Sample records for affordable housing act

  1. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If a...

  2. To be an affordable healthy house, case study Medan

    NASA Astrophysics Data System (ADS)

    Silitonga, Shanty

    2018-03-01

    House has a paramount meaning in human life. Provision of adequate housing will be able to improve the quality of life. Provision of an affordable house is a major step to fulfilling the needs of houses in the big city. Medan has built a lot of affordable houses, and mostly it takes place in the suburbs. Although the affordable house is for low-income people, it must be worthy of its physical condition, affordable in the budget and healthy for its users. House often saw only as physical alone, the provision of a house only to achieve solely in quantity regardless its quality. This study aims to examine the condition of affordable houses in the suburbs of Medan. The research method used qualitative descriptive, using indicator according to affordable healthy house standard according to the regulation in Indonesia and other related theories. This study took place in Medan by taking three areas in the suburbs of Medan. The results show that most affordable houses in the suburbs of Medan are unhealthy. There are several design recommendations for the houses to meet the affordable healthy house category; the most important is the addition of ventilation and window holes.

  3. Housing Affordability And Children's Cognitive Achievement.

    PubMed

    Newman, Sandra; Holupka, C Scott

    2016-11-01

    Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant. Project HOPE—The People-to-People Health Foundation, Inc.

  4. 24 CFR 954.306 - Rental housing: qualification as affordable housing and income targeting.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... affordable housing and income targeting. 954.306 Section 954.306 Housing and Urban Development REGULATIONS... Affordability § 954.306 Rental housing: qualification as affordable housing and income targeting. (a) Rent... tenant; or (ii) A rent that does not exceed 30 percent of the adjusted income of a family whose gross...

  5. 24 CFR 1000.101 - What is affordable housing?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is affordable housing? 1000.101 Section 1000.101 Housing and Urban Development Regulations Relating to Housing and Urban... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.101 What is...

  6. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... percent of Eligible Project Costs are attributable to housing units that meet the affordability... Project Costs must be attributable to housing units that meet the affordability qualifications set forth...

  7. 24 CFR 1000.102 - What are eligible affordable housing activities?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What are eligible affordable housing activities? 1000.102 Section 1000.102 Housing and Urban Development Regulations Relating to... § 1000.102 What are eligible affordable housing activities? Eligible affordable housing activities are...

  8. America's Affordable Health Choices Act of 2009

    THOMAS, 111th Congress

    Rep. Dingell, John D. [D-MI-15

    2009-07-14

    House - 10/14/2009 Placed on the Union Calendar, Calendar No. 168. (All Actions) Notes: For further action, see H.R.3590, which became Public Law 111-148 on 3/23/2010. H.R.3590, often referred to as the Affordable Care Act, is the bill that became the health care reform law. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  9. Challenges of Integrating Affordable and Sustainable Housing in Malaysia

    NASA Astrophysics Data System (ADS)

    Syed Jamaludin, S. Z. H.; Mahayuddin, S. A.; Hamid, S. H. A.

    2018-04-01

    Developing countries including Malaysia have begun to comprehend the needs for affordable and sustainable housing development. The majority of the population is still aspiring for a comfortable, safe and reasonably priced house. Households in the low-middle income range face difficulties to find housing that can satisfy their needs and budget. Unfortunately, most of the housing development programs are considering affordability rather than sustainable aspects. Furthermore, developers are more interested in profit and neglect sustainability issues. Thus, the aim of this paper is to review the challenges in integrating affordable housing and sustainable practices in Malaysia. This paper is produced based on an extensive literature review as a basis to develop strategies of integrated affordable and sustainable housing in Malaysia. The challenges are divided into four sections, namely market challenges, professional challenges, societal challenges and technological challenges. The outcomes of this paper will assist in the decision making involving housing development and in enhancing quality of life for sustainable communities.

  10. Potential implementation of light steel housing system for affordable housing project in Malaysia

    NASA Astrophysics Data System (ADS)

    Saikah, M.; Kasim, N.; Zainal, R.; Sarpin, N.; Rahim, M. H. I. A.

    2017-11-01

    An unparalleled number between housing demand and housing supply in Malaysia has increased the housing prices, which gives consequences to the homeownership issue. One way to reduce the housing price is by faster increase the number of affordable housing, but the construction sector faces difficulties in delivering as expected number by using conventional and current industrialised building system (IBS) due to the issue related high project cost, time and labour. Therefore, light steel housing (LSH) system as one of another type of IBS method can be utilised in housing construction project. This method can replace the conventional method that was currently used in the construction of affordable housing project. The objectives of this study are to identify the potential of LSH and influencing factors of system implementation. This is an initial stage to review the previous study related to LSH implementation in developed and developing countries. The previous study will be analysed regarding advantages and disadvantages of LSH and factors that influence the implementation of the system. Based on the literature review it is expected to define the potential and influencing factors of the LSH system. The findings are meaningful in framing and enhance construction housing method of an affordable housing project in Malaysia.

  11. 12 CFR 1282.13 - Multifamily special affordable housing goal and subgoal.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Multifamily special affordable housing goal... AND MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.13 Multifamily special affordable housing goal and subgoal. (a) Multifamily housing goal and subgoal. An Enterprise shall be in...

  12. 12 CFR 1282.13 - Multifamily special affordable housing goal and subgoal.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Multifamily special affordable housing goal and... MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.13 Multifamily special affordable housing goal and subgoal. (a) Multifamily housing goal and subgoal. An Enterprise shall be in compliance...

  13. 12 CFR 1282.13 - Multifamily special affordable housing goal and subgoal.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Multifamily special affordable housing goal and... MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.13 Multifamily special affordable housing goal and subgoal. (a) Multifamily housing goal and subgoal. An Enterprise shall be in compliance...

  14. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special...

  15. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special...

  16. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special...

  17. Providing Affordable Housing: Small Communities Benefit from Upgrading Dilapidated Homes.

    ERIC Educational Resources Information Center

    Hestekin, Kay

    1991-01-01

    Describes the Affordable Housing Opportunities Program (AHOP) created by the Eau Claire County Housing Authority in Wisconsin. The AHOP buys, renovates, and sells homes for prices below fair market value. This provides safe, sanitary housing for families who could not otherwise afford it. Describes the purchase, renovation, and sale of four…

  18. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION (FANNIE...

  19. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION (FANNIE...

  20. Affordable Housing and the Empty Nester Boom.

    ERIC Educational Resources Information Center

    Hare, Patrick H.

    One of the best ways to produce affordable housing is to address the needs of a group that has too much housing. A baby boom generation generates an empty nester boom. An empty nester boom means dramatic underutilization of the housing stock. If a small percentage of homeowners were to install an accessory apartment, they would have a significant…

  1. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352 Preservation...

  2. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352 Preservation...

  3. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352 Preservation...

  4. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352 Preservation...

  5. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352 Preservation...

  6. 24 CFR 1000.104 - What families are eligible for affordable housing activities?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... affordable housing activities? 1000.104 Section 1000.104 Housing and Urban Development Regulations Relating... Activities § 1000.104 What families are eligible for affordable housing activities? The following families... Indian area. (b) A non-low income Indian family may receive housing assistance in accordance with § 1000...

  7. 78 FR 73204 - Announcement of Requirements and Registration for “Innovation in Affordable Housing Student...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-05

    ... jury of approximately five practitioners and experts in the fields of architecture, urban planning, affordable housing, and other relevant areas, in compliance with the requirements of the COMPETES Act. Jury members will be named after the commencement of the competition. The jury will make decisions based on the...

  8. Stabilizing Affordable Housing for the Future Act

    THOMAS, 112th Congress

    Rep. Velazquez, Nydia M. [D-NY-12

    2012-03-20

    House - 04/26/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  9. Active design in affordable housing: A public health nudge.

    PubMed

    Garland, Elizabeth; Garland, Victoria; Peters, Dominique; Doucette, John; Thanik, Erin; Rajupet, Sritha; Sanchez, Sadie H

    2018-06-01

    This pilot study investigates the impact of active design (AD) strategies on physical activity (PA) among adults living in two Leadership in Energy and Environmental Design (LEED) certified affordable housing developments in the South Bronx, New York. One building incorporates LEED Innovation in Design (ID) Credit: Design for Health through Increased Physical Activity. Tenants in an affordable housing building (AH) incorporating active design strategies completed PA self-assessments at their lease signing and one year later in 2015. Trained research assistants obtained body measurements. Residents of neighboring non-AD affordable housing (MCV) served as a comparison. Thirty four adults were recruited from AH and 29 from MCV, retention was 56% (n = 19) and 52% (n = 15) respectively at one year. The two groups' body mass index (BMI) and high-risk waist-to-hip ratio (WHR) were not statistically significantly different when analyzed as continuous variables, although BMI category had a greater decline at AH than at MCV (p = 0.054). There was a 31.5% increase in AH participants meeting MPA requirements and a statistically significant improvement in females (p = 0.031); while there was no change in the MCV participants overall or when stratified by gender. AH participants were significantly more likely to have reported increased stair use and less likely to have reported no change or decreased stair use than participants from MCV participants (p = 0.033). Housing has a role in individual health outcomes and behavior change, broad adoption of active design strategies in affordable housing is warranted to improve physical activity measures.

  10. Developing affordable housing guidelines near rail transit in Los Angeles : final report.

    DOT National Transportation Integrated Search

    2016-12-01

    Providing affordable housing and reducing greenhouse gases are common goals in cities worldwide. Transit-oriented development (TOD) can enable incremental progress on both fronts, by building affordable housing near transit and by providing alternati...

  11. 26 CFR 1.42-3 - Treatment of buildings financed with proceeds from a loan under an Affordable Housing Program...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... pursuant to section 721 of the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA... from a loan under an Affordable Housing Program established pursuant to section 721 of the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA). 1.42-3 Section 1.42-3 Internal Revenue...

  12. Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ.

    PubMed

    Albright, Len; Derickson, Elizabeth S; Massey, Douglas S

    2013-06-01

    This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ - the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities.

  13. Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ

    PubMed Central

    Albright, Len; Derickson, Elizabeth S.; Massey, Douglas S.

    2016-01-01

    This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ – the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities. PMID:27390552

  14. 76 FR 56781 - Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of Housing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... require additional verification to identify inappropriate or inaccurate rental assistance, and may provide... Affordable Housing Act, the Native American Housing Assistance and Self-Determination Act of 1996, and the... matching activities. The computer matching program will also provide for the verification of social...

  15. Assessing the engineering performance of affordable net-zero energy housing

    NASA Astrophysics Data System (ADS)

    Wallpe, Jordan P.

    The purpose of this research was to evaluate affordable technologies that are capable of providing attractive, cost-effective energy savings to the housing industry. The research did so by investigating the 2011 Solar Decathlon competition, with additional insight from the Purdue INhome. Insight from the Purdue INhome verified the importance of using a three step design process to design a net-zero energy building. In addition, energy consumption values of the INhome were used to compare and contrast different systems used in other houses. Evaluation of unbiased competition contests gave a better understanding of how a house can realistically reach net-zero. Upon comparison, off-the-shelf engineering systems such as super-efficient HVAC units, heat pump hot water heaters, and properly designed photovoltaic arrays can affordably enable a house to become net-zero. These important and applicable technologies realized from the Solar Decathlon will reduce the 22 percent of all energy consumed through the residential sector in the United States. In conclusion, affordable net-zero energy buildings can be built today with commitment from design professionals, manufacturers, and home owners.

  16. Affordable housing and health: a health impact assessment on physical inspection frequency.

    PubMed

    Klein, Elizabeth G; Keller, Brittney; Hood, Nancy; Holtzen, Holly

    2015-01-01

    To characterize the prevalence of health-related housing quality exposure for the vulnerable populations that live in affordable housing. Retrospective cross-sectional study. Affordable housing properties in Ohio inspected between 2007 and 2011. Stratified random sample of physical inspection reports (n = 370), including a case study of properties receiving multiple inspections (n = 35). Health-related housing factors, including mold, fire hazard, and others. The majority of affordable housing property inspections (85.1%) included at least 1 health-related housing quality issue. The prevalence of specific health-related violations was varied, with appliance and plumbing issues being the most common, followed by fire, mold, and pest violations. Across funding agencies, the actual implementation of inspection protocols differed. The majority of physical inspections identified housing quality issues that have the potential to impact human health. If the frequency of physical inspections is reduced as a result of inspection alignment, the most health protective inspection protocol should be selected for funding agency inspections; a standardized physical inspection tool is recommended to improve the consistency of inspection findings between mandatory physical inspections in order to promote optimum tenant health.

  17. The Origination Clause, the Affordable Care Act, and Indirect Constitutional Violations.

    PubMed

    Dysart, Tessa L

    2015-01-01

    "All bills for raising revenue shall originate in the House of Representatives; but the Senate may propose or concur with amendments as on other Bills." U.S. Const. art. I, § 7, cl. 1 (Origination Clause). "As we have often noted, '[c]onstitutional rights would be of little value if they could be . . . indirectly denied.'" United States Term Limits, Inc. v. Thornton, 514 U.S. 779, 829 (1995) The Supreme Court's opinion in National Federation of Independent Business v. Sebelius, upholding the constitutionality of the Patient Protection and Affordable Care Act (ACA) as a permissible exercise of Congress's taxing power rekindled an old question about the constitutionality of the Act: Was the Act unconstitutional under the Origination Clause? The bill that became the ACA, H.R. 3590, originated in the House as the Service Members Home Ownership Tax Act of 2009. It was gutted by the Senate and replaced with the ACA before being passed and sent back to the House for final passage. The Supreme Court has heard very few cases on the Origination Clause, and Origination Clause challenges have met with little success. Most of these cases have developed over the questions of whether the bill is actually a revenue-raising bill that is constitutionally required to be originate in the House, and, if so, whether the Senate amendments were appropriate. But United States Term Limits v. Thornton provides another angle under which to examine the constitutionality of the ACA: an indirect violation of a constitutional prohibition. In this Article, I will provide an overview of the ACA's passage and analyze it through the lenses of traditional Origination Clause arguments and the Term Limits approach.

  18. Diabetes and the Affordable Care Act

    PubMed Central

    Schade, David S.

    2014-01-01

    Abstract The Affordable Care Act—“Obamacare”—is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different “metallic” insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care. PMID:24927108

  19. Affordable Housing Regulation Simplification Act of 2012

    THOMAS, 112th Congress

    Rep. Polis, Jared [D-CO-2

    2012-09-13

    House - 10/01/2012 Referred to the Subcommittee on Capital Markets and Government Sponsored Enterprises. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  20. Strengthening Economic Development Through Affordable Housing Act of 2012

    THOMAS, 112th Congress

    Rep. Baca, Joe [D-CA-43

    2012-03-06

    House - 04/26/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. 24 CFR 1000.242 - When does the requirement for exemption from taxation apply to affordable housing activities?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... exemption from taxation apply to affordable housing activities? 1000.242 Section 1000.242 Housing and Urban... ACTIVITIES Indian Housing Plan (IHP) § 1000.242 When does the requirement for exemption from taxation apply to affordable housing activities? The requirement for exemption from taxation applies only to rental...

  2. 24 CFR 1000.242 - When does the requirement for exemption from taxation apply to affordable housing activities?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... exemption from taxation apply to affordable housing activities? 1000.242 Section 1000.242 Housing and Urban... ACTIVITIES Indian Housing Plan (IHP) § 1000.242 When does the requirement for exemption from taxation apply to affordable housing activities? The requirement for exemption from taxation applies only to rental...

  3. Does employment security modify the effect of housing affordability on mental health?

    PubMed

    Bentley, Rebecca; Baker, Emma; LaMontagne, Anthony; King, Tania; Mason, Kate; Kavanagh, Anne

    2016-12-01

    This paper uses longitudinal data to examine the interrelationship between two central social determinants of mental health - employment security and housing affordability. Data from ten annual waves of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey (which commenced in 2000/1 and is ongoing) were analysed using fixed-effects longitudinal linear regression. Change in the SF-36 Mental Component Summary (MCS) score of working age individuals (25-64 years) (51,885 observations of 10,776 people), associated with changes in housing affordability was examined. Models were adjusted for income, age, survey year, experience of serious injury/illness and separation/divorce. We tested for an additive interaction between the security of a household's employment arrangements and housing affordability. People in insecurely employed households appear more vulnerable than people in securely employed households to negative mental health effects of housing becoming unaffordable. In adjusted models, people in insecurely employed households whose housing became unaffordable experienced a decline in mental health (B=-1.06, 95% CI -1.75 to -0.38) while people in securely employed households experienced no difference on average. To progress our understanding of the Social Determinants of Health this analysis provides evidence of the need to bridge the (largely artificial) separation of social determinants, and understand how they are related.

  4. An Affordability Comparison Tool (ACT) for Space Transportation

    NASA Technical Reports Server (NTRS)

    McCleskey, C. M.; Bollo, T. R.; Garcia, J. L.

    2012-01-01

    NASA bas recently emphasized the importance of affordability for Commercial Crew Development Program (CCDP), Space Launch Systems (SLS) and Multi-Purpose Crew Vehicle (MPCV). System architects and designers are challenged to come up with architectures and designs that do not bust the budget. This paper describes the Affordability Comparison Tool (ACT) analyzes different systems or architecture configurations for affordability that allows for a comparison of: total life cycle cost; annual recurring costs, affordability figures-of-merit, such as cost per pound, cost per seat, and cost per flight, as well as productivity measures, such as payload throughput. Although ACT is not a deterministic model, the paper develops algorithms and parametric factors that use characteristics of the architectures or systems being compared to produce important system outcomes (figures-of-merit). Example applications of outcome figures-of-merit are also documented to provide the designer with information on the relative affordability and productivity of different space transportation applications.

  5. Affordability of the Health Expenditures of Insured Americans Before the Affordable Care Act.

    PubMed

    Nyman, John A; Trenz, Helen M

    2016-02-01

    Central to the Affordable Care Act is the notion of affordability and the role of health insurance in making otherwise unaffordable health care affordable. We used data from the 1996 to 2008 versions of the Medical Expenditure Panel Survey to estimate the portion of overall health care expenditures by insured respondents that would otherwise have been beyond their disposable incomes and assets. We found that about one third of insured expenditures would have been unaffordable, with a much higher percentage among publicly insured individuals. This result suggests that one of the main functions of insurance is to cover expenses that insured individuals would not otherwise be able to afford.

  6. Affordable Housing Preservation and Revitalization Act of 2009

    THOMAS, 111th Congress

    Sen. Wyden, Ron [D-OR

    2009-09-16

    Senate - 09/16/2009 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  7. Affordable Housing Preservation and Revitalization Act of 2011

    THOMAS, 112th Congress

    Sen. Wyden, Ron [D-OR

    2011-02-10

    Senate - 02/10/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  8. California Multifamily Affordable Solar Housing Program: benefitting both owners and tenants

    EPA Pesticide Factsheets

    California’s Multifamily Affordable Solar Housing (MASH) program has brought solar energy to thousands of multifamily building owners and tenants across the state. Discover lessons learned through this case study.

  9. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in the...

  10. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in the...

  11. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in the...

  12. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in the...

  13. Resiliency and affordability of housing design, Kampong Cieunteung-Bale Endah in Bandung Regency as a case study

    NASA Astrophysics Data System (ADS)

    Nurdini, Allis; Yovita, Wanda; Negri, Patriot

    2017-12-01

    Recently the discussion about resiliency and housing design has been fast developed, including design for housing on riverfront as marginal area that usually occupied by low income people. The low income people generally will be the worst affected community in flood disaster situation, because of their un-affordability to achieve quality housing design. In other side, the funding support capacity especially from the local government is limited, so that the resilient environment also need to be supported by the community itself. In this context, the study about low income people's affordability to achieve resilient housing design is essential. This study was conducted to identify two important points: the design choice and the affordability level of resilient housing from the community viewpoints. Kampong Cieunteung, in Bale Endah Area, Bandung Regency is chosen as a case study, because this area annually experience severe flood from overflow of the Citarum River branch. In preliminary research phase, approximately 60% of the Kampong Cieunteung's resident need to stay and become indication that the community need resilient housing design to accommodate their live hood. The next phase, the contingent valuation method was implemented to gain resilient design choice and affordability perspective from the community. It is concluded that the community have ability to choose the resilient housing design based on their aspiration and based on their ability to pay. The result indicates that resilient housing design should have character of optional, module co-operational, and incremental to be afforded by the low income people.

  14. The Affordable Housing Crisis: Residential Mobility of Poor Families and School Mobility of Poor Children.

    ERIC Educational Resources Information Center

    Crowley, Sheila

    2003-01-01

    Helping poor families increase their residential stability can have direct bearing on school stability and student academic achievement. Discusses the role of housing in child and family wellbeing; residential mobility and school performance; residential mobility and housing problems; housing affordability; (federal housing policy); homeownership;…

  15. Housing Policy Act, 31 August 1989.

    PubMed

    1989-01-01

    The goal of this Act is to establish medium and longterm housing policy for Venezuela. The policy is to be implemented by both the private and public sectors and has as targets the provision of housing for 700,000 families between 1989 and 1994, 1,000,000 families between 1994 and 1999, and 1,300,00 families between 1999 and 2004. The priority for the public sector will be provision of housing assistance to families earning under the amount of 3 minimum monthly wages. Priority will also be given to areas that are strategic for decentralization programs and that have a deficit of housing. Assistance is to consist of comprehensive housing programs and can include provision of plots of land with basic services, housing units, loans for constructing and purchasing housing, houses to be leased or sold, rent subsidies, and technical and legal services. Beneficiaries must be contributors to the housing savings program and, in general, not own a house, although special assistance is available for remodeling and enlarging housing. Beneficiaries will receive assistance on the basis of family income and the housing solution provided. Housing assistance is to be financed by the following: 1) 5% of the government's yearly budget; 2) compulsory housing savings of workers in both the public and private sectors consisting of an amount equal to 3% of monthly wages not in excess of the amount of 10 minimum monthly wages, 1% paid by workers and 2% paid by employers; 3) cash reserve resources of mortgage institutions; and 4) private sector funds. Funds obtained from these different sources are to be used for different purposes, as specified by the Act. In addition, the Act also authorizes the government to exempt from payment of various taxes persons involved in the housing projects contemplated by the Act. Further provisions of the Act set forth rules on a guaranty fund to be established to cover housing loans, the creation of the National Housing Council to cooperate in defining

  16. 77 FR 70177 - Multifamily Housing Mortgage and Housing Assistance Restructuring Program (Mark to Market)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5603-N-85] Multifamily Housing Mortgage... Program is authorized under the Multifamily Assisted Housing Reform and Affordability Act of 1997 as... used to determine the eligibility of FHA insured multifamily properties for participation in the Mark...

  17. 75 FR 70160 - Affordable Care Act; Federal External Review Process; Request for Information

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ...-9986-NC] DEPARTMENT OF LABOR Employee Benefits Security Administration 29 CFR Part 2590 Affordable Care... Affordable Care Act, and its implementing regulations. DATES: Submit written or electronic comments by... processes under the Affordable Care Act; those comments are being collected and evaluated on a separate...

  18. Why the affordable care act needs a better name: 'Americare'.

    PubMed

    Sage, William M

    2010-08-01

    The culmination of a century's effort to enact universal coverage in the United States is a law with an uninspiring title, the Patient Protection and Affordable Care Act, and an even more awkward acronym, PPACA. The Obama administration has decided to call the legislation the Affordable Care Act, but the expansion of health coverage that the law sets in motion has no name, and therefore no identity. It badly needs one.

  19. Patient Protection and Affordable Care Act; establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges. Final rule.

    PubMed

    2014-02-24

    The U.S. Office of Personnel Management (OPM) is issuing a final rule implementing modifications to the Multi-State Plan (MSP) Program based on the experience of the Program to date. OPM established the MSP Program pursuant to the Affordable Care Act. This rule clarifies the approach used to enforce the applicable standards of the Affordable Care Act with respect to health insurance issuers that contract with OPM to offer MSP options; amends MSP standards related to coverage area, benefits, and certain contracting provisions under section 1334 of the Affordable Care Act; and makes non-substantive technical changes.

  20. Affordable Housing in transit-oriented developments : impacts on driving and policy approaches.

    DOT National Transportation Integrated Search

    2017-04-01

    This paper studies the intersection of policies promoting affordable housing, transit-oriented developments (TODs), and the reduction of vehicle miles traveled (VMT) in metropolitan areas. In particular, this paper focuses on the following questions:...

  1. Affordable housing in transit-oriented developments : impacts on driving and policy approaches.

    DOT National Transportation Integrated Search

    2017-04-01

    This paper studies the intersection of policies promoting affordable housing, transit-oriented : developments (TODs), and the reduction of vehicle miles traveled (VMT) in metropolitan areas. : In particular, this paper focuses on the following questi...

  2. 78 FR 54069 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, and Eligibility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... Parts 147, 153, 155, et al. Patient Protection and Affordable Care Act; Program Integrity: Exchange... 147, 153, 155, and 156 [CMS-9957-F] RIN 0938-AR82 Patient Protection and Affordable Care Act; Program... Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as...

  3. Surgeon Reimbursements in Maxillofacial Trauma Surgery: Effect of the Affordable Care Act in Ohio.

    PubMed

    Khansa, Ibrahim; Khansa, Lara; Pearson, Gregory D

    2016-02-01

    Surgical treatment of maxillofacial injuries has historically been associated with low reimbursements, mainly because of the high proportion of uninsured patients. The Affordable Care Act, implemented in January of 2014, aimed to reduce the number of uninsured. If the Affordable Care Act achieves this goal, surgeons may benefit from improved reimbursement rates. The authors' purpose was to evaluate the effects of the Affordable Care Act on payor distribution and surgeon reimbursements for maxillofacial trauma surgery at their institution. A review of all patients undergoing surgery for maxillofacial trauma between January of 2012 and December of 2014 was conducted. Insurance status, and amounts billed and collected by the surgeon, were recorded. Patients treated before implementation of the Affordable Care Act were compared to those treated after. Five hundred twenty-three patients were analyzed. Three hundred thirty-four underwent surgery before implementation of the Affordable Care Act, and 189 patients underwent surgery after. After implementation of the Affordable Care Act, the proportion of uninsured decreased (27.2 percent to 11.1 percent; p < 0.001) and the proportion of patients on Medicaid increased (7.8 percent to 25.4 percent; p < 0.001). Overall surgeon reimbursement rate increased from 14.3 percent to 19.8 percent (p < 0.001). After implementation of the Affordable Care Act, we observed a significant reduction in the proportion of maxillofacial trauma patients who were uninsured. Surgeons' overall reimbursement rate increased. These trends should be followed over a longer term to determine the full effect of the Affordable Care Act.

  4. Impact of the Affordable Care Act on stem cell transplantation.

    PubMed

    Farnia, Stephanie; Gedan, Alicia; Boo, Michael

    2014-03-01

    The Patient Protection and Affordable Care Act, signed into law in 2010, will have a wide-reaching impact on the health care system in the United States when it is fully implemented in 2014. Patients will see increased access to care coupled with new insurance coverage protections as well as a minimum set of benefits mandated in each state known as essential health benefits. Providers are likely to see new forms of payment reform, particularly in the Medicare program, and narrower commercial provider networks. In addition, the composition of the health insurance market will broaden with the introduction of health insurance exchanges and expanded Medicaid populations in many states. Furthermore, the Patient Protection and Affordable Care Act calls for quality initiatives such as comparative effectiveness research to increase effective, appropriate and high-value care. This paper will review the main provisions of the Patient Protection and Affordable Care Act with specific attention to their impact on the field of Stem Cell Transplantation.

  5. Who has housing affordability problems? Disparities in Housing Cost burden by Race, Nativity and Legal Status in Los Angeles

    PubMed Central

    McConnell, Eileen Diaz

    2013-01-01

    Housing costs are a substantial component of U.S. household expenditures. Those who allocate a large proportion of their income to housing often have to make difficult financial decisions with significant short-term and long-term implications for adults and children. This study employs cross-sectional data from the first wave of the Los Angeles Family and Neighborhood Survey (L.A.FANS) collected between 2000 and 2002 to examine the most common U.S. standard of housing affordability, the likelihood of spending thirty percent or more of income on shelter costs. Multivariate analyses of a low-income sample of U.S. born Latinos, Whites, African Americans, authorized Latino immigrants and unauthorized Latino immigrants focus on baseline and persistent differences in the likelihood of being cost burdened by race, nativity and legal status. Nearly half or more of each group of low-income respondents experience housing affordability problems. The results suggest that immigrants’ legal status is the primary source of disparities among those examined, with the multivariate analyses revealing large and persistent disparities for unauthorized Latino immigrants relative to most other groups. Moreover, the higher odds of housing cost burden observed for unauthorized immigrants compared with their authorized immigrant counterparts remains substantial, accounting for traditional indicators of immigrant assimilation. These results are consistent with emerging scholarship regarding the role of legal status in shaping immigrant outcomes in the United States. PMID:24077641

  6. Patient Protection and Affordable Care Act; health insurance market rules. Final rule.

    PubMed

    2013-02-27

    This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule clarifies the approach used to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal governmental plans. This final rule also amends the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under the federal rate review program, and revises the timeline for states to propose state-specific thresholds for review and approval by the Centers for Medicare & Medicaid Services (CMS).

  7. Catching up: Latino health coverage gains and challenges under the Affordable Care Act: results from the Commonwealth Fund Affordable Care Act Tracking Survey.

    PubMed

    Doty, Michelle M; Rasmussen, Petra W; Collins, Sara R

    2014-09-01

    For decades, Latinos have had the highest uninsured rates of any racial or ethnic group in the United States. Less than one year after the Affordable Care Act's health insurance marketplaces opened for enrollment, the overall Latino uninsured rate dropped from 36 percent to 23 percent, according to the Commonwealth Fund Affordable Care Act Tracking Survey, conducted April 9 to June 2, 2014. However, the high uninsured rate among Latinos in states that had not expanded their Medicaid program at the time of the survey--33 percent--remained statistically unchanged. These states are home to about 20 million Latinos, the majority of whom live in Texas and Florida.

  8. Patient Protection and Affordable Care Act; establishment of the multi-state plan program for the Affordable Insurance Exchanges.

    PubMed

    2013-03-11

    The U.S. Office of Personnel Management (OPM) is issuing a final regulation establishing the Multi-State Plan Program (MSPP) pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will offer at least two multi-State plans (MSPs) on each of the Affordable Insurance Exchanges (Exchanges). One of the issuers must be non-profit. Under the law, an MSPP issuer may phase in the States in which it offers coverage over 4 years, but it must offer MSPs on Exchanges in all States and the District of Columbia by the fourth year in which the MSPP issuer participates in the MSPP. This rule aims to balance adhering to the statutory goals of MSPP while aligning its standards to those applying to qualified health plans to promote a level playing field across health plans.

  9. 76 FR 20354 - Notice of Intent To Award Supplemental Affordable Care Act Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... Intent To Award Supplemental Affordable Care Act Funding Notice of Intent to award supplemental Affordable Care Act funding to support enhancement of an existing laboratory fellowship training program through funding opportunity CDC-RFA-HM10-1001, ``APHL--CDC Partnership for Quality Laboratory Practice...

  10. Patient Protection and Affordable Care Act

    THOMAS, 111th Congress

    Rep. Rangel, Charles B. [D-NY-15

    2009-09-17

    03/23/2010 Became Public Law No: 111-148. (TXT | PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  11. 76 FR 20352 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... Intent To Award Affordable Care Act (ACA) Funding Notice of Intent to award Affordable Care Act (ACA) funding to two Emerging Infections Program (EIP) grantees, the Connecticut Department of Public Health and... grantees' Fiscal Year (FY) 2011 non-competitive continuation applications under funding opportunity CI05...

  12. Soft System Methodology as a Tool to Understand Issues of Governmental Affordable Housing Programme of India: A Case Study Approach

    NASA Astrophysics Data System (ADS)

    Ghosh, Sukanya; Roy, Souvanic; Sanyal, Manas Kumar

    2016-09-01

    With the help of a case study, the article has explored current practices of implementation of governmental affordable housing programme for urban poor in a slum of India. This work shows that the issues associated with the problems of governmental affordable housing programme has to be addressed to with a suitable methodology as complexities are not only dealing with quantitative data but qualitative data also. The Hard System Methodologies (HSM), which is conventionally applied to address the issues, deals with real and known problems which can be directly solved. Since most of the issues of affordable housing programme as found in the case study are subjective and complex in nature, Soft System Methodology (SSM) has been tried for better representation from subjective points of views. The article explored drawing of Rich Picture as an SSM approach for better understanding and analysing complex issues and constraints of affordable housing programme so that further exploration of the issues is possible.

  13. 78 FR 41074 - 60-Day Notice of Proposed Information Collection: Innovation in Affordable Housing Design Student...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... Information Collection: Innovation in Affordable Housing Design Student Competition AGENCY: Office of Policy Development and Research, HUD. ACTION: Notice. SUMMARY: HUD is seeking approval from the Office of Management... be sent to: Colette Pollard, Reports Management Officer, QDAM, Department of Housing and Urban...

  14. Children, Families, and Disparities: Pediatric Provisions in the Affordable Care Act.

    PubMed

    Grace, Aimee M; Horn, Ivor; Hall, Robert; Cheng, Tina L

    2015-10-01

    The Affordable Care Act has caused and continues to cause sweeping changes throughout the health system in the United States. Poorly explained, complex, controversial, confusing, and subject to continuous legal and regulatory definition, the law stands as a hallmark piece of legislation that will change the health sector in America forever. This article summarizes the Affordable Care Act with a focus on children, families, and disparities. Also provided is the context of the current system of health care coverage in the United States. Published by Elsevier Inc.

  15. Implementing the Affordable Care Act: Promoting Competition in the Individual Marketplaces.

    PubMed

    Cusano, David; Lucia, Kevin

    2016-02-01

    A main goal of the Affordable Care Act is to provide Americans with access to affordable coverage in the individual market, achieved in part by pro­moting competition among insurers on premium price and value. One primary mechanism for meeting that goal is the establishment of new individual health insurance marketplaces where consumers can shop for, compare, and purchase plans, with subsidies if they are eligible. In this issue brief, we explore how the Affordable Care Act is influencing competition in the individual marketplaces in four states--Kansas, Nevada, Rhode Island, and Washington. Strategies include: educating consumers and providing coverage information in one place to ease decision-making; promoting competition among insurers; and ensuring a level playing field for premium rate development through the rate review process.

  16. 78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 54 [REG-120391-10] RIN 1545-BJ60 Coverage of Certain Preventive Services Under the Affordable Care Act; Correction AGENCY: Internal Revenue... Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security...

  17. The Affordable Care Act: The Value of Systemic Disruption

    PubMed Central

    2013-01-01

    It is important to recognize the political and policy accomplishments of the Patient Protection and Affordable Care Act (ACA), anticipate its limitations, and use the levers it provides strategically to address the problems it does not resolve. Passage of the ACA broke the political logjam that long stymied national progress toward equitable, quality, universal, affordable health care. It extends coverage for the uninsured who are disproportionately low income and people of color, curbs health insurance abuses, and initiates improvements in the quality of care. However, challenges to affordability and cost control persist. Public health advocates should mobilize for coverage for abortion care and for immigrants, encourage public-sector involvement in negotiating health care prices, and counter disinformation by opponents on the right. PMID:23409911

  18. Affordable in-house antiretroviral drug resistance assay with good performance in non-subtype B HIV-1.

    PubMed

    Wallis, Carole L; Papathanasopoulos, Maria A; Lakhi, Shabir; Karita, Etienne; Kamali, Anatoli; Kaleebu, Pontiano; Sanders, Eduard; Anzala, Omu; Bekker, Linda-Gail; Stevens, Gwynn; de Wit, Tobias F Rinke; Stevens, Wendy

    2010-02-01

    The introduction of antiretroviral (ARV) therapy in resource-poor settings is effective in suppressing HIV-1 replication and prolonging life of infected individuals. This has led to a demand for affordable HIV-1 drug resistance assays, since treatment failure due to development of drug resistance is common. This study developed and evaluated an affordable "in-house" genotyping assay to monitor HIV-1 drug resistance in Africa, particularly South Africa. An "in-house" assay using automated RNA extraction, and subtype C specific PCR and sequencing primers was developed and successfully evaluated 396 patient samples (viral load ranges 1000-1.6 million RNA copies/ml). The "in-house" assay was validated by comparing sequence data and drug resistance profiles from 90 patient and 10 external quality control samples to data from the ViroSeq HIV-1 Genotyping kit. The "in-house" assay was more efficient, amplifying all 100 samples, compared to 91 samples using Viroseq. The "in house" sequences were 99.2% homologous to the ViroSeq sequences, and identical drug resistance mutation profiles were observed in 96 samples. Furthermore, the "in-house" assay genotyped 260 of 295 samples from seven African sites, where 47% were non-subtype C. Overall, the newly validated "in-house" drug resistance assay is suited for use in Africa as it overcomes the obstacle of subtype diversity. 2009 Elsevier B.V. All rights reserved.

  19. Federal Home Visiting under the Affordable Care Act

    ERIC Educational Resources Information Center

    Strader, Kathleen; Counts, Jacqueline; Filene, Jill

    2013-01-01

    The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…

  20. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ...This final rule will implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors. The Exchanges, which will become operational by January 1, 2014, will help enhance competition in the health insurance market, improve choice of affordable health insurance, and give small businesses the same purchasing clout as large businesses.

  1. 77 FR 16501 - Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ...This advance notice of proposed rulemaking announces the intention of the Departments of Health and Human Services, Labor, and the Treasury to propose amendments to regulations regarding certain preventive health services under provisions of the Patient Protection and Affordable Care Act (Affordable Care Act). The proposed amendments would establish alternative ways to fulfill the requirements of section 2713 of the Public Health Service Act and companion provisions under the Employee Retirement Income Security Act and the Internal Revenue Code when health coverage is sponsored or arranged by a religious organization that objects to the coverage of contraceptive services for religious reasons and that is not exempt under the final regulations published February 15, 2012. This document serves as a request for comments in advance of proposed rulemaking on the potential means of accommodating such organizations while ensuring contraceptive coverage for plan participants and beneficiaries covered under their plans (or, in the case of student health insurance plans, student enrollees and their dependents) without cost sharing.

  2. 24 CFR 1000.156 - Is affordable housing developed, acquired, or assisted under the IHBG program subject to...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... developed, acquired, or assisted under the IHBG program subject to limitations on cost or design standards... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Is affordable housing developed, acquired, or assisted under the IHBG program subject to limitations on cost or design standards? 1000.156...

  3. 24 CFR 1000.156 - Is affordable housing developed, acquired, or assisted under the IHBG program subject to...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... developed, acquired, or assisted under the IHBG program subject to limitations on cost or design standards... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Is affordable housing developed, acquired, or assisted under the IHBG program subject to limitations on cost or design standards? 1000.156...

  4. Affordable Care Act and Diabetes Mellitus.

    PubMed

    Shi, Qian; Nellans, Frank P; Shi, Lizheng

    2015-12-01

    The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population.

  5. Efficient Solutions for Existing Homes Case Study: Demonstration House of Cold-Climate Solutions for Affordable Housing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    T. Schirber, C. Ojczyk, and R. Jacobson

    2016-05-01

    Single family homes in urban areas that are available for renovation by nonprofit developers are often in rough shape (1MM to 2MM nationally). Budgeting has historically focused on improving homes to meet basic housing standards. A rising interest in the long-term impact of homeownership has introduced the need to balance basic needs with home performance. This demonstration project aims to help nonprofit affordable housing developers become familiar with three Building America performance measures, the installation processes, and impacts and benefits of each. A story and a half home in North Minneapolis, MN was presented by Urban Homeworks our local nonprofitmore » partner. The team helped them install three researched upgrade measures: exterior roof insulation or 'overcoat,' exterior foundation insulation, or 'excavationless', and a combined space and water heating HVAC system or 'combi.'« less

  6. Affordable Care Act Impact on Medicaid Coverage of Smoking-Cessation Treatments.

    PubMed

    McMenamin, Sara B; Yoeun, Sara W; Halpin, Helen A

    2018-04-01

    Four sections of the Affordable Care Act address the expansion of Medicaid coverage for recommended smoking-cessation treatments for: (1) pregnant women (Section 4107), (2) all enrollees through a financial incentive (1% Federal Medical Assistance Percentage increase) to offer comprehensive coverage (Section 4106), (3) all enrollees through Medicaid formulary requirements (Section 2502), and (4) Medicaid expansion enrollees (Section 2001). The purpose of this study is to document changes in Medicaid coverage for smoking-cessation treatments since the passage of the Affordable Care Act and to assess how implementation has differentially affected Medicaid coverage policies for: pregnant women, enrollees in traditional Medicaid, and Medicaid expansion enrollees. From January through June 2017, data were collected and analyzed from 51 Medicaid programs (50 states plus the District of Columbia) through a web-based survey and review of benefits documents to assess coverage policies for smoking-cessation treatments. Forty-seven Medicaid programs have increased coverage for smoking-cessation treatments post-implementation of the Affordable Care Act by adopting one or more of the four smoking-cessation treatment provisions. Coverage for pregnant women increased in 37 states, coverage for newly eligible expansion enrollees increased in 32 states, and 15 states added coverage and/or removed copayments in order to apply for a 1% increase in the Federal Medical Assistance Percentage. Coverage for all recommended pharmacotherapy and group and individual counseling increased from seven states in 2009 to 28 states in 2017. The Affordable Care Act was successful in improving and expanding state Medicaid coverage of effective smoking-cessation treatments. Many programs are not fully compliant with the law, and additional guidance and clarification from the Centers for Medicare and Medicaid Services may be needed. Copyright © 2018 American Journal of Preventive Medicine. Published

  7. 78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ...This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule clarifies the approach used to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal governmental plans. This final rule also amends the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under the federal rate review program, and revises the timeline for states to propose state- specific thresholds for review and approval by the Centers for Medicare & Medicaid Services (CMS).

