Re: re: Affordable Care Act

[Guest guest]

Can I say I would so love a place that is politics free?  Seriously.  We do not all share political philosophies, religious beliefs, or even nationalities.  I wish I could go to a place where politics can just not be part of the discussion.  While I realize it is assumed that everyone who supports breastfeeding must also support the same political ideology in all other aspects, that is not necessarily true.  This nation is not a hundred percent united on any political front, and I doubt it ever will be.  Don't we have enough to argue about that relates to our profession without going to our politics too?  In professional circles, I find it so much better to check my politics at the door and focus on the issues of the profession. 

Pam

 

that's your opinion, Gail.  there are a whole lot of people who think otherwise.  Beebe, M.Ed., RLC, IBCLC

Lactation Consultant/Postpartum Doula  www.second9months.com

www.facebook.com/thesecond9months

To: Sent: Friday, June 29, 2012 1:54 AM

Subject: re: Affordable Care Act

 

Unfortunately, this law is full of problems. Insurance companies may have to accept those with pre-existing conditions but they can price the policies so high that they are unaffordable. Prescription formularies will shrink to cover the costs of no more donut hole. States don't have the money to accept more into Medicaid/MediCal. More doctors and clinics will turn away MediCaid patients due to lowered reimbursements, etc., etc.

 

Gail

-- Pam MazzellaDiBosco, IBCLC, RLCBirthing & Beyond, Inc.Labor Support and Lactation Consultant Services

[Guest guest]

AMEN. Lynn, OFS in MO

Can I say I would so love a place that is politics free? Seriously. We do not all share political philosophies, religious beliefs, or even nationalities. I wish I could go to a place where politics can just not be part of the discussion. While I realize it is assumed that everyone who supports breastfeeding must also support the same political ideology in all other aspects, that is not necessarily true. This nation is not a hundred percent united on any political front, and I doubt it ever will be. Don't we have enough to argue about that relates to our profession without going to our politics too? In professional circles, I find it so much better to check my politics at the door and focus on the issues of the profession.

Pam

that's your opinion, Gail. there are a whole lot of people who think otherwise. Beebe, M.Ed., RLC, IBCLC

Lactation Consultant/Postpartum Doula www.second9months.com

www.facebook.com/thesecond9months

To: Sent: Friday, June 29, 2012 1:54 AM

Subject: re: Affordable Care Act

Unfortunately, this law is full of problems. Insurance companies may have to accept those with pre-existing conditions but they can price the policies so high that they are unaffordable. Prescription formularies will shrink to cover the costs of no more donut hole. States don't have the money to accept more into Medicaid/MediCal. More doctors and clinics will turn away MediCaid patients due to lowered reimbursements, etc., etc.

Gail

-- Pam MazzellaDiBosco, IBCLC, RLCBirthing & Beyond, Inc.Labor Support and Lactation Consultant Services

[Guest guest]

Oh, I think it's pretty clear that no one really knows all the ramifications of this healthcare law. I really doubt anyone thought everything Gail said was fact. I was sure it is how she feels (opinion).

That said, I agree with Pam and Lynn, and think any discussion of whether or not this is a wonderful thing should be left off this board. If there are specific questions about how it will affect us, and *if* someone actually *knows* the answer (can point to some section of the law we can read that provides an answer), then those questions and comments by all means should be allowed because they affect our business.

Dee

that's your opinion, Gail. there are a whole lot of people who think otherwise.

Beebe, M.Ed., RLC, IBCLC Lactation Consultant/Postpartum Doula

www.second9months.com

www.facebook.com/thesecond9months

To: Sent: Friday, June 29, 2012 1:54 AMSubject: re: Affordable Care Act

Unfortunately, this law is full of problems. Insurance companies may have to accept those with pre-existing conditions but they can price the policies so high that they are unaffordable. Prescription formularies will shrink to cover the costs of no more donut hole. States don't have the money to accept more into Medicaid/MediCal. More doctors and clinics will turn away MediCaid patients due to lowered reimbursements, etc., etc.

Gail

[Guest guest]

That's what I've been thinking all along. I worry the ACA won't help us in private practice one little bit. Dee Kassing

So if BF help is provided without a copay, how much reimbursement would an IBCLC actually get?

