable,” stated Sr. Mary Haddad. The consequence of being uninsured are significant. Since uninsured patients are often forced to delay receiving necessary care, they are up to four times more likely than insured patients to require affordable hospitalization and emergency care. In addition to being harmful to patients’ health, the lack of coverage adds unnecessary expense to our nation’s health care system and deprives patients with an equitable opportunity for a healthy, productive life.Under the ACA, we as a nation have taken significant steps toward expanding health care access and coverage, as well as improving our nation’s health care delivery system. Nearly 20 million Americans have gained affordable insurance coverage, including 12 million low-income individuals who have gained coverage through state Medicaid program expansions under the ACA. The law also provides protections for 130 million people with pre-existing health conditions – including 17 million children – all of whom no longer need to worry that they will be denied insurance coverage.CHA believes that a decision by the Fifth Circuit to strike down the ACA as unconstitutional, if upheld, would reverse the progress we have made, adversely impacting the health of millions of Americans. We believe, as a matter of human dignity, everyone is entitled to health care. Like any basic element of life, health care sustains us and should always be accessible and affordable for everyone – where they need it, when they need it, no exceptions and no interruptions. CHA will continue to work with policy makers to advance the goal of ensuring everyone has access to affordable health coverage and high-quality health care. July 9, 2019: Daily Memphian posted an article titled: “Pastors urge Lee to request Tennessee drop from Affordable Care Act lawsuit”. It was written by Sam Stockard. From the article: With arguments set Tuesday in a lawsuit to dismantle the Affordable Care Act, a network of pastors is urging Gov. Bill Lee to request Tennessee drop out of the federal case.The Southern Christian Coalition made a public appeal for the governor to call on Attorney General Herbert Slatery to remove the state from Texas v. United States. The case is to be argued in the U.S. Fifth Circuit Court of Appeals in New Orleans, and its next stop would be the U.S. Supreme Court.“I appeal to Gov Lee, as a man of faith and a man of Christian values, to then live up to his values, to care for the least of these, to be compassionate… and to ask Slatery to remove the state of Tennessee from this lawsuit,” said Kelli X, minister of Village Church in Madison.She argued dismantling the Affordable Care Act would take health care coverage from more than a million Tennesseans, decreasing the number of people able to seek mental health care, possibly causing them to wind up in prison and limiting access to health care for babies born with health problems such as asthma……The group points out no plan is in place to provide health care for Tennesseans with preexisting conditions if the law is overturned… July 9, 2019: Roll Call posted an article titled: “States grapple with Medicaid work requirements”. It was written by Sandhya Raman. From the article: State action to implement work requirements into their Medicaid programs is heating up, as some states roll out their programs while others are fighting in court to keep them alive.New Hampshire announced Monday it would delay suspending any Medicaid coverage until September because of consumers’ noncompliance with the work requirements. Meanwhile, Indiana on July 1 began the first steps of implementing its work requirements. Court action in three other states is expected in the coming months,The path to implementing requirements for work or other forms of community service through Medicaid, the health program that covers some of the nation’s poorest individuals, has been tricky and controversial.MaryBeth Musumeci, associate director at the program on Medicaid and the uninsured at the nonpartisan Kaiser Family Foundation, said the overarching issue is whether requiring work is a permissible objective of Medicaid coverage……A June study published in the New England Journal of Medicine found that work requirements are not increasing employment and private insurance coverage……Arkansas was the first state to incorporate 80 hour per month work requirements in 2018 for some enrollees, but these are no longer in effect due to a circuit court ruling this year.New Hampshire became the second state to start phasing in slightly stricter requirements but recently changes them. Starting in June, individuals were supposed to work 100 hours per month, and enrollees would have had until July 7 to report their June hours or risk suspension later this year. Pregnant women and people who are medically frail or have a disability were exempted.But in late June, New Hampshire’s Democratic-controlled legislature passed a compromise scaling back the work requirements and expanding the exemptions. The legislation allowed the New Hampshire Department of Health and Human Services to delay implementation……Indiana rolled out its 20 hours per month requirements on July 1, with stricter requirements being phased in over time. Unlike in Arkansas, compliance is evaluated yearly rather than monthly.Last year, Arkansas terminated consumers’ coverage after three months of noncompliance, resulting in almost 17,000 individuals being dropped from the program……Wisconsin and Michigan are the next states slated to roll out work requirements in late October and January, respectively. Both states also have New Democratic governors.Maine, which also has a New Democratic governor this year, will not implement its work requirements, but it may not be as simple for Wisconsin and Michigan to reverse course……The next legal action expected is for New Hampshire’s program, which will be heard in the U.S. District Court for the District of Columbia.U.S. District Judge James Boasberg, an Obama appointee who previously ruled that both Arkansas and Kentucky’s programs were invalid, is scheduled for the case……Both the Kentucky and Arkansas cases are set to be heard by the U.S. Court of Appeals for the District of Columbia Circuit. The states’ briefings end Aug. 1, and oral arguments are expected by October… July 9, 2019: Des Moines Register posted an article titled: “ACLU says judge should block Iowa law that could limit Medicaid coverage for transition-related care”. It was written by Anna Spoerre. From the article: A judge is expected to rule within the next week on a bid to temporarily block an Iowa law that denies mandatory Medicaid coverage to transgender Iowans for transition-related care. Polk County District Judge David Porter heard arguments Tuesday from the American Civil Liberties Union of Iowa that the law is both discriminatory against and betrays an animus toward transgender individuals……The ACLU of Iowa in May sued to block legislation passed in April that allows government entities to opt out of using public insurance money, including Medicaid, to pay for transition-related surgeries. It was filed on behalf of two transgender Iowans – Mika Covington of Central Iowa and Aiden Vasquez of southeast Iowa – and the LGBTQ advocacy group One Iowa.Added to the health budget bill, the provision allows any state or local government unit or tax-supported district to decline to use public funds for “sex reassignment surgery” or “any other cosmetic reconstructive or plastic surgery procedure related to transsexualism, hermaphroditism, gender identity disorder or body dysmorphic disorder.”The law was passed after the Iowa Supreme Court in March ruled that a different ban on using Medicaid funds for transition-related care violated the Iowa Civil Rights Act. The new legislation, in turn, amended the Civil Rights Act.The lawsuit in question now says the new Medicaid provision runs afoul of the Iowa Constitution. The state Supreme Court did not address that question in its March ruling… July 9, 2019: Deseret News posted an article titled: “Utah leaders react to the uncertain fate of the Affordable Care Act”. It was written by Kim Bojouquez. From the article: Utahs are watching closely as the future of the Affordable Care Act is considered by three judges on the other side of the country.A three-judge panel, two Republican-appointed and one Democrat-appointed, from the U.S. Court of Appeals for the 5th Circuit in New Orleans, heard oral arguments on the constitutionality of the Affordable Care Act, also known as Obamacare, on Tuesday.In February 2018, Utah Attorney General Sean Reyes joined a 20-state coalition lawsuit against the federal government challenging the lawfulness of the health care law and calling it unconstitutional, after Congress repealed a provision that people without health insurance had to pay a fine……Lauren Simpson, policy director for Alliance for a Better Utah, a government advocacy and watchdog organization, said it’s too soon to tell where the judges will lean.“This is something that’s going to have really serious consequences for Utah. It directly contradicts what we know Utahs want,” Simpson said.Last November, Utahns voted in support of Proposition 3 to expand Medicaid coverage in the state. But in February, Gov. Gary Herbert signed a replacement to limit Medicaid expansion… July 10, 2019: Des Moines Iowa Register posted an article titled: “Iowa agrees to give Medicaid management companies 8.6% raises”. It was written by Tony Leys and Stephen Gruber-Miller. From the article: Iowa’s controversial use of private insurers to run its Medicaid program just got $386 million more expensive.That’s how much more state and federal money Iowa officials have agreed to pay through this fiscal year for two national companies to manage the giant health care program.The 8.6% raises will go to Amerigroup and Iowa Total Care, which Iowa hired to insure about 575,000 poor or disabled Iowans whose health care is covered by Medicaid……The Medicaid program is jointly financed by federal and state tax dollars, with rates set in closed-door negotiations between the companies and the Iowa Department of Human Services. The increased costs announced Wednesday include a 6.5% boost in state financing, which translates to $115 million, according to a summary posted by Iowa DHS.The new terms come a year after DHS officials agreed to give Amerigroup and UnitedHealthcare, then the state’s Medicaid managers, a raise of 8.4% in state and federal money for fiscal year 2019. That year’s raise amounted to $344 million, including $103 million more in state money. As a result, legislators had to come up with more money last spring, in the middle of the budget year… July 10, 2019: The Salt Lake Tribune posted an article titled: “Utah health care panel objects to state’s partial Medicaid expansion plan”. It was written by Benjamin Wood. From the article: Most members of Utah’s Medical Care Advisory Committee oppose the state’s plan to partially expand Medicaid through the imposition of service reductions, spending and enrollment caps, and patient work requirements.Ten of the advisory committee’s 19 members – who are appointed by Utah health care entities – signed on to a June 30 letter addressed to the state Department of Health asking local and national administrators to reject proposed changes to Utah’s Medicaid program, which “could risk the health and security of many Utah beneficiaries.”……The advisory committee’s objections were made as part of the public comment for a waiver that Utah is seeking from the federal government to implement a scaled-back version of Medicaid expansion approved by lawmakers earlier this year. The Legislature’s plan, SB96, replaced Proposition 3, a full Medicaid expansion initiative approved by voters last year that would have extended Medicaid services to tens of thousands of additional low-income Utahns.In its letter, the advisory committee highlights four areas of concern with Utah’s waiver request: a per-capita funding scheme that could leave the state liable for increased health care costs without matching federal funds; enrollment caps that could exclude otherwise eligible patients from Medicaid if funding runs dry; a requirement that patients prove they are working, looking for work or engaged in other qualifying activities to participate in Medicaid; and the elimination of some Medicaid benefits for 19- and 20-year-old patients……Last month, the Utah Health Policy Project released a report suggesting that per-capita funding could cause Utah’s Medicaid program to face a $39 million budget shortfall by 2024. Budget constraints were among the primary motivations cited by lawmakers in repealing and replacing Proposition 3 with the scaled-back expansion of SB96 intended to control costs……Utah’s Medicaid program currently is operating under a temporary waiver, often referred to as the “bridge” plan, which includes a limited expansion population and approval for work requirements, but those work requirements have not yet been implemented… July 11, 2019: Planned Parenthood posted a press release titled: “Ninth Circuit Denies Emergency Relief From Domestic Gag Rule”. From the press release: An en banc panel of the U.S. Court of Appeals for the 9th Circuit refused to block the Trump-Pence administration from enforcing the dangerous Title X gage rule. Title X is the nation’s program for affordable birth control and reproductive health care, which serves 4 million people each year. Trump’s gag rule makes it illegal for health care providers in the Title X program to refer patients for abortion, and also blocks access to care through the program at Planned Parenthood by imposing cost-prohibitive and unnecessary “physical separation” requirements. Planned Parenthood will continue its effort to restore the nationwide preliminary injunction and fight to protect health care for millions across the country.Providers that serve nearly half of the patients who get care through Title X have made it clear that the rule would force them out of the program – the administration is putting health care at risk for millions of patients across the country. Title X helps millions of patients struggling to make ends meet – the majority of whom are people of color, Hispanic, or Latino – access birth control, cancer screenings, STI testing, and other essential reproductive health care……Four district court judges had previously blocked the rule, with two judges blocking it nationwide. On June 20, 2019, the 9th Circuit granted the request from the Trump-Pence administration to stay the preliminary injunctions in California, Oregon, and Washington, which allowed the gag rule to be enforced. The 9th Circuit agreed to re-hear the administration’s request for a stay on July 3, 2019. Today’s order makes it clear that while the court is rehearing the request for the stay, the stay remains in place, jeopardizing the care of millions of people who access birth control and other reproductive health services through Title X.In June, the House of Representatives passed a spending package including strong language blocking the Trump-Pence administration’s Title X gag rule from being implemented. Now, the Senate must push for a spending bill that includes protective language to make sure millions of people can continue to access health care through Title X… July 11, 2019: Rewire News posted an article titled: “Republicans Get Another Win in Their Fight to Gut Title X”. It was written by Jessica Mason Pieklo. From the article: The Ninth Circuit Court of Appeals on Thursday ruled the Trump administration’s domestic “gag rule” which bans family planning dollars from going to health-care providers who perform abortions or refer patients for abortion services, can take effect everywhere but the state of Maryland.The ruling jeopardizes comprehensive reproductive health-care for nearly 4 million people……The Trump administration’s changes to the Title X program also mandate a new “physical and financial separation” between a Title X-funded program and a facility that engages in “abortion activities.” This separation must include separate waiting, consulting, examination, and treatment rooms, as well as office entrances and exists. Title X grantees would have to provide different phone numbers and email addresses for those staff members and facilities involved in abortion services. These separation requirements apply to all Title-X funded projects that give referrals to patients who wish to obtain an abortion, as well as any that engage in separately funded advocacy or public education activities that “promote” abortion as determined by the Trump administration.To obtain Title X funding, providers would have to open and operate an entirely independent facility to merely provide a referral for abortion care……First proposed in May of 2018, the administration’s changes had been blocked by the courts from taking effect while lawsuits challenging them proceed. Thursday’s order, however, allows those changes to take effect immediately, except for the separation requirements: Title X grantees will have until March 4, 2020, to comply with those requirements… July 11, 2019: Los Angeles Times posted an article titled: “Trump’s vaunted kidney initiative depends on Obamacare, which he’s trying to kill”. It was written by Michael Hiltzik. From the article: President Trump was showered with praise Wednesday when he unveiled an initiative to fix the country’s wretched and ridiculously expensive system for dealing with kidney disease.Only one problem. Trump’s plan depends on the Affordable Care Act, which he is trying to kill……He has eviscerated effective programs at the Department of Health and Human Services and replaced professional policy officials with ideology-driven hacks. His appointees at HHS have routinely approved state-level changes to Medicaid, the nation’s most important healthcare program for low-income Americans, that deprive enrollees of coverage by thousands at a time……There’s no question that the nation’s existing method of dealing with end-stage kidney disease is a mess. The most common treatment, dialysis, is so expensive – running an average of $90,000 per year per patient – that Congress in 1973 allowed advanced renal patients to enroll in Medicare at any age. The act effectively made end-stage renal disease the only condition subject to a single-payer program.That helped turn dialysis into a hugely profitable business. About 10,000 patients were covered in 1973; today more than 750,000 are. Federal spending through Medicare has soared to more than $34 billion a year from $1.1 billion (in current dollars) in 1973……Two remedies for this situation have long been obvious. One is to increase the rate of kidney transplants, which sharply reduce the cost of treating kidney disease. But kidneys are hard to come by. More than 100,000 patients in the U.S. are on the waiting list, with only about 21,000 donor organs available per year. Kidney transplants cost an average of about $32,000 and annual post-surgical care only about $25,000.The other remedy is to preform more dialysis at home, where it’s cheaper than at the dialysis centers operated by DaVita, Fresenius, and other companies, and certainly more convenient for patients. But only about 12% of U.S. patients receive dialysis at home, far less than in most other developed countries.Trump’s proposal, embodied in an executive order signed Wednesday, aims to increase transplants by covering more of the costs for donors, including lost work time and child care expenses. The White House says that, along with other changes in the transplant system, would double the number of kidneys available for transplant by 2030.The plan aims to increase the share of patients reviving dialysis at home to 80%. This would be done in part by changing the incentives for providers so they steer more patients to home dialysis (assuming that’s the right choice for them).The rub is that such changes would require congressional authorization – if it wasn’t for the Affordable Care Act. The act established the Centers for Medicare and Medicaid Innovation, which allow the changes to be made administratively… July 11, 2019: Planned Parenthood posted a press release titled: “New Multi-State Study Shows Telemedicine Abortion Is as Safe and Effective as In-Person Care”. From the press release: A new study published in Obstetrics & Gynecology shows that medication abortion via telemedicine is just as safe and effective as when the health care provider is in the same health center as the patient. The study was conducted by Planned Parenthood Federation of America – with researchers from Ibis Reproductive Health and University of California San Francisco (UCSF) Advancing New Standers in Reproductive Health (ANSIRH) – and supports existing evidence that outcomes for medication abortion via telemedicine are comparable with medication abortion provided in person.The study is the nation’s largest multi-state study of medication abortion via telemedicine to date, with researchers analyzing records from nearly 6,000 patients receiving medication abortion either through telemedicine or in person at 26 Planned Parenthood health centers in Alaska, Idaho, Nevada, and Washington…Medication abortion has been safe and legal in the U.S. since the FDA approved of its use nearly 20 years ago. It helped ensure that patients are able to make their own private medical decisions, and it has expanded access to reproductive health care.In a health-center-to-health center model of providing abortion via telemedicine, a patient has an ultrasound scan, laboratory testing, and counseling with health center staff. Telemedicine patients then meet with a provider in another health center through a secure videoconferencing platform, while standard medication abortion patients meet with a provider in person. During the study period, researchers compared rates of ongoing pregnancy, the need for a subsequent in-clinic abortion, and any significant adverse effects between the two groups. Researchers concluded that medication abortion provided remotely offers patients the same effective, high-quality care that they would receive if they were in the same room with the same trained providers. The study also found that complications are very rare for medication abortion via telemedicine, which is consistent with findings from previously published research.Restrictions and political attacks on access to abortion have left entire swaths of the country without access to safe, legal abortion, disproportionately affecting people with low incomes, people of color, and people living in rural communities. Right now, anti-abortion politicians are pushing burdensome and medically unnecessary bans that effectively prohibit access to medication abortion via telemedicine. Leading medical associations, such as the American College of Obstetricians and Gynecologists (ACOG), agree that these bans are not based in evidence… July 11, 2019: The Tennessean posted an article titled: “Blue Cross plans to return to Obamacare marketplace in Nashville, Memphis”. It was written by Brett Kelman. From the article: …The state’s largest insurance company, BlueCross BlueShield of Tennessee, plans to reenter the Affordable Care Act marketplace in Nashville, Memphis and surrounding counties next year, providing another option for residents on Obamacare in these cities. Cigna and Oscar Health, are planning to significantly reduce the cost of their coverage plans.Although the proposals are not final, it appears Tennesseans will have more options and competitive prices in the coming year, said Kevin Walters, a spokesman for the Department of Commerce and Insurance…Five insurance companies that currently offer Obamacare coverage plan to continue to do so next year, according to the department. The companies have submitted the following proposals to state regulators for approval:.. Those companies are BlueCross BlueShield of Tennessee, Bright Health, Celtic/Ambetter Insurance, Cigna, and Oscar Health. July 11, 2019: West Dakota FOX posted an article titled: “North Dakota argues Affordable Care Act’s validity”. From the article: …North Dakota’s Democratic Party says if the Affordable Care Act is overturned, there would no longer be penalties.“The penalty for those who don’t carry health insurance, they just reduced that penalty to zero, which essentially means there is no longer a tax,” said Kylie Oversen, Chairwoman of the Dem NPL.House Dem-NPL legislators proposed an amendment to the insurance commissioner’s budget this past session, in case the ACA would be found unconstitutional. It would require health insurance companies in North Dakota to cover people with pre-existing conditions……Insurance Commissioner Jon Godfread says the language on the amendment was unworkable… July 11, 2019: Military Times posted an article titled: “Yearlong birth control supply for female vets could cut costs and unplanned pregnancies”. It was written by Ariana Puzzo. From the article: The Department of Veterans Affairs could save about $2 million a year in prenatal, birth and newborn care costs by offering female veterans a year’s supply of birth control pills, researchers say.The VA does not currently offer an upfront 12-month supply option. Approximately 24,000 women receive oral contraceptives and a policy change could prevent an estimated 583 unintended pregnancies, found Colleen Judge-Golden, an MD, Ph.D. student the University of Pittsburg School of Medicine…Judge-Golden, the lead author of the paper published Monday in the Journal of the American Medical Association, analyzed the expense of the proposed program with senior author Sonya Borrero, M.D., M.S., the associate director of the VA’s Center for Health Equity Research and Promotion. Research found that money saved on health care costs would exceed the cost of providing larger upfront quantities of birth control pills to women.Forty-three percent of women receiving three-month increments of birth control will encounter at least one refill gap over a 12-month period that increases the risk of unintended pregnancies, VA data showed. Women outside of the VA who receive one year’s worth of birth control pills were alternatively found to experience fewer refill gaps and less pregnancies… July 11, 2019: Reuters posted an article titled: “U.S. lawmakers advance bill to boost Puerto Rico Medicaid funding”. From the article: A bill that would substantially boost federal Medicaid funding for Puerto Rico advanced out of a U.S. House subcommittee on Thursday after lawmakers agreed to work on stricter safeguards in the wake of a government corruption scandal in the territory.The Health Subcommittee sent the legislation, which would give the bankrupt U.S. commonwealth an additional $12 billion over four years, to the full House Committee on Energy and Commerce.On Wednesday, U.S. law enforcement officials announced a 32-count indictment and arrests of six people, including two former high-ranking Puerto Rico government officials, who were charged with conspiracy and other crimes in connection with millions of dollars in federal Medicaid and education funds……Federal funding to the five U.S. territories to support the healthcare program for low-income residents is capped, often leading to shortfalls during economic downturns or natural disasters like the devastating hurricanes that hit Puerto Rico in 2017 just months after it filed a form of bankruptcy in U.S. District Court… July 11, 2019: NPR posted an article titled: “Young Undocumented Californians Cheer Promise of Health Benefits”. It was written by Sammy Caiola. From the article: …California’s governor signed a law Tuesday that approved $98 million to expand Medi-Cal to income-eligible undocumented adults from age 19 until they turn 26, making it the first state in the United States to cover this group. California estimates 138,000 young adults will become insured under the new policy.While the state has expanded options for children and young adults, most undocumented people in California still have limited access to health care. They can sign up for “restricted” MediCal, but it only covers emergencies and pregnancy-related care. Many people on this plan end ip putting off treatment or turning to county clinics for help.Supporters who want to further expand Medi-Cal to all residents say that move would boost public health and bring down emergency room costs. California Gov. Gavin Newsom has vowed to make everyone eligible……But after months of debate at the California State Capitol, proposals to offer Medi-Cal to all undocumented adults, as well as a push to cover undocumented seniors, were deemed too costly……President Donald Trump has also criticized California for offering health insurance to undocumented people… July 11. 2019: The Hill posted an article titled: “Nearly half of voters less likely to support lawmakers who back ObamaCare repeal.” From the article: Almost half of Americans say they are less likely to support lawmakers who are in favor of repealing Obamacare, according to a new Hill-HarrisX poll.The survey, released on Thursday, found that 47 percent of registered voters said they were less likely to cast a ballot for members of Congress who backed a lawsuit that aims to eliminate ObamaCare, compared to 28 percent of respondents who were more likely to support those lawmakers.Twenty-six percent of voters said it doesn’t matter either way.Older Americans and minorities were least likely to support lawmakers who favored the ObamaCare lawsuit. The poll found that 58 percent of respondents age 65 and older and 68 percent of African Americans were less inclined to back lawmakers who are opposed to ObamaCare……The survey of 1,001 voters was conducted online July 5-6. The margin of error is plus or minus 3.2 percentage points. July 12, 2019: Planned Parenthood posted a press release titled: “Congress Expands Birth Control Access for Service Members”. From the press release: The House of Representatives approved two amendments to the Fiscal year 2020 National Defense Authorization Act (NDAA) that would expand contraception and reproductive health care access for service members. Most service members receive health insurance coverage through TRICARE, which currently does not offer comprehensive contraception coverage and reproductive health care resources for service members and their families……The amendments were offered by Reps. Jackie Speier (CA-14), Veronica Escobar (TX-16), Katie Hill (CA-25), Deb Haaland (NM-01), Ayanna Pressley (MA-07), Judy Chu (CA-27), and Barbara Lee (CA-13). One amendment adopted into the underlying bill clarifies that all FDA-approved contraceptive methods are covered by TRICARE without a copay, and brings TRICARE in line with the ACA’s birth control benefits. The second amendment passed by a vote of 231-199 establishes a standard family planning education program across all branches of the military, increasing services members’ ability to make the best decisions for themselves and their families. July 12, 2019: Fauquier Times posted an article titled: “Fauquier Free Clinic changes business model to include additional Medicaid patients”. From the article: This year the Fauquier Free Clinic, which has a mission to provide eligible residents of Fauquier and Rappahannock counties with access to comprehensive medical, dental, and mental health care, underwent “extensive changes” to accommodate new and existing patients when Medicaid expanded its services for low-income adults throughout Virginia, the clinic said in a news release.“In the past, our medical patients were not eligible for services if they had any type of medical insurance,” John McMahon, FFC board secretary said in the news release, “Now, approximately 60 percent are Medicaid eligible.”In Fauquier County, between 1,700 and 1,800 more people are now eligible for Medicaid, according to the clinic news release. In Rappahannock County, 300 to 400 people are now eligible. Throughout the state of Virginia, eligibility has been granted to around additional 400,000 people… July 12, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood’s Clergy Advocacy Board Condemns the Trump-Pence Administration’s Gage Rule”. From the press release: An en banc panel of the U.S. Court of Appeals for the 9th Circuit refused to block the Trump-Pence administration from enforcing the dangerous Title X gag rule. Title X is the nation’s program for affordable birth control and reproductive health care, which serves 4 million people each year. The Clergy Advocacy Board of Planned Parenthood Federation of America condemns the Trump-Pence Administration’s dangerous Title X gag rule that makes it illegal for doctors, nurses, hospitals, community health centers, and any other provider in the Title X program to tell patients how they can safely and legally access abortion.The gag rule also makes it impossible for millions of patients to access birth control at Planned Parenthood health centers across the country.“We, the Clergy Advocacy Board condemn this gag rule. It brings politicians into the exam room, impairing access to accurate and complete medical information, undermining the patient’s moral agency, harming the poor and those in need, and for blocking access to preventative health care, including contraception.“We are called as clergy and faith leaders to provide pastoral care to people facing medical decisions. Day in and out, we witness the importance of how our congressional members get or don’t get the help they need, the medical information they need, the benefit of the doctor-patient relationship, and access to the care that arises from these personal, private deliberations.“Our faiths and pastoral experience also bear witness to the urgency and moral good in available access to all forms of contraception, and in keeping abortion safe and legal.” July 12, 2019: Center for Reproductive Rights posted a press release titled: “Oklahoma Court Goes Rogue, Upholds Abortion Ban”. Today, the Oklahoma district court became the first court in the country to uphold a ban on the standard method of ending a pregnancy after approximately 14 weeks. Judge Cindy Truong ruled from the bench, denying the Center for Reproductive Rights’ request to strike down the law, which has been enjoined since 2015……Every other court that has reviewed similar bans has blocked them from taking effect, including in Alabama, Arkansas, Kansas, Kentucky, and Texas. Just last month, the Supreme Court let stand a lower court’s decision, which found an identical ban in Alabama unconstitutional. Major medical organizations, including the American Congress and Obstetricians and Gynecologists (ACOG) oppose these types of bans, writing, “these restrictions represent legislative interference at its worst: doctors will be forced, by ill-advised, unscientifically motivated policy to provide lesser care to patients. This is unacceptable.”