  8. 77 FR 37917 - Notice of Proposed Information Collection: Comment Request; Multifamily Housing Mortgage and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... Information Collection: Comment Request; Multifamily Housing Mortgage and Housing Assistance Restructuring.... This Notice also lists the following information: Title of Proposal: Multifamily Housing Mortgage and... the Multifamily Assisted Housing Reform and Affordability Act of 1997 as extended by the Market to...

  9. Balancing adequacy and affordability?: Essential Health Benefits under the Affordable Care Act.

    PubMed

    Haeder, Simon F

    2014-12-01

    The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Patterns in Health Care Access and Affordability Among Cancer Survivors During Implementation of the Affordable Care Act.

    PubMed

    Nipp, Ryan D; Shui, Amy M; Perez, Giselle K; Kirchhoff, Anne C; Peppercorn, Jeffrey M; Moy, Beverly; Kuhlthau, Karen; Park, Elyse R

    2018-06-01

    Cancer survivors face ongoing health issues and need access to affordable health care, yet studies examining health care access and affordability in this population are lacking. To evaluate health care access and affordability in a national sample of cancer survivors compared with adults without cancer and to evaluate temporal trends during implementation of the Affordable Care Act. We used data from the National Health Interview Survey from 2010 through 2016 to conduct a population-based study of 30 364 participants aged 18 years or older. We grouped participants as cancer survivors (n = 15 182) and those with no reported history of cancer, whom we refer to as control respondents (n = 15 182), matched on age. We excluded individuals reporting a cancer diagnosis prior to age 18 years and those with nonmelanoma skin cancers. We compared issues with health care access (eg, delayed or forgone care) and affordability (eg, unable to afford medications or health care services) between cancer survivors and control respondents. We also explored trends over time in the proportion of cancer survivors reporting these difficulties. Of the 30 364 participants, 18 356 (57.4%) were women. The mean (SD) age was 63.5 (23.5) years. Cancer survivors were more likely to be insured (14 412 [94.8%] vs 13 978 [92.2%], P < .001) and to have government-sponsored insurance (7266 [44.3%] vs 6513 [38.8%], P < .001) compared with control respondents. In multivariable models, cancer survivors were more likely than control respondents to report delayed care (odds ratio [OR], 1.38; 95% CI, 1.16-1.63), forgone medical care (OR, 1.76; 95% CI, 1.45-2.12), and/or inability to afford medications (OR, 1.77; 95% CI, 1.46-2.14) and health care services (OR, 1.46; 95% CI, 1.27-1.68) (P < .001 for all). From 2010 to 2016, the proportion of survivors reporting delayed medical care decreased each year (B = 0.47; P = .047), and the proportion of those needing and not

  11. 76 FR 41263 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH10-1004

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Intent To Award Affordable Care Act (ACA) Funding, EH10-1004 Notice of Intent to award Affordable Care Act (ACA) funding to National Association for Public Health Statistics and Information Systems... under funding opportunity EH10-1004, ``National Environmental Public Health Tracking Program.'' AGENCY...

  12. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... 153 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment; Proposed Rule #0;#0;Federal Register / Vol. 76 , No. 136 / Friday, July 15, 2011...] RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk...

  13. Barriers to Homeless Persons Acquiring Health Insurance Through the Affordable Care Act.

    PubMed

    Fryling, Lauren R; Mazanec, Peter; Rodriguez, Robert M

    2015-11-01

    Medicaid expansion under the Affordable Care Act (ACA) is intended to provide a framework for increasing health care access for vulnerable populations, including the 1.2 million who experience homelessness each year in the United States. We sought to characterize homeless persons' knowledge of the ACA, identify barriers to their ACA enrollment, and determine access to various forms of communication that could be used to facilitate enrollment. At an urban county Level I trauma center, we interviewed all noncritically ill adults who presented to the emergency department (ED) during daytime hours and were able to provide consent. We assessed access to communication, awareness of the ACA, insurance status, and barriers preventing subjects from enrolling in health insurance and compared homeless persons' responses with concomitantly enrolled housed individuals. Of the 650 enrolled subjects, 134 (20.2%) were homeless. Homeless subjects were more likely to have never heard of the ACA (26% vs. 10%). "Not being aware if they qualify for Medicaid" was the most common (70%) and most significant (30%) barrier to enrollment reported by uninsured homeless persons. Of homeless subjects who were unsure if they qualified for Medicaid, 91% reported an income < 138% of the federal poverty level, likely qualifying them for enrollment. Although 99% of housed subjects reported access to either phone or internet, only 74% of homeless subjects reported access. Homeless persons report having less knowledge of the ACA than their housed counterparts, poor understanding of ACA qualification criteria, and limited access to phone and internet. ED-based outreach and education regarding ACA eligibility may increase their enrollment. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. 78 FR 33233 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-04

    ... would affect the ability of employers to offer stand-alone pediatric dental coverage in the FF- SHOP... Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Small... rule. SUMMARY: This final rule implements provisions of the Patient Protection and Affordable Care Act...

  15. Critical Care Implications of the Affordable Care Act

    PubMed Central

    Dogra, Anjali P.; Dorman, Todd

    2015-01-01

    Objectives To provide an overview of key elements of the Affordable Care Act (ACA). To evaluate ways in which the ACA will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the ACA. Data Sources and Synthesis Data sources for this concise review include search results from the PubMed and Embase databases, as well as sources relevant to public policy such as the text of the Patient Protection and Affordable Care Act and reports of the Congressional Budget Office (CBO). As all of the ACA's provisions will not be fully implemented until 2019, we also drew upon cost, population and utilization projections as well as the experience of existing state-based healthcare reforms. Conclusion The ACA represents the furthest reaching regulatory changes in the US healthcare system since the 1965 Medicare and Medicaid provisions of the Social Security Act. The ACA aims to expand health insurance coverage to millions of Americans and place an emphasis on quality and cost-effectiveness of care. From models which link pay and performance to those which center on episodic care, the ACA outlines sweeping changes to health systems, reimbursement structures, and the delivery of critical care. Staffing models that include daily rounding by an intensivist, palliative care integration, and expansion of the role of telemedicine in areas where intensivists are inaccessible are potential strategies that may improve quality and profitability of ICU care in the post-ACA era. PMID:26565630

  16. Essential health benefits and the Affordable Care Act: law and process.

    PubMed

    Bagley, Nicholas; Levy, Helen

    2014-04-01

    Starting in 2014, the Affordable Care Act (ACA) will require private insurance plans sold in the individual and small-group markets to cover a roster of "essential health benefits." Precisely which benefits should count as essential, however, was left to the discretion of the Department of Health and Human Services (HHS). The matter was both important and controversial. Nonetheless, HHS announced its policy by posting on the Internet a thirteen-page bulletin stating that it would allow each state to define essential benefits for itself. On both substance and procedure, the move was surprising. The state-by-state approach departed from the uniform, federal standard that the ACA appears to anticipate and that informed observers expected HHS to adopt. And announcing the policy through an Internet bulletin appeared to allow HHS to sidestep traditional administrative procedures, including notice and comment, immediate review in the courts, and White House oversight. This article explores two questions. First, is the state-by-state approach a lawful exercise of HHS's authority? Second, did HHS in fact evade the procedural obligations that are meant to shape the exercise of its discretion?

  17. Housing ownership and affordability among low-income society in the poorest sub-district of Semarang, Central Java, Indonesia

    NASA Astrophysics Data System (ADS)

    Indrianingrum, Lulut

    2017-03-01

    The Government has intervened to deal with various affordable public housing programs, as well as financing programs for Low Income society in Indonesia. The characteristics of this society in each region are so diverse, that made the housing programs for this social segment uneasy in reaching the right target. Regulation of Housing and Settlement No. 2/2001 has mandated that the State are obliged to implement a habitable public housing for people, especially for the low income society. The purpose of this study is exploring the low-income residents' preferences and affordability of home ownership for their families in the poorest sub-district of Semarang. Aspects of studies include family conditions, financing, location, housing type and price. The research used a descriptive method to analyze a set of questionnaire data, distributed to low income residents in Sub district Tanjungmas, which isthe poorest sub district in Semarang. The results showed that the respondents developed a vision of home ownership by saving their money for the allocated housing budget and taking a bank installment. They tended to plan to get a house in their current neighborhood or nearby or anywhere else with the same price range. They really understood that, in order to get a better home and neighborhood they have to pay for higher prices. Therefore, their housing criteria or standards were set based on the quality of life in their current residential area, and should be located in a township (kampung).

  18. The Affordable Care Act: the ethical call to transform the organizational culture.

    PubMed

    Piper, Llewellyn E

    2014-01-01

    The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

  19. Women's Awareness of Their Contraceptive Benefits Under the Patient Protection and Affordable Care Act.

    PubMed

    Chuang, Cynthia H; Mitchell, Julie L; Velott, Diana L; Legro, Richard S; Lehman, Erik B; Confer, Lindsay; Weisman, Carol S

    2015-11-01

    The Patient Protection and Affordable Care Act mandates that there be no out-of-pocket cost for Food and Drug Administration-approved contraceptive methods. Among 987 privately insured reproductive aged Pennsylvania women, fewer than 5% were aware that their insurance covered tubal sterilization, and only 11% were aware that they had full coverage for an intrauterine device. For the Affordable Care Act contraceptive coverage mandate to affect effective contraception use and reduce unintended pregnancies, public awareness of the expanded benefits is essential.

  20. Patient Protection and Affordable Care Act; program integrity: Exchange, SHOP, and eligibility appeals. Final rule.

    PubMed

    2013-08-30

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases. It also sets forth standards with respect to a State's operation of the Exchange and Small Business Health Options Program (SHOP). It generally is finalizing previously proposed policies without change.

  1. 76 FR 59703 - Notice of Intent To Award Affordable Care Act (ACA) Funding, RFA-TP-08-001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... Intent To Award Affordable Care Act (ACA) Funding, RFA- TP-08-001 AGENCY: Centers for Disease Control and... of Intent to award Affordable Care Act (ACA) funding to Preparedness and Emergency Response Research... continuation application under Funding Opportunity Announcement RFA-TP- 08-001, ``Preparedness and Emergency...

  2. Evaluation of a model community-wide bed bug management program in affordable housing.

    PubMed

    Cooper, Richard A; Wang, Changlu; Singh, Narinderpal

    2016-01-01

    Low-income apartment communities in the United States are suffering from disproportionally high bed bug, Cimex lectularius L., infestations owing to lack of effective monitoring and treatment. Studies examining the effectiveness of integrated pest management (IPM) for the control of bed bugs in affordable housing have been limited to small subsets of bed-bug-infested apartments, rather than at the apartment community level. We developed, implemented and evaluated a complex-wide IPM program for bed bugs in an affordable housing community. Proactive inspections and biweekly treatments using a combination of non-chemical and chemical methods until bed bugs were not detected for three biweekly monitoring visits were key elements of the IPM program. A total of 55 bed-bug-infested apartments were identified during the initial inspection. Property management was unaware of 71% of these infestations. Over the next 12 months, 14 additional infested apartments were identified. The IPM program resulted in a 98% reduction in bed bug counts among treated apartments and reduced infestation rates from 15 to 2.2% after 12 months. Adopting a complex-wide bed bug IPM program, incorporating proactive monitoring, and biweekly treatments of infested apartments utilizing non-chemical and chemical methods can successfully reduce infestation rates to very low levels. © 2015 Society of Chemical Industry.

  3. 75 FR 52689 - Multifamily Housing Reform and Affordability Act: Projects Eligible for a Restructuring Plan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Part 401 [Docket No. FR-5304-P-01] RIN 2502... Counsel, Department of Housing and Urban Development, 451 7th Street, SW., Room 10276, Washington, DC..., Department of Housing and Urban Development, 451 7th Street, SW., Room 10276, Washington, DC 20410-0500. 2...

  4. NorthernSTAR 1-1/2-Story Demonstration House of Cold Climate Solutions for Affordable Housing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schirber, T.; Ojczyk, C.; Jacobson, R.

    Single family homes in urban areas that are available for renovation by nonprofit developers are often in rough shape (1MM to 2MM nationally). Budgeting has historically focused on improving homes to meet basic housing standards. A rising interest in the long-term impact of homeownership has introduced the need to balance basic needs with home performance. This demonstration project aims to help nonprofit affordable housing developers become familiar with three Building America performance measures, the installation processes, and impacts and benefits of each. A story and a half home in North Minneapolis, MN was presented by Urban Homeworks our local nonprofitmore » partner. The team helped them install three researched upgrade measures: exterior roof insulation or 'overcoat,' exterior foundation insulation, or 'excavationless', and a combined space and water heating HVAC system or 'combi'. To maximize efficiency of application and to address budget issues, the Team worked with Urban Homeworks to identify ways to use volunteers and construction training programs to install the measures. An open invitation to visit the job site was extended to other nonprofit developers and industry partners to encourage dialog about the systems during live installation.« less

  5. Promoting Prevention Through the Affordable Care Act: Workplace Wellness

    PubMed Central

    Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William

    2012-01-01

    Public health in the United States can be improved by building workplace “cultures of health” that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public’s health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness. PMID:23237245

  6. 24 CFR 180.410 - Charges under the Fair Housing Act.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Charges under the Fair Housing Act. 180.410 Section 180.410 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

  7. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title...

  8. Racial and Ethnic Health Disparities and the Affordable Care Act: a Status Update

    PubMed Central

    Sealy-Jefferson, Shawnita; Vickers, Jasmine; Elam, Angela; Wilson, M. Roy

    2015-01-01

    Persistent racial and ethnic health disparities exist in the USA, despite decades of research and public health initiatives. Several factors contribute to health disparities, including (but not limited to) implicit provider bias, access to health care, social determinants, and biological factors. Disparities in health by race/ethnicity are unacceptable and correctable. The Patient Protection and Affordable Care Act is a comprehensive legislation that is focused on improving health care access, quality, and cost control. This health care reform includes specific provisions which focus on preventive care, the standardized collection of data on race, ethnicity, primary language and disability status, and health information technology. Although some provisions of the Patient Protection and Affordable Care Act have not been implemented, such as funding for the U.S. Public Health Sciences track, which would have addressed the shortage of medical professionals in the USA who are trained to use patient-centered, interdisciplinary, and care coordination approaches, this legislation is still poised to make great strides toward eliminating health disparities. The purpose of this manuscript is to highlight the unprecedented opportunities that exist for the Patient Protection and Affordable Care Act to reduce racial and ethnic disparities in health in the USA. PMID:26668787

  9. Women’s Awareness of Their Contraceptive Benefits Under the Patient Protection and Affordable Care Act

    PubMed Central

    Mitchell, Julie L.; Velott, Diana L.; Legro, Richard S.; Lehman, Erik B.; Confer, Lindsay; Weisman, Carol S.

    2015-01-01

    The Patient Protection and Affordable Care Act mandates that there be no out-of-pocket cost for Food and Drug Administration–approved contraceptive methods. Among 987 privately insured reproductive aged Pennsylvania women, fewer than 5% were aware that their insurance covered tubal sterilization, and only 11% were aware that they had full coverage for an intrauterine device. For the Affordable Care Act contraceptive coverage mandate to affect effective contraception use and reduce unintended pregnancies, public awareness of the expanded benefits is essential. PMID:26447910

  10. Small businesses and the Affordable Care Act of 2010.

    PubMed

    Collins, Sara R; Davis, Karen; Nicholson, Jennifer L; Stremikis, Kristof

    2010-09-01

    The Patient Protection and Affordable Care Act (ACA) includes several short- and long-term provisions designed to help small businesses pay for and maintain health insurance for their workers, and to allow workers without employer coverage to gain access to affordable, comprehensive health insurance. Provisions include a small business tax credit to offset premium costs for firms that offer coverage starting this taxable year, establishment of state-based insurance exchanges that promise to lower administrative costs and pool risk more broadly, and creation of new market rules and an essential benefit standard to protect small firms and their workers. Analysis shows that up to 16.6 million workers are in firms that would be eligible for the tax credit in 2010 to 2013. Over the next 10 years, small businesses and organizations could receive an estimated $40 billion in federal support through the premium credit program.

  11. Projecting the Unmet Need and Costs for Contraception Services After the Affordable Care Act

    PubMed Central

    Steinmetz, Erika; Gavin, Lorrie; Rivera, Maria I.; Pazol, Karen; Moskosky, Susan; Weik, Tasmeen; Ku, Leighton

    2016-01-01

    Objectives. We estimated the number of women of reproductive age in need who would gain coverage for contraceptive services after implementation of the Affordable Care Act, the extent to which there would remain a need for publicly funded programs that provide contraceptive services, and how that need would vary on the basis of state Medicaid expansion decisions. Methods. We used nationally representative American Community Survey data (2009), to estimate the insurance status for women in Massachusetts and derived the numbers of adult women at or below 250% of the federal poverty level and adolescents in need of confidential services. We extrapolated findings to simulate the impact of the Affordable Care Act nationally and by state, adjusting for current Medicaid expansion and state Medicaid Family Planning Expansion Programs. Results. The number of low-income women at risk for unintended pregnancy is expected to decrease from 5.2 million in 2009 to 2.5 million in 2016, based on states’ current Medicaid expansion plans. Conclusions. The Affordable Care Act increases women’s insurance coverage and improves access to contraceptive services. However, for women who remain uninsured, publicly funded family planning programs may still be needed. PMID:26691128

  12. 24 CFR 791.403 - Allocation of housing assistance.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... as needed for uses that the Secretary determines are incapable of geographic allocation by formula... prescribed set-aside, is, in the determination of the Secretary, incapable of geographic allocation by... programs authorized by the Cranston-Gonzalez National Affordable Housing Act: the Homeownership and...

  13. 76 FR 41262 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH11-1103

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Intent To Award Affordable Care Act (ACA) Funding, EH11-1103 Notice of Intent to award Affordable Care... opportunity EH11-1103, ``National Environmental Public Health Tracking Program-Network Implementation... under funding opportunity EH11-1103, ``National Environmental Public Health Tracking Program-Network...

  14. Procedures for the Handling of Retaliation Complaints Under Section 1558 of the Affordable Care Act. Final rule.

    PubMed

    2016-10-13

    This document provides the final text of regulations governing employee protection (retaliation or whistleblower) claims under section 1558 of the Affordable Care Act, which added section 18C to the Fair Labor Standards Act to provide protections to employees who may have been subject to retaliation for seeking assistance under certain affordability assistance provisions (for example, health insurance premium tax credits) or for reporting potential violations of the Affordable Care Act's consumer protections (for example, the prohibition on rescissions). An interim final rule (IFR) governing these provisions and request for comments was published in the Federal Register on February 27, 2013. Thirteen comments were received; eleven were responsive to the IFR. This rule responds to those comments and establishes the final procedures and time frames for the handling of retaliation complaints under section 18C, including procedures and time frames for employee complaints to the Occupational Safety and Health Administration (OSHA), investigations by OSHA, appeals of OSHA determinations to an administrative law judge (ALJ) for a hearing de novo, hearings by ALJs, review of ALJ decisions by the Administrative Review Board (ARB) (acting on behalf of the Secretary of Labor), and judicial review of the Secretary of Labor's (Secretary's) final decision. It also sets forth the Secretary's interpretations of the Affordable Care Act whistleblower provision on certain matters.

  15. 78 FR 11459 - Implementation of the Fair Housing Act's Discriminatory Effects Standard

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ...Title VIII of the Civil Rights Act of 1968, as amended (Fair Housing Act or Act), prohibits discrimination in the sale, rental, or financing of dwellings and in other housing-related activities on the basis of race, color, religion, sex, disability, familial status, or national origin.\\1\\ HUD, which is statutorily charged with the authority and responsibility for interpreting and enforcing the Fair Housing Act and with the power to make rules implementing the Act, has long interpreted the Act to prohibit practices with an unjustified discriminatory effect, regardless of whether there was an intent to discriminate. The eleven federal courts of appeals that have ruled on this issue agree with this interpretation. While HUD and every federal appellate court to have ruled on the issue have determined that liability under the Act may be established through proof of discriminatory effects, the statute itself does not specify a standard for proving a discriminatory effects violation. As a result, although HUD and courts are in agreement that practices with discriminatory effects may violate the Fair Housing Act, there has been some minor variation in the application of the discriminatory effects standard. ---------------------------------------------------------------------------

  16. Earthquake Insurance Affordability Act

    THOMAS, 112th Congress

    Rep. Campbell, John [R-CA-48

    2011-10-06

    House - 10/21/2011 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  17. Mass Housing Using GFRG Panels: A Sustainable, Rapid and Affordable Solution

    NASA Astrophysics Data System (ADS)

    Cherian, Philip; Paul, Shinto; Krishna, S. R. Gouri; Menon, Devdas; Meher Prasad, A.

    2017-06-01

    This work gives an overview of research and development carried out at IIT Madras, using glass fibre reinforced gypsum (GFRG) panels, to provide an innovative solution for rapid and affordable mass housing. The GFRG panels (124 mm thick), made from recycled industrial waste gypsum (from the fertilizer industry), are prefabricated in 3 m × 12 m sizes with cellular cavities inside, which can be filled with reinforced concrete wherever required and can be used as walls as well as floor slabs. The tests carried out (over the past 12 years) establish the performance of GFRG building systems to resist gravity and lateral loads as a load-bearing system (without beams and columns) in multi-storeyed buildings up to 8-10 storeys, with adequate strength, serviceability, durability and ductility. A two-storeyed four-apartment demonstration building has also been successfully constructed in the IIT Madras campus and presently a mass housing scheme (40 apartment units) using this technology is being demonstrated at Nellore. A structural design code has also been approved by the Bureau of Indian Standards, based on the extensive studies carried out on GFRG building systems.

  18. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Exercise of any right afforded by the Act. 1977.12 Section 1977.12 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS UNDER THE WILLIAMS-STEIGER...

  19. Balancing act: approaches to healthy eating and physical activity among Boston public housing residents.

    PubMed

    Scammell, Madeleine Kangsen; Torres, Shioban; Wayman, Julie; Greenwood, Nechama; Thomas, Gerry; Kozlowski, Lauren; Bowen, Deborah

    2015-01-01

    Boston public housing residents are more likely to report fair or poor health status, been diagnosed with obesity, and to be physically inactive compared with other Boston residents (Digenis-Bury, Brooks, Chen, Ostrem, & Horsburgh, 2008 ). Little is known about perceptions of and opportunities for healthy eating and physical activity in this population. We conducted eight focus groups at public housing developments to explore residents' views regarding opportunities and barriers to healthy eating and physical activity. Sixty-seven English- and Spanish-speaking residents participated. Transcripts were analyzed using qualitative content analysis. All residents described the challenge of balancing considerations of food quality, access, and affordability. Other findings included underutilized nutritional resources; abundant availability of unhealthy food; and economic and structural barriers to exercise. Transportation-related challenges were a dominant theme. Building opportunities for physical activity and providing access to affordable and quality food choices may be important interventions for promoting health among public housing residents.

  20. Data mining of space heating system performance in affordable housing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ren, Xiaoxin; Yan, Da; Hong, Tianzhen

    The space heating in residential buildings accounts for a considerable amount of the primary energy use. Therefore, understanding the operation and performance of space heating systems becomes crucial in improving occupant comfort while reducing energy use. This study investigated the behavior of occupants adjusting their thermostat settings and heating system operations in a 62-unit affordable housing complex in Revere, Massachusetts, USA. The data mining methods, including clustering approach and decision trees, were used to ascertain occupant behavior patterns. Data tabulating ON/OFF space heating states was assessed, to provide a better understanding of the intermittent operation of space heating systems inmore » terms of system cycling frequency and the duration of each operation. The decision tree was used to verify the link between room temperature settings, house and heating system characteristics and the heating energy use. The results suggest that the majority of apartments show fairly constant room temperature profiles with limited variations during a day or between weekday and weekend. Data clustering results revealed six typical patterns of room temperature profiles during the heating season. Space heating systems cycled more frequently than anticipated due to a tight range of room thermostat settings and potentially oversized heating capacities. In conclusion, from this study affirm data mining techniques are an effective method to analyze large datasets and extract hidden patterns to inform design and improve operations.« less

  1. Data mining of space heating system performance in affordable housing

    DOE PAGES

    Ren, Xiaoxin; Yan, Da; Hong, Tianzhen

    2015-02-16

    The space heating in residential buildings accounts for a considerable amount of the primary energy use. Therefore, understanding the operation and performance of space heating systems becomes crucial in improving occupant comfort while reducing energy use. This study investigated the behavior of occupants adjusting their thermostat settings and heating system operations in a 62-unit affordable housing complex in Revere, Massachusetts, USA. The data mining methods, including clustering approach and decision trees, were used to ascertain occupant behavior patterns. Data tabulating ON/OFF space heating states was assessed, to provide a better understanding of the intermittent operation of space heating systems inmore » terms of system cycling frequency and the duration of each operation. The decision tree was used to verify the link between room temperature settings, house and heating system characteristics and the heating energy use. The results suggest that the majority of apartments show fairly constant room temperature profiles with limited variations during a day or between weekday and weekend. Data clustering results revealed six typical patterns of room temperature profiles during the heating season. Space heating systems cycled more frequently than anticipated due to a tight range of room thermostat settings and potentially oversized heating capacities. In conclusion, from this study affirm data mining techniques are an effective method to analyze large datasets and extract hidden patterns to inform design and improve operations.« less

  2. Patient Protection and Affordable Care Act; establishment of exchanges and qualified health plans; exchange standards for employers. Final rule, Interim final rule.

    PubMed

    2012-03-27

    This final rule will implement the new Affordable Insurance Exchanges ("Exchanges"), consistent with title I of the Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors. The Exchanges, which will become operational by January 1, 2014, will help enhance competition in the health insurance market, improve choice of affordable health insurance, and give small businesses the same purchasing clout as large businesses.

  3. Anticipating the effect of the Patient Protection and Affordable Care Act for patients with urologic cancer.

    PubMed

    Ellimoottil, Chandy; Miller, David C

    2014-02-01

    The Affordable Care Act seeks to overhaul the US health care system by providing insurance for more Americans, improving the quality of health care delivery, and reducing health care expenditures. Although the law's intent is clear, its implementation and effect on patient care remains largely undefined. Herein, we discuss major components of the Affordable Care Act, including the proposed insurance expansion, payment and delivery system reforms (e.g., bundled payments and Accountable Care Organizations), and other reforms relevant to the field of urologic oncology. We also discuss how these proposed reforms may affect patients with urologic cancers.

  4. The Affordable Care Act versus Medicare for All.

    PubMed

    Seidman, Laurence

    2015-08-01

    Many problems facing the Affordable Care Act would disappear if the nation were instead implementing Medicare for All - the extension of Medicare to every age group. Every American would be automatically covered for life. Premiums would be replaced with a set of Medicare taxes. There would be no patient cost sharing. Individuals would have free choice of doctors. Medicare's single-payer bargaining power would slow price increases and reduce medical cost as a percentage of gross domestic product (GDP). Taxes as a percentage of GDP would rise from below average to average for economically advanced nations. Medicare for All would be phased in by age. Copyright © 2015 by Duke University Press.

  5. The Patient Protection and Affordable Care Act: opportunities for prevention and public health.

    PubMed

    Shaw, Frederic E; Asomugha, Chisara N; Conway, Patrick H; Rein, Andrew S

    2014-07-05

    The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low health-care efficiency and quality. By 2019, the law will bring health coverage--and the health benefits of insurance--to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realised new provisions to curb costs (including tests of new health-care delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programmes, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides impetus for greater collaboration between the US health-care and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. The Affordable Care Act: the ethical call for value-based leadership to transform quality.

    PubMed

    Piper, Llewellyn E

    2013-01-01

    Hospitals in America face a daunting and historical challenge starting in 2013 as leadership navigates their organizations toward a new port of call-the Patient Protection and Affordable Care Act. Known as the Affordable Care Act (ACA) was signed into law in March 2010 and held in abeyance waiting on 2 pivotal points-the Supreme Court's June 2012 ruling upholding the constitutionality of the ACA and the 2012 presidential election of Barack Obama bringing to reality to health care organizations that leadership now must implement the mandates of health care delivery under the ACA. This article addresses the need for value-based leadership to transform the culture of health care organizations in order to be successful in navigating uncharted waters under the unprecedented challenges for change in the delivery of quality health care.

  7. Crossing 138: two approaches to churn under the Affordable Care Act.

    PubMed

    Ravel, Gabriel; DeSantis, J Angelo

    2014-01-01

    A predicted side effect of the Medicaid expansion and state-based Exchanges under the Affordable Care Act is churn. Churn is the shifting into and out of eligibility for insurance affordability programs due to income changes. Because the line between Medicaid and Exchange eligibility is fine -138% of the federal poverty level -millions of Americans are expected to gain and lose eligibility. Frequently, this churning undermines continuity of care, raises costs, and frustrates those affected. This article explores two proposed programs to mitigate the effects of churn: the Basic Health Program and the Bridge Program. This article evaluates both programs' ability to mitigate the effects of churn, the likely side effects to states' implementing them, and legal and practical obstacles to their implementation. It concludes that the Bridge Program is the better approach.

  8. Patient Protection and Affordable Care Act; standards related to essential health benefits, actuarial value and accreditation. Final rule.

    PubMed

    2013-02-25

    This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.

  9. The bishops and housing.

    PubMed

    Shellabarger, Thomas

    2005-01-01

    According to Catholic social teaching, housing is not a commodity but a human right. To ensure that all people--especially low-income elderly and other vulnerable populations--have access to affordable housing, the church has established a variety of programs, services, and advocacy efforts. Much of this work is based on key concepts: preserving existing housing stock, creating new programs to provide more options for the underserved, empowering residents and communities to deal with housing issues, establishing partnerships to make organizations' efforts more successful, making housing affordable, and ending discrimination in housing. Although church ministries, community groups, the private sector, and other players must work together to find solutions to the housing crisis, federal leadership is essential. Especially with the housing affordability gap growing and the U.S. population aging, the federal government must provide the resources, leadership, and direction for effective housing solutions.

  10. Health insurance issuers implementing medical loss ratio (MLR) requirements under the Patient Protection and Affordable Care Act. Interim final rule with request for comments.

    PubMed

    2010-12-01

    This document contains the interim final regulation implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act).

  11. Patient Protection and Affordable Care Act; establishment of exchanges and qualified health plans; Small Business Health Options Program. Final rule.

    PubMed

    2013-06-04

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) related to the Small Business Health Options Program (SHOP). Specifically, this final rule amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.

  12. Achieving Challenge Home in Affordable Housing in the Hot-Humid Climate

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beal, D.; McIlvaine, J.; Winter, B.

    2014-08-01

    The Building America Partnership for Improved Residential Construction (BA-PIRC), one of the Building America research team leads, has partnered with two builders as they work through the Challenge Home certification process in one test home each. The builder partners participating in this cost-shared research are Southeast Volusia County Habitat for Humanity near Daytona, Florida and Manatee County Habitat for Humanity near Tampa, Florida. Both are affiliates of Habitat for Humanity International, a non-profit affordable housing organization. This research serves to identify viable technical pathways to meeting the CH criteria for other builders in the region. A further objective of thismore » research is to identify gaps and barriers in the marketplace related to product availability, labor force capability, code issues, cost effectiveness, and business case issues that hinder or prevent broader adoption on a production scale.« less

  13. Patient Protection and Affordable Care Act; standards related to reinsurance, risk corridors, and risk adjustment. Final rule.

    PubMed

    2012-03-23

    This final rule implements standards for States related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustment consistent with title I of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. These programs will mitigate the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms and the Affordable Insurance Exchanges ("Exchanges") are implemented, starting in 2014. The transitional State-based reinsurance program serves to reduce uncertainty by sharing risk in the individual market through making payments for high claims costs for enrollees. The temporary Federally administered risk corridors program serves to protect against uncertainty in rate setting by qualified health plans sharing risk in losses and gains with the Federal government. The permanent State-based risk adjustment program provides payments to health insurance issuers that disproportionately attract high-risk populations (such as individuals with chronic conditions).

  14. Implementing the Affordable Care Act: State Action to Establish SHOP Marketplaces.

    PubMed

    Dash, Sarah J; Lucia, Kevin W; Thomas, Amy

    2014-03-01

    The Affordable Care Act seeks to help small employers offer coverage by reforming the small-group market and establishing Small Business Health Options Program (SHOP) marketplaces. Seventeen states and the District of Columbia chose to operate their own SHOP marketplaces in 2014, with the federal government operating the SHOP marketplace in 33 states. This brief examines state decisions to enhance the value of SHOP marketplaces for small employers and finds that most have set predictable participation and eligibility requirements and will offer a competitive choice of insurers and plans. States also are seeking to facilitate small employers' shopping experience through online tools and access to personalized assistance. While not all SHOP marketplaces are yet functioning as intended, their establishment offers an opportunity to identify successful strategies for improving the affordability and accessibility of coverage for small employers.

  15. The Impact of the Affordable Care Act on Funding for Newborn Screening Services.

    PubMed

    Costich, Julia F; Durst, Andrea L

    2016-01-01

    The Affordable Care Act requires most health plans to cover the federal Recommended Uniform Screening Panel of newborn screening (NBS) tests with no cost sharing. However, state NBS programs vary widely in both the number of mandated tests and their funding mechanisms, including a combination of state laboratory fees, third-party billing, and other federal and state funding. We assessed the potential impact of the Affordable Care Act coverage mandate on states' NBS funding. We performed an extensive review of the refereed literature, federal and state agency reports, relevant organizations' websites, and applicable state laws and regulations; interviewed 28 state and federal officials from August to December 2014; and then assessed the interview findings manually. Although a majority of states had well-established systems for including laboratory-based NBS tests in bundled charges for newborn care, billing practices for critical congenital heart disease and newborn hearing tests were less uniform. Most commonly, birthing facilities either prepaid the costs of laboratory-based tests when acquiring the filter paper kits, or the facilities paid for the tests when the kits were submitted. Some states had separate arrangements for billing Medicaid, and smaller facilities sometimes contracted with hearing test vendors that billed families separately. Although the Affordable Care Act coverage mandate may offset some state NBS funding for the screenings themselves, federal support is still required to assure access to the full range of NBS program services. Limiting reimbursement to the costs of screening tests alone would undermine the common practice of using screening charges to fund follow-up services counseling, and medical food or formula, particularly for low-income families.

  16. America's Affordable Housing Crisis: A Contract Unfulfilled

    PubMed Central

    Freeman, Lance

    2002-01-01

    For many poor Americans, having a decent home and suitable living environment remains a dream. This lack of adequate housing is not only a burden for many of the poor, but it is harmful to the larger society as well, because of the adverse effects of inadequate housing on public health. Not only is the failure to provide adequate housing shortsighted from a policy perspective, but it is also a failure to live up to societal obligations. There is a societal obligation to meet the housing needs of everyone, including the most disadvantaged. Housing assistance must become a federally-funded entitlement. PMID:11988431

  17. America's affordable housing crisis: a contract unfulfilled.

    PubMed

    Freeman, Lance

    2002-05-01

    For many poor Americans, having a decent home and suitable living environment remains a dream. This lack of adequate housing is not only a burden for many of the poor, but it is harmful to the larger society as well, because of the adverse effects of inadequate housing on public health. Not only is the failure to provide adequate housing shortsighted from a policy perspective, but it is also a failure to live up to societal obligations. There is a societal obligation to meet the housing needs of everyone, including the most disadvantaged. Housing assistance must become a federally-funded entitlement.

  18. 78 FR 46600 - Notice of Realty Action: Direct Sale of Public Land (N-91073) for Affordable Housing Purposes in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-01

    ...) for Affordable Housing Purposes in Las Vegas, Clark County, NV AGENCY: Bureau of Land Management... 5-acre public land parcel located in the southern portion of the Las Vegas Valley in Clark County... of the Las Vegas Valley in Clark County, Nevada, further described as: Mount Diablo Meridian T. 22 S...

  19. The Human Settlements Authority Act, 1988 (No. 2 of 1988), 4 June 1986.

    PubMed

    1988-01-01

    This Act establishes in Swaziland the Human Settlements Authority, whose members are appointed by the Minister responsible for human settlements. The Authority shall "1) assist the Government in formulating policy relating to human settlements and uphold and give effect to such policy; 2) ensure the orderly development of existing and future urban and rural settlements; 3) establish a finance mechanism for ensuring the supply and maintenance of improved shelter and infrastructure throughout Swaziland, which shall include a system of revenue recovery; 4) prepare appropriate standards for the provision of land, shelter and infrastructure by both private and public developers; 5) regulate real estate transactions including the standardization of lease agreements, rent control and sale of land and buildings; 6) encourage and support research in appropriate methods of providing affordable shelter and infrastructure; and 7) perform all other acts or things as are required by this Act." Under the Act, no person shall establish a human settlement, housing scheme, or private housing scheme without the written permission of the Authority. Further provisions of the Act deal with the membership and meetings of the Authority, the granting of permission for human settlements, and human settlement development plans, among other things. On 4 June 1986, the Government of Swaziland also enacted the National Housing Board Act, 1988 (No. 3 of 1988). This Act establishes a National Housing Board, subject to the provisions of the Human Settlements Act, 1988, to "provide affordable housing generally in Swaziland and take over such housing schemes as the Government may determine." Further provisions of the Act deal with the functions, membership, finances, staffing, assets, and administration of the Board. See Swaziland Government Gazette, Extraordinary, Vol. 26, No. 581, 2 March 1988, pp. S6-S11. full text

  20. Coverage of Certain Preventive Services Under the Affordable Care Act. Final rules.

    PubMed

    2015-07-14

    This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. These regulations finalize provisions from three rulemaking actions: Interim final regulations issued in July 2010 related to coverage of preventive services, interim final regulations issued in August 2014 related to the process an eligible organization uses to provide notice of its religious objection to the coverage of contraceptive services, and proposed regulations issued in August 2014 related to the definition of "eligible organization,'' which would expand the set of entities that may avail themselves of an accommodation with respect to the coverage of contraceptive services.

  1. Nursing homes and the affordable care act: a cease fire in the ongoing struggle over quality reform.

    PubMed

    Hawes, Catherine; Moudouni, Darcy M; Edwards, Rachel B; Phillips, Charles D

    2012-01-01

    Most provisions in the Affordable Care Act that affect nursing homes originated in two earlier attempts at reform, both of which failed multiple times in prior Congressional sessions: the Elder Justice Act and the Nursing Home Transparency and Improvement Act. Both of these earlier efforts focused on improving quality and reducing elder abuse in nursing homes by strengthening oversight and enforcement penalties, expanding staff training, and increasing the information on nursing home quality available to consumers and regulators. Each bill addressed problems that were serious, widespread, and had persisted for years, but each failed to pass on its own. The Affordable Care Act, with its own momentum, became the vehicle for their passage. However, the reasons the bills failed in these earlier efforts suggest implementation challenges now that they have ridden into law on the coattails of the more general effort to reform the health care sector.

  2. Opportunities for oncology in the Patient Protection and Affordable Care Act.

    PubMed

    Patel, Kavita K; Tran, Lisa

    2013-01-01

    The Patient Protection and Affordable Care Act (ACA) contains within it three significant legislative constructs: to enhance access to health care, improve quality, and decrease cost. Also known as the Triple Aim, these three simple, yet monumental, goals have been the object of actions to date as well as future implementation efforts. This article will identify sections of the legislation that would directly provide areas of opportunity to improve health and achieve the triple aim for the oncology profession.

