Obat herbal untuk amandel

health care republican party

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<div align="justify">released man after he had been hiding from authorities. >> republicans who control the minnesota legislature have their plans to address health insurance costs, gop lawmakers vowed to quickly move a relief package for a residence paying premium increases this year 
under the individual market. disagreements with governor mark dayton over how to shape the existence could drag the debate out a few weeks. >> we agree that that's important. it's important we get some of those reforms as well. 
i don't want to do anything to slow down the process, and we want to make sure that the governor is coming in and working with us, and we know for it to happen to have to have an groament. >> it would scale subsidies based on income but cut off 
support for those making 8 times the poverty level, about $190,000 for a family of four. house speaker kurt daudt said it </div>
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health care republican party

released man after he had been hiding from authorities. >> republicans who control the minnesota legislature have their plans to address health insurance costs, gop lawmakers vowed to quickly move a …

health care repeal

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<div align="justify">this is me, and this is my sister, annie sheâ€™s 28, mom to two cats, freelance designer and part-time grad student thereâ€™s just something about freelancing. i feel a lot of creative freedom sheâ€™s also had had chronic back pain, neck pain, migraines for as long as she can remember she health insurance through obamacare, and without it, thereâ€™s no way sheâ€™d be able to affordall her doctorsâ€™ appointments and medications and because she doesnâ€™t have to depend onan employer for insurance, sheâ€™s able to 
work for herself the flexibility works really well with being able to make my appointments around my work schedule on election night, my first thought was, "what does this mean for my sister?" donald trump, elected president of the united states and for the 22 million other people who get their health insurance through obamacare â€œtoday, after over a year of debate, health insurance reform becomes law in theunited states of americaâ€ 
â€œweâ€™re gonna try and repeal thisâ€ â€œthereâ€™s only one way to fix obamacare, and thatâ€™s a full repealâ€ â€œcan we replace this law, completely, in the next presidency, in the next congress. that is our goal, and the answer is yes wecan.â€ "when we win on november 8, we will be able to immediately repeal and replace obamacareâ€ obamacare is a big law, with lots of different parts 
and there are some parts that trump and republicansin congress say they want to keep. for example: before obamacare, companies couldrefuse to sell insurance to people with lots of health problems. obamacare says they canâ€™t do that anymore,and trump and the republicans say they want to keep it that way. the problem is, this piece of the law thatthey like only works because of another piece of thelaw that they donâ€™t like...a piece theyâ€™ve promised to get rid of thatâ€™s the part of the law that says youhave to have health insurance, or pay a fine. 
for health insurance to be affordable, youneed a lot of healthy people to sign up for every one sick personthatâ€™s because health insurance is worth more to sick people, and theyâ€™ll pay morefor it, which pushes up premiums for everyone. the healthy people in the pool help keep thosecosts down. if trump and the republicans get rid of theindividual mandate, which they say they will, a bunch of healthy people are going to stop buying insurance, premiumsgo up, more healthy people leave until all thatâ€™s left are sick people whoare really expensive to cover. without a bunch of healthy people to offsetthat cost, insurance companies would pull 
out of the marketplace we know this because in some places, it was already happening before the election. too many healthy people were choosing thefine over health insurance as a result, states like alabamaand oklahoma only have one insurance plan on the market--and without competition, premiumsshot up last year. if trump and the republicans get rid of theindividual mandate, weâ€™ll likely see this happen in other states. like texas, where my sister lives 
so, what might her life look like under the republican replacement for obamacare? right now, obamacare makes it illegal forinsurance companies to charge her more just because she has health problems.under paul ryanâ€™s plan, that changes. insurance companies would be allowed to chargeher more if she ever let her coverage lapse. instead of forcing insurance companies tooffer affordable plans to people like my sister, paul ryanâ€™s plan would fund â€œhigh-riskpools,â€ insurance plans specifically for people with lots of health problems, but wedonâ€™t know exactly who would be eligible for them. 
these pools were around before obamacare--and without healthy people to balance the sickpeople, these plans end up being about twice as expensive for participants. paul ryanâ€™s plan does call for refundabletax credits to help offset those costs. congressional republicans have tried gettingrid of the individual mandate before. but those votes were largely symbolicbut itâ€™s real now. my sister has built a life for herself where she can takeprofessional risks go back to school , be her own boss, and not have to rely on an employer for health insurance. 
now, she and 22 million others are askinghow long that will last. </div>
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health care repeal

this is me, and this is my sister, annie sheâ€™s 28, mom to two cats, freelance designer and part-time grad student thereâ€™s just something about freelancing. i feel a lot of creative freedom sheâ€™…

health care repeal bill

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<div align="justify">on thursday healthcare.gov posted its biggest enrollment day since the affordable care act exchanges opened in 2013 more than 670,000 people signed up for coverage ahead of the december 15 deadline for january first coverage and that's despite the fact that about 1 million people had to leave their contact information as they couldn't get 
on the site house republicans have voted 56 times to repeal the landmark legislation depending on whom you ask and senate republicans say the only thing stopping then is the president veto pen but what's donald trump is sworn in congressional republicans will be under intense pressure to make good on all the 
promises to block the tyranny of the individual mandate while the replacement effort is underway republicans will risk aggravating up to 30 million people who are covered by the law or by policies with prices affected by its insurance marketplace democrats will be sure to accuse the gop of threatening the health care of billions senate republicans can 
circumvent a filibuster by using a procedure called reconciliation to repeal part of the law that affect the federal budget like the individual mandate health insurance subsidies and medicaid expansion but health analyst and health provider groups are warning that repealing major pieces of the law without immediately replacing them could 
cause a collapse of the individual market that currently covers around 20 million people and many of the laws most popular provisions can't be repealed using reconciliation including guaranteed coverage of pre-existing conditions which used to prevent millions of americans from getting affordable health insurance recent 
polling shows two-thirds of americans want to keep this part of the law even trump's started dialing back the rhetoric it's political suicide which means they have to find some way to save the individual market even with the pre-existing conditions provision in place without the individual mandate in place millions of healthy americans will 
opt out of health insurance and that would be disastrous for an industry that spent hundreds of millions of dollars lobbying congress senator schumer says it reminds him of the story about the dog who caught the bus if you found the information in this video helpful go ahead and share it with a friend and don't forget to click on the subscribe 
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health care repeal bill

on thursday healthcare.gov posted its biggest enrollment day since the affordable care act exchanges opened in 2013 more than 670,000 people signed up for coverage ahead of the december 15 deadline f…