……Only four health centers provide abortion services in the entire state of Oklahoma. In addition to the 72-hour mandatory delay. Oklahoma has passed many other laws restricting abortion access, including: a parental consent requirement for minors; a ban on the use of telemedicine to prescribe pills for medication abortion; and restrictions on when private, public, and state health insurance plans can cover abortion services. These laws disproportionately affect populations that already experience barriers to health care, including people fo color, immigrants, and people with low incomes. July 13, 2019: Reuters posted an article titled: “Democrats take aim as Trump abandons drug pricing plan”. It was written by Ginger Gibson. From the article: …Trump talked regularly about drug prices during his 2016 campaign, but has failed so far to deliver the changes he promised.On Thursday, his administration scrapped one of its most ambitious proposals for lowering prescription medicine prices, backing down from a policy aimed at health insurers and raising the possibility of new measures focused on drugmakers.The abandoned proposal would have required health insurers to pass billions of dollars in rebates from drugmakers to Medicare patients……[Robert] Blendon [a political scientist at Harvard University] said Trump, having failed to broker any deals in Congress, made his drug price plan to complicated, and voters are unlikely to see him as having made any strides. That is an opportunity for Democrats to offer their own effort at messaging……On Thursday, U.S. Senators Kirsten Gillibrand unveiled a plan to lower drug prices. On Friday, Democrat Amy Klobuchar announced a plan to help lower the cost of pharmaceuticals purchased by seniors. Warren also has a Medicare pricing plan.Sanders is heading to Canada later this month for an event to highlight the difference in the price of insulin……Klobuchar’s proposal, which includes investing in research for a cure for Alzheimer’s disease and improving the stability of Social Security, would allow the government to negotiate Medicare Part D costs, which cover prescriptions for seniors.Klobuchar, a U.S. senator from Minnesota, would also let people order prescription drugs from countries like Canada, a proposal proponents say would Lowe drug costs… July 12, 2019: The Rolla Daily News posted an article titled: “Governor Parson signs “Nathan’s Law,” fixes glitch in Affordable Care Act”. It was written by Ron Reports. From the article: Governor Mike Parson signed House Bill 397 and Senate Bill 514 on Thursday. Both bills fixed an oversight in the Affordable Care Act related to youth formerly in foster care. One of the most popular provisions of the Affordable Care Act is the ability for children to stay on their parents’ health insurance until they turn 26…The ACA allows children that aged out of the foster care system at 18 to remain on Medicaid until they are 26 years old. However, the language passed in the ACA only required a state to provide Medicaid to that individual if they aged out of that specific foster system. Currently, if a youth aged out of Illinois’s foster system, but moved to Missouri to work, they are not allowed to maintain their public insurance in Missouri……Research has shown that access to health care for youth previously in foster care is important because they are more likely to have health complications. Ensuring these youth remain insured helps the broader community by keeping them out of crisis that could lead to emergency room visits or hospitalizations……In the fall of 2018, Congress passed and President Trump signed into law a federal fix to this provision within the ACA, but it will not take effect until Jan. 1, 2023. These former foster youth in Missouri will be able to access Medicaid beginning August 28, 2019, when the bill takes effect, according to the nonprofit Kids Win Missouri, whose mission it is to further child well-being… July 15, 2019: Former Vice President Joe Biden (who is running for President) revealed information about his Health Care Plan. Here is some of the key parts of Joe Biden’s Health Care Plan: Giving Americans a new choice, a public health insurance option like Medicare. If your insurance company isn’t doing right by you, you should have another, better choice. Whether you’re covered through your employer, buying you insurance on your own, or going without coverage altogether, the Biden Plan will give you the choice to purchase a public health insurance option like Medicare. As in Medicare, the Biden public option will reduce costs for patients by negotiating lower prices from hospitals and other health care providers. It also will better coordinate among all of a patient’s doctors to improve the efficacy and quality of their care, and cover primary care without any co-payments. And it will bring relief to small businesses struggling to afford coverage for their employees. Increasing the value of tax credits to lower premiums and extend coverage to more working Americans. …The Biden Plan will help middle class families by eliminating the 400% income cap on tax credit eligibility and lowering the limit on the cost of coverage from 9.86% of income to 8.5%. This means that no family buying insurance on the individual marketplace, regardless of income, will have to spend more than 8.5% of their income on health insurance. Additionally, the Biden Plan will increase the size of tax credits by calculating them based on the cost of a more generous gold plan, rather than a silver plan. This will give more families the ability to afford more generous coverage, with lower deductibles and out-of-pocket costs…. Expanding coverage to low-income Americans. …The Biden Plan will ensure these individuals get covered by offering premium-free access to the public option for those 4.9 million individuals who would be eligible for Medicaid but for their state’s inaction, and making sure their public option covers the full scope of Medicaid benefits. States that have already expanded Medicaid will have the choice of moving the expansion population to the premium-free public option as long as the states continue to pay their current share of the cost of covering those individuals. Additional, Biden will ensure people making below 138% of the federal poverty level get covered. He’ll do this by automatically enrolling these individuals when they interact with certain institutions (such as public schools) or other programs for low-income populations (such as SNAP)…. …The Biden Plan has several additional proposals aimed directly at cutting the cost of health care and making the health care system less complex to navigate. The Biden Plan will: Stop “surprise billing”… The Biden Plan will bar health care providers from charging patients out-of-network rates when the patient doesn’t have control over which provider the patient sees (for example, during a hospitalization). Tackle market concentration across our health care system… The Biden Administration will aggressively use its existing antitrust laws to address this problem… Lower costs and improve health outcomes by partnering with the health care workforce. The Biden Administration will partner with health care workers and accelerate the testing and deployment of innovative solutions that improve quality of care and increase wages for low-wage health car workers, like home care workers… Repealing the outrageous exception allowing drug corporations to avoid negotiating with Medicare over drug prices… The Biden Plan will repeal the existing law explicitly barring Medicare from negotiating lower prices with drug corporations. Limiting launch prices for drugs that face no competition and are being abusively priced by manufacturers… For these cases where new speciality drugs without competition are being launched, under the Biden Plan the Secretary of Health and Human Services will establish an independent review board to assess their value. The board will recommend a reasonable price, based the average price in the countries (a process called external reference pricing) or, if the drug is entering the U.S. market first, based on an evaluation by independent board members. This reasonable price will be the rate Medicare and the public option will pay. In addition, the Biden Plan will allow private plans participating in the individual marketplace to access a similar rate. Limiting price increases for all brand, biotech, and abusively priced generic drugs to inflation… The Biden Plan will also impose a tax penalty on drug manufacturers that increase the costs of their brand, biotech, or abusively priced generic over the general inflation rate. Allowing consumer to buy prescription drugs from other countries… The Biden Plan will allow consumers to import prescription drugs from other countries, as long as the U.S. Department of Health and Human Services has certified that those drugs are safe. Terminating pharmaceutical corporations’ tax break for advertisement spending. … As president, Joe Biden will end this tax deduction for all prescription drug ads, as proposed by Senator Jeanne Shaheen. Improving the quality of generics… The Biden Plan supports numerous proposals to accelerate the development of safe generics, such as Senator Patrick Leahy’s proposal too make sure generic manufacturers have access to a sample. Ensure Health Care Is A Right For All, Not A Privilege For Just A Few Expanding access to contraception and protect the constitutional right to an abortion… The Biden Plan supports repealing the Hyde Amendment because health care is a right that should not be dependent on one’s zip code or income. And the public option will cover contraception and a woman’s constitutional right to choose. In addition, the Biden Plan will: Restore federal funding for Planned Parenthood… As president, Biden will reissue guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers the refer for abortions or provide related information and reverse the Trump administration’s rule preventing Planned Parenthood and certain other family planning programs from obtaining Title X funds. …President Biden will rescind the Mexico City Policy (also referred to as the global gag rule) that President Trump reinstated and expanded… Reducing our unacceptably high maternal mortally rate, which especially impacts people of color…California came up with a strategy that halved the state’s maternal death rate. As president, Biden will take this strategy nationwide… Defending health care protections for all, regardless of gender, gender identity, or sexual orientation… President Biden will defend the rights of all people – regardless of gender, sexual orientation, gender identity – to have access to quality, affordable health care free from discrimination. Doubling America’s investment in community health centers… The Biden Plan will double the federal investment in these centers, expanding access to high quality health care for the populations that need it most… Achieving mental health parity and expanding access to mental health care. As Vice President, Biden was a champion for efforts to implement the federal mental health parity law, improve access to mental health care, and eliminate the stigma around mental health. As President, he will redouble these efforts to ensure enforcement of mental health parity laws and expand funding for mental health services… July 15, 2019: Planned Parenthood posted a press release titled: “Nearly 80 Reproductive Health, Rights, and Justice Organization Unveil Proactive Blueprint for Sexual and Reproductive Health, Rights, and Justice”. From the press release: Today, a broad and diverse coalition of nearly 80 organizations released a proactive policy agenda for a fully supportive Congress and Administration to advance sexual and reproductive health in the U.S. and around the world. The Blueprint is significant and unprecedented because it is the first time the wide range of reproductive health, justice, and rights organizations have come together to develop a detailed and intersectional policy agenda.The Blueprint for Sexual and Reproductive Health, Rights, and Justice is centered on five principles:Ensure sexual and reproductive health care is accessible to all people.Ensure discriminatory barriers in health care are eliminated.Ensure research and innovation advance sexual and reproductive health, rights, and justice now and in the future.Ensure health, rights, justice and wellness for all communities.Ensure judges and executive officials advance sexual and reproductive health, rights and justice.The Blueprint is a vision for the future that includes forward thinking ideas to transform sexual and reproductive health, rights, and justice policy domestically and globally, as well as basic and fundamental measures to correct the backtracking that has taken place in recent years.Guided by the five key principles, the Blueprint lays out many critical policy goals, including:Coverage of and access to comprehensive sexual and reproductive health care services and qualified providers at no or low cost and without exception for all people, including immigrants, incarcerated individuals, and young people under the age of 18.Full access to abortion that is best for an individual and their circumstances and comprehensive insurance coverage for care.Comprehensive pregnancy and material health care strategies that prioritize the health care needs of pregnant and birthing individuals.Strong non-discrimination protections for patients, including protections that ensure providers’ religious or personal beliefs do not dictate patient care.Health care system transformation that prioritizes sexual and reproductive health care, including research and development in the field of reproductive health and scientific integrity and transparency in sexual and reproductive health care.Foreign policy that prioritizes sexual and reproductive health and rightsRobust response to the global HIV/AIDS crisis.Economic opportunity, freedom from violence, and healthy and safe environments for all individuals, families, and communities.Selection and conformation of administrative and judicial nominees who will advance sexual and reproductive health, rights, and justice… The nearly 80 organizations who have endorsed the Blueprint are: Abortion Care NetworkAdvocates for YouthAIDS Alliance for Women, Infants, Children,Youth & FamiliesAll-OptionsAll* Above AllAmerican AtheistsAmerican Jewish World ServiceAmerican Medical Student AssociationAmerican Sexual Health AssociationAVACBlack Mamas Matter AllianceBlack Women for WellnessBlack Women’s Health ImperativeCatholics for ChoiceCenter for Health and Gender Equity (CHANGE)Center for Reproductive RightsCivil Liberties & Public Policy ProgramEquity ForwardGender JusticeGlobal Justice CenterGuttmacher InstituteHarambee Village DoulasHealthy Teen NetworkIbis Reproductive HealthIf/When/How: Lawyering for Reproductive JusticeIn Our Own Voice: National Black Women’s Reproductive Justice AgendaInternational Women’s Health Coalition IpasJacobs Institute of Women’s HealthJewish Women InternationalMaroon CalabashNARAL Pro-Choice AmericaNational Abortion FederationNational Asian Pacific American Women’s Forum (NAPAWF)National Black Women’s HIV/AIDS Network National Center for Lesbian RightsNational Council of Jewish WomenNational Family Planning & Reproductive Health AssociationNational Health Law ProgramNational Institute for Reproductive HealthNational Latina Institute for Reproductive HealthNational LGBTQ Task ForceNational Network of Abortion FundsNational Organization for WomenNational Partnership for Women & FamiliesNational Women’s Health NetworkNational Women’s Law CenterNew Voices for Reproductive JusticeNot Without Black WomenPAIPeople For the American WayPhysicians for Reproductive HealthPlanned Parenthood Federation of AmericaPopulation Connection Action FundPopulation CouncilPopulation InstitutePositive Women’s Network-USAPower to DecideReproductive Health Access ProjectSecular Coalition for AmericaSexuality Information and Education Council of the United States (SIECUS)Sierra ClubSisterLove, Inc.SisterReachSocial Workers for Reproductive Justice SPARK Reproductive Justice Now!, Inc. Surge Reproductive JusticeThe Afiya CenterThe American Civil Liberties UnionThe Center for Sexual Pleasure and Health UltraVioletURGE: Unite for Reproductive & Gender Equity#VOTEPROCHOICE Wisconsin Alliance for Women’s Health Women with a VisionWoodhull Freedom Foundation July 17, 2019: Anchorage Daily News posted an article titled: “ACLU sues Dunleavy for veto to Alaska court system over abortion rulings”. It was written by Tegan Hanlon. From the article: The American Civil Liberties Union of Alaska is suing Gov. Mike Dunleavy over his decision to cut funding to the state court system because of its rulings on abortion.The ACLU says Dunleavy is retaliating against the courts and seeking to punish them for the decisions he doesn’t agree with in violation of the Alaska Constitution and the separation of powers doctrine……The lawsuit was filed Wednesday in Superior Court in Anchorage against Dunleavy and the state of Alaska. It comes as Alaska’s divided legislature wrestles with the governor’s $444 million in vetoes to the state operating budget.The ACLU targets one of Dunleavy’s vetos: a $344,700 cut to the court system budget. That amount, Dunleavy has said, is equal to the amount the state spent on “elective abortions” last year.His veto followed years of attempts by Alaska conservatives to bar the state’s Medicaid program from paying for abortions outside of cases of rape, incest, and when the mother’s life is in danger. Each time, they’ve been blocked by the Alaska Supreme Court. Most recently, in February, the court declared two such laws unconstitutional.A document from the Dunleavy administration explaining the veto says: “The Legislative and Executive Branch are opposed to State funded elective abortions; the only branch of the government that insists on State funded elective abortions is the Supreme Court. The annual cost of abortions is reflected by this reduction.”That violates the state constitution, says ACLU’s complaint in the lawsuit……The ACLU is asking the court to rule that Dunleavy has violated the state constitution by breaching the separation of powers when he issued his veto and by illegally reallocating funding. It also wants the court to order that Dunleavy and the state must restore the $344,700 in funding to the court system… July 17, 2019: The American Civil Liberties Union (ACLU) of Alaska posted a press release titled: “ACLU Of Alaska Sues To Reverse Governor Dunleavy’s Retaliatory Veto Of Court System Funding.” From the press release: Today, the ACLU of Alaska filed suit against Governor Dunleavy to block his administration’s attempt to punish the Alaska Court System by vetoing $334,700 in its 2020 budget because the Alaska Supreme Court ruled in a manner at odd with his political views.The veto is an impermissible exercise of executive authority that attacks Alaskans’ deep commitment to an independent judiciary, violates Alaska’s constitutional separation of powers, and illegally attempts to reallocate budget appropriations.“Governor Dunleavy admitted outright that his veto was direct retaliation against the Alaska Court System for a court decision at odds with his political views. That isn’t just petty and vindictive; it is a clear assault on the constitutional power of the judiciary and a grossly inappropriate attempt to use money to coerce judges to a political end,” said ACLU of Alaska Executive Director Joshua A. Decker. He continued, “Alaskans don’t want judges making decisions with one eye on how much money politicians will give them if they rule one way or another. That isn’t how we get justice.” July 17, 2019: Detroit Free Press posted an article titled: “After huge spikes, Obamacare rates in Michigan now falling”. It was written by JC Reindl. From the article: Sticker prices for many Affordable Care Act-compliant individual health insurance plans will drop next year, a reversal from the huge price hikes sought in past years by insurance companies.Insurers’ new proposed rates, which would take effect in 2020 if approved, were announced Wednesday by the Michigan Department of Insurance and Financial Services……The Blue Care Network of Michigan, an HMO that insures the most people in Michigan’s individual market at about 157,400 people, is seeking to lower its individual plan rates by an average of 1.7% in 2020. And the market’s second-most popular Insurer, Priority Health, is looking to shave it’s rates by 0.1%.Blue Cross Blue Shield of Michigan, the third most popular choice with 50,600 people, wants to drop its prices by 7.7%……About 5% of Michiganders, or 333,000 people, currently get health insurance through these individual plans, which are sold on the website Healthcare.gov. The lower rates will not directly benefit many of those policyholders because more than 80% of those in Michigan who buy individual plans do not pay full sticker price since they receive the ACA’s tax credit subsidies……The poorest individuals in Michigan qualify for Medicaid health insurance… July 18, 2019: The American College of Obstetricians and Gynecologists (ACOG) posted a statement titled: “ACOG Statement on Federal Surprise Billing Legislation”. From the statement: Ted L. Anderson, MD, PhD, president of the American College of Obstetricians and Gynecologists (ACOG) issued the following statement about federal legislation to address surprise medical bills:“ACOG believes that patients should be protected from unanticipated medical bills for care provided by an out-of-network physician. This problem can extend beyond patients who receive unexpected care in the emergency setting, also impacting patients who have received expected care, such as childbirth or surgery, from a care team that includes an out-of-network provider. We understand that patients are not always able to choose an in-network provider. For example, in situations where care is provided by an out-of-network provider in an in-network setting, patients should not be punished financially for circumstances beyond their control. After all, women who recently had a child should be able to focus on their growing family and their own health and well-being, rather than the burdensome out-of-pocket costs.“Surprise billing can interfere with the patient-physician relationship. We believe that in order to protect the patient-physician relationship, patients should be absolved from any payment that disputes that arise between physicians and insurers related to out-of-network care. However, we also must ensure that physicians receive fair compensation for the quality of care they provide, and that patients do not face network inadequacy or limitations in access to care. To that end, we support an independent dispute resolution process, such as the proven model in place in New York State. This model enables a neutral third party to evaluate the many variables associated with each case to reach a fair agreement between physicians and insurers that reflects the complexity of the case, the experience of the physician, and insurers that reflects the complexity of the case, the expertise of the physician, and the reasonable rate charged in that geographic area.“We thank Members of Congress, particularly the physicians in Congress, for their attention to this complex situation and look forward to the refinement and enactment of legislation that both protects patients and ensures the financial sustainability of physician practices.” July 18, 2019: CBS News posted an article titled: “House votes overwhelmingly to repeal Obamacare “Cadillac” tax”. From the article: The Democratic-led House of Representatives has overwhelmingly voted to repeal a tax on high-cost health insurance plans under Obamacare known as the “Cadillac tax”.The 419-6 vote is a signal of bipartisan unity against a key provision of the Affordable Care Act. The 40% tax on high-cost plans is meant to help subsidize other plans under the Affordable Care Act, but it’s become unpopular even among many Democrats……Based on Congressional Budget Office estimates, repeal would add $193 billion to the federal deficit from 2022-2029, by removing revenues off the government’s books. The nonpartisan Kaiser Family Foundation expects that about 1 in 5 employers offering health insurance would have at least one insurance plan subject to the tax in 2022, and the share would grow quickly over time.Before the passage of the ACA, employers used to benefit from offering the expensive plans because they were not taxed on employee health care benefits, while they are taxed on the salaries they pay their employees. Labor unions, in particular, disliked the tax because they’re known for their generous health benefits, and they have argued that the 40% tax would affect their members……The president has pledged to introduce a new GOP health care plan, but that has yet to come to fruition. July 18, 2019: News Observer posted an article titled: “Senate Republicans unite agains Cooper, say budget is ‘hostage’ to Medicaid expansion”. It was written by Dawn Baumgartner Vaughan. From the article: North Carolina Senate Republicans didn’t like what Democratic Gov. Roy Cooper said about their leaders Wednesday. They responded in a letter signed by all 29 Republican members the state Senate, saying that Cooper is holding the budget hostage over Medicaid expansion.Talking to reporters after hosting a Medicaid expansion roundtable on Wednesday, Cooper said it was Republican leadership, not rank-and-file legislators, who are holding up budget negotiations……It is almost three weeks into the new fiscal year that started July 1, but there’s still no state budget.The House presented its budget in April, followed by the Senate in May; then they submitted what’s called the conference budget to the governor in June. Both chambers are led by Republicans. Cooper vetoed the budget on June 28, and negotiations have been at a standstill since then. A potential override vote on the veto has been on the House’s calendar for several days, but House Speaker Tim Moore, a Kings Mountain Republican, has yet to call for the vote. At least seven House Democrats and all Republicans would be needed pass a veto override.The House override vote is tied to a Medicaid expansion compromise bill called NC Health Care for Working Families that would expand Medicaid but include work requirements and premiums. It made it through committee with bipartisan support. However, the Senate has not proposed any sort of compromise on Medicaid… July 18, 2019: The Neighbor posted an article titled: “Idaho submits Medicaid waiver request.” It was written by Nathan Brown. From the article: Idaho has submitted its waiver request to let some people who would be covered by Medicaid expansion stay on private insurance.The “Section 1332 Coverage Choice Waiver” was submitted Monday and, if approved by the Centers for Medicare and Medicaid Services, would give people making between 100 percent and 138 percent of the poverty level the option of getting federal tax credits to buy insurance on the Your Health Idaho state exchanges instead of going on Medicaid when the expansion kicks in on Jan. 1, 2020. An estimated 18,000 Idahoans who have exchange insurance now will qualify for expanded Medicaid coverage and would, without a waiver, have to give up their current policies for Medicaid.The state has already taken public comment on the proposed waiver, and also took public comment on a “Section 1115” Medicaid waiver that is related to the proposal to let some people stay on the exchange. However, CMS had some additional questions on that waiver request, said Department of Health and Welfare spokeswoman Niki Forbing-Orr, and it isn’t clear if the state needs to submit two waiver requests or just the 1132 waiver. Forbing-Orr said the state is in talks with CMS to see what is required……Reclaim Idaho, the group that spearheaded last years Medicaid expansion push and lobbied against putting any restrictions on it during the 2019 legislative session, has come out against the proposal to insure some people on the exchange, saying it could cost Idaho taxpayers more than straight expansion……Idaho’s request to spend some Medicaid money on mental health treatment is similar to a waiver that has been allowed in many other states and is expected to be approved. Work requirements, which are the most controversial of the proposed waivers, have been approved in numerous states and the Trump administration supports the idea. The final fate of the concept could be decided by courts through – opponents have sued to block work requirements elsewhere and in March a federal judge sided with them and blocked them in Kentucky and Arkansas. July 18, 2019: WABE posted an article titled: “Georgia’s Medicaid Waiver Application Process Reaches Next Step”. It was written by Emil Moffatt. From the article: An effort to expand Georgia’s Medicaid rolls is moving into its next phase……The consulting group Deloitte, which got a nearly $2 million contract to prepare Medicaid waivers for the state, painted a deficient picture of Georgia’s health insurance system.Its number show 14.8 percent of Georgians are uninsured (compared to a national average of 10.5 percent) and the state ranks third in the nation when it comes to the number of rural hospitals at risk of closing.The data was compiled using numbers from the Department of Insurance plus community and public health data, something Ryan Like with the governor’s office says is unprecedented……And now the at the numbers are in, says Like, the 47-member advisory board group made up of lawmakers, medical professionals, health groups and health insurance companies can weigh in……In the end, it will be Gov. Brian Kemp who’ll decide what exactly goes into the waiver applications.The goal is to bring more federal health care dollars to the state without fully expanding Medicaid under the Affordable Care Act. July 19, 2019: The Hill posted an article titled: “Federal judge upholds Trump’s expansion of non-ObamaCare plans”. It was written by Jessie Hellmann. From the article: A federal judge on Friday upheld the Trump administration’s expansion of health insurance plans that don’t meet ObamaCare’s coverage requirements.U.S. District Judge Richard Leon in Washington ruled against the insurance companies that sued the administration in an attempt to block the rules……The plans aim to “minimize the harm and expense” for individuals who might otherwise decide not to purchase insurance because of high premiums, Leon added.The Trump administration issued a regulation last year allowing short-term health care plans to last up to 12 months instead of three. These plans were originally intended as an option for individuals who need to bridge a gap in health insurance coverage.But the administration extended the length of time they can be sold to provide customers with more affordable options.The plans generally cost less because they don’t have to comply with coverage requirements set by the Affordable Care Act (ACA), such as maternity care and prescription drugs.The short-term plans can also deny coverage to sick people, which ObamaCare insurers are prohibited from doing……The Association for Community Affiliated Plans (ACAP) the plaintiff in the case, said in a statement that it would appeal the decision……The Trump administration has been looking for ways to dismantle ObamaCare through regulation after Congress failed to repeal it in 2017… July 19, 2019: Iowa Public Radio posted an article titled: “Judge Dismisses Lawsuit On Medicaid Funding for Transgender-Related Surgeries”. It was written by Natalie Krebs. From the article: A Polk County judge has dismissed a lawsuit to overturn a law that would allow organizations using public insurance dollars – like Medicaid – to opt out of covering gender-affirming surgery.The lawsuit was filed by the ACLU on behalf of Mika Covington and Aiden Vasquez, two transgender plaintiffs on Medicaid who are seeking the procedure. It asks for the law to be ruled unconstitutional under the state’s Civil Rights Act.The legislature passed the provision as part of a health budget bill in April and it was signed into law by Gov. Kim Reynolds in May.It came just weeks after a state Supreme Court decision struck down a decades-old ban on using Medicaid dollars for transition-related surgery.Polk County Judge David Porter wrote in his ruling released this week that the injunction sought by the ACLU is not “ripe for judicial consideration” because Covington and Vasquez have not yet exhausted the administrative appeals process through the Department of Human Services, which oversees Medicaid.At a hearing last week, Assistant Attorney General Thomas Odgen told the judge the language of the law does not actually ban funding……But it does allow the government insurance program to refuse to provide the surgery… July 19, 2019: Forbes posted an article titled: “Don’t Slash Medicare in Last-Minute Budget Agreement”. It was written by Sally Pipes, who covers health policy as President of the Pacific Research Institute. From the article: …White House officials are feverishly negotiating with congressional leaders to raise the debt ceiling and reach a two-year budget deal that averts more than $126 billion in automatic spending cuts.Democrats want the deal to dramatically raise domestic spending levels. Republicans want to offset those increases with cuts elsewhere. So on Thursday evening, the president sent House Speaker Nancy Pelosi a list detailing $574 billion of possible spending cuts and reforms. One of those proposed offsets would fundamentally transform Medicare’s “Part D” prescription drug benefit.I’ve long advocated systemic reforms to Medicare. And the White House is right to call for offsets. But it’d be a mistake to target Part D, a successful, comparatively free-market program that helps nearly 45 million Americans afford their prescriptions. The proposal would hurt vulnerable seniors and stifle medical innovation…….The program’s success stems from its market-based structure. Private insurers sponsor plans and sell them to seniors. The government subsidizes and regulates these plans, but otherwise, it doesn’t interfere. This forces insurers to compete with each other fir beneficiaries’ business.This market competition helps keep beneficiaries’ premiums down. The average Part D premium totaled just over $39 a month in 2019, a decrease of 4% from the previous year……Medicare Part D is one of the government’s only successful entitlement programs precisely because it relies on private-sector competition. Adjusting the program could lead to higher premiums for beneficiaries and fewer new therapies. Let’s hope the White House and Congress find a smarter way to offset the cost of any budget deal. July 24, 2019: National Organization for Women (NOW) posted a press release titled: “NOW Applauds Arkansas Decision to Protect Abortion Rights”. From the press release: Judge Kristine Baker ruled today to temporarily block three anti-abortion laws the would have left Arkansas residents with only one clinic providing abortion care. Currently, Arkansas has two such clinics, and only one of them performs abortions after 10 weeks into a pregnancy. That clinic would not have been able to meet new burdensome requirements under one of the blocked bills.The National Organization for Women applauds Judge Baker for ruling against these bills and temporarily preventing Arkansas from becoming the seventh state with only one abortion clinic, a dangerous situation that puts the who do not have the resource to travel out of state in danger.We know that these bills were not passed to protect women’s health – because women are safest when they have access to affordable, accessible abortion care, not when clinics have their hands tied or are forced to close. This ruling stands as a strong refusal to value the ideological extremism of a few over the health, safety, and constitutional rights of Arkansas women. July 24, 2019: Mother Jones posted an article titled: “A New Study Found that 15,000 People Died Because Their State Didn’t Expand Medicaid”. It was written by Abigail Weinberg. From the article: Approximately 15,600 people died between 2014 and 2017 as a result of their states refusing to expand Medicaid coverage under the Affordable Care Act, according to a new working paper by the National Bureau of Economic Research.The ACA promise to expand Medicaid coverage to individuals whose income was at or below 138 percent of the federal poverty level, but a 2012 Supreme Court ruling left it up to states to decide whether to expand coverage. Today, 14 states have not yet adopted Medicaid expansion, and three others have adopted it but not yet implemented it.The paper studied mortality rates in expansion states and in non-expansion states before and after the increased Medicaid coverage was implemented. It found that, in states that had expanded Medicaid, 4,800 fewer Medicaid-eligible individuals between the ages of 55 and 64 died per year than in non-expansion states……Harold Pollack, a health policy expert at the University of Chicago, said that NBER’s finding seemed plausible and that the number of people affected could actually be greater……Several Republican governors have refused to expand Medicaid in their stats, even though the federal government finances most of the costs of expansion, likely because the legislation is associated with Barack Obama’s presidency. Still, Medicaid expansion polls well even in red states, and has been favored by voters in states with Republican governors, such as Utah. July 25, 2019: The Guardian posted an article titled: “Doctor claiming to ‘reverse’ abortion was told to stop using medical school’s name”. It was written by Jessica Glenza. From the article: A doctor who has said he invented a procedure to “reverse” abortion has for years falsely claimed an affiliation to a prestigious US medical school, the Guardian can reveal.A medication abortion or “self-managed” abortion, is an FDA approved procedure and is administered through two doses of medicine over 48 hours. Medication abortions now represent nearly one-third of all abortions nationally, according to the Guttmacher Institute. There is no reversal procedure.But Dr George Delgado, the medical director of Culture of Life Family Services in San Diego, claims to have invented a “reversal”, in which women are given a large dose of progesterone following the first dose of a medicated abortion.Delgado’s assertions about the “reversal” procedure have been denounced as “unproven and unethical” in a statement from America’s largest association of women’s doctors, the American College of Obstetricians and Gynecologists. His work has been described as an “unmonitored research experiment” in an article in the New England Journal of Medicine.Despite condemnation from the medical community, Delgado’s claims have been adopted by some Republican state legislators as part of a wider campaign to undermine women’s reproductive rights. North Dakota legislators recently passed a law forcing doctors to tell patients medication abortions are reversible, the fifth state to do so in 2019……Delgado had been listing an affiliation with the University of California San Diego (USD), even after the university asked him to stop last year.Delgado worked in UCSD’s department of family medicine as a voluntary clinical associate professor beginning in 2005, but left in June 2011, according to the school. The school could not describe the scope of Delgado’s duties, but said his position was unpaid, and may have been “as little as teaching a class once a year”, according to the university spokesperson Scott LaFee.”