  3. The Affordable Care Act and Cancer Care Delivery

    PubMed Central

    Brooks, Gabriel A.; Hoverman, J. Russell; Colla, Carrie H.

    2017-01-01

    The Affordable Care Act (ACA) has reformed U.S. health care delivery through insurance coverage expansion, experiments in payment design, and funding for patient-centered clinical and health care delivery research. The impact on cancer care specifically has been far-reaching, with new ACA-related programs that encourage coordinated, patient-centered, cost-effective care. Insurance expansions through private exchanges and Medicaid, along with pre-existing condition clauses, have helped over 20 million Americans gain health care coverage. Accountable care organizations, oncology patient-centered medical homes and the Oncology Care Model—all implemented through the Center for Medicare and Medicaid Innovation—have initiated an accelerating shift toward value-based cancer care. Concurrently, evidence for better cancer outcomes and improved quality of cancer care is starting to accrue in the wake of ACA implementation. PMID:28537961

  4. Achieving Challenge Home in Affordable Housing in the Hot-Humid Climate

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beal, D.; McIlvaine, J.; Winter, B.

    2014-08-01

    The Building America Partnership for Improved Residential Construction (BA-PIRC), one of the Building America research team leads, has partnered with two builders as they work through the Challenge Home certification process (now Zero Energy Ready Home) in one test home each. The builder partners participating in this cost-shared research are Southeast Volusia County Habitat for Humanity near Daytona, Florida and Manatee County Habitat for Humanity near Tampa, Florida. Both are affiliates of Habitat for Humanity International, a non-profit affordable housing organization. This research serves to identify viable technical pathways to meeting the CH criteria for other builders in the region.more » A further objective of this research is to identify gaps and barriers in the marketplace related to product availability, labor force capability, code issues, cost effectiveness, and business case issues that hinder or prevent broader adoption on a production scale.« less

  5. 77 FR 72581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... least two multi-State plans (MSPs) on each of the Affordable Insurance Exchanges (Exchanges). Under the... issuers to offer at least two multi-State plans (MSPs) on each of the Exchanges in the 50 States and the... Patient Protection and Affordable Care Act; Establishment of the Multi- State Plan Program for the...

  6. How the Patient Protection and Affordable Care Act affects Texas dentists.

    PubMed

    Oneacre, Lee P

    2012-10-01

    President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law March 23, 2010 (P.L. 111-148), as arguably the most significant legislative health reform since the creation of Medicare and Medicaid in 1965 (1). Several PPACA provisions will impact dentists as both health care providers and small business owners and employers (2). Overall, the law significantly changes health care financing and facilitates competition in the health insurance market place through the creation of health insurance exchanges (HIX).

  7. The Patient Protection and Affordable Care Act: A Primer for Hand Surgeons

    PubMed Central

    Adkinson, Joshua M.; Chung, Kevin C.

    2014-01-01

    The Affordable Care Act is the largest and most comprehensive overhaul of the United States healthcare industry since the inception of the Medicare and Medicaid. Contained within the 10 Titles are a multitude of provisions that will change how hand surgeons practice medicine and how they are reimbursed. It is imperative that surgeons are equipped with the knowledge of how this law will affect all physician practices and hospitals. PMID:25066853

  8. A Strong Step for Students: House Higher Education Bill Promotes Innovation and Student Success

    ERIC Educational Resources Information Center

    Duke, Amy-Ellen

    2008-01-01

    Last Thursday, the House of Representatives passed the College Opportunity and Affordability Act in a vote of 354-58. This legislation, H.R. 4137, moves Congress one step closer to the long-awaited reauthorization of the Higher Education Act of 1965, which governs federal student financial aid and other programs that promote access for low-income…

  9. Did the Affordable Care Act's dependent coverage mandate increase premiums?

    PubMed

    Depew, Briggs; Bailey, James

    2015-05-01

    We investigate the impact of the Affordable Care Act's dependent coverage mandate on insurance premiums. The expansion of dependent coverage under the ACA allows young adults to remain on their parent's private health insurance plans until the age of 26. We find that the mandate has led to a 2.5-2.8 percent increase in premiums for health insurance plans that cover children, relative to single-coverage plans. We are able to conclude that employers did not pass on the entire premium increase to employees through higher required plan contributions. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. 7 CFR 3575.40 - Equal opportunity and Fair Housing Act requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Equal opportunity and Fair Housing Act requirements. 3575.40 Section 3575.40 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GENERAL Community Programs Guaranteed Loans § 3575.40 Equal...

  11. The patient protection and affordable care act: how will it affect private health insurance for cancer patients?

    PubMed

    Schwartz, Karyn; Claxton, Gary

    2010-01-01

    The Patient Protection and Affordable Care Act will make health coverage more available and affordable while also strengthening regulations on the scope of private health insurance coverage. Most of the law's key provisions take effect in 2014, at which time health insurers will be barred from charging more or denying coverage for individuals with a pre-existing condition. Also in 2014, qualifying individuals will receive subsidies to purchase private insurance through newly created health insurance exchanges. New rules related to caps on benefits and stronger rights to appeal insurance company decisions take effect in 2010. In 2014, all insurance policies sold to individuals and small groups will have to cover an essential benefits package defined by the federal government. Although many Patient Protection and Affordable Care Act provisions do not apply to all types of private coverage, overall the law will provide more protections to cancer patients and survivors in the private health insurance marketplace.

  12. Medical Device Innovation in the Era of the Affordable Care Act

    PubMed Central

    Mattke, Soeren; Liu, Hangsheng; Orr, Patrick

    2016-01-01

    Abstract In this article, the authors explore why medical device innovation has traditionally been geared so thoroughly toward improving performance, with little regard to cost. They argue that the changing incentives in the health care sector and the move to value-based payment models, accelerated by the implementation of the Affordable Care Act, will force device manufacturers to redirect investments from the spectacular toward the prudent, which they dub “the end of sexy.” The authors explore consequences for manufacturers, investors, and policymakers. PMID:28083437

  13. Undocumented and uninsured: aftereffects of the Patient Protection and Affordable Care Act.

    PubMed

    Agabin, Nataly; Coffin, Janis

    2015-01-01

    Although with the implementation of the Patient Protection and Affordable Care Act millions of previously uninsured American residents will gain access to healthcare coverage, millions more will remain uninsured due to the lack of mandatory state Medicaid expansion as well as mandates that forbid undocumented immigrants and legal residents of less than five years from purchasing insurance through the newly available market exchange. With limited options for healthcare coverage due to employment and lack of citizen status, undocumented immigrants rely heavily on funds provided by both Emergency Medicaid and Disproportionate Share Hospital programs. Through reevaluation of current funding, mandates forbidding access to market exchanges, and plans to further enable access to affordable health coverage, states have the unique opportunity to both aid their residents and relieve the financial burden on healthcare facilities and Emergency Medicaid funds.

  14. 77 FR 70583 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... renewability protections, by prohibiting the use of factors such as health status, medical history, gender, and... comply with the provisions of the final rule, including administrative and marketing costs.... SUMMARY: This proposed rule would implement the Affordable Care Act's policies related to fair health...

  15. The patient protection and Affordable Care Act: a primer for hand surgeons.

    PubMed

    Adkinson, Joshua M; Chung, Kevin C

    2014-08-01

    The Affordable Care Act is the largest and most comprehensive overhaul of the United States health care industry since the inception of the Medicare and Medicaid. Contained within the 10 titles are a multitude of provisions that will change how hand surgeons practice medicine and how they are reimbursed. It is imperative that surgeons are equipped with the knowledge of how this law will affect all physician practices and hospitals. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. The Patient Protection and Affordable Care Act - The Role of the School Nurse: Position Statement.

    PubMed

    2015-07-01

    It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) serves a vital role in the delivery of health care to our nation’s students within the health care system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as the Affordable Care Act (ACA). This law presents an opportunity to transform the health care system through three primary goals: expanding access, improving quality, and reducing cost (U.S. Government Printing Office, 2010). School nurses stand at the forefront of this system change and continue to provide evidence-based, quality interventions and preventive care that, according to recent studies, actually save health care dollars (Wang et al., 2014). NASN supports the concept that school nursing services receive the same financial parity as other health care providers to improve overall health outcomes, including insurance reimbursement for services provided to students.

  17. Lessons Learned From the Affordable Care Act: The Premium Subsidy Design May Promote Adverse Selection.

    PubMed

    Graetz, Ilana; McKillop, Caitlin N; Kaplan, Cameron M; Waters, Teresa M

    2017-05-01

    Since 2014, average premiums for health plans available in the Affordable Care Act marketplaces have increased. We examine how premium price changes affected the amount consumers pay after subsidies for the lowest-cost bronze and silver plans available by age in the federally facilitated exchanges. Between 2015 and 2016, benchmark plan premiums increased in 83.3% of counties. Overall, rising benchmark premiums were associated with lower average after-subsidy premiums for the lowest-cost bronze and silver plans for older subsidy-eligible adults, but with higher after-subsidy premiums for younger adults purchasing the same plans, regardless of income. With recent discussions to replace or overhaul the Affordable Care Act, it is critical that we learn from the successes and failures of the current policy. Our findings suggest that the subsidy design, which makes rising premiums costlier for younger adults looking to purchase an entry-level plan, may be contributing to adverse selection and instability in the marketplace.

  18. Harnessing the Affordable Care Act to catalyze delivery system reform and strengthen emergency care in America.

    PubMed

    Maa, John

    2015-01-01

    As health care reform in the US evolves beyond insurance reform to encompass delivery system reform, the opportunity arises to harness the Affordable Care Act to strengthen patient care in America. One area for dedicated individuals to lead this effort is by improving transitions in patient care across the continuum of team members, specialties, settings, and systems. This article will describe innovations of the surgicalist and acute care surgeon that have emerged in response to the challenges facing surgery in specialization, geography, and the need to comply with health care reform mandates. Three ways will be described to integrate these innovations with pilot programs in the Affordable Care Act: to promote teamwork, to reduce readmissions, and to strengthen emergency care because the key location where the joint efforts intersect most acutely with patient need is in our nation's Emergency Departments.

  19. Harnessing the Affordable Care Act to Catalyze Delivery System Reform and Strengthen Emergency Care in America

    PubMed Central

    Maa, John

    2015-01-01

    As health care reform in the US evolves beyond insurance reform to encompass delivery system reform, the opportunity arises to harness the Affordable Care Act to strengthen patient care in America. One area for dedicated individuals to lead this effort is by improving transitions in patient care across the continuum of team members, specialties, settings, and systems. This article will describe innovations of the surgicalist and acute care surgeon that have emerged in response to the challenges facing surgery in specialization, geography, and the need to comply with health care reform mandates. Three ways will be described to integrate these innovations with pilot programs in the Affordable Care Act: to promote teamwork, to reduce readmissions, and to strengthen emergency care because the key location where the joint efforts intersect most acutely with patient need is in our nation’s Emergency Departments. PMID:25663212

  20. Awareness, Perceptions, and Communication Needs about the Affordable Care Act across the Life Span

    ERIC Educational Resources Information Center

    Bergeron, Caroline D.; Friedman, Daniela B.; Sisson, Diana C.; Tanner, Andrea; Kornegay, Vance L.; Owens, Otis L.; Weis, Megan A.; Patterson, Lee L.

    2016-01-01

    Background: By March 2014, all U.S. citizens were required to have health insurance according to the Affordable Care Act (ACA). Purpose: Study objectives were to explore individuals' opinions, perceptions, and communication sources and needs about the ACA and to assess differences by age group. Methods: In November 2013, 10 1-hour focus groups (5…

  1. 76 FR 52663 - Notice of Intent To Award Affordable Care Act Funding, DP-09-001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... Intent To Award Affordable Care Act Funding, DP-09-001 AGENCY: Centers for Disease Control and Prevention... received and competed in response to CDC Funding Opportunity, RFA-DP-09-001, ``Health Promotion and Disease... for this initiative. Award Information Approximate Current Fiscal Year Funding: $10,000,000. [[Page...

  2. 75 FR 19920 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Part 1000 [Docket No. FR-5275-N-08] Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated Rulemaking... Self-Determination Reauthorization Act of 2008. The primary purpose of the committee is to discuss and...

  3. 75 FR 13243 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-19

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Part 1000 [Docket No. FR-5275-N-06] Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated Rulemaking... Self-Determination Reauthorization Act of 2008. The primary purpose of the committee is to discuss and...

  4. 78 FR 20581 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non-Navigator Assistance..., training and certification, and meaningful access standards applicable to Navigators and non-Navigator assistance personnel in Federally- facilitated Exchanges, including State Partnership Exchanges, and to non...

  5. Earthquake Insurance Affordability Act

    THOMAS, 112th Congress

    Sen. Feinstein, Dianne [D-CA

    2011-03-17

    Senate - 03/17/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. 24 CFR 1000.144 - Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of section 205(a)(2)? 1000.144 Section 1000.144... AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.144 Are Mutual Help homes developed under...

  7. 24 CFR 1000.144 - Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of section 205(a)(2)? 1000.144 Section 1000.144... AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.144 Are Mutual Help homes developed under...

  8. Coverage Gains After the Affordable Care Act Among the Uninsured in Minnesota.

    PubMed

    Call, Kathleen Thiede; Lukanen, Elizabeth; Spencer, Donna; Alarcón, Giovann; Kemmick Pintor, Jessie; Baines Simon, Alisha; Gildemeister, Stefan

    2015-11-01

    We determined whether and how Minnesotans who were uninsured in 2013 gained health insurance coverage in 2014, 1 year after the Affordable Care Act (ACA) expanded Medicaid coverage and enrollment. Insurance status and enrollment experiences came from the Minnesota Health Insurance Transitions Study (MH-HITS), a follow-up telephone survey of children and adults in Minnesota who had no health insurance in the fall of 2013. ACA had a tempered success in Minnesota. Outreach and enrollment efforts were effective; one half of those previously uninsured gained coverage, although many reported difficulty signing up (nearly 62%). Of the previously uninsured who gained coverage, 44% obtained their coverage through MNsure, Minnesota's insurance marketplace. Most of those who remained uninsured heard of MNsure and went to the Web site. Many still struggled with the enrollment process or reported being deterred by the cost of coverage. Targeting outreach, simplifying the enrollment process, focusing on affordability, and continuing funding for in-person assistance will be important in the future.

  9. The affordable care ACT on loyalty programs for federal beneficiaries.

    PubMed

    Piacentino, Justin J; Williams, Karl G

    2014-02-01

    To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

  10. Three Words and the Future of the Affordable Care Act.

    PubMed

    Bagley, Nicholas

    2015-06-01

    As an essential part of its effort to achieve near universal coverage, the Affordable Care Act (ACA) extends sizable tax credits to most people who buy insurance on the newly established health care exchanges. Yet several lawsuits have been filed challenging the availability of those tax credits in the thirty-four states that refused to set up their own exchanges. The lawsuits are premised on a strained interpretation of the ACA that, if accepted, would make a hash of other provisions of the statute and undermine its effort to extend coverage to the uninsured. The courts should reject this latest effort to dismantle a critical feature of the ACA. Copyright © 2015 by Duke University Press.

  11. Affordable Communities Employment Act of 2011

    THOMAS, 112th Congress

    Rep. Velazquez, Nydia M. [D-NY-12

    2011-10-25

    House - 01/12/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  12. House Poor in Los Angeles: Examining Patterns of Housing-Induced Poverty by Race, Nativity, and Legal Status*

    PubMed Central

    McConnell, Eileen Diaz

    2013-01-01

    Housing affordability in the United States is generally operationalized using the ratio approach, with those allocating more than thirty percent of income to shelter costs considered to have housing affordability challenges. Alternative standards have been developed that focus on residual income, whether income remaining after housing expenditures is sufficient to meet non-housing needs. This study employs Los Angeles Family and Neighborhood Survey data to consider racial/ethnic, nativity and legal status differences in one residual income standard. Logistic regression analyses of housing-induced poverty focus on whether there are differences among five distinct groups: U.S.born Latinos, Non-Hispanic Whites, and African Americans, authorized Latino immigrants, and unauthorized Latino immigrants. Results suggest that: 1) Latino natives are significantly more likely to be in housing-induced poverty than African Americans and Latino immigrants, and 2) unauthorized Latino immigrants are not more likely to experience the outcome than other groups. The present work extends previous research. First, the results provide additional evidence of the value of operationalizing housing affordability using a residual income standard. Alternatives to the ratio approach deserve more empirical attention from a wider range of scholars and policymakers interested in housing affordability. Second, housing scholarship to date generally differentiates among Latinos by ethnicity, nativity, and citizenship. The present study contributes to emerging research investigating heterogeneity among Latinos by nativity and legal status. PMID:23585711

  13. 76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... to protect CO-OP members against insurance industry involvement and interference. To ensure consumer... Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan (CO-OP) Program... the Consumer Operated and Oriented Plan (CO-OP) program, which provides loans to foster the creation...

  14. The Massachusetts Community Preservation Act: factors influencing acceptance

    Treesearch

    Robert S. Bristow; Matthew T. VanHeynigen

    2008-01-01

    In New England, urban sprawl creates a need for protecting open space. In 2002, residents of Southwick, MA, voted to accept the Massachusetts Community Preservation Act (CPA), which helps communities implement smart growth by providing funds for affordable housing, open space protection, and historic landmark preservation. This paper summarizes the findings of a survey...

  15. 75 FR 60482 - Proposed Extension of Information Collection Request Submitted for Public Comment; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ... Collection Request Submitted for Public Comment; Affordable Care Act Enrollment Opportunity Notice Relating to Dependent Coverage; Affordable Care Act Grandfathered Health Plan Disclosure and Recordkeeping Requirement; Affordable Care Act Rescission Notice; Affordable Care Act Patient Protections Notice; Affordable...

  16. Integrating community health workers within Patient Protection and Affordable Care Act implementation.

    PubMed

    Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C; Trinh-Shevrin, Chau

    2015-01-01

    The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Community health workers can support the effective implementation of PPACA if the capacity and potential of CHWs to serve as cultural

  17. Right-wing conspiracy? Socialist plot? The origins of the Patient Protection and Affordable Care Act.

    PubMed

    Quadagno, Jill

    2014-02-01

    On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Did the ACA signify a government takeover of the health care system, a first step on the road to socialism, as conservative critics charged? Or was it, rather, a sellout to the right wing, as liberal single-payer advocates proclaimed? The ACA's key provisions, the employer mandate and the individual mandate, were Republican policy ideas, and its fundamental principles were nearly identical to the Health Equity and Access Reform Today Act of 1993 (HEART), a bill promoted by Republican senators to deflect support for President Bill Clinton's Health Security plan. Yet the ACA was also a policy legacy of the Clinton administration in important ways that rarely are acknowledged, notably Medicaid expansion and insurance company regulation. Although the ACA departed from the liberal vision of a single-payer plan and adhered closely to the objectives of those who believed that the health care system should encourage the free market, it included provisions that will make coverage more affordable, reliable, and accessible.

  18. The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement

    ERIC Educational Resources Information Center

    Combe, Laurie G.; Sharpe, Susan; Feeser, Cynthia Jo; Ondeck, Lynnette; Fekaris, Nina

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) serves a vital role in the delivery of health care to our nation's students within the healthcare system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as…

  19. Fostering Health: The Affordable Care Act, Medicaid, and Youth Transitioning from Foster Care. Policy Brief

    ERIC Educational Resources Information Center

    Wilson-Simmons, Renée; Dworsky, Amy; Tongue, Denzel; Hulbutta, Marikate

    2016-01-01

    The Affordable Care Act includes language that requires states to provide Medicaid coverage to youth who were in foster care in their state before aging out of the child welfare system. However, most states have interpreted the law differently for youth who move to their state after aging out, determining that automatic Medicaid coverage is an…

  20. Coverage Gains After the Affordable Care Act Among the Uninsured in Minnesota

    PubMed Central

    Lukanen, Elizabeth; Spencer, Donna; Alarcón, Giovann; Kemmick Pintor, Jessie; Baines Simon, Alisha; Gildemeister, Stefan

    2015-01-01

    Objectives. We determined whether and how Minnesotans who were uninsured in 2013 gained health insurance coverage in 2014, 1 year after the Affordable Care Act (ACA) expanded Medicaid coverage and enrollment. Methods. Insurance status and enrollment experiences came from the Minnesota Health Insurance Transitions Study (MH-HITS), a follow-up telephone survey of children and adults in Minnesota who had no health insurance in the fall of 2013. Results. ACA had a tempered success in Minnesota. Outreach and enrollment efforts were effective; one half of those previously uninsured gained coverage, although many reported difficulty signing up (nearly 62%). Of the previously uninsured who gained coverage, 44% obtained their coverage through MNsure, Minnesota’s insurance marketplace. Most of those who remained uninsured heard of MNsure and went to the Web site. Many still struggled with the enrollment process or reported being deterred by the cost of coverage. Conclusions. Targeting outreach, simplifying the enrollment process, focusing on affordability, and continuing funding for in-person assistance will be important in the future. PMID:26447912

  1. 76 FR 73989 - Redelegation of Authority Under Section 3 of the Housing and Urban Development Act of 1968

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5544-D-09] Redelegation of Authority Under Section 3 of the Housing and Urban Development Act of 1968 AGENCY: Office of the Assistant... delegated authority under Section 3 of the Housing and Urban Development Act of 1968 and HUD's implementing...

  2. 24 CFR 180.415 - Notice of proposed adverse action regarding Federal financial assistance in non-Fair Housing Act...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... regarding Federal financial assistance in non-Fair Housing Act matters. 180.415 Section 180.415 Housing and... CONSOLIDATED HUD HEARING PROCEDURES FOR CIVIL RIGHTS MATTERS Proceedings Prior to Hearing § 180.415 Notice of proposed adverse action regarding Federal financial assistance in non-Fair Housing Act matters. (a) Filing...

  3. Income dynamics and the Affordable Care Act.

    PubMed

    Shore-Sheppard, Lara D

    2014-12-01

    To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (<138 percent of the Federal Poverty Level [FPL], 138-250 percent FPL, 250-400 percent FPL, and >400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22-64 years. Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. © Health Research and Educational Trust.

  4. Income Dynamics and the Affordable Care Act

    PubMed Central

    Shore-Sheppard, Lara D

    2014-01-01

    Objective To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Data Source Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Study Design Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (<138 percent of the Federal Poverty Level [FPL], 138–250 percent FPL, 250–400 percent FPL, and >400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Data Collection/Extraction Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22–64 years. Principal Findings Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Conclusions Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. PMID:25327987

  5. American surgery and the Affordable Care Act.

    PubMed

    Stain, Steven C; Hoyt, David B; Hunter, John G; Joyce, Geoffrey; Hiatt, Jonathan R

    2014-09-01

    The Affordable Care Act (ACA) attempts to change the way we finance and deliver health care by coordinating the delivery of primary, specialty, and hospital services in accountable care organizations. The ways in which accountable care organizations will develop and evolve is unclear; however, the effects on surgeons and their patients will be substantial. High-value care in the ACA emphasizes quality, safety, resource use and appropriateness, and the patient's experience of care. Payment will be linked to these principles. Department chairs overseeing a clinical enterprise in academic medical centers now must add financial and quality measures to the traditional missions of education, research, and clinical service. At a time when surgical training is in dramatic evolution, with work hour limitations for residents and an emphasis on quality, productivity, and increasing oversight of trainees for faculty, residency programs will need to meet the increasing demands of an aging population and newly insured patients under the ACA. The American College of Surgeons, with its century-long commitment to quality improvement, research-based standards, and performance measurement and verification, has begun its Inspiring Quality Campaign, is developing new educational tools, and is preparing proposals for payment reform based on surgeons' participation in quality programs.

  6. Patient Protection and Affordable Care Act; exchange and insurance market standards for 2015 and beyond. Final rule.

    PubMed

    2014-05-27

    This final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges (``Exchanges''), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: A modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio

  7. 24 CFR 572.120 - Affordability standards.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND... affordability. (1) The monthly expenditure for principal, interest, taxes, and insurance by an eligible family...

  8. Obamacare: what the Affordable Care Act means for patients and physicians.

    PubMed

    Hall, Mark A; Lord, Richard

    2014-10-22

    The Affordable Care Act's core achievement is to make all Americans insurable, by requiring insurers to accept all applicants at rates based on population averages regardless of health status. The act also increases coverage by allowing states to expand Medicaid (the social healthcare program for families and people with low income and resources) to cover everyone near the poverty line, and by subsidizing private insurance for people who are not poor but who do not have workplace coverage. The act allows most people to keep the same kind of insurance that they currently have, and it does not change how private insurance pays physicians and hospitals. Although the act falls short of achieving truly universal coverage, nine million uninsured people have received coverage so far. Market reforms have not hurt the insurance industry's profitability, prices for individual insurance have been lower than expected, and government costs so far have been less than initially projected. The act expands several ongoing pilot programs in Medicare that reform how doctors and hospitals are paid, but it does not directly change how private insurers pay healthcare providers. Nevertheless, it has set into motion market dynamics that are affecting medical practice, such as limiting insurance networks to fewer providers and requiring patients to pay for more treatment costs out of pocket. In response, many hospitals and physicians are forming closer and larger affiliations. Further time and study are needed to learn whether these evolutionary changes will achieve their goals without harming the doctor-patient relationship. © BMJ Publishing Group Ltd 2014.

  9. 75 FR 14390 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-25

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Part 1000 [Docket No. FR-5275-C-07] Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated Rulemaking Committee Meeting; Correction AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD...

  10. 75 FR 29964 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Part 1000 [Docket No. FR-5275-N-09] Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated Rulemaking Committee Meetings AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD. ACTION...

  11. 75 FR 36022 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-24

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Part 1000 [Docket No. FR-5275-N-10] Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated Rulemaking Committee Meeting AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD. ACTION...

  12. International examples of undocumented immigration and the affordable care act.

    PubMed

    Stutz, Matthew; Baig, Arshiya

    2014-08-01

    As it stands there is no viable health care option for undocumented immigrants of low socioeconomic status. Even more worrisome is that Affordable Care Act simply does not address this issue with any direct plan. The US is in a very influential time period in terms of undocumented immigration and its relationship with health care. The purpose of this paper is to examine international examples of undocumented immigrant health care and their implications for the United States' undocumented immigrant health care. This study found that physicians in the US must work to prevent the initiation of policies which exclude undocumented immigrants from accessing health care. Exclusionary policies implemented in European nations have had disastrous effects on physicians and patients. This paper examines the implications which similar policies would have if implemented in the US.

  13. The Patient Protection and Affordable Care Act: implications for pediatric pharmacy practice.

    PubMed

    Vallejos, Ximena; Benavides, Sandra

    2013-01-01

    The impact of the Patient Protection and Affordable Care Act on the pediatric health care landscape includes expanded health insurance coverage and health care delivery improvements by increasing implementation of patient-centered medical homes and accountable care organizations. These offer opportunities for pharmacists to assume responsibility for the medication-related needs of pediatric patients through pharmacotherapy selection, medication therapy management performance, and medication reconciliation at each transition of care. Medically complex children with at least 2 chronic disease states may be the target population. Studies demonstrating the positive outcomes and cost-effectiveness of pharmacists in pediatric ambulatory care settings are needed.

  14. 76 FR 54774 - Notice of Intent To Award Affordable Care Act Funding, Funding Opportunity Announcement CDC-RFA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Intent To Award Affordable Care Act Funding, Funding Opportunity Announcement CDC-RFA-DP09-905 AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION: Notice. SUMMARY: This notice provides notice of CDC's intent to fund continuation cooperative agreement...

  15. The Influence of Affordability in Strategic Enrollment Management

    ERIC Educational Resources Information Center

    Pugh, Susan L.; Thompson, Roger J.

    2008-01-01

    In state houses around the country, one of the common higher education themes is affordability. As tuition costs have increased at rates exceeding that of inflation, students and families have pressed their legislative representatives to examine these increases. Affordability is a term used by various constituent groups, and its definition varies…

  16. Medicaid expansion under the Affordable Care Act. Implications for insurance-related disparities in pulmonary, critical care, and sleep.

    PubMed

    Lyon, Sarah M; Douglas, Ivor S; Cooke, Colin R

    2014-05-01

    The Affordable Care Act was intended to address systematic health inequalities for millions of Americans who lacked health insurance. Expansion of Medicaid was a key component of the legislation, as it was expected to provide coverage to low-income individuals, a population at greater risk for disparities in access to the health care system and in health outcomes. Several studies suggest that expansion of Medicaid can reduce insurance-related disparities, creating optimism surrounding the potential impact of the Affordable Care Act on the health of the poor. However, several impediments to the implementation of Medicaid's expansion and inadequacies within the Medicaid program itself will lessen its initial impact. In particular, the Supreme Court's decision to void the Affordable Care Act's mandate requiring all states to accept the Medicaid expansion allowed half of the states to forego coverage expansion, leaving millions of low-income individuals without insurance. Moreover, relative to many private plans, Medicaid is an imperfect program suffering from lower reimbursement rates, fewer covered services, and incomplete acceptance by preventive and specialty care providers. These constraints will reduce the potential impact of the expansion for patients with respiratory and sleep conditions or critical illness. Despite its imperfections, the more than 10 million low-income individuals who gain insurance as a result of Medicaid expansion will likely have increased access to health care, reduced out-of-pocket health care spending, and ultimately improvements in their overall health.

  17. 76 FR 21906 - Notice of Intent To Award Affordable Care Act Funding to Approved Applications Formerly Received...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-19

    ... Intent To Award Affordable Care Act Funding to Approved Applications Formerly Received in Response to the Centers for Disease Control and Prevention Funding Opportunity IP11-010, ``Enhanced Surveillance for New... response to CDC Funding Opportunity, CDC-RFA-IP11-010, ``Enhanced Surveillance for New Vaccine Preventable...

  18. Broadband Affordability Act of 2009

    THOMAS, 111th Congress

    Rep. Matsui, Doris O. [D-CA-5

    2009-09-24

    House - 09/25/2009 Referred to the Subcommittee on Communications, Technology, and the Internet. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. 76 FR 54774 - Notice of Intent To Award Affordable Care Act Funding, Funding Opportunity Announcement CDC-RFA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Intent To Award Affordable Care Act Funding, Funding Opportunity Announcement CDC-RFA-DP10-1014 AGENCY... Funding Opportunity CDC-RFA- DP10-1014. It is the intent of CDC to provide continuation funding to one (1... published in the above referenced REACH CORE Funding Opportunity Announcement (FOA). Award Information...

  20. 24 CFR 1000.42 - Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable? 1000.42 Section 1000.42 Housing and... ACTIVITIES General § 1000.42 Are the requirements of section 3 of the Housing and Urban Development Act of...

  1. Homeownership Affordability Act of 2011

    THOMAS, 112th Congress

    Sen. Menendez, Robert [D-NJ

    2011-08-02

    Senate - 08/02/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  2. Electricity Security and Affordability Act

    THOMAS, 113th Congress

    Rep. Whitfield, Ed [R-KY-1

    2014-01-09

    Senate - 05/08/2014 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 374. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  3. Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors.

    PubMed

    Nikpay, Sayeh S; Tebbs, Margaret G; Castellanos, Emily H

    2018-04-17

    The Patient Protection and Affordable Care Act extends Medicaid coverage to millions of low-income adults, including many survivors of cancer who were unable to purchase affordable health insurance coverage in the individual health insurance market. Using data from the 2011 to 2015 Behavioral Risk Factor Surveillance System, the authors compared changes in coverage and health care access measures for low-income cancer survivors in states that did and did not expand Medicaid. The study population of 17,381 individuals included adults aged 18 to 64 years, and was predominantly female, white, and unmarried. The authors found a relative reduction in the uninsured rate of 11.7 percentage points and a relative increase in the probability of having a personal physician of 5.8 percentage points. Stratifying by whether states expanded Medicaid by 2015, the authors found that relative gains in coverage and access were larger among those individuals residing in states with expanded Medicaid compared with those residing in nonexpansion states. The results of the current study suggest that the Patient Protection and Affordable Care Act Medicaid expansion has improved coverage and access for cancer survivors. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  4. 75 FR 16821 - Housing Finance Agency Risk-Sharing Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ...The proposed information collection requirement described below has been submitted to the Office of Management and Budget (OMB) for review, as required by the Paperwork Reduction Act. The Department is soliciting public comments on the subject proposal. Section 542(c) of the Risk Sharing Program authorizes qualified Housing Finance Agencies (HFAs) to underwrite and process loans. HUD provides full mortgage insurance on affordable multifamily housing project processed by HFAs under this program. Qualified HFAs are vested with the maximum amount of processing responsibilities. By entering into Risk-Sharing Agreement with HUD, HFAs contract to reimburse HUD for a portion of the loss from any defaults that occur while HUD insurance is in force.

  5. Health outcomes and green renovation of affordable housing.

    PubMed

    Breysse, Jill; Jacobs, David E; Weber, William; Dixon, Sherry; Kawecki, Carol; Aceti, Susan; Lopez, Jorge

    2011-01-01

    This study sought to determine whether renovating low-income housing using "green" and healthy principles improved resident health and building performance. We investigated resident health and building performance outcomes at baseline and one year after the rehabilitation of low-income housing using Enterprise Green Communities green specifications, which improve ventilation; reduce moisture, mold, pests, and radon; and use sustainable building products and other healthy housing features. We assessed participant health via questionnaire, provided Healthy Homes training to all participants, and measured ventilation, carbon dioxide, and radon. Adults reported statistically significant improvements in overall health, asthma, and non-asthma respiratory problems. Adults also reported that their children's overall health improved, with significant improvements in non-asthma respiratory problems. Post-renovation building performance testing indicated that the building envelope was tightened and local exhaust fans performed well. New mechanical ventilation was installed (compared with no ventilation previously), with fresh air being supplied at 70% of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers standard. Radon was < 2 picocuries per liter of air following mitigation, and the annual average indoor carbon dioxide level was 982 parts per million. Energy use was reduced by 45% over the one-year post-renovation period. We found significant health improvements following low-income housing renovation that complied with green standards. All green building standards should include health requirements. Collaboration of housing, public health, and environmental health professionals through integrated design holds promise for improved health, quality of life, building operation, and energy conservation.

  6. Health Outcomes and Green Renovation of Affordable Housing

    PubMed Central

    Breysse, Jill; Jacobs, David E.; Weber, William; Dixon, Sherry; Kawecki, Carol; Aceti, Susan; Lopez, Jorge

    2011-01-01

    Objective This study sought to determine whether renovating low-income housing using “green” and healthy principles improved resident health and building performance. Methods We investigated resident health and building performance outcomes at baseline and one year after the rehabilitation of low-income housing using Enterprise Green Communities green specifications, which improve ventilation; reduce moisture, mold, pests, and radon; and use sustainable building products and other healthy housing features. We assessed participant health via questionnaire, provided Healthy Homes training to all participants, and measured ventilation, carbon dioxide, and radon. Results Adults reported statistically significant improvements in overall health, asthma, and non-asthma respiratory problems. Adults also reported that their children's overall health improved, with significant improvements in non-asthma respiratory problems. Post-renovation building performance testing indicated that the building envelope was tightened and local exhaust fans performed well. New mechanical ventilation was installed (compared with no ventilation previously), with fresh air being supplied at 70% of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers standard. Radon was <2 picocuries per liter of air following mitigation, and the annual average indoor carbon dioxide level was 982 parts per million. Energy use was reduced by 45% over the one-year post-renovation period. Conclusions We found significant health improvements following low-income housing renovation that complied with green standards. All green building standards should include health requirements. Collaboration of housing, public health, and environmental health professionals through integrated design holds promise for improved health, quality of life, building operation, and energy conservation. PMID:21563714

  7. Without the individual mandate, the Affordable Care Act would still cover 23 million; premiums would rise less than predicted.

    PubMed

    Sheils, John F; Haught, Randall

    2011-11-01

    Many policy analysts fear that eliminating the individual health insurance mandate and penalty from the Affordable Care Act of 2010 would lead to a "premium spiral," in which healthy people would drop coverage, premiums would soar, and the number of people with coverage would plummet. However, there are other provisions of the law that would greatly mitigate this effect. For example, the subsidies provided in the law to help people purchase coverage through health insurance exchanges would restrain a premium spiral by absorbing much of the impact of premium increases. We estimate that if the mandate were lifted, premiums in the individual market would increase by 12.6 percent-somewhat less than other estimates-with 7.8 million people losing coverage, versus other estimates for coverage loss of 16-24 million people. In sum, the Affordable Care Act would still cover 23 million people who would have been uninsured without the law. Our study suggests that although the mandate would have important effects on premiums and coverage, it might not be essential to the act's successful implementation.

  8. Keeping Flood Insurance Affordable Act of 2013

    THOMAS, 113th Congress

    Rep. Capuano, Michael E. [D-MA-7

    2013-11-15

    House - 11/15/2013 Referred to House Rules (All Actions) Notes: For further action, see H.R.3370, which became Public Law 113-89 on 3/21/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  9. The Affordable Care Act and hospital chaplaincy: re-visioning spiritual care, re-valuing institutional wholeness.

    PubMed

    Frierdich, Matthew D

    2015-01-01

    This article focuses on the institutional dimensions of spiritual care within hospital settings in the context of the Patient Protection and Affordable Care Act of 2010 (ACA), applying policy information and systems theory to re-imagine the value and function of chaplaincy to hospital communities. This article argues that chaplaincy research and practice must look beyond only individual interventions and embrace chaplain competencies of presence, ritual, and communication as foundational tools for institutional spiritual care.

  10. Small firm self-insurance under the Affordable Care Act.

    PubMed

    Buettgens, Matthew; Blumberg, Linda J

    2012-11-01

    The Affordable Care Act changes the small-group insurance market substan­tially beginning in 2014, but most changes do not apply to self-insured plans. This exemp­tion provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market. Private stop-loss or reinsurance plans can mediate the risk of self-insurance for small employ­ers, facilitating the decision to self-insure. We simulate small-employer coverage decisions under the law and find that low-risk stop-loss policies lead to higher premiums in the fully insured small-group market. Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed--an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stabil­ity in small-group insurance coverage.

  11. The Affordable Care Act Medicaid Expansions and Personal Finance.

    PubMed

    Caswell, Kyle J; Waidmann, Timothy A

    2017-09-01

    Using a novel data set from a major credit bureau, we examine the early effects of the Affordable Care Act Medicaid expansions on personal finance. We analyze less common events such as personal bankruptcy, and more common occurrences such as medical collection balances, and change in credit scores. We estimate triple-difference models that compare individual outcomes across counties that expanded Medicaid versus counties that did not, and across expansion counties that had more uninsured residents versus those with fewer. Results demonstrate financial improvements in states that expanded their Medicaid programs as measured by improved credit scores, reduced balances past due as a percent of total debt, reduced probability of a medical collection balance of $1,000 or more, reduced probability of having one or more recent medical bills go to collections, reduction in the probability of experiencing a new derogatory balance of any type, reduced probability of incurring a new derogatory balance equal to $1,000 or more, and a reduction in the probability of a new bankruptcy filing.

  12. Lake Hill Administrative Site Affordable Housing Act

    THOMAS, 113th Congress

    Sen. Udall, Mark [D-CO

    2013-07-16

    Senate - 11/20/2013 Committee on Energy and Natural Resources Subcommittee on Public Lands, Forests, and Mining. Hearings held. With printed Hearing: S.Hrg. 113-342. (All Actions) Notes: For further action, see H.R.2337, which became Public Law 113-141 on 7/25/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. Public health law: the constitutionality of the Patient Protection and Affordable Care Act.

    PubMed

    De Ville, Kenneth

    2011-01-01

    Congress of the Patient Protection and Affordable Care Act (PPACA) was immediately challenged by lawsuits attacking the constitutionality of the legislation. The lawsuits, joined by over 2 dozen state's attorney generals, contend that PPACA is an unconstitutional exercise of federal power. Specifically, the suits argue that the individual insurance mandate portion of the law is justified by neither the "Commerce Power" nor Congress' authority to "tax" and provide for "the general welfare." This essay outlines and analyzes the constitutional arguments for, and against, PPACA forecasting the likely resolution of the debate if the suits reach the US Supreme Court.

  14. Housing Assistance Efficiency Act

    THOMAS, 113th Congress

    Rep. Peters, Scott H. [D-CA-52

    2013-07-23

    Senate - 12/03/2014 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  15. The Politics of Native American Health Care and the Affordable Care Act.

    PubMed

    Skinner, Daniel

    2016-02-01

    This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making. Copyright © 2016 by Duke University Press.

  16. Nonsocially housed rats (Ratus norvegicus) seek social interactions and social novelty more than socially housed counterparts.

