A writer must “know and have an ever-present consciousness that this world is a world of fools and rogues… tormented with envy, consumed with vanity; selfish, false, cruel, cursed with illusions… He should free himself of all doctrines, theories, etiquettes, politics…” —Ambrose Bierce (1842-1914?). “The nobility of the writer's occupation lies in resisting oppression, thus in accepting isolation” —Albert Camus (1913-1960). “What are you gonna do” —Bertha Brown (1895-1987).
Brady and the Senate Republican Caucus, with the approval of the Governor, has
introduced their agreed upon budget, Senate Bill 2214, which will
decrease funding to the Teachers Retirement Insurance Program by 1/3 below the
certified levels. This is an even greater underfunding level than was
originally proposed in SB 42, which the IRTA managed to get defeated in the
IRTA is taking this 1/3 reduction to TRIP as an indication that the proposed
Republican budget plan would phase out the TRIP program over the next three
years, which would be a diminishment to your benefits.
reach out yet again to your legislators and tell them to VOTE NO on SB 2214
(the budget) and SB 2217 (the BIMP) and any other measure that would diminish
the benefits to retired educators.
“The Rush Alzheimer’s Disease Center at Rush University
Medical Center is the only site in Illinois, and one of only 15 sites across
the United States leading the Exercise in Adults With Mild Memory Problems
(EXERT) study, which is trying to determine if exercise can slow the progress
of memory loss and cognitive impairment in older adults.
“Neuroscientists are collaborating with the YMCA to provide
individualized, one-on-one exercise programs and personal training to study
participants. Rush will be working with the McGaw YMCA in Evanston, Illinois,
to provide 45-minute personal training sessions for one year.
“‘We want to see if a personalized program implemented in
the community and prescribed by health care providers can be an effective
therapy for people with memory issues,’ said Dr. Neelum Aggarwal, associate
professor of neurology and principal investigator of the EXERT study at Rush. ‘There
have been some studies suggesting that exercise may be able to delay or prevent
dementia,’ Aggarwal continued. ‘The EXERT study is a longer trial looking at a
larger number of participants who have short-term memory loss that may be
impacting some aspect of their day-to-day functioning.’
“‘Some older adults shy away from social situations or being
active because of their memory issues during a time when they need it the most,’
said Aggarwal. ‘The personalized, one-on-one attention from a program
like this may be more beneficial for them.’
“The Rush portion of the EXERT study will be enrolling 300
people ages 65 to 89 with mild memory loss – also known as mild cognitive
impairment, a condition that often precedes Alzheimer’s disease dementia. The
study is looking to enroll people who are not as active, because people who are
physically fit may already be at peak brain function. To qualify for the trial,
participants may have engaged in casual, low-intensity physical activity, but
not rigorous exercise.
“Based on the trial results, neurological researchers are
hoping to develop an evidence-based program that will tell people the type and
frequency of exercise they need to support memory and thinking skills. All
trial participants will receive a free membership at the participating YMCA
where they will work closely with a personal trainer for one year. Participants
then will exercise on their own for an additional six months.
“Participants will be randomly assigned to one of two
groups. The ‘high-intensity’ group will walk on a treadmill and take exercise
classes that raise their heart rate to 75 percent of capacity. The ‘low-intensity’
group will do stretching, balance and range-of-motion exercises. All
participants will work out in four 45-minute sessions per week.
“In addition, they will undergo the following tests and
procedures at the beginning of the trial and then every six months:
and other tests to measure changes in thinking and memory
resonance imaging (a type of brain scan) to measure changes in brain blood
flow and brain size and structure
of blood and cerebrospinal fluid to measure Alzheimer’s-related changes.
“Walking fitness tests and sleep studies are also part of
the trial. The study is part of the NIA-supported Alzheimer’s Disease
Cooperative Study, a consortium of universities and research centers in the
United States and Canada.”
