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Sample records for affordable housing act

  1. Affordable Care Act.

    PubMed

    Rak, Sofija; Coffin, Janis

    2013-01-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA), although a subject of much debate in the Unites States, was enacted on March 23, 2010, and upheld by the Supreme Court on June 28, 2012. This act advocates that "healthcare is a right, not a privilege." The main goals of PPACA are to minimize the number of uninsured Americans and make healthcare available to everyone at an affordable price. The Congressional Budget Office has determined that 94% of Americans will have healthcare coverage while staying under the $900 billion limit that President Barack Obama established by bending the healthcare cost curve and reducing the deficit over the next 10 years. PMID:23767130

  2. Smoking Bans in Affordable Housing Benefit All

    MedlinePlus

    ... 160501.html Smoking Bans in Affordable Housing Benefit All: Study Secondhand exposure lowered, and smokers more likely ... residents of eight affordable housing properties in Minnesota. All the properties prohibited smoking indoors and three also ...

  3. Energy efficient affordable housing. Final report

    SciTech Connect

    1995-07-01

    In 1994, the Southface Energy Institute, working with support from US DOE, initiated a program to provide technical assistance to nonprofit organizations developing affordable housing in the Olympic target communities of Atlanta. The specific project goals were: Identify the barriers that nonprofit affordable housing providers face in increasing the energy and resource efficiency of affordable housing; Assist them in developing the resources to overcome these barriers; Develop specific technical materials and program models that will enable these affordable housing groups to continue to improve the energy efficiency of their programs; and, To transfer the program materials to other affordable housing providers. This report summarizes the progress made in each of these areas.

  4. Section 8: Affordable Housing for Exceptional Families

    ERIC Educational Resources Information Center

    Wright, Wesley E.

    2009-01-01

    Shelter is a basic human need. Unfortunately, affordable housing is a need that low income families who are caring for children and adults with disabilities can rarely afford without assistance. Because participating families generally pay rent of no more than 30 percent of their adjusted monthly income, the Section 8 program can provide…

  5. Affordable housing: Reducing the energy cost burden

    SciTech Connect

    Lee, A.D.; Chin, R.I.; Marden, C.L.

    1995-01-01

    Residential energy expenditures are a key determinant of housing affordability, particularly for lower Income households. For years, federal, state and local governments and agencies have sought to defray energy expenses and Increase residential energy efficiency for low Income households through legislative and regulatory actions and programs. Nevertheless, household energy costs continue to place a major burden on lower Income families. This issue paper was written to help formulate national energy policy by providing the United States Department of Energy`s (DOE`s) Office of Energy Efficiency and Renewable Energy (EE) with Information to help define the affordable housing issue; Identify major drivers, key factors, and primary stakeholders shaping the affordable housing issue; and review how responding to this Issue may impact EE`s goals and objectives and Influence the strategic direction of the office. Typically, housing affordability is an Issue associated with lower income households. This issue paper adopts this perspective, but it is important to note that reducing energy utility costs can make {open_quotes}better{close_quote} housing affordable to any household regardless of income. As energy efficiency is improved throughout all sectors of the economy, special consideration must be given to low income households. Of all households, low income households are burdened the most by residential energy costs; their residences often are the least energy-efficient and have the greatest potential for efficiency improvements, but the occupants have the fewest resources to dedicate to conservation measures. This paper begins with a definition of {open_quotes}affordability{close_quotes} as it pertains to total housing costs and summarizes several key statistics related to housing affordability and energy use by lower income households.

  6. Achieving Sustainable Construction in Affordable Housing

    SciTech Connect

    Barcik, M.K.; Creech, D.B.; Ternes, M.P.

    1998-12-07

    An energy-efficient design and construction checklist and information sheets on energy-efficient design and construction are two products being developed. These products will help affordable housing providers take the first steps toward a whole-house approach to the design and implementation of energy-efficient construction practices. The checklist presents simple and clear guidance on energy improvements that can be readily addressed now by most affordable housing providers. The information sheets complement the checklist by providing installation instructions and material specifications that are accompanied by detailed graphics. The information sheets also identify benefits of recommended energy-efficiency measures and procedures including cost savings and impacts on health and comfort. This paper presents details on the checklist and information sheets and discusses their use in two affordable housing projects.

  7. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 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...

  8. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 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...

  9. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 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...

  10. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 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...

  11. 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...

  12. Electricity Security and Affordability Act

    THOMAS, 113th Congress

    Rep. Whitfield, Ed [R-KY-1

    2014-01-09

    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:

  13. Affordable Care Act and Women

    MedlinePlus

    ... Privacy Policy FOIA Plain Writing Act No Fear Act Disclaimers Viewers & Players Assistant Secretary for Planning and Evaluation, Room 415F U.S. Department of Health and Human Services 200 Independence Avenue, SW Washington, D.C. ...

  14. 24 CFR 92.254 - Qualification as affordable housing: Homeownership.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Qualification as affordable housing: Homeownership. 92.254 Section 92.254 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements § 92.254 Qualification as affordable...

  15. 24 CFR 92.254 - Qualification as affordable housing: Homeownership.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... application under 24 CFR part 597 has incorporated the type of market data described above, that submission... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Qualification as affordable housing... Qualification as affordable housing: Homeownership. (a) Acquisition with or without rehabilitation. Housing...

  16. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE...

  17. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Grants for affordable housing activities. 1006.20 Section 1006.20 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE...

  18. 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 Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  19. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  20. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  1. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  2. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  3. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  4. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  5. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  6. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  7. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Grants for affordable...

  8. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Grants for affordable...

  9. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Grants for affordable...

  10. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Grants for affordable...

  11. 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…

  12. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201 Eligible... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND...

  13. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201 Eligible... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND...

  14. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201 Eligible... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND...

  15. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201 Eligible... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development Regulations Relating to Housing and...

  16. The Affordable Care Act and orthopaedic trauma.

    PubMed

    Issar, Neil M; Jahangir, A Alex

    2014-10-01

    The Affordable Care Act has resulted in a dramatic governmental restructuring of the healthcare insurance market and delivery system. Orthopaedic traumatologists must be aware of the law's impact on their clinical practice, finances, and overall business model. This includes the effect of accountable care organizations, the Independent Payment Advisory Board, and the Physician Value-Based Payment Modifier program, as well as the impact of the Affordable Care Act's grace period provision, medical device excise tax, and cuts to funding for the Disproportionate Share Hospital program. PMID:25229683

  17. 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

  18. 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 Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...

  19. 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 Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...

  20. 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 Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...

  1. Local leadership and the Affordable Care Act.

    PubMed

    Williams, Stephen L; Nichols, Beverly L; Barton, M Katherine; De LaCruz, Maria; Hernandez, Benjamin

    2015-01-01

    Local health departments are in key positions to lead in the education and implementation efforts to advance the Patient Protection and Affordable Care Act. The first enrollment period is over, but the efforts to enroll the uninsured and advocate for expansion of Medicaid in the states that have not yet taken on this expansion will continue for years to come. Political climates may be unsupportive, but some actions may still be possible. PMID:25423062

  2. 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:

  3. The Affordable Care Act and emergency care.

    PubMed

    McClelland, Mark; Asplin, Brent; Epstein, Stephen K; Kocher, Keith Eric; Pilgrim, Randy; Pines, Jesse; Rabin, Elaine Judith; Rathlev, Niels Kumar

    2014-10-01

    The Affordable Care Act (ACA) will have far-reaching effects on the way health care is designed and delivered. Several elements of the ACA will directly affect both demand for ED care and expectations for its role in providing coordinated care. Hospitals will need to employ strategies to reduce ED crowding as the ACA expands insurance coverage. Discussions between EDs and primary care physicians about their respective roles providing acute unscheduled care would promote the goals of the ACA. PMID:25121814

  4. America's Affordable Health Choices Act of 2009

    THOMAS, 111th Congress

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

    2009-07-14

    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:

  5. 12 CFR 1282.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Insurance Fund; and (C) Subject to, and have received at least a satisfactory performance evaluation rating... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Special Affordable Housing Goal. 1282.14 Section 1282.14 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION...

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 24 CFR 92.254 - Qualification as affordable housing: Homeownership.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Zone or Enterprise Community application under 24 CFR part 597 has incorporated the type of market data... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Qualification as affordable housing: Homeownership. 92.254 Section 92.254 Housing and Urban Development Office of the Secretary, Department...

  12. Development of Basic Housing Systems for Maximum Affordability

    SciTech Connect

    Aglan, H.; Gibbons, A.; McQueen, T.M.; Morris, C.; Raines, J.; Wendt, R.L.

    1999-04-19

    The ability to provide safe, habitable, comfortable housing for very low income residents within the target budget of $10,000 presents unique design and construction challenges. However, a number of preliminary conclusions have been inferred as being important concepts relative to the study of affordable housing. The term affordable housing can have many meanings and research is needed to define this explicitly. As it is most often used, affordable housing refers to an economic relationship between the price of housing, household income and current interest rates available from a lending institution. There is no direct relationship between architectural style, construction technology or user needs and the concept of affordability. For any home to be affordable, the home owner must balance the combination of housing needs and desires within the limits of an actual budget. There are many misconceptions that affordable housing must be defined as housing for those who cannot afford the free-market price. The concept of affordable housing must also include a component that recognizes the quality of the housing as an important element of the design and construction. In addition, responses to local climate impacts are necessary and are always part of a regional expression of architectural design. By using careful planning and design it may be possible to construct a limited dwelling unit today for a sum of approximately $10,000. Since the organization of the construction process must involve the owner/occupants as well as other volunteers, the project must not only be well conceived, but well developed and coordinated.

  13. Breastfeeding and the Affordable Care Act.

    PubMed

    Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice

    2015-10-01

    Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding. PMID:26318941

  14. 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. PMID:26458377

  15. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special..., as a Special Affordable Housing Home Purchase Subgoal, 17 percent of the total number of home purchase mortgages in metropolitan areas financed by each GSE's mortgage purchases shall be home...

  16. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special..., as a Special Affordable Housing Home Purchase Subgoal, 17 percent of the total number of home purchase mortgages in metropolitan areas financed by each GSE's mortgage purchases shall be home...

  17. Housing in Los Angeles: Affordable Housing for the Future.

    ERIC Educational Resources Information Center

    Los Angeles Blue Ribbon Committee for Affordable Housing, CA.

