Newly released Senate legislation would provide a longer timeline than the House bill for phasing out the Affordable Care Act's Medicaid expansion; would not penalize consumers for having a break in coverage; and would link premium support to income, age and geography, rather than just age and tie that assistance to "bronze" plans. Similarities between the bills include the approach to premiums for older adults, pathways for states to seek waivers from essential health benefits and repeal of coverage mandates.
The Senate's Better Care Reconciliation Act includes some provisions sought by health plans, which could be enough to prevent some companies from leaving public exchanges next year, but some are worried that steep cuts to Medicaid funding could force them to reduce services for the 75 million Americans covered under the program and cut reimbursement rates. The bill would continue cost-sharing reduction payments to insurers through 2019 and cut an annual fee paid by insurers, but it also would eliminate the individual mandate, which requires all Americans to buy health insurance or pay a financial penalty.
Sens. Rand Paul, R-Ky., Mike Lee, R-Utah, Ted Cruz, R-Texas, and Ron Johnson, R-Wis., said in a joint statement that they do not support the current version of the Senate health care bill, arguing that it does not do enough to unravel the structure of the Affordable Care Act, but they expressed willingness to negotiate. Republican leaders can only afford two defections from their party to pass the bill.
A rural hospital's employee wellness initiative, aimed at night-shift workers, helped prevent holiday weight gain in 88% of the 27 participants, 24 of whom lost weight, according to a study presented at the American Association of Nurse Practitioners' annual meeting. The program included educational emails on obesity and weight gain, and focused on five interventions covering financial literacy, stress management, disease awareness, nutrition and physical activity.
The web development company Basecamp is offering employees a host of benefits and perks, including 16 weeks' paid parental leave, four-day summer work weeks, a $5,000 yearly stipend for vacations, as well as home massages and extra money to help buy fresh produce. CEO Jason Fried credits the company's self-funding model with the freedom to implement new benefits whenever it wants, which has resulted in a very low turnover rate.
A study in The Lancet suggested a self-help exercise program guided by a physiotherapist who provided phone or online video support may help patients with chronic fatigue syndrome manage symptoms and slowly increase physical activity. Researcher Lucy Clark said the 12-week graded exercise program, designed to provide careful progress so people are not pushed too hard and suffer a setback, was safe and helped reduce fatigue for some people.
Survey data showed 45% of women ages 25 to 60 did not know that heart disease is the main cause of death among US women, researchers reported in the Journal of the American College of Cardiology. Most women said they had a health checkup in the past year but only 40% said it included a heart health assessment, and a companion survey of 200 physicians found only 22% of primary care practitioners felt prepared to assess heart disease in women.
Researchers who analyzed data from 71 studies found 78% of indoor workers were vitamin D deficient, compared with 48% of outdoor workers. The study in BMC Public Health found 80% of shift workers were deficient, and that vitamin D deficiency varied by occupation.
As drugmakers push prices higher, some are attacking employers and payers that offer prescription drug coverage, writes John Jones, professor of pharmacy law and ethics. "When it comes to how high drug companies price their products, they want the public to ignore what they spend on marketing and the tax breaks they get for direct-to-consumer advertising," Jones writes.
A draft executive order instructs agencies to review policies that could raise the cost of pharmaceutical research and development and to recommend policy changes in fiscal 2019 budget proposals. The draft instructs trade negotiators to seek deals that increase the prices other countries pay for American prescription drugs.
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