health care reform

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<div align="justify">i think we use - i can't remember the examples - maybe itwas claritin and allegra. let's say the cer comes out and says one is better than the other. what's going to be the requirement forsomebody who's practicing medicine and allegra doesn't work for their patient but claritin does? the doctor decides with the concurrence of the patient. so, does he have to document that hedidn't follow cer guidelines? 
i'm not sure what the rules and regs would be. well, that would be part of what the secretary puts together. that's my whole problem with this is what's the secretary put together? the fact is that i have an amendment, coburn number 9. we really do have a lot of quality problems. we have a lower life expectancy 
than other countries. the united states ranks 45th in life expectancy. we have very poor infant mortality rates. and has startlingly high rates in infant mortality, depression, chronic diseases. from city to city, from physician to physician, and hospital to hospital 
there are huge differences in the amount of care given and the outcomes of that care. we need to identify the best practicesacross the country learn from the successes, and then duplicate those successes everywhere else. we're in the top 5 of medical expenditures in the world but we're 
in the bottom 37th in terms of health outcomes. the who says we rank 37th in the world onhealth care that's behind chile and san salvador. we deserve better than that. when you try to do an internationalcomparison, it is very complicated. i think all too often we tend to be overly simplistic. we look at crude indicators. one finds that americans smoke too much, they drink too much, and they eat too much, especially compared to their northern neighbors. in fact, 
and it pains me to say this as a physician, but probably one of the less important things is health care in that overall equation. one of the things in the bill talks about comparative effectiveness studies. information like your age, your diagnosis, gender, and etcetera goes into a national research pool. they collect this data so that when you enteryour information onto the computer system, which doctors have to go to this computer system now, because the government is mandating it, it collects it and then as this plan goes into place the computer is going to kind of pop up and say "do this, do that. you know, we have this data, here's our recommendation." you go with the recommendation it's good. you don't, it's bad. 
the fear is that if you don't go with what that little government computer is telling you to do, what if you don't get paid. the other area that some of these bills would put government into is collecting more data on healthcare practices and looking for things that are effective and beginning to develop recommendationsand protocols for what should work. we really don't have a good body of knowledge at this point. 
we don't know what works, and for whom it works, and we don't know how much of it you need. so, you have to sort of answer those three questions for a lot of conditions and a lot of treatments,and then you have to keep up with developments and new treatments. so you'retalking about quite a few years of building up a body of knowledge. and then you have to sort ofdemonstrate that it's valid, right? so people have to see that when you make these recommendations that you're not just blowing smoke. what this amendment would require 
that the director of the centerfor comparative effectiveness research shall not mandate any national standards of clinical practice or quality health standards. mandate. that doesn't mean they can't study and recommend. that means they won't mandate it. in this legislation and i've given chapter and verse that we domandate clinical practice. (committee members speaking over each other) there is no clear language that says "we prohibit the mandate 
of this interfering between a doctor and a patient's decision for their care." - go to page 323.- i want to read you the text. that's a big difference and saying theywill not be used as mandates. - could we come back though to qualityhealth standards?- sure. because i don't know what you object there in establishing a standard on quality health care. because all of a sudden we've now said there is one right way to do this and it's the government's way based on by iconic professors anddoctors of medicine 
and it still disregards the patient history, the clinical history, the experience of the physician, and all those combined, which is called theart of medicine. the most important aspect of health care is the doctor-patient relationship. prepare a doctor, sitting down talking to a 
patient who needs health care and the one-on-one relationship has gottenlost in today's society. i'm rick baxley, i'm a family practice physician in orlando, florida. the measured outcome system is another barrier between the doctor-patientrelationship. just a simple example: i have a patient who works a second shift 
and i hand them a perscription that saysthey need to take a pill three times a day because it's a generic and it doesn'tcost as much as the one time a day medicine. well that's fine, and i do that but i know that the patient is not take it butonce or twice a day no matter how many times i've put on the sheet, on that prescription. because of their lifestyle and the way they work and their time andthat kind of thing, and the kids that they 
gotta pick up after their second shiftand all that other stuff that the likelihood of them taking that pillthree times a day is almost zero. but, the pharmacy company says that they're notgoing to pay or the the insurance company says that they're not going to pay the pharmacy for the one pill a day brand. they're going to pay the 3 times a day... they'll pay for the 3 pills a day so whether they get used to not is irrelevant. 
so, there's a lot of nuances that the government and the insurance companieshave not figured out yet. and i don't think they're going to becauseof the economics of the medicine. they are thinking more of the economics than they are the art and science of medicine. this is a very important section of this bill. very important. medicine is personal. medicine is individual. it doesn't fit in a box. 
no, but it does fit practicing guidelines and you, yourself has said that. - that national academy of clinicians...- senator, can i finish my point? please, go ahead. guidelines are important but they're just that. they're guidelines. and if, in fact, you pass this bill out of here with this 
you're going to raise the cost of medicine. because now what we're gonna do - here's the guideline that you need to follow and sort it out, andimplement it. the people who will implement this willbe bureaucrats and the first rule of bureaucrat isnever do what is best when you can do what is safe for your own job. and that will be the logo under which they operate and administer whatever comes up out of 
cer. well, when the law passes the group that passes it may exist for only a moment in time. it's a group of people who probably willnever assemble again exactly the same way. so, who is really able to tell you whatthe bill meant? well, the committees who really wrote it make an effort at it. they write a report and they say, "this is what we mean, this is where we're trying to go, this is the way you should think about interpreting this." and, it's not the law, but it's an instruction to the bureaucracy. 
so, the bill goes over to thebureaucracy, to the agency that is responsible for administering thatprogram, and then the report would go to them. and they're pretty much on the hook to file that report to the extent that they can. and then where they have questions they can call up the staff of the committee saying, "what did you guys mean here?" they can also call up friends they have in the hospital industry and say, "you know we're thinking about writing up some regulations here but we're not sure this would work. what do you think of this?" another thing that people don't understand about the bureaucracy is that the same person has probably been working on that same issue for a 
long time and they're really experts now. sometimes they have their own ideasand so there's something called bureaucratic drift, which is when the bureaucrat sometimesmoves closer to what congress wants and moves further away from what the president wants or if the bureaucrat favors what the president is wanting. they might move closer to the president. and so, the political scientists have developed a term called the zone of indifference. and that is, the bureaucrat can get awaywith writing the rules in a way that 
takes lose interpretation of the law and as long as they don't do it too brashly, if they do it too much, one side or the other - the president or the congress - is going to notice and drive them around. you want to pay close attention to yoursubcommittee because that subcommittee very likely also controls your authorizing legislation. 
and so if you make them mad, they can do subtle things like take away your staff or they can make a recommendation to the appropriations committee thatyour budget get cut or that function be cut. the other place that the bureaucrat gets in a lot of trouble is if it's a highly salient issue. in the case of effectiveness standards in heath care, that's going to be a salient issue. every doc, every medical specialty group is going to be watching that like a hawk because it's going to limit the behavior of the physician. it's going to potentially reduce their income. and so, the zone of indifference get very 
narrow when the issue is salient. so they write these regulations and publish them, and then they have to overseethe process of them being implemented. and then, of course, the people who do the implementing make their own interpretations about what the regulations should be. the concerns were raised that if we dothis work with this several billion dollar effort that in fact we couldn't use the workproduct 
to inform and educate and benefit from the work product that is developed. and the concerns that were raised were raised essentially under the language that we had written that it might prohibit this task force and this agency from actually getting that information out and that's not our intention at all. so,what this amendment simply says, 
we strike a section that we was all thecontroversy last week and then we say are prohibited from being used by anygovernment entity for payment coverage or treatment decisions. nothing in thesection shall be construed as preventing the center for disseminatingreports and recommendations to health care providers. so, the one argument that was trulyraised about our previous language is addressed here, i believe fully, and would not limit in any way, shape, or form thedissemination of that information. 
if, in fact we're not going to use thisto limit care then, what we will be using this for is toimprove care. i disagree with the senator'srecommendation. it is very rigid. it is very stringent. it could absolutely have draconian impact on the practice of care because if you're going to be prohibiting them 
from being able to use by what it says "anygovernment entity." if there is, in fact, information thatarises that gives better information about tools andmethodologies that are being used they would, say at the va, be prohibited from using it. senator whitehouse:i'd like to join senator murkowski in opposing this. 
i understand where senator coburn iscoming from and i appreciate his desire not to have an interference in the doctor-patientrelationship, none of us want that, but i think the affected of this language will be to totally unhinge payment from performance and to do so in ways that could have farreaching affects throughout the rest of the system as we try toimprove quality. 
let's just say that it was clearlyproven that if you could get somebody whopresents at the emergency room with a respiratory infection on to the right antibiotics within three hours that the course of treatment was muchimproved for that individual that the costs went down forthe hospital and for the system and everything was better, if you could dothat. so, cms says, okay well what we're going to do it, we're going to do a 5% percent bounty or 10% percent bounty, anadditional reward payment for every hospitals that's able to get people on theright antibiotic, at the right 
time, within those three hours of theirpresenting. that seems like a kind of thing we wantto encourage the healthcare reimbursement system to do, assuming thatthe evidence truly supports it. so obviously it has to be simply a research enterprise initially, and then a dissemination effort, and you have, you have to find ways to get it into thehands of physicians who are busy and 
lots of demands on their time. they have to be, what you're offering has to be relevant totheir particular practice and their setting. and so, you overcome all those problems first and then you say, i think, at some point you say, if you follow this, 
these recommendations, follow them80% of the time or 75% of the time or something like that then we will not only pay you, but we will pay you a bonus. if you want the bonus, then you've got tofollow these recommendations. and if you don't want to follow the recommendations, you don't have to butyou won't get the bonus. and then at some point you say if you didn't follow the recommendations and you had a bad outcome we're sure as heck not going to pay for you to fix the outcome 
and we may not even pay for you to do that same procedure again. we're just not going to pay for it. but this is years in the future. of course, it's those years in the future that the physicians are worried about. at some point the a recommendation will become mandatory and they might not be right for yourpatient. and physicians tend to feel that their patients are unique. 
as somebody who deals with data, nothing is unique. it's all just a distribution, some people are in it and some people aren't. i've never bought the argument thateach patient is unique. senator whitehouse's argument forgets that medicine is personal. what is the right antibiotic, for me? let's say it's a fluoroquinolone, which is great for pneumonias. 
we talked about a respiratory infection. fluoroquinolones are absolutelycontraindicated most the time in elderly patients because they cause mental confusion. but, there's no question they're the bestmedicine when it comes to treating a large number of respiratory infections.they're oral, they work like an iv antibiotic. but yet they're oral. 
but we're gonna take out that personal knowledge and we're going to say we're going to do it. so, if we want the government to makethose decisions to ignore the art of medicine to ignore the personal nature ofmedicine, that will defeat this amendment. but, if we really want to 
benefit from this agency and get the information out there and then allow the physicians using their gray hair, using their training, using their experience,and also most importantly using the knowledge of the individual patient. not what's something that on a chart that says here's the best way tocookbook this, 
but what about the individual patient? could we save money? yeah. could we have the same kinds of outcomes? no. will we have the same kind of confidence? no. will we lead the world in cures? no. so, you know, it's a big issue and i understand we're not going to winthis vote but the political ramification is thatyou're going in a direction that most 
americans don't want you to go. senator, thank you very much. i presume we'd like a recorded vote on this issue. - yes, yes. - okay then we will call the role on the coburn amendment number 9. (names being called in the background) the bill is open to further amendments. senator coburn. senator coburn:i have coburn amendment number 10. </div>
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health care reform

i think we use - i can't remember the examples - maybe itwas claritin and allegra. let's say the cer comes out and says one is better than the other. what's going to be the requirement forsomebody w…

health care reform proposals

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<img alt="health care reform proposals" height="500" src="http://www.commonwealthfund.org/~/media/images/interactives-and-data/chart-maps/chartcart/issue-brief/trump-health-care-reform/image_02.jpg" title="health care reform proposals" width="500" />
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<div align="justify">wallace graces main with the republicans they're not doinganything a he in the famous uh... they want people todie and they want to die quickly speech beginning part of the speech was abouthow the republicans had the sheets of paper uh... during oklahoma speech to thecongress and that had their health care plan on its own grayson was curious what was any way to go checkit out 
and he found out that the p_a_ paper wasblank and it's like so that's your planetblank piece of paper and in essence that is their plan and they say now that big raisins attackupon although no no no you don't nurse and we've got a lot of stuff them thingsthat were of proposing i probably will be covering uh... veryclosely the finance committee hearings and then republicans have offer a numberof different amendments uh... two million dollars been coveringthe first lady and he had found others and easy amendment that day grassleyintroduced 
where he was have a public option for health care insurance company so that they rent out of money but the government would give them money not osce no we don't get double publicaction a bailout for those companies in advanceof preemptive a lab well the republicans are in favor ofthat well then and now back to the washingtonpost has also been covering the hearings and he has other specific proposals ademocrat and that the republicans say 
have put forward your a for this all right well uh... truck grassleyagain now put up with the other f_-one modified amendment what was that you're gonna be shocked to find outsomething else that helps the healthcare industry but is that i spoke with two its seven million dollars a year feesthe government would normally charge private health insurance companies 
he was saying take that money can give it back to theprivate insurance companies got paid for somehow so easy causing a figure for reducing benefits to poor people andlegal immigrants he's gonna cut medicaid and he's gonna cut any kind of uh...relief legal immigrants piak is that magic it is a little mlmillbank talking with us a little bit or 
refer to it it's a reverse robin hood well look we've got ideas here on the republicanside okay we played a big seven billiondollars in the poor and and legal emigrated legally legalnow mothers i say oh no no we are when they were legal immigration judgesbut what do you legal immigration all of your legal immigrant who's gotyour would take money from you and do the private health insurance companies 
so now we get a sense of where they'regonna get more for you that patch amendment ab seven this is a goes long lines and sort transition relief for further excise taxon high cost insurance plans for any state with a name that begins with the letteryou which state would that be alright yukawa orrin hatch is fraught so he says ice the one excise tax 
cover for my state now i think you'd be a littletongue-in-cheek there okay because he's a guesses overall but these are not serious amends are you kidding me is a reaction to almost all the viewergo commented the sex an amendment to protect the first amendment rights 
no no no not americans health plan so health care providers the actual companies they have to be protected grassley was nearly seven billiondollars let alone the preemptive bailout okay or not you want to make sure that no excise tax reform the high in insurance premiums could getthe government state 
and not kailas said they listen let's make sure their first amendmentrights why so they can spend the money freedomof speech spend money in attack ads to try to kill health care reform you see how this goes uh... orrin hatch with another it's set of amendments well why don't make sense you know makesure that no money goes to supporting 
physician assisted suicide that's a whole different issue but here's what's clear it already does not go to physician-assistedsuicide in this plan so you know what you wanted in be greater republican amendment you know if i am i disagree on thatissue which i knew weeded out about 
other time but this plan never be the jet address position isasleep assisted suicide the first place so in other irrelevant and then the second amendment on that note fifty million dollars for abstinenceeducation this is your plant this is your plan tofix ok america people getting tonight it is apre-existing conditions and decision and saturn set up 
forty seven million uninsured and you are a waste more money aunt abstinence education that's your point way it is racial over and over again itdoesn't work but once the state st uh... teach answers education the most teen pregnancy rate alright at but what does it have to dowith health care 
look if you would given us real proposals and i was a tinypart of an ok but that you may do so part of all those bungalow sultans ofone alright it goes on kyle men denied in this case it was the worst he was super bet you here your address he was the perfect prevent cost effectiveness research 
caught that's a quote no cost effectiveness research but we wouldn't want things to be efficiently and effectively i mean wewould want less effectiveness right but if it involves research you know onthat alright and that then his own grassley had abandoned the brain that one of the eliminate funding forquote comparative effectiveness research they don't want to find out what works 
these amendments well robert port the paper the rich for protect the health care companies don't want to find out what's actuallypossible to by the way why why don't they wanna find out the insurance companies public when theymake more money for really ineffective stopped because it's is bloated and and i'm sort of issues companies in thatcase 
uh... but they'll have a drag up thepremiums but uh... uh... other health care providers alike all you want moretest optimism is cost effective every time you do it s idea level the pharmaceutical companiesetcetera etcetera have you heard any amendments so far it is addressed towards you the american people none right 
so for almost all of these amendments have been protecting the company's nonproductive not addressing their real health careissues in america i keep busting up all night long and i'mgoing to john ensign from nevada amendments e-ten an amendment are in the middle of theauthor debate unquote transparency installers 
this is the school and back foxnewsnonsense about solarz and it said arrests that are the seller these oracle ball there a waste of time that's whatthey're by the way that's exactly right that's what they want to do what whatwhat what we have three kids we propose yes to waste time to try to make sure that health caredoesn't get 
past no reform gets passed no bill getspassed little electoral uh... nothing about health care no wedon't address that will protect gorazde uh... albeit results glenn beck told me about suchtransparency is a no kansas but either way sometimes along those lines amendment f or uh...also from atkinson to strike the word fbi everywhere itappears in the bill and replace it with the word packs 
he's a man this might be a littlepolitical and not really substantive and second of all of their he's they'renot taxes those are two different words beat me to a different banks you moron if you are out there and you think that you know what i don'tlike the idea that i am compare all this money these insurancecompanies and my premiums went up a hundred and nineteen percent in just thelast ten years and when i get sick anemic covered a micturnarounds they are recisions sorry 
we decide to yourself your uh... street was two thousand wheni got to pay for it workable with some exit you will likethat do you think the republicans are here tohelp you doesn't sound like they're here to helpyou know they're here to help the people who pay them that healthcare companies and if you were conservative even theseconservative these republicans are 
conservative in on your side no i consult ironic is almost customersalike or baseball tensions arabella terrible other the back pockets of a body has the right reasons open politicians most of all some of the democrats are don't ever ona lot of them are the majority of them off now the majority if you can at leasthave a debate of the democrats at the 
republican side every single one of them if you think that the politicians are uh... people who are bought and sold and you're a republican you make nosense whatsoever every amendment as the protectorcorporations depicting your back pocket you don'teven know it </div>
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health care reform proposals