    A 1988 mayoral committee assessed the seriousness of Los Angeles (California) housing problems and found that the city's housing efforts were sufficient in the 1960s, when the Federal Government took primary responsibility for housing and the average wage was adequate to support the cost of the average house or apartment. However, the following…

  18. DOE-HUD Initiative: Making Housing Affordable Through Energy Efficiency

    SciTech Connect

    Not Available

    1991-10-01

    A new collaborative program of the U.S. Department of Energy (DOE) and the U.S. Department of Housing and Urban Development (HUD) is a significant step toward making HUD-aided housing more comfortable and affordable through greater energy efficiency. The initiative on Energy Efficiency in Housing combines DOE's technical capabilities and HUD's experience in housing assistance. Over the next decade, the energy savings potential of this initiative is estimated to be 150 trillion Btu (0.15 quad) per year, or nearly $1.5 billion in annual energy costs.

  19. Friendly protection of houses by affordable isolation

    SciTech Connect

    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. Both 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.

  20. Affordable Energy-Efficient New Housing Solutions

    SciTech Connect

    Chandra, Subrato; Widder, Sarah H.; Bartlett, Rosemarie; McIlvaine, Janet; Chasar, David; Beal, David; Sutherland, Karen; Abbott, , K.; Fonorow, Ken; Eklund, Ken; Lubliner, Michael; Salzberg, Emily; Peeks, B.; Hewes, T.; Kosar, D.

    2012-05-31

    Since 2010, the U.S. Department of Energy’s Building America has sponsored research at PNNL to investigate cost-effective, energy-saving home-building technologies and to demonstrate how high-performance homes can deliver lower utility bills, increased comfort, and improved indoor air quality, while maintaining accessibility for low-income homeowners. PNNL and its contractors have been investigating 1) cost-effective whole-house solutions for Habitat for Humanity International (HFHI) and specific HFH affiliates in hot-humid and marine climates; 2) cost-effective energy-efficiency improvements for heating, ventilation, and air-conditioning (HVAC) systems in new, stick-built and manufactured homes; and 3) energy-efficient domestic hot-water systems.

  1. 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

  2. Air Distribution Retrofit Strategies for Affordable Housing

    SciTech Connect

    Dentz, J.; Conlin, F.; Holloway, P.; Podorson, D.; Varshney, K.

    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 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%.

  3. Air Distribution Retrofit Strategies for Affordable Housing

    SciTech Connect

    Dentz, J.; Conlin, F.; Holloway, Parker; Podorson, David; Varshney, Kapil

    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 the 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%.

  4. Housing Assistance Efficiency Act

    THOMAS, 113th Congress

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

    2013-07-23

    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:

  5. Affordable Housing Regulation Simplification Act of 2012

    THOMAS, 112th Congress

    Rep. Polis, Jared [D-CO-2

    2012-09-13

    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:

  6. Lake Hill Administrative Site Affordable Housing Act

    THOMAS, 113th Congress

    Sen. Udall, Mark [D-CO

    2013-07-16

    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:

  7. 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. PMID:26691116

  8. Homeowner Flood Insurance Affordability Act of 2013

    THOMAS, 113th Congress

    Sen. Menendez, Robert [D-NJ

    2013-10-29

    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:

  9. Assistance, Quality, and Affordability Act of 2010

    THOMAS, 111th Congress

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

    2010-05-18

    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:

  10. Keeping Flood Insurance Affordable Act of 2013

    THOMAS, 113th Congress

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

    2013-11-15

    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:

  11. "Having Housing Made Everything Else Possible": Affordable, Safe and Stable Housing for Women Survivors of Violence.

    PubMed

    Clough, Amber; Draughon, Jessica E; Njie-Carr, Veronica; Rollins, Chiquita; Glass, Nancy

    2014-09-01

    Research indicates that the need for safe housing and the economic resources to maintain safe housing are two of the most pressing concerns among abused women who are planning to or have recently left abusers. Intimate partner violence (IPV) is frequently an immediate cause or precursor to homelessness and housing instability. The aim of the study is to explore abused women's experiences accessing affordable, safe, and stable housing. To achieve the aim, adult female IPV survivors answered questions about: 1) steps that were taken to secure housing; 2) safety issues after leaving the abuser; 3) barriers to obtaining housing; and 4) responses from housing and domestic violence advocacy systems related to survivors' housing needs. Four major themes emerged from the in-depth interviews: 1) stable, affordable housing is critical in increasing safety; 2) survivors face multiple systemic or individual barriers; 3) survivors develop and utilize an array of creative and resourceful strategies; and 4) survivors identified a variety of supportive services tailored to address their needs. The findings inform practice, policy and research for both the housing and domestic violence service systems with an emphasis on collaboration to meet the complex safety and stable housing needs of survivors and their families, particularly following the impact on housing of the 2008 U.S. economic crisis and subsequent recession. PMID:25328440

  12. Labour mobility and housing: the impact of housing tenure and housing affordability on labour migration in the Czech Republic.

    PubMed

    Lux, Martin; Sunega, Petr

    2012-01-01

    This article examines whether housing tenure and regional differences in housing affordability have an impact on labour mobility. This relationship is important for understanding the sources of structural unemployment and impediments to economic growth. Using two sample surveys from the Czech Republic, this research reveals that at the individual level housing tenure is the most powerful factor determining willingness to change residence for employment reasons. A time-series regression analysis reveals that the impact of housing affordability on observed interregional migration patterns is relatively weak and that this effect is concentrated among the highly educated seeking employment in the capital, Prague. These results demonstrate that housing tenure has a significant impact on labour migration plans in case of unemployment and that the dynamic impact of regional differences in housing affordability on labour mobility is concentrated within the most highly skilled segment of the labour force. PMID:22500343

  13. 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.

  14. Reform Americans Can Afford Act of 2010

    THOMAS, 111th Congress

    Rep. Herger, Wally [R-CA-2

    2010-05-27

    08/10/2010 Motion to Discharge Committee filed by Mr. Herger. Petition No: 111-12. (Discharge petition text with signatures.) (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:

  15. 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.

  16. Affordable housing through energy efficiency: The Northgate story

    SciTech Connect

    Diamond, R.C.; McAllister, J.A.; Feustel, H.E.; Patullo, C.; Buckley, T.

    1992-03-01

    In this paper we evaluate a comprehensive retrofit and rehabilitation effort to improve the comfort, affordability, and energy efficiency of 336 low-income housing units. The units had complete shell retrofits, including new siding, air-infiltration barriers, new windows and doors, and both roof and foundation insulation. In addition, the existing electric-baseboard heating system was replaced with a new gas-fired boiler for each apartment. New programmable thermostats, refrigerators, and tenant education were also included in the retrofit package. The evaluation of the project included pre- and post-retrofit utility bill analysis, computer simulation to evaluate the cost and saving of the individual measures, and a comprehensive survey of the residents regarding their comfort, behavior, and satisfaction with the retrofits. The analysis has shown energy savings of more than 20% for the shell measures, with a reduction in utility bills of nearly 50% from the combined measures. The resident survey shows high tenant satisfaction with the retrofits.

  17. Affording Housing at the Expense of Health: Exploring the Housing and Neighborhood Strategies of Poor Families

    PubMed Central

    Hernández, Diana

    2016-01-01

    Low-income families often simultaneously encounter housing and neighborhood problems pertaining to safety, affordability, and quality issues that necessitate strategies to maximize limited budgets and ensure safety. Such constrained decisions regarding inadequate housing and poor neighborhood conditions, however, may themselves create or exacerbate health risks. Building on the survival strategies literature, this article offers rich and detailed accounts of coping and management strategies on the part of vulnerable families facing housing and neighborhood hardships. The findings are based on in-depth interviews with 72 respondents and ethnographic observations in an urban community. The results illustrate how low-income women avoid neighborhood danger by relegating family life to the home environment, thereby increasing exposure to health risks such as stress, depression, and asthma. The discussion focuses on public health literature linking housing and health and proposes the use of legal strategies and community engagement as resources to complement current approaches to housing and neighborhood problems. PMID:27057078

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

    SciTech Connect

    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 in 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.

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

    DOE PAGESBeta

    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

  20. 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…

  1. Voters and the Affordable Care Act in the 2014 election.

    PubMed

    Blendon, Robert J; Benson, John M

    2014-11-13

    In this analysis of data from 27 public opinion polls, the authors examine the role of the Affordable Care Act in the 2014 congressional elections. The outcome of the elections is likely to influence implementation of the ACA and future U.S. health care policy. PMID:25353968

  2. 77 FR 33133 - Patient Protection and Affordable Care Act; Data Collection To Support Standards Related to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... HUMAN SERVICES 45 CFR Part 156 RIN 0938-AR36 Patient Protection and Affordable Care Act; Data Collection... the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of... Services (the Secretary). The Affordable Care Act directs that the EHB reflect the scope of...

  3. 76 FR 20354 - Notice of Intent To Award Supplemental Affordable Care Act Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... Affordable Care Act Funding Notice of Intent to award supplemental Affordable Care Act funding to support...: Notice. SUMMARY: This notice provides public announcement of CDC's intent to use Affordable Care Act (ACA....'' Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Title IV, Section...

  4. 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

  5. 24 CFR 1000.104 - What families are eligible for affordable housing activities?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false What families are eligible for affordable housing activities? 1000.104 Section 1000.104 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND...

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

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false What families are eligible for affordable housing activities? 1000.104 Section 1000.104 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND...

  7. 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;…

  8. 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

    ... URBAN DEVELOPMENT 60-Day Notice of Proposed Information Collection: Innovation in Affordable Housing...: Innovation in Affordable Housing Design Student Competition. OMB Approval Number: N/A. Type of Request: New. Form Number: N/A. Description of the need for the information and proposed use: The Innovation...

  9. The Affordable Care Act: Opportunities and Challenges for Physicians.

    PubMed

    Chen, Min

    2015-11-01

    The Affordable Care Act (ACA) will affect many aspects of health care across the nation, presenting both opportunities and challenges. Physicians who have a solid understanding of the recent industry trends and the role they will be playing in the post-ACA world will be able to better adapt to the new environment. This article analyzes the implications of the health care reform for physicians and offers recommendations on how to turn challenges into opportunities. PMID:26501969

  10. Clinical Preventive Services Coverage and the Affordable Care Act

    PubMed Central

    Fox, Jared B.; Shaw, Frederic E.