.. July 29, 2019: Senator Kamala Harris released her Medicare For All plan. It is a plan intended to be a transition from what we have now to Medicare for All. This plan would go into effect if she becomes President of the United States. Here are some key points of that plan: Who will be covered under Medicare for All and what benefits will be offered?Medicare for All will provide every individual in America with access to comprehensive health care. It will cover all medically necessary services, including emergency room visits, doctor visits, hearing aids, vision, dental, mental health and substance use disorder treatment, and comprehensive health care services. These benefits will be covered – no deductibles, and no copays for high-quality care. The plan will also have strong caps on out-of-pocket costs. It will also empower the Secretary of Health to negotiate for lower drug prescription drug prices. My health plan will give more Americans more options to gain access to the health care they need.Under my Medicare for All plan, we will also expand the program to include other benefits Americans desperately need that will save money in the long run – for instance, an expanded mental health program including Telehealth and easier access to early diagnosis and treatment, and innovative patient navigator programs to help people identify the right doctor and understand how to navigate the health system. It will provide a serious auditing of prescription drug costs to ensure Americans aren’t paying more for their prescription drugs than other comparable countries; a comprehensive maternal & child health program to dramatically reduce deaths, particularly among women and infants of color; and meaningful rural health care reforms, such as increasing residency slots for rural areas with workforce shortages and expanding loan forgiveness for rural health care professionals, to promote high-quality access to people regardless of their zip code.Will I be able to keep my doctor under Medicare for All?Yes. 91% of eligible doctors participate in the Medicare program today. Envision a program where you can walk into a doctor’s office knowing that they are in-network and you can walk out without worrying about your out-of-pocket costs or a surprise medical bill. My plan recognizes that doctors, nurses, and your entire health care team who provide high-quality care will have a voice in their workplace and be paid at appropriate rates under my plan.How does this plan work and how will we transition to Medicare for All?Under my Medicare for All plan, we will immediately allow people to buy into a Medicare Transition Plan through an extended 10-year phase-in period.We will automatically enroll newborns (with an opt-out provision for families with employer-sponsored insurance) and the uninsured into a Medicare Transition Plan, and provide a commonsense path for employers, employees, the underinsured, children, and others on federally-designated programs, such as Medicaid or the Affordable Care Act exchanges, to transition into the Medicare Transition Plan. The Medicare Transition Plan will provide enhanced benefits with limited cost-sharing requirements and financial assistance for those who qualify based on income. During the transition, seniors will be able to keep their Medicare with immediate coverage of additional benefits such as dental, vision and hearing aids.Second, after the 10-year transition period, we will have a new Medicare framework where most Americans will be in an expanded and improved public Medicare plan. In my Medicare for All system, similar to Medicare Advantage today, private insurance plans can contact through Medicare and compete with the public Medicare plan. However, these private Medicare plans will be subject to stricter consumer protection requirements than under current law, such as getting reimbursed by Medicare for less than the cost of the public Medicare plan to ensure taxpayers aren’t subsidizing insurance company profits. Americans can then choose whether to stay in the public Medicare plan or opt-out into a private Medicare plan.What about employer-based plans?During the transition period, employees can continue to provide private health coverage to employees. However, employers will also have the opportunity to provide health care for employees through the Medicare Transition Plan, with a shared responsibility payment. Employees will also have the option on their own to buy into the Medicare Transition Plan during the transition period.Following the transition period, under my Medicare for All system, employers will have the option to provide a private Medicare plan for their employees that will be certified by the Medicare program, similar to how employers can offer Medicare Advantage today. Employees could choose to be in that employer Medicare plan, a different private Medicare plan, or the public Medicare plan……How does your plan affect people with disabilities?People with disabilities will also transition to the Medicare system and have access to comprehensive long-term services and supports, as well as necessary equipment and assistance devices. Under my Medicare for All plan, long-term services and supports will be consumer-directed and provided in home- and community-based settings, unless the individual chooses otherwise……How does your plan affect Medicaid?Medicaid will transition to the Medicare for All system, which will ensure that all current Medicaid benefits for low-income individuals will be covered. States will be required to make maintenance effort payments to the Medicare program equal to the amounts they currently spend on Medicaid and CHIP, which will grow with inflation.Does your plan eliminate all private insurance?No. Under my Medicare for All system, the power of big insurance companies will be greatly diminished. After the transition period, private insurance will only exist in two ways1…Under my plan, private health insurers can compete with the new public Medicare plan, as long as the plans they offer adhere to strict requirement like those laid out below. This would function similarly to how Medicare Advantage operates within the Medicare system today….In my Medicare for All system, Medicare will continue to set the rules of the road for these plans, including price and quality, and private insurance companies will play by those rules, not the other way around. But unlike the current program, these private Medicare plans will be held to stricter consumer protection standards than they are today, such as getting reimbursed less than what the public Medicare plan will cost to operate…2. People will be able to purchase supplemental insurance covering services not included under Medicare for All, such as medical insurance for traveling abroad and cosmetic surgery. Employers will still be able to offer their employees retiree supplemental coverage through a private insurance plan… July 30, 2019: Planned Parenthood posted a press release titled: “Breaking: Planned Parenthood takes Missouri to court over one of nation’s most restrictive abortion bans”. From the press release: Today, Planned Parenthood, along with partners at the ACLU and law firm Paul, Weiss, Rifkind, Wharton & Garrison LLP took the state of Missouri to court to stop an unprecedented number of abortion bans from taking effect in the state. If the bans are allowed to go into effect, abortion would be outlawed at nearly every stage of pregnancy. Missouri is one of 12 states to ban abortion just in the first half of this year. State politicians, emboldened by the Trump-Pence administration, have passed a total of 26 abortion bans nationwide in 2019 alone.In May, Missouri Gov. Mike Parson signed House Bill 126, one of the nation’s most restrictive abortion laws, despite massive public outcry. The law also imposes a long list of medically unnecessary restriction designed to shame people who choose to end their pregnancy. This isn’t a coincidence – with Kavanaugh on the Supreme Court, anti-abortion politicians are racing to overturn Roe v. Wade… July 30, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Planned Parenthood and ACLU Take Missouri To Court Over Abortion Bans”. From the press release: Planned Parenthood, the ACLU, and the ACLU of Missouri, along with law firm Paul, Weiss, Riftkind, Wharton & Garrison, LLP, took the state of Missouri to court today to stop an unprecedented number of abortion bans from taking effect in the state. If the bans are allowed to go into effect, abortion would be outlawed at nearly every stage of pregnancy……”Unless they are blocked by the court, these extreme laws would outright ban the vast majority of abortions in Missouri,” said Andrew Beck, senior staff attorney at the ACLU Reproductive Freedom Project. “The impact would be devastating for Missourian seeking abortion care and would be felt mostly by low-income patients and people of color. Politicians have no business dictating personal medical decisions, and we will not stand for it: the ACLU, along with our partners, is in this fight until these laws are blocked once and for all, and everyone who needs an abortion in Missouri can get one.”In May, Missouri Gov. Mike Parson signed House Bill 126, one of the nations’ most restrictive abortion laws. The law also imposes a long list of medically unnecessary restrictions designed to shame people who choose to end their pregnancy. Missouri is one of 12 states to ban abortion just in the first half of this year……Political attacks and targeted restrictions have left Reproductive Health Services of Planned Parenthood of the St. Louis Region as the last remaining health center that still provides abortion in the state. These restrictions – which blocked the only other health center in Missouri from providing abortions – include requiring doctors to perform invasive and medically unnecessary pelvic exams; a 72-hour mandatory delay for patients accessing abortion, which forces patients to make two trips to the health center; and demanding abortion providers hold local hospital and admitting privileges. August 1, 2019: WBTV 3 posted an article titled: “Blue Cross NC is seeking approval to lower Obamacare rates for its customers again”. From the article: People who are Affordable Care Act participants in North Carolina could see a decrease in their insurance bills come January.Blue Cross and Blue Shield of North Carolina, the only insurance company to provide Affordable Care Act coverage in all 100 N.C. counties, has requested an average ACA rate decrease of 5.2% for individuals.The ACA rates have to be approved by the N.C. Department of Insurance, which Blue Cross N.C. expects to happen in late August. The insurance company also requested a average rate decrease of 3.3% for small business ACA plans.Open enrollment in ACA plans, also called Obamacare, begins on Nov. 1 and ends Dec. 15……The company isn’t releasing detailed information on regional pricing right now, but will release more information after getting approval from the Department of Insurance……The insurance company said the rate decreases were made possible by reducing internal operating expenses, and shifting care to value-based provider reimbursement – paying for the value of services provided to the patients, not the quantity……The company said the rate decrease request was also possible because the state legislature didn’t add regulatory burdens on the company. August 1, 2019: Center for Reproductive Rights posted a press release titled: “Record Support in Congress for Bill to Protect Abortion Access”. From the press release: The Center for Reproductive Rights applauds the more than 200 Members of Congress who have signed on to cosponsor the Women’s Health Protection Act of 2019, a bill to preserve equal access to abortion everywhere. As of today, the Women’s Health protection Act has 203 cosponsors in the House of Representatives.The Women’s Health Protection Act was introduced in the House by U.S. Representatives Judy Chu (D-CA), Lois Frankel (D-FL), and Marcia Fudge (D-OH) on May 23, 2019, with 173 original cosponsors. The bill was referred to the House Committee on Energy and Commerce. Senators Richard Blumenthal (D-CT) and Tammy Baldwin (D-WI) introduced an identical bill in the Senate with 42 original cosponsors.The Women’s Health Protection Act establishes a statutory right for health care providers to provide, and their patients to receive, abortion services free from medically unnecessary restrictions and bans…..The surge in support comes as state legislatures continue to pass restrictive abortion laws designed to dismantle the constitutional protections recognized by the Supreme Court in Roe v. Wade, and repeatedly upheld by the Court since then. Despite these legal guarantees, 18 states have enacted 46 new laws this year that prohibit or restrict abortion, including nine unconstitutional pre-viability bans on abortion.The Women’s Heath Protection Act would prohibit bans and medically unnecessary restrictions that single out abortion and impede access to care. These include six-week, eight-week, and 15-week bans, requirements that providers give patients medically inaccurate and false information, and state-mandated medical procedure including unnecessary ultrasounds… August 3, 2019: Arizona Central posted an article titled: “Florida senator wants to block abortion votes unless legislature is at least half women”. It was written by James Call. From the article: A Florida state senator wants voters to decide whether a male-dominated state legislature should be allowed to limit a woman’s access to abortion.State Sen. Lauren Book filed a bill tax calls for a constitutional amendment that would prohibit the Florida House of Representatives and Senate from voting on a bill the would affect access to abortions unless at least half of the members of the chamber are women……A supermajority of the Florida legislature in both chambers are men. They make up 70-percent of the House (84 of 120 members). And it’s the same in the Senate where 12 women senators (30-percent) are among the 40-member chamber.SB 60 would create a constitutional amendment for voters to decide whether to block a legislative vote on proposals that would limit access to an abortion unless 50% of the chamber is female.Book, a Democrat, said the measure is in response to recent attempts to restrict abortion services with measures like the so-called fetal heartbeat bill approved in six states earlier this year. Those bills prohibit abortion in the first trimester when a heartbeat is detected……More than a dozen abortion bills were filed last session by Florida lawmakers – none made it to a floor vote. But state Rep. Mike Hill earlier told the Tallahassee Democrat he intends to file a heartbeat bill again in 2020.Last session, his proposal failed to gain a committee hearing. It is likely that Book’s bill may face the same fate in the Republican-controlled Senate… August 4, 2019: Reuters posted an article titled: “Trump administration considers September unveiling of healthcare plan: WSJ”. It was written by Katanga Johnson. From the article: U.S. President Donald Trump’s administration is considering unveiling, as early as September, his healthcare plan as part of his presidential re-election campaign strategy, the Wall Street Journal reported on Saturday.The plan would lay out an alternative to former President Barack Obama’s Affordable Care Act, which has been challenged by Republicans in court, and could include coverage for people with pre-existing conditions and a variety of insurance options, the Wall Street Journal said, citing unnamed sources.Trump has not signed off on the tentative plan, the newspaper said, describing ongoing debate about the plan and the timing for the roll-out. Polling shows that healthcare is a top concern for voters leading up to the election.The White House did not immediately respond to a request for comment on the timing… August 5, 2019: Wisconsin State Journal posted an article titled: “Wisconsin Democrats try again for Medicaid expansion”. It was written by David Wahlberg. From the article: Democratic state lawmakers said Monday they will try again to expand Medicaid as allowed under federal health law, a move the Republican-controlled Legislature has repeatedly opposed.Sen. Jon Erpenbach, D-West Point, and Rep. Daniel Riemer, D-Milwaukee, said they would introduce a standalone bill to expand Medicaid eligibility to 133% of the federal poverty level and accept additional federal funding under the Affordable Care Act. Republicans this year cut Medicaid expansion from Democratic Gov. Tony Evers’ budget, and most legislative Republicans have opposed the move since it became possible in a statement,Under the plan, eligibility for the state-federal health program would increase from 100% of the poverty level to 133%. The federal government would pay at least 90% of the cost, up from its regular 60% share for most people on Medicaid.Taking Medicaid expansion in 2014 would have saved the state $1.1 billion through 2019, according to the nonpartisan Legislative Fiscal Bureau……Assembly Speaker Robin Vox, R-Rochester, has called the proposal a “massive welfare expansion.” His spokesman didn’t immediately respond to a request for comment.Wisconsin is among 14 states that have not expanded Medicaid as allowed under the ACA, also known as Obamacare.It is the only one of those states that has no gap in coverage for people with low incomes. Wisconsin’s Medicaid program covers people up to the poverty level, unlike those in the other states, and the subsidized private insurance on the Obamacare exchange is available for people who make more. August 6, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Federal Court Blocks Arkansas Abortion Bans and Restrictions”. From the press release: A federal district court judge in Arkansas has issued a preliminary injunction blocking a set of abortion bans and restrictions from taking effect while a lawsuit challenging the laws proceeds. Last month, the court issued a 14-day temporary restraining order, which was set to expire today.The laws included a ban on abortion starting at 18 weeks of pregnancy, a ban on abortion based on the patient’s reason for seeking care, and a law prohibiting qualified physicians from providing abortions. The lawsuit was filed by the ACLU, the ACLU of Arkansas, Planned Parenthood Federation of America, and the law firm of O’Melveny & Myers, LLP on behalf of Little Rock Family Planning Services, Planned Parenthood of Great Plains (PPGP), and two physician providers, challenged three laws…. The ACLU has embedded the preliminary injunction from the United States District Court Eastern District of Arkansas Western Division on the ACLU’s website. …Had the challenged laws been permitted to take effect, people in the state would be left with a single health center which could provide only limited medication abortion care. August 7, 2019: Vox posted an article titled: “Why this law could be a bigger threat to Roe v. Wade than near-total abortion bans”. It was written by Anna North. From the article: …But an Arkansas law requiring physician certification could have nearly the same effect without banning the procedure outright – and it might have a better shot at surviving a court challenge.The law imposes new certification requirements on doctors who provide abortions, which abortion rights advocates say are medically unnecessary. It would also cause Little Rock Family Planning, the only clinic in the state that provides surgical abortions, to shut down. The state’s one other clinic provides only medication abortions, which are only available in the first 10 weeks of pregnancy, leaving the Arkansas law to essentially function like a 10-week ban……For now, the law is on hold – one of three Arkansas abortion laws a federal judge temporarily blocked on Tuesday from going into effect. But Arkansas Attorney General Leslie Rutledge has already filled an appeal, and some experts think that laws like the one in Arkansas have a better chance of getting a Supreme Court hearing than more extreme, and unpopular, near-total bans. If Roe v. Wade does fall, the law that topples it may look more like Arkansas’s than Alabama’s.Passed by the state legislature last session, the law would have required that doctors who provide abortions in the state be board-certified or board-eligible in obstetrics and gynecology. Doctors who are not OB-GYNs – for example, family medical physicians or internal medicine physicians – routinely provide abortions in Arkansas and elsewhere. But under the new law, they wouldn’t be able to……The Arkansas law was scheduled to go into effect last month, but Judge Kristine Baker issued an eleventh-hour temporary restraining order blocking the law along with two other restrictions: a ban on all abortions after 18 weeks’ gestation, and a ban on abortions because of fetal Down syndrome diagnosis. Because the order was set to expire Tuesday, she issued a longer-term injunction blocking enforcement of the laws while the ACLU pursues its case… August 7, 2019: Mother Jones posted an article titled: “Trump’s Anti-Obamacare Insurance Plans Are Ripping People Off”. It was written by Abigail Weinberg. From the article: The so-called “junk insurance” plans the Trump administration promotes may be helping insurance companies more than patients.Short-term, limited-duration health insurance plans – Obamacare workarounds that do not have to copy to the Affordable Care Act – spend less than ACA-compliant plans on medical care, according to a data published last week in the National Association of Insurance Commissioner’s 2018 Accident and Health Policy Report, as Modern Healthcare reported.For every dollar paid in premiums on UnitedHealthcare’s short-term health plans, 37 cents are spend on medical claims. At Cambia Health Solutions, just 9 percent of premium costs go to medical care. The rest of the money goes to administrative expenses or is kept as profit. On average, the report found that among the five health insuraers the earn the most in short-term insurance premiums, 39.2 percent of premiums were going to pay for patients’ medical care……ACA-compliant plans are required to spend 80 percent of premiums on medical care. Essentially, Obamacare set a cap on the percentage of profit health insurance companies can make off premiums, forcing them to spend the majority of their funds on actual medical services. If an insurance company ends up charging higher premiums than that 80 percent rate, the insurers have to send out rebates… August 8, 2019: Roll Call posted an article titled: “Senate GOP plans to divert health, education funds to border wall”. It was written by Paul M. Krawzak. From the article: Senate Republicans are looking to pay for President Donald Trump’s border wall in part by putting about $5 billion less into the largest domestic spending bill, several people with knowledge of the process said.That move signals a likely fight over wall funding, as well as over Trump’s ability to reprogram or transfer funds to the border, when the fiscal 2020 appropriations process resumes after Congress returns in September.According to several people familiar with the process, Senate Appropriations Chairman Richard C. Shelby, an Alabama Republican, wrote an allocation for the fiscal year 2020 Labor-HHS-Education spending bill, that is about $5 billion lower than it would have been to provide funding for the wall……Shelby’s provision for wall funding is not surprising. At the very least, it sets the table for a negotiation with the Democrat-led House, which did not include any wall funds in its Homeland Security bill, and sought to tie the administration’s hands in transferring military and other funds to the border project.In the Senate, it takes 60 votes to end debate to pass appropriations bills. While many Senate Democrats are expected to oppose the $5 billion in wall funds, one former GOP aide said the Labor-HHS-Education bill may be “generous” enough to attract Democrats’ support despite their objections……Senate Democrats will also have the chance to argue for changes more to their liking in a conference over House and Senate bills… August 8, 2019: The Hill posted an article titled: “Graham promises ObamaCare repeal if Trump, Republicans win in 2020”. It was written by Jessie Hellmann. From the article: Sen. Lindsey Graham (R-S.C.) said this week that Republicans would push to repeal ObamaCare if they win back the House and President Trump is reelected in 2020.“If we can get the House back and keep our majority in the Senate, and President Trump wins reelection, I can promise you that not only are we going to repeal ObamaCare, we’re going to do it in a smart way where South Carolina will be the biggest winner,” Graham said in an interview with a South Carolina radio station.“We’ve got to remind people the we’re not for ObamaCare.”Graham’s repeal bill, introduced in 2017, would eliminate major sections of ObamaCare, including subsidies that help people buy insurance and the Medicaid expansion the covers low-income adults in 36 states and Washington D.C.The bill would essentially shift money from states like California that expanded Medicaid to states that didn’t, like South Carolina. Such a move could force some states to cut health care services and reduce eligibility……Graham on Tuesday touted his bill, which would allow states to opt out of consumer protections, like those that prevent insurers from charging people with pre-existing conditions more for coverage… August 9, 2019: Pueblo Chieftain posted an article titled: “Health advocacy group backs Affordable Care Act in Pueblo”. It was written but Zach Hillstrom. From the article: Stage 4 cancer survivor and Denver resident Laura Packard rolled up to the Pueblo office of Republican Sen. Cory Gardner on Friday in a large van resembling an ambulance to deliver a petition asking Gardner to support a resolution protecting the Affordable Care Act.Packard and Hillary Glasgow, the president of the Southern Colorado Labor Council, made the stop at Gardner’s Office as part of the Health Care Emergency Tour – a 22-city tour highlighting Republican efforts to overturn the ACA hosted by the health care advocacy organization Protect Our Care.“We’re here going to Sen. Gardner’s office in Pueblo to drop off a petition asking him to sign on to Sen. (Jeanne) Shaheen’s resolution to protect the Affordable Care Act and stop the court case that threatens protection for everyone,” Packard said……The resolution sponsored by Shaheen that Packard referenced seeks to sway the Department of Justice to reverse its decision supporting a December ruling of a Texas court, which found the ACA o be unconstitutional…Packard, who was diagnosed with stage 4 cancer in April 2016, underwent six months of chemotherapy treatment and one month of radiation and was finally declared in remission at the beginning of 2018.She was insured both before and after the ACA was passed, and said one of the primary reasons she is taking part in the Health Care Emergency Bus Tour is to protect others like her, who have preexisting conditions that could disqualify them from receiving insurance if the ACA is repealed… August 9, 2019: IndyStar posted an article titled: “Here’s how Pete Buttigeig would improve rural health care”. It was written by Chris Sikich. From the article: Democratic presidential hopeful Pete Buttigeig released a second major policy proposal this week, delving into how he would reform health care for rural Americans.The South Bend mayor points to the widening gap between rural and urban life and how each needs different approaches.Some of the ideas are familiar pitches from stump speeches, such as expanding access to Medicare, while others sound new, including increasing the available of doctors through a variety of means.Buttigeig released the 10-page proposal in an email to supporters Friday. It calls for significant taxpayer investment in programs like Medicare, Medicaid, the Affordable Care Act, and numerous grants, though it is unclear precisely how much it would cost or how he would pay for it. His campaign did not immediately return a phone call… August 9, 2019: South Bend Mayor Pete Buttigeig, who is running for president, released a 10-page plan called Securing a Health Future for Rural America. Here are some key points from his plan: Guarantee an affordable health insurance option through Medicare for All Who Want It: Implement Medicare for All Who Want It. This approach makes a Medicare-type insurance plan available for all people. This plan will make coverage more affordable by creating incentives that encourage corporate insurers to compete with the cheaper Medicare-type plan. It will also give people more choice in health care options, which is critical in rural areas the frequently face a shortage of coverage options. If corporate insurers don’t lower costs to deliver something dramatically better than what is available today, competition will lead us toward Medicare for All.Increase and expand access to federal subsidies for marketplace coverage. Pete will increase subsidies for low-income Americans and expand the subsidies to middle-income Americans. The subsidies from the ACA have made affordable for many low-income Americans, and we know that more generous subsidies would help improve both affordability and coverage. Dramatically reduce care shortages in rural areas by increasing the number of physicians and other health providers, with an emphasis on primary care, maternal care, mental health, and addition providers. Expand the Public Service Loan Forgiveness Program (PSLF) and the National Health Service Corps. We will expand PSLF program beyond government-, and not-for-profit- based employment to include employment in rural private hospitals and practice groups. We will also restructure the program so that rather than relieving all the debt at the end of a 10-year period, the PSLF will forgive a portion of loan debt annually.Increase Medicare reimbursement rates – and encourage states to increase Medicaid reimbursement rates – for providers working in medically underserved areas. Increasing rural providers’ reimbursement rates will help make it more sustainable for them to treat patients in rural settings and help avoid hospital closures.Expand funding for training models that incentivize medical students and residents to work in rural communities. This includes development and expansion of graduate medical education (GME) and rural residency training track (RTT) programs and supports other initiatives to rebalance GME training funds from urban settings – where 99% of the funding goes – to rural ones. This can include decoupling GME funding from hospitals and instead tying it to Federally Qualified Health Centers (FQHCs) Rural Health Clinics (RHCs) and community-based programs. Assure universal access to prevention and treatment for mental illness and addiction, and invest in making communities livable, resilient, and healthy. … To address this crisis, we will begin by prioritizing ensuring universal access to effective treatment, such as therapy and medication to treat opioid addiction, and enforcing mental health parity. We will also train communities to address sigma and better support each other through a pillar of our National Service Plan, the Community Health Corps. These policies, and more, will be fully articulated in a forthcoming mental health and addiction policy plan. Reduce maternal morality rates by expanding access to high quality care and support before, during, and after pregnancy. Ensure coverage for and access to the full range of reproductive health care and family planning services in rural areas, including through increased funding for Title X family planning, and protection of Medicaid expansion and the ACA’s Essential Health Benefits that provide preventive reproductive care for women with no cost sharing.Support the Rural MOMS Act. The Act will improve data collection of maternal mortality and morbidity in rural areas, develop grants to establish regional networks of care, support telehealth initiatives and infrastructure specific to maternal health, and train family medicine physicians, nurse practitioners, doulas, and other professionals to provide maternal care services in rural settings.Support the MOMMA Act, Maternal CARE Act, MOMS Act, and MOMMIES Act. These Acts require training to address implicit bias and racism in hospitals and other health care settings, expand Medicaid coverage for one year postpartum, expand evidence-based programs shown to reduce disparities in pregnancy outcomes, such as the maternal safety bundles developed by the Alliance for Innovation on Maternal Health, and establish pregnancy medical home demonstrations to improve continuity of care. Make it easier for patients to be treated at or near their home by investing in telehealth. Massively expand coverage of high-speed broadband Internet across the country by the end of the first term. This policy will be fleshed out in a forthcoming policy plan for rural communities and small towns.Help health providers purchase and implement the technology necessary to provide telehealth services by doubling the funding for the Federal Communication Commissions (FCC) Rural Health Care Program to $1 billion annually. This includes support for the FCC’s Connected Care pilot program, which will develop telehealth programs for rural veterans and low-income people.Expand the types of care settings that can receive reimbursement for telehealth services. This expansion will include outpatient rehabilitation centers and other locations outside traditional health care settings.Allow health professionals to get compensated for virtually treating patients at home, including for annual wellness visits, chronic care management, acute visits, and remote patient monitoring. August 12, 2019: ABC WKBW Buffalo posted an article titled: “Health insurance premiums to drop under Affordable Care Act”. From the article: Health insurance premiums are set to drop next year under the Affordable Care Act.The Department of Financial Services (DFS) announced Premium Rates for 2020 on Monday. According to a news release issued by the department, “rates for individuals are more than 55% lower than prior to the establishment of the NY State of Health in 2014, adjusting for inflation but not counting federal financial assistance that the ACA makes available to many consumers purchasing insurance. Approximately 326,000 New Yorkers are currently enrolled in individual commercial plans.”The DFS, “reduced overall Insurers’ Requested Rate for Individual Coverage from 9.2% to 6.8%, saving consumer over $50million.”… August 12, 2019: Politico posted an article titled: “Trump to deny green cards to immigrants receiving public benefits”. It was written by Ted Hesson. From the article: The Trump administration issued a final rule Monday that allows for federal officials to deny green cards to legal immigrants who have received certain public benefits or are deemed likely to do so in the future.The “public charge” regulation – pushed by White House senior advisor Stephen Miller and other hard-line officials – is the latest part of President Donald Trump’s vast immigration crackdown. While Trump has railed against migrants arriving at the U.S.-Mexico border, the new regulation represents his most ambitious effort yet to restrict legal immigration has he gears up for his 2020 reelection campaign……Still, the contentious policy is already triggering legal challenges, with one pro-immigrant group, the Los Angeles-based National Immigration Law Center, announcing this morning that it will file suit……A collection of public health associations, educators, and pro-migrant activists have argues the public charge rule will force patients to forgo essential services for their children. Both House and Senate Democrats criticized the measure after a draft version published in October.The benefits covered under the regulation include food stamps, welfare, Medicaid, and housing assistance. Even before the administration issued a proposed rule last year, agencies across the country reported decreased enrollment in a federal nutrition program aimed and pregnant women and children.The overall thrust of the regulation, which will be effective October 15, is unchanged from the proposed version, but there are some notable differences outlined by USCIS in a related summary released Monday.The regulation will not consider enrollment in Children’s Health Insurance Program toward a public charge determination. The draft published this fall asked whether CHIP – which provides low-cost coverage to families that earn too much to qualify for Medicaid – should be included in the list of benefits.In addition, the use of Medicaid by children, pregnant women, and new mothers during a 60-day period after going birth will not lead to being labeled a public charge. The final also dropped a prescription drug subsidy program, known as Medicare Part D, from a list of restricted benefits.The final regulation specifically noted that the use of the WIC program, a supplemental food benefit for low to moderate-income pregnant women, infants, and children, would not contribute to a public charge determination.While the Homeland Security Department acknowledged it was “plausible” the regulation could have a chilling effect driving families away from the nutrition program, the department stopped short of qualifying the phenomenon… August 12, 2019: The Hill posted an article titled: “Data shows drop in coverage among people ineligible for ObamaCare subsidies”. It was written by Peter Sullivan. From the article: Health insurance enrollment decline among people who do not qualify for financial help under ObamaCare as premiums rose to make coverage less affordable, new federal data shows.The data release by the Centers for Medicare and Medicaid Services (CMS) on Monday shows that enrollment declined by 1.2 million people, or 24 percent, between 2017 and 2018 among people with incomes too high to qualify for ObamaCare subsidies.In contrast, in the same period, enrollment ticked up by 300,000 people among those with lower incomes who did qualify for financial help under ObamaCare.The data illustrates that while ObamaCare remains stable given the subsidies available to lower-income people, premium increases helped drive away people with higher incomes, experts said……Cynthia Cox, another Kaiser Family Foundation expert, pointed out that the individual market for health insurance, including both those who receive and do not receive ObamaCare subsidies, is still larger than it was before the Affordable Care Act (ACA).“There were about 10.6 million people signed up ON the exchange markets in early 2019,” she wrote on Twitter. “Plus, there are a few more million people signed up OFF-exchange”.“Pre-ACA, the entire individual market was about 10.5 million people,” she added. August 12, 2019: The Sacramento Bee posted an article titled: “Charity case spending by California hospitals has plunged in wake of Affordable Care Act”. It was written by Harriet Blair Rowan. From the article: California hospitals are providing significantly less free and discounted credit to low-income patients since the Affordable Care Act took effect.As a proportion of their operating expenses, the state’s general acute-care hospitals spent less than half on these patients in 2017 than they did in 2013, according to data the hospitals reported to California’s Office of Statewide Health Planning and Development.The biggest decline in charity care spending occurred from 2013 to 2015, when it dropped from just over 2 percent to under 1 percent. The spending has continued to decline, though less dramatically, since then.The decline was true of for-profit hospitals, so-called nonprofit hospitals and those designated as city, county, district or state hospitals.Health experts attribute the drop in charity care spending largely to the implementation of the federal Affordable Care Act, popularly known as Obamacare. The law expanded insurance coverage to millions of Californians, starting in 2014, and hospitals are now treating far fewer uninsured patients who cannot pay for the care they receive……The data on charity care comes from most of the state’s general acute-care hospitals but does not include Kaiser Permanente hospitals, which are not required by the state to report their charity care totals……Nonprofit “hospitals get tax-exempt status, but they don’t get it for free,” said Ge Bai, associate professor of accounting and health policy at Johns Hopkins University. Charity care “is part of the implicit contract between hospital and taxpayers.”Bai sees the reduced spending on charity care as part of a trend of nonprofit hospitals acting more like their for-profit counterparts.Many nonprofit hospitals “no longer consider charity care their primary mission,” she said. “They are making more and more money but they are dropping their charity care.”