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WASHINGTON (AP) -- Whether you love it or hate it or are just plain confused by it, you've got to give the health care law this much: There's plenty of drama.
The nail biting goes on. As the clock ticks toward the Jan. 1 start of insurance coverage under President Barack Obama's big, bold and bedraggled creation, there are inklings it might get a second wind.
But that could turn out to be just hot air.
Time will tell, soon, as policies take effect in new health insurance markets that have been enrolling customers - or trying - for nearly three months.
A look at the law's broad strokes, its brush with disaster and the roots of a possible rebound:
No more denying people coverage when they've been sick. No more stratospheric premiums for the previously or currently ill, either. No more cutting off insurance payments because someone has used up a year's worth of benefits. For all the headaches signing up, questionnaires are also notable for questions they do not ask: Have you been treated for cancer? What is your medical history? It won't matter anymore.
Few in the polarized debate over the health care overhaul defend the history of an insurance system that can drive people into poverty when they get sick or steer them away from treatment they need. The critics quarrel with the means more than these particular ends. And families like the fact that adult children can stay on their parents' plans until they are 26, an early consequence of the law and one of its few visible effects until now.
More than 4 million people lost coverage because their policies fell short of new federal standards. Far fewer gained insurance in the new markets in that time. This happened despite Obama's repeated and now discredited pledge that people happy with their insurance could simply keep it. He partnered that assurance with a promise that people happy with their doctors could keep them, too. Not so, in many cases. Another rude awakening.
After a wave of cancellations, the government revised its rules on substandard policies to let insurance companies offer them for one more year. It's not clear how many plans will be retrieved from the dustbin as a result. Some will be allowed to buy bare-bones catastrophic plans. And people who lost their insurance can shop for new plans that in many cases will offer better terms. But better coverage will often come at a higher cost.
Ugly goes to HealthCare.gov, the federal government's buggy online insurance portal, impenetrable for weeks for many if not most who tried to see what plans they could choose from and perhaps sign up for one. It's on the mend. But until coverage begins for those who took that route, its prognosis remains uncertain.
Washington can put a positive spin on almost anything, and federal officials did just that at the very start. Yes, HealthCare.gov is buckling under the user load. That's because folks love it!
The smiley face soon melted into a swamp of recriminations. Led by Republicans, of course, who feigned indignation that the law many of them despise wasn't working out so well. A more authentic response came from Democrats: the heebie-jeebies. They'd gone to bat for the law in the mighty struggle to pass it in 2010 and faced down all efforts that followed from the GOP to repeal it. With elections coming next year, Democrats are not happy.
"The president needs to man up, find out who was responsible and fire them," Rep. Rick Nolan of Minnesota steamed.
"No one is held to account," agreed Democratic Sen. Bill Nelson of Florida.
On opening day, Oct. 1, some 3 million people had tried to access the site. Merely six people signed up for coverage, according to a congressional committee's documents. The online Spanish-language portal wasn't ready as promised. But really, for weeks, the English one wasn't, either.
"No excuse for it," Obama said, repeatedly vowing to fix it.
No one has been fired. When GOP Rep. Marsha Blackburn of Tennessee asked who's to blame for the "debacle," Health and Human Services Secretary Kathleen Sebelius replied, "Hold me responsible for the debacle."
So everyone, rather unusually, was on the same page in sizing up the launch, or at least they were on the same word. It was a debacle.
Seat-of-the-pants patches, pivots and delays began before the debut of the woebegone 1.0 website and spread well beyond it.
In July, the government postponed one of the law's central features for a year - the mandate that all businesses employing 50 or more people provide health coverage or risk a penalty.
In late November, it announced a one-year delay in the online marketplace for small businesses to find coverage for their employees. They could still get insurance from the exchanges through traditional avenues like brokers, but direct access had to wait as the government gave priority to making the portal work for individuals.
Meantime, insurance companies were sending out cancellation notices for more than 4 million individual policies that didn't meet new federal requirements, prompting an about-face by the government. Federal officials decided these substandard policies could exist for one more year. It remains to be seen how many canceled policies will be revived as a result.
Then there was the paper-phone-Web conundrum.
With the online system ailing, Obama urged people to apply by mail and phone and used the megaphone of the presidency to give out the toll-free number, 800-318-2596.