wallace graces main with the republicans they're not doinganything a he in the famous uh... they want people todie and they want to die quickly speech beginning part of the speech was abouthow the re…

health care reform plan

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<div align="justify">the president:good evening, everybody. tonight, after nearly 100 years of talk and frustration, after decadesof trying, and a year of sustained effort and debate, the united states congress finallydeclared that america's workers and america's families and america's small businesses deservethe security of knowing that here, in this country, neither illness nor accident shouldendanger the dreams they've worked a lifetime to achieve. tonight, at a time when the punditssaid it was no longer possible, we rose above the weight of our politics. we pushed backon the undue influence of special interests. we didn't give in to mistrust or to cynicismor to fear. instead, we proved that we are still a people capable of doing big thingsand tackling our biggest challenges. we proved 
that this government -- a government of thepeople and by the people -- still works for the people. i want to thank every member ofcongress who stood up tonight with courage and conviction to make health care reforma reality. and i know this wasn't an easy vote for a lot of people. but it was the rightvote. i want to thank speaker nancy pelosi for her extraordinary leadership, and majorityleader steny hoyer and majority whip jim clyburn for their commitment to getting the job done.i want to thank my outstanding vice president, joe biden, and my wonderful secretary of healthand human services, kathleen sebelius, for their fantastic work on this issue. i wantto thank the many staffers in congress, and my own incredible staff in the white house,who have worked tirelessly over the past year 
with americans of all walks of life to forgea reform package finally worthy of the people we were sent here to serve. today's voteanswers the dreams of so many who have fought for this reform. to every unsung americanwho took the time to sit down and write a letter or type out an e-mail hoping your voicewould be heard -- it has been heard tonight. to the untold numbers who knocked on doors andmade phone calls, who organized and mobilized out of a firm conviction that change in thiscountry comes not from the top down, but from the bottom up -- let me reaffirm that conviction:this moment is possible because of you. most importantly, today's vote answers the prayersof every american who has hoped deeply for something to be done about a health care systemthat works for insurance companies, but not 
for ordinary people. for most americans, thisdebate has never been about abstractions, the fight between right and left, republicanand democrat -- it's always been about something far more personal. it's about every americanwho knows the shock of opening an envelope to see that their premiums just shot up againwhen times are already tough enough. it's about every parent who knows the desperationof trying to cover a child with a chronic illness only to be told "no" again andagain and again. it's about every small business owner forced to choose between insuringemployees and staying open for business. they are why we committed ourselves to this cause.tonight's vote is not a victory for any one party -- it's a victory for them. it'sa victory for the american people. and it's 
a victory for common sense. now, it probablygoes without saying that tonight's vote will give rise to a frenzy of instant analysis.there will be tallies of washington winners and losers, predictions about what it meansfor democrats and republicans, for my poll numbers, for my administration. but long afterthe debate fades away and the prognostication fades away and the dust settles, what willremain standing is not the government-run system some feared, or the status quo thatserves the interests of the insurance industry, but a health care system that incorporatesideas from both parties -- a system that works better for the american people. if you havehealth insurance, this reform just gave you more control by reining in the worst excessesand abuses of the insurance industry with 
some of the toughest consumer protectionsthis country has ever known -- so that you are actually getting what you pay for. ifyou don't have insurance, this reform gives you a chance to be a part of a big purchasingpool that will give you choice and competition and cheaper prices for insurance. and it includesthe largest health care tax cut for working families and small businesses in history -- so that if you lose your job and you change jobs, start that new business, you'll finallybe able to purchase quality, affordable care and the security and peace of mind that comeswith it. this reform is the right thing to do for our seniors. it makes medicare strongerand more solvent, extending its life by almost a decade. and it's the right thing to dofor our future. it will reduce our deficit 
by more than $100 billion over the next decadeand more than $1 trillion in the decade after that. so this isn't radical reform. butit is major reform. this legislation will not fix everything that ails our health caresystem. but it moves us decisively in the right direction. this is what change lookslike. now as momentous as this day is, it's not the end of this journey. on tuesday, thesenate will take up revisions to this legislation that the house has embraced, and these arerevisions that have strengthened this law and removed provisions that had no place in it.some have predicted another siege of parliamentary maneuvering in order to delay adoption ofthese improvements. i hope that's not the case. it's time to bring this debate toa close and begin the hard work of implementing 
this reform properly on behalf of the americanpeople. this year, and in years to come, we have a solemn responsibility to do it right.nor does this day represent the end of the work that faces our country. the work of revitalizingour economy goes on. the work of promoting private sector job creation goes on. the workof putting american families' dreams back within reach goes on. and we march on, withrenewed confidence, energized by this victory on their behalf. in the end, what this dayrepresents is another stone firmly laid in the foundation of the american dream. tonight,we answered the call of history as so many generations of americans have before us. whenfaced with crisis, we did not shrink from our challenge -- we overcame it. we did notavoid our responsibility -- we embraced it. 
we did not fear our future -- we shaped it.thank you, god bless you, and may god bless the united states of america. </div>
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health care reform plan

the president:good evening, everybody. tonight, after nearly 100 years of talk and frustration, after decadesof trying, and a year of sustained effort and debate, the united states congress finallyde…

health care reform act

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<img alt="health care reform act" height="500" src="http://agencyfortheprofessions.com/wp-content/uploads/Healthcare-Reform-Act.jpg" title="health care reform act" width="500" />
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<div align="justify">hello everyone and welcome to the young informer.today, we will be taking a look at the affordable care act, otherwise known as obamacare anddiscussing its pro's and con's. obamacare is actually pretty complicated,so first we'll need to understand it well before we can form an opinion. so, what isobamacare? in 2010, president barack obama signed a healthcare reform law which basically makes health insurance more affordable, higher quality,and overall less costs. this was brought with the condition that coverage must be obtainedby 2014 or you would need to pay a monthly fee. so now lets take a look at how it all works.there are a few ways us citizens are being 
covered with obamacare, the main ones arethrough the through employment, government, and private purchasing. now that the law isput into effect, roundabout half of people are getting insurance from jobs, a third aregetting it through special programs such as medicare and medicaid by the government, thena tenth of people are forced to buy it on their own, but where does that leave the othertenth, or 30 million people will not have coverage. not much will be changing for employed americanswho are already covered, an example of a positive change is that there is a cap on how muchan individual has to spend on their own, also, you can get free preventative care. the realdifferences are going to be felt by those 
working for large companies and that are yetto be covered. starting from this year, 2014, the government started requiring both smalland large companies, with upwards of 50 employees to cover them, unless they wish to pay a penalty.this therefore will definitely be beneficial toward the employee, but a burden on the employer.in order to facilitate this process, the government opened up insurance marketplaces where businessowners can easily purchase medical insurance online.so in all, most company employees will be able to enjoy a medical insurance plan. others will be covered through help of thegovernment through medicare and medicaid. these people shouldn't see too much of a change. 
and for the rest of the people, they willbe able to buy healthcare plans on their own, through websites such as healthcare.gov. onthere, you will find a plethora of insurers. and unlike before, insurers wont be able todrop a client if it turns out they are sick and they wont be allowed to ask for more moneyif the person wishing to obtain the plan has any already-present conditions. males andfemales alike, will be charged the same price and as the price will decrease for peopleof higher ages, the price will increase for young people, but this is shielded by thefact that kids up to the age of 26 will be permitted to live under their parents' plan. so now lets take a look at the pro's and con'sof obamacare. i was talking earlier about 
how employers with over 50 full-time employeeswill be forced to purchase a healthcare plan. this in itself is extremely important dueto the high costs of insurance plans. consequently this leads employers into cutting employeehours into part-time to avoid the costs. so in the end its not the company that pays forit, but the workers. another huge con is the individual mandate,this essentially forces people to be covered by an insurance plan, if not like in the caseof employers, they will be paying a fine. a gallup poll done not so long ago found that40% of americans who are not covered, did not know about the individual mandate, alongwith its penalty. in case you were wondering how much the penaltywould cost and how it would be taxed, well 
here it is. the penalty is supposed to increasegradually, in 2014, its 1% of income, in 2015 its 2% and in 2016 its 2.5%. but these numbersshould definitely increase as time moves on, an example being that the income tax was 1%when first implemented. keep in mind that if you are part of the verylow income bracket, well then you will qualify for a tax break to cover the costs. this whole system closely resembles to corporatismas insurance companies operate as a sort of middle man between the government and theindividual. so they will still be getting paid the complete amount and will of coursebe making a profit. this middle man is a pretty big issue. thefact that americans want to pay for any medical 
assistance such as checkups or pharmaceuticaldrugs, has led health insurance companies to drive up costs, increasing premiums forthe customer. but if you think about it, you'll still be paying the same for the same producteven without the insurance plan, except without the additional costs of the middle man inquestion. so at this point what the affordable careact does is just put this system into actual law, and to top it off adds the individualmandate in order to force you through intimidation of the state. consequently, insurance companiesare provided with a set customer base that has no way out. you'd think that the individual mandate wouldbe a necessity in keeping the price of insurance 
low, but on the contrary, premiums for coveragehas been rising consistently. some states are seeing an increase of 298%. for peoplewho cannot afford insurance, the government helps them in the form of subsidies, but still,the insurance companies get paid the full amount. as you can guess, this just a massivedriver of debt for the us government's already pretty big 17 trillion deficit. unfortunately it doesn't stop here, the insuranceplans of millions of americans was canceled because of obamacare, but its hard to go intodetail on that. although all these reasons are pretty compellingto convince you that obamacare is bad, you cannot ignore the most important fact. healthcareis a basic human right, simple as that. the 
amount you earn can't be the reason why youare deprived of healthcare. this is the main reason why president obama actually decidedto implement this law in the first place. before, many people would try to suppresstheir illnesses in order not to have to pay the medical bills. therefore, although plaguedwith several flaws, its hard to argue against what obamacare or the affordable care act,stands for. so what do you think about obamacare? do youagree, do you disagree? do you feel as though it enriches the lives or the people, or doyou think it only enriches the insurance companies? leave your thoughts and comments below. this was the young informer, thanks for watching,and i'll see you next ti 
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health care reform act

hello everyone and welcome to the young informer.today, we will be taking a look at the affordable care act, otherwise known as obamacare anddiscussing its pro's and con's. obamacare is actually pret…