… August 12, 2019: Kaiser Family Foundation posted information titled: “Changes to “Public Charge” Inadmissibility Rule: Implications for Health and Health Coverage”. Here are the key takeaways from the information: In August 2019, the Trump Administration announced a final rule that changes the public charge policies used to determine whether an individual applying for admission or adjustment of status is inadmissible to the U.S. Under longstanding policy, the federal government can deny an individual entry into the U.S. or adjustment to legal permanent resident (LPR) status (i.e. a green card) if he or she is determined likely to become a public charge. Under the rule, officials will newly consider use of certain previously excluded programs, including non-emergency Medicaid for non-pregnant adults, the Supplemental Nutrition Assistance Program (SNAP) and several housing programs, in public charge determinations.The changes will create new barriers to getting a green card or immigrating to the U.S. and likely lead to decreases in participation in Medicaid and other programs among immigrant families and their primarily U.S.-born children beyond those directly affected by the new policy. Nationwide, over 13.5 million Medicaid and CHIP enrollees, including 7.6 million children, live in a household with at least one noncitizen or are noncitizen themselves and may be at risk for decreased enrollment a result of the rule.Decreased participation in these programs will contribute to more uninsured individuals and negatively affect the health and financial stability of families and the growth and healthy development of their children. August 12, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood Responds to Trump Administration’s “Public Charge” Rule”. From the press release: Today, the Trump-Pence administration’s Department of Homeland Security released its final public charge rule, a harmful rule designed to keep families separated and to dissuade immigrants from accessing health care and meeting other basic needs. Under this new rule, people could be denied visas, green cards, and entry into the U.S. simply because they have received any one of a broad range of public benefits they are legally allowed to access, including health care, nutrition assistance, and housing assistance. The rule will likely take effect on or around October 15, 2019.Statement from Alexis McGill Johnson, Acting President, Planned Parenthood Federation of America:“This is a racist and cruel attack against immigrants, on the heels of massive raids that have torn apart families, and racist and hateful rhetoric from the president himself. These relentless attacks on immigrants by the Trump-Pence administration have contributed to a culture of fear in immigrant communities, and keep far too many from seeking the health care they need.No one’s health or safety should be at risk because of their immigration status. If this harmful rule goes into effect, it would have a devastating impact on millions of people including our patients. Planned Parenthood is committed to standing with all immigrants. Living in a safe and healthy environment alongside their family is part of living a healthy, complete life.This administration is punishing people simply for taking care of their health, for feeding their families, or for putting a roof over their heads. This is inhumane. No person should be punished for meeting their basic needs, or for caring for their families. August 12, 2019: CBS News posted an article titled: “Tennessee to push for total abortion ban with sights on Supreme Court”. It was written by Kate Smith. From the article: After struggling to pass a six-week abortion ban earlier this year, Tennessee lawmakers are now considering one of the most restrictive abortion laws in the country: a total ban on the procedure.On Monday and Tuesday, the state’s judiciary committee will hear testimony from more than 20 witnesses and debate an 11-page amendment to its stalled “fetal heartbeat” bill. If the changes are adopted, the legislation will ban abortion once a woman knows she’s pregnant.The committee, which has seven Republicans and two Democrats, is expected to accept the changes. The amended bill would be put up for a vote in January 2020, when the legislature reconvenes.This week’s summer study comes as states have raced to pass legislation restricting abortion, hoping to challenge Roe v. Wade, the 1973 Supreme Court decision that protects access to the procedure. This year six states — Arkansas, Georgia, Kentucky, Louisiana, Mississippi and Ohio — passed so-called “heartbeat” bills, legislation that bans abortion after cardiac activity can be detected in a fetus. Missouri passed an eight-week ban in May, and Alabama went a step further passing an near-total abortion ban.Tennessee nearly joined those conservative states with House Bill 77, a “fetal heartbeat” bill that doesn’t provide exceptions for victims of rape or incest.It passed the state’s House in March but stalled in the Senate when conservative leaders questioned the efficacy of the bill, said state Senator Kerry Roberts, who serves on the state’s judiciary committee, in a telephone interview with CBS News……Rather than cutting off access to abortion after cardiac activity is detected, the amendment redefines fetal viability. Federal standards, based on past Supreme Court decisions, consider viability to mean when a fetus can survive on its own outside the womb. In Tennessee, policy makers have proposed that viability is when a pregnancy can be detected… August 13, 2019: The American College of Obstetricians and Gynecologists (ACOG) posted a press release titled: “Joint Statement of America’s Frontline Physicians Opposing Public Charge Final Rule”. From the press release: The Department of Homeland Security issued a final regulation that changes long-standing rules governing how and whether immigrants can be determined to be a “public charge;” widens the scope of programs considered by the government in making such a determination; and serves as a barrier to accessing health care for legal immigrants, as doing so can now serve as a basis for denying individuals green cards or U.S. visas.In response, the Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Osteopathic Association, American College of Physicians, and American Psychiatric Association, collectively representing more than 597,000 of America’s frontline physicians, issued this statement:Our organization, which represent more than 597,000 physicians and medical students, are united in expressing our deep concern and opposition to the final public charge regulation issued by the Department of Homeland Security (DHS). The regulation upends decades of settled policy with regard to public charge and makes it much more likely that the lawfully present immigrants may not seek health care, whether preventative services or treatment, when faced with illness, since doing so could be used to deny green cards or U.S. visas, or even lead to deportations.Rather than face that threat, impacted patients currently served by our members almost certainly will avoid needed care from their trusted physicians, jeopardizing their own health and that of their communities. Many of our members have already witnessed this chilling effect among their own patient populations, with patients avoiding health services and programs out of fear. The public charge final rule not only threatens our patients’ health, but as this deferred care leads to more complex medical and public health challenges, it will also significantly increase costs to the health care system and U.S. taxpayers. Most important, the order puts a governmental barrier between physicians and patients and stands in stark contrast to the mission our organizations share: ensuring meaningful access to health care for patients in need.We urge DHS to rescind the public charge final rule and work with us to ensure broader access, improved quality, and more affordable care for our patients. August 13, 2019: WHYY posted an article titled: “Pa. N.J. health experts warn new Trump immigration rule will increase uninsured”. It was written by Nina Feldman. From the article: The Trump administration is making it more difficult for some immigrants who are in the United States legally and receiving certain public benefits to be granted permanent legal status here.As it stands, if people are considered likely to become a “public charge” to the state, that will be counted against them in their applications for green cards. The new rule, which was announced Monday and will be published the Federal Register Wednesday, will expand the definition of “public charge” to include those on public benefits such as Medicaid, food stamps, and housing vouchers.In New Jersey, the Department of Human Services estimated that as many as 200,000 eligible women and children enrolled in Medicaid and CHIP could be affected y the chilling effect of the proposed rule……Although the new rule does not include enrollment in CHIP, the Children’s Health Insurance Program, as a cause for public charge designation, researchers and advocates are worried that parents will confuse that insurance program with Medicaid, causing their kids – many of whom are U.S.-born citizens – to lose health insurance……The new rule expands the number of factors to be considered in public charge designations. On top of receiving public benefits like Medicaid, Medicare Part D, and subsidized public housing, the adjusted rule also considers a person’s income and part-time student status… August 13, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “ACLU Of Arkansas Tells Trump Admin: Don’t Roll Back Health Care Rights”. From the press release: The ACLU of Arkansas urged the United States Department of Health and Human Services not to roll back critical nondiscrimination protections for vulnerable people and communities. In comments submitted yesterday objecting to proposed changes to the Health Care Rights Law, Section 1557 of the Affordable Care Act, the ACLU of Arkansas stressed the devastating health consequences for transgender people, those seeking reproductive health care including abortion, as well as people of color, people who are disabled, those with limited English proficiency, and others.“No one should be blocked from care for being themselves. But two years after attempting to eliminate protections for pre-existing conditions, the Trump administration is once again putting the health of Arkansans at risk by proposing to roll back critical nondiscrimination protections for our most vulnerable communities,” said Jayme Womack, policy director for the ACLU of Arkansas. “Health care discrimination causes lasting and life-threatening harm to people’s health and well-being, and transgender and non-binary people are especially vulnerable to being denied care.”……Since taking office, the Trump administration has attempted to roll back protections for transgender people in education, the military, prisons, and homeless shelters, in addition to health care. It has also supported allowing insurance companies to discriminate and deny care to people with pre-existing conditions like cancer and diabetes.On October 8, the Supreme Court will hear arguments in a case involving Aimee Stephens, who was fired because she is transgender. While a federal appeals court and the federal agency in charge of workplace discrimination complaints have said that transgender people are protected from discrimination, the Department of Justice reversed positions under the Trump administration. However, in both health care and employment, the Trump administration cannot erase decades of court decisions saying trans people are protected under laws prohibiting sex discrimination… August 13, 2019: The American Civil Liberties Union (ACLU) posted “ACLU Comment On Proposed Changes To Section 1557 Of The Health Care Law”. It is a letter that the ACLU sent to the U.S. Department of Health and Human Services Office for Civil Rights. From the letter: …The American Civil Liberties Union (“ACLU”) submits these comments on the proposed rule published … with the title “Nondiscrimination in Health and Health Education Programs or Activities” (the “Proposed Rule” or “Rule”)……The Proposed Rule is yet another attempt by the Trump Administration (the “Administration”) and the Department of Health and Human Services (the “Department” or “HHS”) to undermine access to health care for the most vulnerable individuals and communities, while emboldening discriminatory and dangerous denials of care. Instead of combatting discrimination in access to health care and insurance coverage, the Department set out to weaken anti discrimination protections for transgender, non-binary, and gender-nonconforming people, who already face threats of violence and discrimination in all aspects of their lives. Further, case after case has confirmed that transgender people are protected under the antidiscrimination statute, Section 1557, which the Administration cannot change even if this rule is finalized.The Proposed Rule also rolls back protections for people who face discrimination on other grounds. The Proposed Rule explicitly narrows the scope of Section 1557’s anti discrimination protections and implicit invites health care providers to deny access to care. The Department offers these dangerous amendments, despite its original position that discrimination in health care leads to adverse health outcomes and exacerbates existing health disparities in underserved communities. It thus sanctions and completely disregards these harms to individuals trying to access health care and coverage. The proposed changes are contrary to the statutory language and reverse the reasoned policy decisions of the current regulations implementing the statute. As a result, the Proposed Rule will fail to accomplish its stated goal to decrease confusion instead of increasing the burdens and costs of compliance.For these reasons, as well as the ones that follow, we recommend that the Department decline to finalize any part of the Proposed Rule… August 13, 2019: The American Medical Association (AMA) posted a press release titled: “AMA condemns efforts to remove patient nondiscrimination protections.” From the press release: In formal comments today, the American Medical Association (AMA) spoke out against the Trump administration’s misguided proposal to remove anti-discrimination protections related to sexual orientation, gender identity, and the termination of pregnancy across a wide variety of health care programs and insurance plans.The AMA noted that the proposal perverts the nondiscrimination provisions included in the Affordable Care Act by drastically limiting coverage protections despite decades of case law recognizing these protections.The letter said: “This proposal marks the rare occasion in which a federal agency seeks to remove civil rights protections. It legitimizes unequal treatment of patients by not only providers, health care organizations, and insurers, but also by the government itself – and it will harm patients. Such policy should not be permitted by the U.S. government, let alone proposed by it.”The letter concludes: “HHS should not finalize the proposed rule, but rather should redefine their efforts toward advancing health care access and equality for all. The AMA remains ready to assist with such efforts.”The full text of the letter can be downloaded here. August 14, 2019: Planned Parenthood posted a press release titled: “New Filing: Unless Ninth Circuit Intervenes by August 19, Planned Parenthood, Which Serves 40 Percent of the 4 Million Title X Patients, Will be Forced Out of The Title X Program”. From the press release: Facing an HHS-imposed deadline of Aug. 19, Planned Parenthood today informed the 9th Circuit Court of Appeals that unless it intervenes, Planned Parenthood entities who are Title X grantees will be forced out of the Title X program by August 19 – putting access to affordable birth control at risk for people across the country. Planned Parenthood health center serve 40 percent of the 4 million Title X patients, and have been a part of the Title X program since its inception.Title X is the nation’s only dedicated program for affordable birth control and reproductive health care. The gag rule makes it illegal for any provider in the Title X program to tell patients how or where to access abortion, and imposes cost-prohibitive and unnecessary “physical separation” restrictions on health centers that provide abortion – moves that are clearly meant to push Planned Parenthood health centers and other reproductive health care providers out of Title X. HHS – which has asked all direct grantees to submit a plan for complying with the unethical gag rule by August 19 – even awarded $1.7 million in Title X funding this year to the Obria Group in California, an anti-abortion group that has made clear they “do not provide contraceptives.”……Congress is also looking to take long-term action to protect Title X. In June, the House of Representatives passed a spending package including strong language blocking the Trump-Pence administration’s Title X gag rule from being implemented. Now, the Senate must push for a spending bill that includes protective language to make sure millions of people can continue to access health care through Title X……Planned Parenthood is not the only direct grantee who will be forced out under the Trump Administration’s unethical gag rule – in total, the gag rule would force providers that serve nearly half of all Title X patients out of the program. So far, five governors (HI, IL, NY, OR, WA) have made clear that the could not participate in the Title X program if the gag rule was implemented, two state legislatures (MA and MD) have passed laws to that effect, and the only Title X direct grantee that serves the state of Maine has made clear they would not participate in Title X under the gag rule. In total, these eight states and Planned Parenthood health centers collectively serve 47 percent of the Title X patients in the Unites States… August 14, 2019: The American Civil Liberties Union (ACLU) posted a statement titled: “ACLU Comment On Department of Labor Proposal To License Discrimination In The Name of Religion”. From the statement: Ian Thompson, senior legislative counsel for the American Civil Liberties Union, issued the following statement in response to a rule proposed today by the Department of Labor:“Once again, the Trump administration is shamefully working to license taxpayer-funded discrimination in the name of religion. Nearly one-quarter of the employees in the U.S. work for an employer that has a contract with the federal government. We will work to stop this rule that seeks to undermine our civil rights protections and encourages discrimination in the workplace.” August 16, 2019: California Attorney General Xavier Becerra posted a press release on his official website titled: “Attorney General Becerra Leads Coalition of Five Attorneys General, Files Suit Challenging Trump Administration Public Charge Rule”. From, the press release: California Attorney General Xavier Becerra today led a multistage coalition in challenging in court the Trump Administration’s Inadmissibility on Public Charge Grounds Final Rule, known as the “Department of Homeland Security (DHS) Public Charge Rule.” The lawsuit, filed in the U.S. District Court for the Northern District of California, claims the Rule targets working immigrants and their families by creating unnecessary new barriers to lawful admission to the United States. The Rule discourages hardworking eligible families from accessing critical health, nutrition, and housing programs that supplement their modest wages and help them make ends meet. The Rule creates such a strict standard that, if it were applied to citizens across the country, a substantial portion would be considered likely to be a ‘public charge’……Public benefit programs are designed to help working families make ends meet and ensure strong, healthy families in California. Current guidance by the federal government defines a public charge as a person who is primarily dependent on either public as assistance for income maintenance or institutional long-term care at the government’s expense. The Rule declares that use of additional government programs, including nutrition and food support through CalFresh (California’s Supplemental Nutrition Assistance Program), healthcare through MediCal (California’s Medicaid program), and housing families through Section 8 housing assistance, now constitute grounds for a public charge determination. These changes would discourage many immigrants and mixed immigration-status families, who are not otherwise subject to the rule, from accessing benefits for which they are eligible and entitled. It will also make it harder for hard-working, low and moderate-income immigrants to be admitted into the United States or get green cards. In the lawsuit, the Attorneys Generals argue that the rule: Violates the Equal Protection Guarantee of the Fifth Amendment: The Rule will disproportionately block admission of non-white, non-European immigrants from Asia, Latin America, and Africa. It will also prevent higher numbers of immigrants of color from extending their visas or becoming lawful permanent residents, and ultimately create more obstacles in the path to U.S. citizenship.Arbitrary and Capricious: The Rule punishes immigrants for participating in widely used public benefits programs that are designed to mitigate economic inequality and bolster self-sufficiency, particularly among low wage workers. The Rule also fails to adequately assess the costs that increasing the poverty of families and U.S. citizen children will have on the Nation, its states, and communities.Contrary to Law: The Rule is contrary to law, interfere with the states’ rights to protect their residents, and exceeds the Administration’s authority under federal immigration law by circumventing congressional intent… …Joining Attorney General Becerra in filing the lawsuit are the Attorneys General of Maine, Oregon, Pennsylvania, and the District of Columbia. A copy of the complaint is available to view online on the California Office Of Attorney General website. August 16, 2019: The Hill posted an article titled: “Appeals court again allows Trump family planning rules to go into effect”. It was written by Tal Axelrod. From the article: A U.S. appeals court Friday again declined to block new rules from the Trump administration that prohibit clinics that receive federal funds from referring patients for abortions.The 9th U.S. Circuit Court of Appeals rejected a lawsuit from over 20 states, Planned Parenthood and the American Medical Association to suspend the rules while their case against them is litigated, according to The Associated Press.A three-judge panel and an 11-judge panel had already ruled that the rules can go into effect while the administration appeals district court rulings against them. Oral arguments are slated to commence next month.Planned Parenthood, the nation’s chief abortion provider, said this week it would leave the federal Title X program Monday unless the administration’s rules are blocked. The group stopped using Title X family planning funds last month after the restrictions were announced but told the Department of Health and Human Services (HHS) it would stay in the program while it sues over the changes.Planned Parenthood has been a staple in the program for decades, serving about 40 percent of all Title X patients and receiving millions of dollars in federal funds… August 26, 2019: Planned Parenthood posed a press release titled: “Planned Parenthood’s Clergy Advocacy Board: The Title X Gag Rule is Immoral, Harms Those in Need”. From the press release: On Monday, the Trump administration used its immoral, unethical, and dangerous gag rule to force Planned Parenthood health centers out of Title X – – putting health care at risk for 1.5 million people. The Clergy Advocacy Board of Planned Parenthood Federation of America stands against this attempt to strip poor people of their health care, and stands with the millions of people across the country who rely on Planned Parenthood and its affiliates for their reproductive care.Planned Parenthood health centers have been a part of Title X since it was created nearly 50 years ago, and the organization has been the largest provider, serving 40 percent of all patients who get care through the program. Title X is meant to ensure that patients who are poor or struggling to make ends meet can still access birth control, breast and cervical cancer screenings, and STI testing and treatment. This gag rule puts that care out of reach by asking doctors and nurses to withhold information about abortion from patients in order to stay in the program – – a complete violation of ethics……Made up of leaders from diverse faith traditions, members of the Clergy Advocacy Board recognize that their religious traditions call them to stand with the vulnerable. The Clergy Advocacy Board stands against efforts by politicians to deny millions of people the right to exercise their own moral beliefs in making the best health care decisions for themselves and their families. The Clergy Advocacy Board condemns this gag rule and affirms the goodness of supporting access to comprehensive reproductive care for every person – – including access to accurate and complete medical information… August 26, 2019: ABC News posted an article titled: “Judge expected to rule Tuesday on injunction of abortion law”. It was written by Summer Ballentine and Margaret Stafford. From the article: A federal judge says he will issue a ruling Tuesday that will determine whether Missouri’s new abortion law banning abortions at or after eight weeks of pregnancy will take effect as scheduled this week.During a court hearing on Monday, Planned Parenthood and the American Civil Liberties Union asked U.S. District Judge Howard Sachs to issue a temporary restraining order to stop the law from taking effect on Wednesday until a legal challenge against it is decided. Sachs told attorneys had a draft of his written ruling ready, but that he wanted to consider Monday’s arguments before issuing it on Tuesday. He did not indicate how he would rule. The law is scheduled to take effect Wednesday. It would also ban abortions based solely on race, sex, or a diagnosis indicating the potential for Down syndrome.Claudia Hammerman, an attorney for Planned Parenthood and the American Civil Liberties Union, argued that earlier abortion-related rulings from courts across the country, including the U.S. Supreme Court, make it clear the bans are unconstitutional because they address abortions before the fetus is considered viable outside the womb, which can be from 24 to 28 weeks……The Missouri law in question also includes an outright ban on abortions except in cases of medical emergencies, but that would only take effect if the landmark 1973 U.S. Supreme Court’s Roe v Wade ruling that legalized abortion nationwide is overturned… August 26, 2019: NBC News posted an article titled: “Idaho must provide sex reassignment surgery for trans inmate, court rules”. It was written by Tim Fitzsimons. From the article: Depriving a transgender inmate with severe gender dysphoria of sex reassignment surgery is a form of “cruel and unusual punishment,” a federal appeals court ruled Friday, affirming a lower court ruling.The 9th U.S. Circuit Court of Appeals ordered the state of Idaho to provide the surgery for trans inmate Adree Edmo. The ruling is the first time an appeals court has ordered a state to provide gender-affirming surgery to a prisoner, and the decision is at odds with a ruling issued earlier this year by the 5th U.S. Circuit Court of Appeals.Idaho’s Republican governor, Brad Little, vowed to appeal the decision to the U.S. Supreme Court……”Responsible prison authorities were deliberately indifferent to Edmo’s gender dysphoria, in violation of the Eight Amendment,” the 9th Circuit ruling stated, adding it was established that “Edmo had a serious medical need, that the appropriate treatment was GCS [gender confirmation surgery], and that prison authorities had not provided that treatment despite full knowledge of Edmo’s ongoing and extreme suffering and medical needs.”… August 27, 2019: BBC News posted an article titled: “US judge blocks Missouri eight-week abortion ban”. From the article: A US federal judge has temporarily blocked Missouri from enforcing a law banning nearly all abortions in the state after eight weeks of pregnancy.The law was set to take effect on Wednesday.It would ban abortions after eight weeks except in cases of medical emergency.US District Judge Howard Sachs said it was not to be enforced, “pending litigation or further order of the court……”While federal courts should generally be very cautious before delaying the effect of State laws, the sense of caution may be mitigated when the legislation seems designed, as here, as a protest against Supreme Court decisions,” Mr Sachs wrote in his opinion on Tuesday.A portion of the legislation prohibiting abortions based solely on race, sex or a diagnosis indicating the potential for Down syndrome was permitted to take effect……The law, dubbed Missouri Stands With The Unborn, would outlaw performing an abortion in nearly all cases.Exemptions would be made for medical emergencies, but not pregnancies caused by rape or incest.Doctors who performed abortions more than eight weeks into pregnancy would face five to 15 years in prison.A woman who had an abortion would not be held criminally liable… August 27, 2019: Planned Parenthood posted a press release titled: “BREAKING: FEDERAL COURT IN MISSOURI BLOCKS CASCADING ABORTION BANS”. From the press release: Today, a U.S. District Court judge in the Western District of Missouri granted a preliminary injunction, blocking several of Missouri’s sweeping abortion bans passed earlier this year. The blocked bans, which would have made abortion illegal starting at eight weeks, would have taken effect tomorrow. This lawsuit challenges a law that created an unprecedented number of bans at once, at nearly every stage of pregnancy which is part of a multi-layered effort by state politicians to push abortion out of reach for 1.1 million Missourians of reproductive age. The provision the court allowed to take effect, at least at this preliminary stage, blocks patients from seeking an abortion based on race, gender, or Down syndrome diagnosis. Missouri is now one of eight states that force doctors to investigate why their patients are making a deeply personal medical decision. The court indicated openness to reviewing the issue again on a renewed motion.In May, emboldended by the Trump administration, Gov. Mike Parson signed House Bill 126, which imposes a series of draconian abortion bans and medically unnecessary restrictions designed to make it impossible for patients to access abortion. Last month, Planned Parenthood, along with partners at the ACLU and law firm Paul, Weiss, Rifkind, Wharton & Garrison LLP, gook the state of Missouri to court over the clearly unconstitutional abortion bans. With only one abortion provider left in the state, access hanging by a thread……Missouri is one of 12 states to pass an abortion ban just in the first half of this year. State politicians, emboldened by President Trump, have passed a total of 26 abortion bans nationwide in 2019 alone. With Justice Kavanaugh on the Supreme Court, anti-abortion politicians are racing to pass bills designed to overturn Roe v. Wade……While the state is cutting off access to abortion, maternal and reproductive health in the state is in crisis. Maternal mortality rates in Missouri are more than 50 percent higher than the national average, and a syphilis outbreak is sweeping the state. The same politiciaons who claim to value “life” continue to sit idly by while public health outcomes worsen. August 28, 2019: The American Civil Liberties Union (ACLU) posted a press release titled: “Victory: Appeals Court Upholds Block On Unconstitutional Abortion Restrictions”. From the press release: The 7th Circuit Court of Appeals today upheld a preliminary injunction against a restrictive abortion law, SEA 404, that would have imposed undue burdens on young women’s personal medical decisions.The American Civil Liberties Union of Indiana challenged the law on behalf of Planned Parenthood of Indiana and Kentucky (PPINK) and its patients. In 2017, a federal district court blocked the law from taking effect, concluding that it “places an unjustifiable burden on mature minors in violation of the Fourteenth Amendment.”SEA 404 included an unnecessary and dangerous add-on to Indiana’s existing parental consent law, which the lawsuit asserts would endanger young women in vulnerable circumstances. The U.S. Supreme Court has held that a minor who is unable or unwilling to obtain parental consent for an abortion must be allowed to obtain an abortion if a judge determines that she is sufficiently mature to make the best decision herself or if an abortion is in her best interests. Indiana has long had such a procedure.SEA 404 would burden a minor’s ability to obtain an abortion by allowing parents to be notified, even in cases which a judge has determined that a young woman is mature enough to make the decision herself. The evidence in the case demonstrated that the notice provision might lead to young women being harmed or harming themselves.Ken Falk, Legal Director at the ACLU of Indiana, released the following statement: “This decision affirms that the state must continue to provide a safe alternative for young women who – whatever their circumstances – are unable to talk to their parents about this difficult and personal decision. Legislators need to stop targeting women with invasive hurdles and start respecting the rights of all Hoosiers to make their own personal medical decisions. These heavy-handed restrictions would have burdened young women’s constitutional rights and put their health and safety at risk.”… August 29, 2019: BBC News posted an article titled: “US hospital ‘forced’ Catholic nurse to assist with abortion”. From the article: The US government has accused a hospital in Vermont of violating the civil rights of a nurse by forcing her to help carry out an abortion.The nurse, who has not been named, said she told the hospital that she could not take part in pregnancy terminations because of her religious beliefs.Health care workers are protected under federal law from discrimination based on their religious or moral beliefs.The University of Vermont Medical Center (UVMC) denies the allegations……The incident took place in 2017 and the nurse, who is a Catholic, no longer works at the hospital.On Wednesday, the Department of Health and Human Services warned UVMC that it had 30 days to comply with civil rights law or it could face funding cuts……This is the first action of its kind since the department created a conscience and religious freedom division last year. The Trump administration has supported religious freedom measures.In a statement, the hospital said the allegations “were not supported by the facts.”… September 4, 2019: Reuters posted an article titled: “U.S. Judge approves CVS purchase of insurer Aetna”. It was written by Diane Bartz. From the article: A federal judge reviewing a Justice Department decision to allow U.S. pharmacy chain and benefits manager CVS Health Corp to merge with health insurer Aetna said in Wednesday that the agreement was in fact legal under antitrust law.Judge Richard Leon of U.S. District Court for the District of Columbia had been examining a government plan announced in October to allow the merger on condition that Aetna sell its Medicare prescription drug plan business to WellCare Health Plans Inc. Both deals have already closed.Leon had initially balked at approving the merger conditions and insisted on hearing from critics of the deal, but finally decided to grant the motion to approve the consent agreement……Critics of the CVS-Aetna deal included the American Medical Association and the AIDS Healthcare Foundation.Another critic, U.S. PIRG, expressed skepticism that savings from the merger would end up in consumers’ pockets… September 4, 2019: The American Medical Association (AMA) posted a statement titled: “Court ruling in CVS-Aetna merger leaves patients unprotected”. The statement was attributed to Patrice A. Harris, M.D., M.A., President, American Medical Association. From the statement: “Despite an unprecedented review that dragged many details of this merger into the light, today’s decision ultimately fails patents, will likely raise prices, lower quality, reduce choice, and stifle innovation. The American people and our health system will not be served well by allowing a merger that combines health insurance giant Aetna Inc. with CVS Health Corporation – the nation’s largest retail pharmacy chain, specialty pharmacy, pharmacy benefits management (PBM) and Medicare Part D Stand-Alone Prescription Drug Plan (PDP) insurer.” For patients and employers struggling with recurrent increases to health insurance premiums, out-of-pocket costs, and prescription drug prices, it’s hard to find any upside to a merger that leaves them with fewer choices. Nothing in the deal guarantees reductions on insurance premiums or prescription drug costs. As for promised efficiency savings, that money will likely go straight to CVS’s bottom line. CVS made no commitment to pass much-hyped savings onto consumers through lower premiums or drug costs.“We know from history that when health insurance and pharmaceutical benefit management markets are ruled by only a few massive companies, patients pay a steep price. The court found our concerns ‘warranted serious consideration’ and sufficient to hold an unprecedented judicial review that included a hearing with expert testimony. Regulators should now be on notice of the antitrust risks associated with the CVS/Aetna merger, and must vigilantly monitor the conduct of the merged fire to make sure this colossal new entity does not hurt patients in the PBM services, health insurance, retail pharmacy, speciality pharmacy, and PDP markets, which are already highly concentrated.