But snail mail, if helping in a pinch, wasn't proving to be an efficient substitute for the streamlined process envisioned by the law. Kelly Fristoe, an insurance agent in Wichita Falls, Texas, told AP he'd submitted 25 paper applications in two months and hadn't received any responses by early December, despite assurances from Washington that all paper applications received in October had been processed.
The same week that federal health officials told reporters there were no problems with paper applications, they were quietly discouraging further use of paper in contacts with enrollment counselors, insurance brokers and others. It was time to get back to the website as time grew ever shorter to apply by Dec. 23 for coverage starting Jan. 1.
As December progressed, another batch of improvisation emerged.
The government announced a one-month extension of a special insurance program for nearly 86,000 people who cannot get any other coverage because of pre-existing illness. The program should not be needed in the new year because coverage can no longer be denied to the previously sick. But the risk of insurance gaps from the troubled rollout prompted officials to keep the program around a while longer to be safe.
Similarly, Washington ordered insurers to provide coverage on Jan. 1 for any customer who pays by New Year's Eve. The industry went the government one better, extending the deadline until Jan. 10. The administration also allowed some of those with canceled policies to sign up for catastrophic insurance.
On Dec. 1, the government reported progress fixing the website. Now people had a 19-in-20 chance of finding it in operation. You could click more than 99 times out of 100 and not see pages crash. Some 50,000 people could use it at once. But did that mean smooth signups? Not necessarily.
The user experience was clearly much better, but that's only half of it. The back end, where insurance companies take in the information for processing, was problematic. Insurers complained of errors, garble and duplication, a data tangle that the government blamed mostly on a bug affecting Social Security numbers - soon overcome, officials said.
By the middle of the month, things were looking up, though not rosy.
On Dec. 20, Obama said more than a million people had been able to sign up for coverage, a big improvement over the 365,000 who'd had coverage three weeks earlier. But even as he announced the new number at a news conference, some applicants were having problems with the website.
Officials are braced for a late surge of insurance hunters. And for the 2014 installments of a drama seemingly without end.
WEST READING, Pa. (AP) — Thousands of Christmas carolers are gathered to sing outside the home of a terminally ill Pennsylvania girl.
The singers are fulfilling one of 8-year-old Delaney Brown's wishes: a huge holiday sing-along outside her West Reading home. On her "Team Laney" Facebook page, a picture of Delaney giving two thumbs up was accompanied by the text, "I can hear you now!!! Love you!"
Delaney was diagnosed with a rare form of leukemia in May. Her family says earlier this week doctors gave her only days to live.
Supporters have been trying to fulfill a number of Delaney's wishes. She video chatted with singer Taylor Swift on Friday, her eighth birthday.
DE KALB, Miss. (AP) — America's newest, most expensive coal-fired power plant is hailed as one of the cleanest on the planet, thanks to government-backed technology that removes carbon dioxide and keeps it out of the atmosphere.
But once the carbon is stripped away, it will be used to do something that is not so green at all.
It will extract oil.
When President Barack Obama first endorsed this "carbon-capture" technology, the idea was that it would fight global warming by sparing the atmosphere from more greenhouse gases. It makes coal plants cleaner by burying deep underground the carbon dioxide that typically is pumped out of smokestacks.
But that green vision proved too expensive and complicated. So the administration accepted a trade-off.
To help the environment, the government allows power companies to sell the carbon dioxide to oil companies, which pump it into old oil fields to force more crude to the surface. A side benefit is that the carbon gets permanently stuck underground.
The program shows the ingenuity of the oil industry, which is using government green-energy money to subsidize oil production. But it also showcases the environmental trade-offs Obama is willing to make, but rarely talks about, in his fight against global warming.
Companies have been injecting carbon dioxide into old oil fields for decades. But the tactic hasn't been seen as a pollution-control strategy until recently.
Obama has spent more than $1 billion on carbon-capture projects tied to oil fields and has pledged billions more for clean coal. Recently, the administration said it wanted to require all new coal-fired power plants to capture carbon dioxide. Four power plants in the U.S. and Canada planning to do so intend to sell their carbon waste for oil recovery.
Just last week former Energy Secretary Steven Chu announced he was joining the board of a company developing carbon capture technology.
The unlikely marriage of coal burners and oil producers hits a political sweet spot.