This could be tough, if a mom wouldn't want to pay out of pocket, but the reimbursement was not a living wage.

Lynn in MO

[Guest guest]

In my state of MN lactation services under Medicaid will be reimbursed for the following credentials; DR, NP, BSN, 4 yr health educator with an IBCLC ,But the pay to provider can only be a DR, hospital or community Clinic Ran by a dr.Not good in my opinionSent from my iPhone

Here is the press release regarding the

Affordable Care Act as it relates to breastfeeding. In my role for USLCA we are

working with Medicaid and major insurers to put procedures in place for

provision of these services. It is legally possible form any private insurer or

Medicaid exchange insurer to “credential†an IBCLC based solely on that

qualification to provide these services. For Medicaid itself, all providers

must be licensed. That is why we are working toward licensure in many states. If

you want to help make this happen email me and I will make use of your skills

and time.

Judy

Judith L. Gutowski, BA, IBCLC, RLC

From: U.S.

Breastfeeding Committee

Sent: Thursday, June 28, 2012 7:47

PM

To: jlgutowski@...

Subject: Supreme Court Upholds

Health Care Law

FOR IMMEDIATE RELEASE

CONTACT: Renner, , mrenner@...

Supreme

Court Upholds Health Care Law:

Implementation of Breastfeeding Provisions Continues

View web version of this release

Washington, DC—Earlier today, the U.S.

Supreme Court issued its ruling to uphold the Patient Protection and Affordable Care Act

(health care reform). The law includes several provisions that support

women and their families to reach their personal breastfeeding goals, and

this ruling ensures that these (and others) will continue to be fully

implemented:

Break

Time for Nursing Mothers: Section 4207 of the

Act amends the Fair Labor Standards Act, requiring employers to

provide reasonable break time in a private, non-bathroom place for

breastfeeding mothers to express breast milk during the workday, for

one year after the child's birth.

Women's Preventive

Services Required Health Plan Coverage Guidelines: The Act requires

health plans to cover preventive services for women with no cost

sharing, including breastfeeding support, supplies, and counseling.

Non-grandfathered plans and issuers are required to provide coverage

without cost sharing consistent with these guidelines in the first

plan/policy year that begins on or after August 1, 2012.

Community

Transformation Grants: The CDC's Community

Transformation Grant program funds community-level efforts to

improve health, reduce health disparities, and control health care

spending. Under Strategic Direction 2: Active Living and Healthy

Eating, many communities are implementing Recommended Evidence and

Practice-Based Strategies to 1) increase the number of designated

Baby-Friendly hospitals; and 2) increase policies and practices to

support breastfeeding in health care, community, workplaces, and

learning and childcare settings.

"Our Nation's public health leaders have come together to

call for real changes in the policies, systems, and environments that

impact breastfeeding families," said USBC Chair Jeanne Blankenship.

"The Surgeon General's Call to Action to

Support Breastfeeding, National Prevention Council Action Plan, and the Institute of

Medicine's report, Accelerating Progress in Obesity Prevention, all identify the

important role of breastfeeding in prevention and reducing health care

spending. The Affordable

Care Act helps to ensure that the United States

continues to improve the landscape of breastfeeding support so that all

mothers have the opportunity to reach their personal breastfeeding

goals."

The United States Breastfeeding Committee will continue will

continue to work with Congress, the Administration and state governments

during the law's implementation. For additional details on the law, visit

www.healthcare.gov.

USBC is

an organization of organizations. Opinions expressed by USBC are not

necessarily the position of all member organizations and opinions

expressed by USBC member organization representatives are not necessarily

the position of USBC.

The United States Breastfeeding

Committee (USBC) is an independent

nonprofit coalition of more than 40 nationally influential professional,

educational, and governmental organizations. Representing over one

million concerned professionals and the families they serve, USBC and its

member organizations share a common mission to improve the Nation's

health by working collaboratively to protect, promote, and support

breastfeeding. For more information about USBC, visit www.usbreastfeeding.org.

United States Breastfeeding Committee:

Advancing breastfeeding on our Nation's agenda.