    PubMed

    Templer, Victoria L; Wise, Taylor B; Dayaw, Katrina Isabel T; Dayaw, Judith Nicole T

    2018-04-23

    Sociability is the act or quality of social interaction and can be quantified by determining the number and duration of interactions with conspecifics. The purpose of this study was to examine the extent to which sustained social contact, as achieved by constant social living conditions, influenced social behavior. Beginning in juvenility, 19 male Long-Evans rats were housed in enriched environments, with half living socially in a large group and half living individually. After several months in these housing conditions, rats were tested on a sociality test and a social novelty preference test. Nonsocially housed rats exhibited more social behavior than socially housed rats. In the sociality test, nonsocially housed rats engaged with an unfamiliar rat more than socially housed rats. Similarly, in the social novelty test, nonsocially housed rats visited a novel stranger more than the now-familiar rat (from the sociality test) as compared with the socially housed rats. It is unlikely that general anxiety factors can account for between-groups social effects, as there were no group differences in behavior on the elevated zero maze and open field test. Furthermore, socially and nonsocially housed rats were matched in spontaneous object exploration and novelty preference in a novel object recognition test, eliminating the possibility that general exploratory behavior or novelty preference accounted for group differences in the sociability tasks. These results suggest that lack of social interaction in nonsocially housed rats may be more powerful for social motivation than the consistent opportunity for social contact afforded by social living conditions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. Patient Protection and Affordable Care Act of 2010: a primer for neurointerventionalists.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2012-03-01

    The Patient Protection and Affordable Care Act (the ACA, for short) became law on 23 March 2010. It represents the most significant transformation of the American healthcare system since Medicare and Medicaid. Essentials of ACA include: (1) a mandate for individuals and businesses requiring as a matter of law that nearly every American has an approved level of health insurance or pay a penalty; (2) a system of federal subsidies to completely or partially pay for the now required health insurance for ∼34 million Americans who are currently uninsured-subsidized through Medicaid and Exchanges; (3) extensive new requirements on the health insurance industry and (4) changes in the practice of medicine. The Act is divided into 10 titles. It contains provisions that went into effect starting on 21 June 2010 with many of the provisions going into effect in 2014 and later. The ACA goes well beyond insurance and payment reform. Practicing physicians will potentially be impacted by the Independent Payment Advisory Board and the Patient Centered Outcomes Research Institute.

  18. Structuring payment to medical homes after the affordable care act.

    PubMed

    Edwards, Samuel T; Abrams, Melinda K; Baron, Richard J; Berenson, Robert A; Rich, Eugene C; Rosenthal, Gary E; Rosenthal, Meredith B; Landon, Bruce E

    2014-10-01

    The Patient-Centered Medical Home (PCMH) is a leading model of primary care reform, a critical element of which is payment reform for primary care services. With the passage of the Affordable Care Act, the Accountable Care Organization (ACO) has emerged as a model of delivery system reform, and while there is theoretical alignment between the PCMH and ACOs, the discussion of physician payment within each model has remained distinct. Here we compare payment for medical homes with that for accountable care organizations, consider opportunities for integration, and discuss implications for policy makers and payers considering ACO models. The PCMH and ACO are complementary approaches to reformed care delivery: the PCMH ultimately requires strong integration with specialists and hospitals as seen under ACOs, and ACOs likely will require a high functioning primary care system as embodied by the PCMH. Aligning payment incentives within the ACO will be critical to achieving this integration and enhancing the care coordination role of primary care in these settings.

  19. The impact of the Patient Protection and Affordable Care Act on radiology: beyond reimbursement.

    PubMed

    Krishnaraj, Arun; Norbash, Alexander; Allen, Bibb; Ellenbogen, Paul H; Kazerooni, Ella A; Thorwarth, William; Weinreb, Jeffrey C

    2015-01-01

    The 2014 ACR Forum focused on the noneconomic implications of the Affordable Care Act on the field of radiology, with specific attention to the importance of the patient experience, the role of radiology in public and population health, and radiology's role in the effort to lower overall health care costs. The recommendations generated from the Forum seek to inform ACR leadership on the best strategies to pursue to best prepare the radiology community for the rapidly evolving health care landscape. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

    ERIC Educational Resources Information Center

    Caldwell, Joe; Alston, Reginald J.

    2012-01-01

    The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

  1. 75 FR 7559 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-22

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Part 1000 [Docket No. FR-5275-N-05] Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated Rulemaking... governing the IHBG and Title VI Loan Guarantee programs are located in part 1000 of HUD's regulations in...

  2. Procedures for the handling of retaliation complaints under section 1558 of the Affordable Care Act. Interim final rule; request for comments.

    PubMed

    2013-02-27

    This document provides the interim final regulations governing the employee protection (whistleblower) provision of section 1558 of the Affordable Care Act, which added section 18C of the Fair Labor Standards Act, to provide protections to employees of health insurance issuers or other employers who may have been subject to retaliation for reporting potential violations of the law's consumer protections (e.g., the prohibition on denials of insurance due to pre-existing conditions) or affordability assistance provisions (e.g., access to health insurance premium tax credits). This interim rule establishes procedures and time frames for the handling of retaliation complaints under section 18C, including procedures and time frames for employee complaints to the Occupational Safety and Health Administration (OSHA), investigations by OSHA, appeals of OSHA determinations to an administrative law judge (ALJ) for a hearing de novo, hearings by ALJs, review of ALJ decisions by the Administrative Review Board (ARB) (acting on behalf of the Secretary of Labor), and judicial review of the Secretary's final decision.

  3. Patient Protection and Affordable Care Act; program integrity: exchange, premium stabilization programs, and market standards; amendments to the HHS notice of benefit and payment parameters for 2014. Final rule.

    PubMed

    2013-10-30

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Exchanges (FFEs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFE, and makes certain amendments to definitions and standards related to the market reform rules. These standards, which include financial integrity provisions and protections against fraud and abuse, are consistent with Title I of the Affordable Care Act. This final rule also amends and adopts as final interim provisions set forth in the Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 interim final rule, published in the Federal Register on March 11, 2013, related to risk corridors and cost-sharing reduction reconciliation.

  4. 78 FR 72321 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2015

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-02

    ... post all comments received before the close of the comment period on the following Web site as soon as... market Medicaid expansion plans, and seeks comment on how to adjust the geographic cost factor in the... Affordable Care Act, establishes permissible rating factors that may be used to vary the premium rate charged...

  5. 77 FR 26046 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ... for OMB Review; Comment Request; Affordable Care Act Internal Claims and Appeals and External Review...) titled, ``Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non... provisions of the Affordable Care Act pertaining to internal claims and appeals, and the external review...

  6. Medical Device Innovation in the Era of the Affordable Care Act: The End of Sexy.

    PubMed

    Mattke, Soeren; Liu, Hangsheng; Orr, Patrick

    2016-06-20

    In this article, the authors explore why medical device innovation has traditionally been geared so thoroughly toward improving performance, with little regard to cost. They argue that the changing incentives in the health care sector and the move to value-based payment models, accelerated by the implementation of the Affordable Care Act, will force device manufacturers to redirect investments from the spectacular toward the prudent, which they dub "the end of sexy." The authors explore consequences for manufacturers, investors, and policymakers.

  7. 24 CFR 92.254 - Qualification as affordable housing: Homeownership.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... revitalization strategy under § 91.215(e)(2) of its consolidated plan or Empowerment Zone or Enterprise Community... owner-occupied unit would not be subject to the income targeting or affordability provisions of § 92.254...

  8. Influence of Medical Insurance Under the Affordable Care Act on Access to Pain Management of the Trauma Patient.

    PubMed

    Wiznia, Daniel H; Zaki, Theodore; Maisano, Julianna; Kim, Chang-Yeon; Halaszynski, Thomas M; Leslie, Michael P

    The Affordable Care Act intended to "extend affordable coverage" and "ensure access" for vulnerable patient populations. This investigation examined whether the type of insurance (Medicaid, Medicare, Blue Cross, cash pay) carried by trauma patients influences access to pain management specialty care. Investigators phoned 443 board-certified pain specialists, securing office visits with 235 pain physicians from 8 different states. Appointments for pain management were for a patient who sustained an ankle fracture requiring surgery and experiencing difficulty weaning off opioids. Offices were phoned 4 times assessing responses to the 4 different payment methodologies. Fifty-three percent of pain specialists contacted (235 of 443) were willing to see new patients to manage pain medication. Within the 53% of positive responses, 7.2% of physicians scheduled appointments for Medicaid patients, compared with 26.8% for cash-paying patients, 39.6% for those with Medicare, and 41.3% with Blue Cross (P < 0.0001). There were no differences in appointment access between states that had expanded Medicaid eligibility for low-income adults versus states that had not expanded Medicaid eligibility. Neither Medicaid nor Medicare reimbursement levels for new patient visits correlated with ability to schedule an appointment or influenced wait times. Access to pain specialists for management of pain medication in the postoperative trauma patient proved challenging. Despite the Affordable Care Act, Medicaid patients still experienced curtailed access to pain specialists and confronted the highest incidence of barriers to receiving appointments.

  9. The patient protection and affordable care act: what does it mean for mental health services for older adults?

    PubMed

    Sorrell, Jeanne M

    2012-11-01

    The U.S. Supreme Court recently upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). It is important to think about how this act will affect mental health services for older adults. The act has the potential to improve health outcomes across all income and age groups. There are specific provisions that are expected to improve care for individuals with mental illness, but there is little information about how these provisions will affect older adults with mental illness. As we move toward implementation of the PPACA, psychiatric nurses need to be aware of myths surrounding the act and to think about changes in the health care system, such as collaborative models of care, that may help identify and overcome barriers to treatment of older adults with mental illness. Copyright 2012, SLACK Incorporated.

  10. Seizing opportunities under the Affordable Care Act for transforming the mental and behavioral health system.

    PubMed

    Mechanic, David

    2012-02-01

    The Affordable Care Act, along with Medicaid expansions, offers the opportunity to redesign the nation's highly flawed mental health system. It promotes new programs and tools, such as health homes, interdisciplinary care teams, the broadening of the Medicaid Home and Community-Based Services option, co-location of physical health and behavioral services, and collaborative care. Provisions of the act offer extraordinary opportunities, for instance, to insure many more people, reimburse previously unreimbursed services, integrate care using new information technology tools and treatment teams, confront complex chronic comorbidities, and adopt underused evidence-based interventions. The Centers for Medicare and Medicaid Services and its Center for Medicare and Medicaid Innovation should work intensively with the states to implement these new programs and other arrangements and begin to fulfill the many unmet promises of community mental health care.

  11. Comparing mandated health care reforms: the Affordable Care Act, accountable care organizations, and the Medicare ESRD program.

    PubMed

    Watnick, Suzanne; Weiner, Daniel E; Shaffer, Rachel; Inrig, Jula; Moe, Sharon; Mehrotra, Rajnish

    2012-09-01

    In addition to extending health insurance coverage, the Affordable Care Act of 2010 aims to improve quality of care and contain costs. To this end, the act allowed introduction of bundled payments for a range of services, proposed the creation of accountable care organizations (ACOs), and established the Centers for Medicare and Medicaid Innovation to test new care delivery and payment models. The ACO program began April 1, 2012, along with demonstration projects for bundled payments for episodes of care in Medicaid. Yet even before many components of the Affordable Care Act are fully in place, the Medicare ESRD Program has instituted legislatively mandated changes for dialysis services that resemble many of these care delivery reform proposals. The ESRD program now operates under a fully bundled, case-mix adjusted prospective payment system and has implemented Medicare's first-ever mandatory pay-for-performance program: the ESRD Quality Incentive Program. As ACOs are developed, they may benefit from the nephrology community's experience with these relatively novel models of health care payment and delivery reform. Nephrologists are in a position to assure that the ACO development will benefit from the ESRD experience. This article reviews the new ESRD payment system and the Quality Incentive Program, comparing and contrasting them with ACOs. Better understanding of similarities and differences between the ESRD program and the ACO program will allow the nephrology community to have a more influential voice in shaping the future of health care delivery in the United States.

  12. Young adults' health care utilization and expenditures prior to the Affordable Care Act.

    PubMed

    Lau, Josephine S; Adams, Sally H; Boscardin, W John; Irwin, Charles E

    2014-06-01

    To examine young adults' health care utilization and expenditures prior to the Affordable Care Act. We used 2009 Medical Expenditure Panel Survey to (1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and (2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other sociodemographic factors, including race/ethnicity and income. Young adults had (1) significantly lower rates of overall utilization (72%) than other age groups (83%-88%, p < .001), (2) the lowest rate of office-based utilization (55% vs. 67%-77%, p < .001) and (3) higher rate of emergency room visits compared with adolescents (15% vs. 12%, p < .01). Uninsured young adults had high out-of-pocket expenses. Compared with the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/person, p < .001) but essentially the same out-of-pocket expenses ($403 vs. $380/person, p = .57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language, and sex. Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of emergency room visits. The Affordable Care Act provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address noninsurance barriers and ensure equal access to health services. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. College Affordability Act of 2013

    THOMAS, 113th Congress

    Rep. Schwartz, Allyson Y. [D-PA-13

    2013-10-30

    House - 10/30/2013 Referred to the Committee on Ways and Means, and in addition to the Committee on Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the... (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Healthy Libraries Develop Healthy Communities: Public Libraries and their Tremendous Efforts to Support the Affordable Care Act

    PubMed Central

    Collins, Lydia N.

    2015-01-01

    This article is about the dedication of public library staff and my role as the Consumer Health Coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region (NN/LM MAR) to support outreach efforts for health insurance enrollment under the Patient Protection and Affordable Care Act (ACA). ACA was created in order to ensure that all Americans have access to affordable health care. What we didn’t know is that public libraries across the nation would play such an integral role in the health insurance enrollment process. The National Network of Libraries of Medicine (NN/LM) worked closely with public libraries in order to assist with this new role. As we approach the second enrollment and re-enrollment periods, public libraries are gearing up once again to assist with ACA. PMID:25798077

  15. Does Question Wording Predict Support for the Affordable Care Act? An Analysis of Polling During the Implementation Period, 2010-2016.

    PubMed

    Holl, Kristen; Niederdeppe, Jeff; Schuldt, Jonathon P

    2018-07-01

    The Patient Protection and Affordable Care Act (ACA) continues to be the subject of fierce political debate in the United States. Drawing on issue framing theory, together with research on wording effects in survey responding, we tested how common differences in the wording of ACA surveys relate to apparent public support for the law. We report on a content analysis of N = 376 U.S. national opinion surveys fielded during a more than six-year period, beginning 23 March 2010 (when President Obama signed the bill into law) and ending 8 November 2016 (Election Day), and use ordinary least squares (OLS) regression models to predict public support for the law as a function of variation in question wording. We coded questions gauging general sentiment toward the law for differences in issue labeling (e.g., Obamacare, Affordable Care Act), whether or not they referenced particular political entities (e.g., President Obama, Congress) or segments of the public (e.g., You, Your Family), various opinion metrics (e.g., Support, Favor), and different response options (e.g., Repeal, Expand) which we used to model aggregate levels of support. The results revealed several key differences in question wording-for example, generic references to the Healthcare Law were employed much more frequently than Obamacare or Affordable Care Act-a number of which reliably predicted aggregate levels of public support. The discussion considers possible explanations for these patterns and reiterates the value of attending to questionnaire design features when interpreting survey data about politically contentious health policy issues.

  16. Reform Americans Can Afford Act of 2010

    THOMAS, 111th Congress

    Rep. Herger, Wally [R-CA-2

    2010-05-27

    House - 08/10/2010 Motion to Discharge Committee filed by Mr. Herger. Petition No: 111-12. (All Actions) Notes: On 8/10/2010, a motion was filed to discharge the Committees on Energy and Commerce, Appropriations, Ways and Means, Education and Labor, the Judiciary, Natural Resources, House Administration, and Rules from consideration of H.R.5424. A discharge petition requires 218 signatures for... Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  17. Medicaid Expansion Under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas.

    PubMed

    Soni, Aparna; Hendryx, Michael; Simon, Kosali

    2017-04-01

    To analyze the differential rural-urban impacts of the Affordable Care Act Medicaid expansion on low-income childless adults' health insurance coverage. Using data from the American Community Survey years 2011-2015, we conducted a difference-in-differences regression analysis to test for changes in the probability of low-income childless adults having insurance in states that expanded Medicaid versus states that did not expand, in rural versus urban areas. Analyses employed survey weights, adjusted for covariates, and included a set of falsification tests as well as sensitivity analyses. Medicaid expansion under the Affordable Care Act increased the probability of Medicaid coverage for targeted populations in rural and urban areas, with a significantly greater increase in rural areas (P < .05), but some of these gains were offset by reductions in individual purchased insurance among rural populations (P < .01). Falsification tests showed that the insurance increases were specific to low-income childless adults, as expected, and were largely insignificant for other populations. The Medicaid expansion increased the probability of having "any insurance" for the pooled urban and rural low-income populations, and it specifically increased Medicaid coverage more in rural versus urban populations. There was some evidence that the expansion was accompanied by some shifting from individual purchased insurance to Medicaid in rural areas, and there is a need for future work to understand the implications of this shift on expenditures, access to care and utilization. © 2017 National Rural Health Association.

  18. What do we know about location affordability in U.S. shrinking cities?

    DOT National Transportation Integrated Search

    2017-07-01

    In late 2013, the Department of Housing and Urban Development (HUD) launched the Location Affordability Index (LAI) portal. Their dataset uses models to estimate typical amount households spend on housing and transportation at the block group level, ...

  19. Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.

    PubMed

    Zhang, Shuang Qin; Polite, Blase N

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.

  20. How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.

    PubMed

    Beronio, Kirsten; Glied, Sherry; Frank, Richard

    2014-10-01

    The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.

  1. Earthquake Insurance Affordability Act of 2013

    THOMAS, 113th Congress

    Sen. Feinstein, Dianne [D-CA

    2013-12-12

    Senate - 12/12/2013 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  2. Assessing Elderly Housing. A Planning Guide for Mayors, Local Officials, and Housing Advocates.

    ERIC Educational Resources Information Center

    American Association of Retired Persons, Washington, DC.

    This guidebook was designed to assist mayors, local officials, community activists, community-based organizations, and other aging and housing advocates in developing a framework to measure elderly housing needs and to develop a systematic strategy for assisting the elderly in their city with choices in suitable and affordable living arrangements.…

  3. 24 CFR 266.100 - Qualified housing finance agency (HFA).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Qualified housing finance agency... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Housing Finance Agency Requirements § 266.100 Qualified housing finance agency (HFA). (a) Qualifications...

  4. 24 CFR 266.100 - Qualified housing finance agency (HFA).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Qualified housing finance agency... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Housing Finance Agency Requirements § 266.100 Qualified housing finance agency (HFA). (a) Qualifications...

  5. 24 CFR 266.100 - Qualified housing finance agency (HFA).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Qualified housing finance agency... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Housing Finance Agency Requirements § 266.100 Qualified housing finance agency (HFA). (a) Qualifications...

  6. 24 CFR 266.100 - Qualified housing finance agency (HFA).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Qualified housing finance agency... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Housing Finance Agency Requirements § 266.100 Qualified housing finance agency (HFA). (a) Qualifications...

  7. Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation

    PubMed Central

    Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C.; Trinh-Shevrin, Chau

    2015-01-01

    and potential of CHWs to serve as cultural brokers and bridges among medically underserved communities and health care delivery systems is fully tapped. Patient Protection and Affordable Care Act and current payment structures provide an unprecedented and important vehicle for integrating and sustaining CHWs as part of these new delivery and enrollment models. PMID:25414955

  8. Childhood Cancer Survivor Study participants' perceptions and understanding of the Affordable Care Act.

    PubMed

    Park, Elyse R; Kirchhoff, Anne C; Perez, Giselle K; Leisenring, Wendy; Weissman, Joel S; Donelan, Karen; Mertens, Ann C; Reschovsky, James D; Armstrong, Gregory T; Robison, Leslie L; Franklin, Mariel; Hyland, Kelly A; Diller, Lisa R; Recklitis, Christopher J; Kuhlthau, Karen A

    2015-03-01

    The Patient Protection and Affordable Care Act (ACA) established provisions intended to increase access to affordable health insurance and thus increase access to medical care and long-term surveillance for populations with pre-existing conditions. However, childhood cancer survivors' coverage priorities and familiarity with the ACA are unknown. Between May 2011 and April 2012, we surveyed a randomly selected, age-stratified sample of 698 survivors and 210 siblings from the Childhood Cancer Survivor Study. Overall, 89.8% of survivors and 92.1% of siblings were insured. Many features of insurance coverage that survivors considered "very important" are addressed by the ACA, including increased availability of primary care (94.6%), no waiting period before coverage initiation (79.0%), and affordable premiums (88.1%). Survivors were more likely than siblings to deem primary care physician coverage and choice, protections from costs due to pre-existing conditions, and no start-up period as "very important" (P < .05 for all). Only 27.3% of survivors and 26.2% of siblings reported familiarity with the ACA (12.1% of uninsured v 29.0% of insured survivors; odds ratio, 2.86; 95% CI, 1.28 to 6.36). Only 21.3% of survivors and 18.9% of siblings believed the ACA would make it more likely that they would get quality coverage. Survivors' and siblings' concerns about the ACA included increased costs, decreased access to and quality of care, and negative impact on employers and employees. Although survivors' coverage preferences match many ACA provisions, survivors, particularly uninsured survivors, were not familiar with the ACA. Education and assistance, perhaps through cancer survivor navigation, are critically needed to ensure that survivors access coverage and benefits. © 2015 by American Society of Clinical Oncology.

  9. Childhood Cancer Survivor Study Participants' Perceptions and Understanding of the Affordable Care Act

    PubMed Central

    Park, Elyse R.; Kirchhoff, Anne C.; Perez, Giselle K.; Leisenring, Wendy; Weissman, Joel S.; Donelan, Karen; Mertens, Ann C.; Reschovsky, James D.; Armstrong, Gregory T.; Robison, Leslie L.; Franklin, Mariel; Hyland, Kelly A.; Diller, Lisa R.; Recklitis, Christopher J.; Kuhlthau, Karen A.

    2015-01-01

    Purpose The Patient Protection and Affordable Care Act (ACA) established provisions intended to increase access to affordable health insurance and thus increase access to medical care and long-term surveillance for populations with pre-existing conditions. However, childhood cancer survivors' coverage priorities and familiarity with the ACA are unknown. Methods Between May 2011 and April 2012, we surveyed a randomly selected, age-stratified sample of 698 survivors and 210 siblings from the Childhood Cancer Survivor Study. Results Overall, 89.8% of survivors and 92.1% of siblings were insured. Many features of insurance coverage that survivors considered “very important” are addressed by the ACA, including increased availability of primary care (94.6%), no waiting period before coverage initiation (79.0%), and affordable premiums (88.1%). Survivors were more likely than siblings to deem primary care physician coverage and choice, protections from costs due to pre-existing conditions, and no start-up period as “very important” (P < .05 for all). Only 27.3% of survivors and 26.2% of siblings reported familiarity with the ACA (12.1% of uninsured v 29.0% of insured survivors; odds ratio, 2.86; 95% CI, 1.28 to 6.36). Only 21.3% of survivors and 18.9% of siblings believed the ACA would make it more likely that they would get quality coverage. Survivors' and siblings' concerns about the ACA included increased costs, decreased access to and quality of care, and negative impact on employers and employees. Conclusion Although survivors' coverage preferences match many ACA provisions, survivors, particularly uninsured survivors, were not familiar with the ACA. Education and assistance, perhaps through cancer survivor navigation, are critically needed to ensure that survivors access coverage and benefits. PMID:25646189

  10. Child-only coverage and the Affordable Care Act: lessons for policymakers.

    PubMed

    Keith, Katie; Lucia, Kevin W; Corlette, Sabrina

    2012-10-01

    The Affordable Care Act prohibited insurers from denying or limiting cover­age for children under the age of 19 in 2010. In response, some insurers ceased to offer coverage to children in need of individual health insurance, known as a "child-only" pol­icy. This issue brief examines new state legislative and regulatory action to promote the availability of child-only policies in response to this market disruption. The analysis finds that 22 states and the District of Columbia passed new legislation or issued a new regula­tion or subregulatory guidance. As a result, child-only coverage is available in nearly all of these states. These findings suggest that states have flexibility to take innovative actions to maintain or improve their markets and insurers are highly sensitive to the risk of adverse selection. The findings also suggest the need for meaningful regulatory incentives to avoid market disruption in successfully implementing broader reforms in 2014.

  11. Twitter Sentiment Predicts Affordable Care Act Marketplace Enrollment

    PubMed Central

    Sap, Maarten; Schwartz, Andrew; Town, Robert; Baker, Tom; Ungar, Lyle; Merchant, Raina M

    2015-01-01

    Background Traditional metrics of the impact of the Affordable Care Act (ACA) and health insurance marketplaces in the United States include public opinion polls and marketplace enrollment, which are published with a lag of weeks to months. In this rapidly changing environment, a real-time barometer of public opinion with a mechanism to identify emerging issues would be valuable. Objective We sought to evaluate Twitter’s role as a real-time barometer of public sentiment on the ACA and to determine if Twitter sentiment (the positivity or negativity of tweets) could be predictive of state-level marketplace enrollment. Methods We retrospectively collected 977,303 ACA-related tweets in March 2014 and then tested a correlation of Twitter sentiment with marketplace enrollment by state. Results A 0.10 increase in the sentiment score was associated with an 8.7% increase in enrollment at the state level (95% CI 1.32-16.13; P=.02), a correlation that remained significant when adjusting for state Medicaid expansion (P=.02) or use of a state-based marketplace (P=.03). Conclusions This correlation indicates Twitter’s potential as a real-time monitoring strategy for future marketplace enrollment periods; marketplaces could systematically track Twitter sentiment to more rapidly identify enrollment changes and potentially emerging issues. As a repository of free and accessible consumer-generated opinions, this study reveals a novel role for Twitter in the health policy landscape. PMID:25707038

  12. NorthernSTAR 1-½-Story Demonstration House of Cold Climate Solutions for Affordable Housing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Schirber, T.; Ojczyk, C.; Jacobson, R.

    2016-03-01

    This demonstration project is an example of three high-performance measures applied to one house in Minneapolis, Minnesota. The selected vacant home was completely renovated by Urban Homeworks (UHW), which is a nonprofit housing partner, with the intent of selling the home to a low-income family. The renovation included the addition of the three advanced-performance technologies that were applied to the overall scope of the project.

  13. Improving America's Schools Act, Conference Report (To Accompany H.R. 6). House of Representatives, 103D Congress, 2d Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House.

    This report from the United States House of Representatives presents the complete amended version of the House bill to extend for 5 years the authorizations of appropriations for the programs under the Elementary and Secondary Education Act. The current reauthorization bill is known as the "Improving America's Schools Act." The first…

  14. Behind the scenes of the Patient Protection and Affordable Care Act: the making of a health care co-op.

    PubMed

    Giaimo, Susan

    2013-06-01

    A primary goal of the Patient Protection and Affordable Care Act (PPACA) is to reduce the number of uninsured by making health insurance more affordable for small businesses and individuals. Toward that end, the PPACA encourages the creation of nonprofit, member-owned health insurance cooperatives to operate inside each state exchange. Co-ops face significant challenges in entering mature insurance markets, but they also possess unique characteristics that may help them survive and thrive. Using Common Ground Healthcare Cooperative in Wisconsin as a case study, this article traces the origins of co-ops in health care reform at national and state levels and analyzes the political and technical challenges and opportunities facing these organizations.

  15. The Affordable Care Act: new opportunities for cardiac rehabilitation in the workplace?

    PubMed

    Pinkstaff, Sherry O; Arena, Ross; Myers, Jonathan; Kaminsky, Leonard; Briggs, Paige; Forman, Daniel E; Patel, Mahesh J; Cahalin, Lawrence P

    2014-08-01

    Many people affected by cardiovascular disease (CVD) are working age. Employers bear a large percentage of the costs associated with CVD. Employers pay 80 times more in diagnosis and treatment than in prevention, although there is evidence that 50% to 70% of all diseases are associated with preventable health risks. As a result, the worksite is an appealing location to deliver health care.Cardiac rehabilitation has developed a track record of delivering improved outcomes for patients with CVD. Partnerships between cardiac rehabilitation providers and worksite health programs have the potential to improve referral and participation rates of employees with CVD. The current era of health reform in the United States that has been stimulated by the Affordable Care Act provides an ideal opportunity to reconsider worksite health programs as an essential partner in the health care team.

  16. Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements.

    PubMed

    Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina

    2014-10-01

    The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as "essential health benefits." Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees' experiences with their coverage--information called for under the law's delayed transparency requirements--to determine whether states' differing strategies are producing the coverage improvements promised by reform.

  17. 24 CFR 91.310 - Housing market analysis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... affordable housing. The plan must explain whether the cost of housing or the incentives to develop, maintain..., growth limits, and policies that affect the return on residential investment. (Approved by the Office of...

  18. 24 CFR 91.310 - Housing market analysis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... affordable housing. The plan must explain whether the cost of housing or the incentives to develop, maintain..., growth limits, and policies that affect the return on residential investment. (Approved by the Office of...

  19. Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.

    PubMed

    2012-07-20

    This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.

  20. Assessing Alternative Modifications to the Affordable Care Act: Impact on Individual Market Premiums and Insurance Coverage.

    PubMed

    Eibner, Christine; Saltzman, Evan

    2015-03-20

    The goals of the Affordable Care Act (ACA) are to enable all legal U.S. residents to have access to affordable health insurance and to prevent sicker individuals (such as those with preexisting conditions) from being priced out of the market. The ACA also instituted several policies to stabilize premiums and to encourage enrollment among healthy individuals of all ages. The law's tax credits and cost-sharing subsidies offer a "carrot" that may encourage enrollment among some young and healthy individuals who would otherwise remain uninsured, while the individual mandate acts as a "stick" by imposing penalties on individuals who choose not to enroll. In this article, the authors use the COMPARE microsimulation model, an analytic tool that uses economic theory and data to predict the effects of health policy reforms, to estimate how eliminating the ACA's individual mandate, eliminating the law's tax credits, and combined scenarios that change these and other provisions of the act might affect 2015 individual market premiums and overall insurance coverage. Underlying these estimates is a COMPARE-based analysis of how premiums and insurance coverage outcomes depend on young adults' propensity to enroll in insurance coverage. The authors find that eliminating the ACA's tax credits and eliminating the individual mandate both increase premiums and reduce enrollment on the individual market. They also find that these key features of the ACA help to protect against adverse selection and stabilize the market by encouraging healthy people to enroll and, in the case of the tax credit, shielding subsidized enrollees from premium increases. Further, they find that individual market premiums are only modestly sensitive to young adults' propensity to enroll in insurance coverage, and ensuring market stability does not require that young adults make up a particular share of enrollees.

  1. The Affordable Care Act and Health Insurance Exchanges: Advocacy Efforts for Children's Oral Health.

    PubMed

    Orynich, C Ashley; Casamassimo, Paul S; Seale, N Sue; Litch, C Scott; Reggiardo, Paul

    2015-01-01

    To evaluate legislative differences in defining the Affordable Care Act's (ACA) pediatric dental benefit and the role of pediatric advocates across states with different health insurance Exchanges. Data were collected through public record investigation and confidential health policy expert interviews conducted at the state and federal level. Oral health policy change by the pediatric dental profession requires advocating for the mandatory purchase of coverage through the Exchange, tax subsidy contribution toward pediatric dental benefits, and consistent regulatory insurance standards for financial solvency, network adequacy and provider reimbursement. The pediatric dental profession is uniquely positioned to lead change in oral health policy amidst health care reform through strengthening state-level formalized networks with organized dentistry and commercial insurance carriers.

  2. Post-acute care and vertical integration after the Patient Protection and Affordable Care Act.

    PubMed

    Shay, Patrick D; Mick, Stephen S

    2013-01-01

    The anticipated changes resulting from the passage of the Patient Protection and Affordable Care Act-including the proposed adoption of bundled payment systems and the promotion of accountable care organizations-have generated considerable controversy as U.S. healthcare industry observers debate whether such changes will motivate vertical integration activity. Using examples of accountable care organizations and bundled payment systems in the American post-acute healthcare sector, this article applies economic and sociological perspectives from organization theory to predict that as acute care organizations vary in the degree to which they experience environmental uncertainty, asset specificity, and network embeddedness, their motivation to integrate post-acute care services will also vary, resulting in a spectrum of integrative behavior.

  3. Preparedness of Americans for the Affordable Care Act.

    PubMed

    Barcellos, Silvia Helena; Wuppermann, Amelie C; Carman, Katherine Grace; Bauhoff, Sebastian; McFadden, Daniel L; Kapteyn, Arie; Winter, Joachim K; Goldman, Dana

    2014-04-15

    This paper investigates whether individuals are sufficiently informed to make reasonable choices in the health insurance exchanges established by the Affordable Care Act (ACA). We document knowledge of health reform, health insurance literacy, and expected changes in healthcare using a nationally representative survey of the US population in the 5 wk before the introduction of the exchanges, with special attention to subgroups most likely to be affected by the ACA. Results suggest that a substantial share of the population is unprepared to navigate the new exchanges. One-half of the respondents did not know about the exchanges, and 42% could not correctly describe a deductible. Those earning 100-250% of federal poverty level (FPL) correctly answered, on average, 4 out of 11 questions about health reform and 4.6 out of 7 questions about health insurance. This compares with 6.1 and 5.9 correct answers, respectively, for those in the top income category (400% of FPL or more). Even after controlling for potential confounders, a low-income person is 31% less likely to score above the median on ACA knowledge questions, and 54% less likely to score above the median on health insurance knowledge than a person in the top income category. Uninsured respondents scored lower on health insurance knowledge, but their knowledge of ACA is similar to the overall population. We propose that simplified options, decision aids, and health insurance product design to address the limited understanding of health insurance contracts will be crucial for ACA's success.

  4. Metropolitan Housing Desegregation: The Case for an Affirmative Program under Title VI of the Civil Rights Act of 1964.

    ERIC Educational Resources Information Center

    Levin, Arthur, J.; Silard, John

    A 1966 document reviews a number of issues about housing segregation, which are related to Title IV of the Civil Rights Act of 1964. Discussed in five sections are the displacement impact of major Federal construction programs, Federal assistance to private housing, metropolitan housing desegregation, affirmative programs for desegregation, and…

  5. Patient Protection and Affordable Care Act of 2010 and children and youth with special health care needs.

    PubMed

    Feldman, Heidi M; Buysse, Christina A; Hubner, Lauren M; Huffman, Lynne C; Loe, Irene M

    2015-04-01

    The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN.

  6. Anticipating the Impact of the Patient Protection and Affordable Care Act for Patients with Urological Cancer

    PubMed Central

    Ellimoottil, Chandy; Miller, David C.

    2014-01-01

    The Affordable Care Act seeks to overhaul the US healthcare system by providing insurance for more Americans, improving the quality of healthcare delivery, and reducing healthcare expenditures. While the law’s intent is clear, its implementation and effect on patient care remains largely undefined. Herein, we discuss major components of the ACA, including the proposed insurance expansion, payment and delivery system reforms (e.g. bundled payments and Accountable Care Organizations) and other reforms relevant to the field of urologic oncology. We also discuss how these proposed reforms may impact patients with urological cancers. PMID:24588021

  7. Small employer perspectives on the Affordable Care Act's premiums, SHOP exchanges, and self-insurance.

    PubMed

    Gabel, Jon R; Whitmore, Heidi; Pickreign, Jeremy; Satorius, Jennifer L; Stromberg, Sam

    2013-11-01

    Beginning January 1, 2014, small businesses having no more than fifty full-time-equivalent workers will be able to obtain health insurance for their employees through Small Business Health Options Program (SHOP) exchanges in every state. Although the Affordable Care Act intended the exchanges to make the purchasing of insurance more attractive and affordable to small businesses, it is not yet known how they will respond to the exchanges. Based on a telephone survey of 604 randomly selected private firms having 3-50 employees, we found that both firms that offered health coverage and those that did not rated most features of SHOP exchanges highly but were also very price sensitive. More than 92 percent of nonoffering small firms said that if they were to offer coverage, it would be "very" or "somewhat" important to them that premium costs be less than they are today. Eighty percent of offering firms use brokers who commonly perform functions of benefit managers--functions that the SHOP exchanges may assume. Twenty-six percent of firms using brokers reported discussing self-insuring with their brokers. An increase in the number of self-insured small employers could pose a threat to SHOP exchanges and other small-group insurance reforms.

  8. The Relevance of the Affordable Care Act for Improving Mental Health Care.

    PubMed

    Mechanic, David; Olfson, Mark

    2016-01-01

    Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce.

  9. Affordable Care Act Provision Lowered Out-Of-Pocket Cost And Increased Colonoscopy Rates Among Men In Medicare.

    PubMed

    Hamman, Mary K; Kapinos, Kandice A

    2015-12-01

    Colorectal cancer screening is one of the few cancer screenings with an "A" rating from the US Preventive Services Task Force, meaning that the procedure confers a substantial health benefit. However, 40 percent of people who should receive colorectal cancer screenings do not receive them. Colonoscopies are the most thorough method of screening because they allow physicians to view the entire length of the colon and remove polyps as needed. Billing methods that distinguish between screening and therapeutic procedures have kept expected colonoscopy costs high. However, the Affordable Care Act partially closed the so-called colonoscopy loophole and reduced expected out-of-pocket expenses for all Medicare beneficiaries. Using data from the Behavioral Risk Factor Surveillance System, we found that annual colonoscopy rates among men ages 66-75 increased significantly (by 4.0 percentage points) after the Affordable Care Act policy change, and we found some evidence of even larger increases among socioeconomically disadvantaged men. We found no significant increases among women, a result that may be explained by health behavior and other factors and that requires further study. Our research indicates that cost may be an important barrier to colorectal cancer screening, at least among men, and that making further policy changes to close remaining loopholes may improve screening rates. Project HOPE—The People-to-People Health Foundation, Inc.

  10. Early Impact of the Affordable Care Act on Uptake of Long-acting Reversible Contraceptive Methods.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The Affordable Care Act (ACA) required most private insurance plans to cover contraceptive services without patient cost-sharing as of January 2013 for most plans. Whether the ACA's mandate has impacted long-acting reversible contraceptives (LARC) use is unknown. The aim of this article is to assess trends in LARC cost-sharing and uptake before and one year after implementation of the ACA's contraceptive mandate. A retrospective cohort study using Truven Health MarketScan claims data from January 2010 to December 2013. Women aged 18-45 years with continuous insurance coverage with claims for oral contraceptive pills, patches, rings, injections, or LARC during 2010-2013 (N=3,794,793). Descriptive statistics were used to assess trends in LARC cost-sharing and uptake from 2010 through 2013. Interrupted time series models were used to assess the association of time, ACA, and time after the ACA on LARC cost-sharing and initiation rates, adjusting for patient and plan characteristics. The proportion of claims with $0 cost-sharing for intrauterine devices and implants, respectively, rose from 36.6% and 9.3% in 2010 to 87.6% and 80.5% in 2013. The ACA was associated with a significant increase in these proportions and in their rate of increase (level and slope change both P<0.001). LARC uptake increased over time with no significant change in level of LARC use after ACA implementation in January 2013 (P=0.44) and a slightly slower rate of growth post-ACA than previously reported (β coefficient for trend, -0.004; P<0.001). The ACA has significantly decreased LARC cost-sharing, but during its first year had not yet increased LARC initiation rates.

  11. Differing Impacts Of Market Concentration On Affordable Care Act Marketplace Premiums.

    PubMed

    Scheffler, Richard M; Arnold, Daniel R; Fulton, Brent D; Glied, Sherry A

    2016-05-01

    Recent increases in market concentration among health plans, hospitals, and medical groups raise questions about what impact such mergers are having on costs to consumers. We examined the impact of market concentration on the growth of health insurance premiums between 2014 and 2015 in two Affordable Care Act state-based Marketplaces: Covered California and NY State of Health. We measured health plan, hospital, and medical group market concentration using the well-known Herfindahl-Hirschman Index (HHI) and used a multivariate regression model to relate these measures to premium growth. Both states exhibited a positive association between hospital concentration and premium growth and a positive (but not statistically significant) association between medical group concentration and premium growth. Our results for health plan concentration differed between the two states: It was positively associated with premium growth in New York but negatively associated with premium growth in California. The health plan concentration finding in Covered California may be the result of its selectively contracting with health plans. Project HOPE—The People-to-People Health Foundation, Inc.

  12. 78 FR 42823 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ...This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally- facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. The final rule also directs that each Exchange designate organizations which will then certify their staff members and volunteers to be application counselors that assist consumers and facilitate enrollment in qualified health plans and insurance affordability programs, and provides standards for that designation.

  13. 76 FR 47225 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

  14. 76 FR 4127 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-24

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

  15. 75 FR 41510 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-16

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by...). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period...