It silences critics who say the administration is killing coal and discouraging oil production. It appeases environmentalists who want Obama to get tougher on coal, the largest source of carbon dioxide.
It also allows Obama to make headway on a second-term push to tackle climate change, even though energy analysts predict that few coal plants will be built in the face of low natural gas prices and Environmental Protection Agency rules that require no controls on carbon for new natural gas plants.
"By using captured man-made carbon dioxide, we can increase domestic oil production, promote economic development, create jobs, reduce carbon emissions and drive innovation," Judi Greenwald told Congress in July, months before she was hired as deputy director of the Energy Department's climate, environment and energy efficiency office.
Before joining the Energy Department, Greenwald headed the National Enhanced Oil Recovery Initiative, a consortium of coal producers, power companies and state and environmental officials promoting the process.
But the environmental benefits of this so-called enhanced oil recovery aren't as certain as the administration advertises.
"Enhanced oil recovery just undermines the entire logic of it," said Kyle Ash of Greenpeace, one of the few environmental groups critical of the process. "They can't have it both ways, but they want to really, really bad."
That has become a theme in some of Obama's green-energy policies. To promote new, cleaner technologies, the administration has allowed companies to do things it otherwise would oppose as harmful to the environment.
For wind power, the government has shielded companies from prosecution for killing protected birds with giant turbines.
For corn-based ethanol, the administration underestimated the environmental effects of millions of new acres of corn farming. The government even failed to conduct required air and water quality studies to document its toll on the environment.
The administration wants to make similar concessions to make carbon-capture technology a success.
The EPA last week exempted carbon dioxide injection from strict hazardous waste laws. It classified the wells used to inject the gas underground for oil production in a category that offers less protection for drinking water.
Oil companies using carbon to get oil also aren't subject now to the tougher reporting and monitoring requirements that experts say are necessary to ensure the carbon stays underground, and they're fighting an EPA proposal that would require them to be if the carbon comes from power plants covered by the new federal rules.
"It amounts to looking the other way," said George Peridas, a scientist with the Natural Resources Defense Council, which supports using carbon for oil extraction. The group believes it replaces dirtier oil or oil produced in more environmentally sensitive places and reduces carbon in the atmosphere.
The administration also did not evaluate the global warming emissions associated with the oil production when it proposed requiring power plants to capture carbon.
A 2009 peer-reviewed paper found that for every ton of carbon dioxide injected underground into an oil field, four times more carbon dioxide is released when the oil produced is burned.
"There is no form of energy that is free of impacts. It is always about trade-offs and someone will always be unhappy," the paper's author, Paulina Jaramillo, the assistant professor at Carnegie Mellon University, said in an interview.
Administration officials counter by saying the oil was going to be extracted anyway, so the policy should only be seen as reducing carbon dioxide from coal plants.
The administration also promotes the benefits for energy security. Every barrel of oil produced here will mean one less produced abroad.
"We are taking carbon dioxide that would have gone to the atmosphere in coal plants, storing it and displacing imported oil with domestic oil," said Energy Secretary Ernest Moniz, asking a question posed by The Associated Press on C-SPAN's "Newsmakers" program in September.
In Mississippi, where Southern Company's Kemper County power plant eventually will supply two oil producers with carbon dioxide, Denbury Resources Inc. says it would not be able to produce oil there otherwise.
Denbury is already using carbon dioxide trapped beneath a salt dome near Jackson to produce oil in the state. But it can use more carbon dioxide than nature can provide. That's where the power plant comes in.
The federal support for Kemper lowers the cost of installing the carbon capture equipment, and ultimately, the cost of carbon dioxide for the oil producer.
The company has entered into a long-term contract with Southern for carbon dioxide. It will allow Denbury to recover a total of between 3.5 million and 4.2 million barrels of oil, a tiny fraction of the 91 million barrels of oil the world consumed daily last month. But for the oil companies, it still means millions of dollars more in revenue.
The nearly $5-billion project received $270 million from the Energy Department, prior to the Obama administration, and $279 million more in federal tax credits.
A member of Mississippi's Public Service Commission, Brandon Presley, bristled over what he described as pressure from Washington to approve the project, which already has meant a 15 percent increase in utility bills for Mississippi Power customers.
