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HEALTH OVERHAUL BENEFITS TAKE EFFECT WITH NEW YEAR

Thursday, 02 January 2014 07:20 Published in National News

SACRAMENTO, Calif. (AP) — After a troubled rollout, President Barack Obama's health care overhaul now faces its most personal test: How will it work as people seek care under its new mandates?

Most major pieces of the Affordable Care Act take full effect with the new year. That means people who had been denied coverage because of a pre-existing medical condition can book appointments and get prescriptions.

Caps on yearly out-of-pocket medical expenses will mean people shouldn't have to worry about bankruptcy after treatment for a catastrophic illness or injury. And all new insurance policies must offer a minimum level of essential benefits, ranging from emergency room treatment to maternity care.

The law's benefits apply to individual policies as well as those offered through employers.

But one benefit didn't take effect as expected after Supreme Court Justice Sonia Sotomayor late Tuesday night temporarily blocked the part of the law requiring some religious-affiliated organizations to provide their workers with insurance that includes birth control. Government officials have until Friday to respond to her emergency stay.

Administration officials said this week that 2.1 million consumers have enrolled through the federal and state-run health insurance exchanges that are a central feature of the Affordable Care Act. Millions more have been enrolled in Medicaid, after the federal law allowed states to expand the health insurance program for the poor.

Yet how many of those who signed up for coverage on the exchanges will follow through and pay their premiums will not be known for a couple of weeks. People who signed up on the federal website have until Jan. 10 to pay premiums for coverage retroactive to Jan. 1, while consumers in some states have until Jan. 6.

Those who enrolled during the exchanges' first three months, persisting through serious technological problems and jammed call center phone lines, are probably motivated to make sure they have a policy in place as soon as possible, said Anthony Wright, executive director of Health Access California, which advocates for lower-income people and supports the federal health care changes.

"These are people who made a point of signing up and signing up before the deadline so they could start on Jan. 1. That suggests to me that that will be a population that is more likely to follow through with the payment," he said.

Premiums paid after the deadline will be applied to coverage starting Feb. 1 or later. Consumers have until March 31 to sign up in time to avoid a federal tax penalty for remaining uninsured. That fine starts at $95 for an individual this year but climbs rapidly, to a minimum of $695 by 2016. There is an additional fine for parents who do not get health insurance for their children.

Although the federal website is apparently fixed for consumers, the start of the year still could bring plenty of confusion.

Insurers say they are receiving thousands of erroneous sign-up applications from the government, and some people who thought they had enrolled for coverage have not received confirmation. Undoubtedly, some will find out they don't have the immediate coverage they thought they did.

Some states, including Minnesota and Rhode Island, extended their sign-up period until the final day of 2013, leading to a last-minute crush of paperwork for insurers. Call center wait times in Minnesota extended beyond two hours on Tuesday, a possible sign of heavy consumer interest.

Anticipating disruptions, major drug store chains such as CVS and Walgreens have announced they will help customers who face coverage questions, even providing temporary supplies of medications without insisting on up-front payment. Many smaller independent pharmacies also are ready to help.

Some parts of the Affordable Care Act took effect previously, such as the ability of young people to remain on their parents' insurance policies until age 26.

Others have been delayed until 2015, including the law's requirement that companies with 50 or more workers must provide affordable coverage or pay fines. The administration says it's trying to iron out burdensome reporting requirements.

POLL: AMERICANS HAVE LITTLE FAITH IN GOVERNMENT

Thursday, 02 January 2014 07:19 Published in National News

WASHINGTON (AP) — Americans enter 2014 with a profoundly negative view of their government, expressing little hope that elected officials can or will solve the nation's biggest problems, a new poll finds.

Half say America's system of democracy needs either "a lot of changes" or a complete overhaul, according to the poll conducted by the AP-NORC Center for Public Affairs Research. Just 1 in 20 says it works well and needs no changes.

Americans, who have a reputation for optimism, have a sharply pessimistic take on their government after years of disappointment in Washington.