For more information about the EXERT study, contact the Rush
Alzheimer’s Disease Center at (312) 942-0500.
members of Congress and their staffs choose from among 57 gold plans from four
insurers sold on the DC Health Link's small business marketplace this year...”
(NPR, April 2017).
it’s sometimes hard to understand what makes Republican legislators so angry,
here is a theory: their fury may not stem from some ungraspable principle, or
hatred of President Obama’s historic victory (or of Obama himself), but,
rather, from something personal, and selfish. Under the A.C.A., members of
Congress, and congressional staff, among other Capitol Hill employees, were no
longer eligible for the F.E.H.B.P. In the chilly language of government
directives, the Office of Personnel Management Web site said that 'Section 1312
of the Affordable Care Act requires that Members of Congress and their official
staff obtain coverage by health plans created under the Affordable Care Act or
coverage offered via an Affordable Insurance Exchange.'
“Ouch! In other words, the comfortable choices that were available for more
than fifty years were suddenly transferred to the slightly murky passageways of
Obamacare. And it follows that, if the Affordable Care Act is repealed, members
of Congress would be able to return to the federal plan that they, like
millions of federal employees, were so fond of. Twenty million other Americans
won’t..." (The New Yorker, Jan. 2017).
ACA requires members of Congress and many congressional staffers to leave the
Federal Employees Health Benefit Program and join the health-care exchanges in
the District. Through the federal plan, lawmakers and their staff members had
about 70 percent of their insurance premiums covered by the federal government.
“But members and their staff members generally make too much money to qualify
for subsidies in the exchanges, which were intended for people who previously
did not get insurance from employers. So the Obama administration made an
exception that allowed them to use the D.C. small-business exchange to receive
health-care stipends from their employer (the federal government).
“Yes, you read that correctly. The law allows individual congressional offices
to be counted as small businesses of 50 or fewer employees. On the exchanges,
members and staff members get an employer (i.e., taxpayer) contribution of 72
percent for their premiums.
this allowed them to receive a similar subsidy as they did under the federal
health plan. Some members say they donate to charity an amount equivalent to
the taxpayer-funded subsidy[Really?]...” (Washington Post, April, 2017).
Q: So what does the House Republican bill include and
“In broad strokes, the legislation has a lot of financial
aspects. For instance, it would substantially
reduce the funding for subsidies that the ACA provides to most people
seeking health coverage through insurance marketplaces the law created. It also
would make other changes to those subsidies in ways that, overall, would help
younger adults and increase premiums for
older people.The bill also would
eliminate several taxes the ACA created to help pay for its provisions,
including on health insurers and affluent Americans.
“The House GOP plan would not eliminate the requirement that
most Americans carry health insurance. Instead, it would get rid of the penalty
imposed for not having insurance and would create a new deterrent for having a
gap in coverage: a one-year 30 percent surcharge that insurers could tack onto
Q: Would this affect the number of people with
insurance in the United States?
“Yes. According to an estimate of the bill's original
version by the Congressional Budget Office, 24
million more people would be uninsured by 2026. The CBO did not
update that forecast since House Republicans tinkered with aspects of the
legislation to secure enough GOP votes for it to narrowly pass.
Q: What would happen to the ACA's marketplaces?
“The bill would not end the federal and state marketplaces
that, since 2014, have been a route to insurance for people who cannot get
affordable health benefits through a job. However, while the ACA's premium
subsidies can be used only within these marketplaces, the bill's new tax
credits could also be used outside them. A looming question is what effect the
House's vote on Thursday will have on insurers' willingness to stay in the
marketplaces for 2018 — a particularly pressing question since spring is
generally when insurers need to tell states whether they are in or out for the
Q: How would the bill change protections for people
with preexisting conditions?