“Although this outcome is not what we fought for, the AMA is optimistic that this case and the thorough examination of its underlying facts are a sign of things to come. When the public interest is harmed by health care mergers, courts charged with scrutinizing DOJ merger settlements must not be a rubber stamp.” September 4, 2019: NBC News posted an article titled: “Reproductive health clinics serving Latinas grapple with ‘domestic gag rule'”. It was written by Nicole Acevedo. From the article: Latinas who provide reproductive services in areas with few options for low-income women and women of color are grappling with a new Trump administration rule that can limit clinics’ access to federal funding, making it harder to offer affordable care to women.In the Rio Grande Valley of Texas, where 92 percent of the population is Hispanic and many are immigrants or lack health insurance, “our bodies and our health have become political pawns,” says Lucy Ceballos Félix, associate director of field advocacy in Texas for the National Latino Institute for Reproductive Health.At issue is the “domestic gag rule” that went into effect at the end of August, stating that health clinics can’t receive specific federal funding – known as Title X – designated for family planning and other reproductive health services if abortions are performed at the facility of if specialists refer patients to centers where they can get abortions.Clinics are now facing a choice: halt family planning consultations or services that include abortion as a viable option and keep receiving Title X funds; or, like Planned Parenthood, withdraw from the federal family planning program and continue to offer full services at their facilities while looking for alternative sources of funding such as donations or private grants……The Department of Health and Human Services argues the new restrictions should not be considered a “gag rule” because it doesn’t prohibit health care providers from counseling patients on abortion.But the rule explicitly states that if a Title X funded center “encourages, promote, advocates, supports, or assists with, abortion” the clinic would be considered one “where abortion is a method of family planning” – therefore ineligible for family planning funds……Even though abortions are legal, advocates say the Trump administration is using anti-abortion rhetoric to defund reproductive health services… September 4, 2019: Planned Parenthood posted a press release titled: “‘Planned Parenthood Direct’ App Expands to More Than Half the Country”. From the press release: Planned Parenthood is excited to announce that Planned Parenthood Direct, an app that offers birth control and UTI treatment, is now available in more than half the country – 27 stats and the District of Columbia – and will be live in all 50 states by the end of 2020. The app is a convienent way for people to access high-quality sexual and reproductive health care from Planned Parenthood’s trusted, expert providers though a smartphone – no matter where they are.With the Planned Parenthood Direct app, users can request birth control pills to be delivered to their door, get a prescription for UTI treatment sent to a nearby pharmacy, learn about different methods of birth control, or make an appointment at a Planned Parenthood health center……There’s currently a vast unmet need for sexual and reproductive health care in the United States. Recently, the Trump administration forced Planned Parenthood out of Title X, the nation’s only dedicated program for affordable birth control and reproductive care. The administration’s move will greatly impact access to birth control, STI testing, cancer screenings, and other critical health services, particularly for people of color, people with low-incomes, and people in rural and remote communities. In the wake of increasing restrictions on sexual and reproductive health care, the Planned Parenthood Direct app is helping to break down barriers and get people the timely care and information they need……The Planned Parenthood Direct app is free and available for download in the App STore or on Google Play. Quick and convenient to use – on your lunch break or after hours – it’s currently available in Alaska, Arizona, California, Colorado, Connecticut, the District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Maryland, Minnesota, Montana, Nebraska, New Jersey, New York, North Dakota, Ohio, Pennsylvania, Rhode Island, South Dakota, Texas, Utah, Vermont, Virginia, and Washington… September 5, 2019: NPR posted an article titled: “California Again Considers Making Abortion Pills Available At Public Colleges”. It was written by April Dembosky. From the article: …Public university health centers in California do not perform abortions. But state lawmakers are expected to pass a bill in the coming weeks that would require student health centers at all 34 state campuses to provide medication abortions. If the measure becomes law, it will be the first of its kind in the U.S.The bill’s supporters say they want to remove the obstacles women face accessing medical abortion off campus……While a consortium of women’s groups that support abortion rights has promised to pay for all the required ultrasound equipment and upfront training costs of providing the abortion pill on campus, eventually universities would likely need to dip into tax dollars or student fees for ongoing costs……The State Legislature has until mid-September to pass the bill, and the governor has a month after that to sign or veto it. The bill mentioned in the above article is SB-24 Public Health: public university student health centers: abortion by medication techniques. It was originally introduced by Senator Leyva in December of 2018. Here are some key parts of the bill: The bill would require, on and after January 1, 2023, each student health care services clinic on a California State University or University of California campus to offer abortion by medication techniques, as specified. The bill would require the Commission of the Status of Women and Girls to administer the College Student Health Center Sexual and Reproductive Health Preparation Fund, which the bill would establish.The bill would continuously appropriate the moneys in that fund to the commission for allocations to each public university student health care clinic for specified activities in preparation for providing abortion by medication techniques, thereby making an appropriation. The bill would provide that its requirements would be implemented only if, and to the extend that, a total of at least $10,290,000 in private moneys is made available to the fund in a timely manner on or after January 1, 2020.Abortion care is a constitutional right and an integral part of comprehensive sexual and reproductive health care.The state has an interest in ensuring that every pregnant person in California who wants to have an abortion can obtain access to that care as easily and as early in pregnancy as possible. When pregnant young people decide that abortion is the best option for them, having early, accessible care can help them stay on track to achieve their educational and other aspirational life plans.All California public university campuses have on-campus student health centers, but none of these health centers currently provide abortion by medication techniques. Abortion by medication techniques is extremely safe, highly effective, and cost effective. Abortion by medication techniques is an essential part of comprehensive sexual and reproductive health care, and should be accessible at on-campus student health centers.Staff at on-campus student health centers include health professionals who are licensed to provide abortion by medication techniques. Under current California law, all residency programs in obstetrics and gynecology include training in abortion. Physicians, nurses practitioners, physician assistants, and certified nurse-midwives are legally authorized to perform abortions by medication techniques. Any clinician legally authorized to provide abortion, but not currently trained to provide abortion by medication techniques, can be trained inexpensively to do so, and such training falls within the requirements of continuing education for medical providers. September 5, 2019: ABC News posted an article titled: “Texas hoping to revive law on burial of fetal remains”. It was written by Kevin McGill. From the article: Texas attorneys asked a federal appeals court Thursday to revive the state’s requirement that fetal remains from abortions and miscarriages at health care facilities be buried or cremated.A three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans gave no indication when it would rule following the arguments. One panel member raised the possibility that a decision could be delayed until after the Supreme Court rules in a pending Louisiana abortion regulation case. No date for consideration has been set in that case.The law, blocked last year by U.S. District Judge David Ezra, requires that fetal tissue remains from abortions, miscarriages, or ectopic pregnancies at health care facilities, including abortion clinics, be buried or cremated. It requires that ashes from cremation of such remains be scattered “in any manner as authorized by law” or buried. It says they cannot be placed in a landfill..…Ezra also found that the law imposes a burden on women seeking abortions because it “increases the grief, stigma, shame, and distress of women experiencing an abortion, whether induced or spontaneous.”……The case was heard by the 5th Circuit’s chief judge Carl Stewart, a nominee of President Bill Clinton; Judge Rhesa Barksdale, nominated to the court by President George H.W. Bush; and Judge Gregg Costa, nominated by President Barack Obama……The 5th Circuit is already holding a decision on another Texas abortion regulation case in abeyance pending action in the Louisiana case. September 6, 2019: Kaiser Health News posted an article titled: “Groupons For Medical Treatment? Welcome To Today’s U.S. Health Care”. It was written by Lauren Weber. From the article: Emory University medical fellow Dr. Nicole Herbst was shocked when she saw three patients who came in with abnormal results from chest CT scans they had bought on Groupon……Similar deals have shown up for various lung, heart and full-body scans across Atlanta, as well as in Oklahoma and California. Groupon also offers discount coupons for expectant parents looking for ultrasounds, sold as “fetal memories”……For Paul Ketchel, CEO and founder of MDsave, a site that contracts with providers to offer discount-priced vouchers on bundled medical treatments and services, the use of medical Groupons and his own company’s success speak to the brokenness of the U.S. health care system.MD Save offers deals at over 250 hospitals across the country, selling vouchers for anything from MRIs to back surgery. It has experienced rapid growth and expansion in the several years since its launch. Ketchel attributes that growth to the general lack of price transparency in the U.S. health care industry amid rising costs to consumers……But Dr. Andrew Bierhals, a radiology safety expert at Washington University in St. Louis’ Mallinckrodt Institute of Radiology, warned that such deals maybe leading patients to get unnecessary initial scans – which can lead to unnecessary tests and radiation… September 10, 2019: Planned Parenthood posted a press release titled: “BREAKING – TITLE X: Senate Republican Leaders Scrap Spending Bill to Prevent Bipartisan Vote to Reverse Gag Rule”. From the press release: Today, Senator Richard Shelby (R-AL), chairman of the Senate Appropriations Committee, abruptly cancelled a scheduled vote on the Labor, Health and Human Services, Education, and Related Agencies (LHHS) subcommittee’s spending bill, after learning that Ranking Member Patty Murray (D-WA) planned to ask for a vote to reverse the harmful Title X “gag rule,” a regulation opposed by a bipartisan majority of the committee and a majority of the American public.Statement from Jacqueline Ayers, Vice President, Government Relations & Public Policy, Planned Parenthood Federation of America:“This is a shocking and disgusting display by Chairman Shelby, Leader McConnell, and Republican leaders who are desperate to hide the fact that the Trump administration’s Title X gag rule is deeply unpopular. The overwhelming majority of Americans believe that we should have access to birth control, cancer screenings, and STI testing. Chairman Shelby knows that if he tries to hold up our nation’s budget over blocking access to birth control and cancer screenings, it’s a fight he will lose.“We thank Senator Murray for making it clear that Democrats and Republicans should stand together and insist that Title X be protected in any spending bill moving through Congress.“The Trump administration’s gag rule is already hurting patients across the country. This isn’t a partisan issue, this is birth control, cancer screenings, and STI screenings. This is standard reproductive health care. Senators have a duty to protect their constitutients. It’s time for Chairman Shelby and Republican leadership to stop playing politics with reproductive health care and allow a vote to reverse this deeply harmful gag rule right away… September 10, 2019: Center for Reproductive Rights posted a press release titled: “Court Blocks North Dakota Law Forcing Physicians to Lie About Abortion”. From the press release: Today, a federal district court in North Dakota granted the Center for Reproductive Rights’ request for a preliminary injunction, blocking a state law passed earlier this year and scheduled to take effect last month. The law requires physicians to tell patients that a medication abortion (abortion by pills) may be “reversed” – a patently false and unproven claim. The lawsuit was filed in June by the Center for Reproductive Rights on behalf of the American Medical Association (AMA) and the Red River Women’s Clinic, the only abortion clinic in North Dakota.In the decision, Chief Judge Daniel Hoveland wrote, “State legislatures should not be mandating unproven medical treatments, or requiring physicians to provide patients with misleading and inaccurate information. The provisions of [this law] violate a physician’s right not to speak and go far beyond any informed consent laws addressed by the United States Supreme Court, the Eight Circuit Court of Appeals, or other courts to date.”……Eight states – Arkansas, Idaho, Kentucky, North Dakota, South Dakota, Oklahoma, Nebraska, and Utah – have passed similar bills requiring abortion providers to tell patients about so-called medication abortion “reversal”. Five of those eight laws were passed in 2019.This lawsuit is also challenging an existing North Dakota law, which requires physicians to tell patients that abortion terminates “the life of a whole, separate, unique, living human being” – a controversial, ideological, and non-medical message. The court has yet to rule on this aspect of the case… September 11, 2019: The Hill posted an article titled: “Senate panel cancels vote on key spending bill amid standoff”. It was written by Jordain Carney. From the article: The Senate Appropriations Committee on Wednesday canceled votes on two spending bills that had been scheduled for the following day, marking the latest sign of turmoil as lawmakers try to fund the government beyond Sept. 30.The panel had been scheduled to vote Thursday on spending bills covering the departments of Health and Human Serices (HHS), Labor and Education, as well as the State Department and foreign operations.HHS-Labor-Education, in particular, is viewed as a key priority for Democrats, but had emerged as a headache this week because of fights on controversial issues including abortion and President Trump’s border wall.Senate Approriations Commitee Chairman Richard Shelby (R-Ala.) told a small group of reporters on Tuesday that he was likely to cancel the panel vote on the legislation unless he could work out a deal with Democrats on how to proceed……The committee is still expected to vote Thursday on a defense spending bill and a spending measure covering energy and water development.Canceling the full commitee vote on HHS-Labor-Education comes after a subcommitte vote on the same bill, scheduled for Tuesday, was also canceled……The backlash was asparked by Democratic Sen. Patty Murray’s (Wash.) plan to offer an amendment to HHS-Labor-Education that would block the Trump administration’s Title X rule that prohibits federal funds for health care providers who offer information about abortion.. September 17, 2019: Bloomberg posted an article titled: Health Insurance That Doesn’t Cover the Bills has Flooded the Market Under Trump”. It was written by Zeke Faux, Polly Mosendz, and John Tozzi. From the article: …The Diazes’ plan was nothing like the ones consumers have come to expect under the 2010 Affordable Care Act, which bars insurers from capping coverage, canceling it retroactively, or turning away people with preexisting conditions. But the law includes an exemption for short-term plans that serve as a stopgap for people between jobs. The Trump administartion, thwarted in its attempts to overturn the ACA, has widened that loophole by stretching the definition of “short-term” for three months to a year, with the option of renewing it for as long as three years.Fewer than 100,000 people had such plans at the end of last year, according to state insurance regulators, but the Trump administartion says that number will jump by 600,000 in 2019 as a result of the changes, Some brokers are taking advantage, selling plans so skimpy that they offer no meaningful coverage. And Health Insurance Innoavations is at the center of the market. In interviews, lawsuits, and complaints to regulators, dozens of its customers say they were tricked into buying plans they didn’t realize were substandard until they were stuck with surprise bills. The company denies responsibility for any such incidents, saying its a technology platform that helps people find affordable policies through reputable agents……The ACA was designed around a fundamental economic bargain: Insurance companies would no longer be allowed to deny coverage to people who were already sick, and polices would have to cover a broad set of benefits, including prescription drugs, maternity care, and hospitalization. In return insurers were guaranteed that consumers would buy coverage or face tax penalties, and that subsidies would be available for people who needed them. The approach spread the financial risk of getting sick and aimed to guarantee that no one with insurance would have to worry about being bankrupted by necessary care. Preserving the bargain was essential, though; too many exceptions, and the edifice would crumble.…When the Republican-controlled Senate failed in 2017 to pass Trump-backed legislation that would have gutted the ACA, the administration instead seized on the loophole allowing customers to buy certain noncompliant plans. Trump used an executive order to extend the time limit for temporary plans, which he and otehr Republicans talked up as a potential solution for cash-strapped customers……On June 14. Trump held a cerempny in the White House Rose Garden to announce a new policy that lets employes steer as much as $1,800 in tax-exempt funds to their employees instead of offering them comprehansive health plans……Brokers are already gearing up for November, when the open enrollment period for Obamacare plans will drive millions of potential customers online.. September 18, 2019: Planned Parenthood posted an article titled: “Senate Republicans to Avoid Votes on Trump Administration Gag Rules”. From the press release: Senate Republican leadership is scrambling to rush through a vote on the Labor, Health and Human Services, Education, and Related Agencies (LHHS) and State and Foreign Operations (SFOPS) spending bills today in order to avoid members having to take a public vote on the Trump administration’s Title X and global gag rules. After abruptly cancelling a scheduled committee vote last week on both the LHHS and SFOPS bills to avoid bipartisan votes on blocking the Title X and global gag rules, Senate Republican leadership is once again truing to force through legislation and avoid having to take a public stance on policies that strip people of their health and rights.Just last week, new polling showed that voters in Arizona, Colorado, and key swing Congressional districts nationwide oppose the Trump administration’s Title X gag rule, and are less likely to support legislators that don’t act to block it… September 19, 2019: Planned Parenthood posted a press release titled: “Senate Bill Would Continue to Block Access to Abortion for D.C. Residents With Low Incomes”. From the press release The Senate Appropriations Committee voted today to advance a FY2020 Financial Services and General Government (FSGG) spending bill that includes a provision that blocks low income residents of the District of Columbia (D.C.) from accessing safe, legal abortion. In the markup, FSGG ranking member Senator Chris Coons (D-DE) expressed his disapproval of the measure and told his colleagues he hoped the issue could be resolved as the bill moves forward. The House of Representatives previously stopped Republican leadership’s efforts to block safe, legal abortion access in D.C. for people with low-incomes… September 23, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood Tells Court: We Will Never Give Up on Our Patients”. From the press release: Today, an 11-member panel of the U.S. Court of Appeals for the 9th Circuit heard oral arguments in several challenges to the Trump administration’s unethical, illegal, and dangerous gag rule on Title X, the nation’s program for birth control and reproductive health care. Planned Parenthood and the American Medical Association sued the Trump administration in March to block the rule, which makes it illegal for any provider in the Title X program to tell patients how or where to access abortion, and imposes cost-prohibitive and unnecessary “physical separation” restrictions on health centers that provide abortion. These move are clearly meant to push Planned Parenthood health centers and other reproductive health care providers out of Title X.Statement from Alexis McGill Johnson, Acting President and CEO, Planned Parenthood Federation of America:“Planned Parenthood will never give up on our patients. The impacts of the Trump administration’s dangerous gag rule are already being felt across the country. I’m thinking of people who are struggling to make ends meet and may no longer be able to access their trusted provider – including those people in rural areas and communities of color. Health care shouldn’t come down to how much you earn, where you live, or who you are.”… September 23, 2019: American Civil Liberties Union (ACLU) posted news titled: “We’re in Court to Protect Family Planning Care for Millions of Low-Income Patients.” It was written by Fiona Kaye. From the news: Title X is a federally funded family planning program that guarantees low-income people can recieve critical health care services for free or at a reduced cost. For decades it’s been one of the most effective federal health care programs, providing a wide range of vital reproductive and other services for millions of people across the country who wouldn’t otherwise be able to afford them.However, the Trump administration wants to undermine that success as part of an overall agenda that attacks people’s access to reproductive health care. Today, we are in the 9th Circuit arguing that the program should be protected from their efforts to destroy it.Services that are provided under Title X include contraceptive care and information, sexually transmitted infection testing and prevention, cancer screening, and pregnancy testing and counseling. In 2018, Title X family planning care was provided to nearly four million patients. Two-thirds of them had incomes at or below the federal poverty level, and more than half were people of color. For many, the providers they see through Title X are their only ongoing source of health care and health education……Under Title X’s previous rules, any patient who tested positive for pregnancy was providing counseling about their options, along with referrals to other providers – including abortion providers – upon request.But the Trump administration’s new Title X rule allows providers to refuse to provide counseling that includes all pregnancy options for any reason, including if those options violate their religious beliefs. It also requires providers to refer all pregnant patients for prenatal care, even if the patient has decided to have an abortion, and blocks them from referring patients to abortion providers……In March, ACLU filed a lawsuit to block the new rule on behalf of the National Family Planning & Reproductive Health Asociation (NFPRHA), which is a membership organization representing family planning providers across the country, including Cedar Rapids Clinics, who we also represent in the case.We asked the district court to enter a preliminary injunction that would prevent the Trump administration’s new rule from going into effect. We agrued tha the new rule violates the law and that if enforced, it would cause serious irreparable harm. And we won.But the government appealed, asking the U.S. Court of Appeals for the Ninth Circuit to lift the injunction so that it could enforce the new rule while the case moves forward in the lower court. The Ninth Circuit ruled in the government’s favor. This mean that the Trump administration has already started dismantling the Title X network by requiring compliance with the new rule, which has forces many long-time providers to leave the program.Today we’re asking the Ninth Circuit to reinstate the injunction to prevent the Trump administration from further carrying out its anti-health agenda and robbing people of critical family planning care. September 25, 2019: Center for Reproductive Rights posted a press release titled: “Center for Reproductive Rights Sues to Protect Free Speech of Oklahoma Physicians”. From the press release: Today, the Center for Reproductive Rights filed a lawsuit in Oklahoma state court on behalf of abortion providers in the state. The lawsuit challenges an Oklahoma law forcing doctors to tell patients that medication abortion (abortion by pills) can be “reversed” – a false claim unsupported by scientific evidence. This false information must be relayed to the patient 72 hours before their medication abortion appointment, or physicians can be charged with a felony.The Center is asking the court to block the law (S.B. 614) before it takes effect on November 1, 2019. Earlier this month, a federal court blocked a similar law from taking effect in North Dakota……In addition to conveying this false information orally, abortion providers must also informa patients of a website and 24-hour hotline for Heartbeat International’s “Abortion Pill Reversal Network”. Providers must also post signage in their health centers with the network’s contact information, and directly give it to patients again following their appointment. Physicians who violate the law are guilty of a felony, and clinics will face a $10,000 fine per day for failure to display the required signs.The lawsuit argues that this law violates the Oklahoma constitution’s free speech protections by forcing physicians to convey false information and non-medical statements with which they disagree. Just last term, the U.S. Supreme Court held in National Institute of Family & Life Advocates v. Becerra that the government cannot regulate speech of medical professionals to advance controversial ideas or to discriminate based on teh content and/or viewpoint of the speaker……Only four health centers provide abortion services in the entire state of Oklahoma. In addition to the law challenged in this suit, Oklahoma has passed many other abortion restrictions, including: a paternal consent requirement for minors; a ban on the use of telemedicine to prescribe pills for medication abortion; and restrictions on when private, public, and state health insurance plans can cover abortion care. These laws disproportionately affect populations that already experience barriers to health care, including people of color, immigrants, and people with low incomes. The Center is currently challenging two other Oklahoma laws — a law banning the standard abortion procedure after about 14 weeks of pregnancy, and another law that forces patients to wait 72 hours to access abortion. September 25, 2019: The American College of Obstetricians and Gynecologists (ACOG) and Physicians for Reproductive Health released a joint statement: “The science of medicine is not subjective, and a strongly held personal belief should never outweight scientific evidence, override standards of medical care, or drive policy that puts a person’s health and life at risk.“Pregnancy imposes significant physiological changes on a person’s body. These changes can exacerbate underlying or preexisting conditions, like renal or cardiac disease, and can severely compromise health or even cause death. Determining the appropriate medical intervention depends on a patient’s specific medical condition. There are situations where pregnancy termination in the form of an abortion is the only medical intervention that can preserve a patient’s health or save their life.“As physicians, we are focused on protecting the health and lives of the patients for whom we provide care. Without question, abortion can be medically necessary.” September 26, 2019: Planned Parenthood posted a press release titled: “For First Time in Nearly 20 Years, Senate Committee Passes Bill Failing to Repeal the Global Gag Rule”. From the press release: For the first time in nearly 20 years, today, on World Contraception Day, the U.S. Senate Commitee on Appropriations advanced a State and Foreign Operations (SFOPs) bill that did not repeal the global gag rule, which undermines investments in global health and access to contraception and otehr health services across the world. The committee blocked consideration of Sen. Jeanne Shaheen’s (D-NH) bipartisan amendment to repeal the rule, demonstrating the lengths Senate Republicans will go to back the Trump-Pence administration and its relentless attacks on health care and reproductive rights in the United States and around the globe……In January 2017, Trump reinstated an unprecedented expansion of the global gag rule, which bars international organizations that work on any U.S. funded global health program, including HIV/AIDS prevention and treatment, maternal and child health, and malaria programs, from providing abortion services, referral, or counseling or advocating for abortion access. This policy leaves the world’s most vulnerable people to suffer and undermines years of efforts to improve health worldwide. September 27, 2019: The American College of Obstetricians and Gynecologists (ACOG) posted a statement titled: “ACOG Statement on CMS Removal of Burdensome Regulatory Requirements”. From the statement: Ted L. Anderson, MD, PhD, president of the American College of Obstetricians and Gynecologists (ACOG), issued the following statement regarding the new rule from the Centers for Medicare & Medicaid Services (CMS) removing regulations that required ambulatory surgical centers to have written hospital transfer agreements or that required that all physicians performing surgery in an ambulatory surgical center have admitting privileges in a hospital:“ACOG commends CMS for improving patients’ access to surgical care by removing medically unnecessary, burdensome regulatory requirements for ambulatory surgical centers (ACSs). ACOG agrees with CMS that existing laws and regulations already ensure patient safety and that the requirements were limiting access to care. Moreover, these requirements represented an inefficient use of health care dollars and created administrative barriers to efficient ASC operations.“In fact, ACOG has continuously advocated for the removal of similar burdonsome regulatory requirements for medical facilities. The patient-physician relationship is best protected when politicians and regulators refrain from imposing unjustified requirements on health care providers. Bureaucratic hurdles that provide no benefit to patients and that impose administrative burdens on doctors to impede the provision of evidence-based care. ACOG is pleased that CMS has taken measures to allow more medical facilities to keep their doors open to patients. We will continue to support policies tha advance patient access to care and to oppose unnecessary, unjustified regulatory restrictions that impede care.” September 30, 2019: Center for Reproductive Rights posted a press release titled: “Federal Court Rules on Virginia Abortion Restrictions”. From the press release: Today, a federal district court ruled on four Virginia laws that have impeded abortion access for years and made it difficult for abortion clinics to stay open in the state. The decision comes after a two-week trial earlier this year in Richmond, Virginia. The case was filed on behalf of Virginia abortion providers including Falls Church Healthcare Center, Whole Woman’s Health Alliance, the Virginia League for Planned Parenthood, and Dr. Jane Doe. The Centers for Reproductive Rights, Planned Parenthood Federation of America, and O’Melveny and Meyers LLP represent the providers along with local counsel, the ACLU of Virginia.In a win for abortion rights groups, the court struck down:The Second Trimester Hospital Requirement: a law that required all second semester abortions to be performed at a licensed outpatient hospital, despite clear medical consensus that these procedures are just as safe when performed at a clinic or physician’s office. The court recognized that non-surgical second trimester abortions can safely be performed in a clinic setting. All second trimester abortions are non-surgical, as they do not require incisions.Facilities Requirements: Regulations that would have required clinics that provide first trimester abortions to meet the same facility requirements as general and surgical hospitals. For exampe, clinics would have had to redesign hallway widths and adhere to minimum square footage of procedure rooms, among other requirements unnecessary to the provision of care. If enforced, the law would have forced most clinics in the state to immediately close.As part of the same decision the court upheld the following laws that hinder abortion access:The Two-Trip Mandatory Delay Law: A law that forces women to undergo an unnecessary ultrasound and listen to state-mandated information designed to shame the patient at least 24 hours before their procedure. This means patients must unnecessarily make at least two trips to a medical facility and delay their procedure by at least 24 hours.The Physician-Only Law: The court acknowledged the “pursuasive evidence” that Advanced Practice Clinicians can safely provide abortion care, yet this law was upheld, and will contineu to restrict abortion access. It bars highly skilled and qualified medical professionals such as nurse practitioners and physician’s assistants from providing safe, early abortion care, despite evidence, medical consensus, and even the judge’s findings that they can do so just as safely as physicians. The impact is especially severe in underserved parts of the Commonwealth.The Licensing Scheme: Abortion providers must meet onerous licensing requirements that have no legitimate medical basis and do not apply to any other health providers. The licensing scneme singles out any medical facility where five or more first trimester aboritons are performed each month and subjects them to regulations that affect virtually every aspect of care. (The building requirements section of this scheme was struck down, as noted above.)… October 1, 2019: The Center for Reproductive Rights posted a press release titled: “Federal Court Blocks Georgia’s Abortion Ban From Taking Effect”. From the press release: Today, the U.S. District Court in Atlanta granted a preliminary injunction to a challenge to Georgia’s ban on abortion from the earliest weeks in pregnancy, blocking the law from taking effect and protecting critical health care for more than 2.1 million people of reproductive age. The ban, which was signed into law by Gov. Brian Kemp in May 2019, would have banned abortion from the earliest weeks of pregnancy, before many people even know they’re pregnant. With a broad coalition of healthcare provdiers, attorneys for Planned Parenthood, ACLU, and the Center for Reproductive Rights filed a challenge to the law, SisterSong v. Brian Kemp, in June.Nearly half of the more than 300 bills restricting abortion filed this year in state legislatures would severely restrict access to abortion. This year, Georgia was one of seven states, along with Alabama, Kentucky, Louisiana, Mississippi, Missouri, and Ohio to enact similar abortion bans in early pregnancy. After widespread opposition from business leaders, the film and entertainment industry, and activists across Georgia, the bill passed by a narrow one-vote margin. The $9 billion Georgia film and entertainment industry published letters, threatening to boycott work in Atlanta if the ban was enacted, and more than 6,000 Georgians signed a petition opposing it……”The court recognized today that this law is blatantly unconstitutional and a clear attempt to overturn Roe v. Wade,” said Emily Nestler, Senior Staff Attorney at the Center for Reproductive Rights. “Instead of passing laws that restrict the rights of pregnant women, Georgia lawmakers should be implementing policies that help pregnant women. Georgia has the worst maternal mortality rate in the country. Black women in Georgia face the highest risk – they are much more likely to die from pregnancy-related complications than white women.”