Collaboration

Leadership

Advocacy

United States Breastfeeding Committee

2025 M Street, NW, Suite

800 ♦ Washington, DC

20036

Phone: 202/367-1132 ♦ Fax:

202/367-2132

E-mail: office@...

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[Guest guest]

Well, that's not the opinion of many, many hospital, drs and nurses and other health care providers that I have heard speak. Just b/c I don't work in a hosp. doesn't mean I don't know the issues. My insurance premium is ALREADY paying for all the folks that are uninsured and use the ER for healthcare. this is not perfect, but it's a start. things just can't keep going the way they are. It's out of control. What baffles me is that so few people are talking about Drs being paid a salary instead of pay per procedure. That would change everything! I have a feeling we'd all have fewer procedures and be healthier. Beebe, M.Ed., RLC, IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months To: Sent: Saturday, June 30, 2012 2:04 AM Subject: re: Affordable Care Act

, no it's not just my opinion and I am not misleading anyone. It's also the opinion of just about every healthcare professional. You don't work in a doctor's office, clinic, nursing home or hospital so you don't see just how bad finances are now. Because you are not a doctor, nurse, physician assistant, hospital administrator, nurse practitioner, nurse midwife, etc., you don't understand how this will affect health care finance in the future. It is a fact that insurance may have to cover some more things and it's a fact that the bill doesn't regulate many things like paying for meds that a doctor prescribes but isn't on the insurance plan formulary, how much insurance companies can charge for their plans-they can change whatever they want , so who can afford $1500 a month because they have a pre-existing condition, etc.. Clinics and doctors offices will have to turn away Medicaid and Medicare patients. Many will close especially in rural areas. That will be a disaster.

Obamacare has a few good parts but mostly bad ones. The states just do not have funding for this. And over 51% of Americans polled don't like it either, being forced to pay for a health plan or a tax when they can't afford living now. The exchanges are going to cost $511 billion-the US can't afford that when we are already trillions in debt.

Here are some links for you to read:

http://www.cbsnews.com/8301-505183_162-28553806-10391735/top-5-reasons-obamacare-is-bad-for-business/

http://www.rove.com/articles/322 (Wall Street Journal article)

http://fixhealthcarepolicy.com/research/obamacare-one-pill-two-pill-red-pill-blue-pill/

http://voices.washingtonpost.com/fact-checker/2011/01/health_care_myths.html

Like Pam, politics doesn't belong on the list but someone asked if the insurance companies would now be forced to pay for lactation consultants. In America people have a right to make choices, such as home birth vs hospital birth, pay for insurance or not, etc. The Supreme Court decision effectively took many Americans' right away.

Gail

[Guest guest]

Amen, . You said it better than I could have. We are all paying... whether we realize it or not. I have to pay into social security, I have to pay into medicare. Those are taxes that I am forced to pay for the good of all of us. People fussed about those things when they were implemented also. Beebe, M.Ed., RLC, IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months To: Sent: Saturday, June 30, 2012 6:14 AM Subject: Re: Affordable Care Act

Judy:

Thank you very much for the update on how Medicaid will be covered in your area. This is EXACTLY why we need to discuss the implications of the Affordable Health Care Act. We cannot stick our head in the sand or speculate about what our personal politics might lead us to THINK the Affordable Health Care Act might mean. We need to keep abreast of the FACTS of what is actually happening in our own areas and across the country. It is not a matter of avoiding ruffling anyone's feathers, it is a matter of survival -- particularly for the private practice IBCLC.

Others:

It is not clear to me whether or not the Affordable Health Care Act will harm or help IBCLCs at this time. It seems to me that lobbying can improve our chances of either a) minimizing harm or more hopefully improve our ability to earn a living. There are many aspects of this bill that will probably be refined over time and just sticking our heads in the sand and not talking about it because "it might be political" does not serve us well.