“Under the ACA, insurers are prohibited from denying
coverage to individuals based on preexisting medical conditions, such as
cancer, high blood pressure or asthma. And the ACA requires insurers to offer ‘community
rating,’ meaning they cannot charge those with costly medical conditions more
than they charge other consumers in the general insurance pool.
an amendment written last week by Rep. Tom MacArthur (R-N.J.) would allow
states to obtain a waiver from the Health and Human Services Department so they
could charge customers with preexisting conditions more than other people.
If HHS did not respond to a state’s waiver request within 60 days, the
requested change would automatically go into effect.
experts predict that the result would be a sharp rise in premium increases for
those with medical problems. Before the ACA
became law, individuals with chronic diseases paid several times as much as
others — if they could afford or be approved for a policy in the first place.
“Concerned about the effect the MacArthur amendment would
have on those with long-standing medical conditions, GOP Reps. Fred Upton
(Mich.) and Billy Long (Mo.) crafted
a provision Wednesday to provide $8 billion to help these patients pay for
increased premiums and out-of-pocket costs. That money would be spread among
whichever states decided to let insurers return to the practice of charging
higher rates to certain customers. As part of a waiver application to HHS, a
state would be required to include a ‘risk-sharing plan’ — either recreating a
so-called high-risk pool, which many states tried before the ACA — or designing
a subsidy program for residents with preexisting conditions.
Q: Does the bill treat domestic violence, sexual assault,
Caesarean section and postpartum depression as preexisting conditions?
bill does not spell out either what sort of preexisting conditions insurers may
take into account if states seek a waiver from the existing federal law.
But in the past, some insurers had identified domestic violence, sexual
assault, Caesarean section and postpartum depression as grounds for either
denying coverage or charging higher premiums.
“‘When you can’t predict the future,’ Alina Salganicoff,
vice president and director of women’s health policy at the Kaiser Family
Foundation, said Thursday, ‘one looks back to see what the prior experience has
Q. What would happen to “essential health benefits”?
“The ACA compels insurers to include a specific set of
benefits in all health plans sold to individuals and small businesses. The
House bill would change that, leaving it up to each state whether to preserve
this rule or create its own set of coverage requirements — or no requirements
at all. A recent
Washington Post-ABC News poll found wide public support for leaving in
place both this federal rule and the one regarding preexisting conditions...
Q: Would Medicaid be affected?
bill would cut $880 billion from the Medicaid program over the next
decade, according to the most recent CBO estimate. This program provides
health coverage for low-income Americans and helps pay for long-term care for
people with disabilities and seniors.
“Under the ACA, 11 million people have gained coverage through
the ACA's Medicaid expansion. For the next few years, the 31 states that chose
to broaden their programs could keep going with that, but new people eligible
under the expansion could not enroll.
“Then, starting in 2020, Medicaid would switch nationwide to
a very different method of federal payments, breaking with its history of
paying a certain proportion for everyone enrolled and moving to a system in
which each state would be given a certain amount per person — a change that
critics predict would starve the program as time goes by as well as affect
beneficiaries' access to care…
Q: How would the bill affect public health programs?
GOP bill would eliminate funds for fundamental public health programs,
including for the prevention of bioterrorism and disease outbreaks, as well as
money to provide immunizations and heart-disease screenings. It would gut
something called the Prevention and Public Health Fund, which provides almost
$1 billion annually to the Centers for Disease Control and Prevention. That
fund accounts for about 12 percent of CDC’s total budget. If the GOP bill
eventually becomes law, those
public health monies would be eliminated starting in October 2018.
significant portion of those funds, about $625 million a year, goes directly to
state and local health departments. If prevention funding is lost, public
health advocates warn that Americans will be at greater risk for
vaccine-preventable disease, food-borne infections and deadly infections
contracted in hospitals. One of the biggest recipients of the
prevention fund is the CDC’s immunization program, which last year received
$324 million. The money is sent directly to states and local communities to
improve immunization infrastructure, such as registries that allow providers to
know which patients have received what vaccines…” (Washington Post, May 2017).