  16. 77 FR 42754 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

  17. 75 FR 5339 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-02

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

  18. 78 FR 4427 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

  19. 78 FR 44580 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by... interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning...

  20. 77 FR 4359 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-27

    ... Programs Under the National Housing Act--Debenture Interest Rates AGENCY: Office of the Assistant Secretary... in the interest rates to be paid on debentures issued with respect to a loan or mortgage insured by...). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period...

  1. The Patient Protection and Affordable Care Act and the regulation of the health insurance industry.

    PubMed

    Jha, Saurabh; Baker, Tom

    2012-12-01

    The Patient Protection and Affordable Care Act is a comprehensive and multipronged reform of the US health care system. The legislation makes incremental changes to Medicare, Medicaid, and the market for employer-sponsored health insurance. However, it makes substantial changes to the market for individual and small-group health insurance. The purpose of this article is to introduce the key regulatory reforms in the market for individual and small-group health insurance and explain how these reforms tackle adverse selection and risk classification and improve access to health care for the hitherto uninsured or underinsured population. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. The Affordable Care Act's implications for a public health workforce agenda: taxonomy, enumeration, and the Standard Occupational Classification system.

    PubMed

    Montes, J Henry; Webb, Susan C

    2015-01-01

    The Affordable Care Act brings a renewed emphasis on the importance of public health services and those whose occupations are defined by performing the essential public health functions. The Affordable Care Act Prevention and Public Health Fund is a signal to the field that its work is important and critical to the health of the nation. Recent reports by the Institute of Medicine describe the changing dimensions of public health work in primary care integration and the need for enhanced financing of public health as investment. Gaining knowledge about the public health workforce, that is, how many workers there are and what they are doing, is of growing interest and concern for the field. Although enumeration of the public health workforce has been attempted several times by the federal government beginning as early as 1982, it was not until the year 2000 that a major effort was undertaken to obtain more complete information. Limitations that hampered Enumeration 2000 have persisted however. With implementation of the Affordable Care Act and other new ventures, key federal agencies are developing strategies to pursue a systemic and systematic enumeration and consistent taxonomy process. Included in these efforts is use of the Bureau of Labor Statistics, Standard Occupational Classification system. A clear and accurate understanding of the public health workforce and its characteristics is a major challenge. A well-constructed, systematic enumeration process can add to our understanding of the nature and functions of that workforce. In addition, discussion of enumeration must include the need for a consensus within the field that leads to a consistent taxonomy for the public health occupations. This article will provide a stage-setting brief of historical actions regarding enumeration, and it will examine selected enumeration activities taking place currently. It will discuss positive and negative implications facing public health and the potential for enhancing the

  3. 12 CFR 1282.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...”) Insurance Program, 12 U.S.C. 1715z-20; mortgages guaranteed under the Rural Housing Service's Single Family...-going, sustainable efforts to ensure that additional loans that meet the goal are originated. (iv... of the Community Support Program; or (B) Community development credit unions; community development...

  4. DOE ZERH Case Study: Mutual Housing California, Mutual Housing at Spring Lake, Woodland, CA

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning multifamily project of 62 affordable-housing apartment home in the hot-dry climate that exceeded CA Title 24-2008 by 35%, with 2x4 16” on center walls with R-21 fiberglass bass walls, uninsulated salb on grade foundation; vented attic with R-44 blown fiberglass; air to water heat pumps.

  5. Affordable Mortgage for Homeowners Act of 2011

    THOMAS, 112th Congress

    Rep. Hastings, Alcee L. [D-FL-23

    2011-12-19

    House - 01/12/2012 Referred to the Subcommittee on Capital Markets and Government Sponsored Enterprises. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. The Patient Protection and Affordable Care Act: what every provider of gynecologic oncology care should know.

    PubMed

    Duska, Linda R; Engelhard, Carolyn L

    2013-06-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama in 2010. While initial implementation of the law began shortly thereafter, the full implementation will take place over the next few years. With respect to cancer care, the act was intended to make care more accessible, affordable, and comprehensive across different parts of the country. For our cancer patients and our practices, the ACA has implications that are both positive and negative. The Medicaid expansion and access to insurance exchanges are intended to increase the number of insured patients and thus improve access to care, but many states have decided to opt out of the Medicaid program and in these states access problems will persist. Screening programs will be put in place for insured patients but may supplant federally funded programs that are currently in place for uninsured patients and may not follow current screening guidelines. Both hospice and home health providers will be asked to provide more services with less funding, and quality measures, including readmission rates, will factor into reimbursement. Insured patients will have access to all phases of clinical trial research. There is a need for us as providers of Gynecologic Oncology care to be active in the implementation of the ACA in order to ensure that our patients and our practices can survive and benefit from the changes in health care reimbursement, with the ultimate goals of improving access to care and quality while reducing unsustainable costs. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Differential Health and Social Needs of Older Adults Waitlisted for Public Housing or Housing Choice Vouchers.

    PubMed

    Carder, Paula; Luhr, Gretchen; Kohon, Jacklyn

    2016-01-01

    Affordable housing is an important form of income security for low-income older persons. This article describes characteristics of older persons waitlisted for either public housing or a housing choice voucher (HCV; previously Section 8) in Portland, Oregon. 358 persons (32% response rate) completed a mailed survey with questions about demographics, health and housing status, food insecurity, and preference for housing with services. Findings indicate that many waitlisted older persons experienced homelessness or housing instability, poor health, high hospital use, and food insecurity. Public housing applicants were significantly more likely to report lower incomes, homelessness, and food insecurity than HCV applicants. We conclude with policy implications for housing and health agencies that serve low-income older persons.

  8. 12 CFR 1282.19 - Affordability-Rent level definitions-tenant income is not known.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... very low-, low-, or moderate-income families where the income of the family in the dwelling unit is not known to the Enterprise, the affordability of the unit is determined based on unit size as follows: (a) For moderate-income, maximum affordable rents to count as housing for moderate-income families shall...

  9. Treatment for Substance Use Disorder: Opportunities and Challenges under the Affordable Care Act

    PubMed Central

    Tai, Betty; Volkow, Nora D.

    2016-01-01

    Addiction is a chronic brain disease with consequences that remain problematic years after discontinuation of use. Despite this, treatment models focus on acute interventions and are carved out from the main health care system. The Patient Protection and Affordable Care Act (2010) brings the opportunity to change the way substance use disorder (SUD) is treated in the United States. The treatment of SUD must adapt to a chronic care model offered in an integrated care system that screens for at-risk patients and includes services needed to prevent relapses. The partnering of the health care system with substance abuse treatment programs could dramatically expand the benefits of prevention and treatment of SUD. Expanding roles of health information technology and nonphysician workforces, such as social workers, are essential to the success of a chronic care model. PMID:23731411

  10. Flood Insurance Affordability and Risk Notification Act

    THOMAS, 111th Congress

    Sen. Durbin, Richard J. [D-IL

    2010-12-01

    Senate - 12/01/2010 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  11. The Affordable Care Act Appears to Have Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Care Among Young Adults.

    PubMed

    Lipton, Brandy J; Decker, Sandra L; Sommers, Benjamin D

    2017-04-01

    Prior to the Affordable Care Act, one in three young adults aged 19 to 25 years were uninsured, with substantial racial/ethnic disparities in coverage. We analyzed the separate and cumulative changes in racial/ethnic disparities in coverage and access to care among young adults after implementation of the Affordable Care Act's 2010 dependent coverage provision and 2014 Medicaid and Marketplace expansions. We find that the dependent coverage provision was associated with similar gains across racial/ethnic groups, but the 2014 expansion was associated with larger gains in coverage among Hispanics and Blacks relative to Whites. After the 2014 expansion, coverage increased by 11.0 and 10.1 percentage points among Hispanics and Blacks, respectively, compared with a 5.6 percentage point increase among Whites. The percentage with a usual source of care and a recent doctor's visit also increased more for Blacks relative to Whites. Increases in coverage were larger in Medicaid expansion compared with nonexpansion states for most racial/ethnic groups.

  12. Rural Housing Preservation Act of 2011

    THOMAS, 112th Congress

    Rep. Fortenberry, Jeff [R-NE-1

    2011-01-12

    House - 03/23/2011 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. Rural Housing Preservation Act of 2012

    THOMAS, 112th Congress

    Rep. Fortenberry, Jeff [R-NE-1

    2012-09-14

    House - 10/01/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Housing Finance Reform Act of 2011

    THOMAS, 112th Congress

    Rep. Campbell, John [R-CA-48

    2011-05-12

    House - 07/29/2011 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Work Force Housing Act of 2011

    THOMAS, 112th Congress

    Rep. Pompeo, Mike [R-KS-4

    2012-01-25

    House - 02/09/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Social welfare and the Affordable Care Act: is it ever optimal to set aside comparative cost?

    PubMed

    Mortimer, Duncan; Peacock, Stuart

    2012-10-01

    The creation of the Patient-Centered Outcomes Research Institute (PCORI) under the Affordable Care Act has set comparative effectiveness research (CER) at centre stage of US health care reform. Comparative cost analysis has remained marginalised and it now appears unlikely that the PCORI will require comparative cost data to be collected as an essential component of CER. In this paper, we review the literature to identify ethical and distributional objectives that might motivate calls to set priorities without regard to comparative cost. We then present argument and evidence to consider whether there is any plausible set of objectives and constraints against which priorities can be set without reference to comparative cost. We conclude that - to set aside comparative cost even after accounting for ethical and distributional constraints - would be truly to act as if money is no object. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Patient Protection and Affordable Care Act of 2010 and Children and Youth With Special Health Care Needs

    PubMed Central

    Buysse, Christina A.; Hubner, Lauren M.; Huffman, Lynne C.; Loe, Irene M.

    2015-01-01

    ABSTRACT: The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN. PMID:25793891

  18. State and regional tools for coordinating housing and transportation.

    DOT National Transportation Integrated Search

    2014-01-01

    Federal, state, and local governments spend billions on transportation infrastructure and affordable : housing subsidies, but rarely with complete coordination. States and regional entities are pivotal in : shaping transportation and housing systems....

  19. Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Final rules.

    PubMed

    2012-02-15

    These regulations finalize, without change, interim final regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the Patient Protection and Affordable Care Act.

  20. A Healthy New World: Emergent Opportunities for Clinical Psychologists in the Patient Protection and Affordable Care Act

    PubMed Central

    Beidas, Rinad S.; Manderscheid, Ronald W.

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) is radically transforming the health and mental health care landscape. Emergent opportunities exist for clinical psychologists to redefine their role in healthcare. We reflect on the Chor and colleagues article (this issue) elucidating key issues for psychologists, and present additional recommendations for consideration. Specifically, we highlight three points: (1) moving beyond just training and hoping; (2) recovery, not just symptom reduction; and (3) it’s a healthy new world. Under each of these points, we suggest tactics for how to achieve these goals. PMID:24954983

  1. Affordances and the musically extended mind.

    PubMed

    Krueger, Joel

    2014-01-06

    I defend a model of the musically extended mind. I consider how acts of "musicking" grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of "musical affordances" and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances - via soliciting different forms of entrainment - enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

  2. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act

    PubMed Central

    Abdus, Salam; Mistry, Kamila B.

    2015-01-01

    Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. PMID:26447920

  3. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act.

    PubMed

    Abdus, Salam; Mistry, Kamila B; Selden, Thomas M

    2015-11-01

    We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions.

  4. EVALUATING ECOMOD: BUILDING PERFORMANCE MONITORING AND POST-OCCUPANCY EVALUATION OF AN ECOLOGICAL, MODULAR HOUSE

    EPA Science Inventory

    Many people in this country cannot afford well-built houses, much less the energy required to run them. Newly built low-income single-family homes tend to be trailers or some variant of manufactured housing. While they are affordable and easily installed in various location...

  5. The Affordable Care Act: overview and implications for county and city behavioral health and intellectual/developmental disability programs.

    PubMed

    Manderscheid, Ron

    2014-01-01

    The author begins by reviewing the 5 key intended actions of the Affordable Care Act (ACA)-insurance reform, coverage reform, quality reform, performance reform, and information technology reform. This framework provides a basis for examining how populations served and service programs will change at the county and city levels as a result of the ACA, and how provider staff also will change over time as a result of these developments. The author concludes by outlining immediate next steps for county and city programs.

  6. 77 FR 76064 - Notice of Proposed Information Collection for Public Comment; Public Housing Reform Act: Changes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... on hand and available for inspection policies related to admission and continued occupancy, so as to... through the Freedom of Information Act. Written documentation of policies relating to public housing and...

  7. The Affordable Care Act and Abortion Comparing the U.S. and Western Europe.

    PubMed

    McFarlane, Deborah R

    2015-01-01

    The 2010 Affordable Health Care Act (ACA) treats abortion differently than any other health service, precluding public funding for abortion and imposing other restrictions on American states. To determine whether the ACA's abortion restrictions are uniquely American or have counterparts in other national health systems, this study employs a cross-sectional design comparing abortion restrictions in the ACA with those in 17 Western European countries. Using a six-item scale, the intensity of abortion restrictions is compared across Western European nations. A similar scale is employed for a five-state sample of state-level abortion restrictions. Although the United States is not alone in having abortion restrictions, how abortion is proscribed in the ACA has no counterpart in Western Europe. Unlike many Western European countries, the ACA's restrictions focus on abortion funding, not the length of gestation or the health of the pregnant woman.

  8. The affordable care act and long-term care: comprehensive reform or just tinkering around the edges?

    PubMed

    Miller, Edward Alan

    2012-01-01

    The Patient Protection and Affordable Care Act (ACA) includes several provisions that aim to improve prevailing deficiencies in the nation's long-term care system. But just how effective is the ACA likely to be in addressing these challenges? Will it result in meaningful or marginal reform? This special issue of Journal of Aging & Social Policy seeks to answer these questions. The most prominent long-term care provision is the now-suspended Community Living Assistance Services and Supports Act. Others include incentives and options for expanding home- and community-based care, a number of research and demonstration projects in the areas of chronic care coordination and the dually eligible, and nursing home quality reforms. There are also elements that seek to improve workforce recruitment and retention, in addition to benefit improvements and spending reductions under Medicare. This article reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them. It also includes a brief overview of issue content.

  9. Financial Issues and Adult Immunization: Medicare Coverage and the Affordable Care Act

    PubMed Central

    Hurley, Laura P.; Lindley, Megan C.; Allison, Mandy A.; Crane, Lori A.; Brtnikova, Michaela; Beaty, Brenda L.; Snow, Megan; Bridges, Carolyn B.; Kempe, Allison

    2017-01-01

    Background Financial barriers to adult vaccination are poorly understood. Our objectives were to assess among general internists (GIM) and family physicians (FP) shortly after Affordable Care Act (ACA) implementation: 1) proportion of adult patients deferring or refusing vaccines because of cost and frequency of physicians not recommending vaccines for financial reasons; 2) satisfaction with reimbursement for vaccine purchase and administration by payer type; 3) knowledge of Medicare coverage of vaccines; and 4) awareness of vaccine-specific provisions of the ACA. Methods We administered an Internet and mail survey from June to October 2013 to national networks of 438 GIMs and 401 FPs. Results Response rates were 72% (317/438) for GIM and 59% (236/401) for FP. Among physicians who routinely recommended vaccines, up to 24% of GIM and 30% of FP reported adult patients defer or refuse certain vaccines for financial reasons most of the time. Physicians reported not recommending vaccines because they thought the patient’s insurance would not cover it (35%) or the patient could be vaccinated more affordably elsewhere (38%). Among physicians who saw patients with this insurance, dissatisfaction (‘very dissatisfied’) was highest for payments received from Medicaid (16 % vaccine purchase, 14 % vaccine administration) and Medicare Part B (11 % vaccine purchase, 11 % vaccine administration). Depending on the vaccine, 36–71% reported not knowing how Medicare covered the vaccine. Thirty-seven percent were ‘not at all aware’ and 19% were ‘a little aware’ of vaccine-specific provisions of the ACA. Conclusions Patients are refusing and physicians are not recommending adult vaccinations for financial reasons. Increased knowledge of private and public insurance coverage for adult vaccinations might position physicians to be more likely to recommend vaccines and better enable them to refer patients to other vaccine providers when a particular vaccine or vaccines are

  10. 75 FR 81662 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ... for OMB Review; Comment Request; Affordable Care Act Patient Protection Notice ACTION: Notice. SUMMARY... Security Administration (EBSA) sponsored information collection request (ICR) titled, ``Affordable Care Act Patient Protection Notice,'' to the Office of Management and Budget (OMB) for review and approval for...

  11. Affordable Care Act risk adjustment: overview, context, and challenges.

    PubMed

    Kautter, John; Pope, Gregory C; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses will be able to purchase private health insurance through competitive marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge and the incentive for plans to avoid sicker enrollees. This article--the first of three in the Medicare & Medicaid Research Review--describes the key program goal and issues in the Department of Health and Human Services (HHS) developed risk adjustment methodology, and identifies key choices in how the methodology responds to these issues. The goal of the HHS risk adjustment methodology is to compensate health insurance plans for differences in enrollee health mix so that plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula that together address this program goal as well as three issues specific to ACA risk adjustment: 1) new population; 2) cost and rating factors; and 3) balanced transfers within state/market. The risk adjustment model, described in the second article, estimates differences in health risks taking into account the new population and scope of coverage (actuarial value level). The transfer formula, described in the third article, calculates balanced transfers that are intended to account for health risk differences while preserving permissible premium differences.

  12. Landowners and the Structure of Affordable Housing Provision in Rural Scotland

    ERIC Educational Resources Information Center

    Satsangi, M.

    2005-01-01

    This paper looks at the behaviour of private landowners in rural Scotland in relation to housing supply, particularly renting and low-cost housing. The theme is one that has received relatively little research. In consequence, the paper is set in the context of two rather broader traditions in the literature of examining investor/developer…

  13. 76 FR 11283 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-01

    ... for OMB Review; Comment Request; Affordable Care Act Internal Claims and Appeals and External Review...) titled, ``Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non... rules relating to internal claims and appeals and external review processes. On July 23, 2010, the EBSA...

  14. 78 FR 1224 - Supportive Housing for the Elderly; Advance Notice of Senior Preservation Rental Assistance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-08

    ...The Section 202 Supportive Housing for the Elderly Act of 2010, signed into law in January 2011, authorizes HUD to provide Senior Preservation Rental Assistance Contracts (SPRACs) with 20-year terms to prevent displacement of elderly residents of certain projects assisted under HUD's Section 202 Supportive Housing for the Elderly program in the case of refinancing or recapitalization and to further preserve and maintain affordability of Section 202 Direct Loan projects. In Fiscal Year (FY) 2012, $16 million was made available for SPRAC funding. This notice advises of HUD's intent to award SPRACs through the proposed application process described in this notice. HUD is soliciting comments on the proposed process for awarding SPRACs and the associated criteria for establishing eligibility to apply for a SPRAC.

  15. The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals

    PubMed Central

    Ross, Raven E.; Garfield, Lauren D.; Brown, Derek S.; Raghavan, Ramesh

    2016-01-01

    American Indian and Alaska Native (AI/AN) populations report poor physical and mental health outcomes while tribal health providers and the Indian Health Service (IHS) operate in a climate of significant under funding. Understanding how the Patient Protection and Affordable Care Act (ACA) affects Native American tribes and the IHS is critical to addressing the improvement of the overall access, quality, and cost of health care within AI/AN communities. This paper summarizes the ACA provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the IHS. PMID:26548665

  16. The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act.

    PubMed

    Buck, Jeffrey A

    2011-08-01

    Public substance abuse treatment services have largely operated as an independent part of the overall health care system, with unique methods of administration, funding, and service delivery. The Affordable Care Act of 2010 and other recent health care reforms, coupled with declines in state general revenue spending, will change this. Overall funding for these substance abuse services should increase, and they should be better integrated into the mainstream of general health care. Reform provisions are also likely to expand the variety of substance abuse treatment providers and shift services away from residential and stand-alone programs toward outpatient programs and more integrated programs or care systems. As a result, patients should have better access to care that is more medically based and person-centered.

  17. Silver bullet or trojan horse? The effects of inclusionary zoning on local housing markets in the United States.

    PubMed

    Schuetz, Jenny; Meltzer, Rachel; Been, Vicki

    2011-01-01

    Many local governments are adopting inclusionary zoning (IZ) as a means of producing affordable housing without direct public subsidies. In this paper, panel data on IZ in the San Francisco metropolitan area and suburban Boston are used to analyse how much affordable housing the programmes produce and how IZ affects the prices and production of market-rate housing. The amount of affordable housing produced under IZ has been modest and depends primarily on how long IZ has been in place. Results from suburban Boston suggest that IZ has contributed to increased housing prices and lower rates of production during periods of regional house price appreciation. In the San Francisco area, IZ also appears to increase housing prices in times of regional price appreciation, but to decrease prices during cooler regional markets. There is no evidence of a statistically significant effect of IZ on new housing development in the Bay Area.

  18. Assistance, Quality, and Affordability Act of 2010

    THOMAS, 111th Congress

    Rep. Waxman, Henry A. [D-CA-30

    2010-05-18

    Senate - 08/05/2010 Read twice and referred to the Committee on Environment and Public Works. (All Actions) Notes: For further action, see S.3874, which became Public Law 111-380 on 1/4/2011. Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  19. Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act.

    PubMed

    Novak, Priscilla; Anderson, Andrew C; Chen, Jie

    2018-05-12

    The Affordable Care Act (ACA) aims to expand health insurance coverage and minimize financial barriers to receiving health care services for individuals. However, little is known about how the ACA has impacted individuals with mental health conditions. This study finds that the implementation of the ACA is associated with an increase in rate of health insurance coverage among nonelderly adults with serious psychological distress (SPD) and a reduction in delaying and forgoing necessary care. The ACA also reduced the odds of an individual with SPD not being able to afford mental health care. Mental health care access among racial and ethnic minority populations and people with low income has improved during 2014-2016, but gaps remain.

  20. The Medicaid Rebate: Changes in Oncology Drug Prices After the Affordable Care Act.

    PubMed

    Bonakdar Tehrani, Ali; Carroll, Norman V

    2017-08-01

    Prescription drug spending is a significant component of Medicaid total expenditures. The Affordable Care Act (ACA) includes a provision that increases the Medicaid rebate for both brand-name and generic drugs. This study examines the extent to which oncology drug prices changed after the increase in the Medicaid rebate in 2010. A pre-post study design was used to evaluate the correlation between the Medicaid rebate increase and oncology drug prices after 2010 using 2006-2013 State Drug Utilization Data. The results show that the average annual price of top-selling cancer drugs in 2006, adjusted for inflation and secular changes in drug prices, have increased by US$154 and US$235 for branded and competitive brand drugs, respectively, following the 2010 ACA; however, generic oncology drug prices showed no significant changes. The findings from this study indicate that oncology drug prices have increased after the 2010 ACA, and suggest that pharmaceutical companies may have increased their drug prices to offset increases in Medicaid rebates.

  1. Providing Health Information to Latino Farmworkers: The Case of the Affordable Care Act.

    PubMed

    Arcury, Thomas A; Jensen, Anna; Mann, Mackenzie; Sandberg, Joanne C; Wiggins, Melinda F; Talton, Jennifer W; Hall, Mark A; Quandt, Sara A

    2017-01-01

    Providing health program information to vulnerable communities, such as Latino farmworkers, is difficult. This analysis describes the manner in which farmworkers receive information about the Affordable Care Act, comparing farmworkers with other Latinos. Interviews were conducted with 100 Latino farmworkers and 100 urban Latino North Carolina residents in 2015. Most farmworkers had received health information from a community organization. Trusted sources for health information were health care providers and community organizations. Sources that would influence decisions to enroll were Latino nurses and doctors, religious leaders, and family members. Traditional media, including oral presentation and printed material at the doctor's office, were preferred by the majority of farmworkers and non-farmworkers. Farmworkers used traditional electronic media: radio, television, and telephone. More non-farmworkers used current electronic media: e-mail and Internet. Latino farmworkers and non-farmworkers prefer traditional media in the context of a health care setting. They are willing to try contemporary electronic media for this information.

  2. Expected and Unexpected Consequences of the Affordable Care Act: The Impact on Patients and Surgeons-Pro and Con Arguments.

    PubMed

    Rudnicki, Marek; Armstrong, John H; Clark, Clancy; Marcus, Stuart G; Sacks, Lee; Moser, A James; Reid-Lombardo, K Marie

    2016-02-01

    The Patient Protection and Affordable Care Act (PPACA), called the Affordable Care Act (ACA) or "ObamaCare" for short, was enacted in 2010. The Public Policy and Advocacy Committee of the Society for Surgery of the Alimentary Tract (SSAT) hosted a debate with an expert panel to discuss the ACA and its impact on surgical care after the first year of patient enrollment. The purpose of this debate was to focus on the impact of ACA on the public and surgeons. At the core of the ACA are insurance industry reforms and expanded coverage, with a goal of improved clinical outcomes and reduced costs of care. We have observed supportive and opposing views on ACA. Nonetheless, we will witness major shifts in health care delivery as well as restructuring of our relationship with payers, institutions, and patients. With the rapidly changing health care landscape, surgeons will become key members of health systems and will likely need to lead transition from solo-practice to integrated care systems. The full effects of the ACA remain unrealized, but its implementation has begun to change the map of the American health care system and will surely impact the practice of surgery. Herein, we provide a synopsis of the "pro" and "con" arguments for the expected and unexpected consequences of the ACA on society and surgeons.

  3. Homeowner Flood Insurance Affordability Act of 2013

    THOMAS, 113th Congress

    Sen. Menendez, Robert [D-NJ

    2013-10-29

    Senate - 10/29/2013 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Notes: For further action, see H.R.3370, which became Public Law 113-89 on 3/21/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  4. Self-rated health, generalized trust, and the Affordable Care Act: A US panel study, 2006-2014.

    PubMed

    Mewes, Jan; Giordano, Giuseppe Nicola

    2017-10-01

    Previous research shows that generalized trust, the belief that most people can be trusted, is conducive to people's health. However, only recently have longitudinal studies suggested an additional reciprocal pathway from health back to trust. Drawing on a diverse body of literature that shows how egalitarian social policy contributes to the promotion of generalized trust, we hypothesize that this other 'reverse' pathway could be sensitive to health insurance context. Drawing on nationally representative US panel data from the General Social Survey, we examine whether the Affordable Care Act of 2010 could have had influence on the deteriorating impact of worsening self-rated health (SRH) on generalized trust. Firstly, using two-wave panel data (2008-2010, N = 1403) and employing random effects regression models, we show that a lack of health insurance coverage negatively determines generalized trust in the United States. However, this association is attenuated when additionally controlling for (perceived) income inequality. Secondly, utilizing data from two separate three-wave panel studies from the US General Social Survey (2006-10; N = 1652; 2010-2014; N = 1187), we employ fixed-effects linear regression analyses to control for unobserved heterogeneity from time-invariant factors. We demonstrate that worsening SRH was a stronger predictor for a decrease in generalized trust prior (2006-2010) to the implementation of the Affordable Care Act. Further, the negative effect of fair/poor SRH seen in the 2006-2010 data becomes attenuated in the 2010-2014 panel data. We thus find evidence for a substantial weakening of the previously established negative impact of decreasing SRH on generalized trust, coinciding with the most significant US healthcare reforms in decades. Social policy and healthcare policy implications are discussed. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  5. HOUSING IN YOUR TOWN, WHAT CAN YOU DO ABOUT IT.

    ERIC Educational Resources Information Center

    CROSBY, ALEXANDER L.

    THE ROLE OF THE UNION MEMBER IN REGARD TO HOUSING PROBLEMS WAS PRESENTED. DESPITE THE CLAIMS OF EXPERTS, AN INDIVIDUAL CANNOT AFFORD A HOUSE COSTING THREE TIMES HIS ANNUAL INCOME, THERE IS NO PLACE IN THE COUNTRY WHERE HE CAN BUY A NEW, STANDARD HOUSE WITH THREE BEDROOMS FOR $7,680. THEREFORE, BECAUSE NEW HOUSES ARE SO EXPENSIVE, MOST PEOPLE LIVE…

  6. To repeal the Patient Protection and Affordable Care Act.

    THOMAS, 111th Congress

    Rep. King, Steve [R-IA-5

    2010-03-25

    House - 06/16/2010 Motion to Discharge Committee filed by Mr. King (IA). Petition No: 111-11. (All Actions) Notes: On 6/16/2010, a motion was filed to discharge the Committees on Energy and Commerce, Ways and Means, Education and Labor, the Judiciary, Natural Resources, Rules, House Administration, and Appropriations from consideration of H.R.4972. A discharge petition requires 218 signatures for... Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  7. 77 FR 54602 - Notice of Intent To Conduct Affirmatively Furthering Fair Housing Demonstration in Baltimore, MD...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-05

    ... available in mixed-income, integrated communities. In addition, HUD will require that this new affordable... fair housing marketing plan satisfactory to HUD for both the market-rate units and the units that will... (a satisfactory affirmative fair housing marketing plan must include marketing of affordable units to...

  8. Changes in Young Adult Primary Care Under the Affordable Care Act

    PubMed Central

    Ford, Carol A.; French, Benjamin; Rubin, David M.

    2015-01-01

    Objectives. We sought to describe changes in young adults’ routine care and usual sources of care (USCs), according to provider specialty, after implementation of extended dependent coverage under the Affordable Care Act (ACA) in 2010. Methods. We used Medical Expenditure Panel Survey data from 2006 to 2012 to examine young adults’ receipt of routine care in the preceding year, identification of a USC, and USC provider specialties (pediatrics, family medicine, internal medicine, and obstetrics and gynecology). Results. The percentage of young adults who sought routine care increased from 42.4% in 2006 to 49.5% in 2012 (P < .001). The percentage identifying a USC remained stable at approximately 60%. Among young adults with a USC, there was a trend between 2006 and 2012 toward increasing percentages with pediatric (7.6% vs 9.1%) and family medicine (75.9% vs 80.9%) providers and declining percentages with internal medicine (11.5% vs 7.6%) and obstetrics and gynecology (5.0% vs 2.5%) providers. Conclusions. Efforts under the ACA to increase health insurance coverage had favorable effects on young adults’ use of routine care. Monitoring routine care use and USC choices in this group can inform primary care workforce needs and graduate medical education priorities across specialties. PMID:26447914

  9. Perceived Impacts of the Affordable Care Act: Perspectives of Buprenorphine Prescribers

    PubMed Central

    Knudsen, Hannah K.; Studts, Jamie L.

    2017-01-01

    The Affordable Care Act (ACA) has been heralded as a major policy change that is expected to transform the delivery of substance use disorder (SUD) treatment. Few studies have reported on the perceived impacts of ACA from the perspectives of SUD treatment providers, such as physicians who prescribe buprenorphine to patients with opioid use disorder. The present study describes buprenorphine prescribers’ perceptions regarding impacts of the ACA on the delivery of buprenorphine and examines whether state-level approaches to implementing ACA are associated with its perceived impacts. Data are drawn from a national sample of current buprenorphine prescribers (n=1,174) who were surveyed by mail. On average, buprenorphine prescribers reported ambivalence regarding the impacts of the ACA, as indicated by a mean of 2.75 (SD=0.69) on a scale that ranged from 1 (“strongly disagree”) to 5 (“strongly agree”). A multi-level mixed effects regression model indicated that physicians practicing in states that were supportive of ACA, as indicated by adopting both the Medicaid expansion and implementing a state-based health insurance exchange, had more positive perceptions of the ACA than physicians in states that had declined both of these policies. This study suggests that state approaches to ACA may be associated with varied impacts. PMID:28296579

  10. Dental plan premiums in the Affordable Care Act marketplaces trended downward from 2014 through 2016.

    PubMed

    Nasseh, Kamyar; Vujicic, Marko

    2017-04-01

    Pediatric dental benefits must be offered in the health insurance marketplaces created under the Affordable Care Act. The authors analyzed trends over time in premiums and the number of dental insurers participating in the marketplaces. The authors collected dental benefit plan data from 35 states participating in the federally facilitated marketplaces in 2014, 2015, and 2016. For each county, they counted the number of issuers offering stand-alone dental plans (SADPs) and medical plans with embedded pediatric dental benefits. They also analyzed trends in premiums. From 2014 through 2016, the number of issuers of stand-alone dental plans and medical plans with embedded pediatric dental benefits either did not change or increased in most counties. Average premiums for low-actuarial-value SADPs declined from 2014 through 2016. The increase in the number of issuers of stand-alone dental plans and medical plans with embedded dental benefits may be associated with lower premiums. However, more research is needed to determine if this is the case. Affordable dental plans in the marketplaces could induce people with lower incomes to sign up for dental benefits. Newly insured people could have significant oral health needs and pent-up demand for dental care. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  11. A Place To Call Home. The Crisis in Housing for the Poor.

    ERIC Educational Resources Information Center

    Leonard, Paul A.; And Others

    For most low-income households, housing has become increasingly unaffordable. High housing cost burdens have serious implications, including the growing problems of homelessness and hunger. Data on national trends and housing conditions suggest that just as the affordable housing problems worsened dramatically for low-income households between the…

  12. Clean, Low-Emission, Affordable, New Transportation Efficiency Act

    THOMAS, 111th Congress

    Rep. Blumenauer, Earl [D-OR-3

    2009-03-05

    House - 03/06/2009 Referred to the Subcommittee on Railroads, Pipelines, and Hazardous Materials. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. 24 CFR 92.254 - Qualification as affordable housing: Homeownership.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... in the jurisdiction annually, as follows. The participating jurisdiction must set forth the price for... purchase price. (3) The housing must be acquired by a homebuyer whose family qualifies as a low-income... and set forth the requirements in its consolidated plan. HUD must determine that they are appropriate...

  14. Pharmacists' perspectives on the Patient Protection and Affordable Care Act.

    PubMed

    Khanna, Rahul; Mahabaleshwarkar, Rohan; Holmes, Erin R; Jariwala, Krutika

    2015-01-01

    Passed in 2010, the Patient Protection and Affordable Care Act (PPACA) resulted in significant changes to the health care system in the United States (US). Though general population surveys reveal the fractious political debate surrounding the law, insights on pharmacists' perspectives on the PPACA are lacking in the literature. The objectives of this study were to determine pharmacists' perspectives on the PPACA and determine whether pharmacists' demographic and practice-related characteristics and political beliefs influence their perspectives on the PPACA. This study was conducted using a descriptive, cross-sectional design. Study data were collected with a self-administered online questionnaire distributed to 21,769 registered pharmacists in five states. A total of 1127 completed surveys were received (5.6% response rate). Roughly 37% of pharmacists reported that they understood the major provisions of the PPACA although most (89%) respondents agreed that understanding such policies is important for practicing pharmacy. Just over half (50.6%) of respondents did not support the PPACA while 47.7% supported the legislation. Political orientation, age, gender, and race were found to be significantly related to pharmacists' perspectives on the PPACA. Respondent pharmacists' perceptions of the PPACA appear to be related to political orientation and demographic characteristics. Given that pharmacists will be impacted by the implementation of the PPACA and are so accessible to the public, additional information on health care policy and PPACA should be provided to pharmacists. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Public Housing Tenants Respect Act of 2011

    THOMAS, 112th Congress

    Rep. Rangel, Charles B. [D-NY-15

    2011-12-06

    House - 01/12/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Senior Veterans Housing Assistance Act of 2011

    THOMAS, 112th Congress

    Rep. Turner, Michael R. [R-OH-3

    2011-12-01

    House - 01/12/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  17. Affordable Housing: A Crisis for Wisconsin Families. A WisKids Count Special Report.

    ERIC Educational Resources Information Center

    Wisconsin Council on Children and Families Inc., Madison.

    Growing up in poor quality, unsafe, and/or overcrowded housing magnifies all the other challenges and disadvantages that go along with poverty. Noting that as more and more families in Wisconsin and nationwide struggle to achieve sustainable housing, the connection between housing and child well-being is becoming increasingly obvious, this WisKids…

  18. Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist

    PubMed Central

    Wise, Paul H.; Halfon, Neal

    2014-01-01

    The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The “voltage drop” framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children’s health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation. PMID:25225140

  19. The Patient Protection and Affordable Care Act: the victory of unorthodox lawmaking.

    PubMed

    Beaussier, Anne-Laure

    2012-10-01

    The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as "unorthodox lawmaking," enabled the Democratic leadership to overcome multiple institutional and political veto players.

  20. Flexibility to Innovate for College Affordability Act

    THOMAS, 113th Congress

    Rep. Gowdy, Trey [R-SC-4

    2013-10-30

    House - 10/30/2013 Referred to the Committee on Education and the Workforce, and in addition to the Committee on Rules, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. Problems and Issues of High Rise Low Cost Housing in Malaysia

    NASA Astrophysics Data System (ADS)

    Wahi, Noraziah; Mohamad Zin, Rosli; Munikanan, Vikneswaran; Mohamad, Ismail; Junaini, Syahrizan

    2018-03-01

    Major cities in developing countries are undergoing an enormous migration of peoples from countryside regions. This migration from the countryside regions were mostly to develop carrier and expecting for higher salary for their living survival. Consequently, the large amount of immigrants from countryside to the cities each year had created a great demand for urban housing. The impact from that, Kuala Lumpur, Selangor and its surrounding area now is crowded by the low-income group who cannot afford to own an affordable house. The government of Malaysia had aware of this situation and therefore had created the low cost housing especially for urban poor. However, there are many issues and problems arise regarding the low cost housing in Malaysia especially in urban area. The research is regarding a study on problems and issues of high rise low-cost housing in Malaysia. The need to examine the problems associated with the high rise low cost housing is to ensure the success of future low cost housing development in Malaysia.

  2. Key Provisions of the Patient Protection and Affordable Care Act (ACA): A Systematic Review and Presentation of Early Research Findings.

    PubMed

    French, Michael T; Homer, Jenny; Gumus, Gulcin; Hickling, Lucas

    2016-10-01

    To conduct a systematic literature review of selected major provisions of the Affordable Care Act (ACA) pertaining to expanded health insurance coverage. We present and synthesize research findings from the last 5 years regarding both the immediate and long-term effects of the ACA. We conclude with a summary and offer a research agenda for future studies. We identified relevant articles from peer-reviewed scholarly journals by performing a comprehensive search of major electronic databases. We also identified reports in the "gray literature" disseminated by government agencies and other organizations. Overall, research shows that the ACA has substantially decreased the number of uninsured individuals through the dependent coverage provision, Medicaid expansion, health insurance exchanges, availability of subsidies, and other policy changes. Affordability of health insurance continues to be a concern for many people and disparities persist by geography, race/ethnicity, and income. Early evidence also indicates improvements in access to and affordability of health care. All of these changes are certain to ultimately impact state and federal budgets. The ACA will either directly or indirectly affect almost all Americans. As new and comprehensive data become available, more rigorous evaluations will provide further insights as to whether the ACA has been successful in achieving its goals. © Health Research and Educational Trust.

  3. Energy Efficiency in Housing Act of 2009

    THOMAS, 111th Congress

    Sen. Whitehouse, Sheldon [D-RI

    2009-06-25

    Senate - 06/30/2010 Committee on Banking, Housing, and Urban Affairs Subcommittee on Housing, Transportation and Community Development. Hearings held. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  4. Friendly protection of houses by affordable isolation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mazzolani, Federico M.; Mandara, Alberto; Froncillo, Salvatore

    2008-07-08

    The paper deals with a case of seismic isolation carried out in Campania (Italy), referring to the construction of a house building. The concerned case is a three-storey reinforced concrete frame building, in which the isolation system has been applied between the basement top and the first floor deck. The paper reports the main steps of this work, starting from the design, carried out according to the latest Italian seismic code, going throughout the construction stage, up to the extensive on-site testing program performed to evaluate the dynamic response of the building. Relevant technological solutions are illustrated and discussed. Bothmore » theoretical calculation and experimental measurements demonstrate the effectiveness of the solution adopted, not only from the technical point of view, but also in an economic perspective.« less

  5. Vulnerable Veterans Housing Reform Act of 2013

    THOMAS, 113th Congress

    Rep. Heck, Joseph J. [R-NV-3

    2013-04-25

    Senate - 10/29/2013 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  6. Vulnerable Veterans Housing Reform Act of 2012

    THOMAS, 112th Congress

    Rep. Heck, Joseph J. [R-NV-3

    2012-09-10

    Senate - 09/20/2012 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  7. The Patient Protection and Affordable Care Act: the impact on urologic cancer care.