health care proposals

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<img alt="health care proposals" height="500" src="http://newshour-tc.pbs.org/newshour/wp-content/uploads/2016/07/RTX2ICSM.jpg" title="health care proposals" width="500" />
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<div align="justify">good morning hank it's tuesday. thanks for your excellent video about hillary clinton and bernie sanders' tax plans today i'm gonna discuss the tax plans put forth by donald trump and ted cruz. i would talk about john kasich's tax plan, but he hasn't put out a detailed one yet, so i can't. ok but first, a brief overview of the federal budget for which these taxes pay. about a third of the us's 3.8 trillion dollar federal budget goes to social security and unemployment, mostly to social security, which provides income for elderly and disabled people. 27% goes to healthcare spending. 
this is mostly medicare, our publicly-funded health insurance program for the elderly. 16% goes to the military, 6% to service the national debt, 4% to veteran's benefits, and after that, the pieces of the pie start to get pretty small. so hank, as you pointed out last week, [hank talking] taxes aren't any fun. they are also very, very complicated, and i want to emphasize that i am neither a tax policy expert nor an economist. although in 1994, i did win the bronze medal in economics at the alabama state academic decathlon. so for one brief shining moment, i was the third-best economist of all seventeen-year-old c students in the state of alabama. 
but i recognize that's not expertise. i have, however, read a lot of experts. ok, so both donald trump and ted cruz have proposed tax refoms that will dramatically simplify the american tax code. in fact, cruz has promised to make taxation so straightforward that we won't even need an internal revenue service anymore, so let's start there with his plan. so right now in the us we have seven tax brackets, so like if you're married and filing jointly, and you made a million dollars last year, first off, congratulations. but as for your taxes, the first 18,450 of your million dollars are taxed at 10%. 
the next 56,449 dollars are taxed at 15%, et cetera, with everything over 465-ish thousand dollars taxed at the top us marginal tax rate of 39.6%. except not, actually, because of deductions. like if you have a mortgage, you can deduct the interest you pay, money you give to charity can be deducted as well, your student loan interest might be deductible, some retirement savings, some childcare costs, lots of other stuff. but let's imagine an extremely unlikely scenario where you're making a million dollars a year, but don't claim any of these deductions. you can still claim the so-called 'standard deduction'. this is a tax deduction available to everyone. if you're married and filing jointly, it's currently $12,600 per year. so your first $12,600 of income wouldn't be taxed regardless. in the end, with a million dollars of income, 
taking only the standard deduction, you'd pay about $343,427 in tax, an affective tax rate of like, 34.3%. the same family earning $250,000 a year would pay $53,755, an effective tax rate of 21.5%. and if your family had the median household income of about $52,000, you'd pay just under $5,000 in federal income taxes, an effective tax rate of about 9.6%. ted cruz's plan is to collapse these seven tax brackets into a single 10% tax rate for all income. this is sometimes called a flat tax. crucially, cruz would also increase the standard deduction to $20,000 a year for married couples filing jointly. so the median us household income would end up paying $3,200 a year in federal taxes instead of 5,000, a reduction of $1,800, or 34%. the family making a million dollars a year would pay $98,000 a year in taxes, a reduction of $245,000 a year, or 72%. 
so everyone would pay less tax, but the wealthiest americans would see, by far, the biggest cuts, both in percentage and absolute dollars. cruz would also eliminate most of the aforementioned tax deductions, except for mortgage interest and charitable giving. he would also eliminate all federal gift and estate taxes, and repeal all corporate and payroll taxes, in favour of a 16% kind-of vat, which is where it gets really interesting. insofar that this stuff can be interesting. by the way, europeans were like, 'oh my god, he finally said a word i recognize, vat!' kinda. in most european countries, there's a broad tax on consumption called the vat or value-added tax cruz's vat is a little different. basically, it taxes businesses revenues minus their capital investments and the money they pay to other companies. i'm gonna oversimplify here a little bit, but imagine i wanted to 
start a company selling t-shirts that celebrated my love of pizza, that were available for $20 right now at dftba.com. now imagine that i had to pay a company $10 to manufacture each t-shirt. i would only pay vat on the $10 difference. the other company would pay vat on the $10 that i payed them. and then they would get to subtract any non-wage costs they incurred making the shirt, et cetera. also, if i wanted to buy my own machine to make t-shirts, i could subtract the cost of that machine from my revenue before paying the vat. the money left over is either profit that goes to owners, or wages that go to employees. so basically, it's a tax on both wages and corporate profits, and it would aim to do a better job than our current system does of actually, like, taxing economic activity. which would be good, because, as you might've heard, with the current system, there's a fair bit of tax avoidance going on. 
lots of economists, although certainly not all of them, like the idea of this kind of vat. but cruz's specific plan would dramatically reduce the amount of federal revenue. like, the nonpartisan tax policy center calculates that cruz's plan would reduce federal revenue by 8.6 trillion dollars over the next ten years. now, cruz says that by eliminating the irs and a few other federal agencies, the government can save 500 billion dollars over the next decade, but that's less than 10% the shortfall,. like, if you ceased all military spending in the united states, you still be 2 trillion dollars short. but cruz doesn't want to eliminate military spending, instead he wants to increase it dramatically. now, some economists argue the shortfall will partly be made up by increased economic growth, but even the most optimistic independent modelling i could find still showed a dramatic increase in the 
budget deficit under a cruz tax plan, barring huge cuts to either medicare, or social security, or some combination of the two. okay, so then there's donald trump's plan. trump would also increase the standard deduction, but by more, so that any couple making $50,000 a year or less would pay no federal income tax. and he would collapse the 7 tax brackets into 4, with the top rate being 25% on income over $432,000 per year. trump's plan is similar to cruz's in that he would also eliminate gift and estate taxes, and most deductions. but he would cut corporate tax rates rather than replace them with a vat, which would probably lead to a lot of people identifying as corporations instead of human beings for complicated reasons explained here if you wanna pause the video. the other facet of trump's tax plan that he talks a lot about on the campaign trailers that currently hedgefund managers and some of the other people who currently work in finance 
can be paid in what's called, carried interest, which allows them to pay a lower tax rate. and trump's plan would end this. but, because income tax rates would be so low under the trump plan almost all hedgefund managers will pay less tax than they do now while campaigning, trump has also repeatedly said that his tax tax plan will quote, "cost me a fortune" which is just not true. like under the trump plan, if you make a million dollars a year you'll pay about $200,000 a year in taxes, which is much higher than under the cruz plan 
but much, much lower than the current rates. but altogether, trump's proposed tax plan would actually cost the federal government more revenue than cruz's plan, somewhere between 10 and 12 trillion dollars over the next decade. that's about like, uh, 25% of the total federal budget. he has said that his tax policy will be revenue-neutral, but in response to that the right-leaning center for federal tax policy wrote an op-ed entitled, "donald trump's tax plan will not be revenue-neutral under any circumstances" the tax policy center, meanwhile, estimates that eliminating the united states military all together 
would cover just about half of the revenue gap created by trump's tax plan. so in summary, ted cruz's tax plan involves a radical simplification of the tax code. a flat 10% income tax would lead to lower taxes for all americans, but the wealthy would benefit the most and cruz's strategy for revamping the corporate tax code has support among a lot of economists, but the low rates would lead to dramatically higher budget-deficits. trump's tax plan would probably lead to even bigger deficits. as with cruz's tax plan, everyone would pay lower taxes, but the rich get the majority of the benefit. although, trump's tax plan does not benefit the rich as much as cruz's does. but more importantly, 
neither of these plans is at all feasible. unless, we completely reimagine the role that government plays in american lives. especially the lives of the elderly, the disabled, and military veterans. budget cuts to services benefitting those people are extremely politically unpopular, so much so, that both candidates have promised to find away to preserve those programs. but to speak frankly, neither of these candidates has offered a serious explanation for how they would do that. you simply cannot cut government receipts by 20% while preserving the programs that together make up more than 80% of the budget. hank, i'll see you on friday. 
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health care proposals

good morning hank it's tuesday. thanks for your excellent video about hillary clinton and bernie sanders' tax plans today i'm gonna discuss the tax plans put forth by donald trump and ted cruz. i wo…