… October 2, 2019: The Chicago Tribune posted an article titled: “New abortion clinic being built in southern Illinois, near border with St. Louis”. It was written by Jim Salter. From the article: Planned Parenthood has quietly been building a new abortion clinic in Illinois, just across the Mississippi River from St. Louis, as women concerned about the uncertain future of Missouri’s sole abortion clinic flock across the state line.The 18,000-square-foot clinic in Fairview Heights, 12 miles east of St. Louis, will provide abortion services as well as family planning when it opens in mid-October, Planned Parenthood officials said at a news conference Wednesday……Planned Parenthood has been battling Missouri’s health department for months to try and keep open its St. Louis clinic……Missouri’s Administrative Hearing Commission is deciding the fate of the St. Louis clinic.Meanwhile, Missouri women have been increasingly getting abortions at the Hope Clinic for Women in Granite City, Illinois, another St. Louis suburb. Deputy Director Alison Reith said 58 percent of the abortions performed at the Hope Clinic through August of this year involved Missouri women, and 37 percent were from Illinois.Missouri is among several conservative states to pass new restrictions on abortions in the hope that the increasingly conservative U.S. Supreme Court will eventually overturn Roe v. Wade. Republican Gov. Mike Parson signed legislation in May banning abortions at or beyond eight weeks of pregnancy, with exceptions for medical emergencies but not for rape or incest.A federal judge in August temporarily blocked implementation of the law until the legal challenge plays out in court, which could take several months… October 3, 2019: Center for Reproductive Rights posted a press release titled: “Abortion Case Heads to Oklahoma Supreme Court”. From the press release: Today, the Center for Reproductive Rights filed an appeal with the Oklahoma Supreme Court asking it to block a law that bans the standard method of abortion after approximately 14 weeks of pregnancy. This law had been blocked since 2015, but earlier this month, an Oklahoma state judge became the first judge in the country to uphold such a law, paving the way for the ban to take effect.As part of hte same appeal, the Center is also asking the Oklahoma Supreme Court to strike down a law that forces women to wait at least 72 hours after recieving state-mandated counseling before they can have an abortion. That law has been in effect since 2015……Doctors who violate either of these laws could be charged with a felony. Doctors who violate the ban could face up to two years in prison and a $10,000 fine. Major medical organizations, including the American College of Obstetricians and Gynecologists (ACOG) oppose these types of bans, writing, “these restrictions represent legislative interference at its worst: doctors will be forced, by ill-advised, unscientifically motivated policy, to provide lesser care to patients.”……You can read the Center’s emergency motion here. October 3, 2019: President Trump issued Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors. He started off by attacking the Medicare for All Act of 2019. Here are some key parts of the executive order: …Sec. 2. Policy. It is the policy of the United States to protect and improve the Medicare program by enhancing its fiscal sustainability through alternative payment methodilogies that link payment to value, increase choice, and lower regulatory burdens imposed upon providers.Sec. 3 Providing More Plan Choices to Seniors. (a) Within 1 year of the date of this order, the Secretary shall propose a regulation and implement other administrative actions to enable the Medicare program to provide beneficiaries with more diverse and affordable plan choices. The proposed actions shall:(i) encourage innovative MA benefit structures and plan designs, including through changes in the regulations and guidance that reduce barriers to obtaining Medicare Medical Savings Accounts and that promote innovations in supplemental benefits and telehealth services;(ii) include a payment model that adjusts supplemental MA benefits to allow Medicare beneficiaries to share more directly in the savings from the program, including through cash or monetary rebates, thus creating more incentives to seek high-value care; and(iii) ensure that, to the extent permitted by law, FFS Medicare is not advantaged or promoted over MA with respect to its administration.(b) The Secretary, in consultation with the Chairman of the Council of Economic Advisers, shall submit to the President, through the Assistants to the President for Domestic and Economic Policy, a report within 180 days from the date of this order that identifies approaches to modify Medicare FFS payments to more closely reflect the prices paid for services in MA and the commercial insurance market, to encourage more robust price competition, and otherwise to inject market pricing into Medicare FFS reimbursement.Section 4. Improving Access Through Network Adequacy. Within 1 year of the date of this order, the Secretary shall propose a regulation to provide beneficiaries with improved access to providers and plans by adjusting network adequacy requirements for MA plans to account for:(a) the competitiveness of the health market in the States and in which such plans operate, including whether those States maintain certificate-of-need laws or other anti-competitive restrictions on health access; and(b) the enhanced access to health outcomes made possible through telehealth services or other innovative technologies.Sec. 5. Enabling Providers to Spend More Time with Patients. Within 1 year of the date of this order, the Secretary shall propose reforms to the Medicare program to enable providers to spend more time with patients by:(a) proposing a regulation that would eliminate burdensome regulatory billing requirements, conditions of participation, supervision requirements, benefit definitions, and all other licensure requirements of the Medicare program that are more stringent than applicable Federal or State laws require; and that limit professionals from practicing at the top of their profession;(b) proposing a regulation that would ensure appropriate reimbursement by Medicare for time spent with patients by both primary and specialist health providers practicing in all types of health professions; and(c) conducting a comprehensive review of regulatory policies that create disparities in reimbursement between physicians and non-physician practicitoners and proposing a regulation that would, to the extend allowed by law, ensure that items and services provided by clinicians, including physician assistants, and nurse practitioners, are appropriately reimbursed in accordance with the work performed rather than the clinician’s occupation.. October 3, 2019: Congresswoman Pramila Jayapal (Democrat – Washington) posted news on her official website titled: “Jayapal and Dingell: Trump’s Medicare Advantage Expansion Puts Profits Over People”. From the news: Today, in response to President Trump’s announcement of an executive order to bolster the privitazation of Medicare Advantage, the private-sector version of Medicare, Congresswoman Jayapal (D-WA) and Congresswoman Dingell (D-MA) released the following statement:“From the beginning, this president and his administration have made repeated attempts to sabotage the Affordable Care Act, cut health services from women, and limit access to health care for immigrants and other vulnerable populations. Now, he is threatening the health and financial well being of our seniors by pushing more of them into risky, for-profit Medicare Advantage plans.“If the president is serious about ‘protecting and improving Medicare,’ he should stop parroting falsehoods about ‘socialism’ and work with us to ensure everyone has access to quality, affordable healthcare. Our Medicare for All bill would remove the profit motive in our health care without worrying about unaffordable premiums, co-pays, and deductibles.”“Medicare Advantage” has a history of overbilling taxpayers and lining the pockets of private insurance companies through restrictive provider networks. This program has proven risky for seniors in poor or declining health as it includes plans that deny seniors access to care, often leaving them no choice but to drop their plans. These same for-profit insurance companies have even maintained lists of “unprofitable patients” and target seniors who are healthier to increase their profit margins.The Medicare For All Act of 2019:Gives seniors the benefits they need. For too long, Medicare has not provided seniors with access to the benefits they need, such as dental, vision, hearing, and long-term care. Medicare for All covers all of these benefits with no premiums, co-pays or out-of-network deductibles.Allows seniors to have more choices without worrying about whether a provider is in-network.Covers home and community-based long term care for seniors, people with disabilities, and those with terminal illnesses, allowing these Americans to live with dignity with loved ones in their own homes.Jayapal and Dingell are Co-chairs of the Medicare for All Caucus and lead sponsors for the Medicare for All Act of 2019. October 3, 2019: CNBC posted an article titled: “Trump signs executive order on Medicare, says he won’t let Democrats steal your health care”. It was written by Berkeley Lovelace Jr. From the article: President Donald Trump signed an executive order Thursday that he said would improve private Medicare plans for seniors, slamming Democrats for what he described as putting health care “under threat” with “Medicare for All” proposals.Trump, speaking for an hour at a campaign-style rally at a retirement community in Florida, offered few details on his executive order and spent most of his speech attacking the health policies of 2020 Democratic presidential contenders. He said as long as he’s president, “no one will lay a hand on your Medicare benefits.”……The executive order is intended to bolster Medicare Advantage, which is a private Medicare insurance for seniors, the officials sad on a call with reporters. The plan would also offer more affordable plan options, encourage the wider use of telehealth services, promote wellness benefits and bring payments in Medicare fee-for-service program in line with payments for Medicare Advantage, officials said… October 4, 2019: Planned Parenthood posted a press release titled: “U.S. SUPREME COURT AGREES TO RECONSIDER ITS PRECEDENT BY TAKING LOUISIANA ABORTION CASE”. From the press release: Today, the U.S. Supreme Court announced it will review Louisiana’s Act 620, an abortion restriction nearly identical to one of the Texas restrictions struck down by the Supreme Court in Whole Woman’s Health v. Hellerstedt just three years ago.In Whole Woman’s Health, the Supreme Court issued a landmark ruling that made it clear that medically unnecessary abortion restrictions, such as Texas’s requirement of local hospital admitting privileges, imposed an undue burden on women seeking to access health care, and therefore should not be allowed to stand. The U.S. Court of Appeals for the 5th Circuit, which heard the nearly identical Texas law, blatently disregarded Supreme Court precedent when it upheld Louisiana’s abortion restriction in September 2018. If this law is allowed to take effect, Louisiana could become the seventh state to have only one abortion provider.By granting review in this case, the Supreme Court is agreeing to reconsider its own 2016 decision in Whole Woman’s Health – and if the court allows this Louisian law to stand, it will be breaking with its own precedent and dismantling constitutional protections to abortion access. If the court overturns Roe or renders it meaningless, it could leave 25 million women of reproductive age in America at risk of losing access to abortion……The Louisiana law, like the Texas restriction the court struck down, would force abortion providers to obtain local hospital admitting privileges – a medically unnecessary move meant to make abortion more difficult to access. The Supreme Court has already found that admitting privileges did not help “even one woman obtain better treatment” in Texas. And medical experts agree that Louisiana is no different. The American College of Gynecologists and Obstetricians and the American Medical Association oppose forcing abortion providers to obtain admitting privileges……While politicians remain hellbent on stripping reproductive rights from Americans, support for abortion access is at its highest level on record – 77% of Americans say they do not want to see Roe overturned. This year in nearly half the states, champions have pushed for bills that codify abortion rights into state law, repeal harmful policies that create barriers to care, and treat abortion as health care, not a crime. Illinois, New York, Rhode Island, and Vermont joined nine other states with laws protecting abortion access – and creating critical backstops to the Trump administration and the shift in the balance of the Supreme Court. October 6, 2019: Center for Reproductive Rights posted a press release titled: “Center for Reproductive Rights Back at U.S. Supreme Court; Identical Abortion Issued Decided in 2016”. From the press release: Today, the U.S. Supreme Court granted a petition for certorari filed by the Center for Reproductive Rights, agreeing to hear June Medical Services v. Gee. The case challenges a Louisiana law that would close every abortion clinic in the state except for one. The disputed law (Act 620) prevents doctors from providing abortion services unless they have admitting priviliges at a hospital within 30 miles.June Medical Services v. Gee is the first abortion case to be heard by the Supreme Court since the confirmation of Justices Gorsuch and Kavanaugh. The Supreme Court struck down an identical Texas law in 2016, the landmark case of Whole Woman’s Health v. Hellerstedt – a case also brought by the Center. In that case, the court found that admitting privilege requirements post an “undue burden” on the right to abortion, and that any state law restricting abortion access must have tangible benefits that outweigh the burdens placed on women.“Louisiana is openly defying the Supreme Court’s decision from just three years ago, in which they found an identical Texas law unconstitutional,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “We are counting on the Court to follow its precident, otherwise, clinics will needlessly close and there will be just one doctor left in the entire state to provide abortion care.”..…There is no medical justification for requiring abortion providers to have admitting privileges, as abortion is extremely safe. Leading medical organizations, like the AMA and the American College of Obstetricans and Gynecologists, oppose these kinds of laws. Hospitals frequently deny admitting privileges to doctors who provide abortions for reasons ranging from ideological oposition to the fact that too few of their patients will ever need hospital care.The Court also granted a petition from the state of Lousiana, asking the court to review whether the doctors and clinics in the case have standing to bring the lawsuit. The Supreme Court has consistently recognized that abortion providers have standing… October 7, 2019: The Guardian posted an article titled: “California becomes first state to allow HIV prevention pills without perscription”. From the article: Pharmacists in California will be able to dispense HIV prevention pills to patients without a doctor’s prescription after the state’s governor signed legislation that supporters say will greately reduce the spread of infection.Advocates of Senate Bill 159 say California is the first state to authorize pre-exposure prophylaxis, also called PrEP, and post-exposure prophylaxis, known as PEP, without perscriptions. California is already considered a leader in Aids prevention, they say.PrEP is a once-daily pill for HIV-negative people whole PEP is a medication that people take to prevent the virus from taking hold. Supporters say PEP significantly reduces the risk of infection, but only if started within 72 hours of exposure to the virus. Not everyone can get to a doctor in that time frame, says Rick Zbur, executive director of Equality California……The California Medical Assocation was initially opposed to the legislation but became netural on it after it was amended to limit the number of PrEP pills patients can get without a physician’s note to 60 days, said Anthony York, spokesman for the association……The law also prohibits insurance companies from requiring patients to get prior authorization before using insurance to get the drugs, eliminating another obstacle……Pharmacists in California are already authorized to dispense emergency conraceptives and birth control without a prescription.. October 7, 2019: Planned Parenthood posted a press relase titled: “Planned Parenthood Publishes New Guidelines to Help States Effectively Implement Contraceptive Care Quality Measures”. From the press release: Today, Planned Parenthood Federation of America and Manatt Health released a policy paper that helps state policymakers and payers implement contraceptive care quality measures to improve access to all forms of contraception.The paper, “Measuring Quality Contraceptive Care in a Value-Based System,” serves as a tool for policymakers, detailing how to incorporate contraceptive care quality measures in Value Based Payment (VBP) initiatives to both ensure agency in women’s contraceptive choices and develop strategies to improve people’s access to contraception…The tool outlines 5 specific guidelines for Medicaid Managed Care Organizations (MMCO) and other payers to follow when implementing contraceptive care quality measures:Leverage pay for reporting models;Avoid incorporating contraceptive care quality measures into pay-for-performance models;Proceed cautiously when using contraceptive care quality measures in shared savings or population-based models;Require statified demographic data against measures; andUse additional measures or approaches that are designed to complement contraceptive care quality measures, including patient satisfaction and pregnancy intention… October 8, 2019: HuffPost posted an article titled: “California Takes New Steps to Stop Black Women from Dying in Childbirth”. It was written by Sarah Ruiz-Grossman. From the article: California Gov. Gavin Newsom signed a bill Monday aiming to address the issue of Black women dying in childbirth at disproportionately high rates compared to their white peers.The legislation, authored by California state Sen. Holly Mitchell (D), will require hospitals and clinics in the state to implement implicit bias training for all health care providers working in perinatal services. Sponsored by NARAL, Black Women for Wellness and other groups, the bill also requires the state’s health department to track and publish additional data around pregnancy-related deaths, in an effort to better understand the issue.The U.S. has the worst maternal moratlity rate among all developed countries. And the risk of pregnancy-related deaths is three to four times higher for Black women than for white women, according to the U.S. Centers for Disease Control and Prevention.Most pregnancy-related deaths in the United States are fully preventable – and they can happen up to a year after a person gives birth, according to a recent CDC report… October 8, 2019: Bloomberg Law posted an article titled: “Trump Asks SCOTUS to Review Obamacare Birth Control Rules”. It was written by Mary Anne Pazanowski. From the article: The Trump administration wants the U.S. Supreme Court to review an order blocking rules that allow religious and moral objectors to refuse to provide insurance that pays for employees’ birth control……The administration is asking the court to overturn a decision by the U.S. Court of Appeals for for the Third Circuit, which affirmed a lower court’s nationwide injunction agaisnt the opt-out rules. The injunction will remain in effect while the rule’s validity is being litigated.The Third Circuit said the ACA didn’t give the agencies authority to exempt some employers from providing insurance coverage for preventative services like contraceptive care……Rules implementing the ACA require large employers to provide employee health plans. The plans must cover certain essential services, including contraceptive care. Churches are exempt from the contraceptive mandate, but religious-based organizations and groups objecting to the requirement on moral grounds arent.These non-exempt groups filed multiple court cases saying the contraceptive coverage mandate violated their religious and moral rights. The Supreme Court eventually heard oral argument on the issue, but didn’t decide it. Instead, the high court sent the cases back to the federal appeals court with instructions for the government and the group sto work out a compromise……Parallel cases are pending in California and Massachusettes. The Ninth Circuit heard oral argument in the California case June 6. It previously upheld an order blocking enforcement of a non-final version of the rule……The case is Trump v. Pennsylvania.. October 11, 2019: Ms. Magazine posted an article titled: “Young Feminists Just Won the Fight for Abortion Access on Campus in California”. From the article: California Governor Gavin Newsom signed SB 24, or The College Student Right to Access Act, into law today – mandating that public universities in California provide medication abortion at their student health centers.No California public university health centers currently provide abortion services, which created major barriers to access for students. Over two-thirds of University of California students and one-third of California State University students don’t have a car, and 22 of these campuses across the state, which accommodate 62 percent of the student body in the system, are more than 30 minutes away from the closest off-campus abortion provider via public transportation. Low-income students were hit hardest by these gaps in access, as were many students of color and first-generation students.Now, studies show that an estimated 322 to 519 college students each month in the state who seek to terminate a pregnancy will be able to recieve their care on campus.Feminist students in the Golden State led the fight to expand on campus. Students at UC Berkley concieved of the law after passing a similar resolution in the student government on their campus. When former Governor Jerry Brown vetoed the same measure last year, they weren’t detererred……This law makes California the first state in the country to ever require medication abortion access on campus – but Massachusetts lawmakers are now considering a similar bill…. October 15, 2019: Representative Deb Haaland (Democrat – New Mexico District 1) posted a press release on her official website titled: “Reps. Jayapal, Haaland, Proud to Introduce Health Equity and Access under the law for Immigrant Women and Families Act (HEAL Act). From the press release: Today, Representatives Pramila Jayapal (Wash. – 07) and Deb Haaland (NM-01) – introduced the Health Equity and Access under the Law for Immigrant Women and Famileis Act (HEAL Act).Reps. Jayapal and Haaland worked on the bill with support from the National Asian Pacific American Women’s Forum, the National Latina Institute for Reproductive Health, the Black Alliance for Just Immigration. The HEAL Act addresses barriers to healthcare access for immigrants in the United States by removing the five year bar that immigrants must wait before becoming eligible for Medicaid and the Children’s Health Insurance Program (CHIP), enabling undocumented folks to purchase health insuranec plans from the marketplace made available by the Affordable Care Act, and restoring Medicaid eligibility for COFA migrants… October 15, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood Applauds Reintroduction of HEAL Act’. From the press release: Today, Rep. Pramila Jayapal (WA-07) and Rep. Debra Haaland (NM-01) and other reproductive health champions reintroduced the Health Equity and Access under the law (HEAL) for Immigrant Women and Families Act of 2019, which removes political interference so immigrants are able to fully participate in federal health care programs……The Trump administration has continued to attack immigrant communities, most recently releasing a public charge rule designed to keep families separated and to dissuade immigants from accessing health care and meeting other basic needs. Under this rule, people could be denied visas, green cards, and entry into the U.S. simply because they have recieved any one of a broad range of public benefits in the past, including health care, nutrition assistance, and public housing. Due to the many barriers in accessing basic health care and information, immigrants face challenging and life-endangering health care disparities – and that’s why three different judges blocked it. Many women in immigrant communities are more likely to die from breast and cervical cancers, and some immigrant groups have higher rates of HIV and other sexually transmitted infections than other groups in the U.S. – all of which could be screened for, and in some cases prevented, with equal access to care.Planned Parenthood is committed to ensuring that all individuals, regardless of citizenship, have access to quality care, including reproductive health care. October 15, 2019: NARAL Pro-Choice America posted an press release titled: “NARAL Celebrates Newsom Signing Groundbreaking Reproductive Freedom Legislation into Law”. From the press release: Last week, California Governor Gavin Newsome signed into law two NARAL-sponsored bills, the College Student Right to Access Act (SB 24), which makes California the first state in the nation to expand abortion access to college campuses, and the Dignity in Pregnancy and Childbirth Act (SB 464), which will save lives by addressing bias in reproductive health care and reducing California’s high rates of pregnancy-related deaths among Black women……Background on SB 24:Each month, hundreds of California’s public university students are unable to obtain abortion care on-campus, forcing them to travel long distances to access care – often with serious logistical and financial barriers – to the detriment of their academic success and well-being. Some students have had to pay exorbitant copays, had trouble finding a clinic that takes their insurance, and experienced several weeks of delays in getting the care they need. California has long affirmed the right to abortion care. The College Student Right to Access Act makes this right a reality for the hundreds of thousands of students who attend California’s public universities……Background on SB 464:Over the last fifteen years, California has made great strides to become the state with the lowest maternal mortality rates in the country. However, Black wonen in California continue to die in pregnancy-related deaths at a rate of 3 to 4 times higher than white women – a disparity that cannot be explained by education, income, prenatal care, or other social determinants of health. Evidence points to bias in health care as one cause of this disparity. SB 464 addresses this problem head-on by requiring that all perinatal healthcare providers participate in evidence-based implicit bias training and improving California’s data collection to better understand pregnancy-related deaths… October 18, 2019: American Civil Liberties Union (ACLU) posted news titled: “Patients’ Needs, Not Personal Beliefs, Come First in Health Care”. It was written by Lindsey Kaley. From the article: From the start, the Trump administration has issued one regulation after another that uses religion to deny people – particularly pregnant people, people with low-incomes, and LGBTQ people – health care access and coverage. Today, we are asking a federal district court in New York to strike down one of the most pernicious of these regulations: the refusal of care.The refusal of care rule, issued by the Deparment of Health and Human Services (HHS), allows health care providers who receive federal funds to withhold critical information and to obstruct patient’s access to essential health care involing their personal religious or moral beliefs – even in emergencies. The rule means that even if a hospital discovers an employee would be unwilling to care for all patients equally, they have to remain employed.This could be deadly for patients. When asked, HHS refused to even answer whether the rule would allow a paramedic to refuse to drive a patient with a life-threatening ectopic pregnancy to the hospital because the paramedic knows the patient will recieve an abortion. You read that right: The federal agency whose mission it is “to enhance and protect the health and well-being” of all of us would allow paramedics to abandon patients in an emergency because they personally are anti-abortion. Everyone is entitled to their religious beliefs, but those beliefs cannot be used to discriminate against others to or to deny critical care……Most recently, in May 2019, the Trump administration went after protections for transgender individuals and others who face sex discrimination in health care and insurance coverage. HHS has included a proposal to roll back those protections by carving out an absolute exemption for religiously-affiliated health care providers from the prohibition on sex discrimination. This would not just apply to a handful of providers: One in six patients is treated in a Catholic facility each year, and religious hospitals are also increasingly the only health care option in many regions. In 2016, 46 communities relied on a Catholic provider as their sole community hospital……If this rule goes into effect next month as planned, the harms to patients and the health care providers that care for them will be real and exceedingly difficult to mitigate. That’s why we’re heading to cout today to protect patients and make sure that the Trump administration does not do any more damage to health care access. October 21, 2019: Governor of Pennsylvania Tom Wolf posted news on his official website titled: “Gov. Wolf Reiterates Vow to Veto Any Abortion Ban”. From the article: Governor Tom Wolf today reiterated his opposition to abortion ban legislation and other regressive health care policies that target women and families.“Let me be clear: I will veto any abortion ban that is put on my desk. The latest bill, a six-week abortion ban, defies all practical understanding of modern women’s health care. These policies run counter to the notion of individual freedom and lack a sound scientific basis. Further, as we have seen in other states, these policies are detrimental to efforts to attract and retain businesses, entrepreneurs and workers.“My administration is committed to reducing maternal mortality and giving women, children and families the support they need to succed. This should be our focus, not regressive policies that make it harder for vulnerable people making difficult and deeply personal decisions.” October 23, 2019: Center for Reproductive Rights posted a press release titled: “Court Blocks Oklahoma Law that Violates Doctors’ Free Speech”. From the press release: Today, a state district court judge ruled from the bench and temporarily blocked an Oklahoma law forcing doctors to tell patients that medication abortion (abortion by pills) can be “reversed” – a misleading claim unsupported by scientific evidence. Under this law, physicians can be charged with with a felony if this misleading information is not repeatedly relayed to the patient, including at least 72 hours before their medication abortion appointment and on mandiatory signs in the clinic. The preliminary injunction was requested by Center for Reproductive Rights, Well, Gotshal & Manges, LLP, and Walding & Patton PLLC on behalf of Tulsa Women’s Reproductive Clinic, LLC and Dr. Alan Braid.“This law is a glaring free speech violation and the court recognized that today,” said Gail Deadly, staff attorney at the Center for Reproductive Rights. “There is no credible scientific evience that medication abortion is reversible. Forcing doctors to tell patients otherwise would violate not only their free speech rights, but medical ethics.”……The law being challenged, S.B. 614, was scheduled to take effect on November 1, 2019. In addition to forcing doctors to tell their patients that a medication abortion can be “reversed”, the law also requires providers to repeatedly direct patients to Heartbeat International’s Abortion Pill Reversal Network 24-hour hotline. Providers must also post signage throughout their health center with the network’s information, and directly provide it to patients following their appointment.Last month, a court blocked a similar law in North Dakota, in a case filed by the Center for Reproductive Rights.. October 29, 2019: CNN posted an article titled: “Federal judge blocks Alabama’s near-total abortion ban”. It was written by Caroline Kelly. From the article: A federal judge has blocked a controversal Alabama abortion bill that would block almost all abortions, calling it a “ban” that “contravenes clear Supreme Court precedent.”US District Judge Myron Thompson issued a preliminary injunction on Tuesday barring the Human Life Protection Act from taking effect until the court resolves the case in full. The law was slated to go into effect next month.Thompson’s decision to block the Alabama law means that all of the state laws passed this year restricting early-stage abortions have been blocked from going into effect by the courts.In the 17-page opinion, Thompson wrote that the state’s abortion ban “violates the right of an individual to privacy, to make choices central to personal dignity and autonomy.” Thompson also stated that the ban “diminishes the capacity of women to act in society, and to make reproductive decisions.”Thompson added, “It defies the United States Constitution.”……The bill, which Republican Gov. Kay Ivey signed into law in May, would punish doctors who perform abortions with life in prison. The law only allows exceptions “to avoid a serious health risk to the unborn child’s mother,” or for ectopic pregnancy and if the “unborn child has a lethal anomoly” – – not for instances of rape or incest… October 29, 2019: Planned Parenthood posted a press release titled: “Alabama Abortion Ban Blocked By Federal Court”. From the press release: Today, a U.S. District Court in Alabama granted a preliminary injunction, blocking an extreme Alabama law that would have banned abortion in nearly all instances and threatened doctors with up to 99 years in prison for performing an abortion. This harmful ban, slated to go into effect on November 15, would have blocked abortion access for nearly one million women of reproductive age in Alabama.The American Civil Liberties Union (ACLU), ACLU of Alabama and Planned Parenthood Federation of America brought the lawsuit on behalf of Alabama abortion providers and their patients. Today’s decision comes on the heels of decisions by other courts blocking similar bans in Georgia, Kentucky, Mississipps, Missouri, and Ohio… October 29, 2019: Georgtown University Health Policy Institute Center for Chidlren and Families posted a press release titled: “Georgetown University Report Finds Number of Uninsured Children Now at Highest Levels Since Major Provisions of Affordable Care Act Took Effect”. From the press release: …The number of uninsured children increased by more than 400,000 between 2016 and 2018, reversing a long-standing positive trend according to a new report released by Georgetown University Center for Children and Families. Nationwide, more than 4 million children were uninsured in 2018.“Recent policy changes and the failure to make children’s health a priority have undercut bipartisan initiatives and the Affordable Care Act, which had propelled our nation forward on children’s health coverage,” said Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the McCourt School of Public Policy. “”This serious erosion of child health coverage is due in large part to the Trump Administration’s actions or inactions that have made health coverage harder to access and have detered families from enrolling their eligible children in Medicaid and CHIP.”The report finds the following factors have contributed to the erosion in children’s health coverage: efforts to repeal the Affordable Care Act and cut Medicaid: delays in funding the Children’s Health Insurance Program; elimination of the individual mandate penalty; cuts to enrollment outreach and advertising; inadequate oversight over state Medicaid programs that have created more red tape barriers; and the creation of a climate of fear and confusion for immigrant families that discourages them from enrolling eligible children in Medicaid or CHIP.The child uninsured rate increased from 4.7 percent to 5.2 percent between 2016 and 2018. Coverage losses were widespread, with 15 states showing statistically significant increases in the number and/or rate of uninsured children (Alabama, Arizona, Florida, Georgia, Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Texas, Utah and West Virginia). Only one state, North Dakota, moved in the right direction. States where the uninsured rate for children has increased most sharply, in order of magnitude are: Tennsesee, Georgia, Texas, Utah, West Virginia, Florida, and Ohio……Loss of children’s health coverage was most pronounced for white children and Latino children, some of whom may fall into both categories and for young children under the age of six. The loss was also concentrated among families with low and moderate incomes – between 138 percent and 250 percent of the federal poverty level, or roughly $29,000 to $53,000 annually for a family of three.The majority of uninsured children are eligible for Medicaid or the Children’s Health Insurance Program but are not currently enrolled……States in the South have a disproportionately large share of uninsured kids relative to their child population. Texas has the largest proportion of uninsured children and is home to more than one in five uninsured children in the U.S..Three-quarters of the children who lost coverage between 2016 and 2018 live in states that have not expanded Medicaid to low-income adults. The uninsured rate for children in these states increased at triple the rate experienced by those in states that had expanded… October 29, 2019: Planned Parenthood posted a press release titled: “Planned Parenthood’s Statement on Missouri’s Top Health Official Admitting He Investigated Menstrual Cycles of Missouri Women”. From the press release: During today’s Administrative Hearing Commission hearing to protect the last health center in Missouri that provides abortion, Gov. Mike Parson’s state health director, Randall Williams, admitted he investigated menstrual cycles of Missouri women. Today’s revelation is just the latest evidence that politicians have weaponized the health center’s licencing process with the ultimate goal of ending abortion in the state of Missouri.Statement from Alexis McGill Johnson, Acting President and CEO of Planned Parenthood Federation of America:“This is the reality when people in power want to strip away our rights and freedoms. They force medically unnecessary pelvic exams, investigate menstrual cycles, and do whatever it takes to take control of our bodies, our lives, and our futures. Enough is enough. Every person deserves access to safe, legal abortion without fearing their personal information will be used to wage political war. This is unacceptable and we demand better – for our patients and any person who needs access to safe, legal abortion.”