    2016-01-01

    The Affordable Care Act requires many health plans to provide coverage for certain recommended clinical preventive services without charging copays or deductible payments. This provision could lead to greater uptake of many services that can improve health and save lives. Although the coverage provision is broad, there are many caveats that also apply. It is important for providers and public health professionals to understand the nuances of the coverage rules to help maximize their potential to improve population health. PMID:25393173

  11. Issaquah Highlands Zero Energy Affordable Housing (WA) - YWCA

    SciTech Connect

    Tom, Vincent; DeRobbio, Wendy; Hall, Linda

    2012-04-30

    The YWCA Family Village at Issaquah, Net Zero Energy Approach Project provides a compelling model for how the nation can seriously respond to the critical need for affordable housing while advancing environmental standards and reducing economic inequities. Affordable housing developments for vulnerable members of the community and in today's workforce cannot overlook issues, such as climate impact, energy security and water conservation. This project's advanced building design was based on the goal of creating a 100 year building that could achieve net zero energy usage if funding had been available to support the final pieces of energy generation. The team worked closely with community stakeholders to ensure the baseline components of high quality and efficient building envelopes along with efficient systems were in place to set the stage for future incorporation of energy generating systems such as solar panels. As built, these 146 homes, large child care center and community services areas are proving the value of investing upfront for the benefit of future generations by reducing ongoing utility and maintenance costs with an eye toward environmental stewardship and community/resident education. The DOE award helped fund two critical energy conservation features for the YWCA Family Village at Issaquah campus: 1) super-insulated roof assembly with a continuous air barrier and 2) domestic hot water preheat system. The roof system at the YWCA Family Village at Issaquah project was built to include 6" of Polyiso rigid insulation (R-38) on top of the roof sheathing to provide a super-insulated roof in line with the other green features of the project. Placing the rigid insulation on top of the roof sheathing allows the building to have a continuous layer of insulation and provides a continuous air barrier. The domestic hot water preheat system includes flat panel arrays on roofs of the buildings that heat the water using solar power, which reduces the amount of

  12. Chamberlain Heights Redevelopment: A Large Scale, Cold Climate Study of Affordable Housing Retrofits

    SciTech Connect

    Donnelly, K.; Mahle, M.

    2012-03-01

    The City of Meriden Housing Authority (MHA) collaborated with affordable housing developer Jonathon Rose Companies (JRC) to complete a gut renovation of 124 residential units in the Chamberlain Heights retrofit project. The affordable housing community is made up of 36 buildings in duplex and quad configurations located on 22 acres within two miles of downtown Meriden, CT. The final post-retrofit analysis showed 40-45% source energy savings over the existing pre-retrofit conditions.

  13. 24 CFR 1000.240 - When is a local cooperation agreement required for 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 When is a local cooperation... ACTIVITIES Indian Housing Plan (IHP) § 1000.240 When is a local cooperation agreement required for affordable housing activities? The requirement for a local cooperation agreement applies only to rental and...

  14. 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... 2010 and 2011, the goal for each Enterprise's purchases of mortgages on multifamily residential housing... low-income housing subgoal. For the years 2010 and 2011, the subgoal for each Enterprise's...

  15. 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. PMID:26124300

  16. 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. PMID:25316210

  17. Behavioral health parity and the Affordable Care Act.

    PubMed

    Frank, Richard G; Beronio, Kirsten; Glied, Sherry A

    2014-01-01

    Prior to the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Patient Protection and Affordable Care Act (ACA), about 49 million Americans were uninsured. Among those with employer-sponsored health insurance, 2% had coverage that entirely excluded mental health benefits and 7% had coverage that entirely excluded substance use treatment benefits. The rates of noncoverage for mental and substance use disorder care in the individual health insurance markets are considerably higher. Private health insurance generally limits the extent of these benefits. The combination of MHPEA and ACA extended overall health insurance coverage to more people and expanded the scope of coverage to include mental health and substance abuse benefits. PMID:24483783

  18. The Affordable Care Act, remedy, and litigation reform.

    PubMed

    Maher, Brendan S

    2014-01-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) rewrote the law of private health insurance. How the ACA rewrote the law of civil remedies, however, is a question largely unexamined by scholars. Courts everywhere, including the U.S. Supreme Court, will soon confront this important issue. This Article offers a foundational treatment of the ACA on remedy. It predicts a series of flashpoints over which litigation reform battles will be fought. It identifies several themes that will animate those conflicts and trigger others. It explains how judicial construction of the statute's functional predecessor, the Employee Retirement Income Security Act of 1974 (ERISA), converted a protective statute into a uniquely effective piece of federal litigation reform. Ultimately, it considers whether the ACA--which incorporates, modifies, and rejects ERISA in several notable ways--will experience a similar fate. PMID:25335202

  19. 77 FR 31513 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... HUMAN SERVICES 45 CFR Parts 155, 156, and 157 RIN 0938-AQ67 Patient Protection and Affordable Care Act... Federal Register on March 27, 2012, entitled ``Patient Protection and Affordable Care Act; Establishment... rule regarding the codification of section 1413(c) of the Affordable Care Act. To align the...

  20. 77 FR 70643 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial Value, and... Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits, Actuarial... Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation...

  1. 76 FR 59702 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... Services (HHS). ACTION: Notice. Overview Information Notice of Intent to Award Affordable Care Act (ACA...: This notice provides public announcement of CDC's intent to award Affordable Care Act...

  2. 77 FR 19750 - Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy; Small... of consideration. ADDRESSES: Direct all written comments to Office of Domestic Finance, Small... be directed to the Office of Domestic Finance, Small Business Lending Fund; Daniel Rourke;...

  3. 77 FR 42831 - Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TREASURY Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy; Small... INFORMATION CONTACT: Requests for additional information should be directed to the Office of Domestic...

  4. 24 CFR 954.307 - Homeownership: qualification as affordable housing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... with 24 CFR 203.18b; and (ii) Has an estimated appraised value at acquisition, if standard, or after... appealed in accordance with 24 CFR 203.18b; and (2) The housing is the principal residence of an owner... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Homeownership: qualification...

  5. 75 FR 70160 - Affordable Care Act; Federal External Review Process; Request for Information

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... provisions of PHS Act section 2719 on July 23, 2010, at 75 FR 43330. Section 2719(b)(1) of the PHS Act and... Administration 29 CFR Part 2590 Affordable Care Act; Federal External Review Process; Request for Information... Act, as amended by the Affordable Care Act, and its implementing regulations. DATES: Submit written...

  6. Are Americans finding affordable coverage in the health insurance marketplaces? Results from the Commonwealth Fund Affordable Care Act Tracking Survey.

    PubMed

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

    2014-09-01

    By the end of the first open enrollment period for coverage offered through the Affordable Care Act's marketplaces, increasing numbers of people said they found it easy to find a plan they could afford, according to The Commonwealth Fund's Affordable Care Act Tracking Survey, April-June 2014. Adults with low or moderate incomes were more likely to say it was easy to find an affordable plan than were adults with higher incomes. Adults with low or moderate incomes who purchased a plan through the marketplaces this year have similar premium costs and deductibles as adults in the same income ranges with employer-provided coverage. A majority of adults with marketplace coverage gave high ratings to their insurance and were confident in their ability to afford the care they need when sick. PMID:25265646

  7. 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...

  8. “Having Housing Made Everything Else Possible”: Affordable, Safe and Stable Housing for Women Survivors of Violence

    PubMed Central

    Clough, Amber; Draughon, Jessica E.; Njie-Carr, Veronica; Rollins, Chiquita; Glass, Nancy

    2013-01-01

    Research indicates that the need for safe housing and the economic resources to maintain safe housing are two of the most pressing concerns among abused women who are planning to or have recently left abusers. Intimate partner violence (IPV) is frequently an immediate cause or precursor to homelessness and housing instability. The aim of the study is to explore abused women’s experiences accessing affordable, safe, and stable housing. To achieve the aim, adult female IPV survivors answered questions about: 1) steps that were taken to secure housing; 2) safety issues after leaving the abuser; 3) barriers to obtaining housing; and 4) responses from housing and domestic violence advocacy systems related to survivors’ housing needs. Four major themes emerged from the in-depth interviews: 1) stable, affordable housing is critical in increasing safety; 2) survivors face multiple systemic or individual barriers; 3) survivors develop and utilize an array of creative and resourceful strategies; and 4) survivors identified a variety of supportive services tailored to address their needs. The findings inform practice, policy and research for both the housing and domestic violence service systems with an emphasis on collaboration to meet the complex safety and stable housing needs of survivors and their families, particularly following the impact on housing of the 2008 U.S. economic crisis and subsequent recession. PMID:25328440

  9. THE AFFORDABLE CARE ACT: A HIDDEN JOBS KILLER?

    PubMed

    Baker, Dean; Jorgensen, Helene

    2015-01-01

    Many opponents of the Affordable Care Act (ACA) predicted the law would hurt employment. A common complaint was that the requirement that firms employing more than 50 employees either provide insurance for employees working more than 30 hours a week or pay a penalty would lead many firms to cut back workers' hours to just below the 30-hour cutoff. This article uses the Current Population Survey to compare the share of workers employed between 25-29 hours in the first four months of 2013 with the same months of 2012. While the Obama administration subsequently delayed the application of this portion of the ACA, at the time larger employers would have expected to be subject to the insurance requirement. The analysis found the share of employment in this hour band was slightly lower in 2013 than in 2012. PMID:26460453

  10. How Insurers Competed in the Affordable Care Act's First Year.

    PubMed

    Swartz, Katherine; Hall, Mark A; Jost, Timothy S

    2015-06-01

    Prior to the Affordable Care Act (ACA), most states' individual health insurance markets were dominated by one or two insurance carriers that had little incentive to compete by providing efficient services. Instead, they competed mainly by screening and selecting people based on their risk of incurring high medical costs. One of the ACA's goals is to encourage carriers to participate in the health insurance marketplaces and to shift the focus from competing based on risk selection to processes that increase consumer value, like improving efficiency of services and quality of care. Focusing on six states--Arkansas, California, Connecticut, Maryland, Montana, and Texas--this brief looks at how carriers are competing in the new marketplaces, namely through cost-sharing and composition of provider networks. PMID:26159009

  11. Medical loss ratio regulation under the Affordable Care Act.

    PubMed

    Harrington, Scott E

    2013-01-01

    The minimum medical loss ratio (MLR) regulations in the Affordable Care Act guarantee that a specific percentage of health insurance premiums is spent on medical care and specified activities to improve health care quality. This paper analyzes the regulations' potential unintended consequences and incentive effects, including: higher medical costs and premiums for some insurers; less innovation to align consumer, provider, and health plan incentives, less consumer choice and increased market concentration; and the risk that insurers will pay rebates if claim costs are lower than projected when premiums are established, despite the regulations' permitted "credibility adjustments." The paper discusses modifications and alternatives to the MLR regulations to help achieve their stated goals with less potential for adverse effects. PMID:23720876

  12. Local Perspectives on Rural Housing Affordability and Implications for the Localism Agenda in England

    ERIC Educational Resources Information Center

    Gallent, Nick; Robinson, Steve

    2011-01-01

    Drawing on consultation meetings with eight community groups across rural England, this paper examines local perspectives on housing affordability, and the consequences of low levels of "within area" housing access for rural economies and communities, contrasting the reflective understanding of residents with normative and established perspectives…

  13. 77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... Medicaid eligibility changes under the Affordable Care Act (listed in more detail in 76 FR 51155) and... Services 42 CFR Parts 431, 435 and 457 Medicaid Program; Eligibility Changes Under the Affordable Care Act... Parts 431, 435, and 457 RIN 0938-AQ62 Medicaid Program; Eligiblity Changes Under the Affordable Care...