The percentage of Americans saying the nation is heading in the right direction hasn't topped 50 in about a decade. In the new poll, 70 percent lack confidence in the government's ability "to make progress on the important problems and issues facing the country in 2014."

The poll comes about two months after partisan gridlock prompted the first government shutdown in 17 years.

People feel somewhat better about their personal lives. Most have at least some confidence that they'll be able to handle their own problems in the coming year. A narrow majority say they'd do a better job running the country than today's leaders in Washington.

Local and state governments inspire more faith than the federal government, according to the poll, with 45 percent at least moderately confident in their state government and 54 percent expressing that much confidence in their local government.

When asked to name up to 10 world or national problems they would "like the government to be working on" in 2014, Americans chiefly cite issues that have dominated — and often flummoxed — the White House and Congress for five years. Health care reform topped the list. It is likely, however, that those naming the issue include both opponents and supporters of President Barack Obama's sweeping health care overhaul.

Jobs and the economy were next, followed by the nation's debt and deficit spending.

Some issues that draw ample media and campaign attention rank lower in the public's priorities. No more than 3 percent of Americans listed gay rights, abortion or domestic spying as prime topics for government action.

Regardless of the issue, however, Americans express remarkably little confidence that the federal government can make real progress.

For instance, 86 percent of those who called health care reform a top priority said they want the government to put "a lot" or "a great deal" of effort into it. But about half of them (49 percent) are "not at all confident" there will be real progress, and 20 percent are only "slightly confident."

This yawning gap between public desires and expectations is one of the poll's most striking findings. Even on an issue completely within the federal government's control, the budget and national debt, 65 percent of those who called it a priority say they have no confidence in the government's ability to fix it. Another 20 percent are only "slightly confident."

When it comes to the issues people cited as most important to them, 80 percent want the government to spend significant effort working on them. Yet 76 percent say they have little or no confidence the government will make real progress.

But asked generally about the role of government in society, the AP-NORC Center poll finds Americans divided on how active they want government to be. Half say "the less government the better." However, almost as many (48 percent) say "there are more things that government should be doing."

On the economy, an area historically driven by the private sector, the poll finds a clear public desire for active government. Fifty-seven percent of Americans say "we need a strong government to handle today's complex economic problems."

Even among those who say "the less government the better," 31 percent feel the nation needs a strong government to handle those complex problems.

Americans don't feel terribly optimistic about their own economic opportunities. Although 49 percent say their standard of living surpasses their parents', most are broadly pessimistic about the opportunity to achieve the American Dream. And they are mixed on whether people like them have a good chance to improve their standard of living.

Few are hopeful that the pieces are in place for the government to improve. About half are pessimistic about the country's ability to produce strong leaders generally. And 61 percent are pessimistic about the system of government overall and the way leaders are chosen.

Kathy Wooters of Houston's Kingwood community is among those who think the federal government should just get out of the way.

"We have too big of a government. I'd like it to be less in control of our lives," said Wooters, 57, a mother of four and grandmother of nine. "We are adults," she said. "We can make wise decisions with our money," rather than have the federal government dictate insurance choices and dole out more assistance to those who "want everything for free."

Wooters, a Republican and tea party supporter, said she taught her children to fend for themselves and avoid debt.

The AP-NORC Center poll was conducted online Dec. 12-16 among a random national sample of 1,141 adults. The survey has a margin of sampling error of plus or minus 3.7 percentage points for all respondents.

The survey was conducted by GfK using KnowledgePanel, a probability-based Internet panel designed to be representative of the U.S. population. Respondents to the survey were first selected randomly, using phone or mail survey methods, and were later interviewed online. People selected for KnowledgePanel who didn't otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.

___

AP News Survey Specialist Dennis Junius contributed to this report.

___

Online:

AP-NORC Center for Public Affairs Research: http://www.apnorc.org

JUSTICE DELAYS HEALTH LAW'S BIRTH CONTROL MANDATE

Thursday, 02 January 2014 07:17 Published in National News

WASHINGTON (AP) -- The Supreme Court has thrown a hitch into President Barack Obama's new health care law by blocking a requirement that some religion-affiliated organizations provide health insurance that includes birth control.