… October 30, 2019: Center for Reproductive Rights posted a press release titled: “Civil Rights Groups and County of Santa Clara Urge Court to Block HHS Denial of Care Rule”. From the press release: Today, the Center for Reproductive Rights, Americans United for Separation of Church and State, Lambda Legal, and the County of Santa Clara argued before the U.S. District Court for the Northern District of California that the Trump administration’s Denial of Care Rule should be ruled unlawful and blocked from taking effect. The organizations, along with pro bono counsel Mayer Brown LLP, are representing myriad health care providers and medical professionals, as co-plaintiffs with the County, in the lawsuit County of Santa Clara v. HHS.The Denial of Care Rule, which was issued in May by the U.S. Department of Health and Human Services and is scheduled to take effect next month, invites any health care worker – including doctors, nurses, EMT’s, administrators, janitors, and clerical staff – to deny medical treatment, information and services to patients because of personal religious or moral beliefs. Health care facilities risk losing essential funding if they do not grant employees carte blanche to deny services. Because the rule is confusing and infeasible to implement, many health care facilities will likely be forced to eliminate services such as reproductive and LGBTQ care, leaving millions across the United States without access to critical health care.Today, the civil rights organizations and the County argued that HHS exceeded its authority and arbitrarily and capriciously failed to consider the rule’s potential harm to patients and the health care system, in violation of the federal Administrative Procedure Act. They also argued that the rule is unconstitutional because it advances specific religious beliefs in violation of the First Amendment; violates patients’ rights to privacy, liberty and equal dignity as guaranteed by the Fifth Amendment; and chills patients’ speech and expression in violation of the First Amendment, all to the detriment of patients’ health and well-being……The lawsuit’s plaintiffs include the County of Santa Clara, which runs an extensive health and hosptial system that serves as a safety-net provider of the county’s 1.9 million residents; the health providers Bradbury-Sullivan LGBT Community Center in Allentown, Pa., Center on Halsted in Chicago, Hartford GYN in Connecticut, Los Angeles LGBT Center, Mazzoni Center in Philadelphia, Trust Women Seattle and Whitman-Walker Health in Washington D.C.; the associations AGLP, GLMA and Medical Students for Choice; and five doctors. October 30, 2019: Mother Jones posted an article titled: “Missouri Has Been Tracking the Menstrual Cycles of Planned Parenthood Patients, Top Health Official Admits.” It was written by Jessica Washington. From the article: Missouri’s top health official admitted the state government has been tracking the menstrual cycles of Planned Parenthood patients as it weighs the fate of the state’s last remaining abortion clinic.Randall Williams, the Missouri state health director, said Tuesday that the state health department had been keeping a spreadsheet of patients who had visited Planned Parenthood, with personal data on each patient including the date of the last menstrual period. The state collected this information as a part of its annual inspection of the clinic and later used this information to try to determine whether patients had undergone failed abortions. According to the Kansas City Star, which first reported the news, the spreadsheet also included “medical identification numbers, dates of medical procedures and the gestational ages of fetuses.”……This hearing is just the latest chapter in a fight between the Missouri Department of Health and Planned Parenthood of the St. Louis Region. In May, state regulators demanded to question clinic doctors over “ongoing concerns about deficient practices,” but the clinic declined to make providers available for interviews that it considered intimidation. As a result, the health department refused to renew the clinic’s license to perform abortions, leading Planned Parenthood to sue the state.If the St. Louis Planned Parenthood fails to get its license renewed, Missouri will become the first state without any abortion clinics since the Supreme Court’s 1973 Roe v. Wade ruling upholding the right to an abortion.. October 30, 2019: Cal Matters posted an article titled: “In California, the teen birth rate has hit a record low. How?” It was written by Elizabeth Castillo. From the article: …While Kern County still has one of the highest teen pregnancy rates in California, across the state, rates are declining to record lows, according to the newest data, from 2017. It shows California with a rate of nearly 14 births per 1,000 females ages 15-19. That’s the 16th lowest teen birth rate in the nation, and below the national average of nearly 19 births per 1,000 females in that age range. Arkansas ranks highest with 33; Massachusetts lowest with 8.But within California, there are wide variations. Affluent Marin County has the lowest rate with just over 6 births, while Imperial County is highest, and Arkansas-like level of just over 33. Kern County, with nearly 32, ranks third-highest and is nearly double the state average.Even so, teen birht rates are falling in every California county – sometimes dramatically. Kern County’s rate has actually been cut almost in half in just a decade.What explains the drop? Many experts cite California’s comprehensive sex education and guarantees of confidential access to birth control. California law allows anyone under 18 to seek birth control services or the morning-after pill on their own. Minors 12 and older can seek treatment for sexually transmitted disease without parental consent. And as a result of a California Supreme Court ruming, they can get an abortion without parental consent or notification.But a variety of factors are no doubt in play. Research has even shown that the struggles depicted in MTV’s “16 and Pregnant” and “Teen Mom” may have prompted some teens to be more vigilant about birth control, according to a 2014 Brookings Report……Other factors behind the decline include teens waiting longer to have sex and using more than one form of contraception during sex, according to the California Department of Public Health……More than half of California high schoolers reported using a condom the last time they had sex, according to the federal Centers for Disease Control and Prevention. And 30% reported relying on the birth control pill, shot, or IUD the last time they had six.Californai law since 2016 has required traditional public schools to provide comprehensive sex education, based on medically accurate facts that does not mostly stress abstaining from sex. The law was expanded to public charter schools last year… November 1, 2019: CNBC posted an article titled: “Obamacare open enrollment begins with new lower rates and legal uncertainty”. It was written by Bertha Coombs. From the article: The sixth year of Obamacare open enrollment began Friday, and Americans shopping for 2020 health plans will find premiums edging lower for the second straight year, down 4% on average.They’ll also find more insurers to choose from in many markets.The Trump administration is taking a victory lap for bringing stability to the Obamacare marketplaces, even as it supports a federal lawsuit pending the 5th U.S. Circuit Court of Appeals that could overturn the Afforable Care Act……According to CMS, the average premium for a 27-year-old who buys a benchmark silver plan will be $388 a month in 2020, before subsidies, down from the current $406. In half a dozen states the federally run Healthcare.gov marketplaces, including Nebraska, North Dakota, and Montana, premiums will be down 10% or more next year.The number of insurers offering plans on Healthcare.gov will rise from 155 this year to 175. It’s the second highest straight year of expansion, though overall insurer participation on the exchanges is down 26% from 2016……While premiums are edging lower, eHealth notes that exchange plan out-of-pocket costs are moving higher for 2020. The firm calculates that the average deductible for a mid-tier individual silver plan is going up 6%, from $4,050 to $4,292, while family plan deductibles are set to rise an average of 5% to $15,551 from $14,873.Those are the rates for enrollees who don’t recive subsidies, but nearly 90% of current Obamacare enrollees recieve premium tax credits, and those with low incomes also qualify for subsidies to help with out-of-pocket costs. CMS estimates that subsidies will result in lower deductibles in 2020 for low-income enrollees.Critics say the administration has not done enough to get the message out to people who could qualify for financial assistance……Just as Americans begin to ship for new plans, a federal appeals court could cast uncertainity over the fate of the Affordable Care Act itself. The 5th Circuit is expected to issue a decision any day now on a lower court ruling that overturned the ACA, in a case known as Texas vs. the United States.If the appeals court upholds the ruling finding the law unconstitutional, analysts expect that the court will issue a stay allowing open enrollment and 2020 coverage to continue because the decision will almost certainly be appealed to the Supreme Court.Yet ACA advocates worry that headlines about the case could cause confusion and dissuade people from signing up on the exchanges… November 1, 2019: Planned Parenthood posted a statement titled: “Proposed Rule Will Encourage Discrimination Against LGBTQ People, Women, and Other Marginalized Groups”. From the statement: Planned Parenthood Federation of America released the following statement in opposition to the Trump administration’s proposed rule that would encourage discrimination in federally funded programs offered through the Department of Health and Human Services, such a HIV prevention and other treatment programs, foster care placement progams, and other critical programs.Statement form Jacqueline Ayers, Vice President, Government Relations & Public Policy, Planned Parenthood Federation of America:“Once again, the Trump administration is trying to attack and erase LGBTQ people and other marginalized groups, many of whom face far too many barriers to accessing health care and social services, raising their families, and living their most authentic lives. This proposed rule would undermine public health and make it even harder for members of the LGBTQ community to acces the critical services they need. It is particularly alarming that the administration is indicating it will stop enforcing the current reguation that prohibits discrimination, even before people have been able to voice their opinions and concerns. Planned Parenthood vehemently opposes this rule and will continue working to build a world where no one experiences discrimination because of their gender identity, gender expression, or sexual orientation.” November 4, 2019: Center on Budget and Policy Prioities posted a report titled: “ACA Lawsuit Would Cut Taxes for the Most Well-Off While Ending Health Coverage for Millions”. It was written by Aviva Aron-Dine, Chye-Ching Huang and Samantha Washington. From the report: The Trump administration and 18 state attorneys general are asking the courts to strike down the entire Affordable Care Act (ACA) as unconstitutional. If the lawsuit were to succeed, 20 million people would lose health insurance, and millions more would face higher costs for health insurance or health care. But there would also be some winners from the lawsuit, because striking down the ACA would cut taxes sharply for the highest-income Americans and certain corporations. In effect, the Administration and the state attorneys general are seeking a massive transfer of income from low- and moderate-income Americans to people on the top rungs of the income ladder.If their legal postion were to prevail:Households with incomes over $250,000 for couples ($200,000 for singles) would recieve tax cuts worth about $45 billion per year. That roughly equals what low- and moderate-income consumers would lose from cuts to federal health coverage programs in 37 states (including the District of Columbia), where 6.2 million people would become uninsured.Most of these tax cuts would go to households with incomes over $1 million, who would recieve tax cuts averaging about $46,000 apiece.The 1,400 highest-income taxpayers – the 1 in 100,000 households with annual incomes over $53 million apiece – would recieve tax cuts totaling about $3.8 billion. That exceeds the ACA premium tax credits for over 600,000 individual market consumers with moderate incomes in 18 states (including the District of Columbia).Pharmeceutical companies would pay $2.8 billion less in taxes each year, even as seniors would pay billions more for prescription drugs because eliminating the ACA would reopen the “donut hole” gap in Medicare’s prescription drug benefit……Striking down the ACA would end the law’s expansion of Medicaid to low-income adults, eliminate the health insruance marketplaces and premium tax credits that help millions of people afford individual market coverage, and end nationwide protections for people with pre-existing health conditions, as well as a range of other coverage expansions and consumer protections.It would also eliminate the law’s revenue measures. This analysis focuses on three such provisions, which together, comprise the majority of the revenue that the law raises.Medicare tax on high earners. The ACA imposed a 0.9 percent tax on earnings over $250,000 for couples ($200,000 for single filers), with the proceeds going to the Medicare Trust Fund.Medicare Net Investiment Income Tax. The ACA also imposed a 3.8 percent tax on unearned income (such as capital gains, dividends, taxable interest, and royalties) for couples with income over $250,000 ($200,000 for single filers).Pharmaceutical company fee. The ACA imposed a $2.8 billion annual fee on pharmaceutical companies, allocated based on their sales of brand-name drugs……Striking down the ACA would also transfer billions of dollars from seniors to pharmaceutical companies. Eliminating the ACA’s branded drug fee would cut taxes for pharmaceutical companies by $2.8 billion each year. At the same time, at least 5 million seniors would pay at least $1,000 more per year, on average, for prescription drugs because eliminating the ACA would reopen the Medicare “donut hole”: a range of beneficiaries’ drug spending where the Medicare prescription drug benefit initially provided no coverage, requiring beneficiaries to pay 100 percent of the costs. The ACA gradually eliminated the donut hole.. November 4, 2019: Center for Reproductive Rights posted a press release titled: “Oklahoma Supreme Court Steps in to Block Abortion Ban After Rogue Ruling”. From the press release: Today, the Oklahoma Supreme Court granted an emergency request to block the states’ ban on the standard method of abortion after approximately 14 weeks of pregnancy. The Center for Reproductive Rights asked the state’s high court to step in after an Oklahoma state trial court upheld the ban earlier this year, becoming the first court in the country to uphold such a law. The ban was passed in 2015 and has never gone into effect.“Today’s decision means Oklahomans can continue recieving high-quality, evidence-based abortion care,” said Autumn Katz, Senior Counsel at the Center for Reproductive Rights and lead counsel on this case. “Under this law, doctors would be subject to criminal penalties by providing abortions consistent with the standard of care. This ban was motivated by politics, not medicine, and the Oklahoma Supreme Court recognized that today.”.. November 4, 2019: Forbes posted an article titled: “The Fate Of ACA in Kentucky Hangs In The Balance As Tuesday’s Gubernatorial Election Looms”. It was written by Clary Estes. From the article: …Unlike Lexington, Kentucky the rest of the state is quiet, with many people feeling from the vitriolic gubernatorial race. When Bevin was elected in 2015, only about a third of the state voted and the numbers for 2019 don’t look to be any better.Beven, who is a proponent of the Koch model of governance focusing on outsourcing government programs to the private sector, immediately targeted the states Medicaid program almost as soon as he came into office. Bevin has repeatedly attempted to challenge Kentucky Medicaid with budget cuts and work requirements. Unfortunately for Bevin, many of his volleys against the program have been met with defendants of the program on all fronts. Medicaid in Kentucky has become a battle line.Kentucky was one of the first states to effectively integrate the Affordable Care Act by starting Kynect, now renamed Kentucky Health Benefit Exchange. The platform allowed Kentuckyians to both shop for health coverage, as well as apply for Medicaid coverage and was successful within the first four days of its creation with 137,000 individuals using the website in October 2013 and 410,000 Kentuckians signing up for insurance plans by April 2014.For the first time Kentuckians statewide were given access to nearly full medical coverage including dental and vision. Kentucky’s Medicaid program also opened up the state’s drug treatment opportunities in a regin that has been descimated by the opioid crisis. When Bevin came into the office he quickly pushed to “overhaul” the Medicaid program and incorporate work requirements and premiums for “able-bodied” Medicaid recipients – a move that has been rejected twice by federal judges and is incredibly unpopular statewide. In response to federal rejection of his proposed changes, Bevin took aim at Medicaid’s vision and dental by cutting coverage for almost 500k Kentucky Medicaid recipients, a move that shocked healthcare providers and patients alike and many Democratic lawmakers called “rash”, “harsh”, and contended was “possibly illegal.” Bevin soon reversed his cuts.Ultimately, the battle over Kentucky’s Medicaid coverage will be determined, in part, by the November 5th election… November 6, 2019: Planned Parenthood posted a press release titled: “Victory: Court Strikes Down Trump Administration’s Discriminatory Refusal of Care”. From the press release: Today, the U.S. District Court for the Southern District of New York struck down a Trump administration rule that would have allowed health care workers’ personal beliefs to dictate patient care. The rule was finalized in May and set to take effect on November 22. The administration’s “refusal of care” rule would ahve endangered patients by granting health care workers – from physicians and nurses to receptionists, EMTs, and call center staff – the right to put their personal beliefs ahead of people’s health, even in emergencies. Patients could have been denied access to information and health care for any reason – simply because a health care worker disagrees with a particular service. This rule would have impacted more than 600,000 health centers, including Planned Parenthood, and created barriers to providers who want to provide the full range of reproductive health services. This rule runs counter to Planned Parenthood’s mission and would have required health centers to retain staff workers, or volunteers, who do not want to provide care and information……Planned Parenthood Federation of America, on behalf of its member-affiliates, and Planned Parenthood of Northern New England sued the Trump administration in June to block the rule. Planned Parenthood was represented by attorneys from Planned Parenthood Federation of America, National Women’s Law Center, Democracy Forward, and Covington & Burling.This “refusal of care” rule is part of the Trump administration’s broader agenda to impose its ideology on all people and block patients from accessing sexual and reproductive health services at Planned Parenthood. Repeated attempts by extreme politicians would compound the obstacles that can stand in the way of access to essential and lifesaving health care for women, LGBTQ people, and people of color.. November 6, 2019: CNBC posted an article titled: “Judge rejects Trump moral-objection rule for health care”. From the article: A federal judge on Wednesday struck down a new rule, not yet in effect, that allowed health care providers to refuse participation in abortions and other services on moral or religious grounds.U.S. District Judge Paul A. Englemayer in New York said he was tossing out the rule in its entirety.The decision came after 19 states, the District of Columbia, three local governments, health organizations and others sued the U.S. Department of Health and Human Services.The rule let clinicians object to providing abortions and other services that conflict with their moral and religious beliefs.Englemayer said his ruling came in three consolidated lawsuits……Plaintiffs had argued that the rule was unconstitutional because it would be discriminatory and stall access to health care for populations nationwide……Englemayer, who was appointed by Democratic President Barack Obama, wrote that existing laws already define the duties of employers with respect to religious obligations.The 2019 rule, which had been set to take effect late this month, would effectively supersede existing law in the health care field, he said. The judge rejected arguments that the rule was “mere housekeeping.” Rather, he said, it relocates “the who, what, when, where, and how – of conscience protection under federal law.”The Department of Health and Human Services lacked authority to create major portions of its rule, including to terminate an entity’s federal health funding if it violates one of the provisions… November 6, 2019: Mother Jones posted an article titled: “Judge Blocks Trump Administation’s “Conscience Rule” to Deny Health Care on Religious Grounds”. It was written by Jessica Washington. From the article: The Trump administration’s “conscience rule,” which would have allowed health care providers to refuse to offer services such as abortions, contraceptive care, and vaccinations that they disagree with on religious or moral grounds, was declared unconstitutional by a federal judge on Wednesday.The rule, which was set to go into effect later this month, was voided by US District Court Judge Paul Englemayer in Manhattan. In 147-page opinion, Englemayer stated that the administration did not have the authority to enact major portions of the rule change and that several parts of the Department of Health and Human Services’ argument in favor of the change were factually inaccurate.Had the rule, also known as the refusal-of-care rule, gone into effect, it would have enabled providers, pharmacists, and potentially employers to deny health care services, information, or referrals to patients on moral or religious grounds, even in emergencies. Hospitals that forced their employees to provide care over their personal objections would have been subject to penalties such as losing federal funding. The rule would have also allowed providers to decline to refer a patient to another provider in order to recieve care based on personal objections to the service.The lawsuit that resulted in Wednesday’s ruling was brought by New York Attorney General Letitia James, nearly two dozen other states and cities, and two reproductive rights groups……Critics of the rule argued that it would disproportinately affect the LGBTQ population by giving further protection to providers to deny care to patients based on their identities… November 6, 2019: The Hill posted an article titled: “ObamaCare enrollment reaches 177,000 in first two days of enrollment period”. It was written by Jessie Hellmann. From the article: More than 177,000 people signed up for ObamaCare plans during the first two days of open enrollment, according to numbers released Wednesday by the Trump administration.Nov. 1 marked the first day of open enrollment on healthcare.gov, the federal government’s enrollment platform used by 38 states.Of the 177,082 people who selected plans on healthcare.gov Friday and Saturday, nearly 49,000 were new customers.During the first week of open enrollment last year – which spanned three days instead of two – 371,676 people signed up.Enrollment numbers are likely slightly lower this year due to technical issues that occured on the site Friday, according to a statement from the Centers for Medicare and Medicaid Services, which manages Obamacare….…CMS says it will continue to “closely monitor” healthcare.gov throughout open enrollment, which ends Dec. 15. November 8, 2019: Center for Reproductive Rights posted a press release titled: “New Abortion Lawsuit Seeks to Expand Access in Oklahoma”. From the press release: Today, the Center for Reproductive Rights filed a lawsuit challenging two anti-abortion laws in Oklahoma, both of which are medically unnecessary and limit abortion care. This is the sixth lawsuit the Center for Reproductive Rights has filed against Oklahoma in five years.The laws being challenged in this case are:Telemedicine Ban: This Oklahoma law bans abortion providers from using telemedicine to provide medication abortion (abortion by pills). Medication abortion has been approved by the FDA sine 2000 and is extremely safe – the serious complication rate is less than one-half of one percent, whether provided in-person or by telemedicine. Telemedicine expands access to safe and legal health care.“Physician Only Law”: This Oklahoma law bans advanced practice registered nurses (APRNs) from providing abortion care, despite the fact that APRNs can provide early abortion care with the same safety and efficacy as physicians. For this reason, sixteen other states already authorize APRNs to provide early abortion care. Major medical organizations, including the American College of Obstetricans and Gynecologists, the American Public Health Association and the World Health Organization have concluded that laws prohibiting APRNs from providing early abortion services are medically unfounded.“If we get these senseless laws off th books, we can expand abortion access in Oklahoma, which has very few abortion providers,” said Nancy Northup, President and CEO of the Center for Reproductive Rights. “As clinics shutter across the country, telemedicine is a crucial way to keep services available.”……You can read the full complaint for this case here… November 8, 2019: Tuscon.com posted an article titled: “If ACA goes away, some GOP leaders want Arizona to keep preexisting conditions rule”. It was written by Howard Fischer. From the article: Two Republican legislators and the attorney general are taking steps to propose legislation ensuring that Arizonans with preexisting conditions can still buy health insurance if federal courts strike down the Affordable Care Act.The move comes even as Republican attorneys generals – including Arizona’s Mark Brnovich – are working to have the Affordable Care Act declared unconstitutional, including provisions about coverage access. They contend Congress lacks the power to mandate that people buy health insurance.Last December, a federal judge in Texas agreed. That sent the case to the 5th U.S. Circuit Court of Appeals, which could rule any day.But the final word is likely to belong to the U.S. Supreme Court. Depending on how quickly it schedules arguments, a ruling could come as early as next spring……But Sen. J.D. Mesnard, R-Chandler, said that if the Affordable Care Act disappears, so does the provision requiring insurers to provide coverage for those with preexisting conditons. And he acknowledged that particular part of the law remains popular with consumers.“I think there’s growing appreciation that we want to make sure that those with preexisting conditions aren’t now somehow unable to get coverage,” he said. How that would work and who would pay for it, however, remains to be decided……Costs, he said, are likely to be passed on to all people with health insurance, no matter where and how it is purchased..…Brnovich is working with Menard, and Rep. Jeff Weinger, R-Chandler, to address what will happen to Arizonans if the entire law is struck down.. November 24, 2019: The Hill posted an article titled: “Trump draws ire after retreat on drug prices pledge”. It was written by Peter Sullivan. From the article: President Trump is backing off his 2016 campaign pledge to negotiate drug prices for Medicare with pharmaceutical companies, drawing fire from Democrats after months of talks on the issue with Speaker Nancy Pelosi (D-Calif.)During his campaign, Trump famously broke with Republican orthodoxy with his support for having the government negotiate lower drug prices……Pelosi’s staff spent months over the course of this year trying to get White House support for her measure to allow the government to negotiate prices for up to 250 drugs per year, with tough financial penalties for companies that refused to come to the table.But after months of holding his fire, Trump is now publicly bashing Pelosi’s bill. And while Trump still talks about the need to lowe drug prices in general, he has not proposed an alternative drug price negotiation plan of his own……The White House is instead supporting a somewhat more modest bipartisan bill in the Senate from Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) That bill does not include negotiation, though. Instead, it would cap out-of-pocket drug costs for seniors and limit drug price increases in Medicare to the rate of inflation……The pharmaceutical industry is a powerful force in Washington, making any action difficult. Even the more modest Grassley-Wyden bill faces a tough path, given that many Republican senators oppose one of its key provisions which would limit Medicare drug price increases to the rate of inflation… November 26, 2019: CBS News posted an article titled: “One of the Supreme Court’s most important abortion cases since Roe v. Wade has just begun”. It was written by Kate Smith. From the article: The lawsuit that will decide the future of abortion access in Louisiana – and the rest of the country – is officially underway.A 63-page opening brief was filed late Monday night by the Center for Reproductive Rights (CRR) in a Supreme Court case that could leave Louisiana without access to legal abortion and provide a roadmap for other anti-abortion access states to follow.At the center of the case – June Medical Services v Gee – is Act 620, Louisiana’s “Unsafe Abortion Prevention Act,” a 2014 state law not currently in effect that would require doctors performing abortions to have hospital admitting privileges at a nearby hospital. If the law is allowed to be implemented, all of Louisiana’s abortion clinics would close, as first reported last month by CBS News.CCR represents June Medical Services, a clinic that does business as Hope Medical Group and is one of the state’s last three abortion providers. In the opening brief, CRR outlined its argument against Act 620, identifying two reasons why it believes the regulation should be struck down by the high court. First, CRR argued that since the Supreme Court struck down the same type of restriction in Whole Woman’s Health v. Hellerstedt in 2016, Louisiana’s restriction should also be deemed unconstitutional. Second, the law in question “is unconstitutional even assuming the burdens here are less than that in Whole Woman’s Health,” according to the brief.Previous Supreme Court precedent says that abortion restrictions cannot create an “undue burden” for women seeking the procedure……Louisiana’s Attorney General’s office, which will be responsible for arguing in favor of the law, has not yet filed its opening brief, which is due by December 26, according to a spokesperson for the office… CBS News embedded a copy of the full brief into their article November 26, 2019: Rewire News posted an article titled: “Atlanta Wants to Blunt the Impact of Georgia’s Near-Total Abortion Ban”. It was written by Casey Quinlan. From the article: …The Atlantic City Counsel approved a resolution last week to create a Reproductive Justice Commission designed to mitigate the effects of the state’s near-total ban, which outlaws abortion care six weeks into pregnancy, before many know they’re pregnant. Georgia is one of several states with Republican-majority legislatures that passed a near-total abortion ban this year.The Georgia law was temporarily blocked by a a federal judge in October.The Atlanta commission will research policy and recommend ways to “incrase awareness around access to reproductive care as well as public and private resources.” It will focus on how to improve health outcomes “related to reproductive, maternal and infant health, and abortion access in Atlanta.”Council member Amir Farokhi, who introduced the Reproductive Justice Commission resolution, said Atlanta’s charter does not allow the commission to “get involved with public health or social service work,” since that is the county’s purview. Instead, the commission can examine zoning and potential improvements to transit routes and locations for reproductive health-care facilities. The commission, Farokhi said, could also make sure workers have reproductive health care.Although the Atlanta Reproductive Justice Commission may point out opportunities for better funding of reproductive health-care services, there will be no public funds allocated to the commission, Farokhi said… November 29, 2019: The Guardian posted an article titled: “Ohio bill orders doctors to ‘reimplant etopic pregnancy’ or face ‘abortion murder’ charges”. It was written by Jessica Glenza. From the article: A bill to ban abortion introduced in the Ohio state legislature requires doctors to “reimplant an ectopic pregnancy” into a woman’s uterus – a procedure that does not exist in medical science – or face charges of “abortion murder”.This is the second time practicing obstetricians and gynecologists have tried to tell the Ohio legislature that the idea is currently medically impossible……Ohio’s move on ectopic pregnancies – where an embryo implants on the mother’s fallopian tube rather than her uterus rendering the pregnancy unviable – is one of the most extreme bills to date……An etopic pregnancy is a life-threatening condition, which can kill a woman if the embryonic tissue grows unchecked.In addition to ordering doctors to do the impossible or face criminal charges, House Bill 413 bans abortion outright and defines a fertilized egg as an “unborn child”.It also appears to punish doctors, women and children as young as 13 with “abortion murder” if they “perform or have an abortion”. This crime is punishable by life in prison. Another new crime “aggravated abortion murder”, is punishable by death, according to the bill.The bill is sponsored by representatives Candic Keller and Ron Hood, and co-sponsored by 19 members of Ohio’s 99-member House… November 28, 2019: Governor of Utah Gary R. Herbert (Republican) posted a press release on his official website titled: “Gov. Herbert Proposes New Rule to Ban Conversion Therapy on Minors”. From the press release: Gov. Gary R. Herbert has directed the Utah Division of Occupational and Professional Licensing, Utah Department of Commerce, to file a new rule to ban converstion therapy on minors in the state of Utah. The rule uses language from H.B. 399, presented by Rep. Craig Hall during the 2019 General Legislative Session, and will apply to all licenses therapists practicing in Utah.The rule is backed by a wide variety of public leaders, organizations, and policy groups, who are united in supporting this critical effort to end the harmful practice of conversion therapy on minors.This development brings resolution to conflicts surrounding technical language and comes after an exhausstive process. Since the public comment period closed, DOPL has been immersed in considering all 2,465 individual comments submitted regarding the first draft of a rule regulating conversion therapy. Since that time, the governor’s office has worked with a number of stakeholders with input on specific, technical aspects of the language in the rule……DOPL is working to file the rule, which will be published on Dec. 15. The 30-day public comment period will end on Jan. 14, 2020. The new rule could be effective as early as Jan. 22, 2020. November 28, 2019: CNN posted an article titled: “Utah governor proposes statewide ban on conversion therapy for minors”. It was written by Chandelis Duster. From the article: The rule comes amid ongoing discussions in the state to ban the widely discredited practice that seeks to change a person’s sexual orientation or gender identity. Earlier this year, a similar bill banning the practice for minors, presented by Republican state Rep. Craig Hall, stalled in the state’s legislature. On Tuesday, Herbert, a Republican, said that he directed the Division of Occupational and Professional to file the new rule that includes input from advocates, policy groups, and organizations……CNN previously reported the Herbert directed the state Psychologist Licensing Board to draft rules to regulate conversion therapy in the state. According to an audio recording of a meeting held by the board at that time, the board agreed that it would draft its rules to apply to adults and minors — which the governor’s office approved during the meeting. The board also said it would try to make the rules as “broad” and “comprehensive” as possible……Sixteen states, the District of Columbia, and Puerto Rico have banned conversion therapy for young people, according to the Human Rights Campaign. Medical and mental health professional organizations, including the American Medical Association, have denounced conversion therapy… THIS BLOG WILL BE UPDATED WHENEVER ADDITIONAL RELEVANT, CREDIBLE INFORMATION IS FOUND. A Timeline of the GOP’s Attempts to Destroy Obamacare – Part Three – Continued is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

Other Video Games

- Why I’m Not Boycotting Blizzard