health care policy

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<img alt="health care policy" height="500" src="http://www.ma4web.org/wp-content/uploads/2014/10/health-insurance-policy.jpg" title="health care policy" width="500" />
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<div align="justify">good morning, hank. it's tuesday. letâ€™s talk about the healthcare proposalsof donald trump and hillary clinton, but first i should say that if youâ€™re interestedin healthcare or health in general, you should check out health care triage, hosted by dr.aaron carroll. itâ€™s an amazing show. okay, to understand the candidatesâ€™ proposals,we need to look at the current healthcare system and its problems, so journey back withme to 2008. at the time, most americans got insurancethrough private companies. there was a publicly funded program for theelderly to get insurance called medicare. 
many low-income families got coverage througha publicly funded program called medicaid, and about 15% of americans had no health insuranceat all. so, broadly speaking, back in 2008, our healthcaresystem had three huge problems. the first was those 15% of people withoutinsurance. many people who didn't work for big companies,including me, literally could not get health insurance for any price because private insurerscould deny you based on pre-existing conditions. and for many other people, private insuranceplans were just too expensive to afford. and that brings me to our second big problemback in 2008, which was that our health care just cost too much. 
we were spending 16% of our nation's totaleconomic output on healthcare. most other rich nations spent under 10%. like, our healthcare costs were so stupefyinglyhigh that in the united states, more tax dollars per capita went to healthcare spending thangermany, japan, the united kingdom, or canada. all those countries spending fewer tax dollarsper person on healthcare had universal, publicly funded healthcare. the united states had nothing close to that. also, lastly, for all this money we were spendingnot to insure everyone, we werenâ€™t getting particularly good healthcare outcomes, like,by almost any measure. 
from life expectancy to medical errors tohospital admissions for preventable diseases, the united states was not near the top. so then comes the affordable care act of 2010,which was designed to address some of these problems, with the emphasis on the â€œsome.â€ the aca was primarily designed to get morepeople health insurance. about half of the newly insured were supposedto get medicaid, which was expanded to include everyone making up to 138% of the povertyline, and the other half were supposed to get insurance through exchanges, these marketplaceswhere everyone can get health insurance regardless of pre-existing conditions. 
and the insurance would be affordable becausehouseholds making up to 400% of the poverty line would have their insurance costs subsidizedby the government on these exchanges. the aca also sought to reduce spending bylowering costs within medicare, and it raised some new taxes, including one on medical devices. but it left the rest of the u.s. healthcaresystem largely unchanged. so that was the basic idea. now, the aca has never been fully implementedbecause a 2012 supreme court decision made the medicaid expansion optional for states,and nineteen states have so far declined to do it, which means that millions of pooreramericans remain uninsured. 
that said, the aca has been successful atreducing the number of uninsured people. today, itâ€™s around 9.1%. and it may have played a role, although expertsdisagree about this, in the slowing growth of healthcare costs in the united states. for the twenty years before 2008, healthcarecosts in the united states rose by an average of 8%. in the last five years, theyâ€™ve risen byan average of 5.5%. but, to be clear, costs are still rising fasterthan inflation and median weekly earnings. healthcare outcomes continue to lag behind,and our healthcare system is still far, far more expensive than any other nation on earth,although the gap with europe has closed a bit. 
the aca wasnâ€™t really designed to addressthose problems, and it hasnâ€™t. and there are other problems, too. in the employer market, premiums and deductiblesare rising as employers cover on average a smaller percentage of healthcare expensesthan they did ten years ago. on the exchanges, some insurance companiesare offering fewer plans. and because companies are insurers are nowrequired to offer comprehensive coverage with no lifetime benefit limits, many people whopreviously had bare bones insurance plans have seen their insurance costs go way up. these are all real problems, but itâ€™s veryimportant to understand that the structural 
shortcomings of the united states healthcaresystem are much, much older than obamacare. the aca is not the reason our healthcare costsare so high, and we know that because they were very high before the aca. so with all that in mind, letâ€™s look atboth candidatesâ€™ healthcare reform proposals, using analysis from the rand corporation,which is nonpartisan and widely considered centrist. letâ€™s start with trumpâ€™s plan. first, he would repeal the aca. now, trump has said heâ€™ll find ways to makesure that private insurers continue offering plans to people with pre-existing conditions,but he hasnâ€™t said how this would be possible. 
trump would also change the way medicaid isfunded, to block grants. this would basically mean that states wouldget to administer their own medicaid programs, but most analyses see these block grants over timeinvolving lots of cuts. and lastly, trump would allow insurance companiesto sell plans across state lines, and he would also make all health insurance premiums taxdeductible. but remember, these are deductions, not tax credits,so they would mostly benefit people with high incomes for reasons explained in this video. altogether, the rand analysis concludes, iâ€™mjust gonna quote here: â€œthe trump proposals decrease the number of insured, increase out-of-pocketspending for consumers enrolled in individual 
market plans, and raise the federal deficitcompared to the aca.â€ so, hereâ€™s how: around 19.7 million peoplewould lose their insurance if the aca were repealed, and medicaid block grants wouldprobably increase the number of uninsured further. sales of plans across state lines and taxdeductible premiums would get some people insured, but all in all, rand concludes thatabout 20.3 million fewer americans would have health insurance under trumpâ€™s plan. out-of-pocket expenses would go up, accordingto rand, for two reasons. first, because the tax deductions offeredby the trump plan are less generous than the tax credits offered by the aca. 
and secondly, they estimate that sales ofplans across state lines would raise out-of-pocket expenses because there would be an increasein the so-called bare bones plans. these are plans with high co-pays or deductibles,or limits to annual or lifetime benefits. rand estimates that the average annual out-of-pocketexpenses per person, including deductibles and co-pays and insurance premiums and everything,would go from about $3200 per person to $5700 per person. and the deficit would go up, because withthe repeal of the aca, the taxes it raised would also be repealed, as would the changesin medicare reimbursement. this would lower some taxes, but most of thesavings were in changes to medicare, so all in all, under trumpâ€™s plan, according torand, the deficit would go up by about 5.8 billion dollars. 
and i should add that all the nonpartisananalyses i could find agreed on all three fronts: that trumpâ€™s plan would reduce thenumber of insured people, increase out-of-pocket costs, and increase the deficit. okay, letâ€™s move on to hillary clintonâ€™sproposals. clinton would amend the aca in three big ways. first she would introduce a $2500 tax credit,or $5000 for married couples filing jointly, that could be applied to healthcare expensesover 5% of income. so if youâ€™re a single person making $50,000a year and you pay $5000 a year in health insurance premiums, you would get a $2500tax credit. 
because this is a tax credit and not a deduction,it would be available to everyone, not just high-income households, but that also meansit would be more expensive. secondly, clinton would reduce the marketplacepremium maximum. i know this is a little confusing. healthcare policy makes tax policy look likea pleasant walk in the park. but basically, right now the cost of healthinsurance premiums on the marketplace exchanges is effectively capped at 9.6% of income. to not benefit from the cap, a family of fourhas to make $96,000 a year or more. basically, clintonâ€™s plan would lower thecap from 9.6% to 8.5% for most households. 
but of course, that program would also costmoney. and then lastly, and maybe most interestingly,clinton would offer a public insurance option on the exchanges. this would allow anyone, not just seniorsand low-income people to get their insurance from the government. rand hasnâ€™t yet updates its analysis ofthe public option, but basically, it would probably be cheaper than private insurancebecause it would share administrative costs with medicare, and so it would slightly reducethe deficit by reducing healthcare subsidies. so all in all, according to rand, iâ€™m justgonna quote again: â€œall of the policies 
considered increase the number of insuredpeople and reduce consumersâ€™ out-of-pocket spending on health care.â€ rand estimates that the clinton tax creditalone would lead to 9.6 million more people getting health insurance, and that householdsof all income levels would see their out-of-pocket healthcare expenses go down. the biggest reduction in healthcare costswould be for families making between thirty and sixty thousand dollars a year, but theywould go down for everyone. but of course these problems would also increasethe federal deficit by what rand estimates to be ninety billion dollars. 
so that is randâ€™s summary. trumpâ€™s plan would lead to significantlyhigher out-of-pocket costs, fewer insured people, and a modestly higher budget deficit. clintonâ€™s plan would insure more people,lower out-of-pocket costs, but raise the deficit more. but of course you have to consider those deficitsin the broader context of the candidatesâ€™ budget and tax proposals. and to be clear, overall, under trumpâ€™sproposals, the budget deficit would be trillions of dollars more than under clintonâ€™s proposals. the other question, of course, is will eitherof these proposals significantly reduce the 
overall cost of u.s. healthcare? and the answer is probably not. the trump campaign will argue that sellingpolicies across state lines will increase competition, but that is deeply contested. and also, even in the rosiest projections,it wouldnâ€™t decrease spending much. the clinton campaign, meanwhile, will saythat a public option would put real price pressure on private insurers. and it might, but iâ€™ll put a link in thedooblydoo explaining why a single-payer healthcare system would not magically fix the u.s.â€™sproblems. 
the truth is, this is a complicated, multifacetedproblem, and anyone trying to sell you simple solutions probably isnâ€™t telling you thewhole story. and that includes me, by the way. this is definitely only an introduction. if you want to learn much more about healthcarepolicy and health insurance and different strategies for dealing with it, check outhealth care triage. theyâ€™ve got a great video out now aboutmedicaidâ€™s return on investment, and next week, theyâ€™re have a much more comprehensiveanalysis of the candidatesâ€™ healthcare plans, so subscribe to them. 
you can find sources, as well as informationabout how to vote in the dooblydoo below. hank, i will see you on friday, unless youhave a child in the interim. end screen, hank always says i need an endscreen. so i put some videos here about health insurance,why you need it, what the healthcare system in the united states is like, why itâ€™s soincredibly complicated. also, if youâ€™re looking for a hot sliceof tax policy, that video is just one click away, and rosianna drew you a bunny to cheeryou up. thanks, rosianna. </div>
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health care policy

good morning, hank. it's tuesday. letâ€™s talk about the healthcare proposalsof donald trump and hillary clinton, but first i should say that if youâ€™re interestedin healthcare or health in general,…

health care plans

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<div align="justify">the president:here are the detailsthat every american needs to know about this plan. first, if you are among thehundreds of millions of americans who alreadyhave health insurance, nothing in this plan willrequire you or your employer to change the coverage orthe doctor you have. under this plan, it will beagainst the law for insurance companies to deny youcoverage because of a preexisting condition. 
as soon as i sign this bill,it will be against the law for insurance companies to drop yourcoverage when you get sick or water it down whenyou need it the most. they will no longer be able toplace some arbitrary cap on the amount of coverage youcan receive in a given year or in a lifetime. we will place a limit on howmuch you can be charged for out-of-pocket expenses, becausein the united states of america, no one should go brokebecause they get sick. 
and insurance companieswill be required to cover, with no extra charge, routinecheckups and preventive care, like mammograms andcolonoscopies -- (applause) -- because there's no reason weshouldn't be catching diseases like breast cancer and coloncancer before they get worse. if you lose your jobor you change your job, you'll be able to get coverage. if you strike out on your ownand start a small business, 
we'll do this by creating anew insurance exchange -- a marketplace where individualsand small businesses will be able to shop for healthinsurance at competitive prices. now, for those individuals andsmall businesses who still can't afford the lower-pricedinsurance available in the exchange, we'llprovide tax credits, the size of which willbe based on your need. for those americans who can'tget insurance today because they have preexistingmedical conditions, 
we will immediately offerlow-cost coverage that will protect you againstfinancial ruin if you become seriously ill. this was a good idea whensenator john mccain proposed it in the campaign,it's a good idea now, and we should all embrace it. but an additional step we cantake to keep insurance companies honest is by making anot-for-profit public option available in theinsurance exchange. 
let me be clear. it would only be an option forthose who don't have insurance. no one would be forced to chooseit and would also keep pressure on private insurers to keeptheir policies affordable and treat their customers better iwill not sign a plan that adds one dime to our deficits --either now or in the future. we've estimated that most ofthis plan can be paid for by finding savings within theexisting health care system, a system that is currentlyfull of waste and abuse. 
the only thing this plan wouldeliminate is the hundreds of billions of dollarsin waste and fraud, as well as unwarrantedsubsidies in medicare that go to insurance companies. and we will also create anindependent commission of doctors and medical expertscharged with identifying more waste in the years ahead. these steps will ensure that you-- america's seniors -- get the benefits you've been promised. 
and we can use some of thesavings to fill the gap in coverage that forces too manyseniors to pay thousands of dollars a year out of their ownpockets for prescription drugs. many in this chamber --particularly on the republican side of the aisle -- have longinsisted that reforming our medical malpractice lawscan help bring down the cost of health care. i know that the bushadministration considered authorizing demonstrationprojects in individual states to 
test these ideas. i think it's a good idea, andi'm directing my secretary of health and human servicesto move forward on this initiative today. the time for bickering is over. the time for games has passed. now is the season for action. now is when we must bring thebest ideas of both parties together, and show the americanpeople that we can still do what 
we were sent here to do. now is the time todeliver on health care. </div>
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health care plans

the president:here are the detailsthat every american needs to know about this plan. first, if you are among thehundreds of millions of americans who alreadyhave health insurance, nothing in this pla…