  14. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable 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...

  15. 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

  16. 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. PMID:26809161

  17. 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

  18. The Affordable Care Act: implications for cardiothoracic surgery.

    PubMed

    Ferguson, T Bruce; Babb, Joseph A

    2013-01-01

    The Affordable Care Act legislation that was passed by the US Congress and signed into law by President Obama on March 23, 2010 is having a substantial effect throughout all of health care in the United States. Cardiothoracic surgeons, as hospital-based procedural specialists, bring unique assets and certain important liabilities into this massive restructuring of our health care delivery system. This article highlights how each of the 10 titles in the Obamacare legislation might affect our specialty; its collaborative relationship with our cardiovascular, medical specialty, and primary care colleagues; and our clinical practice roles and responsibilities in accountable care organizations and primary care medical homes. This article also addresses the unique assets in clinical data in medicine and quality improvement demonstrated by our specialty that have been used to help shape the current and future landscape. Finally, key resources are identified to allow the cardiothoracic community to monitor the ongoing progress of Obamacare as implementation begins. Keeping abreast of these rapidly changing developments will be an important role for our specialty societies and for practitioners alike going forward. PMID:24673956

  19. 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. PMID:24687292

  20. 78 FR 15553 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-11

    ... Care Act; Establishment of Exchanges and Qualified Health Plans; Proposed Rule, 76 FR 41866 (July 15...) Requirements Under the Patient Protection and Affordable Care Act; Interim Final Rule, 75 FR 74864, 74918-20... of the Patient Protection and Affordable Care Act and the Health Care and Education...

  1. 76 FR 20352 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act (ACA) Funding Notice of Intent to award Affordable Care Act (ACA) funding to two Emerging Infections... Care Act (ACA) appropriations to the Connecticut Department of Public Health and the Georgia...

  2. 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...

  3. 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... 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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

  8. Preparedness of Americans for the Affordable Care Act

    PubMed Central

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

    2014-01-01

    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. PMID:24706843

  9. 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. PMID:25364625

  10. 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

    ... rehabilitation of affordable housing and homebuyer assistance) and model activities. Acquisition includes assistance to a family to buy housing. Units with the same number of bedrooms must be comparable with...

  11. 24 CFR 1000.156 - Is affordable housing developed, acquired, or assisted under the IHBG program subject to...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... rehabilitation of affordable housing and homebuyer assistance) and model activities. Acquisition includes assistance to a family to buy housing. Units with the same number of bedrooms must be comparable with...

  12. 24 CFR 1000.156 - Is affordable housing developed, acquired, or assisted under the IHBG program subject to...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... rehabilitation of affordable housing and homebuyer assistance) and model activities. Acquisition includes assistance to a family to buy housing. Units with the same number of bedrooms must be comparable with...

  13. 24 CFR 1000.156 - Is affordable housing developed, acquired, or assisted under the IHBG program subject to...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... rehabilitation of affordable housing and homebuyer assistance) and model activities. Acquisition includes assistance to a family to buy housing. Units with the same number of bedrooms must be comparable with...

  14. 12 CFR 1282.13 - Multifamily special affordable housing goal and subgoal.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Multifamily special affordable housing goal and... least 215,000 such dwelling units. (3) For the year 2014, the goal for each Enterprise's purchases of... dwelling units. (3) For the year 2014, the subgoal for each Enterprise's purchases of mortgages...

  15. 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

    ... Care Act Funding, DP-09-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Centers (U48).'' It is the intent of CDC to fund the applications with Patient Protection Affordable Care... 4002 of the Patient Protection and Affordable Care Act (Pub. L. 111-148.). DATES: The effective...

  16. Why do so many Americans oppose the Affordable Care Act?

    PubMed

    Dalen, James E; Waterbrook, Keith; Alpert, Joseph S

    2015-08-01

    The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congressmen, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it. Polls have consistently shown that it is supported by <50% of Americans. The most important goal of the ACA is to improve the health of Americans by increasing the number covered by health insurance. In the first year of its implementation, more than 10 million citizens gained health insurance. The percentage of Americans without health insurance decreased from 18% in July 2013 to 13.4% in June 2014. In addition, the ACA has eliminated many of the negative features of private insurance such as the denial of coverage for those with "prior conditions." The benefits of Medicare have been enhanced to decrease the cost of prescription drugs and to eliminate co-pays for preventive services. Despite these positive changes, a near majority of Americans still oppose the ACA, even though they approve of most of its features. They oppose the mandate that all Americans must have health insurance (the individual mandate), and they oppose a government role in health care. Yet Medicare, a mandatory insurance for seniors administered by the federal government since 1965, is overwhelmingly approved by the American public. The opposition to a government role in health care is based on the fact that that the vast majority of our citizens do not trust their government. Republicans are much less trusting of the federal government and much less supportive of a government role in health care than Democrats. The overwhelmingly negative TV ads against the ACA by the Republican candidates in the elections of 2012 and 2014 have had a major impact on Americans' views of the ACA. More than 60% of Americans have stated that most of what they know about the ACA came from watching TV. Opposition to a government role in health care

  17. 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

    ... 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 Section 1000.156 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY...

  18. 24 CFR 1000.40 - Do lead-based paint poisoning prevention requirements apply to affordable housing activities...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Do lead-based paint poisoning prevention requirements apply to affordable housing activities under NAHASDA? 1000.40 Section 1000.40 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND...

  19. 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

    ...). (a) Treatment under sections 42(i) and 42(b). A below market loan funded in whole or in part with... reason of the Affordable Housing Program funds, a below market Federal loan as defined in section 42(i)(2... Treatment of buildings financed with proceeds from a loan under an Affordable Housing Program...

  20. 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

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

    PubMed

    McConnell, Eileen Diaz

    2013-09-01

    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

  2. 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.

  3. 24 CFR 954.306 - Rental housing: qualification as affordable housing and income targeting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of family participation under 24 CFR part 882 (rental certificate program) or a rental voucher under 24 CFR part 887 (rental voucher program) or to the holder of a comparable document evidencing... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Rental housing: qualification...

  4. Evaluation of Affordable Prototype Houses at Two Levels of Energy Efficiency

    SciTech Connect

    Hendron, R.; Barker, G.; Hancock, E.; Reeves, P.

    2006-10-01

    Two high performance prototype houses were built in Carbondale, Colorado, as part of the U.S. Department of Energy's Building America (BA) Program. Each prototype was a 1256 ft2 (117 m2), 1-story, 3-bedroom house, and met the local requirements for affordable housing. The National Renewable Energy Laboratory (NREL) performed short-term field testing and DOE-2.2 simulations in support of this project at the end of December 2004. We also installed long-term monitoring equipment in one of the houses, and are currently tracking the performance of key building systems under occupied conditions. One of the houses (designated H1) included a package of cost-effective energy efficiency features that placed it well above the Energy Star level, targeting a Home Energy Rating System (HERS) score of 88-89. The other (designated H2) was a BA research house, targeting a HERS score of 94-95, and 45% whole-house energy savings compared to the BA Benchmark. Preliminary results from the field evaluation indicate that the energy savings for both houses will exceed the design targets established for the project, although the performance of certain building systems, including the ventilation and foundation systems, leave some room for improvement.

  5. 24 CFR 92.252 - Qualification as affordable housing: Rental housing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... market rent for existing housing for comparable units in the area as established by HUD under 24 CFR 888... are not required to pay as rent an amount that exceeds the market rent for comparable,...

  6. Predictors of Smoke-Free Policies in Affordable Multiunit Housing, North Carolina, 2013

    PubMed Central

    Suttie, Janet; Baker, Laura; Agans, Robert; Xue, Wei; Bowling, J. Michael

    2015-01-01

    Introduction Smoke-free policies can effectively protect nonsmokers from secondhand smoke (SHS) exposure in multiunit housing. We surveyed all affordable multiunit housing properties in North Carolina to determine the statewide prevalence of smoke-free policies and to identify predictors of smoke-free policies. Methods Representatives of affordable housing properties in North Carolina completed a mailed or online survey during June through October 2013. The primary outcome measure was presence of a smoke-free policy, defined as prohibiting smoking in all residential units. We used χ2 analysis and multivariate logistic regression to identify correlates of smoke-free policies. Results Of 1,865 eligible properties, responses were received for 1,063 (57%). A total of 16.5% of properties had policies that prohibited smoking in all residential units, while 69.6% prohibited smoking in indoor common areas. In multivariate analysis, an increase in the number of children per unit was associated with a decrease in the odds of having a smoke-free policy at most properties. Newer properties across all company sizes were more likely to have smoke-free policies. Accessing units from interior hallways predicted smoke-free policies among medium-sized companies. Conclusion More smoke-free policies in affordable multiunit housing are needed to protect vulnerable populations, particularly children, from SHS exposure. Public health professionals should continue to educate housing operators about SHS and the benefits of smoke-free policies at all properties, including older ones and ones where units are accessed from outside rather than from an interior hallway. PMID:25974143

  7. 78 FR 75581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-12

    ... MANAGEMENT Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the... Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges... Act of 2008; Technical Amendment to External Review for Multi-State Plan Program'' (78 FR 68240)....

  8. 78 FR 18246 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... MANAGEMENT 45 CFR Part 800 RIN 3206-AM47 Patient Protection and Affordable Care Act; Establishment of the..., entitled ``Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for... defined in section 1402(b) of the Affordable Care Act.'' 8. On Web page 15568, in the third column,...