The one area where I see that the Act will help many private practice IBCLCs is in the arena of affordable health insurance. Many IBCLCs I know in New York City are struggling , particularly if they don't have a job that provides benefits such as health insurance. Health insurance in New York State is very expensive. My husband and I had a reasonably good plan. That plan went up from $20,000 to $30,000 per year -- with a letter from the insurance company saying that it was due to the Affordable Health Care Act. That was patently false because NONE of the provisions that would influence this insurance company were in effect, nor would they for MANY years. That so-called reasonably good plan refused to cover the cost of having my arm casted when I broke my arm. That's how ridiculous the insurance industry has become -- denying coverage for a no brainer situation such as an arm case -- at an astronomical price. We switched plans to a higher

deductable to another plan at $20,000. Again, this year, we get another letter that our new insurance company is raising the rates to $30,000 a year with no justification whatsoever. Then --- my husband is one year away from Medicare. Guess how much of a reduction we get when he goes on Medicare? $0. That's right. If we want to retain our health insurance -- we get no reduction even though Medicare is picking up the tab for his health care. It does seem that New York State does want to rein in the abuses of the health insurance industry. I'm cautiously optimistic and grateful that I live in New York State where these problems are at least on the political radar screen.

I know from the inside from a physical therapist who treated one of the heads of United Health Care that they are raking in profits hand over fist. They have no intention of actually covering our conditions -- it is all about maximizing profits by avoiding paying for the services we PAY FOR. The Affordable Health Care Act does have provisions for reining in unreasonable increases in insurance rates and New York State was ready to start the insurance exchanges. In theory, this should reduce the costs of paying for health insurance. We shall see if this actually occurs and we should be lobbying for provisions that makes sure that IBCLCs can AFFORD health insurance.

For people like my husband and myself and for other IBCLCs I know who don't have one partner with an employer based insurance plan -- these exchanges offer hope that we can afford to get health insurance. Most IBCLCs I know cannot compete with the large businesses that get reduced rates because they can bargain. So, if we can afford health insurance, we subsidize a) the insurance companies who are raking in high profits and all the administrative staff that are trained to maintain those profits, the large companies that can bargain for lower rates which results in our paying far higher rates to compensate for them and c) people like my next door neighbor who is perfectly capable of working but chooses not to and uses the "free" services at the hospital which cost my husband and I more in taxes that cover her services. I resent being self-employed and subsidizing everyone else.

So, if IBCLCs can now afford to buy more affordable health insurance and use it seek treatment early, this will reduce health care costs. In theory -- this should lead the insurance companies to lower rates -- we shall see if that actually occurs as well.

Finally, in the state where I am actually fifth generation (but no longer live) -- California -- the tax revolution has led to a crumbling of almost all public services to the point of disfunction if not teetering on collapse. When I went through the school system, it was near the top in the nation. My brother is a firefighter AND a full fledged paramedic. The lack of affordable health insurance has lead to extreme problems with the services provided by firefighters. They have experienced a dramatic increase in the number of emergency calls for health conditions that should have been treated earlier. The costs of calling an ambulance (which ends up being the fire department) is astronomically more expensive than had people been treated earlier. Most of the calls are for conditions that COULD have been treated earlier in clinics. So, because there are so many emergency calls because people can't afford health care (at the point when it would cost

far less for them to be treated) the response time for all emergency health conditions has dropped. This means that those people who have the type of emergencies that SHOULD be responded to with an ambulance are no longer getting as rapid a response as they deserve. So, take my neighbor - as much as I resent her going to the clinic on my tax dollars -- it actually costs me LESS if she goes to those clinics than if she calls an ambulance when her health condition deteriorates. It also makes it more likely if she goes to that clinic, that the response time if I need an ambulance will be faster than if she waits until she deteriorates to the point that she uses an ambulance.

This affects not just how we practice, but whether or not we can continue to practice and survive should we get ill. I personally think we have been penny wise and pound foolish in the United States in how we have looked at health care and health insurance. It costs ALL of us when people are ill and cannot get adequate care.

Best regards,

E. Burger, MHS, PhD, IBCLC

[Guest guest]

Both my husband and I are healthcare professionals....and are over the moon. In case you are not aware, look into what MA has been doing for years, this is not a new thing.

And, as a mother of a chronically sick child whose life weighs heavily on machine and monitors to live, I'm thrilled. He will be able to obtain insurance without the " preexisting " stigma. May you never have to walk in our shoes....but perhaps you'd like to come visit to see the other side, and perhaps you will see the compassionate side of this.