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health care plans for 2016

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<div align="justify">bob: welcome. iâ€™m bob burton, and iâ€™mhere today with chris owen, marketing manager for the calpers health benefits program forpublic agencies and schools. we want to welcome everyone to the 2016 calpers health plan rateand benefit changes webinar. chris and i are here today to have a conversation about nextyearâ€™s health plan rates and benefit changes. so chris, what can you tell us about the ratesand benefits for next year? chris: well thank you bob. letâ€™s take alook at the overview weâ€™ve got for the 2016 where we look at the overall health premiumchanges which will be a percentage of change for all the hmo, ppo, and association plans.next, weâ€™re going to take a look at individual premium changes which will cover thestate of california as well as our five regional 
rates as well as association plans and ourout of state health plans. next, we are going to talk about 2016 health program changeswhich we will go over the plans that will be expanding their areas and offer differentservices for next year. next, weâ€™re going to take a look at the health program benefitchanges which will cover a new benefit such as the new single payer supplement to medicareplan. then, weâ€™re going to do a recap on the dev project. and lastly, weâ€™ll coversome information and resources for open enrollment. bob: sounds similar to what we went over lastyear. before we dive into this, is there anything employers need to know about this webinarspecifically? like how they can ask questions or access supplemental information? 
chris: yes, based on feedback from last yearwe want to be clear that this is a pre-recorded webinar as it does save time and help to targetthe subjects for next year and it also gives us the time to research all the answers weare going to get from questions that have been submitted on the webinar, from variousprogram areas. that being said, we encourage questions and comments during this webinarusing the submission box on your screen and we also would direct you to some feedbackvia a short survey at the end of this webinar to help us improve future webinars. thereâ€™salso a dialogue box thatâ€™s located on your screen for a download of all supplementalinformation such as this script and slides as well as information about the health planchooser. 
bob: alright, beginning with the first topicof our overview, explain what you mean by â€œoverall health premium changes for 2016â€? chris: well, depending on upon what kind ofagency you are working for will determine the kinds of plans youâ€™re going to takea look at and we are going to briefly go through each plan type and show average increasesfor next year. bob: so you mean all of the hmos, ppos, associationplans, medicare plans etcâ€¦? chris: that is correct. bob: so here we begin with the basic hmoâ€™snow chris at 7.21%. this means that if i am currently in an hmo the average increase forall of the hmos went up 7.21%. 
chris: that is correct. itâ€™s the same kindof idea when we are taking a look at the ppos, the basic association, then the medicare hmosupplement, medicare supplement ppo, as well as the medicare supplement association. bob: just so i understand you chris, for thosehealth benefit officers out there that are with the csu campuses or judges and legislators,youâ€™ll probably pay more attention to the hmo and ppo percentage increases, while correctionalfacilities for example would interested in the basic association changes? chris: thatâ€™s correct. basically becauseyou know your california correctional peace officers have access to the basic associationplan, the ccpoa association plan, while the 
csu, and jlrs would look at hmo and ppo changessince those are the kinds of plans their employees would be more interested in. bob: so what plans your employees are moreconcerned with will depend on what kind of agency they work for. chris: thatâ€™s very accurate. just kind ofkeeping in mind itâ€™s a picture of average premium changes for 2016 and is meant to givea general idea of those changes for next year based on plan type. as it is with every newcontract year some plans went down and others went up and calpers is always striving tokeep overall keep healthcare premiums in check. bob: alright, it seems most members and retireesare likely more interested in what their current 
health plan premium will be for 2016. whatâ€™sthe point of giving average increases? chris: well, the rates when they first comeout are kind of the first rung on the ladder that all members and employers take a lookat. because calpers is one of the largest purchasers of health insurance in the unitedstates, many sees us as an indicator of industry trends and lots of health benefit officerswould like to compare other regional prices to their own. that being said, weâ€™re goingto take a look at individual plan changes by region once we first go over the statepremiums for all state and csu active employees. bob: is there really a reason for the statepremiums as a key to understanding regional premium rates? 
chris: well not exactly, itâ€™s just simplythat the state premiums are first created for all of our state active employees andthen the regional rating is done to reflect the cost of health care for each of thoseareas. bob: so these premiums are for all of thestate of california and csu employees? chris: correct. now when we look at the bayarea, you can see how they differ from the state premiums. here is the sacramento region.health net added smartcare to several counties for northern california so you will note thatthere wonâ€™t be a percentage change for that health plan for next year. bob: do regions ever change? 
chris: not this year. last year, the regionalchange we had was the yolo county being grouped with the sacramento region instead of thebay area region. bob: why does calpers have regional ratingfor public agencies and schools, but not for the state of california? chris: regional rating was created in 2005to reflect the cost of all the five different regions in california. basically, becausesouthern california was disproportionately lower in cost than the more rural northerncalifornia areas. as you can see the los angeles region from that slide you can see itâ€™sstill true today and itâ€™s also the same with the other southern region. 
bob: so regional rating was created to chargepremiums that reflect the cost of care in that geographic area. can members choose theregion they would like to use? chris: members must select a region basedon their residential or work zip code. we have included the eligibility zip code linkon our materials in the download. as you can see the percentage changes for each plan canvary significantly between. again, this difference in pricing between regions reflects the marketcost of services in those areas. bob: just to clarify once again chris, regionalrates only apply to public agency and school members while state employees are not regionallyrated? chris: that is correct. the only exceptionis when we are talking about out of state 
or supplement to medicare plans. bob: from a quick glance at the rates it seemsthat there were pretty significant increases in the premiums. can you give us some insightto why that happened? chris: well, pharmacy costs accounted fornearly 45 percent of overall rate increases for both the hmo and ppo plans in 2016. additionallycalifornia is one of the more expensive states for health care costs. itâ€™s just part ofthe case where every contract year some plans will go up and some plans will go down andcalpers is trying to mitigate the increases as much as we can. bob: now what about our retirees and membersthat may live out of state? what happens for 
those folks? chris: kaiser/out-of-state is available tomembers based on the eligibility zip code which is part of the download and we willalso cover a little bit later here, whereas pers choice and perscare are available nationwideand worldwide. all of these plans are not regionally rated. bob: how does medicare work with regionalpricing? chris: again, medicare is also not regionallyrated. given that most of our audience today is comprised of health benefit officers foractive employees, and contracting agencies and schools, there may not be as many inquiriesabout medicare plans. however we have included 
our understanding medicare publication inthe download in case thereâ€™s inquires on medicare. bob: there are a lot of plans chris, itâ€™sa bit overwhelming. have we covered all of them? chris: well almost. we do have our associationplans and these are offered exclusively to our dues paying members of three associations:the california association of highway patrol, the california correctional peace officersassociation, and the peace officers research association of california. and for more informationon these benefit changes for next year, we encourage our members to contact the associationsdirectly for more information and at this 
point we have covered all of our calpers sponsoredhealth plans. bob: a ton of information, how would i findout if my doctor contracts with a plan? chris: included in the download are all ofthe calpers micro-sites for all of our plans and from there once you go to those micro-sitesyou can find all of the doctors that would be available if you select that plan as wellas the various medical groups that participate. bob: okay chris, that seems pretty straightforward.whatâ€™s going to be new or different for 2016? chris: well, now weâ€™re taking a look atsome of the health program changes and the big change that we have is the unitedhealthcare'smedicare advantage preferred provider organization 
plan will be the prevailing medicare supplementfor anthem blue cross, blue shield of california, health net, and sharp. the kaiser permanente'smedicare advantage and the ppo medicare plans will remain the same for their supplementto medicare. public agency and schools will also be able, if youâ€™re retired and havemedicare, have the option of a dental and vision plan as part of the unitedhealthcaresupplement to medicare bob: so now to get back to our active members,what should our actives be aware of regarding individual plan changes? chris: well the good news is we wonâ€™t haveany drastic changes such as office co-pays or deductibles for 2016. what we do have,letâ€™s just run through a little bit of each 
plan, say for anthem blue cross for example,theyâ€™re going to expand their pers select into san diego county and theyâ€™ll be alsoextending their castlight pilot project which is basically the calpers compare functionwhich allows you to look at different kinds of, maybe hip replacement surgery or so forththrough different medical providers to see what costs would be more cost effective. thereâ€™salso going to be a standardization of acupuncture and chiropractic benefits for medicare witha $15.00 co-pay and 20 combined visits per year. bob: i remember when ann boynton and i dida calpers insight interview on the castlight or calpers compare function. 
chris: oh yes, itâ€™s a great way for membersto do their own cost comparing between different medical groups and itâ€™s hopefully goingto cause the industry to pay a little bit more attention to what the cost would be forvarious procedures. letâ€™s see, letâ€™s move on to blue shield is next. blue shield designchange will be enhancing their prescription benefit to include a 90-day supply option. bob: and what does that mean exactly? chris: well, itâ€™s just that if the 90 daysupply is not available through the blue shieldâ€™s primemail service, the customer can go toa retail pharmacy and get the same amount for the same cost instead. 
bob: okay, sounds very convenient, good toknow. what else will be new for 2016? chris: well as mentioned in the basic premiumchanges earlier, health net will be expanding into alameda, contra costa, fresno, kern,essentially expanding into northern california for 21 counties completely serviced. bob: okay, health net smartcare doesnâ€™thave a percent change since it will be new for 2016? chris: right, thatâ€™s what we kind of mentioneda little earlier because it is brand new and the premiums are just beginning for thosenew areas that theyâ€™re servicing. we donâ€™t actually have a change to report yet. 
bob: more choices for next year is a goodthing, what else can we share with the folks out there for next year? chris: again this is more for retirees thanit is for actives but the kaiser is going to standardize their acupuncture and chiropracticbenefit providing the 20 combined visits with a $15 copay. bob: thatâ€™s good to know for our retireesthat have kaiser; who is the next carrier with changes for next year? chris: now we come to united healthcare, expandingtheir united alliance hmo into kings, marin and san diego. theyâ€™ll also standardizetheir 90-day supply of mail order similar 
where if you canâ€™t get it through the mailservice you can go to a retail location as well as the option for the public agency andschools that have a medicare supplement plan the option of a dental and vision plan. bob: another expansion and easier access for90-day prescriptions, and now the public agencies and schools have dental and vision care thatoption that they enjoy using united healthcare as a supplement to medicare. chris: well thatâ€™s correct and with thepublic agency and school united healthcare medicare enrollees having this option as astraight supplement to medicare or a supplement to medicare that includes dental and visionis something that has been discussed for a 
long time and weâ€™re very happy that we canhave this option for those public agency and school retirees. bob: really is great news. i know questionsabout dental and vision have come up in the past, so it is huge. do current medicare enrolleesneed to be aware of anything else? chris: there will be more information sentout to those that are going to be affected by anything but if someone is enrolled ina combination basic and medicare plan and itâ€™s not kaiser, our ppos, or united healthcarefolks will be notified to decide to select a different plan. and folks that are affectedwill receive correspondence if they fall into a category with directions on what to do. 
bob: any other changes to go over for anyof the other carriers? chris: well, blue shield and anthem blue crossare going to be introducing welvie product to members which is an online tool to helpeducate folks about minimizing unnecessary surgeries. bob: okay, i believe that pretty well wrapsup the health plan changes for next year. our next item is the dependent eligibilityverification or dev project. i know we were into this last year. chris: right, we talked a little bit aboutthe dev project last year and the big news obviously is that the dev project is over.the reason why weâ€™re bringing this up is 
to indicate to those that are listening thathaving proper documentation is still really important to minimize the cost as well asto protect your agency if youâ€™re audited by calpers so to make sure you got those birthcertificates and marriage certificates and so forth all on file. bob: i know dev project was a huge undertakingand all the employers, i bet, are certainly glad itâ€™s over with. now, we are gettingdown to our last bit about open enrollment information. chris: yes, this year, open enrollment willtake place from september 14th through october 9th. open enrollment packets will be mailedout to all enrolled members in two waves. 
the first wave is going to go out august 17thand the second will be mailed on august 24th. also important, these packets go to enrolledactive and retired members so if you know of active employees or if thereâ€™s retireesout there that are eligible but not enrolled, theyâ€™re not going to get a packet and itis up to these individuals to kind of seek out either through the health benefit officersor to contact calpers to ask how to get enrollment information if theyâ€™re interested. again,that number for calpers is 1-888-225-7377. another important point to mention about theopen enrollment circular letter which is scheduled to be sent out at the end of july so employersshould receive open enrollment information at that time and itâ€™s also very importantto make sure that their contact information 
is up to date. bob: okay well, how does the employer keeptheir contact information current? chris: this, through the system access administratorfor the agency, they update contact information in the my|calpers systems under the businesspartner contacts and thatâ€™s essentially how calpers communicates with all of our agencies. bob: so if the contact information is missingor incorrect no communication? chris: thatâ€™s right. that is why itâ€™sso important to update contacts periodically. if folks are listening out there and do notknow how to update the contact information or donâ€™t know who their system access administratoris, again, contact calpers. our contact number 
888-225-7377.bob: well, weâ€™ve covered a lot of information, as you mentioned, there more details providedin the download for this webinar. i know iâ€™ve learned a few things and enjoyed our timetoday. chris: well, thank you bob, itâ€™s alwaysa pleasure to talk with you, and share information with our employers and members. i know i mentionedthe survey at the end of this webinar so i am going to mention it again so please tellus what was useful to you or what you would like to find more useful in future webinars. bob: chris, youâ€™re certainly welcome andthank you everybody out there for your participation. this concludes that 2016 calpers health planrate and changes webinar. we appreciate your 
time and attention. like us on facebook orfollow us on twitter and check out the calpers videos on youtube. have a great day. </div>
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health care plans for 2016

bob: welcome. iâ€™m bob burton, and iâ€™mhere today with chris owen, marketing manager for the calpers health benefits program forpublic agencies and schools. we want to welcome everyone to the 2016 …