  October 13, 2019Hearthstone / Other Video GamesAs you may have heard, there was a controversy involving Hearthstone (made by Blizzard Entertainment, which is part of Activision/Blizzard), and a Hearthstone player who publicly stated a viewpoint that has been described as political. This led to many fans of Blizzard’s games to call for a boycott of the company. (You may have seen #BoycottBlizzard trending on Twitter). I am not among those who are boycotting Blizzard. Yes, I realize that there will be people who choose to become angry with me because I am not doing what they have decided to do. I’m sharing my reasons anyway, in part because I doubt I’m the only person in the world who chooses not to join in this boycott. What Happened? Before I get too far ahead of myself, I’m going to do an explanation about what happened. A Hearthstone player named Ng Wai Chung (who is known as Blitzchung) won the 2019 Hearthstone Grandmaster tournament. On October 9, 2019, CNBC explained the situation this way: Activision Blizzard suspended a professional player from an esports tournament and stripped him of his earnings after he made a statement over the weekend in support of protests in Hong Kong.In a post-match interview on the Taiwanese stream of Blizzard Entertainment game Hearthstone, Chung “Blitzchung” Ng Wai wore a gas mask and goggles and appeared to shout a slogan often associated with Hong Kong protesters: “Liberate Hong Kong, revolution of our time.” The day before, October 8, 2019, Blizzard posted news on its Hearthstone website titled: “Hearthstone Grandmasters Asia-Pacific Ruling“. Here is a small portion from it: During the Asia-Pacific Grandmasters broadcast over the weekend, there was a competition rule violation during a post-match interview, involving Blitzchung and two casters, which resulted in the removal of the match VOD replay. Blizzard then states that what happened violated the 2019 Hearthstone Grandmaster’s Official Competition rules section 6.1 (o) and is individual behavior which does not represent Blizzard or Hearthstone Esports. That rule states: Engaging in any act that, in Blizzard’s sole discretion, brings you into public disrepute, offends a portion or group of the public, or otherwise damages Blizzard image will result in removal from Grandmasters and reduction of the player’s prize total to $0 USD, in addition to other remedies which may be provided for under the Handbook and Blizzard’s Website terms. Blizzard then issued a consequence: Effective immediately, Blitzchung is removed from Grandmasters and will receive no prizing for Grandmasters Season 2. Additionally, Blitzchung is ineligible to participate in Hearthstone esports for 12 months beginning from Oct. 5th, 2019 and extending to Oct. 5, 2020. We will also immediately cease working with both casters. Heavy reported on October 8, 2019, that when Blitzchung said the slogan used by Hong Kong protesters, the interviewers (or, casters) “hid under the table for a moment and then cut to a commercial.” There has been speculation about that, which seems to have led to a few unanswered questions. Were the casters taken by surprise by what Blitzchung was saying – so they hid under the table to avoid consequences? Or, did the casters know ahead of time what Blitzchung was going to say – and hid under the table in an effort to avoid consequences? I have no idea which is true. It is my understanding that the #BoycottBlizzard hashtag started trending as a result of Blizzard’s decision regarding Blitzchung (and the two casters). People posted screenshots proving that they were deleting Blizzard’s games. Some tried to let Blizzard know that they wanted the company to delete their data – but it appears that wasn’t working out as hoped. On October 9, 2019, Brian Kibler posted a Statement on Blitzchung on BMK Gaming. To summarize, he states that he felt that Blizzard’s action against Blitzchung was “incredibly harsh.” He continued: …I won’t pretend to understand either the intricacies of the geopolitical situation in China and Hong Kong or the full extent of Blizzard’s business interests there, but to me this penalty feels like it is deeply rooted in both. The heavy-handedness of it feels like someone insisted that Blizzard make an example of Blitzchung, not only to discourage others from similar acts in the future but also to appease those upset by the outburst itself.That kind of appeasement is not something I can in good conscience be associated with. When I learned about the ruling, I reached out to Blizzard and informed them that I no longer feel comfortable casting the Grandmasters finals at Blizzcon. I will not be a smiling face on camera that tacitly endorses this decision. Unless something changes, I will have no involvement in Grandmasters moving forward…. On October 10, 2019, Nathan Zamora (also known as Admirable”), issued a statement on Twitter regarding Blitzchung, Hearthstone Grandmasters, and Blizzard. Here is a little bit from that statement: …I will not be part of the broadcast team for Hearthstone for the remainder of this Grandmasters season, for the Masters Tour in Bucharest, or BlizzCon.Blitzchung’s actions to support Hong Kong speak to me far more than I could have imagined. It takes courage to stand up for what you believe in, and to make sacrifices in the process. His actions are inspiring to me, and I support him wholeheartedly…. October 12, 2019, Blizzard posted news on their website titled: “Regarding Last Weekend’s Hearthstone Grandmasters Tournament“. In my opinion, it appears that the backlash and controversy about their decision with Blitzchung had an effect. The post is signed by President of Blizzard Entertainment, J. Allen Brack. Some have pointed out that the wording and sentence structure in that post feels a bit… off. There has been some speculation about whether or not J. Allen Brack wrote that news himself – or if someone who was perhaps connected to the Taiwanese branch of Blizzard wrote it in Chinese (and it didn’t translate to English very smoothly). I have no means of confirming or debunking this speculation. I’m simply noting that I’ve seen this speculation passed around. The key points from the news include: …Over the past few days, many players, casters, esports fans, and employees have expressed concerns about how we determined the penalties. We’ve had a chance to pause, to listen to our community, and to reflect on what we could have done better. In hindsight, our process wasn’t adequate, and we reacted too quickly.We want to ensure that we maintain a safe and inclusive environment for all our players, and that our rules and processes are clear. All of this is in service of another important Blizzard value – Play Nice; Play Fair.In the tournament itself, Blitzchung * played * fair. We now believe he should receive his prizing. We understand that for some this is not about the prize, and perhaps others it is disrespectful to even discuss it. That is not our intention.But playing fair also includes appropriate pre-and post-match conduct, especially when a player accepts recognition for winning in a broadcast. When we think about the suspension, six months for Blitzchung is more appropriate, after which time he can compete in Hearthstone pro circuit again if he so chooses. There is a consequence for taking the conversation away from the purpose of the event and disrupting or derailing the broadcast.With regard to the casters, remember their purpose is to keep the event focused on the tournament. That didn’t happen here, and we are setting their suspension to six months as well…. On October 12, 2019, Blitzchung responded in a tweet that contained a link to a longer personal statement. Here is part of that statement: …Many people have been asking me if I accept the latest decision of Blizzard, I will discuss that on two parts. Tournament prizing and suspension. For tournament prizing, I quote what Blizzard said on the official website, they mention that I played fair in the tournament and they believe I should receive my prizing. This is the part I really appreciate. Blizzard also said they understand for some this is not about the prize, but perhaps others it is disrespectful to even discuss it. People from Blizzard explained this to me through a phone call and I really appreciate that and I accept their decision on this part.For second part about the suspension, Blizzard changed their suspension on me from a year to six months. Once again, I appreciate their reconsideration on this. To be honest I think six months is still quite a lot to me. But I also being told that I can continue to compete in hearthstone pro circuit which they mean the grandmaster tournament. I appreciate this decision they made because grandmaster is currently the highest level tournament in competitive hearthstone. However, I wish Blizzard can reconsider about their penalty on the two casters involved… From all of this, it seems to me that the situation has been handled. Blizzard made a quick decision regarding Blitzchung (and the two casters). People who play Blizzard’s games made it very clear that they disagreed with that decision, in part by advocating for a boycott of Blizzard’s games. Blizzard reconsidered their decision, and gave Blitzchung a less harsh penalty than they originally imposed. If the backlash and negative press was specifically because people who play one or more of Blizzard’s games felt the penalty on Blitzchung was too harsh – well, it seems that’s been resolved. There is now no need for me to boycott Blizzard in response to the penalty they originally imposed on Blitzchung. What is happening in Hong Kong? There is a whole lot going on in Hong Kong. I don’t have the time to do as much research as I would like to about this in order to explain it to people who are just tuning in now about the situation. Instead, I will refer you to a BBC post that provides some context. It was written on September 4, 2019. There’s a good chance things may have changed since then, and you may want to see what else the BBC has written about Hong Kong in since then. The BBC wrote that Hong Kong “…was a British colony for more than 150 years – part of it, Hong Kong island, was ceded to the UK after a war in 1842. Later, China also leased the rest of Hong Kong – the New Territories – to the British for 99 years.” Skipping ahead in time: …Then, in the early 1980s, as the deadline of the 99-year-lease approached, Britain and China began talks on the future of Hong Kong – with the communist government in China arguing that all of Hong Kong should be returned to Chinese rule.The two sides reached a deal in 1984 that would see Hong Kong return to China in 1987, under the principle of “one country, two systems.”This meant that while becoming part of one country with China, Hong Kong would enjoy “a high degree of autonomy, except in foreign and defense affairs” for 50 years.As a result, Hong Kong has its own legal system and borders, and rights including freedom of assembly and free speech are protected. For example, it is one of the few places in Chinese territory where people can commemorate the 1989 Tiananmen Square crackdown, where the military opened fire on unarmed protesters in Beijing…. The BBC mentions that one “sticking point” has been democratic reform. …Hong Kong’s leader, the chief executive, is currently elected by a 1,200-member election committee – a mostly pro-Beijing body chosen by just 6% of eligible voters.Not all of the 70 members of the territory’s lawmaking body, the Legislative Council, are directly chosen by Hong Kong’s voters. Most seats not directly elected are occupied by pro-Beijing lawmakers.Hong Kong’s mini-constitution, the Basic Law, says it should ultimately both the leader, and the Legislative Council, should be elected in a more democratic way – but there’s been disagreement over what this should look like.The Chinese government said in 2014 it would allow voters to choose their own leaders from a list approved by a pro-Beijing committee, but critics called this a “sham democracy” and it was voted down in Hong Kong’s legislature.In 28 years’ time, in 2047, the Basic Law expires – and what happens to Hong Kong’s autonomy after that is unclear… In short, the people who are protesting in Hong Kong are doing so because they want to be independent of China. There is literally more than 100 years of history to consider regarding this situation. Personally, I do not feel that deleting the Blizzard games that I currently play, canceling my WoW subscription, and trying to convince Blizzard to delete whatever data they have on me is going to make any change at all regarding what is happening in Hong Kong. I’m not an “influencer”. I’m certainly not a celebrity or a well-known politician. My social media presence is (intentionally) tiny. I don’t spend a lot of time playing video games, in part because my chronic illnesses can make it hard for me to do that. There was a time when I was streaming on Twitch, but I stopped doing that a while ago. There is no logical reason to presume that if I chose to boycott Blizzard that China would have any reason to even notice that I have done so. The country certainly isn’t going to be influenced to change their stance on Hong Kong based on what I do. There is no reason to assume that Blizzard (or Activsion/Blizzard) would immediately separate itself from working with Chinese gaming companies or the Chinese government as a result of some players boycotting Blizzard’s games. I suspect that it would not be easy to sever that arrangement. What About Blizzard Employees? I’m going to flip things around for a minute, and take a different viewpoint. Assume that the purpose of boycotting Blizzard is to cause the company to lose money. Let’s say that more than half of the people who regularly play Blizzard’s games, who purchase in-game items, and who pre-pay for expansions or other upcoming content all deleted their Blizzard games today. Let’s presume that more than half of the people who purchased BlizzCon tickets (and paid for hotel rooms, transportation costs, and intended to buy a bunch of swag at the event) instead decide not to attend. For this thought exercise, I’m going to suggest that the results of the above are enough to not only make Blizzard’s stock drop (and its stockholders angry) but also to cause a significant financial hardship for Blizzard. A half-empty BlizzCon would look terrible. Those who were boycotting Blizzard would likely conclude that their message was heard – loud and clear – by Blizzard Entertainment. What would happen next? Well, we’ve already seen the answer to that question. In February of 2019, Polygon reported that Blizzard laid off more than 800 people after 12 months of record setting financial performance. From the article: On Tuesday afternoon, Activision Blizzard told approximately 800 employees they were laid off. The company, which is comprised of Call of Duty publisher Activision Publishing, World of Warcraft and Overwatch developer Blizzard Entertainment, Candy Crush maker King Digital, Major League Gaming, and more did not have a bad year. In fact, it “achieved record results in 2018,” Activision Blizzard CEO Bobby Kotick said during an investor call.Activision made $7.5 billion is sales and $1.8 billion in profit last year. But in the eyes of management, the success wasn’t enough to keep the entire company employed. Record results. 800 employees out of work. Those facts are more than just a recipe for cognitive dissonance, they create cerebral friction that could spark a forest fire… In other words, I believe that if the #BoycottBlizzard trend is successful, the result won’t actually cause any harm to the “big wigs” at Activision Blizzard. (And it certainly won’t convince them to extricate themselves from whatever Chinese companies they are working with). Instead, Activision Blizzard will simply fire hundreds of employees – again. I don’t want to see that happen because exactly zero of those employees had anything to do with the decision Blizzard made regarding Blitzchung. My best guess is that many of them first heard about the controversy when they read about it on Twitter (or maybe Facebook). None of this is their fault, and they shouldn’t have to lose their jobs because of it. That’s one thing that I don’t think many people consider when they choose to boycott a big company. It is quite easy to give in to the immediate anger one feels about what was obviously a poorly made decision by Blizzard, and to decide to call for a boycott. Few appear to realize that even the most successful boycott outcome is going to mostly hurt the people who make the games that we all (until recently, it seems) love to play. If you choose to boycott Blizzard, that’s on you. I’m not your mom, and I have no interest in trying to convince you one way or the other on this subject. This blog post is my (long-winded) way of explaining why I am not going to boycott Blizzard. Why I’m Not Boycotting Blizzard is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- Flight Rising: Holiday Bears
  October 6, 2019Flight Rising / Other Video GamesThere are many holidays in Flight Rising where players can purchase special Familiars by gathering up enough in-game currency. The Holiday Bears Familiar Set was released in June of 2014, through May of 2015. Each one corresponds to a specific Elemental Flight. If you don’t have them, your best chance of collecting them is through the Auction House. All of the artwork in this post is copyright of Flight Rising. Sunbeam Ursa: Familiar – Guardian of the Sunbeam Ruins. (Brightshine Jubilee 2014). Magma Embear: Familiar – Guardian of the Ashfall Waste. (Flameforger’s Festival 2014). Hibernal Starbear: Familiar – Guardian of the Starfall Isles. (Starfall Celebration 2014). Graveyard Guardian: Familiar – Guardian of the Scarred Wasteland. (Riot of Rot 2014). Craigbacked Bouldursa: Familiar – Guardian of Dragonhome. (Rockbreaker’s Ceremony 2014). Polarfreeze Defender: Familiar – Guardian of the Southern Icefield. (Crystalline Gala 2015). Murktooth Bramblekeep: Familiar – Guardian of the Tangled Wood. (Trickmurk Circus 2015). Cloudkeeper Herald: Familiar – Guardian of the Windswept Plateau. (Mistral Jamboree 2015). Wavebreak Snarler: Familiar – Guardian of the Sea of a Thousand Currents. (Wave Crest Saturnalia 2015). Timber Tender: Familiar – Guardian of the Viridian Labyrinth. (Greenskeeper Gathering 2015). Flight Rising: Holiday Bears is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

TV & Movie Reviews

- Things from Mad Men that are Different from Today – Season Seven
  April 8, 2017TV and Movie ReviewsSeason Seven was the final season of Mad Men. I was kind of sad to have reached the end of the story, but I liked how it ended. I can always re-watch it if I want to. My husband and I watched the entire series of Mad Men on Netflix. I took notes on the things in Mad Men that are different from today. Before you read this post, you might want to read what I wrote about previous Seasons: Mad Men Season One Mad Men Season Two Mad Men Season Three Mad Men Season Four Mad Men Season Five Mad Men Season Six Warning: There are spoilers. Episode 1: Don flies to California where his wife, Megan, is living. She has a tiny black and white television. He buys her a huge console television. The thing is so heavy that it requires two big men to carry it inside. It looks like a cabinet with the television embedded in it, and I think it had built in speakers on either side of the TV. This was a top-of-the-line, expensive, color television…. that Megan didn’t want. Episode 2: * Don wakes up to a buzzing noise. It is coming from his alarm clock, which can be described as an analog electric alarm clock. The numbers flip over. * Don and his daughter, Sally, are at a diner. She wants to call her friends. Don put two quarters on the table. Sally takes the quarters, gets up, walks across the diner, and puts the quarters into the payphone that is on the wall. Today, Sally would have picked up her smartphone and made the call (or would have borrowed her dad’s smartphone to make the call). Episode 3: * Harry finally tells one of the other partners that he’s been lying – for a long time – about there being a computer that he uses to figure out the best ad placement for television ads. He’s been lying to the customers about it, too. There is no computer. This revelation sparks a conversation about the company needing to invest in a computer. Today, its hard to imagine an entire office without computers. * Betty goes on a field trip with her son, Bobby. She is a chaperone. Betty and Bobby ride on the school bus with his classmates, teacher, and a few other moms. Betty smokes a cigarette on the way, and ashes out the window. Episode 4: * The creative’s lounge is taken away from them because the office is going to put a computer there. It takes up that entire space. The only thing this computer could do was “crunch numbers” – literally computing. * The computer is an IBM 360. It is a mainframe computer that was accessed by remote terminals. It had 8,000,000 characters in bulk core storage. Monthly rentals ranged from $27,000 for a basic configuration to $115,000 for a typical large multi system configuration. * The “System/360″ became available for delivery in 1965. The office in Mad Men is getting it installed in 1969. Today, most offices do not invest in computers that are four years old. * Harry asks the IBM guy who is overseeing the computer installation to tell him where to find a keypunch service. The IBM 360 ran on punch cards. A keypunch service had people (often women) whose job it was to put a deck of blank cards into a hopper. The worker would type an operator command, and the hopper machine would feed one card at a time into a punch station. A series of dies punched holes into an individual card. Harry needed a service to make those cards for the office’s computer. * In order to operate the mainframe, a person needed to – by hand – put the stack of punchcards, in a specific order, into the mainframe one by one. * I have personally done that a few times when I was a little kid (because my dad sometimes took me to work with him.). Dropping the punch cards on the floor was a complete disaster. It meant you had to stop entering the cards, stop the computer, take the time to put the cards back in order, and start putting them into the computer again. If you accidentally put one card into the computer in the wrong order – the computer wouldn’t work. Once all the punchcards were correctly entered, you had to wait around for the mainframe to process them before you could start working from a terminal. * Don uses a typewriter at his desk to get some work done. He has a piece of white paper, then a sheet of carbon, then another piece of white paper sandwiched together. The purpose of this was so Don could make two copies of what he was typing at the same time. Episode 5: * There is now a secretary who sits at the terminal inside the room the giant computer is in. She appears to be typing something into the terminal. Behind her is a computer with a magnetic reel tape drive. * The giant mainframe computer makes a constant humming noise. The computer room always has the doors closed because it needs to be in an air conditioned room. Episode 6: * Peggy is working on an ad campaign for Burger Chef. She and Don decide to come up with a new idea rather than what they originally planned. Peggy mentions something about the ad including a mother who is picking up Burger Chef for her family on the way home from work. Don says “Mothers who work is too sad for an ad.” Peggy points out that he is surrounded by mothers who work. This doesn’t change Don’s mind. They end up going with a completely different idea. Episode 7: * This episode focuses on the Moon Landing. Everyone watches the rocket lifting off on television. Then, they watched the first space walk on television. * Peggy is in Indiana with Don, Pete, and Harry because they are pitching to Burger Chef the next day. Peggy went out to get alcohol, but Indiana was dry on Sundays – meaning stores could not sell alcohol. She ends up having to buy two cans of beer from the hotel clerk. Indiana was dry on Sundays until July 1, 2016. The laws changed on that date to allow distilleries, breweries, and wineries to sell alcohol on Sundays. The laws still did not allow people to buy alcohol and bring it home with them on a Sunday. Episode 8: * Don has an answering service. He calls and a female worker answers and tells him who called him and when. The service is not work related – it is taking calls from women in Don’s social life. * Joan and Peggy are talking to their client, Topaz pantyhose, about a problem. L’Eggs pantyhose – a competitor – is a lower price and is selling more than Topaz. L’Eggs pantyhose came in a plastic egg shaped container. Episode 9: * I didn’t see anything new in this episode, that you don’t see today (that hadn’t already been mentioned in this post or in posts about previous seasons.) Episode 10: * Sally’s friend Glenn comes to visit. He is now 18 years old. Glenn, and a female friend he brought with, ask Sally to go to Playland with them. Glenn reveals that he has joined the military and will be going to Vietnam. Sally gets very upset about this and rushes to her room. Later, Glenn returns, knowing that Sally is not there. (She was on a class trip.). Glenn came to see Betty. Betty gives Glenn a beer. The legal drinking age in New York was 18 until 1982 – when it went up to 19. On December 1, 1985, the legal drinking age in New York moved up to age 21. * Don was running late for work, so he shaves at his desk in his office while his secretary fills him in about what is scheduled for the day. He uses a battery powered electric razor. Those types of razors increased in popularity in the 1960s. * The office has a darkroom which Stan (one of the creatives) uses to develop film – usually for ad campaigns. People have to knock on the door before coming in because opening the door lets light into the room. Doing that at the wrong time can completely destroy film. Episode 11: * Peggy and Stan are working with children for an ad campaign. There is a table of toys in front of the kids. One of the toys is a metal slinky. Episode 12: * The office gets absorbed by McCann. They lose the computer that took over the creative’s lounge. Harry says that McCann has a team of people who do statistics – so they don’t need the computer. * McCann has an informal “ladies club”. The women who work there get together to complain about work (and drink). * Peggy’s last remaining creative guy chooses not to go to McCann. He is still at the old office. He says he is still being paid, so he thought he’d “make some long distance calls”. Long distance calls were very expensive at the time. Episode 13: * Don has gone on an impromptu road trip. He doesn’t carry luggage. Instead, he has a large paper bag with a change of clothes in it. The bag says Sears. Today, a lot of Sears stores are closing. Episode 14: * Don’s road trip continues. This time he is carrying a bag from Penney’s. The bag probably came from JC Penney’s (which, today, is also closing a lot of stores.) Things from Mad Men that are Different from Today – Season Seven is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Patreon or at PayPal.me. Thank you!...
- Things from Mad Men that are Different from Today – Season Six
  April 7, 2017TV and Movie ReviewsAs my husband and I watched our way through Mad Men, I took notes about things that are in the show that are different from today. This post is about Mad Men Season Six. We watched the entire series on Netflix. Before you read this, you might want to read what I wrote about previous Seasons: Mad Men Season One Mad Men Season Two Mad Men Season Three Mad Men Season Four Mad Men Season Five Warning: There are spoilers. Episode 1: * Megan uses a Kodak Instamatic camera to take a photo of Don while they are on a work/vacation in Hawaii. The Kodak Instamatic was launched in 1963. It used a 126 film cartridge. The Kodak Instamatic 104 was released in 1968. It had a holder for a single flashbulb on the top of the camera. Take a photo with the flashcube, and cock the camera for the next exposure (meaning – roll the film for the next photo). The flashcube would turn 90 degrees to bring the next flashbulb into position automatically. * The maid was vacuuming while Don was watching TV. The television had two squiggly lines of interference across it – one near the top of the screen and one near the bottom. It was not a common problem, and the TV went back to normal when after the vacuum was shut off. Episode 2: I did not see anything in this episode that was different from today (and that wasn’t already mentioned in this list or the lists about previous seasons.) Episode 3: * The news in the background on televisions in various scenes discuss the Vietnam War. It has been said that Vietnam was the first “television war”, or the first “living-room war” (the room people watched television in.) Being able to sit in your home, in front of your TV, and watch what was happening in a war far away had an effect on people. At first, TV stations were trying to be upbeat – providing wire reports or a battlefield roundup. Later, things got darker and some “horror of war” was televised. The ability to watch the war on TV had an effect on people’s opinion about the war. In 1968, the Tet Offensive happened. It appears that this is what the television news is talking about in this episode of Mad Men. Episode 4: * Joan and her friend Kate go to a restaurant where there is a telephone at every table. The name of the restaurant is “Ma Bells”. The name is a play on The Bell Telephone Company. Ma Bells was the creation of Restaurant Associates. The restaurant actually existed. Every table had a telephone on it. People called their order into the kitchen. The telephones could also be used to call someone who was sitting at another table. * Megan and Don go out to dinner with Megan’s coworker and boss (who are a married couple.). During the dinner, it is revealed that the couple are “Swingers” who are interested in swinging with Megan and Don. Swingers were people who had open relationships. Some were heterosexual, and some were bisexual. Being a swinger became popular in the late 1960s, when the “free love” movement was taking place and casual sex was becoming an accepted thing among some people. Swingers felt it was natural to have sexual desires outside of your relationship, and to act on those desires (if the desired person was consenting.) Episode 5: * This episode focused on when Martin Luther King Jr. was shot and killed. * Someone (I forgot who) turns on a black and white television. A bright dot appears in the center of the screen, which becomes a horizontal line, that eventually spread out over the screen. This was how televisions at the time warmed up if they had not been turned on in a while. * Don takes Bobby to watch a movie. They see “The Planet of the Apes.” At the end of the movie, it’s clear that Bobby liked it. Don asked “Do you want to see it again?” Bobby does, so they stay in their seats and watch the movie again. This wasn’t unusual and was allowed at the time. Episode 6: * I didn’t see anything in this episode that hasn’t already been mentioned in this list (or the lists I put together about previous episode) Episode 7: * Pete’s mother comes to his apartment. The handyman calls Pete to let him know she is there. Pete tells the handyman to fix his mother a drink. The ice cube tray is made out of aluminum. It has a quick release handle on it that you pull up to crack the ice cubes. Today, ice cube trays are plastic and you twist them to crack the ice. Episode 8: * The office is visited by a “doctor” (brought in by one of the partners of the company that Don’s company merged with). The man is not really a doctor. He was brought to “fix everyone up.” Don agrees to see the “doctor” because he is suffering from a bad cough. The “doctor” injects several of the men in the office with an unknown concoction. Based on the actions of the men who took this injection – it appears that at least some of it is amphetamine. The “doctor” appears to be somewhat based on a real person named Max Jacobson who was known as “Dr. Feelgood”. Jacobson did have a background as a doctor – but was known for mixing up unknown ingredients (along with amphetamine) and injecting that into the (often famous) people who came to him for help. Jacobson “treated” JFK, Marylin Monroe, Eddie Fisher, and others. Episode 9: * Don stops at a gas station and tries to get the gas station attendant’s attention. It was a full service gas station (which was standard at the time). People did not pump their own gas – the attendant did it for them. The gas station attendant would fill the tank, check the tire pressure, check the oil, and wash the cars windows. People paid for the gas, but the other services were provided for free. Gas stations used to hand out trinkets as well – for travelers to collect. (drinking glasses, key chains, calendars, road maps, etc). There are some places in the United States today where people are required by law to allow a gas station attendant to pump their gas for them. It is no longer a common practice – and does not come with the extra services. Episode 10: * Joan tells a potential client that Harry works on figuring out where to place television ads “with a computer as big as this room”. The first personal computer wasn’t introduced until 1975 – and they were kits that people had to put together themselves. * This episode focused on the 1968 Democratic National Convention that took place in Chicago. * Megan watches the violence that took place outside the DNC. She calls Don, who is watching it, too, (while away on business). Megan says she can’t vote – but still cares about what’s going on. Megan is Canadian. She was from Quebec. * There is a lava lamp on the desk in the Creatives Office. The lava lamp was created by Edward Craven Walker (who was a British accountant). He sold the U.S. manufacturing rights in 1965 to a company named Lava Lite. In 1968, lava lamps were marketed to executives. Episode 11: * The office, which is in New York, receives fresh oranges from California from Sunkist (who is a client). In a previous episode, Roger’s daughter told him that her husband had this great idea about investing in refrigerated trucks that ship produce. This indicates that it was not easy to obtain fresh oranges from California if you lived in New York. Those oranges were a big deal. * Sylvia and Arnold (Don’s neighbors) have a son, Mitchell, who is 18. He returned his draft card as a form of protest of the Vietnam War. After Mitchell dropped out of school, the military re-classified him 1-A. This designation meant that it was extremely likely that Mitchell would be drafted and sent to Vietnam. Mitchell tells his problem to Megan (who relays the problem to Don). Megan said that Mitchell was “going to run”. This meant that Mitchell was going to leave the United States and go to Canada in order to avoid being drafted. Megan considers helping Mitchell because she has family in Canada. Much of this episode is about how to solve Mitchell’s problem. Episode 12: * I didn’t notice anything new in this episode (that wasn’t already mentioned in this post or in posts from previous seasons.) Episode 13: * Sally get suspended from boarding school because she used a fake ID with her mother’s name on it and bought alcohol for herself and the other girls. Betty calls Don, all upset. Betty tells Don that the reason why “nothing is working” and “the bad is beating the good” is because Sally is “from a broken home.” That’s not a phrase people use today in regards to a child from a family where the parents got divorced and remarried. Things from Mad Men that are Different from Today – Season Six is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on Patreon or at PayPal.me. Thank you!...

Cockatiels

- Peaceful Cockatiels
  August 16, 2019CockatielsPinky is interested in the camera, while Pepper snoozes in the background. The photos you see in this blog post were taken by Shawn Thorpe. Morris is suddenly interested in the camera. Morris doesn’t sit still for very long. He got distracted by the door that we open up when their water needs to be refilled. Morris likes to open and shut that little door, over and over. Morris likes to sit in the corner of the cage, with feet spread apart so he can touch two sides at the same time. He has become interested in the lemon tree outside the window, and has spent time watching it. The tree is growing, and needs to be cut back. We think Morris has bad vision, so maybe this is the first time he’s seen the tree. #Blaugust2019 Peaceful Cockatiels was originally posted on Book of Jen. It is not allowed to be posted to other websites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- Crackers
  January 24, 2019CockatielsMorris was offered some crackers as a treat. He sang a nice song to the crackers, and decided to chew on the napkin. Morris does not want a cracker right now. This post was originally posted on Book of Jen. It is not allowed to be posted to other websites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...

Coloring Pages

- Johanna Basford Coloring Calendar – May
  April 23, 2019ColoringI’ve been slowly working my way through the Johanna Basford 2018 coloring calendar. It has been a very relaxing experience, and good for my rheumatoid arthritis (which is in my hands, among other places). My chronic health issues make it difficult for me to keep up with the “do one of these every day” type of projects. I will be done whenever I get there. In this blog, I have the coloring pages from the May 2018 part of the calendar. May 1 May 2 May 3 May 4 May 5 and 6 May 7 May 8 May 9 May 10 May 11 May 12 and 13 May 14 May 15 May 16 May 17 May 18 May 19 and 20 May 21 May 22 May 23 May 24 May 25 May 26 and 27 May 28 May 29 May 30 May 31 Johanna Basford Coloring Calendar – May is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...
- Johanna Basford 2019 Coloring Calendar – March
  April 17, 2019ColoringI’m working my way through the 2019 Johanna Basford coloring calendar. A friend gave it to me as a Christmas gift. My goal is to try not to fall too far behind. Coloring is a good for my health. It reduces stress (which is bad for my fibromyalgia). I also color to keep my hands active, which is good for my rheumatoid arthritis. March 1 March 2 and 3 March 4 March 5 March 6 March 7 March 8 March 9 and 10 March 11 March 12 March 13 March 14 March 15 March 16 and 17 March 18 March 19 March 20 March 21 March 22 March 23 and 24 March 25 March 26 March 27 March 28 March 29 March 30 and 31 Johanna Basford 2019 Coloring Calendar – March is a post written by Jen Thorpe on Book of Jen and is not allowed to be copied to other sites. If you enjoyed this blog post please consider supporting me on PayPal.me. Thank you!...