 

, no it's not just my opinion and I am not misleading anyone. It's also the opinion of just about every healthcare professional. You don't work in a doctor's office, clinic, nursing home or hospital so you don't see just how bad finances are now. Because you are not a doctor, nurse, physician assistant, hospital administrator, nurse practitioner, nurse midwife, etc., you don't understand how this will affect health care finance in the future. It is a fact that insurance may have to cover some more things and it's a fact that the bill doesn't regulate many things like paying for meds that a doctor prescribes but isn't on the insurance plan formulary, how much insurance companies can charge for their plans-they can change whatever they want , so who can afford $1500 a month because they have a pre-existing condition, etc.. Clinics and doctors offices will have to turn away Medicaid and Medicare patients. Many will close especially in rural areas. That will be a disaster.

 

Obamacare has a few good parts but mostly bad ones. The states just do not have funding for this.  And over 51% of Americans polled don't like it either, being forced to pay for a health plan or a tax when they can't afford living now. The exchanges are going to cost $511 billion-the US can't afford that when we are already trillions in debt.

 

Here are some links for you to read:

 

http://www.cbsnews.com/8301-505183_162-28553806-10391735/top-5-reasons-obamacare-is-bad-for-business/

 

http://www.rove.com/articles/322 (Wall Street Journal article)

 

http://fixhealthcarepolicy.com/research/obamacare-one-pill-two-pill-red-pill-blue-pill/

 

http://voices.washingtonpost.com/fact-checker/2011/01/health_care_myths.html

 

Like Pam, politics doesn't belong on the list but someone asked if the insurance companies would now be forced to pay for lactation consultants. In America people have a right to make choices, such as home birth vs hospital birth, pay for insurance or not, etc. The Supreme Court decision effectively took many Americans' right away.

 

Gail

 

[Guest guest]

I'm so not going to jump into this fray, because I see no point, but I want to

acknowledge a couple things that I think we can all agree on:

1. What we have now is a behemoth that isn't working and

2. Tying health insurance coverage to employment stinks for a lot of people

I have an individual catastrophic HSA plan and rarely go to the doctor. When I

do, I essentially pay out of pocket, and my doc even offers a 25% cut to people

who aren't insured or who will file it themselves. When the first version of

this new plan passed, my premiums went up 30%, and now I'm paying double.

I am not optimistic about one behemoth being any better than another behemoth,

but I am open to being pleasantly surprised.

Lynn OFS in MO

[Guest guest]

Your missing my point Gail, along with so many others.

And working in healthcare and living with someone day in and day out is  completely different things.

I'm choosing to leave this discussion. The forest is clearly being missed here...

 

, I have read everything and more. Yes, I did post Carl Rove's article, mostly filled with fact. The government (Medicare and Medicaid/MediCal) and HMOs have been denying care for years, as have private insurance companies, ending many's lives. It's totally true and have seen it happen.

 

Of course the states will have to come up with money to add millions to the Medicaid/MediCal roles. Most states will probably have to opt out, especially my state of Calif. because of financial problems for many years. Have you thought about how the exchanges will be funded? TAXES! I don't know about you, but I can't afford more taxes.

 

Protection for preexisting conditions sounds nice on paper but insurance companies are private enterprises and they can charge insanely high prices for those policies that no one can afford. The government can't really restrict rate raises because they are privately owned companies. Just like the government can't stop a grocery chain from charging $10 for a gallon of milk if they wanted to.

 

More than 50-52% of Americans are against most of the Affordable Care Act. Go to yahoo and do a search for the percentage of Americans against the Affordable Care Act. This is fact and has been in the newspapers and on the internet.

 

Kelli, I'm very sorry your son has chronic illnesses and I hope you will be able to find him affordable insurance but unfortunately, economists say that isn't going to be the case for most.  Medical care is expensive so policies can't be inexpensive. And as I said before, the insurance companies can charge $2,000 a month for a plan with preexisting conditions. I'm a nurse and know what 'the other side' is.

 

Lynn, I'm glad to hear that your doctor cuts his rates for those un and underinsured. More should be like him. My Anthem Blue Cross policy premiums dramatically went up also and I expect it to continue to rise due to this act.

 

Gail