Justice Sonia Sotomayor late Tuesday night decided to block implementation of the contraceptive coverage requirement, only hours before the law's insurance coverage went into effect on New Year's Day.

Her decision, which came after federal court filings by Catholic-affiliated groups from around the nation in hopes of delaying the requirements, throws a part of the president's signature law into temporary disarray. At least one federal appeals court agreed with Sotomayor, issuing its own stay against part of the Affordable Care Act, also known as Obamacare.

The White House on Wednesday issued a statement saying that the administration is confident that its rules "strike the balance of providing women with free contraceptive coverage while preventing non-profit religious organizations with religious objections to contraceptive coverage from having to contract, arrange, pay, or refer for such coverage."

Sotomayor acted on a request from an organization of Catholic nuns in Denver, the Little Sisters of the Poor Home for the Aged. Its request for an emergency stay had been denied earlier in the day by a federal appeals court.

The government is "temporarily enjoined from enforcing against applicants the contraceptive coverage requirements imposed by the Patient Protection and Affordable Care Act," Sotomayor said in the order.

Sotomayor, who was in New York Tuesday night to lead the final 60-second countdown and push the ceremonial button to signal the descent of the Times Square New Year's Eve ball, gave government officials until 10 a.m. EST Friday to respond to her order. A decision on whether to make the temporary injunction permanent or dissolve it likely won't be made before then.

"The government has lots of ways to deliver contraceptives to people," said Mark Rienzi, a lawyer for the nuns. "It doesn't need to force nuns to participate."

Under the health care law, most health insurance plans have to cover all FDA-approved contraceptives as preventive care for women. That means the coverage is provided free of charge.

Churches and other houses of worship are exempt from the birth control requirement, but affiliated institutions that serve the general public are not. That includes charitable organizations, universities and hospitals.

The requirement prompted an outcry from religious groups, which led the administration to try to craft a compromise. Under that compromise, insurers or health plan administrators must provide birth control coverage, and the religious institution itself is not responsible.

But the administration's compromise did not satisfy some critics, who called it a fig leaf.

The nuns would have to sign a form authorizing their insurance company to provide contraceptive coverage, which would still violate their beliefs, Rienzi said.

"Without an emergency injunction, Mother Provincial Loraine Marie Maguire has to decide between two courses of action: (a) sign and submit a self-certification form, thereby violating her religious beliefs; or (b) refuse to sign the form and pay ruinous fines," Rienzi said.

The Little Sisters operate homes for the elderly poor in the United States and around the world. They were joined in their lawsuit by religious health benefit providers, Christian Brothers Services and Christian Brothers Employee Benefits Trust.

Sotomayor's decision to delay the contraceptive portion of the law was joined by the U.S. Court of Appeals for the District of Columbia Circuit, which also issued an emergency stay for Catholic-affiliated groups challenging the contraceptive provision, including the Archdiocese of Washington, D.C., and Catholic University.

But one judge on the three-judge panel that made the decision, Judge David S. Tatel, said he would have denied their motion.

"Because I believe that appellants are unlikely to prevail on their claim that the challenged provision imposes a `substantial burden' under the Religious Freedom Restoration Act, I would deny their application for an injunction pending appeal," Tatel said.

The archdiocese praised the appeals court's action in a statement.

"This action by the U.S. Court of Appeals for the D.C. Circuit is in line with the rulings of courts all across the country which have held that the HHS mandate imposes a substantial and impermissible burden on the free exercise of religion," the archdiocese said. "These decisions also vindicate the pledge of the U.S. Catholic bishops to stand united in resolute defense of the first and most sacred freedom - religious liberty."

The Supreme Court already has decided to rule on whether businesses may use religious objections to escape a requirement to cover birth control for employees. That case, which involves Hobby Lobby Inc., an Oklahoma City-based arts and crafts chain with 13,000 full-time employees, is expected to be argued in March and decided by summer.

---

Follow Jesse J. Holland on Twitter at HTTP://WWW.TWITTER.COM/JESSEJHOLLAND .

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

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