health care plans 2016

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<div align="justify">what i'm going to walk through today is a live 2016 application in one of our test environments. and i'm going to point out some of the new features that we've added this year and then i'll also kind of talk about some of the other things that we won't necessarily have time to walk through with everyone but we'll certainly be in training materials that we'll post on martketplace.cms.gov later this -- well i guess it's friday, [laughs] so probably this weekend or next week. and again, of course, if you have questions as i go please feel free to enter them into the chat window and then we'll try to go through the 
questions at the end after i finish walking through everything. i went ahead and pre-setup some accounts so i went ahead and did [unintelligible] to save a little bit of time and i'm going to start with a brand new consumer for 2016 applying for this year. i'm going to start with logging in. and one of the new things that we did add this year is a lot more tailored contents for consumers when they first log in depending on the phase that they're in. one of the other new things that we did is we actually updated the content of the major call to action on the welcome page for both new and 
re-enrolling consumers. this used to say "visit the marketplace for individuals and families" this year we re-labeled it "to start a new application or update an existing application." in some of the consumer testing that we were doing leading up to this open enrollment period we found that re-enrolling consumers were a little bit confused by this before with the prior content. they weren't sure it was actually for them so we actually tested some different pieces of content and this way we're hoping that it calls out to both new people as well as people that are coming back just to update their information to stay covered for 
2016 and it also is evergreen throughout the year if they're coming back to report a life change later in the year. this next page that says "need coverage for 2016" at the top is one of our new guiding pages. it has tailored content on it, depending on your consumer scenario. so a new consumer that logs in for the first time beginning on sunday, when open enrollment launches, will see a page that looks like this. that sets the framework for what are they going need to do. they're going to need to: (1) complete a 2016 application; (2) view their eligibility results; and then (3) choose a plan by december 
15th if they want coverage that begins january 1. and then we'll ask for the consumer's state. this content also changes as we get past different enrollment deadlines, so right now we're letting consumers know that december 15th is the deadline if they want their coverage to start by january 1st. this stage will have a minor content update, one for past december 15th to remind consumers that open enrollment will end on january 31st so that they know up front when they actually need to complete enrollment by. and then i will, at the very end, i'll come back and log in to a couple other accounts i pre-set up. this page is 
tailored for re-enrollees as well that recognizes the fact that they're coming back in and welcomes them and sets a slightly different frame for them about what their experience will be, such as updating their application, viewing their updated eligibility results, and then picking a plan, again, with the same deadline reminder messaging. i'm going to go ahead and start my application. and again, for brand new consumer they would actually go through i.d. proofing first, which i went ahead and set up so that we could save some time as we were walking through this. there aren't any changes to that process this year, so 
for those of you who might have been around for last year's open enrollment or our first launching year, it is the same screens that we walked through previously and i believe that we already have training materials out there on that as well if you have questions. so getting started, when you're a brand new consumer we have a quick couple of questions that we want to know what your situation is. i'm going to use the scenario for a parent with one child so that we can see some mixed eligibility when i get to the end so that we actually have a family that will receive qhp eligibility, appc eligibility, and then 
we'll have one family member that's also met -- eligible for medicaid or chip. and these couple of questions in the beginning help us figure out if the consumer scenario can go through our streamlined application user interface or will go for a classic application user interface. for this new scenario i'm going to use -- assess where we can actually go through the streamlined application so we can point out how that has changed this year. and then if we still have time left i'll do a quick run through of the classic application on a re-enrollee just so that you can kind of see the differences between the two and where we've added 
different help text and some new questions this year. and -- sorry i'm catching up on myself, answering my questions [laughs]. we summarize all of these questions at the end of the application for everybody and i'm just going to quickly go through these so i can get into the actual application. and on the first application screen, this is pretty populated with the information that john carson [spelled phonetically], who is our primary application contact provided when he actually went through identify proofing, so that's why the email address, the phone number, is already 
populated. and for sisters, this question right here underneath household contact information for another person that's helping me complete my application, this is an important checkbox to check because this is where you would actually put in your information if you're working with a consumer. i'm going to uncheck this box since i am working through this myself right now. and a mailing address, again, is already populated from my identity proofing questions. i'm going to go ahead and put in my test case social security number because i didn't do that originally when i i.d. proofed, but for most consumers you would 
have already put that in. and for race/ethnicity, these are completely optional questions. do make sure when you're going through with consumers that who's applying for coverage question is answered either yes or no. that helps us figure out who in the household leader needs coverage. so i'm going to start entering in john's spouse, who's suzanne carson [spelled] phonetically] and her date of birth, her social security number, and then i'll also enter in their child's information, which will be anna carson [spelled phonetically]. and i am asking for coverage for suzanne 
and anna, their youngest child who is 10. and anna's social security number. right after we do basic contact information when you're using the streamlined application in the back end we're verifying some of the information as we go. so then i have kind of a progress bar that anna makes on the application button just to let them know what's happening in the background before they get the next stage of questions. so as we're submitting household contact information, that -- that data that they entered in has been saved. next up is that we actually ask for income information. for the 
scenario i'm running through today, this is a pretty simple scenario that i've loaded up just so that we can make sure we get through everything today. but the one thing i will point out in one second is for folks that don't have a constant stream of income, there's a way to help the consumer estimate what that is. and i'll show you how to do that when i have suzanne's information and under yearly income i'm just verifying that that's in total what john thinks he's going to have for his income for the year. for suzanne, i'm going to enter in her job. and she's going to make about the same so that i can have a scenario 
that comes out with mixed household eligibility. just for purposes of running through. and if she makes about the same amount of money per year we should have a household that makes about $32,000. however, if you have consumers that don't necessarily earn a steady income, you would want to make sure you add each source of income that they do know about and the amounts for each one and how often they receive it, depending on the type. for those that don't have steady income, when you get to this yearly income for each person this hover will let you know what to do. it 
actually says "click no if your income for the year won't be the addition of everything that you've entered above." when you click "no," underneath that based on what you know today, you think suzanne's going to make about the $16,000, if you click on "i don't know, help me estimate my yearly income" this brings up a calendar view for those consumers that don't have steady month-to-months and i'll just type in numbers here so you can see it just starts to add up, so consumers that need help estimating it for unsteady income this is a quick and easy way that you can help them do that on-screen. but for this scenario i have 
suzanne as having $16,000 for the year. anna, their daughter, does not have any income so i don't need to add any sources and i'm going to say yes for her total income being zero. the next set of -- oops, sorry i missed one as i was talking. for suzanne, her hours worked. the next set of questions that loads helps up identify consumers that might be eligible for medicaid due to non-income based reasons. so there are three questions in the application that ask about physical disability and mental health. if people have additional assistance with daily living activities or if 
they need help paying for their medical bills for the prior three months. these questions help us flag consumers that may want to seek a determination or review with their state medicaid office to see if they may qualify for reasons other than income. our determinations are based on income at this point in time but we ask those questions so that hopefully we can get the most amount of consumers into the right program that best meets their needs given their situation. if any consumers do have other health coverage, if you say yes here, this is for consumers that have a family member that has medicaid or chip in particular in 
their particular state or any of these other health insurance programs is where they answer. otherwise you would say "no" if they don't have health coverage through any other programs. and under our additional coverage options, we also have this question, if anybody was recently denied eligibility for medicaid or chip. this is a question that would be important to answer here so that we don't send them back through the same door through this application process, and if they do select a person, they'll ask you the date and who. for my scenario i'm not going to say anybody was denied so that we can 
actually have eligibility come out with one person that's eligibility for medicaid. questions about life changes are commonly what we use to help figure out seps for common scenarios that are granted through the application for special enrollment periods. since we're in 2016 open enrollment, i'm not going to answer any of these, but there could be scenarios where somebody has experienced a special enrollment period event. in which case that would still grant a special enrollment period that could last longer than open enrollment, particularly if we get into january. so 
it's important to review this information with your clients as they come in. and for our renewal of coverage question, this just asks whether they're -- that they will allow the marketplace in a future year to tax data which helps with auto enrollment and re-enrollment each year. and whether we can automatically ping to try to see if their income has changed, know what they might be eligible for in the future year. this last question, the tax filer attestation is one the new questions that we've added this year. everybody will see it on all applications for 2016. we want to make sure that we don't miss anybody. it is only 
really relevant for those consumers that had marketplace coverage and received premium tax credits in 2014. if they did, we've wanting to know if they reconciled this premium tax credit on their 2014 tax return yet. if they haven't yet, then we have a lot of messaging we've been doing a lot of pushing before open enrollment and will continue to reach out to those folks during open enrollment to try to make sure that they reconcile their taxes with irs and come back to tell us that they've done that. this question helps us help them to stay covered for january with tax credits if they just filed but maybe the records at irs have 
not caught up with that yet. for most consumers that are brand new, this obviously wouldn't apply to them, so they have nothing to check or answer on this question. "review my application" is going to take us to a summary of all the information the consumer has put in so far. with the ability to edit any one of these sections, it'll take you back to the page where this information was entered and then you can actually correct any type-o's or adjust information as needed before submitting it for an eligibility determination. as we get into the bottom of these household questions 
some of these are the questions that we ask at the very, very front when we were working to figure out are they going to go through the streamlined application user interface, which this scenario is walking through. or if they went through classic application they see a different application review but it does the same thing where it puts together all the questions and the answers that the consumer provided so they can verify the information before submitting it for an eligibility determination. at the very end of the review our attestations again for agreeing and 
confirming if anybody ends up eligible and enrolls in medicaid, it's stating that they know they need to come back and contact the marketplace. there are other rules and regulations that govern how those two programs interact with each other, which is most of what the attestations and the help text here explain. and then at the very end before signing and submitting, we electronically type in our name. so for this scenario it's john carson. and as we submit the application, again, you can see that there's a progress bar on this application that lets the consumer know that it's processing and kind of what's going on 
behind the scenes before they get to their eligibility results. so as we get to the very end of our processing, you should see -- i'm sorry, i'm letting the webinar catch up -- a check mark saying it was submitted. and then we're going to land on our new eligibility results page. this is one of the improvements this year that we've internally been very excited about. this has high level on-screen eligibility results displayed for consumers. so for those of you who've been working in the field with us for a while, you're probably well aware our previous 
eligibility results screen just had a link to download their eligibility determination notice and then a button to continue to enrollment if they were eligible. what we've been able to add this year is an onscreen summary of their program level eligibility so we can see anna carson here is eligible for medicaid and then john and suzanne, since they share eligibility are grouped together in a box and we can see that the two of them are eligible to purchase a qhp, they both have $653 a month in premium tax credits that they can apply to their premiums. we can also see that these consumers are eligible for cautionary reductions on 
silver plans. so this is one thing that's really important to help highlight for those consumers that are going to be eligible for those cautionary reductions when they get into enrollment that this cautionary reductions apply to silver plan choices and not necessarily other metal levels. the other big new feature here is this red text for temporary eligibility. this is our onscreen flag to let the consumers know that there is an inconsistency or a data matching issue and that they have roughly three months to resolve it, in -- in the eligibility determination notice they 
have the exact number of days, for the onscreen summary we just summarized it to about three months. but we wanted to make sure that this was called out to consumers and was more visible on the screen, and to help them understand that they needed to do something else in order to stay covered. the next piece of information under step 2, "review your eligibility results," this part of the screen will have some dynamic content, depending on what the consumers are eligible for. so in this scenario we have consumers that are eligible for medicaid or chip but we also 
have qhp and appc eligible individuals. some consumers, if they're eligible for a special enrollment period, there will actually be text here onscreen that says "you're eligible for special enrollment period" and to read your notice for more details about what the timeline is to enroll during that window. if it's either during open enrollment or if the sep runs longer than open enrollment or for outside of open enrollment, it's just a highlight for consumers to let them know that, hey you do have a special enrollment period, make sure your read your notice to understand your next steps for that. 
the next thing we added was a split between viewing eligibility results and the third step for -- to continue to enrollment. for consumers that aren't eligible for qhp coverage, if the whole family was medicaid and chip eligible, they would not see a step 3 here because this "continue to enrollment" heads into our plan selection part of our process for choosing a plan and enrolling. so it is now dynamic so that they don't see the button or be confused by it if they have other eligibility and don't have qhp coverage. we've also disabled this button until consumers have downloaded and viewed their eligibility notice -- and 
bear with our quick technology check while i download the file, i know it probably looks white for a second. the pdf notices for eligibility determinations, the examples are posted out on marketplace.cms.gov, but they have a couple of improvements this year, one of which is some improved headings and we moved a lot of the static content that used to be higher up in the notice to the end so that consumers are seeing their next steps and really the dynamic portions that are relevant to them closer to the top of the notice. and then for those consumers that have questions or want to read further 