  9. 76 FR 41501 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH09-907

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... intent to award Affordable Care Act (ACA) appropriations to the following 7 grantees: Colorado, Iowa.... Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Section 4002 [42 U.S.C....

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

    THOMAS, 111th Congress

    Rep. King, Steve [R-IA-5

    2010-03-25

    06/16/2010 Motion to Discharge Committee filed by Mr. King (IA). Petition No: 111-11. (Discharge petition text with signatures.) (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:

  11. 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. PMID:23991479

  12. 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

    ... Care Act; Health Insurance Market Rules; Rate Review'' (77 FR 70584). These standards apply to health... Essential Health Benefits, Actuarial Value, and Accreditation'' (77 FR 70644), herein referred to as the EHB.... Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review; Final Rule...

  13. 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? PMID:24305849

  14. 78 FR 25591 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-02

    ... MANAGEMENT 45 CFR Part 800 RIN 3206-AM47 Patient Protection and Affordable Care Act; Establishment of the... Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable... 11, 2013 (78 FR 15560) and the final rule correction published March 26, 2013 (78 FR 18246)...

  15. 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. PMID:25735057

  16. New Whole-House Solutions Case Study: Affordable Cold Climate Infill Housing with Hybrid Insulation Approach, Wyandotte, Michigan

    SciTech Connect

    2013-11-01

    Even builders who are relatively new to energy-efficient construction can consistently reach a target whole house airtightness of 1.5 air changes per hour at 50 Pascals (ACH50) with high R-value enclosures that use a hybrid insulation approach. In 2010, the City of Wyandotte, Michigan, started construction to build affordable, energy-efficient homes on lots in existing neighborhoods. A goal was to engage local builders in energy-efficient construction and be able to deliver the new houses for less than $100/ft2. By the end of 2012, approximately 25 new houses were built by five local builders under this program. To help builders consistently achieve the airtightness target, a local architect worked with researchers from Building Science Corporation, a Building America team, to develop a technology specification with several key pieces. A high R-value wall and roof assembly made use of 2 ×6 advanced framing and a hybrid insulation approach that included insulating sheathing to control thermal bridging and closed cell spray polyurethane foam insulation (ccSPF) for its airtightness and vapor control benefits. This approach allows the air barrier to be completed and tested before any finishing work occurs, ensuring that problems are spotted and corrected early in the construction process.

  17. 75 FR 9033 - 2010-2011 Enterprise Affordable Housing Goals; Enterprise Book-Entry Procedures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-26

    ...\\ See 74 FR 39873 (Aug. 10, 2009). The Safety and Soundness Act, as amended by HERA, requires the... continuing in effect for 2004), and in the 2004 housing goals rule for 2005-08. \\13\\ See 58 FR 53048 (Oct. 13, 1993) and 58 FR 53072 (Oct. 13, 1993). \\14\\ See 60 FR 61846 (Dec. 1, 1995). \\15\\ See 65 FR 65044...

  18. 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. PMID:26318953

  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. PMID:26447910

  20. 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

  1. Affordable Cold Climate Infill Housing with Hybrid Insulation Approach, Wyandotte, Michigan (Fact Sheet)

    SciTech Connect

    Metzger, C.; Lukachko, A.; Grin, A.; Bergey, D.

    2013-11-01

    Even builders who are relatively new to energy-efficient construction can consistently reach a target whole house airtightness of 1.5 air changes per hour at 50 Pascals (ACH50) with high R-value enclosures that use a hybrid insulation approach. The City of Wyandotte, Michigan, started a construction program in 2010 to build affordable, energy-efficient homes on lots in existing neighborhoods. A goal of the program was to engage local builders in energy-efficient construction and be able to deliver the new houses for less than $100/ft2. By the end of 2012, approximately 25 new houses were built by five local builders under this program. To help builders consistently achieve the airtightness target, a local architect worked with researchers from Building Science Corporation, a U.S. Department of Energy Building America team, to develop a technology specification with several key pieces. A high R-value wall and roof assembly made use of 2 ?6 advanced framing and a hybrid insulation approach that included insulating sheathing to control thermal bridging and closed cell spray polyurethane foam insulation (ccSPF) for its airtightness and vapor control benefits. This approach allows the air barrier to be completed and tested before any finishing work occurs, ensuring that problems are spotted and corrected early in the construction process.

  2. 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. PMID:26910926

  3. Energy Efficiency in Housing Act of 2009

    THOMAS, 111th Congress

    Sen. Whitehouse, Sheldon [D-RI

    2009-06-25

    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. Health Care Disparities in the Post–Affordable Care Act Era

    PubMed Central

    Preston, Michael A.; Gonzales, Gilbert

    2015-01-01

    Disparities in health care have been targeted for elimination by federal agencies and professional organizations, including the American Public Health Association. Although the Affordable Care Act (ACA) provides a valuable first step in reducing the disparities gap, progress is contingent upon whether opportunities in the ACA help or hinder populations at risk for impaired health and limited access to medical care. PMID:25879149

  5. 78 FR 76212 - Patient Protection and Affordable Care Act; Maximizing January 1, 2014 Coverage Opportunities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ...; Exchange Standards for Employers (77 FR 18310),\\1\\ hereinafter referred to as the Exchange Establishment...; Exchange Standards for Employers, 77 FR 18310 (March 27, 2012). \\2\\ Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review, 78 FR 13406 (February 27, 2013), hereinafter...

  6. 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…

  7. 76 FR 51147 - Medicaid Program; Eligibility Changes Under the Affordable Care Act of 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... Register (76 FR 41866) (``Patient Protection and Affordable Care Act; Establishment of Exchanges and... August 3, 2010 Federal Register (75 FR 45584). Second, Initial Guidance to States on Exchanges was... process for waivers for State innovation was published in the March 14, 2011 Federal Register (76 FR...

  8. 77 FR 4564 - Request for Information Regarding the Reinsurance Program Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-30

    ..., 2011 (76 FR 41930). The Affordable Care Act instructs each State to establish or contract with an.... ACTION: Request for information. SUMMARY: This notice is a request for information (RFI) to gain market information on entities that could administer a transitional reinsurance program. This RFI will inform one...

  9. 78 FR 65045 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... Programs, and Market Standards'' (78 FR 37032), which was published in the Federal Register on June 19... Federal Register on March 11, 2013 (78 FR 15541), related to risk corridors and cost-sharing reduction..., 77 FR 18310 (March 27, 2012). \\2\\ Patient Protection and Affordable Care Act; Standards Related...

  10. 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…

  11. 77 FR 28790 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... Patient Protection and Affordable Care Act (75 FR 34538) published on June 17, 2010, it was estimated that... on May 5, 2010 (75 FR 24470) relating to the Federal health care reform insurance Web Portal... Federal Register on April 14, 2010 (75 FR 19297). On December 1, 2010, the Department of Health and...

  12. 78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... published in the Federal Register on Wednesday, February 6, 2013 (77 FR 8456). The proposed rules propose... of Publication Accordingly, the proposed rules (REG-120391-10), that was the subject of FR Doc. 2013... Affordable Care Act; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correction...

  13. 77 FR 17219 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... and the RFC, where relevant. On July 15, 2011, we published in the Federal Register (76 FR 41950-41956... Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment; Final Rule #0;#0...; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment AGENCY: Department of Health and...

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

    SciTech Connect

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

    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 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.

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

    SciTech Connect

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

    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. 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.

  16. Affordable High-Performance Homes: The 2002 NREL Denver Habitat for Humanity House, A Cold-Climate Case Study

    SciTech Connect

    Norton, P.; Stafford, B.; Carpenter, B.; Hancock, C. E.; Barker, G.; Reeves, P.; Kriescher, P.

    2005-04-01

    A trend towards ''green'' building with a focus on energy efficiency is sweeping the United States homebuilding industry. An integrated systems-design approach leads to homes that are more efficient, more comfortable, more affordable, and more durable than homes built with standard practices. Habitat for Humanity affiliates throughout the country are taking the lead on this approach to home building for affordable housing. This approach supports Habitat's goals of supplying quality housing and reducing the energy cost burden on families in Habitat homes--goals that are especially important in these days of increasing energy costs.

  17. Vulnerable Veterans Housing Reform Act of 2013

    THOMAS, 113th Congress

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

    2013-04-25

    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:

  18. Vulnerable Veterans Housing Reform Act of 2012

    THOMAS, 112th Congress

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

    2012-09-10

    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:

  19. 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. PMID:25926418

  20. 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

  1. How Do Children Perceive and Act on Dynamic Affordances in Crossing Traffic-Filled Roads?

    PubMed Central

    Plumert, Jodie M.; Kearney, Joseph K.

    2014-01-01

    Successfully perceiving and acting on dynamic affordances is critical for children and adults to function. In our work, we look at how children cross roads as a model for understanding how they learn to perceive and act on dynamic affordances. Ten- to 14-year-old children and adults ride an interactive bicycling simulator through an immersive virtual environment where they cross intersections with continuous cross traffic. We consistently find developmental and individual differences in children’s ability to tightly time their entry into the roadway relative to the lead car in the gap. Given that children do not adjust their gap choices to match their less precise timing abilities, children take more risks when crossing roads than adults. We conclude by discussing possible reasons for these developmental differences in movement timing. PMID:25530798

  2. 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. PMID:25068882

  3. 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. PMID:23903938

  4. 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. PMID:26173301

  5. Kaupuni Village: A Closer Look at the First Net-Zero Energy Affordable Housing Community in Hawai'i (Brochure)

    SciTech Connect

    Not Available

    2012-05-01

    This is the first of four Hawaii Clean Energy Initiative community brochures focused on HCEI success stories. This brochure focuses on the first LEED Platinum net-zero energy affordable housing community in Hawaii. Our lead NREL contact for HCEI is Ken Kelly.