    PubMed

    Keegan, Kirk A; Penson, David F

    2013-10-01

    In March 2010, the Patient Protection and Affordable Care Act as well as its amendments were signed into law. This sweeping legislation was aimed at controlling spiraling healthcare costs and redressing significant disparities in healthcare access and quality. Cancer diagnoses and their treatments constitute a large component of rising healthcare expenditures and, not surprisingly, the legislation will have a significant influence on cancer care in the USA. Because genitourinary malignancies represent an impressive 25% of all cancer diagnoses per year, this legislation could have a profound impact on urologic oncology. To this end, we will present key components of this landmark legislation, including the proposed expansion to Medicaid coverage, the projected role of Accountable Care Organizations, the expected creation of quality reporting systems, the formation of an independent Patient-Centered Outcomes Research Institute, and enhanced regulation on physician-owned practices. We will specifically address the anticipated effect of these changes on urologic cancer care. Briefly, the legal ramifications and current barriers to the statutes will be examined. Published by Elsevier Inc.

  8. The Patient Protection and Affordable Care Act: The Impact on Urologic Cancer Care

    PubMed Central

    Keegan, Kirk A.; Penson, David F.

    2012-01-01

    In March 2010, the Patient Protection and Affordable Care Act as well as its amendments were signed into law. This sweeping legislation was aimed at controlling spiraling healthcare costs and redressing significant disparities in healthcare access and quality. Cancer diagnoses and their treatments constitute a large component of rising healthcare expenditures and, not surprisingly, the legislation will have a significant influence on cancer care in the United States. Because genitourinary malignancies represent an impressive 25% of all cancer diagnoses per year, this legislation could have a profound impact on urologic oncology. To this end, we will present key components of this landmark legislation, including the proposed expansion to Medicaid coverage, the projected role of Accountable Care Organizations, the expected creation of quality reporting systems, the formation of an independent Patient-Centered Outcomes Research Institute, and enhanced regulation on physician-owned practices. We will specifically address the anticipated effect of these changes on urological cancer care. Briefly, the legal ramifications and current barriers to the statutes will be examined. PMID:22819697

  9. The Affordable Care Act and Diabetes Diagnosis and Care: Exploring the Potential Impacts

    PubMed Central

    Laiteerapong, Neda

    2016-01-01

    This article reviews available data on the implications of the Affordable Care Act (ACA) for the diagnosis and care of type 2 diabetes. We provide a general overview of the major issues for diabetes diagnosis and care, and describe the policies in the ACA that affect diabetes diagnosis and care. We also estimate that approximately 2.3 million of the 4.6 million people in the USA with undiagnosed diabetes aged 18–64 in 2009–2010 may have gained access to free preventive care under the ACA, which could increase diabetes detection. In addition, we note two factors that may limit the success of the ACA for improving access to diabetes care. First, many states with the highest diabetes prevalence have not expanded Medicaid eligibility, and second, primary care providers may not adequately meet the increase in Medicaid patients because federal funding to increase provider reimbursement for Medicaid visits recently expired. We close by discussing current gaps in the literature and future directions for research on the ACA’s impact on diabetes diagnosis, care, and health outcomes. PMID:26892908

  10. Policy Dilemmas in Latino Health Care and Implementation of the Affordable Care Act

    PubMed Central

    Ortega, Alexander N.; Rodriguez, Hector P.; Bustamante, Arturo Vargas

    2016-01-01

    The changing Latino demographic in the United States presents a number of challenges to health care policy makers, clinicians, organizations, and other stakeholders. Studies have demonstrated that Latinos tend to have worse patterns of access to, and utilization of, health care than other ethnic and racial groups. The implementation of the Affordable Care Act (ACA) of 2010 may ameliorate some of these disparities. However, even with the ACA, it is expected that Latinos will continue to have problems accessing and using high-quality health care, especially in states that are not expanding Medicaid eligibility as provided by the ACA. We identify four current policy dilemmas relevant to Latinos’ health and ACA implementation: (a) the need to extend coverage to the undocumented; (b) the growth of Latino populations in states with limited insurance expansion; (c) demands on public and private systems of care; and (d) the need to increase the number of Latino physicians while increasing the direct patient-care responsibilities of nonphysician Latino health care workers. PMID:25581154

  11. Housing Nondiscrimination Act of 2010

    THOMAS, 111th Congress

    Rep. Towns, Edolphus [D-NY-10

    2010-03-11

    House - 04/26/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  12. Vulnerable Veterans Housing Reform Act

    THOMAS, 113th Congress

    Sen. Heller, Dean [R-NV

    2013-11-14

    Senate - 11/14/2013 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. On Medicaid and the Affordable Care Act in Connecticut

    PubMed Central

    Manthous, Constantine A.; Sofair, Andre N.

    2014-01-01

    Background: Medicaid is the federal program, administered by states, for health care for the poor. The Affordable Care Act (ACA) has added a large number of new recipients to this program. Hypothesis: Medicaid programs in some, if not many, states do not provide patients uniform access to subspecialty care guaranteed by the federal statutes. Insofar as the ACA does not address this pre-existing “sub-specialty gap” and more patients are now covered by Medicaid under the ACA, the gap is likely to increase and may contribute to disparities of health care access and outcomes. Methods: A brief description of previous studies demonstrating or suggesting a subspecialty gap in Medicaid services is accompanied by perspectives of the authors, using published literature — most notably the Denver, Colorado health care system — to propose various solutions that may be deployed to address gaps in subspecialty coverage. Results: All published studies describing the Medicaid subspecialty gap are qualitative, survey designs. There are no authoritative objective data regarding the exact prevalence of gaps for each subspecialty in each state. However, surveys of caregivers suggest that gaps were prevalent in the United States prior to initiation of the ACA. Even fewer papers have addressed solutions (in light of the paucity of data describing the magnitude of the problem), and proposed solutions remain speculative and not grounded in objective data. Conclusions: There is reason to believe that a substantial proportion of U.S. citizens — those who are guaranteed a full complement of health services through Medicaid — have difficult or no access to some subspecialty services, many of which other citizens take for granted. This problem deserves greater attention to verify its existence, quantify its magnitude, and develop solutions. PMID:25506291

  14. The Patient Protection and Affordable Care Act and Reproductive Health: Harnessing Data to Improve Care

    PubMed Central

    Stulberg, Debra

    2013-01-01

    The Patient Protection and Affordable Care Act (PPACA) has great potential to improve reproductive health through several components: expanded coverage of people of reproductive age; required coverage of many reproductive health services; and insurance exchange structures that encourage individuals and states to hold plans and providers accountable. These components can work together to improve reproductive health. But in order for this to work, consumers and states need information with which to assess plans. This review article summarizes state contracting theory and argues that states should use this structure to require health plans to collect and report meaningful data that patients, providers, plans, payers, and third-party researchers can access. Now that the Supreme Court has upheld the PPACA and states must set up health insurance exchanges, populations can benefit from improved care and outcomes through data transparency. PMID:23262767

  15. Plastic surgery practice models and research aims under the Patient Protection and Affordable Care Act.

    PubMed

    Giladi, Aviram M; Yuan, Frank; Chung, Kevin C

    2015-02-01

    As the health care landscape in the United States changes under the Affordable Care Act, providers are set to face numerous new challenges. Although concerns about practice sustainability with declining reimbursement have dominated the dialogue, there are more pressing changes to the health care funding mechanism as a whole that must be addressed. Plastic surgeons, involved in various practice models each with different relationships to hospitals, referring physicians, and payers, must understand these reimbursement changes to dictate adequate compensation in the future. In this article, the authors discuss bundle payments and accountable care organizations, and how plastic surgeons might best engage in these new system designs. In addition, the authors review the value of a focused and driven health-services research agenda in plastic surgery, and the importance of this research in supporting long-term financial stability for the specialty.

  16. Health insurance exchanges under the Patient Protection and Affordable Care Act: regulatory and design challenges.

    PubMed

    Hoffmann, Stephanie M

    2012-12-01

    Under the Patient Protection and Affordable Care Act, all states are required to establish health insurance exchanges, marketplaces where individuals and small businesses can purchase health care coverage. In establishing these exchanges, states must address a range of regulatory and design issues to ensure that their exchanges are sustainable and meet the needs of their populations. The issues include the degree of federal involvement in the management of the exchanges, the overall structure and governance of the exchanges, the requirements for insurance plans to be offered on the exchanges, and the design of the exchanges themselves. Each of these issues will play a crucial role in determining the quality of coverage offered to consumers and how effectively they can access that coverage. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Plastic Surgery Practice Models and Research Aims Under the Patient Protection and Affordable Care Act

    PubMed Central

    Giladi, Aviram M.; Yuan, Frank; Chung, Kevin C.

    2014-01-01

    As the healthcare landscape in the United States changes under the Affordable Care Act (ACA), providers are set to face numerous new challenges. Although concerns about practice sustainability with declining reimbursement have dominated the dialogue, there are more pressing changes to the healthcare funding mechanism as a whole that must be addressed. Plastic surgeons, involved in various practice models each with different relationships to hospitals, referring physicians, and payers, must understand these reimbursement changes in order to dictate adequate compensation in the future. Here we discuss bundle payments and Accountable Care Organizations (ACOs), and how plastic surgeons might best engage in these new system designs. In addition, we review the value of a focused and driven health-services research agenda in plastic surgery, and the importance of this research in supporting long-term financial stability for the specialty. PMID:25626805

  18. Historically Black Colleges and Universities Historic Building Restoration and Preservation Act. Report of the House Committee on Resources To Accompany H.R. 1179. House of Representatives, 104th Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Resources.

    This report of the Committee on Resources recommends House of Representatives approval of (H.R. 1179), the Historically Black Colleges and Universities Historic Building Restoration and Preservation Act, as amended, to ensure the preservation of buildings eligible for funding under the Historic Preservation Act on the campuses of historically…

  19. Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act.

    PubMed

    Frean, Molly; Gruber, Jonathan; Sommers, Benjamin D

    2017-05-01

    Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange. The individual mandate's exemptions and penalties had little impact on coverage rates. The law increased Medicaid among individuals gaining eligibility under the ACA and among previously-eligible populations ("woodwork effect") even in non-expansion states, with no resulting reductions in private insurance. Overall, exchange premium subsidies produced 40% of the coverage gains explained by our ACA policy measures, and Medicaid the other 60%, of which 1/2 occurred among previously-eligible individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Emergency Department Profits Are Likely To Continue As The Affordable Care Act Expands Coverage

    PubMed Central

    Wilson, Michael; Cutler, David

    2014-01-01

    To better understand the financial viability of hospital emergency departments (EDs), we created national estimates of the cost to hospitals of providing ED care and the associated hospital revenue using hospital financial reports and patient claims data from 2009. We then estimated the effect the Affordable Care Act (ACA) will have on the future profitability of providing ED care. We estimated that hospital revenue from ED care exceeded costs for that care by $6.1 billion in 2009, representing a profit margin of 7.8 percent (net revenue expressed as a percentage of total revenue). However, this is primarily because hospitals make enough profit on the privately insured ($17 billion) to cover underpayment from all other payer groups, such as Medicare, Medicaid, and unreimbursed care. Assuming current payer reimbursement rates, ACA reforms could result in an additional 4.4-percentage-point increase in profit margins for hospital-based EDs compared to what could be the case without the reforms. PMID:24799576

  1. Physicians, the Affordable Care Act, and primary care: disruptive change or business as usual?

    PubMed

    Jacobson, Peter D; Jazowski, Shelley A

    2011-08-01

    The Patient Protection and Affordable Care Act 1 (ACA) presages disruptive change in primary care delivery. With expanded access to primary care for millions of new patients, physicians and policymakers face increased pressure to solve the perennial shortage of primary care practitioners. Despite the controversy surrounding its enactment, the ACA should motivate organized medicine to take the lead in shaping new strategies for meeting the nation's primary care needs. In this commentary, we argue that physicians should take the lead in developing policies to address the primary care shortage. First, physicians and medical professional organizations should abandon their long-standing opposition to non-physician practitioners (NPPs) as primary care providers. Second, physicians should re-imagine how primary care is delivered, including shifting routine care to NPPs while retaining responsibility for complex patients and oversight of the new primary care arrangements. Third, the ACA's focus on wellness and prevention creates opportunities for physicians to integrate population health into primary care practice.

  2. Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

    PubMed Central

    Logani, Sachin; Green, Adam; Gasperino, James

    2011-01-01

    The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU) are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees) and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform. PMID:22110908

  3. The Effect of Eliminating the Affordable Care Act's Tax Credits in Federally Facilitated Marketplaces.

    PubMed

    Saltzman, Evan; Eibner, Christine

    2015-07-15

    In this study, RAND Corporation researchers assess the expected change in enrollment and premiums in the Patient Protection and Affordable Care Act (ACA)-compliant individual market in federally facilitated marketplace (FFM) states if the U.S. Supreme Court decides to eliminate subsidies in FFM states. The analysis used the Comprehensive Assessment of Reform Efforts (COMPARE) microsimulation model, an economic model developed by RAND researchers, to assess the impact of proposed health reforms. The authors found that enrollment in the ACA-compliant individual market, including plans sold in the marketplaces and those sold outside of the marketplaces that comply with ACA regulations, would decline by 9.6 million, or 70 percent, in FFM states if subsidies were eliminated. They also found that unsubsidized premiums in the ACA-compliant individual market would increase 47 percent in FFM states. This corresponds to a $1,610 annual increase for a 40-year-old nonsmoker purchasing a silver plan.

  4. 76 FR 39119 - Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of Housing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... of a Computer Matching Program Between the Department of Housing and Urban Development (HUD) and the...: Notice of a computer matching program between the HUD and ED. SUMMARY: In accordance with the Privacy Act of 1974 (5 U.S.C. 552a), as amended by the Computer Matching and Privacy Protection Act of 1988 (Pub...

  5. Keeping up with the Cadillacs: What Health Insurance Disparities, Moral Hazard, and the Cadillac Tax Mean to The Patient Protection and Affordable Care Act.

    PubMed

    Fletcher, Rebecca Adkins

    2016-03-01

    A major goal of The Patient Protection and Affordable Care Act is to broaden health care access through the extension of insurance coverage. However, little attention has been given to growing disparities in access to health care among the insured, as trends to reduce benefits and increase cost sharing (deductibles, co-pays) reduce affordability and access. Through a political economic perspective that critiques moral hazard, this article draws from ethnographic research with the United Steelworkers (USW) at a steel mill and the Retail, Wholesale and Department Store Union (RWDSU) at a food-processing plant in urban Central Appalachia. In so doing, this article describes difficulties of health care affordability on the eve of reform for differentially insured working families with employer-sponsored health insurance. Additionally, this article argues that the proposed Cadillac tax on high-cost health plans will increase problems with appropriate health care access and medical financial burden for many families. © 2014 by the American Anthropological Association.

  6. Cancer Preventive Services, Socioeconomic Status and the Affordable Care Act

    PubMed Central

    Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D

    2016-01-01

    Background Out of pocket expenditures are thought to be an important barrier to receipt of cancer preventive services, especially among lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. Our objective was to determine changes in uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation. Methods Using Medicare claims data, we identified women ≥ 70 without mammography in the previous 2 years, and men and women ≥ 70 at increased risk for colorectal cancer without colonoscopy in the past 5 years. We identified procedure receipt in the two-year period prior to ACA implementation (2009-2010) and after implementation (2011-September 2012). Multivariable generalized estimating equation models determine the independent association of and county-level quartile of median income and education with receipt of testing. Results For mammography, lower SES quartile was associated with less uptake but the post-ACA disparities were smaller compared to the pre-ACA period. In addition, mammography rates increased from pre- to post-ACA in all SES quartiles. For colonoscopy, in both the pre- and post-ACA periods, there was an association between uptake and educational level and to some extent, income. However, there were no appreciable changes with colonoscopy and SES following the ACA. Conclusions Removal of out-of-pocket expenditures may overcome a barrier to receipt of recommended preventive services but for colonoscopy, other procedural factors may remain as deterrents. PMID:28067955

  7. Three-Year Impacts Of The Affordable Care Act: Improved Medical Care And Health Among Low-Income Adults.

    PubMed

    Sommers, Benjamin D; Maylone, Bethany; Blendon, Robert J; Orav, E John; Epstein, Arnold M

    2017-06-01

    Major policy uncertainty continues to surround the Affordable Care Act (ACA) at both the state and federal levels. We assessed changes in health care use and self-reported health after three years of the ACA's coverage expansion, using survey data collected from low-income adults through the end of 2016 in three states: Kentucky, which expanded Medicaid; Arkansas, which expanded private insurance to low-income adults using the federal Marketplace; and Texas, which did not expand coverage. We used a difference-in-differences model with a control group and an instrumental variables model to provide individual-level estimates of the effects of gaining insurance. By the end of 2016 the uninsurance rate in the two expansion states had dropped by more than 20 percentage points relative to the nonexpansion state. For uninsured people gaining coverage, this change was associated with a 41-percentage-point increase in having a usual source of care, a $337 reduction in annual out-of-pocket spending, significant increases in preventive health visits and glucose testing, and a 23-percentage-point increase in "excellent" self-reported health. Among adults with chronic conditions, we found improvements in affordability of care, regular care for those conditions, medication adherence, and self-reported health. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Challenges and Opportunities for Integrating Preventive Substance-Use-Care Services in Primary Care through the Affordable Care Act

    PubMed Central

    Ghitza, Udi E.; Tai, Betty

    2014-01-01

    Undertreated or untreated substance use disorders (SUD) remain a pervasive, medically-harmful public health problem in the United States, particularly in medically underserved and low-income populations lacking access to appropriate treatment. The need for greater access to SUD treatment was expressed as policy in the Final Rule on standards related to essential health benefits, required to be covered through the 2010 Affordable Care Act (ACA) health insurance exchanges. SUD treatment services have been included as an essential health benefit, in a manner that complies with the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. Consequently, with the ACA, a vast expansion of SUD-care services in primary care is looming. This commentary discusses challenges and opportunities under the ACA for equipping health care professionals with appropriate workforce training, infrastructure, and resources to support and guide science-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) for SUD in primary care. PMID:24583486

  9. Evaluating Energy Savings in All-Electric Public Housing in the Pacific Northwest, Tacoma, Washington (Fact Sheet)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    2014-03-01

    This project analyzes the cost effectiveness of energy savings measures installed by a large public housing authority in Salishan, a community in Tacoma Washington. Research focuses on the modeled and measured energy usage of the first six phases of construction, and compares the energy usage of those phases to phase 7. Market-ready energy solutions were also evaluated to improve the efficiency of affordable housing for new and existing (built since 2001) affordable housing in the marine climate of Washington State.

  10. Keeping Flood Insurance Affordable Act of 2013

    THOMAS, 113th Congress

    Rep. Capuano, Michael E. [D-MA-7

    2013-11-15

    House - 11/15/2013 Referred to the Committee on Financial Services, and in addition to the Committee on Rules, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (All Actions) Notes: For further action, see H.R.3370, which became Public Law 113-89 on 3/21/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  11. Inpatient Trauma Mortality after Implementation of the Affordable Care Act in Illinois

    PubMed Central

    Dresden, Scott M.; Powell, Emilie S.; Feinglass, Joe

    2018-01-01

    Introduction Illinois hospitals have experienced a marked decrease in the number of uninsured patients after implementation of the Affordable Care Act (ACA). However, the full impact of health insurance expansion on trauma mortality is still unknown. The objective of this study was to determine the impact of ACA insurance expansion on trauma patients hospitalized in Illinois. Methods We performed a retrospective cohort study of 87,001 trauma inpatients from third quarter 2010 through second quarter 2015, which spans the implementation of the ACA in Illinois. We examined the effects of insurance expansion on trauma mortality using multivariable Poisson regression. Results There was no significant difference in mortality comparing the post-ACA period to the pre-ACA period incident rate ratio (IRR)=1.05 (95% confidence interval [CI] [0.93–1.17]). However, mortality was significantly higher among the uninsured in the post-ACA period when compared with the pre-ACA uninsured population IRR=1.46 (95% CI [1.14–1.88]). Conclusion While the ACA has reduced the number of uninsured trauma patients in Illinois, we found no significant decrease in inpatient trauma mortality. However, the group that remains uninsured after ACA implementation appears to be particularly vulnerable. This group should be studied in order to reduce disparate outcomes after trauma. PMID:29560058

  12. The Patient Protection and Affordable Care Act of 2010: impact on otolaryngology practice and research.

    PubMed

    Sun, Gordon H; Davis, Matthew M

    2012-05-01

    The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama on March 23, 2010. Since its passage, the PPACA has led to increased health insurance coverage for millions more Americans, and it includes provisions leading to new avenues for clinical and health services research funding. The legislation also favors development of the primary care specialties and general surgery, increased training of midlevel health care providers, and medical training and service in underserved areas of the United States. However, the PPACA does not effectively engage otolaryngologists in quality improvement, despite modifications to the Physician Quality Reporting System. The legislation also levies a tax on cosmetic procedures, affecting both clinicians and patients. This article reviews the sections of the PPACA that are most pertinent to otolaryngologists and explains how these components of the bill will affect otolaryngologic practice and research over the coming decade.

  13. A House-Framing System for Low-Cost Construction

    Treesearch

    Jerry O. Newman

    1966-01-01

    Housing is needed by many people with low incomes in all parts of the country. Low-income persons usually cannot afford to pay for the labor to build their houses and they have difficulty in doing the building themselves because many of the construction methods and standard practices are too complicated. Simplification of the construction methods therefore seems to be...

  14. Housing mobility and adolescent mental health: The role of substance use, social networks, and family mental health in the Moving to Opportunity Study.

    PubMed

    Schmidt, Nicole M; Glymour, M Maria; Osypuk, Theresa L

    2017-12-01

    The Moving to Opportunity (MTO) experiment was a housing mobility program begun in the mid-nineties that relocated volunteer low income families from public housing to rental units in higher opportunity neighborhoods in 5 US cities, using the Section 8 affordable housing voucher program. Compared to the control group who stayed behind in public housing, the MTO voucher group exhibited a harmful main effect for boys' mental health, and a beneficial main effect for girls' mental health. But no studies have examined how this social experiment caused these puzzling, opposite gender effects. The present study tests potential mediating mechanisms of the MTO voucher experiment on adolescent mental health (n=2829, aged 12-19 in 2001-2002). Using Inverse Odds Ratio Weighting causal mediation, we tested whether adolescent substance use comorbidity, social networks, or family mental health acted as potential mediators. Our results document that comorbid substance use (e.g. past 30 day alcohol use, cigarette use, and number of substances used) significantly partially mediated the effect of MTO on boys' behavior problems, resulting in -13% to -18% percent change in the total effect. The social connectedness domain was a marginally significant mediator for boys' psychological distress. Yet no tested variables mediated MTO's beneficial effects on girls' psychological distress. Confounding sensitivity analyses suggest that the indirect effect of substance use for mediating boys' behavior problems was robust, but social connectedness for mediating boys' psychological distress was not robust. Understanding how housing mobility policies achieve their effects may inform etiology of neighborhoods as upstream causes of health, and inform enhancement of future affordable housing programs.

  15. 77 FR 18731 - Public Housing and Section 8 Programs: Housing Choice Voucher Program: Streamlining the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... Submission of Comments. Interested persons may submit comments electronically through the Federal eRulemaking..., the elderly, and the disabled to afford decent, safe, and sanitary housing in the private market. The... can pay toward a unit is determined by the payment standard set using the annual Fair Market Rents...

  16. Evaluation of Modeled and Measured Energy Savings in Existing All Electric Public Housing in the Pacific Northwest

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gordon, A.; Lubliner, M.; Howard, L.

    2014-04-01

    This project analyzes the cost effectiveness of energy savings measures installed by a large public housing authority in Salishan, a community in Tacoma Washington. Research focuses on the modeled and measured energy usage of the first six phases of construction, and compares the energy usage of those phases to phase 7. Market-ready energy solutions were also evaluated to improve the efficiency of affordable housing for new and existing (built since 2001) affordable housing in the marine climate of Washington State.

  17. Affordable house designs to improve health in rural Africa: a field study from northeastern Tanzania.

    PubMed

    von Seidlein, Lorenz; Ikonomidis, Konstantin; Mshamu, Salum; Nkya, Theresia E; Mukaka, Mavuto; Pell, Christopher; Lindsay, Steven W; Deen, Jacqueline L; Kisinza, William N; Knudsen, Jakob B

    2017-08-01

    The population of sub-Saharan Africa is currently estimated to be 1245 million and is expected to quadruple by the end of the century, necessitating the building of millions of homes. Malaria remains a substantial problem in this region and efforts to minimise transmission should be considered in future house planning. We studied how building elements, which have been successfully employed in southeast Asia to prevent mosquitos from entering and cooling the house, could be integrated in a more sustainable house design in rural northeastern Tanzania, Africa, to decrease mosquito density and regulate indoor climate. In this field study, six prototype houses of southeast Asian design were built in in the village of Magoda in Muheza District, Tanga Region, Tanzania, and compared with modified and unmodified, traditional, sub-Saharan African houses. Prototype houses were built with walls made of lightweight permeable materials (bamboo, shade net, or timber) with bedrooms elevated from the ground and with screened windows. Modified and unmodified traditional African houses, wattle-daub or mud-block constructions, built on the ground with poor ventilation served as controls. In the modified houses, major structural problems such as leaking roofs were repaired, windows screened, open eaves blocked with bricks and mortar, cement floors repaired or constructed, and rain gutters and a tank for water storage added. Prototype houses were randomly allocated to village households through a free, fair, and transparent lottery. The lottery tickets were deposited in a bucket made of transparent plastic. Each participant could draw one ticket. Hourly measurements of indoor temperature and humidity were recorded in all study houses with data loggers and mosquitoes were collected indoors and outdoors using Furvela tent traps and were identified with standard taxonomic keys. Mosquitoes of the Anopheles gambiae complex were identified to species using PCR. Attitudes towards the new house

  18. Supportive Housing and Surveillance

    PubMed Central

    Boyd, Jade; Cunningham, David; Anderson, Solanna; Kerr, Thomas

    2016-01-01

    Urban centres in the US, Britain and Canada have responded to identified visible ‘social problems’ such addiction, mental health and homelessness by providing some supportive housing for the urban poor and marginalized. While some critics have questioned what supportive housing specifically entails in terms of the built environment, what remains under explored, though a growing area of concern, is the relationship between surveillance and supportive housing for urban residents identified as having addiction and mental health problems — a gap addressed in this paper. Drawing upon qualitative ethnographic observational data we examine some of the measures of control and coercion that are encroaching into social housing primarily established for poor and marginalized people with addiction and mental health problems in the urban centre of Vancouver, Canada. We witnessed three modes of regulation and control, that vary widely, among the residencies observed: physical surveillance technologies; site-specific modes of coercion; police presence and staff surveillance, which all together impact the everyday lives of residents living in low-income and supportive housing. We argue that supportive housing has the potential to provide its intended commitment— safe and secure affordable housing. However, owing to an (over)emphasis on ‘security’, the supportive housing we observed were also sites of social control. PMID:27453148

  19. Patient Protection and Affordable Care Act: Potential Effects on Physical Medicine and Rehabilitation

    PubMed Central

    Boninger, Joseph W.; Gans, Bruce M.; Chan, Leighton

    2012-01-01

    The objective was to review pertinent areas of the Patient Protection and Affordable Care Act (PPACA) to determine the PPACA’s impact on physical medicine and rehabilitation (PM&R). The law, and related newspaper and magazine articles, was reviewed. The ways in which provisions in the PPACA are being implemented by the Centers for Medicare and Medicaid Services and other government organizations were investigated. Additionally, recent court rulings on the PPACA were analyzed to assess the law’s chances of successful implementation. The PPACA contains a variety of reforms that, if implemented, will significantly impact the field of PM&R. Many PPACA reforms change how rehabilitative care is delivered by integrating different levels of care and creating uniform quality metrics to assess quality and efficiency. These quality metrics will ultimately be tied to new, performance-based payment systems. While the law contains ambitious initiatives that may, if unsuccessful or incorrectly implemented, negatively impact PM&R, it also has the potential to greatly improve the quality and efficiency of rehabilitative care. A proactive approach to the changes the PPACA will bring about is essential for the health of the field. PMID:22459177

  20. Young Adults' Selection and Use of Dependent Coverage under the Affordable Care Act.

    PubMed

    Chen, Weiwei

    2018-01-01

    The dependent coverage expansion under the Affordable Care Act (ACA) required health insurance policies that cover dependents to offer coverage for policyholder' children up to age 26. It has been well documented that the provision successfully reduced the uninsured rate among the young adults. However, less is known about whether dependent coverage crowded out other insurance types and whether young adults used dependent coverage as a fill-in-the-gap short-term option. Using data from the Survey of Income and Program Participation 2008 Panel, the paper assesses dependent coverage uptake and duration before and after the ACA provision among young adults aged 19-26 versus those aged 27-30. Regressions for additional coverage outcomes were also performed to estimate the crowd-out rate. It was found that the ACA provision had a significant positive impact on dependent coverage uptake and duration. The estimated crowd-out rate ranges from 27 to 42%, depending on the definition. Most dependent coverage enrollees used the coverage for 1 or 2 years. Differences in dependent coverage uptake and duration remained among racial groups. Less healthy individuals were also less likely to make use of dependent coverage.

  1. Young Adults’ Selection and Use of Dependent Coverage under the Affordable Care Act

    PubMed Central

    Chen, Weiwei

    2018-01-01

    The dependent coverage expansion under the Affordable Care Act (ACA) required health insurance policies that cover dependents to offer coverage for policyholder’ children up to age 26. It has been well documented that the provision successfully reduced the uninsured rate among the young adults. However, less is known about whether dependent coverage crowded out other insurance types and whether young adults used dependent coverage as a fill-in-the-gap short-term option. Using data from the Survey of Income and Program Participation 2008 Panel, the paper assesses dependent coverage uptake and duration before and after the ACA provision among young adults aged 19–26 versus those aged 27–30. Regressions for additional coverage outcomes were also performed to estimate the crowd-out rate. It was found that the ACA provision had a significant positive impact on dependent coverage uptake and duration. The estimated crowd-out rate ranges from 27 to 42%, depending on the definition. Most dependent coverage enrollees used the coverage for 1 or 2 years. Differences in dependent coverage uptake and duration remained among racial groups. Less healthy individuals were also less likely to make use of dependent coverage. PMID:29445721

  2. Shelter from the Storm: Roles, responsibilities, and challenges in United States housing policy governance.

    PubMed

    Willison, Charley

    2017-11-01

    Housing is a critical social determinant of health. Housing policy not only affects health by improving housing quality, affordability, and insecurity; housing policy affects health upstream through the politics that shape housing policy design, implementation, and management. These politics, or governance strategies, determine the successes or failures of housing policy programs. This paper is an overview of challenges in housing policy governance in the United States. I examine the important relationship between housing and health, and emphasize why studying housing policy governance matters. I then present three cases of housing governance challenges in the United States, from each pathway by which housing affects health - housing quality, affordability, and insecurity. Each case corresponds to an arm of the TAPIC framework for evaluating governance (Krieger and Higgins) [1], to assess mechanisms of housing governance in each case. While housing governance has come a long way over the past century, political decentralization and the expansion of the submerged state have increased the number of political actors and policy conflict in many areas. This creates inherent challenges for improving accountability, transparency, and policy capacity. In many instances, too, reduced government accountability and transparency increases the risk of harm to the public and lessens governmental integrity. Copyright © 2017 The Author. Published by Elsevier B.V. All rights reserved.

  3. Plastic Surgeons’ Perceptions of the Affordable Care Act: Results of a National Survey

    PubMed Central

    Israel, Jacqueline S.; Chen, Jenny T.; Rao, Venkat K.

    2015-01-01

    Background: The Affordable Care Act (ACA) aims to expand coverage to the uninsured, improve quality, and contain costs. The goal of this study was to ascertain how plastic surgeons perceive the ACA. Methods: An electronic questionnaire was e-mailed to members of the American Society of Plastic Surgeons between May and June 2014. The survey was anonymous and voluntary and included questions to assess understanding and opinions of the ACA. Results: The survey was sent to 3070 members of the American Society of Plastic Surgeons, and the response rate was 17%. Sixty-eight percent agree or strongly agree that they understand the basic concepts of the ACA. The majority of respondents disagree (38% strongly disagree, 31% disagree) with the notion that the ACA will positively affect their practice, and 51% agree with the statement, “I do not support the ACA, and I believe it did too much.” Two thirds (66%) believe that the ACA deserves a grade of D or F. When answers were analyzed across demographics, 42% of respondents with “Academic” practice background identify with the statement, “I support the ACA but I think it needs more work,” compared to 15% of those who selected “Solo Practice” (p <0.001). Conclusions: The ACA will affect all specialties, including plastic surgery. The results of this survey suggest that many plastic surgeons believe that they have a baseline understanding of current health-care reform. The majority of surveyed surgeons do not support the Act. It is imperative that plastic surgeons possess the knowledge of the ACA; its changes, both current and impending, will likely affect patient mix, coverage of procedures, and reimbursement. PMID:25674374

  4. Linked Learning Pathways Affording College and Career Success Act

    THOMAS, 111th Congress

    Rep. Chu, Judy [D-CA-32

    2010-09-22

    House - 11/18/2010 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  5. The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities.

    PubMed

    Bartels, Stephen J; Gill, Lydia; Naslund, John A

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA.

  6. The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities

    PubMed Central

    Bartels, Stephen J.; Gill, Lydia; Naslund, John A.

    2015-01-01

    Abstract The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA. PMID:25811340

  7. Assessing black progress: voting and citizenship rights, residency and housing, education.

    PubMed

    Farley, R

    1986-01-01

    Farley discusses progress US blacks have made in the areas of voting and citizenship rights, residency and housing, and education. A major goal of the civil rights movement was to permit blacks to influence the electoral process in the same manner as whites. Most important in this regard was the Voting Rights Act of 1965; the proportion of southern blacks casting ballots increased sharply since the early 1960s. The Civil Rights Act of 1875 outlawed racial segregation in public accommodations, but by the turn of the century, Jim Crow laws in southern states called for segregation in most public places. Common customs and government policy in the North resulted in similar segregation of blacks from whites. The Montgomery bus boycott and similar protests in dozens of other cities led to enactment of Title II of the Civil Rights Act of 1964, which proscribed such racial practices. By the late 1960s, blacks in all regions could use the same public accommodations as whites. In most metropolitan areas, de facto racial segregation persisted long after the laws were changed. Supreme Court decisions and local open-housing ordinances supported the right of blacks to live where they could afford. However the major change was the Fair Housing Act of 1968, which outlawed racial discrimination in the sale or rental of most housing units. The separation of blacks from whites did not end in the 1970s. Today, in areas which have large black populations, there are many central city neighborhoods and a few in the suburbs which are either all-black or are becoming exclusively black enclaves. Most other neighborhoods have no more than token black populations. Another major effort of civil rights organizations has been the upgrading of housing quality for blacks. By 1980, only 6% of the homes and apartments occupied by blacks lacked complete plumbing facilities (down from 50% in 1940). Unlike the modest changes in residential segregation, racial differences in housing quality have been

  8. The impact of the Affordable Care Act on Medicare Advantage plan availability and enrollment.

    PubMed

    Afendulis, Christopher C; Landrum, Mary Beth; Chernew, Michael E

    2012-12-01

    To assess the impact of the Patient Protection and Affordable Care Act's (ACA) changes in Medicare Advantage (MA) payment rates on the availability of and enrollment in MA plans. Secondary data on MA plan offerings, contract offerings, and enrollment by state and county, in 2010-2011. We estimated regression models of the change in the number of plans, the number of contracts, and enrollment as a function of quartiles of FFS spending and pre-ACA MA payment generosity. Counties in the lowest quartile of spending are treated most generously by the ACA. Relative to counties in the highest quartile of spending, the number of plans in counties in the first, second, and third quartiles rose by 12 percent, 7.6 percent, and 5.4 percent, respectively. Counties with more generous MA payment rates before the ACA lost significantly more plans. We did not find a similar impact on the change in contracts or enrollment. The ACA-induced MA payment changes reduced the number of plan choices available for Medicare beneficiaries, but they have yet affected enrollment patterns. © Health Research and Educational Trust.

  9. An Evidence Roadmap for Implementation of Integrated Behavioral Health under the Affordable Care Act

    PubMed Central

    Kwan, Bethany M.; Valeras, Aimee B.; Levey, Shandra Brown; Nease, Donald E.; Talen, Mary E.

    2015-01-01

    The Affordable Care Act (ACA) created incentives and opportunities to redesign health care to better address mental and behavioral health needs. The integration of behavioral health and primary care is increasingly viewed as an answer to address such needs, and it is advisable that evidence-based models and interventions be implemented whenever possible with fidelity. At the same time, there are few evidence-based models, especially beyond depression and anxiety, and thus further research and evaluation is needed. Resources being allocated to adoption of models of integrated behavioral health care (IBHC) should include quality improvement, evaluation, and translational research efforts using mixed methodology to enhance the evidence base for IBHC in the context of health care reform. This paper covers six key aspects of the evidence for IBHC, consistent with mental and behavioral health elements of the ACA related to infrastructure, payments, and workforce. The evidence for major IBHC models is summarized, as well as evidence for targeted populations and conditions, education and training, information technology, implementation, and cost and sustainability. PMID:29546130

  10. An early look at changes in employer-sponsored insurance under the Affordable Care Act.

    PubMed

    Blavin, Fredric; Shartzer, Adele; Long, Sharon K; Holahan, John

    2015-01-01

    Critics frequently characterize the Affordable Care Act (ACA) as a threat to the survival of employer-sponsored insurance. The Medicaid expansion and Marketplace subsidies could adversely affect employers' incentives to offer health insurance and workers' incentives to take up such offers. This article takes advantage of timely data from the Health Reform Monitoring Survey for June 2013 through September 2014 to examine, from the perspective of workers, early changes in offer, take-up, and coverage rates for employer-sponsored insurance under the ACA. We found no evidence that any of these rates have declined under the ACA. They have, in fact, remained constant: around 82 percent, 86 percent, and 71 percent, respectively, for all workers and around 63 percent, 71 percent, and 45 percent, respectively, for low-income workers. To date, the ACA has had no effect on employer coverage. Economic incentives for workers to obtain coverage from employers remain strong. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Housing characteristics and their influence on health-related quality of life in persons living with HIV in Ontario, Canada: results from the positive spaces, healthy places study.

    PubMed

    Rourke, Sean B; Bekele, Tsegaye; Tucker, Ruthann; Greene, Saara; Sobota, Michael; Koornstra, Jay; Monette, LaVerne; Bacon, Jean; Bhuiyan, Shafi; Rueda, Sergio; Watson, James; Hwang, Stephen W; Dunn, James; Hambly, Keith

    2012-11-01

    Although lack of housing is linked with adverse health outcomes, little is known about the impacts of the qualitative aspects of housing on health. This study examined the association between structural elements of housing, housing affordability, housing satisfaction and health-related quality of life over a 1-year period. Participants were 509 individuals living with HIV in Ontario, Canada. Regression analyses were conducted to examine relationships between housing variables and physical and mental health-related quality of life. We found significant cross-sectional associations between housing and neighborhood variables-including place of residence, housing affordability, housing stability, and satisfaction with material, meaningful and spatial dimensions of housing-and both physical and mental health-related quality of life. Our analyses also revealed longitudinal associations between housing and neighborhood variables and health-related quality of life. Interventions that enhance housing affordability and housing satisfaction may help improve health-related quality of life of people living with HIV.

  12. Health insurers' financial performance and quality improvement expenditures in the Affordable Care Act's second year.

    PubMed

    McCue, Michael J; Hall, Mark

    2015-02-01

    The Affordable Care Act requires health insurers to rebate any amounts less than 80%-85% of their premiums that they fail to spend on medical claims or quality improvement. This study uses the new comprehensive reporting under this law to examine changes in insurers' financial performance and differences in their quality improvement expenditures. In the ACA's second year (2012), insurers' median medical loss ratios continued to increase and their median administrative cost ratios dropped, producing moderate operating margins in the group markets but a small operating loss in the individual market, at the median. For-profit insurers showed larger changes, in general, than did nonprofits. For quality improvement, insurers reported spending a significantly greater amount per member in their government plans than they did on their self-insured members, with spending on commercial insurance being in between these two extremes. The magnitude and source of these differences varied by corporate ownership. © The Author(s) 2014.

  13. Effects of Affordable Care Act Marketplaces and Medicaid Eligibility Expansion on Access to Cancer Care.

    PubMed

    Graves, John A; Swartz, Katherine

    The aim of this study was to inform oncologists about how repealing the Affordable Care Act (ACA) may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials. Similarly, we examined federal and state rules affecting Medicaid beneficiaries' access to cancer treatments. Repealing various provisions of the ACA will restrict who has access to both current and new cancer treatments. Such changes also will impact oncology research that depends on having heterogeneous people in clinical trials. Significant changes to the ACA will affect oncology treatment choices of everyone with health insurance-not only the 10 million people newly covered by ACA health plans and the 70 million people with Medicaid coverage.