Secretary Chu wrote Presley a letter in May 2010 that said without the Kemper County project, the U.S. government might not be able to use the technology anywhere. The commission approved it over Presley's objection.
"The (Energy Department) is knee deep in this," Presley said. "I don't think you'll find anywhere in the country where you've found more heavy-handedness by the federal government or by elected officials than what went on here to try and get this passed."
In an interview with the AP, Chu said pairing oil production with pollution reduction is an imperfect method for "developing the capture and ramping up the technologies."
"It's not one for one," he said. "You are not sequestering all the carbon dioxide."
While Kemper is the first, it's not the only one.
The Energy Department has provided $1.1 billion to six projects that capture carbon and sell it to oil companies. Four of those projects are power plants.
The EPA recently highlighted two of those projects, with a combined $858 million in federal money, as a way to reduce power plant emissions. Both plan on selling the carbon dioxide to oil companies.
"We sold the carbon dioxide immediately," said Laura Miller, a spokeswoman for Summit Power's Texas Clean Energy Project, which is still working on getting the financing needed to break ground on the 400-megawatt power plant in West Texas. "The projects that are still alive are the ones that are selling the carbon dioxide."
Despite billions in federal aid, coal projects that simply stored carbon dioxide failed to take off.
In 2010, a plan for a $1.8 billion power plant in Illinois was replaced with a scaled-back project after it couldn't secure private financing. In July 2011, American Electric Power, shelved a project in West Virginia that had received $334 million in late 2009, in part because a Democrat-controlled Congress failed to enact legislation, backed by the administration, that would have created a marketplace for carbon dioxide.
Oil recovery provided a market for carbon dioxide in the absence of federal legislation or regulations that put a price on it. For power plant operators, it could help offset the cost of the technology to capture it.
But the marriage was rocky from the start.
Oil companies want to use the least amount of carbon dioxide possible to extract oil, not exactly what is desired in a strategy to reduce pollution. Oil producers, no stranger to federal regulations, don't want to deal with any more rules, such as strict and costly monitoring and reporting requirements aimed at verifying that the carbon doesn't escape.
On the coal side, it takes more energy, and thus more coal and more carbon dioxide pollution, to run the equipment needed to capture carbon and compress it to be sent down a pipeline to an oil field.
It's the other environmental effects that have local environmentalists concerned.
There still is a 31,000-acre surface mine, and the other pollutants that power plants emit that could sully the air locally. Southern Co. was recently cited by the state for discharges from its reservoir on site, which the company blames on excessive rainfall and the fact that equipment that draws water from the reservoir for use in the plant was not ready.
"If you add up all the environmental costs, this is not going to be green," said Stan Flint, a Jackson-based consultant who works with environmental groups.
In June, the Energy Department and California Energy Commission raised serious environmental concerns about a California-based carbon capture-enhanced oil recovery project funded by the Obama administration and recognized by the EPA when it released its power plant standards.
In a preliminary environmental evaluation, state and federal officials found the Hydrogen Energy California Project would fail to comply with laws and standards in eight out of 16 environmental areas evaluated. The concerns included whether the project would comply with state landfill rules and its impacts on the blunt-nosed leopard lizard, a protected species.
Other studies have looked at the association between carbon dioxide injection and earthquakes. A peer-reviewed study published in November linked for the first time earthquakes in Texas to the injection of carbon dioxide in oil fields.
Another potential risk is blowouts. Many oil fields that are ideal candidates for carbon dioxide injection have many old and abandoned wells that may or may not be plugged properly.
Denbury Resources has had a series of uncontrolled blowouts in recent years, as the pressure created by injecting carbon dioxide tests the cement plugs in long-shuttered wells. The largest, and one that was responsible for one of the largest environmental fines in Mississippi in the past decade, occurred in 2011 at the Tinsley Field, one of several old oil fields that will receive carbon from Southern Co.'s power plant.
The company paid $662,500 for a blowout that vented carbon dioxide, oil and drilling mud for 37 days. So much carbon dioxide came out that it settled in some hollows, suffocating deer and other animals, Mississippi officials said. The company ultimately drilled a new well to plug the old one, and removed 27,000 tons of drilling mud and contaminated soil and 32,000 barrels of liquids from the site.
The company still claims it's green because of the carbon it is storing as part of its oil production process.