  6. 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

  7. 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. PMID:23714567

  8. 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. PMID:25557569

  9. 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

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

    PubMed

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

    2015-12-01

    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

  11. Clearing the Air: Smoke-Free Housing Policies, Smoking, and Secondhand Smoke Exposure Among Affordable Housing Residents in Minnesota, 2014–2015

    PubMed Central

    Reckinger, Dawn

    2016-01-01

    Introduction During the past 30 years, local and state tobacco use control laws in the United States have helped reduce smoking prevalence and exposure to secondhand smoke, but progress among low socioeconomic populations has been slow. Implementing smoke-free housing policies in affordable housing may help address this issue. The purpose of our study was to assess how such policies affect smoking rates and exposure to secondhand smoke among residents of affordable housing. Methods We conducted a pretest–posttest longitudinal study of 180 residents from 8 affordable housing properties in Minnesota. Participating properties agreed to adopt a smoke-free housing policy covering indoor grounds, and 3 of these properties also prohibited smoking on all outdoor grounds. Policies were implemented with assistance from local public health departments and the Statewide Health Improvement Program. Participants completed surveys one month before policy implementation and 6 months postimplementation. Surveys assessed smoking, quit attempts, and indoor and outdoor secondhand smoke exposure. Results Results indicated a significant reduction in nonsmokers’ indoor exposure to secondhand smoke (F 1,144 = 22.69, P < .001) and no change in outdoor exposure to secondhand smoke from Time 1 (pretest) to Time 2 (posttest) (F 1,140 = 2.17, P = .14). However, when examining sites that only prohibited smoking indoors, we observed an increase in outdoor secondhand smoke exposure that approached significance (F 1,118 = 3.76, P = .055). Results showed no change in quit attempts over time, but 77% of residents who smoked at pretest reported reducing the amount that they smoked at posttest, and an additional 5% reported that they had quit. Conclusions Smoke-free housing policies may be an effective strategy to reduce exposure to indoor secondhand exposure and promote decreased cigarette smoking among residents of affordable housing. PMID:27536903

  12. Americans' Experiences with ACA Marketplace Coverage: Affordability and Provider Network Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016.

    PubMed

    Gunja, Munira Z; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2016-07-01

    For people with low and moderate incomes, the Affordable Care Act's tax credits have made premium costs roughly comparable to those paid by people with job-based health insurance. For those with higher incomes, the tax credits phase out, meaning that adults in marketplace plans on average have higher premium costs than those in employer plans. The law's cost-sharing reductions are reducing deductibles. Lower-income adults in marketplace plans were less likely than higher-income adults to report having deductibles of $1,000 or more. Majorities of new marketplace enrollees and those who have changed plans since they initially obtained marketplace coverage are satisfied with the doctors participating in their plans. Overall, the majority of marketplace enrollees expressed confidence in their ability to afford care if they were to become seriously ill. This issue brief explores these and other findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016. PMID:27400465

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

    PubMed

    2013-06-01

    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. PMID:23734400

  14. Healthy Housing Council Act of 2013

    THOMAS, 113th Congress

    Sen. Reed, Jack [D-RI

    2013-02-13

    02/13/2013 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (text of measure as introduced: CR S790) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Healthy Housing Council Act of 2011

    THOMAS, 112th Congress

    Sen. Reed, Jack [D-RI

    2011-09-22

    09/22/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (text of measure as introduced: CR S5911-5913) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. 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. PMID:26062333

  17. 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. PMID:26259258

  18. Language Access and Health Equity: Changes under the Affordable Care Act.

    PubMed

    Applebaum, Bethany; Robbins, Sarah

    2016-01-01

    Health disparities between English-proficient and limited English-proficient (LEP) groups in the United States have been widely documented. Provisions of the Affordable Care Act (ACA), including increased funding to community health centers and resources to help consumers who are purchasing Marketplace coverage afford new access to health care for speakers of languages other than English, which includes more than 60 million individuals, one-third of whom are LEP. This commentary discusses the legislative precedent for, successes of, and potential future directions for the implementation of the ACA as it relates to language access, health disparities, health equity, access to health care, and the linguistic needs of the LEP population in the United States. PMID:27180685

  19. What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.

    PubMed

    Joseph, Tiffany D

    2016-02-01

    The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide. PMID:26567382

  20. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    PubMed

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142

  1. Elected Officials Travel in Parallel Universes Regarding the Affordable Care Act.

    PubMed

    Elwood, Thomas W

    2015-01-01

    This authoritative appraisal of the much debated U.S. Patient Protection and Affordable Care Act, often referred to as Obamacare, describes the controversy, support, and opposition from federal and state governments during the first 5.5 years since the law was passed. Its history, the impact on individual and community health status, the limitations of health reform, its accomplishments and deficiencies, and the impact of societal determinants on program implementation are presented in a refreshing, candid, objective, and knowledgeable manner. PMID:26543040

  2. Why employers will continue to provide health insurance: the impact of the Affordable Care Act.

    PubMed

    Blumberg, Linda J; Buettgens, Matthew; Feder, Judith; Holahan, John

    2012-01-01

    The Congressional Budget Office, the Rand Corporation, and the Urban Institute have estimated that the Patient Protection and Affordable Care Act (ACA) will leave employer-sponsored coverage largely intact; in contrast, some economists and benefit consultants argue that the ACA encourages employers to drop coverage, thereby making both their workers and their firms better off (a "win-win" situation). This analysis shows that no such "win-win" situation exists and that employer-sponsored insurance will remain the primary source of coverage for most workers. Analysis of three issues-the terms of the ACA, worker characteristics, and the fundamental economics of competitive markets-supports this conclusion. PMID:22931019

  3. 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). PMID:23311030

  4. Affordable Care Act Impact on Community Health Center Staffing and Enrollment: A Cross-Sectional Study.

    PubMed

    Miller, Sophie C; Frogner, Bianca K; Saganic, Laura M; Cole, Allison M; Rosenblatt, Roger

    2016-01-01

    Over 500 000 Washingtonians gained health insurance under the Affordable Care Act (ACA). As more patients gain insurance, community health centers (CHCs) expect to see an increase in demand for their services. This article studies the CHCs in Washington State to examine how the increase in patients has been impacting their workload and staffing. We found a reported mean increase of 11.7% and 5.4% in new Medicaid and Exchange patients, respectively. Half of the CHCs experienced large or dramatic workload impact from the ACA. Our findings suggest that CHCs need further workforce support to meet the expanding patient demand. PMID:27576050

  5. National workplace health promotion surveys: the Affordable Care Act and future surveys.

    PubMed

    DeJoy, David M; Dyal, Mari-Amanda; Padilla, Heather M; Wilson, Mark G

    2014-01-01

    This commentary reviews findings from the four previous national surveys of workplace health promotion activities (1985, 1992, 1999, and 2004, respectively) and offers recommendations for future surveys mandated under the Affordable Care Act of 2010. Future surveys should place greater emphasis on assessing program quality, reach, and effectiveness. Both employer and employee input should be sought. In addition, sampling plans should differentiate worksites from employers, and results should include public as well as private sector organizations. Ideas are offered for addressing these limitations and for creating a sustainable survey process and multifunctional database of results. PMID:24380423

  6. Reform of the Individual Insurance Market in New Jersey: Lessons for the Affordable Care Act.

    PubMed

    Cantor, Joel C; Monheit, Alan C

    2016-08-01

    The individual health insurance market has played a small but important role in providing coverage to those without access to group insurance or public programs. With implementation of the Affordable Care Act (ACA), the individual market has attained a more prominent role. However, achieving accessible and affordable coverage in this market is a long-standing challenge, in large part due to the threat of adverse risk selection. New Jersey pursued comprehensive reforms beginning in the 1990s to achieve a stable, accessible, and affordable individual market. We review how adverse risk selection can pose a challenge to achieving such objectives in the individual health insurance market. We follow this discussion by describing the experience of New Jersey through three rounds of legislative reform and through the first year of the implementation of the ACA coverage provisions. While the New Jersey reforms did not require individuals to purchase coverage, its experiences with direct and indirect market subsidies and regulations guiding plan design, issuance, and rating have important implications for how the ACA may achieve its coverage goals in the absence of the controversial individual purchase mandate. PMID:27127253

  7. Will employers drop health insurance coverage because of the Affordable Care Act?

    PubMed

    Buchmueller, Thomas; Carey, Colleen; Levy, Helen G

    2013-09-01

    Since the passage of the Affordable Care Act, there has been much speculation about how many employers will stop offering health insurance once the act's major coverage provisions take effect. Some observers predict little aggregate effect, but others believe that 2014 will mark the beginning of the end for our current system of employer-sponsored insurance. We use theoretical and empirical evidence to address the question, "How will employers' offerings of health insurance change under health reform?" First, we describe the economic reasons why employers offer insurance. Second, we recap the relevant provisions of health reform and use our economic framework to consider how they may affect employers' offerings. Third, we review the various predictions that have been made about those offerings under health reform. Finally, we offer some observations on interpreting early data from 2014. PMID:24019355

  8. First year participation in the affordable care act: costs and accessibility to gynecologic oncology.

    PubMed

    Pavlik, Edward J; Ore, Robert; Toyama, Aimi; Woolum, Dylan; Pavlik, Thomas E; Baldwin, Lauren

    2015-11-01

    With the ending of the operational first year of the American Affordable Care Act, health insurance premiums were accessed online. For a US$50,000 income, the lowest premiums ranged from US$805 annually (age 20 years) to US$3802 (age 64 years), while the highest ranged from US$2186 (age 20 years) to US$10,326 (age 64 years). The lowest premiums at age 50 years were higher in rural areas in contrast to the highest premiums that were less expensive rurally. At age 64 years, the lowest premiums were 9-12.6% of a US$50,000 income, while the most expensive varied between 16.5 and 39%. Access to gynecologic oncologists was variable in different networks. Medicaid enrollment nationally was ∼6× higher than paid enrollment. Eligible participation in Affordable Care Act coverage exceeded expectations by >190%. Performance of four healthcare exchange traded funds indicated that investor confidence is high in the American healthcare sector. PMID:26387757

  9. 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. PMID:23500090

  10. 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. PMID:24193605

  11. 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…

  12. 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…

  13. 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. PMID:24131670

  14. 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. PMID:26567380

  15. Improving The Affordable Care Act: An Assessment Of Policy Options For Providing Subsidies.

    PubMed

    Saltzman, Evan A; Eibner, Christine; Enthoven, Alain C

    2015-12-01

    A key challenge of health reform efforts is to make health insurance affordable for individuals and families who lack coverage without harming those with coverage or increasing federal spending. The Affordable Care Act (ACA) addresses this challenge in part by providing tax subsidies to qualified individuals for purchasing individual insurance and retaining tax exemptions for employer and employee contributions to the cost of premiums of employer-sponsored insurance. These tax exemptions cost approximately $250 billion annually in lost tax revenue and have been criticized for favoring higher earners and conferring preferential treatment of employer-sponsored over individual insurance. We analyzed three options for leveling the financial playing field between the two insurance markets by reallocating the value of tax benefits of employer coverage. We found that one option that uses the subsidy formula employed in the insurance Marketplaces under the ACA for both the individual and employer-sponsored insurance markets, and additionally requires the subsidy to be at least $1,250 without an upper income limit on subsidy eligibility imposed, could expand insurance coverage and reduce individual market premiums relative to the ACA with no additional federal spending. PMID:26643630

  16. 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

  17. Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform.