  14. Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act

    PubMed Central

    Corman, Juliane; Levin, David

    2016-01-01

    Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans’ support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political debate has changed. Where it had been about the government provision of healthcare as an abstract principle, it became a debate imbued with evaluations of the implementation of the ACA itself. This spawned a new line of research examining the consequences of the ACA’s implementation on public attitudes toward government provision of healthcare. The change in support for government provision of healthcare and the new post-ACA research highlight a need for a long-term examination of trends in support over the past two decades that will provide context for the new studies. This study provides that examination. PMID:27257309

  15. Responding to the Affordable Care Act: a leadership opportunity for social workers in employee assistance programs.

    PubMed

    Frauenholtz, Susan

    2014-08-01

    Until recently, estimates indicated that more than half of Americans obtain health insurance through their employers. Yet the employer-based system leaves many vulnerable populations, such as low-wage and part-time workers, without coverage. The changes authorized by the Affordable Care Act (2010), and in particular the Health Insurance Marketplace (also known as health insurance exchanges), which became operational in 2014, are projected to have a substantial impact on the provision of employer-based health care coverage. Because health insurance is so intricately woven with employment, social workers in employee assistance programs (EAPs) are positioned to assume an active leadership role in guiding and developing the needed changes to employer-based health care that will occur as the result of health care reform. This article describes the key features and functions of the Health Insurance Marketplace and proposes an innovative role for EAP social workers in implementing the exchanges within their respective workplaces and communities. How EAP social workers can act as educators, advocates, and brokers of the exchanges, and the challenges they may face in their new roles, are discussed, and the next steps EAP social workers can take to prepare for health reform-related workplace changes are delineated.

  16. What's at Stake in U.S. Health Reform: A Guide to the Affordable Care Act and Value-Based Care.

    PubMed

    Rambur, Betty A

    2017-05-01

    The U.S. presidential election of 2016 accentuated the divided perspectives on the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. The perspectives included a pledge from then candidate Donald J. Trump to "repeal and replace on day one"; Republican congressional leaders' more temperate suggestions in the first weeks of the Trump administration to "repair" the Affordable Care Act (ACA); and President Trump's February 5, 2017 statement-16 days after inauguration-that a Republican replacement for the ACA may not be ready until late 2017 or 2018. The swirling rhetoric, media attention, and the dizzying rate of U.S. health and payment reforms both within and outside of the ACA makes it difficult for nurses, both United States and globally, to discern which health policy issues are grounded in the ACA and which aspects reflect payer-driven "volume to value" reimbursement changes. Moreover, popular and controversial elements of the ACA-for example, the clause that prohibits insurance carriers to deny coverage to those with preexisting health conditions and the more controversial individual mandate that bears Supreme Court support as a constitutional provision-are paired in ways that might be unclear to those unfamiliar with nuances of insurance rate determination. To support nurses' capacity to maximize their impact on health policy, this overview distills the 906-page ACA into major themes and describes payment reform legislation and initiatives that are external to the ACA. Understanding the political and societal forces that affect health care policy and delivery is necessary for nurses to effectively lead and advocate for the best interests of their patients.

  17. Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy.

    PubMed

    Kaaronen, Roope O

    2017-01-01

    Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition 'to the brain,' focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude-action, value-action or knowledge-action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio-ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio-ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio-ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit between local

  18. Affording Sustainability: Adopting a Theory of Affordances as a Guiding Heuristic for Environmental Policy

    PubMed Central

    Kaaronen, Roope O.

    2017-01-01

    Human behavior is an underlying cause for many of the ecological crises faced in the 21st century, and there is no escaping from the fact that widespread behavior change is necessary for socio-ecological systems to take a sustainable turn. Whilst making people and communities behave sustainably is a fundamental objective for environmental policy, behavior change interventions and policies are often implemented from a very limited non-systemic perspective. Environmental policy-makers and psychologists alike often reduce cognition ‘to the brain,’ focusing only to a minor extent on how everyday environments systemically afford pro-environmental behavior. Symptomatic of this are the widely prevalent attitude–action, value–action or knowledge–action gaps, understood in this paper as the gulfs lying between sustainable thinking and behavior due to lack of affordances. I suggest that by adopting a theory of affordances as a guiding heuristic, environmental policy-makers are better equipped to promote policies that translate sustainable thinking into sustainable behavior, often self-reinforcingly, and have better conceptual tools to nudge our socio–ecological system toward a sustainable turn. Affordance theory, which studies the relations between abilities to perceive and act and environmental features, is shown to provide a systemic framework for analyzing environmental policies and the ecology of human behavior. This facilitates the location and activation of leverage points for systemic policy interventions, which can help socio–ecological systems to learn to adapt to more sustainable habits. Affordance theory is presented to be applicable and pertinent to technically all nested levels of socio–ecological systems from the studies of sustainable objects and households to sustainable urban environments, making it an immensely versatile conceptual policy tool. Finally, affordance theory is also discussed from a participatory perspective. Increasing the fit

  19. A five-year assessment of the affordable care act: market forces still trump the common good in U.S. Health care.

    PubMed

    Geyman, John P

    2015-01-01

    The Affordable Care Act (ACA) was enacted in 2010 as the signature domestic achievement of the Obama presidency. It was intended to contain costs and achieve near-universal access to affordable health care of improved quality. Now, five years later, it is time to assess its track record. This article compares the goals and claims of the ACA with its actual experience in the areas of access, costs, affordability, and quality of care. Based on the evidence, one has to conclude that containment of health care costs is nowhere in sight, that more than 37 million Americans will still be uninsured when the ACA is fully implemented in 2019, that many more millions will be underinsured, and that profiteering will still dominate the culture of U.S. health care. More fundamental reform will be needed. The country still needs to confront the challenge that our for-profit health insurance industry, together with enormous bureaucratic waste and widespread investor ownership throughout our market-based system, are themselves barriers to health care reform. Here we consider the lessons we can take away from the ACA's first five years and lay out the economic, social/political, and moral arguments for replacing it with single-payer national health insurance. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  20. Stable and variable affordances are both automatic and flexible

    PubMed Central

    Borghi, Anna M.; Riggio, Lucia

    2015-01-01

    The mere observation of pictures or words referring to manipulable objects is sufficient to evoke their affordances since objects and their nouns elicit components of appropriate motor programs associated with object interaction. While nobody doubts that objects actually evoke motor information, the degree of automaticity of this activation has been recently disputed. Recent evidence has indeed revealed that affordances activation is flexibly modulated by the task and by the physical and social context. It is therefore crucial to understand whether these results challenge previous evidence showing that motor information is activated independently from the task. The context and the task can indeed act as an early or late filter. We will review recent data consistent with the notion that objects automatically elicit multiple affordances and that top-down processes select among them probably inhibiting motor information that is not consistent with behavior goals. We will therefore argue that automaticity and flexibility of affordances are not in conflict. We will also discuss how language can incorporate affordances showing similarities, but also differences, between the motor information elicited by vision and language. Finally we will show how the distinction between stable and variable affordances can accommodate all these effects. PMID:26150778

  1. Affordances and the musically extended mind

    PubMed Central

    Krueger, Joel

    2014-01-01

    I defend a model of the musically extended mind. I consider how acts of “musicking” grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of “musical affordances” and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances – via soliciting different forms of entrainment – enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea. PMID:24432008

  2. Rural Housing Preservation and Stabilization Act of 2010

    THOMAS, 111th Congress

    Rep. Kanjorski, Paul E. [D-PA-11

    2010-04-14

    Senate - 04/28/2010 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  3. 21st Century FHA Housing Act of 2009

    THOMAS, 111th Congress

    Rep. Adler, John H. [D-NJ-3

    2009-07-09

    Senate - 09/16/2009 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  4. 24 CFR 1000.136 - What insurance requirements apply to housing units assisted with NAHASDA grants?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What insurance requirements apply... ACTIVITIES Affordable Housing Activities § 1000.136 What insurance requirements apply to housing units assisted with NAHASDA grants? (a) The recipient shall provide adequate insurance either by purchasing...

  5. Housing and Health: Time Again for Public Health Action

    PubMed Central

    Krieger, James; Higgins, Donna L.

    2002-01-01

    Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing “Healthy Homes” programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing. PMID:11988443

  6. Cancer preventive services, socioeconomic status, and the Affordable Care Act.

    PubMed

    Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D

    2017-05-01

    Out-of-pocket expenditures are thought to be an important barrier to the receipt of cancer preventive services, especially for those of a lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. The objective of this study was to determine changes in the uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation. Using Medicare claims data, this study identified women who were 70 years old or older and had not undergone mammography in the previous 2 years and men and women who were 70 years old or older, were at increased risk for colorectal cancer, and had not undergone colonoscopy in the past 5 years. The receipt of procedures in the 2-year period before the ACA's implementation (2009-2010) and after its implementation (2011 to September 2012) was also identified. Multivariate generalized estimating equation models were used to determine the independent association and county-level quartile of median income and education with the receipt of testing. For mammography, a lower SES quartile was associated with less uptake, but the post-ACA disparities were smaller than those in the pre-ACA period. In addition, mammography rates increased from the pre-ACA period to the post-ACA period in all SES quartiles. For colonoscopy, in both the pre- and post-ACA periods, there was an association between uptake and educational level and, to some extent, income. However, there were no appreciable changes in colonoscopy and SES after implementation of the ACA. The removal of out-of-pocket expenditures may overcome a barrier to the receipt of recommended preventive services, but for colonoscopy, other procedural factors may remain as deterrents. Cancer 2017;123:1585-1589. © 2017 American Cancer Society. © 2017 American Cancer Society.

  7. Insurance Enrollment at a Student-Run Free Clinic After the Patient Protection and Affordable Care Act.

    PubMed

    McGeehan, Megan; DeMaria, Rebecca; Charney, Pamela; Batavia, Ashita S

    2017-08-01

    The Patient Protection and Affordable Care Act (ACA) aims to increase insurance coverage through government subsidies. Medical student-run free clinics (SRFC) are an important entry point into the healthcare system for the uninsured. SRFCs do not have a standardized approach for navigating the complexities of enrollment. The Weill Cornell Community Clinic (WCCC) developed a unique enrollment model that may inform other SRFCs. Our objective is to describe enrollment processes at SRFCs throughout New York City, and to evaluate enrollment outcomes and persistent barriers to coverage at WCCC. We surveyed SRFC leadership throughout NYC to understand enrollment processes. We evaluated enrollment outcomes at WCCC through chart review and structured phone interviews. Subjects included WCCC patients seen in clinic between October 1, 2013 and September 30, 2015 (N = 140). Demographic information, method of insurance enrollment, and qualitative description of enrollment barriers were collected. SRFCs in New York City have diverse enrollment processes. 48% (N = 42) of WCCC patients obtained health insurance. Immigration status was a barrier to coverage in 21% of patients. Failure to gain coverage was predicted by larger household size (p = 0.02). Gender and employment status were not associated with remaining uninsured. The main barriers to enrollment were inability to afford premiums and lack of interest. Insurance enrollment processes at SRFCs in New York City are mostly ad hoc and outcomes are rarely tracked. Following implementation of the ACA, WCCC stands out for its structured approach, with approximately half of eligible WCCC patients gaining coverage during the study period.

  8. Annual Demographic Data for Migrant Family Housing Centers: 1985 Harvest Season.

    ERIC Educational Resources Information Center

    California State Dept. of Housing and Community Development, Sacramento.

    California, largest employer of seasonal labor in the United States, employs an average of 119,600 seasonal farmworkers per year. To ease problems of housing this seasonal workforce, the State Department of Housing and Community Development's Office of Migrant Services contracts with local government agencies to provide decent/affordable housing…

  9. Annual Demographic Data for Migrant Family Housing Centers: 1986 Harvest Season.

    ERIC Educational Resources Information Center

    California State Dept. of Housing and Community Development, Sacramento.

    California, largest employer of seasonal labor in the United States, employs an average of 119,600 seasonal farmworkers per year. Since 1966 the State Department of Housing and Community Development's Office of Migrant Services has contracted with local government agencies to provide decent/affordable housing for approximately 50,220 families…

  10. Effective Strategies for Affordable Care Act Enrollment in Immigrant-Serving Safety Net Clinics in New Mexico.

    PubMed

    Getrich, Christina M; García, Jacqueline M; Solares, Angélica; Kano, Miria

    2017-01-01

    In the new Affordable Care Act (ACA) health care environment, safety-net institutions continue to serve as important sources of culturally appropriate care for different groups of immigrant patients. This article reports on a qualitative study examining the early ACA enrollment experiences of a range of health care providers (n = 29) in six immigrant-serving safety-net clinics in New Mexico. The six clinics configured their ACA enrollment strategies differently with regard to operations, staffing, and outreach. Providers reported a generally chaotic rollout overall and expressed frustration with strategies that did not accommodate patients, provided little training for providers, and engaged in minimal outreach. Conversely, providers lauded strategies that flexibly met patient needs, leveraged trust through strategic use of staff, and prioritized outreach. Findings underscore the importance of using and funding concerted strategies for future enrollment of immigrant patients, such as featuring community health workers and leveraging trust for outreach.

  11. The effect that state and federal housing policies have on vehicle miles of travel.

    DOT National Transportation Integrated Search

    2016-11-07

    This report examines the ability of existing and proposed affordable housing policies to align : with sustainable transportation goals in California. First, we compare the ability of Low Income : Housing Tax Credit (LIHTC) and Redevelopment funded pr...

  12. Housing Non-Discrimination Act of 2010

    THOMAS, 111th Congress

    Rep. Sestak, Joe [D-PA-7

    2010-03-25

    House - 06/15/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. Housing Opportunities Made Equal (HOME) Act

    THOMAS, 111th Congress

    Rep. Nadler, Jerrold [D-NY-8

    2010-12-08

    House - 12/20/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. “Will Employers Drop Health Insurance Coverage because of the Affordable Care Act?” Health Affairs 32(9): 1522–1530

    PubMed Central

    Buchmueller, Thomas; Carey, Colleen; Levy, Helen G.

    2014-01-01

    Since the passage of the Affordable Care Act, there has been considerable speculation about how many employers will stop offering health insurance once the major coverage provisions of the Act take effect. While some observers predict little aggregate effect, others believe that 2014 marks the beginning of the end for our current system of employer- sponsored insurance. We address the question “how will employer health insurance offering respond to health reform?” using theoretical and empirical evidence. First, we describe economic models of why employers offer insurance. Second, we recap the relevant provisions of health reform and use our economic framework to consider how they may affect employer offers. Third, we review the various predictions that have been made on this subject. Finally, we offer some observations on interpreting early data from 2014. PMID:24019355

  15. Preserving Access to Manufactured Housing Act

    THOMAS, 112th Congress

    Sen. Brown, Sherrod [D-OH

    2012-08-02

    Senate - 08/02/2012 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Healthy Housing Council Act of 2013

    THOMAS, 113th Congress

    Sen. Reed, Jack [D-RI

    2013-02-13

    Senate - 02/13/2013 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  17. Healthy Housing Council Act of 2011

    THOMAS, 112th Congress

    Sen. Reed, Jack [D-RI

    2011-09-22

    Senate - 09/22/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  18. Promoting Small House Nursing Homes Act

    THOMAS, 111th Congress

    Sen. Casey, Robert P., Jr. [D-PA

    2009-04-01

    Senate - 04/01/2009 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. Workforce Residential Housing Act of 2011

    THOMAS, 112th Congress

    Sen. Moran, Jerry [R-KS

    2012-01-26

    Senate - 01/26/2012 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  20. Rural Housing Preservation Act of 2011

    THOMAS, 112th Congress

    Sen. Nelson, Ben [D-NE

    2011-05-04

    Senate - 05/04/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. Workforce Residential Housing Act of 2014

    THOMAS, 113th Congress

    Sen. Moran, Jerry [R-KS

    2014-09-18

    Senate - 09/18/2014 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  2. Healthy Housing Council Act of 2009

    THOMAS, 111th Congress

    Sen. Reed, Jack [D-RI

    2009-09-10

    Senate - 09/10/2009 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  3. Participatory Evaluation of a Community Mobilization Effort to Enroll Wyandotte County, Kansas, Residents Through the Affordable Care Act

    PubMed Central

    Sepers, Charles E.; McKain, Wesley

    2015-01-01

    Successful implementation of the Affordable Care Act (ACA) depends on the capacity of local communities to mobilize for action. Yet the literature offers few systematic investigations of what communities are doing to ensure support for enrollment. In this empirical case study, we report implementation and outcomes of Enroll Wyandotte, a community mobilization effort to facilitate enrollment through the ACA in Wyandotte County, Kansas. We describe mobilization activities during the first round of open enrollment in coverage under the ACA (October 1, 2013–March 31, 2014), including the unfolding of community and organizational changes (e.g., new enrollment sites) and services provided to assist enrollment over time. The findings show an association between implementation measures and newly created accounts under the ACA (the primary outcome). PMID:25905820

  4. Job mobility among parents of children with chronic health conditions: Early effects of the 2010 Affordable Care Act.

    PubMed

    Chatterji, Pinka; Brandon, Peter; Markowitz, Sara

    2016-07-01

    We examine the effects of the 2010 Patient Protection and Affordable Care Act's (ACA) prohibition of preexisting conditions exclusions for children on job mobility among parents. We use a difference-in-difference approach, comparing pre-post policy changes in job mobility among privately-insured parents of children with chronic health conditions vs. privately-insured parents of healthy children. Data come from the 2004 and 2008 Survey of Income and Program Participation (SIPP). Among married fathers, the policy change is associated with about a 0.7 percentage point, or 35 percent increase, in the likelihood of leaving an employer voluntarily. We find no evidence that the policy change affected job mobility among married and unmarried mothers. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Physician knowledge of and attitudes toward the Patient Protection and Affordable Care Act.

    PubMed

    Rocke, Daniel J; Thomas, Steven; Puscas, Liana; Lee, Walter T

    2014-02-01

    To assess otolaryngology physician knowledge of and attitudes toward the Patient Protection and Affordable Care Act (PPACA) and compare the association of bias toward the PPACA with knowledge of the provisions of the PPACA. Cross-sectional survey. Nationwide assessment. Members of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngology physicians answered 10 true/false questions about major provisions of the PPACA. They also indicated their level of agreement with 9 statements about health care and the PPACA. Basic demographic information was collected. Email solicitation was sent to 9972 otolaryngologists and 647 responses were obtained (6.5% response rate). Overall correct response rate was 74%. Fewer than 60% of physicians correctly answered questions on whether small businesses receive tax credits for providing health insurance, the effect of the PPACA on Medicare benefits, and whether a government-run health insurance plan was created. Academic center practice setting, bias toward the PPACA, and Democratic Party affiliation were associated with significantly more correct responses. Overall physician knowledge of the PPACA is assessed as fair, although better than the general public in 2010. There are several areas where knowledge of physicians regarding the PPACA is poor, and this knowledge deficit is more pronounced within certain subgroups. These knowledge issues should be addressed by individual physicians and medical societies.

  6. The ethics of the affordability of health insurance.

    PubMed

    Saloner, Brendan; Daniels, Norman

    2011-10-01

    In this essay we argue that the concept of affordable health insurance is rooted in a social obligation to protect fair equality of opportunity. Specifically, health insurance plays a limited but significant role in protecting opportunity in two ways: it helps keep people functioning normally and it protects their financial security. Together these benefits enable household members to exercise reasonable choices about their plans of life. To achieve truly affordable coverage, society must be able to contain the overall cost of health care, and health insurance must be progressively financed, meaning that those who are best able to pay for coverage should pay the largest share. While the recently passed Patient Protection and Affordable Care Act (ACA) falls short on both of these counts, we argue that it makes important contributions toward household affordability through the use of subsidies and regulations. The main shortcoming of the ACA is an insufficient protection against burdensome cost sharing, which we illustrate using several hypothetical scenarios. We conclude with recommendations about how to make opportunity-enhancing expansions to the current coverage subsidies.

  7. Manufactured Homes as Affordable Housing in Rural Areas. Rural Information Center Publication Series, No. 5.

    ERIC Educational Resources Information Center

    Czerniak, Robert, Comp.

    This bibliography includes citations of approximately 60 books and articles pertaining to manufactured housing or "mobile homes," an important segment of the national housing industry. The availability of manufactured homes for low and moderate income groups is significant in light of skyrocketing new-housing costs. The South leads the nation with…

  8. Changes in Receipt of Cancer Screening in Medicare Beneficiaries Following the Affordable Care Act

    PubMed Central

    Kou, Tzuyung D.; Schluchter, Mark D.; Dor, Avi; Koroukian, Siran M.

    2016-01-01

    Background: The Affordable Care Act (ACA) removed copayments for screening mammography and colonoscopy in Medicare beneficiaries, but its clinical impact is unknown. Methods: Using a 5% random sample of Medicare claims from 2009 through 2012 in individuals age 70 years or older who were due for screening, we examined claims for screening mammography and screening or surveillance colonoscopy for two years prior to ACA (2009–2010) and two years post-ACA (2011–2012). Receipt of the procedures at the patient level was compared across years using generalized estimating equations. Statistical tests were two-sided. Results: Compared with 2009, we found an increase in mammography uptake during the ACA coverage period, with multivariable odds ratios (MOR) of 1.22 (95% confidence interval [CI] = 1.20 to 1.25, P < .001) for 2011 and 1.17 (95% CI = 1.15 to 1.20, P < .001) for 2012 and less change in 2010 (OR = 1.03, 95% CI = 1.01 to 1.05, P = .01). In contrast to mammography, uptake of screening or surveillance colonoscopy decreased in 2012 (MOR = 0.95, 95% CI = 0.92 to 0.98, P = .002) compared with 2009, with no change in 2010 (MOR = 1.01, 95% CI = 0.99 to 1.04, P = .47) or 2011 (MOR = 1.01, 95% CI = 0.99 to 1.04, P = .34). Other factors associated with procedure receipt included younger age and prior preventive health visits. In an analysis restricted to patients age 70 to 74 years, colonoscopy use increased slightly in 2011 but was unchanged in 2012, and the findings by year for mammography were consistent with the main analysis. Conclusions: Following ACA implementation with concomitant reduction in out-of-pocket expenditures, there was a statistically significant increment in mammography uptake but not colonoscopy. This suggests that affordability is a necessary but not sufficient facilitator of preventive services. PMID:26640244

  9. Changes in Receipt of Cancer Screening in Medicare Beneficiaries Following the Affordable Care Act.

    PubMed

    Cooper, Gregory S; Kou, Tzuyung D; Schluchter, Mark D; Dor, Avi; Koroukian, Siran M

    2016-05-01

    The Affordable Care Act (ACA) removed copayments for screening mammography and colonoscopy in Medicare beneficiaries, but its clinical impact is unknown. Using a 5% random sample of Medicare claims from 2009 through 2012 in individuals age 70 years or older who were due for screening, we examined claims for screening mammography and screening or surveillance colonoscopy for two years prior to ACA (2009-2010) and two years post-ACA (2011-2012). Receipt of the procedures at the patient level was compared across years using generalized estimating equations. Statistical tests were two-sided. Compared with 2009, we found an increase in mammography uptake during the ACA coverage period, with multivariable odds ratios (MOR) of 1.22 (95% confidence interval [CI] = 1.20 to 1.25, P < .001) for 2011 and 1.17 (95% CI = 1.15 to 1.20, P < .001) for 2012 and less change in 2010 (OR = 1.03, 95% CI = 1.01 to 1.05, P = .01). In contrast to mammography, uptake of screening or surveillance colonoscopy decreased in 2012 (MOR = 0.95, 95% CI = 0.92 to 0.98, P = .002) compared with 2009, with no change in 2010 (MOR = 1.01, 95% CI = 0.99 to 1.04, P = .47) or 2011 (MOR = 1.01, 95% CI = 0.99 to 1.04, P = .34). Other factors associated with procedure receipt included younger age and prior preventive health visits. In an analysis restricted to patients age 70 to 74 years, colonoscopy use increased slightly in 2011 but was unchanged in 2012, and the findings by year for mammography were consistent with the main analysis. Following ACA implementation with concomitant reduction in out-of-pocket expenditures, there was a statistically significant increment in mammography uptake but not colonoscopy. This suggests that affordability is a necessary but not sufficient facilitator of preventive services. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. Local Television News Coverage of the Affordable Care Act: Emphasizing Politics Over Consumer Information.

    PubMed

    Gollust, Sarah E; Baum, Laura M; Niederdeppe, Jeff; Barry, Colleen L; Fowler, Erika Franklin

    2017-05-01

    To examine the public health and policy-relevant messages conveyed through local television news during the first stage of Affordable Care Act (ACA) implementation, when about 10 million Americans gained insurance. We conducted a content analysis of 1569 ACA-related local evening television news stories, obtained from sampling local news aired between October 1, 2013, and April 19, 2014. Coders systematically collected data using a coding instrument tracking major messages and information sources cited in the news. Overall, only half of all ACA-related news coverage focused on health insurance products, whereas the remainder discussed political disagreements over the law. Major policy tools of the ACA-the Medicaid expansion and subsidies available-were cited in less than 10% of news stories. Number of enrollees (27%) and Web site glitches (33%) were more common features of coverage. Sources with a political affiliation were by far the most common source of information (> 40%), whereas research was cited in less than 4% of stories. The most common source of news for Americans provided little public health-relevant substance about the ACA during its early implementation, favoring political strategy in coverage.

  11. Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act.

    PubMed

    Gruber, Jonathan

    2014-06-01

    Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.

  12. 24 CFR 401.2 - What special definitions apply to this part?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Development (Continued) OFFICE OF HOUSING AND OFFICE OF MULTIFAMILY HOUSING ASSISTANCE RESTRUCTURING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MULTIFAMILY HOUSING MORTGAGE AND HOUSING ASSISTANCE RESTRUCTURING... part? (a) MAHRA means the Multifamily Assisted Housing Reform and Affordability Act of 1997, title V of...

  13. 24 CFR 401.2 - What special definitions apply to this part?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Development (Continued) OFFICE OF HOUSING AND OFFICE OF MULTIFAMILY HOUSING ASSISTANCE RESTRUCTURING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MULTIFAMILY HOUSING MORTGAGE AND HOUSING ASSISTANCE RESTRUCTURING... part? (a) MAHRA means the Multifamily Assisted Housing Reform and Affordability Act of 1997, title V of...

  14. 24 CFR 401.2 - What special definitions apply to this part?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Development (Continued) OFFICE OF HOUSING AND OFFICE OF MULTIFAMILY HOUSING ASSISTANCE RESTRUCTURING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MULTIFAMILY HOUSING MORTGAGE AND HOUSING ASSISTANCE RESTRUCTURING... part? (a) MAHRA means the Multifamily Assisted Housing Reform and Affordability Act of 1997, title V of...

  15. 24 CFR 401.2 - What special definitions apply to this part?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Development (Continued) OFFICE OF HOUSING AND OFFICE OF MULTIFAMILY HOUSING ASSISTANCE RESTRUCTURING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MULTIFAMILY HOUSING MORTGAGE AND HOUSING ASSISTANCE RESTRUCTURING... part? (a) MAHRA means the Multifamily Assisted Housing Reform and Affordability Act of 1997, title V of...

  16. Family Leave Legislation in the U.S. House: Voting on the Family and Medical Leave Act of 1990.

    ERIC Educational Resources Information Center

    Monroe, Pamela A.; And Others

    1995-01-01

    A model of roll call voting by House members on the Family and Medial Leave Act (FMLA) of 1990 was tested. Found that support for the FMLA was tied to a range of dispositional and contextual demand variables: conservatism, presidential support, etc. The model accurately predicted 90% of the votes. (RJM)

  17. Frank Melville Supportive Housing Investment Act of 2009

    THOMAS, 111th Congress

    Rep. Murphy, Christopher [D-CT-5

    2009-03-23

    Senate - 07/23/2009 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Notes: For further action, see S.1481, which became Public Law 111-374 on 1/4/2011. Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  18. Knowledge as a Predictor of Insurance Coverage Under the Affordable Care Act.

    PubMed

    Hoerl, Maximiliane; Wuppermann, Amelie; Barcellos, Silvia H; Bauhoff, Sebastian; Winter, Joachim K; Carman, Katherine G

    2017-04-01

    The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10%-15% of the US population remains uninsured. To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant. Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013. A total of 2742 US residents ages 18-64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel. Self-reported health insurance status and type as of spring 2015. Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared with low financial literacy, and 9.2 percentage points higher with high compared with low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance through Medicaid or the Marketplaces compared with being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates. A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics.

  19. Affordable Care Act's Mandate Eliminating Contraceptive Cost Sharing Influenced Choices Of Women With Employer Coverage.

    PubMed

    Carlin, Caroline S; Fertig, Angela R; Dowd, Bryan E

    2016-09-01

    Patient cost sharing for contraceptive prescriptions was eliminated for certain insurance plans as part of the Affordable Care Act. We examined the impact of this change on women's patterns of choosing prescription contraceptive methods. Using claims data for a sample of midwestern women ages 18-46 with employer-sponsored coverage, we examined the contraceptive choices made by women in employer groups whose coverage complied with the mandate, compared to the choices of women in groups whose coverage did not comply. We found that the reduction in cost sharing was associated with a 2.3-percentage-point increase in the choice of any prescription contraceptive, relative to the 30 percent rate of choosing prescription contraceptives before the change in cost sharing. A disproportionate share of this increase came from increased selection of long-term contraception methods. Thus, the removal of cost as a barrier seems to be an important factor in contraceptive choice, and our findings about long-term methods may have implications for rates of unintended pregnancy that require further study. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Post-Recession Housing Crisis on Staten Island

    ERIC Educational Resources Information Center

    Lo Re, Mary L.

    2014-01-01

    This paper investigates the experience of Staten Island's diverse urban communities with limited financial resources regarding access to affordable housing after the 2008 economic downturn. It details a successful partnership in researching the challenges faced in these communities and offers recommendations for the targeting of resources to…

  1. 24 CFR 1000.120 - May a recipient use Indian preference or tribal preference in selecting families for housing...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false May a recipient use Indian preference or tribal preference in selecting families for housing assistance? 1000.120 Section 1000.120... AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.120 May a recipient use Indian preference...

  2. Public Housing Reinvestment and Tenant Protection Act of 2011

    THOMAS, 112th Congress

    Rep. Waters, Maxine [D-CA-35

    2011-02-17

    House - 04/04/2011 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  3. 7 CFR Exhibit C to Subpart L of... - Housing in Underserved Areas

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...—Housing in Underserved Areas I. Objective A. To improve the quality of affordable housing by targeting... Arizona, California, New Mexico or Texas; 2. Is in the area of the United States within 150 miles of the border between the United States and Mexico, except that the term does not include any standard...

  4. There's No Place Like Home: How America's Housing Crisis Threatens Our Children.

    ERIC Educational Resources Information Center

    Sandel, Megan; Sharfstein, Joshua; Shaw, Randy

    This report pulls together recent research from the Centers for Disease Control, leading medical and public health journals, and firsthand observations by pediatricians across the country on the link between affordable housing and children's health and outcomes. Also included are the most recent data from the America Housing Survey, the U.S.…

  5. Perceptions of Physical Inspections as a Tool to Protect Housing Quality and Promote Health Equity.

    PubMed

    Holtzen, Holly; Klein, Elizabeth G; Keller, Brittney; Hood, Nancy

    2016-01-01

    Physical inspections that assess how well affordable housing properties meet quality and safety standards help to ensure that low-income tenants live in a healthy built environment. This study was part of a larger Health Impact Assessment (HIA) conducted between January 2012 and November 2013 to inform policymakers about the potential health consequences of a proposed policy decision to align the physical inspections required by housing funding agencies, which would result in a reduction of the frequency of physical inspections. Key informant interviews (n=18) of property managers and tenants were used to explore the inspection process, identification of housing quality issues, and potential effects on the health of affordable housing tenants and the impact on property management practices. Results indicate that physical inspection frequency may be an important trigger for property managers and tenants to adhere to proper maintenance schedules.

  6. Remarks by James P. Turner, Acting Assistant Attorney General, Civil Rights Division, before the First Annual Conference, National Fair Housing Alliance, Washington, D.C.

    ERIC Educational Resources Information Center

    Turner, James P.

    This speech by an official of the U.S. Department of Justice reports on the steps that the Department is taking through its Civil Rights Division to enforce the new Fair Housing Act Amendments, and discusses how the Act fosters a cooperative interagency approach to enforcement. Between passage of the Act and its effective date of March 12, 1989,…

  7. Implementing the Affordable Care Act: state approaches to premium rate reforms in the individual health insurance market.

    PubMed

    Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina

    2014-12-01

    The Affordable Care Act protects people from being charged more for insurance based on factors like medical history or gender and establishes new limits on how insurers can adjust premiums for age, tobacco use, and geography. This brief examines how states have implemented these federal reforms in their individual health insurance markets. We identify state rating standards for the first year of full implementation of reform and explore critical considerations weighed by policymakers as they determined how to adopt the law's requirements. Most states took the opportunity to customize at least some aspect of their rating standards. Interviews with state regulators reveal that many states pursued implementation strategies intended primarily to minimize market disruption and premium shock and therefore established standards as consistent as possible with existing rules or market practice. Meanwhile, some states used the transition period to strengthen consumer protections, particularly with respect to tobacco rating.

  8. Impact of Patient Protection and Affordable Care Act on academic radiology departments' clinical, research, and education missions.

    PubMed

    Mansoori, Bahar; Vidal, Lorenna L; Applegate, Kimberly; Rawson, James V; Novak, Ronald D; Ros, Pablo R

    2013-10-01

    The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment. Copyright © 2013. Published by Elsevier Inc.

  9. The Patient Protection and Affordable Care Act's provisions regarding medical loss ratios and quality: evidence from Texas.

    PubMed

    Quast, Troy

    2013-01-01

    The Patient Protection and Affordable Care Act (PPACA) includes a provision that penalizes insurance companies if their Medical Loss Ratio (MLR) falls below a specified threshold. The MLR is roughly measured as the ratio of health care expenses to premiums paid by enrollees. I investigate whether there is a relationship between MLRs and the quality of care provided by insurance companies. I employ a ten-year sample of market-level financial data and quality variables for Texas insurers, as well as relevant control variables, in regression analyses that utilize insurer and market fixed effects. Of the 15 quality measures, only one has a statistically significant relationship with the MLR. For this measure, the relationship is negative. Although the MLR provision may provide incentives for insurance companies to lower premiums, this sample does not suggest that there is likely to be a beneficial effect on quality.

  10. 24 CFR 886.309 - Housing assistance payment to owners.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Section 8 Housing Assistance Program for the Disposition of HUD-Owned Projects § 886.309 Housing... under this paragraph unless he or she: (1) Immediately upon learning of the vacancy, has notified HUD of... not in a project insured under the National Housing Act except pursuant to section 244 of that Act...

  11. The Role of Housing: A Comparison of Front-Line Provider Views in Housing First and Traditional Programs

    PubMed Central

    Stanhope, Victoria; Padgett, Deborah K.

    2011-01-01

    Purpose Within the mental health system, there are two distinct service models for adults who have severe mental illness and are homeless: one prioritizes treatment before accessing permanent housing (Treatment First) while the other provides permanent housing upfront followed by clinical support (Housing First). Investigating front-line providers working within these two models affords an opportunity to learn more about their implementation from an insider perspective, thus shedding light on whether actual practice is consistent with or contrary to these program models’ contrasting philosophical values. Methods Forty-one providers were recruited from four agencies as part of a NIMH funded qualitative study. Multiple, in-depth interviews lasting 30–45 min were conducted with providers that explored working within these agencies. Thematic analysis was utilized to compare the views of 20 providers working in Housing First versus the 21 providers working in Treatment First programs. Results Providers viewed housing as a priority but differences emerged between Treatment First and Housing First providers along three major themes: the centrality of housing, engaging consumers through housing, and (limits to…) a right to housing. Conclusion Ironically, this study revealed that providers working within Treatment First programs were consumed with the pursuit of housing, whereas Housing First providers focused more on clinical concerns since consumers already had housing. Clearly, how programs position permanent housing has very different implications for how providers understand their work, the pressures they encounter, and how they prioritize client goals. PMID:20521164

  12. The Perceived Impact of the Patient Protection and Affordable Care Act on North Carolina's Free Clinics.

    PubMed

    Swan, Greg A; Foley, Kristie L

    2016-01-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) may dramatically affect the demographics of the uninsured population and the funding prospects for free health clinics. We conducted a cross-sectional survey of 64 of 80 free clinics (80.0% response rate) in North Carolina to assess free clinic directors' knowledge of the ACA and their perceptions of how the ACA would affect clinic operations. Free clinic directors were knowledgeable about well publicized aspects of the ACA (eg, lack of Medicaid expansion in North Carolina), but they were less knowledgeable about provisions such as the Federal Tort Claims Act and high-risk pools, which may have direct and indirect effects on free clinics. Directors expressed concern over the unintended consequences of the ACA, such as reduced funding and reduced volunteerism. Anticipated clinic changes as a result of the ACA include initiation of electronic medical records and, to a lesser extent, a move to become "hybrid" clinics (federally qualified health center look-alikes). This study is focused on North Carolina free clinics that are members of the North Carolina Association of Free Clinics (NCAFC). Findings cannot be generalized to non-NCAFC free clinics or to free clinic networks outside the state. Despite its effort to expand health insurance coverage, the ACA may have unintended consequences to low-cost free clinics that serve uninsured populations. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  13. Animal Housing: Emotional Support Animals on Campuses

    ERIC Educational Resources Information Center

    Salminen, Erik; Gregory, Dennis E.

    2018-01-01

    The results of recent cases indicate that residences and dormitories owned by higher education institutions should be considered "dwellings," and thus subject to the Fair Housing Act. The Fair Housing Act (1968) as amended requires that the providers of dwellings accommodate assistance animals, which includes not only service animals,…

  14. Putting out the welcome mat-targeting outreach efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program.

    PubMed

    Dybdal, Kristin; Blewett, Lynn A; Pintor, Jessie Kemmick; Johnson, Kelli

    2015-01-01

    An evaluation of the Minnesota Community Application Agent (MNCAA) Program was conducted for the MN Minnesota Department of Human Services and funded by the Health Resources and Services Administration's State Health Access Program grant. The MNCAA evaluation assessed effectiveness in reaching disparate populations, explored overall program value, and sought lessons applicable to the Navigator programs required under the Affordable Care Act. Mixed-methods approach using quantitative analysis of tracking and payment data and interviews with key informants to elicit "lessons learned" about the MNCAA program. The MNCAA program offers incentive payments and technical assistance to community partner organizations that assist individuals in applying for public health care coverage. A total of 140 unique community organizations participated in the MNCAA program in 2008 to 2012. Outreach staff and directors from participating MNCAAs and state/local government officials were interviewed. The article highlights a strategy for targeting outreach to individuals eligible for Medicaid coverage or subsidies under the Affordable Care Act by presenting evaluation findings from a unique outreach program to increase access to care for vulnerable populations in Minnesota. Almost two-thirds of applicants were successfully enrolled but lengthy waiting periods persisted. Seventy percent of applications came from health care organizations. Only 13% of applicants assisted by MNCAAs were new to public health care programs. Most MNCAAs believed that the incentive payment-$25 per successful enrollee-was insufficient. Significant expertise in enrolling individuals in public health care programs exists within a core group of community organizations. Incentives to leverage the capacity of community organizations must be accompanied by recruiting and training. Outreach providers and navigators also need timely access to client information. More investment in financial incentives will be required.

  15. Forecasting the Value of Podiatric Medical Care in Newly Insured Diabetic Patients During Implementation of the Affordable Care Act in California.

    PubMed

    Labovitz, Jonathan M; Kominski, Gerald F

    2016-05-01

    Because value-based care is critical to the Affordable Care Act success, we forecasted inpatient costs and the potential impact of podiatric medical care on savings in the diabetic population through improved care quality and decreased resource use during implementation of the health reform initiatives in California. We forecasted enrollment of diabetic adults into Medicaid and subsidized health benefit exchange programs using the California Simulation of Insurance Markets (CalSIM) base model. Amputations and admissions per 1,000 diabetic patients and inpatient costs were based on the California Office of Statewide Health Planning and Development 2009-2011 inpatient discharge files. We evaluated cost in three categories: uncomplicated admissions, amputations during admissions, and discharges to a skilled nursing facility. Total costs and projected savings were calculated by applying the metrics and cost to the projected enrollment. Diabetic patients accounted for 6.6% of those newly eligible for Medicaid or health benefit exchange subsidies, with a 60.8% take-up rate. We project costs to be $24.2 million in the diabetic take-up population from 2014 to 2019. Inpatient costs were 94.3% higher when amputations occurred during the admission and 46.7% higher when discharged to a skilled nursing facility. Meanwhile, 61.0% of costs were attributed to uncomplicated admissions. Podiatric medical services saved 4.1% with a 10% reduction in admissions and amputations and an additional 1% for every 10% improvement in access to podiatric medical care. When implementing the Affordable Care Act, inclusion of podiatric medical services on multidisciplinary teams and in chronic-care models featuring prevention helps shift care to ambulatory settings to realize the greatest cost savings.