details, some of the other static information has been moved toward the end of that notice. the other key improvement, which we actually launched much earlier this year back in the springtime in the eligibility determination notice is that the notice does include the income amount that the consumer told us that their eligibility determination is based on, so that's just a good key reference to remember as you're walking consumer through applying and enrolling in coverage for 2016. now that i've downloaded by eligibility results, we actually have the ability to continue to enrollment. at this point i'm 
going to pause and jump into another scenario before i head into there so that i can make sure it covers some of the newer pieces and then i have a couple of screen shots at the end that just call out the few changes we made in the enrollment funnel. but for the most part that's pretty much been the same. the pause in eligibility results. we do have a couple of targeted content things that i wanted to show folks so as you guys are in the field you're not surprised when these things comes in. when we have consumers that start their application but don't finish, the next time 
they log back in they actually will see targeted content recognizing that they started their application but they didn't submit it for results. and that will help remind them of what steps they have left to do before they actually are completely done for enrollment. so this is an account i has started already where i had an application where i had started updating it but i hadn't actually submitted it so i hadn't gotten to eligibility results yet. and, again, we have tailored content for new and for re-enrollees. the messaging there is pretty much the same, which is, you have to finish and submit your application. that's 
your first next step. after that reaffirming you need to view your eligibility results and then choose a plan. so this is a dynamic page and it recognizes where they last left off in the process and we'll jump them back into it. and really quick, i'll show you a version where they had submitted their application but they had not enrolled yet. and another account that i had set up just ahead of time. and again, for re-enrollee's the messaging slightly tailored but the core concepts are exactly the same. so, on this page, where the last step is, they've already submitted their application. they've viewed 
their eligibility results. the last thing they need to do is choose a plan. our steps come down to just one thing, choose a plan. so that hopefully we can remind consumers that they're not done yet and they have one more step to go before they're ready. and with that, i'm going to switch over to a quick re-enrollee scenario. i'm going to go through this part of the application pretty quickly, so that we can still leave some time for questions at the end. for re-enrolling consumers, they -- some consumers will be able to use the streamline application. some consumers will be using the classic application interface. for this 
scenario i'm going to use classic app just so that we can see both sides so that you guys can see some of the differences that show up in both application flows. so for this re-enrollee, when i first logged in, it's recognizing the fact that, hey we already know you're enrolled from 2015, so welcome back. what you need to do now is review and update your 2016 application. submit it, and then you'll see updated eligibility results and then even if you want to stay in the same plan, you still need to choose a plan and enroll by december 15th so that there's not a gap in 
coverage. and this also helps us reinforce that updating your application isn't the only step, we want to make sure that this application updates you made get carried over into your enrollment with your plan. so the very last step for re-enrollees is still to actively choose a plan and enroll. even if they want to choose the same plan if it's still available to them. and the button text here changed for re-enrollees from new consumers. this page for new consumers asks them for their state because we didn't know what it was. and the button is called "action let's start my application" for re-enrollee's we're 
pre-populating all of their information from their 2015 application, so it's more of a review and update process so we'll see the information already in there and then we can just update and edit the information that may have changed year over year. particularly income, if that might be something that they expect to change for 2016. and for "review and update your application" we can see there's a quick pre-pop summary, pre-population summary of the persons that are on this application. and i'm going to say "update a person's information or add a new person." i want to skip over to our re-enrollment scenario in 
classic. so i'm going to go through this very, very fast and we'll catch questions at the end if i need to. so, kind of ignore the questions that i'm answering here because i'm just kind of getting myself out of this flow for demonstration purposes. so we are popping now into a classic application that's been pre-populated from 2015 into 2016. but, again, the consumer's address is already here. if they've moved in the same state, then here they could actually report a change in their address for 2016 coverage. consumers that have moved to a new state in the new year, back on that initial guiding blue page at the 
bottom there was a call out to say if you've moved a new state you'll need to start a new application. each application for each state is using eligibility logic rules for that particular state, which is dynamic from state to state. so when consumers move from one state to a new state, they'll actually need to fill out a new application and tell us about that up front rather than trying to change their address in the middle of an application for a different state. as we do address verification -- and again, so in classic application for sisters, you guys are probably well familiar with it, but depending 
on your entity type, this is where you'd actually enter in your information when you're helping with an application. and i'm going to flip through a couple of these screens really, really fast just confirming that john carson and his family members. we already have his wife and his daughter on here with their information entered when we get into family and household. again, these answers are already populated. the social security number, if it was already in there and it was clear and it didn't have any issues is hashed out, except for the last four digits. just a reminder, if folks do have an open data matching issue. 
particularly on social security number or integration document information, it's important to help those consumers re-enter it and make sure it's accurate this year. one of the new pieces of functionality i will show you that we added earlier this year is i'm going to delete john carson's ssn -- not that you should normally do that, but just to actually demonstrate one of these reminder pop-ups that we added earlier this year. this is relevant for both social security numbers and consumers that have reported eligible integration status. if they haven't entered in all of the information or they try to skip the 
question without entering in their social security number, we do have a reminder pop-up to ask if we're sure they want to do that. not providing a social security number if they have one will generate a data matching issue down the road. i will actually skip it for this one so that we can put in a data matching issue, but i just wanted to make sure that you guys could see one of those reminder pop-ups with a consumer tries to continue without that. one of the other new things on the application in the classic realm that i wanted to make sure we flag, this is kind of asked a little bit 
differently on the streamlined application but when you're in the classic one, in previous years we know that some consumers would get confused with this question, "does john carson plan to file federal income tax return in 2016 for the next year." for those consumers who don't normally file taxes, sometimes they get confused by this and not realize the impact of saying, "well no i don't normally file taxes so i wouldn't plan to file next year." and not realize that by saying that, that actually makes them ineligible for advanced payments of the premium tax credit. so we added help text on the question to basically help 
consumers understand that they don't have to file taxes to apply, but they would need to file if they want to be able to get aptc to help pay for coverage now. and if the consumer selects "no" on this question, this actually pops up additional help information to understand why we're asking this and the implications of that before they get all the to the point of having an eligibility determination that doesn't have qualifications for premium tax credits. so for this scenario i'm going to say yes because we do want the consumer to end up with an aptc determination. but that's just one of the -- the key places we added 
some help content to this year that we wanted to make sure folks were aware of. this we do know some consumers have been confused by that question in the past. and as we get into the rest of the family's household information, this is going to look familiar with suzanne and anna. i'm just going to breeze through these screens really fast. since everything's pre-populated already and at this point i don't need to edit any of this information for this year for our scenario. so we have anna's information very quickly. and then at the tail end of our household 
section we will have a quick review summary before we do income. and, again, this is just confirming their relationships again to see if any information has changed for this year from last year. and again, these first two questions when we're about this household, these are the same questions that might be able to help us flag for consumers that could be eligible for medicaid for reasons other than income. they are pre-populated from the 2015 application answers. this last question is the question about whether a consumer may have been denied medicaid or chip recently. this is not pre-populated since we're asking about the 
last 90 days. so we want to make sure that the answer here is fresh. but i'm going to say none of these people for the scenario we're walking through right now. at the tail end we've got our summary page of all the stuff that we answered in family and household before we go into income. and in our 2015 application we had put in 26 -- or $16,000 so for 2016 it's pre-populating the income that the consumer told us about last year. if a consumer has a different income source, they can add a new one. if they just want to adjust the amount that they expect to earn for 2016 
they can select edit and then just update the amount. they can change how frequently they get that amount if they want to or they can add a new source if needed. and they can also remove it if they no longer work at that job or have that source of income they can physically click "remove." so it's more of an edit and update process when you're a re-enrollee coming back in for 2016. and the same thing we'll see for both suzanne and john once we get there -- sorry, suzanne and anna. and just confirming our last pieces, so same thing with suzanne's information i'm going to keep her income the same for this year as last 
year and say she doesn't have any new deductions and that it's steady throughout the year. anna didn't have any income and she still doesn't have any income this year. so then we get to our final income summary which just includes all the information that the household has put in for each person and what they earn on a yearly and monthly basis. and lastly in the additional information section, this is where we ask about other coverage if they have other enrollment and other healthcare programs. you can check the box for any one of these for each person we'll ask this. and if any consumer happens to have cobra or job 
coverage, there's additional help text here and if they say yes and whether it's to walk through to how to fill out this information if somebody falls into that scenario. in the interest of time i'm just going to breeze through this so that we can get to the end of the re-enrollee scenario so that we can see the updated eligibility results. and now my last coverage, these are our special enrollment period questions again that help us determine if they might be eligible for a special enrollment period based on a recent change such as losing coverage, about to lose coverage, having moved. if somebody recently 
gained eligible immigration status and if anybody was recently released from incarceration. at the very end this is the same failed to reconcile ftr attestation questions, which if a consumer had 2014 tax credits and they reconciled them on their federal tax return already, they would simply check this box. since this is a re-enrollee scenario i'm going to go ahead and check it and assume that this household actually had 2014 tax credits. and in our review and sign our classic application again we've got the full list of all of the information that the consumer entered as they were going through so that they can 
actually see it. make sure everything is accurate before they submit it for an eligibility determination. lastly we have our attestations these are the same this year as last year and our electronic signature where john is going to type in his name to indicate that he is signing this application. and for re-enrollment the eligibility results page is similar. some of the content is a tiny bit different for re-enrollees but not significantly so. all of the eligibility pieces of information are the same so again we have, since i skipped putting in john carson's social security number 
that generated a data matching issue on this application. so we have that flag here that they're going to need to provide more information. we have anna and medicaid, we have the summary for the premium tax credits for their household and the eligibility for cost sharing reductions if they enroll in a silver plan. and again their eligibility results notice would be available for download and until they download it they won't be able to continue to enrollment. so at this point i'm going to pause and pull up just a couple of screens in our plans and pair flow that we can highlight just a couple of the new pieces this 
year because we don't quite have time to walk through every piece of re-enrollment. let me switch applications. somewhat of a highlight this year is the updated enrolled to-do list. we have changed the wording on these tasks and the buttons and we also changed the button design here. previously for those of you -- might remember that this had some slightly confusing terminology that used to say "set" on the button and locked on the greet out tasks, which didn't quite resonate with [laughs] the resonate -- with consumers as to what that actually meant and what they'd be doing. so we updated each one to 
be clear about what you're going to do for that activity. so if the consumer has eligibility for tax credits in the enrolled to-do list we actually have that first task say "set tax credit." we updated the button design to look like a button to show up in the white bar rather than a whole green block at the end, which some consumers were confused by. they weren't quite sure where to click. and even for the tasks that aren't unlocked yet, that they haven't completed the prior one in order to get to the next one like answer questions here, it still has in the grayed out text what that step will be so they can actually see what 
will be coming up next. so this is an example of an un-started enrolled to-do list for a partly completed one. as you're moving through we've also updated the buttons for the edit and change features for each task so that consumers could actually go back. they can still change those but now they actually know what they're editing. and for choosing a health plan, again, we updated the language here so that it didn't just say "set" it actually said "choose a health plan." the last new piece of information in our plan compare enrollment fees for this year is re-enrolling messaging if 
their same or similar plan is available to them. so the rest of plan compare, the flow is pretty much the same. there isn't anything else new or special about it this year. the updated to-do list is certainly one of those improvements that we've been looking forward to for a long time. the other thing is for re-enrollees, last year if they wanted to enroll or compare their same plan they needed to have their issuer letter that they received before open enrollment in front of them and that included a 14-digit plan i.d. on it. and the consumer would have had to manually type that number into a search by plan i.d. box on the 
left side of the plan compare screen. this year for re-enrollees we have a pop-up message right before they see plan results that lets them know whether their plan is available or not. so this is an example of the one where if their plan is available we're letting them know it's up in a section called "saved plans" which is at the top of the screen. as soon as they hit continue they load as the plan results and then they can go up to the top, hit "saved plans" and check the compare box on that same plan so that -- if it's available. some consumers' plans may not be available to them. that 
could be due to the plan not offering the same or similar coverage this year, so there's no plan crosswalk. it's also possible that you may have some consumers where they're no longer eligible to enroll in the plan that they were enrolled in previously based on the enrollment groups that they've set up for this year or the information that's now in their application. in that case they'll actually see a message that says unfortunately your same plan or similar plan isn't available this year, so please take a look, compare, and shop around for coverage that you want for 2016. 
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health care plans 2016

what i'm going to walk through today is a live 2016 application in one of our test environments. and i'm going to point out some of the new features that we've added this year and then i'll also kind…

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Jumlah	Disscount	Harga
1 Botol	-	240.000
4 Botol	40.000	920.000
6 Botol	160.000	1.280.000

Jumlah	Disscount	Harga
1 Box	-	730.000
2 Box	100.000	1.360.000
4 Box	200.000	2.720.000

Jumlah	Disscount	Harga
2 Botol	50.000	310.000
4 Botol	120.000	600.000
6 Botol	240.000	840.000