    PubMed

    Oberlander, Jonathan

    2016-08-01

    The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA. PMID:27127261

  18. 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. PMID:25099406

  19. THE AFFORDABLE CARE ACT AND MEDICAL LOSS RATIOS: NO IMPACT IN FIRST THREE YEARS.

    PubMed

    Day, Benjamin; Himmelstein, David U; Broder, Michael; Woolhandler, Steffie

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) set limits on insurers' overhead, mandating a medical loss ratio (MLR) of at least 80 percent in the individual and small-group markets and 85 percent in the large-group market starting in 2011. In implementing the law, the Obama administration introduced new rules that changed (and inflated) how insurers calculate MLRs, distorting time trends. We used insurers' filings with the U.S. Securities and Exchange Commission to calculate the largest insurers' MLRs before and after the ACA regulations took effect, using a constant definition of MLR. MLRs averaged 83.04 percent in the three years before reform and 83.05 percent in the three years after reform. We conclude that the ACA had no impact on insurance industry overhead spending. PMID:26460451

  20. The Impact of the Affordable Care Act on Large Employers: A Retrospective.

    PubMed

    Abbott, Randall K

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) has created a new environment for employer health benefit plan management that is influencing costs, benefit design, delivery, administration, financing and compliance as well as the positioning of health care within the benefits portfolio and the broader total rewards strategy. This article will examine the key pragmatic effects of health reform for larger employers to date, quantifying its direct costs and discussing the new dimensions of management that reform has introduced. The discussion will focus on nongrandfathered self-funded plans and will address only major influences. It is not intended to be all-encompassing and is, of necessity, general in nature. Each employer will have somewhat differing experiences and results but should find the discussion to be helpful both in understanding what has evolved as well as what is to come. PMID:26540937

  1. How Has the Affordable Care Act Affected Health Insurers' Financial Performance?

    PubMed

    Hall, Mark A; McCue, Michael J

    2016-07-01

    Starting in 2014, the Affordable Care Act transformed the market for individual health insurance by changing how insurance is sold and by subsidizing coverage for millions of new purchasers. Insurers, who had no previous experience under these market conditions, competed actively but faced uncertainty in how to price their products. This issue brief uses newly available data to understand how health insurers fared financially during the ACA's first year of full reforms. Overall, health insurers' financial performance began to show some strain in 2014, but the ACA's reinsurance program substantially buffered the negative effects for most insurers. Although a quarter of insurers did substantially worse than others, experience under the new market rules could improve the accuracy of pricing decisions in subsequent years. PMID:27459740

  2. The CBO's Crystal Ball: How Well Did It Forecast the Effects of the Affordable Care Act?

    PubMed

    Glied, Sherry; Arora, Anupama; Solís-Román, Claudia

    2015-12-01

    The Congressional Budget Office (CBO), a nonpartisan agency of Congress, made official projections of the Affordable Care Act's impact on insurance coverage rates and the costs of providing subsidies to consumers purchasing health plans in the insurance marketplaces. This analysis finds that the CBO overestimated marketplace enrollment by 30 percent and marketplace costs by 28 percent, while it underestimated Medicaid enrollment by about 14 percent. Nonetheless, the CBO's projections were closer to realized experience than were those of many other prominent forecasters. Moreover, had the CBO correctly anticipated income levels and health care prices in 2014, its estimate of marketplace enrollment would have been within 18 percent of actual experience. Given the likelihood of additional reforms to national health policy in future years, it is reassuring that, despite the many unforeseen factors surrounding the law's rollout and participation in its reforms, the CBO's forecast was reasonably accurate. PMID:26702467

  3. Comparing Individual Health Coverage On and Off the Affordable Care Act's Insurance Exchanges.

    PubMed

    McCue, Michael J; Hall, Mark A

    2015-08-01

    The new health insurance exchanges are the core of the Affordable Care Act's (ACA) reforms, but how the law improves the nonsubsidized portion of the individual market is also important. This issue brief compares products sold on and off the exchanges to gain insight into how the ACA's market reforms are functioning. Initial concerns that insurers might seek to enroll lower-risk customers outside the exchanges have not been realized. Instead, more-generous benefit plans, which appeal to people with health problems, constitute a greater portion of plans sold off-exchange than those sold on-exchange. Although insur­ers that sell mostly on the exchanges incur an additional fee, they still devote a greater portion of their premium dollars to medical care. Their projected admin­istrative costs and profit margins are lower than are those of insurers selling only off the exchanges. PMID:26372970

  4. 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. PMID:26259257

  5. Patient navigator programs, cancer disparities, and the patient protection and affordable care act.

    PubMed

    Moy, Beverly; Chabner, Bruce A

    2011-01-01

    Patients in vulnerable population groups suffer disproportionately from cancer. The elimination of cancer disparities is critically important for lessening the burden of cancer. Patient navigator programs have been shown to improve clinical outcomes. Among its provisions relevant to disparities in cancer care, The Patient Protection and Affordability Care Act authorizes continued funding of patient navigator programs. However, given the current economic and political environment, this funding is in jeopardy. This article describes patient navigator programs and summarizes the elements of the health care law that are relevant to these programs. It is vital that the entire oncology community remain committed to leading efforts toward the improvement of cancer care among our most vulnerable patients. PMID:21804070

  6. The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act.

    PubMed

    Konchak, Juleigh Nowinski; Moran, Margaret R; O'Brien, Matthew J; Kandula, Namratha R; Ackermann, Ronald T

    2016-06-01

    Type 2 diabetes is a major public health problem in the USA, affecting over 12 % of American adults and imposing considerable health and economic burden on individuals and society. There is a strong evidence base demonstrating that lifestyle behavioral changes and some medications can prevent or delay the onset of type 2 diabetes in high risk adults, and several policy and healthcare system changes motivated by the Patient Protection and Affordable Care Act (ACA) have the potential to accelerate diabetes prevention. In this narrative review, we (1) offer a conceptual framework for organizing how the ACA may influence diabetes prevention efforts at the level of individuals, healthcare providers, and health systems; (2) highlight ACA provisions at each of these levels that could accelerate type 2 diabetes prevention nationwide; and (3) explore possible policy gaps and opportunity areas for future research and action. PMID:27145778

  7. 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. PMID:24857142

  8. 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. PMID:22282865

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

    PubMed

    Mechanic, David; Olfson, Mark

    2016-03-28

    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. PMID:26666969

  10. Implications of the Affordable Care Act for occupational therapy practitioners providing services to Medicare recipients.

    PubMed

    Fisher, Gail; Friesema, Jennifer

    2013-01-01

    The passage of the Patient Protection and Affordable Care Act of 2010 (ACA; Pub. L. 111-148) represents the largest expansion in government funding of health care since Medicare and Medicaid were established in 1965 (Curfman, Abel, & Landers, 2012). Although the health insurance mandate and Medicaid expansion have received the most attention as a result of legal challenges and the July 2012 Supreme Court ruling on the legality of the ACA (Henry J. Kaiser Family Foundation, 2012), other ACA initiatives may have even greater implications for occupational therapy. The ACA includes sections on improving quality and health systems performance for Medicare recipients, with some sections also applying to Medicaid recipients. Insurance companies commonly follow Medicare rules; therefore, the Medicare reforms are likely to spread across all payers, health care settings, and care recipients. PMID:23968787

  11. Rethinking the Affordable Care Act's "Cadillac tax": A More Equitable Way to Encourage "Chevy" Consumption.

    PubMed

    Nowak, Sarah; Eibner, Christine

    2015-12-01

    The Affordable Care Act's "Cadillac tax" will apply a 40 percent excise tax on total employer health insurance premiums in excess of $10,200 for single coverage and $27,500 for family coverage, starting in 2018. Employer spending on premiums is currently excluded from income and payroll taxes. Economists argue that this encourages overconsumption of health care, favors high-income workers, and reduces federal revenue. This issue brief suggests that the Cadillac tax is a "blunt instrument" for addressing these concerns because it will affect workers on a rolling timetable, does relatively little to address the regressive nature of the current exclusion, and may penalize firms and workers for cost variation that is outside their control. Replacing the current exclusion with tax credits for employer coverage that scale inversely with income might allow for regional adjustments in health care costs and eliminate aspects of the tax exclusion that favor high-income over low-income workers. PMID:26702468

  12. 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

  13. Why we should not use the Affordable Care Act to encourage widespread whole genome sequencing.

    PubMed

    Ossorio, Pilar N; Kelleher, J Paul

    2014-02-01

    Perry Payne argues that the health care system should encourage provision of whole genome sequencing (WGS) for most people in the near future. Payne's essay contains two distinct claims. One claim is that near-universal access to WGS would be beneficial both to individuals and to populations who, without it, could be on the losing end of widening health disparities. The second claim is that the preventive services provisions of the Patient Protection and Affordable Care Act (ACA) should be invoked to establish legal entitlements to WGS, without any patient cost sharing. We believe there are strong reasons to reject both of these claims. Indeed, the reasons that count against providing wide access to WGS are the very same reasons that undermine Payne's argument for providing WGS under the preventive services provisions of the ACA. PMID:24193611

  14. 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

  15. 78 FR 13222 - Procedures for the Handling of Retaliation Complaints Under Section 1558 of the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    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......