  16. Knowledge as a predictor of insurance coverage under the Affordable Care Act

    PubMed Central

    Hoerl, Maximiliane; Wuppermann, Amelie; Barcellos, Silvia H.; Bauhoff, Sebastian; Winter, Joachim K.

    2016-01-01

    Background The Affordable Care Act established policy mechanisms to increase health insurance coverage in the United States. While insurance coverage has increased, 10 to 15% of the U.S. population remains uninsured. Objectives To assess whether health insurance literacy and financial literacy predict being uninsured, covered by Medicaid, or covered by Marketplace insurance, holding demographic characteristics, attitudes toward risk, and political affiliation constant. Research Design Analysis of longitudinal data from fall 2013 and spring 2015 including financial and health insurance literacy and key covariates collected in 2013. Subjects 2,742 U.S. residents ages 18-64, 525 uninsured in fall 2013, participating in the RAND American Life Panel, a nationally representative internet panel. Measures Self-reported health insurance status and type as of spring 2015. Results Among the uninsured in 2013, higher financial and health insurance literacy were associated with greater probability of being insured in 2015. For a typical uninsured individual in 2013, the probability of being insured in 2015 was 8.3 percentage points higher with high compared to low financial literacy, and 9.2 percentage points higher with high compared to low health insurance literacy. For the general population, those with high financial and health insurance literacy were more likely to obtain insurance via Medicaid or the Marketplaces compared to being uninsured. The magnitude of coefficients for these predictors was similar to that of commonly used demographic covariates. Conclusions A lack of understanding about health insurance concepts and financial illiteracy predict who remains uninsured. Outreach and consumer-education programs should consider these characteristics. PMID:27820594

  17. Changes in perception-action tuning over long time scales: How children and adults perceive and act on dynamic affordances when crossing roads.

    PubMed

    O'Neal, Elizabeth E; Jiang, Yuanyuan; Franzen, Lucas J; Rahimian, Pooya; Yon, Junghum Paul; Kearney, Joseph K; Plumert, Jodie M

    2018-01-01

    This investigation examined developmental change in how children perceive and act on dynamic affordances when crossing roads on foot. Six- to 14-year-olds and adults crossed roads with continuous cross-traffic in a large-screen, immersive pedestrian simulator. We observed change both in children's gap choices and in their ability to precisely synchronize their movement with the opening of a gap. Younger children were less discriminating than older children and adults, choosing fewer large gaps and more small gaps. Interestingly, 12-year-olds' gap choices were significantly more conservative than those of 6-, 8-, 10-, and 14-year-olds, and adults. Timing of entry behind the lead vehicle in the gap (a key measure of movement coordination) improved steadily with development, reaching adultlike levels by age 14. Coupled with their poorer timing of entry, 6-, 8-, and 10-year-olds' gap choices resulted in significantly less time to spare and more collisions than 14-year-olds and adults. Time to spare did not differ between 12-year-olds, 14-year-olds, and adults, indicating that 12-year-olds' more conservative gap choices compensated for their poorer timing of entry. The findings show that children's ability to perceive and act on dynamic affordances undergoes a prolonged period of development, and that older children appear to compensate for their poorer movement timing skills by adjusting their gap decisions to match their crossing actions. Implications for the development of perception-action tuning and road-crossing skills are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Alternatives to the ACA's Affordability Firewall.

    PubMed

    Nowak, Sarah A; Saltzman, Evan; Cordova, Amado

    2016-05-09

    The Affordable Care Act (ACA) was designed to increase health insurance coverage while limiting the disruption to individuals with existing sources of insurance coverage, particularly those with employer-sponsored insurance (ESI). To limit disruption to those with coverage, the ACA implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable." This article examines the policy impacts of the affordability firewall and investigates two potential modifications. Option 1, which is the "entire family" scenario, involves allowing an exception to the firewall for anyone in a family where the family ESI premium contribution exceeds 9.5 percent of the worker's household income. In Option 2, the "dependents only" scenario, only dependents (and not the worker) become eligible for Marketplace subsidies when the ESI premium contribution exceeds 9.5 percent of the worker's household income. Relative to the ACA, RAND researchers estimate that nongroup enrollment will increase by 4.1 million for Option 1 and by 1.4 million for Option 2. However, the number without insurance only declines by 1.5 million in Option 1 and 0.7 million in Option 2. The difference between the increase in nongroup enrollment and the decrease in uninsurance is primarily due to ESI crowd-out, which is more pronounced for Option 1. Researchers also estimated that about 1.3 million families who have ESI and unsubsidized nongroup coverage under current ACA policy would receive Marketplace subsidies under the alternative affordability firewall scenarios. For these families, health insurance coverage would become substantially more affordable; these families' risk of spending at least 20 percent of income on health care would drop by more than two thirds. We additionally estimated that federal

  19. A systems thinking approach to analysis of the Patient Protection and Affordable Care Act.

    PubMed

    Williams, John C

    2015-01-01

    The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article highlights the ACA from a systems perspective. The conceptual model presented encompasses both health reform variables (eg, health care provisions, key legislative components, system environment) and system variables (eg, inputs, outputs, feedback, and throughput) needed to understand current health care reform efforts from a systems perspective. The model presented shows how the interrelationships and interconnections of elements of a system come together to achieve its purpose or goal.

  20. Early impact of the Affordable Care Act on health insurance coverage of young adults.

    PubMed

    Cantor, Joel C; Monheit, Alan C; DeLia, Derek; Lloyd, Kristen

    2012-10-01

    To evaluate one of the first implemented provisions of the Patient Protection and Affordable Care Act (ACA), which permits young adults up to age 26 to enroll as dependents on a parent's private health plan. Nearly one-in-three young adults lacked coverage before the ACA. STUDY DESIGN, METHODS, AND DATA: Data from the Current Population Survey 2005-2011 are used to estimate linear probability models within a difference-in-differences framework to estimate how the ACA affected coverage of eligible young adults compared to slightly older adults. Multivariate models control for individual characteristics, economic trends, and prior state-dependent coverage laws. This ACA provision led to a rapid and substantial increase in the share of young adults with dependent coverage and a reduction in their uninsured rate in the early months of implementation. Models accounting for prior state dependent expansions suggest greater policy impact in 2010 among young adults who were also eligible under a state law. ACA-dependent coverage expansion represents a rare public policy success in the effort to cover the uninsured. Still, this policy may have later unintended consequences for premiums for alternative forms of coverage and employer-offered rates for young adult workers. © Health Research and Educational Trust.

  1. Early Impact of the Affordable Care Act on Health Insurance Coverage of Young Adults

    PubMed Central

    Cantor, Joel C; Monheit, Alan C; DeLia, Derek; Lloyd, Kristen

    2012-01-01

    Research Objective To evaluate one of the first implemented provisions of the Patient Protection and Affordable Care Act (ACA), which permits young adults up to age 26 to enroll as dependents on a parent's private health plan. Nearly one-in-three young adults lacked coverage before the ACA. Study Design, Methods, and Data Data from the Current Population Survey 2005–2011 are used to estimate linear probability models within a difference-in-differences framework to estimate how the ACA affected coverage of eligible young adults compared to slightly older adults. Multivariate models control for individual characteristics, economic trends, and prior state-dependent coverage laws. Principal Findings This ACA provision led to a rapid and substantial increase in the share of young adults with dependent coverage and a reduction in their uninsured rate in the early months of implementation. Models accounting for prior state dependent expansions suggest greater policy impact in 2010 among young adults who were also eligible under a state law. Conclusions and Implications ACA-dependent coverage expansion represents a rare public policy success in the effort to cover the uninsured. Still, this policy may have later unintended consequences for premiums for alternative forms of coverage and employer-offered rates for young adult workers. PMID:22924684

  2. Impacts of the Affordable Care Act on Community Health Centers: Characteristics of New Patients and Early Changes in Delivery of Care.

    PubMed

    Hatch, Brigit; Smith, Ning; McBurnie, Mary Ann; Quach, Thu; Mayer, Kenneth H; Dunne, Mary J; Cottrell, Erika

    2018-05-15

    The aim of this study was to assess the impact of the Affordable Care Act (ACA) on community health centers (CHCs). Using electronic health records from the Community Health Applied Research Network, we assessed new patient characteristics, office visit volume, and payer distribution among CHC patients before and after ACA implementation, 2011-2014 (n = 442 455). New patients post-ACA were younger, more likely to be female and have chronic health conditions, and utilized more primary care (P < .05 for each). Post-ACA, clinics delivered 19% more office visits and more visits were reimbursed by Medicaid. The support of CHCs is needed to meet increased demand post-ACA.

  3. 24 CFR 266.405 - Title.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Mortgage and Closing...

  4. "Affordable" Private Schools in South Africa. Affordable for Whom?

    ERIC Educational Resources Information Center

    Languille, Sonia

    2016-01-01

    The paper sets out to challenge the notions of "affordable" private schools in the context of South Africa. It is guided by one main question: "affordable private schools for whom?" It argues that, contrary to claims by its public and private proponents, affordable private schools in South Africa do not cater for poor children.…

  5. Affordability of Meteorology Graduate Programs in the United States and Canada.

    NASA Astrophysics Data System (ADS)

    Gilmore, Matthew S.; Toracinta, E. Richard

    1998-06-01

    The authors surveyed 55 university departments in the United States and Canada that grant doctor of philosophy and/or master of science degrees in meteorology or the atmospheric sciences. Two-thirds of university departments responded. Survey topics included graduate student income (stipends and health insurance benefits) and mandatory costs (tuition, fees, and health insurance costs) incurred for fall 1996.Results show that most graduate students do have funding but only one-quarter of departments indicate that health insurance benefits are provided to graduate assistants. The largest mandatory cost is typically housing, which was estimated (except for Canadian schools) with 1996 Fair Market Rent data from the U.S. Department of Housing and Urban Development. For schools not providing it, the second largest cost is typically health insurance. The smallest costs are typically tuition (waived for graduate assistants in most cases) and fees.The difference between income and mandatory costs over a nine-month period gives an "effective income." Evidence was found associating greater effective income with larger departments and with locations where housing costs are larger. No significant evidence was found to associate differences in effective income with city size or geographic region. The broad range in effective income between the departments suggests that some graduate programs may be much more affordable than others.This information can aid university departments in planning budgets that keep them competitive with one another. This paper will also help prospective graduate students by raising awareness about important issues of graduate program affordability.

  6. Library Services and Construction Act Amendments of 1990. Conference Report (To Accompany H.R. 2742). House of Representatives, 101st Congress, 2nd Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC.

    This conference report on the Library Services and Construction Act Amendments of 1990 includes the text of a substitute amendment agreed to by a committee of House of Representatives and Senate members. Amendments are presented for the following sections of the act: (1) Short Title; References; (2) Definitions; (3) Authorization of…

  7. 75 FR 39575 - Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of Housing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-09

    ... of a Computer Matching Program Between the Department of Housing and Urban Development (HUD) and the.... ACTION: Notice of a computer matching program between the HUD and the USDA. SUMMARY: In accordance with the Privacy Act of 1974 (5 U.S.C. 552a), as amended by the Computer Matching and Privacy Protection...

  8. 75 FR 67755 - Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of Housing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... of a Computer Matching Program Between the Department of Housing and Urban Development (HUD) and the.... ACTION: Notice of a computer matching program between the HUD and the SBA. SUMMARY: In accordance with the Privacy Act of 1974 (5 U.S.C. 552a), as amended by the Computer Matching and Privacy Protection...

  9. Media Messages and Perceptions of the Affordable Care Act during the Early Phase of Implementation.

    PubMed

    Fowler, Erika Franklin; Baum, Laura M; Barry, Colleen L; Niederdeppe, Jeff; Gollust, Sarah E

    2017-02-01

    Public opinion about the Affordable Care Act (ACA) has been polarized since the law's passage. Past research suggests these conditions would make any media influence on the public limited at best. However, during the early phase of implementation, locally broadcast ACA-related media messages-in the form of paid health insurance and political advertisements and news media stories-abounded as advocates, insurance marketers, and politicians sought to shape the public's perceptions of the law. To what extent did message exposure affect ACA perceptions during the first open enrollment period? We merge data on volumes of messaging at the media market level with nationally representative survey data to examine the relationship between estimated exposure to media messaging and the public's perceptions of how informed they were about and favorable toward the ACA in October 2013. We find that higher volumes of insurance advertising and local news coverage are associated with participants' perceptions of being informed about the law. Volumes of insurance advertising and of local news coverage are also associated with participants' favorability toward the law, but the relationship varies with partisanship, supporting the growing body of research describing partisan perceptual bias. Copyright © 2017 by Duke University Press.

  10. Gain in Insurance Coverage and Residual Uninsurance Under the Affordable Care Act: Texas, 2013-2016.

    PubMed

    Pickett, Stephen; Marks, Elena; Ho, Vivian

    2017-01-01

    To examine the effects of the Affordable Care Act's (ACA's) Marketplace on Texas residents and determine which population subgroups benefited the most and which the least. We analyzed insurance coverage rates among nonelderly Texas adults using the Health Reform Monitoring Survey-Texas from September 2013, just before the first open enrollment period in the Marketplace, through March 2016. Texas has experienced a roughly 6-percentage-point increase in insurance coverage (from 74.7% to 80.6%; P = .012) after implementation of the major insurance provisions of the ACA. The 4 subgroups with the largest increases in adjusted insurance coverage between 2013 and 2016 were persons aged 50 to 64 years (12.1 percentage points; P = .002), Hispanics (10.9 percentage points; P = .002), persons reporting fair or poor health status (10.2 percentage points; P = .038), and those with a high school diploma as their highest educational attainment (9.2 percentage points; P = .023). Many population subgroups have benefited from the ACA's Marketplace, but approximately 3 million Texas residents still lack health coverage. Adopting the ACA's Medicaid expansion is a means to address the lack of coverage.

  11. Neurosurgery value and quality in the context of the Affordable Care Act: a policy perspective.

    PubMed

    Menger, Richard P; Guthikonda, Bharat; Storey, Christopher M; Nanda, Anil; McGirt, Matthew; Asher, Anthony

    2015-12-01

    Neurosurgeons provide direct individualized care to patients. However, the majority of regulations affecting the relative value of patient-related care are drafted by policy experts whose focus is typically system- and population-based. A central, prospectively gathered, national outcomes-related database serves as neurosurgery's best opportunity to bring patient-centered outcomes to the policy arena. In this study the authors analyze the impact of the Affordable Care Act (ACA) on the determination of quality and value in neurosurgery care through the scope, language, and terminology of policy experts. The methods by which the ACA came into law and the subsequent quality implications this legislation has for neurosurgery will be discussed. The necessity of neurosurgical patient-oriented clinical registries will be discussed in the context of imminent and dramatic reforms related to medical cost containment. In the policy debate moving forward, the strength of neurosurgery's argument will rest on data, unity, and proactiveness. The National Neurosurgery Quality and Outcomes Database (N(2)QOD) allows neurosurgeons to generate objective data on specialty-specific value and quality determinations; it allows neurosurgeons to bring the patient-physician interaction to the policy debate.

  12. Building community while complying with the Affordable Care Act in the Lehigh Valley of Pennsylvania.

    PubMed

    Mathews, A Lanethea; Coyle, Bonnie S; Deegan, Michele Moser

    2015-01-01

    The Affordable Care Act (ACA) requires nonprofit hospitals to conduct community health needs assessments (CHNA) every 3 years. Best practices for CHNAs are still emerging and, along with growing economic pressures, contribute to uncertainty about the short- and long-term costs hospitals will face as a result of the ACA. This article describes a community-based partnership coordinated by a nonprofit hospital and a consortium of academic institutions as a model for conducting a CHNA. Similar partnerships offer key advantages in complying with the ACA: local academic institutions are existing stakeholders in the community--they possess research expertise and have a vested interested in shaping implementation strategies to improve health; the process of collaborating itself helps to generate community resources, conceive of community health as a shared and iterative enterprise, and mobilize community partners in supporting long-term health priorities. No CHNA is ever perfect, but there are compelling reasons for nonprofit hospitals to seek community-based partnerships, not only because such partnerships comply with the law but, more importantly, because they hold great promise for linking the CHNA process and results to the health realities of local communities, ultimately bolstering community engagement while creating shared health priorities.

  13. The Affordable Care Act's Effects On The Formation, Expansion, And Operation Of Physician-Owned Hospitals.

    PubMed

    Plummer, Elizabeth; Wempe, William

    2016-08-01

    The Affordable Care Act (ACA) imposed new restrictions on the formation and expansion of physician-owned hospitals. These restrictions provided incentives for the hospitals and their owners to take preemptive actions before the effective dates of ACA provisions and modify their operations thereafter. We studied 106 physician-owned hospitals in Texas to determine how they responded to ACA restrictions. We found that there were significant pre-ACA increases in the formation, physician ownership, and physical capacity of physician-owned hospitals, which suggests that they reacted quickly to the policy changes. After the ACA's provisions took effect, the hospitals improved the use of their assets to generate increased amounts of services, revenue, and profits. We found no evidence that existing physician-owned hospitals stopped accepting Medicare to avoid the ACA restrictions, although some investors adopted a seemingly unsuccessful strategy of not accepting Medicare at physician-owned hospitals formed after implementation of the ACA. We conclude that the ACA restrictions effectively eliminated the formation of new physician-owned hospitals, thus accomplishing what previous legislative efforts had failed to do. Project HOPE—The People-to-People Health Foundation, Inc.

  14. How Will the Affordable Care Act's Cost-Sharing Reductions Affect Consumers' Out-of-Pocket Costs in 2016?

    PubMed

    Collins, Sara R; Gunja, Munira; Beutel, Sophie

    2016-03-01

    Health insurers selling plans in the Affordable Care Act's market­places are required to reduce cost-sharing in silver plans for low- and moderate-income people earning between 100 percent and 250 percent of the federal pov­erty level. In 2016, as many as 7 million Americans may have plans with these cost-sharing reductions. In the largest markets in the 38 states using the federal website for marketplace enrollment, the cost-sharing reductions substantially lower projected out-of-pocket costs for people who qualify for them. However, the degree to which consumers' out-of-pocket spending will fall varies by plan and how much health care they use. This is because insurers use deductibles, out-of-pocket limits, and copayments in different combinations to lower cost-sharing for eligible enrollees. In 2017, marketplace insurers will have the option of offering standard plans, which may help simplify consumers' choices and lead to more equal cost-sharing.

  15. Buffering the Uneven Impact of the Affordable Care Act: Immigrant-serving Safety-net Providers in New Mexico.

    PubMed

    Getrich, Christina M; García, Jacqueline M; Solares, Angélica; Kano, Miria

    2018-06-01

    We conducted a study in early 2014 to document how the initial implementation of the Affordable Care Act (ACA) affected health care provision to different categories of immigrants from the perspective of health care providers in New Mexico. Though ACA navigators led enrollment, a range of providers nevertheless became involved by necessity, expressing concern about how immigrants were faring in the newly configured health care environment and taking on advocacy roles. Providers described interpreting shifting eligibility and coverage, attending to vulnerable under/uninsured patients, and negotiating new bureaucratic barriers for insured patients. Findings suggest that, like past efforts, this recent reform to the fragmented health care system has perpetuated a condition in which safety-net clinics and providers are left to buffer a widening gap for immigrant patients. With possible changes to the ACA ahead, safety-net providers' critical buffering roles will likely become more crucial, underscoring the necessity of examining their experiences with past reforms. © 2017 by the American Anthropological Association.

  16. The Affordable Care Act and genetic testing for inheritable cancer syndromes: impact on high-risk underserved minorities.

    PubMed

    Walcott, Farzana L; Dunn, Barbara K; DeShields, Mary; Baquet, Claudia

    2014-02-01

    Genetic testing for inheritable cancer syndromes is becoming a critical part of preventive health services. The Patient Protection and Affordable Care Act (PPACA) Essential Health Benefits package addresses breast cancer susceptibility-gene testing for women who are unaffected by cancer. The absence of provisions for 1) men, 2) cancer patients, 3) other inheritable cancer syndromes, and 4) risk-reducing interventions are limitations of PPACA. We discuss provisions and limitations of PPACA pertaining to genetic testing and effects on high-risk populations, in particular minorities. The PPACA is the beginning of an ongoing process of incorporating genetic testing in the armamentarium of cancer prevention. Future efforts should focus on ensuring equitable access to genetic testing as a preventive service under PPACA to high-risk populations other than women. Consideration should also be given to provisions for risk-reducing interventions, especially in underserved minority populations, who are known to underutilize genetic testing and may have limited financial resources for medical intervention.

  17. The Affordable Care Act: a case study for understanding and applying complexity concepts to health care reform.

    PubMed

    Larkin, D Justin; Swanson, R Chad; Fuller, Spencer; Cortese, Denis A

    2016-02-01

    The current health system in the United States is the result of a history of patchwork policy decisions and cultural assumptions that have led to persistent contradictions in practice, gaps in coverage, unsustainable costs, and inconsistent outcomes. In working toward a more efficient health system, understanding and applying complexity science concepts will allow for policy that better promotes desired outcomes and minimizes the effects of unintended consequences. This paper will consider three applied complexity science concepts in the context of the Patient Protection and Affordable Care Act (PPACA): developing a shared vision around reimbursement for value, creating an environment for emergence through simple rules, and embracing transformational leadership at all levels. Transforming the US health system, or any other health system, will be neither easy nor quick. Applying complexity concepts to health reform efforts, however, will facilitate long-term change in all levels, leading to health systems that are more effective, efficient, and equitable. © 2014 John Wiley & Sons, Ltd.

  18. Smart Housing in Disasters Act of 2011

    THOMAS, 112th Congress

    Rep. Thompson, Bennie G. [D-MS-2

    2011-01-05

    House - 01/31/2011 Referred to the Subcommittee on Emergency Communications, Preparedness, and Response. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. Smart Housing in Disasters Act of 2009

    THOMAS, 111th Congress

    Rep. Thompson, Bennie G. [D-MS-2

    2009-07-31

    House - 09/08/2009 Referred to the Subcommittee on Emergency Communications, Preparedness, and Response. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  20. Insurers' policies on coverage for behavior management services and the impact of the Affordable Care Act.

    PubMed

    Edelstein, Burton L

    2014-01-01

    The impact of the Affordable Care Act (ACA) on dental insurance coverage for behavior management services depends upon the child's source of insurance (Medicaid, CHIP, private commercial) and the policies that govern each such source. This contribution describes historical and projected sources of pediatric dental coverage, catalogues the seven behavior codes used by dentists, compares how often they are billed by pediatric and general dentists, assesses payment policies and practices for behavioral services across coverage sources, and describes how ACA coverage policies may impact each source. Differences between Congressional intent to ensure comprehensive oral health services with meaningful consumer protections for all legal-resident children and regulatory action by the Departments of Treasury and Health and Human Services are explored to explain how regulations fail to meet Congressional intent as of 2014. The ACA may additionally impact pediatric dentistry practice, including dentists' behavior management services, by expanding pediatric dental training and safety net delivery sites and by stimulating the evolution of novel payment and delivery systems designed to move provider incentives away from procedure-based payments and toward health outcome-based payments.

  1. 78 FR 26559 - Homeless Emergency Assistance and Rapid Transition to Housing: Rural Housing Stability Assistance...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-07

    ...). SUPPLEMENTARY INFORMATION: The Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH... Homelessness Grant program. The HEARTH Act also directs HUD to promulgate regulations for these new programs...

  2. Safe and Healthy Housing Act of 2009

    THOMAS, 111th Congress

    Rep. Brady, Robert A. [D-PA-1

    2009-10-21

    House - 06/18/2010 Referred to the Subcommittee on Department Operations, Oversight, Nutrition and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  3. Standards of Housing for Rent Built by Municipal Social Building Society in Bialystok (Poland) during 1996 - 2012

    NASA Astrophysics Data System (ADS)

    Tokajuk, Andrzej

    2017-10-01

    The period of economic transformation in Poland started from 1989 and resulted in significant changes on the housing market. Flats became goods and process of privatizing of the housing market took place in last decade of the 20th century. It became clear, that it was necessary to create the system of housing for the people who cannot afford to buy the flat on free market. Such solutions were implemented in 1996 and since then affordable housing associations started coming into existence - organizations building flats for rent, supported by city and government budget. Large complex of such housing for rent was built in Bialystok, the major city of northeastern Poland, and it is regarded as one of the biggest in the country. The purpose of the study is characteristics of the contemporary social housing for rent in Bialystok, as good example of that kind of housing realized in Poland. The author uses a kind of parametrical method and analysis some aspects of housing environment: the urban concepts of housing developments, architectural ideas, standards of flats, and also solutions of parking places, road systems and access to basic services, including recreational areas. He gets factors of housing standards as a final result.

  4. The Development Mechanism of Financial Resources of the Housing Mortgage Lending in Russia

    ERIC Educational Resources Information Center

    Savinova, Valentina A.; Solodilova, Marija N.; Zgegalova, Elena V.; Tershukova, Marina B.; Rutkauskas, Tatiana K.

    2016-01-01

    The urgency of the analyzed issue is due to the priority of state issues of providing the population with affordable and comfortable housing. The purpose of research is to develop the main provisions of the development mechanism of financial resources of the housing mortgage lending and to develop practical recommendations for its implementation.…

  5. Towards sentiment analysis application in housing projects

    NASA Astrophysics Data System (ADS)

    Mahadzir, Nurul Husna; Omar, Mohd Faizal; Nawi, Mohd Nasrun Mohd

    2016-08-01

    In becoming a develop nation by 2020, Malaysia Government realized the need in providing affordable house to the public. Since Second Malaysia Plan, government has implemented various affordable housing projects and it continues until recent Malaysia Plan. To measure the effectiveness of the initiatives taken, public opinion is necessary. A social media platform has been seen as the most effective mechanism to get information on people's thought and feeling towards certain issues. One of the best ways to extract emotions and thoughts from what people post in social media is through Sentiment Analysis (SA). There are three different levels of analysis: document level, sentence level and feature level. Most of previous research focused on the classification of sentiment at document or sentence level. Unfortunately, both document and sentence level does not discover what exactly people like or not. While the analysis based on feature, there exist accuracy problem when classifying the sentiment scores. This paper will propose a new framework that focuses on sentiment classification scores at feature level to overcome the uncertainty and accuracy issues on the result.

  6. Air Distribution Retrofit Strategies for Affordable Housing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dentz, Jordan; Conlin, Francis; Holloway, Parker

    2014-03-01

    In multifamily and attached buildings, traditional duct sealing methods are often impractical or costly and disruptive because of the difficulty in accessing leakage sites. In this project, two retrofit duct sealing techniques -- manually-applied sealants and injecting a spray sealant, were implemented in several low-rise multi-unit buildings. An analysis on the cost and performance of the two methods are presented. Each method was used in twenty housing units: approximately half of each group of units are single story and the remainder two-story. Results show that duct leakage to the outside was reduced by an average of 59% through the usemore » of manual methods, and by 90% in the units where the injected spray sealant was used. It was found that 73% of the leakage reduction in homes that were treated with injected spray sealant was attributable to the manual sealing done at boots, returns and the air handler. The cost of manually-applying sealant ranged from $275 to $511 per unit and for the injected spray sealant the cost was $700 per unit. Modeling suggests a simple payback of 2.2 years for manual sealing and 4.7 years for the injected spray sealant system. Utility bills were collected for one year before and after the retrofits. Utility bill analysis shows 14% and 16% energy savings using injected spray sealant system and hand sealing procedure respectively in heating season whereas in cooling season, energy savings using injected spray sealant system and hand sealing were both 16%.« less

  7. Air Distribution Retrofit Strategies for Affordable Housing

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dentz, J.; Conlin, F.; Holloway, Parker

    2014-03-01

    In multifamily and attached buildings, traditional duct sealing methods are often impractical or costly and disruptive because of the difficulty in accessing leakage sites. In this project, two retrofit duct sealing techniques, manually-applied sealants and injecting a spray sealant, were implemented in several low-rise multiunit buildings. An analysis on the cost and performance of the two methods are presented. Each method was used in twenty housing units: approximately half of each group of units are single story and the remainder are two story. Results show that duct leakage to the outside was reduced by an average of 59% through themore » use of manual methods, and by 90% in the units where the injected spray sealant was used. It was found that 73% of the leakage reduction in homes that were treated with injected spray sealant was attributable to the manual sealing done at boots, returns and the air handler. The cost of manually-applying sealant ranged from $275 to $511 per unit and for the injected spray sealant the cost was $700 per unit. Modeling suggests a simple payback of 2.2 years for manual sealing and 4.7 years for the injected spray sealant system. Utility bills were collected for one year before and after the retrofits. Utility bill analysis shows 14% and 16% energy savings using injected spray sealant system and hand sealing procedure respectively in heating season whereas in cooling season, energy savings using injected spray sealant system and hand sealing were both 16%.« less

  8. Medicare Advantage Penetration and Hospital Costs Before and After the Affordable Care Act.

    PubMed

    Henke, Rachel Mosher; Karaca, Zeynal; Gibson, Teresa B; Cutler, Eli; White, Chapin; Wong, Herbert S

    2018-04-01

    Research has suggested that growth in the Medicare Advantage (MA) program indirectly benefits the entire 65+-year-old population by reducing overall expenditures and creating spillover effects of patient care practices. Medicare programs and innovations initiated by the Affordable Care Act (ACA) have encouraged practices to adopt models applying to all patient populations, which may influence the continued benefits of MA program growth. This study investigated the relationship between MA program growth and inpatient hospital costs and utilization before and after the ACA. Primary data sources were 2005-2014 Health Care Cost and Utilization Project hospital data and 2004-2013 Centers for Medicare & Medicaid Services enrollment data. County-year-level regression analysis with fixed effects examined the relationship between Medicare managed care penetration and hospital cost per enrollee. We decomposed results into changes in utilization, severity, and severity-adjusted inpatient resource use. Analyses were stratified by whether the admission was urgent or nonurgent. A 10% increase in MA penetration was associated with a 3-percentage point decrease in inpatient cost per Medicare enrollee before the ACA. This effect was more prominent in nonurgent admissions and diminished after the ACA. Results suggest that MA enrollment growth is associated with diminished spillover reductions in hospital admission costs after the ACA. We did not observe a strong relationship between MA enrollment and inpatient days per enrollee. Future research should examine whether spillover effects still are observed in outpatient settings.

  9. Stop the Drop Houses Act of 2010

    THOMAS, 111th Congress

    Rep. Mitchell, Harry E. [D-AZ-5

    2010-07-19

    House - 07/26/2010 Referred to the Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. Preserving Neighborhood Opportunity: Where Federal Housing Subsidies Expire

    PubMed Central

    Lens, Michael C.; Reina, Vincent

    2017-01-01

    Rent burdens are increasing in U.S. metropolitan areas while subsidies on privately owned, publicly subsidized rental units are expiring. As a result, some of the few remaining affordable units in opportunity neighborhoods are at risk of being converted to market rate. Policy makers face a decision about whether to devote their efforts and scarce resources toward developing new affordable housing, recapitalizing existing subsidized housing, and/or preserving properties with expiring subsidies. There are several reasons to preserve these subsidies, one being that properties may be located in neighborhoods with greater opportunity. In this article, we use several sources of data at the census tract level to learn how subsidy expirations affect neighborhood opportunity for low-income households. Our analysis presents several key findings. First, we find that units that left the project-based Section 8 program were – on average – in lower opportunity neighborhoods, but these neighborhoods were improving. In addition, properties due to expiry from the Section 8 program between 2011 and 2020 are in higher opportunity neighborhoods than any other subsidy program. On the contrary, new Low-Income Housing Tax Credit (LIHTC) units were developed in tracts similar to those where LIHTC units are currently active, which tend to be lower opportunity neighborhoods. PMID:28553063

  11. Preserving Neighborhood Opportunity: Where Federal Housing Subsidies Expire.

    PubMed

    Lens, Michael C; Reina, Vincent

    2016-01-01

    Rent burdens are increasing in U.S. metropolitan areas while subsidies on privately owned, publicly subsidized rental units are expiring. As a result, some of the few remaining affordable units in opportunity neighborhoods are at risk of being converted to market rate. Policy makers face a decision about whether to devote their efforts and scarce resources toward developing new affordable housing, recapitalizing existing subsidized housing, and/or preserving properties with expiring subsidies. There are several reasons to preserve these subsidies, one being that properties may be located in neighborhoods with greater opportunity. In this article, we use several sources of data at the census tract level to learn how subsidy expirations affect neighborhood opportunity for low-income households. Our analysis presents several key findings. First, we find that units that left the project-based Section 8 program were - on average - in lower opportunity neighborhoods, but these neighborhoods were improving. In addition, properties due to expiry from the Section 8 program between 2011 and 2020 are in higher opportunity neighborhoods than any other subsidy program. On the contrary, new Low-Income Housing Tax Credit (LIHTC) units were developed in tracts similar to those where LIHTC units are currently active, which tend to be lower opportunity neighborhoods.

  12. 24 CFR 266.616 - Transfer of partial interest under participation agreement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HOUSING ACT AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Assignments § 266.616 Transfer of partial interest...

  13. Housing Trust Fund Elimination Act of 2011

    THOMAS, 112th Congress

    Rep. Royce, Edward R. [R-CA-40

    2011-07-07

    House - 07/12/2011 Forwarded by Subcommittee to Full Committee (Amended) by the Yeas and Nays: 18 - 14 . (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Community health workers and the Patient Protection and Affordable Care Act: an opportunity for a research, advocacy, and policy agenda.

    PubMed

    Shah, Megha K; Heisler, Michele; Davis, Matthew M

    2014-02-01

    Community health workers (CHWs), who have been shown to be effective in multiple roles in the provision of culturally appropriate health care in a variety of settings, have the potential to be important members of an interdisciplinary health care team. Recent efforts have started to explore how best to integrate CHWs into the health system. However, to date, there has been limited policy guidance, support, or evidence on how best to achieve this on a larger scale. The Patient Protection and Affordable Care Act (ACA), through several provisions, provides a unique opportunity to create a unified framework for workforce integration and wider utilization of CHWs. This review identifies four major opportunities to further the research, advocacy, and policy agenda for CHWs.

  15. Trends in Total Hip Arthroplasty Under the Patient Protection and Affordable Care Act: A National Database Analysis Between 2008 and 2015.

    PubMed

    Etcheson, Jennifer I; George, Nicole E; Gwam, Chukwuweike U; Nace, James; Caughran, Alexander T; Thomas, Melbin; Virani, Sana; Delanois, Ronald E

    2018-05-16

    The Patient Protection and Affordable Care Act expanded health coverage for low-earning individuals and families. With more Americans having access to care, the use of elective procedures, such as total hip arthroplasty (THA), was expected to increase. Therefore, the aim of this study was to evaluate trends in THA before and after the initiation of the Patient Protection and Affordable Care Act regarding race, age, body mass index, and sex between 2008 and 2015. The National Surgical Quality Improvement Program database was queried for all individuals who had undergone primary THA between 2008 and 2015. This yielded a total of 104,209 patients. Descriptive statistics were used to analyze patient-level data. A Cochran-Armitage test assessed trends in categorical data points over time. Analysis indicated an increased percentage of blacks or African Americans undergoing THA (7.8% vs 9.2%, P<.001), followed by Native Americans or Pacific Islanders (0.0% vs 0.4%, P<.001), American Indians or Alaskan Natives (0.3% vs 0.5%, P=.016), and Asians (1.4% vs 1.5%, P=.002). An increased percentage of patients 55 to 80 years old received THAs (68.6% vs 74.1%, P<.001). The percentage of patients with a body mass index of 25.0 to 29.9 kg/m 2 , 30.0 to 34.9 kg/m 2 , and 35.0 to 39.9 kg/m 2 increased (32.9% vs 33.1%, 24.2% vs 25.6%, 12.6% vs 13.3%, respectively, P<.001 for all). These findings may provide insight on the changing patient characteristics for orthopedic surgeons performing THA. Furthermore, these findings may inform health policy makers interested in increasing access to procedures underutilized by specific patient populations and the creation of strategies to meet increased demand. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.

  16. Trends in smoking and obesity among US adults before, during, and after the great recession and Affordable Care Act roll-out.

    PubMed

    Pernenkil, Vikash; Wyatt, Taylor; Akinyemiju, Tomi

    2017-09-01

    This study examined trends in smoking and overweight/obesity rates among United States (US) adults ages 40years and older by race and socio-economic status (SES) across three study periods; pre-recession (2003-2005), recession (2007-2009), and post-recession/Affordable Care Act (2010-2012). Data was obtained from the Behavioral Risk Factor Surveillance System (BRFSS), and multivariable regression analysis was used to examine changes in overweight/obesity, smoking, physical activity and smoking cessation rates over the study periods. There were 2,805,957 adults included in the analysis; 65.5% of the study population was overweight/obese, and 33.3% were current smokers. Smoking prevalence increased marginally among those with lower SES (income<$10,000) from pre-recession (52.5%) to post-recession (52.9%), but declined in other socio-demographic groups. The odds of overweight/obesity increased in the post-recession (OR: 1.22, 95% CI: 1.21-1.23) and recession (OR: 1.11, 95% CI: 1.11-1.12) periods compared with pre-recession, but odds of smoking overall decreased in the post-recession (OR: 0.93, 95% CI: 0.92-0.94) and recession (OR: 0.95, 95% CI: 0.94-0.97) periods. Overweight/obesity increased over the study periods, regardless of race, SES or healthcare access, while smoking rates showed significant declines post-recession compared with pre-recession, except in low SES groups. These findings suggest that strategies focused on reducing overweight/obesity and increasing access to smoking cessation services, especially among low-income adults, are needed. Prospective studies are needed to better evaluate the influence of the economic recession and Affordable Care Act on behavioral risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Education of the Handicapped Act Amendments of 1990. Conference Report. House of Representatives, 101st Congress, 2d Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House.

    This report of the committee of conference reconciles differences in versions of bills passed by the United States Senate and the House of Representatives on a bill (S. 1824) to amend the Education of the Handicapped Act. The text of the recommended bill is presented, with the following sections: general provisions, assistance for education of all…

  18. 24 CFR 266.622 - Notice and date of termination by the Commissioner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HOUSING ACT AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Termination § 266.622 Notice and date of termination...

  19. The U.S. health insurance marketplace: are premiums truly affordable?

    PubMed

    Graetz, Ilana; Kaplan, Cameron M; Kaplan, Erin K; Bailey, James E; Waters, Teresa M

    2014-10-21

    The Patient Protection and Affordable Care Act requires that individuals have health insurance or pay a penalty. Individuals are exempt from paying this penalty if the after-subsidy cost of the least-expensive plan available to them is greater than 8% of their income. For this study, premium data for all health plans offered on the state and federal health insurance marketplaces were collected; the after-subsidy cost of premiums for the least-expensive bronze plan for every county in the United States was calculated; and variations in premium affordability by age, income, and geographic area were assessed. Results indicated that-although marketplace subsidies ensure affordable health insurance for most persons in the United States-many individuals with incomes just above the subsidy threshold will lack affordable coverage and will be exempt from the mandate. Furthermore, young individuals with low incomes often pay as much as or more than older individuals for bronze plans. If substantial numbers of younger, healthier adults choose to remain uninsured because of cost, health insurance premiums across all ages may increase over time.

  20. The Voyage of a Navigator An aspiring scholar's inside observations on the Affordable Care Act's rocky roll-out in North Carolina.

    PubMed

    Tripp, Hollie L

    2015-01-01

    North Carolina, a federally facilitated marketplace under the Affordable Care Act (ACA), stumbled in 2013 when opening its health-insurance exchange. Trouble was easy to foresee, as North Carolina had instituted a law barring any state agency from assisting enrollment in health-insurance plans made available through the ACA. Trained workers were needed to help citizens and legal immigrants "navigate" to these plans. Some of these "navigators" could be paid with federal funds, but many others had to work as volunteers. I was one of these volunteer navigators. Much went wrong in training, staffing, and operations, but much still was accomplished. Here I report observations, share assessments, and offer suggestions for similarly complex situations.