  16. The Patient Protection and Affordable Care Act's Effect on Emergency Medicine: A Synthesis of the Data.

    PubMed

    Medford-Davis, Laura N; Eswaran, Vidya; Shah, Rohan M; Dark, Cedric

    2015-11-01

    This review synthesizes the existing literature to provide evidence-based predictions for the future of emergency care in the United States as a result of the Patient Protection and Affordable Care Act, with a focus on emergency department (ED) visit volume, acuity, and reimbursement. Patient behavior will likely be quite different for patients gaining Medicaid than for those gaining private insurance through the Marketplaces. Despite the threat of the individual mandate, not all uninsured patients will enroll, and those who choose to enroll will likely be a different population from those who remain uninsured. New Medicaid enrollees will be a sicker population and will likely increase their number of ED visits substantially. Their acuity will be higher at first but will then revert to the traditionally high number of low-acuity visits made by Medicaid patients. Most patients enrolling through the Marketplace are choosing high-deductible health plans, and they will initially avoid the ED because of high out-of-pocket costs but may present later and sicker after self-rationing their care. Most patients gaining health coverage through the Affordable Care Act will be shifting from uninsured to either Medicaid or private insurance, both of which reimburse more than self-pay, so ED collections should increase. Because of the differences between Medicaid and Marketplace plans, there will be a difference in ED volume, acuity, and financial outcomes, depending on states' current demographics, whether states expand Medicaid, and how aggressively states advertise new options for coverage in Medicaid or state health insurance Marketplaces. PMID:25976250

  17. 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…

  18. Not-for-profit hospitals and Affordable Care Act: Navigating the new health care landscape.

    PubMed

    Nakra, Prema; Nakra, Sushma

    2016-08-01

    On a sunny Thursday morning, June 25, 2015, President Obama strode into the Rose Garden and declared a victory for the Affordable Care Act (ACA) by stating that the act was working exactly the way it was supposed to work. He further reinforced that ACA has enabled young Americans up to the age of 26 to remain on their parents' health plans. It disallows the insurance companies from denying coverage based on preexisting conditions. Above all, an expansion of Medicaid has also brought an additional 16 million Americans under health coverage in a span of less than 2 years. The ACA went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options across the country. As the states expand Medicaid and provide new coverage options through the federal health insurance marketplace, they are busy streamlining application and enrollment processes for coverage programs. This article highlights the positive impact of the ACA on uninsured and the challenges that not-for-profit and public hospitals are facing as they navigate the new health care landscape. PMID:27547877

  19. 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. PMID:25095628

  20. 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. PMID:21990501

  1. 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

  2. Update on the Affordable Care Act. King v. Burwell and Obergefell v. Hodge.

    PubMed

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

    2016-03-01

    Patients with respiratory diseases, critical illness, or sleep disorders who lack health insurance endure disparities in access to care and worse health outcomes. These disparities were partly addressed in the United States in 2010 by passage of the Affordable Care Act. Low- and moderate-income individuals and families with incomes between 138 and 400% of the federal poverty level are eligible for insurance premium subsidies when purchasing policies on the health insurance marketplace exchanges. Since the act was passed, nearly 16.5 million Americans have gained health insurance. In 2015, the act survived what may be the last significant judicial challenge to the law: King v. Burwell. The plaintiffs challenged whether people who purchased health insurance in states that use the federal insurance marketplace HealthCare.gov , rather than a state-run marketplace, were eligible to receive insurance premium subsidies. At the time of the ruling, 34 states used the federal exchange, and as a result, nearly 7.5 million people could have lost their health insurance if the court had ruled in favor of the plaintiffs. However, in King v. Burwell, the Court ruled six to three in support of the legality of subsidies regardless of type of marketplace states use, thereby ensuring continued health insurance coverage for patients in states using the federal marketplace exchange. In 2015, the Supreme Court also heard a landmark case, Obergefell v. Hodge, in which the Court upheld the right for two people of the same sex to marry, thereby opening crucial access to both state and federal benefits and protections for same-sex couples. PMID:26731515

  3. To Enroll or Not to Enroll? Why Many Americans Have Gained Insurance Under the Affordable Care Act While Others Have Not. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    PubMed

    Collins, Sara R; Gunja, Munira; Doty, Michelle M; Beutel, Sophie

    2015-09-01

    According to the most recent Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015, an estimated 25 million adults remain uninsured. To achieve the Affordable Care Act's goal of near-universal coverage, policymakers must understand why some people are enrolling in the law's marketplace plans or in Medicaid coverage and why others are not. This analysis of the survey finds that affordability--whether real or perceived--is playing a significant role in adults' choice of marketplace plans and the decision whether to enroll at all. People who have gained coverage report significantly more positive experiences shopping for health plans than do those who did not enroll. Getting personal assistance--from telephone hotlines, navigators, and insurance brokers, among other sources--appears to make a critical difference in whether people gain health insurance PMID:26470402

  4. Prevention under the Affordable Care Act (ACA): has the ACA overpromised and under delivered?: Comment on "Interrelation of preventive care benefits and shared costs under the Affordable Care Act (ACA)".

    PubMed

    Molinari, Carol

    2014-08-01

    This policy brief discusses preventive care benefits and cost-sharing included in health insurance provisions of the Affordable Care Act (ACA) legislation and highlights some consequences to Americans and the country in terms of healthcare costs and value. PMID:25197682

  5. The Legacy of the 1968 Fair Housing Act

    PubMed Central

    Massey, Douglas S.

    2016-01-01

    Civil rights activists in 1968 hoped that the passage of the Fair Housing Act would lead to the residential desegregation of American society. In this article I assess the degree to which this hope has been fulfilled. I begin by reviewing how the black ghetto came to be a universal feature of American cities during the 20th Century and the means by which high levels of black segregation were achieved. I then describe the legislative maneuvers required to pass the Fair Housing Act and review its enforcement provisions to assess its potential for achieving desegregation. After examining trends in residential segregation since 1970, I conclude with an appraisal of the prospects for integration as we move toward the 50th anniversary of the Act’s passage.2 PMID:27034538

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

    PubMed

    Myerson, Rebecca; Laiteerapong, Neda

    2016-04-01

    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

  7. The impact of the Affordable Care Act on health education: perceptions of leading health educators.

    PubMed

    Gastmyer, Christine L; Pruitt, B E Buzz

    2014-05-01

    The health care system in the United States is being overhauled by major legislation, the Patient Protection and Affordable Care Act (ACA). This study's goal was to provide insight into the perceived impact and changes that could occur within the health education profession as a result of this health care reform legislation. Seven leaders of the health education profession participated in this qualitative research study. Six semistructured, exploratory interviews were conducted, and one participant provided written responses to the interview questions. A thematic analysis of the content of the interviews yielded five themes: (a) a fragmented sick-care system, (b) ACA becomes law: the participants' reactions, (c) ACA becomes law: the profession's reactions, (d) impact on the profession, and (e) health education in 2020. This article describes the fourth theme, the impact of the ACA on the health education profession. Leaders of the health education profession believed that the ACA creates a more favorable environment for health education practice. The positive elements of this legislation, however, will need to be protected, strengthened, and verified, through the work of health education professionals. As more mandates within the law are enacted over time, the impact on the profession, more than likely, will shift. PMID:24013465

  8. 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. PMID:25414950

  9. The Affordable Care Act, Substance Use Disorders, and Low-Income Clients: Implications for Social Work.

    PubMed

    McCabe, Heather A; Wahler, Elizabeth A

    2016-07-01

    Social workers are leaders in the substance abuse services field and may often work in substance use disorder (SUD) education, prevention, assessment, treatment, or resource coordination and case management roles. As the Patient Protection and Affordable Care Act (ACA) (2010) drives changes in the fields of health and behavioral health, social workers have an opportunity to lead structural changes at the micro and macro levels that will have a positive impact on low-income clients with SUDs. In this article, authors examine the current state of SUDs and health care access, the impact of the ACA on the field, and implications for social work practice and education. Social workers should seek specialized education and credentialing in SUD services, know how to help clients apply for health care coverage, and advocate for integrated substance abuse treatment and health care programs and an expansion of Medicaid in their local communities. Social workers are well positioned to be a voice for clients to ensure that the current structural changes result in a better, integrated system of care that is able to respond to the needs of low-income clients with SUDs. PMID:27501640

  10. 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

  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. PMID:27140995

  12. 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

  13. Health Education Specialists' Knowledge, Attitudes, and Perceptions of the Patient Protection and Affordable Care Act.

    PubMed

    Strong, Jessica; Hanson, Carl L; Magnusson, Brianna; Neiger, Brad

    2016-03-01

    The changing landscape of health care as a result of the Patient Protection and Affordable Care Act (ACA) may provide new opportunities for health education specialists (HES). The purpose of this study was to survey HES in the United States on their knowledge and attitudes of the ACA and assess their perceptions of job growth under the law. A random sample of 220 (36% response rate) certified HES completed a 53-item cross sectional survey administered online through Qualtrics. Findings were compared to public opinion on health care reform. HES are highly favorable of the law (70%) compared to the general public (23%). A total of 85% of respondents were able to list a provision of the ACA, and most (81%) thought the ACA would be successful at increasing insured Americans. Over half (64.6%) believe job opportunities will increase. Those who viewed the law favorably were significantly more likely to score better on a knowledge scale related to the ACA. HES understand publicized provisions but are uncertain about common myths and specific provisions related to Title IV, "Prevention of Chronic Disease and Improving Public Health." Directed and continuing education to HES regarding the ACA is warranted. PMID:26272884

  14. Barriers to Health Insurance Pre- and Post-Affordable Care Act Implementation in Providence, RI.

    PubMed

    Pigoga, Jennifer; Kibria, Farzana; Pinilla, Mauricio; Bicki, Alexandra; Joseph, Valerie; De Groot, Anne S

    2015-12-01

    The impact of healthcare reform under the Affordable Care Act (ACA) on individuals living in cities has not yet been quantified by local Departments of Health. This makes it difficult for safety net sources of healthcare, such as free clinics, to plan for the future. Therefore, members of Clinica Esperanza/Hope Clinic conducted a survey in predominantly Latino communities of South and West Providence, RI, using a convenience sample method (N = 206). Survey results were compared to a prior survey conducted in the same communities prior to ACA implementation. Despite gains due to Obamacare, a much higher level of uninsurance was reported in this survey than has been reported statewide. In 2014, as compared to 2010, 48% vs. 95% of respondents reported being uninsured, and more held private (20% vs. 5%) or government-subsidized health insurance (32% vs. 1%). Undocumented immigration status and cost were the two most commonly reported reasons for remaining uninsured under the ACA. First-generation immigrants living in urban centers are still reporting significantly higher rates of uninsurance (48%) than the general population in RI (7.4%). PMID:26623454

  15. 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. PMID:26621419

  16. 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

  17. New York City Taxi Drivers' Knowledge and Perceptions of the Affordable Care Act.

    PubMed

    Gany, Francesca; Flores, Cristina; Winkel, Gary; Alam, Ishtiaq; Genoff, Margaux; Leng, Jennifer

    2015-12-01

    This study was conducted to assess New York City taxi drivers' knowledge and perceptions of the Affordable Care Act (ACA). A cross-sectional street-intercept study design was used to assess drivers' knowledge about the ACA. A 146-item questionnaire was administered from September 12 to December 6, 2013 to 175 yellow taxi and for-hire vehicle drivers. 91 % of drivers were foreign-born; 50 % were uninsured. Mean knowledge about the ACA was quite low; 78 % of the sample either knew nothing or only a little bit about the ACA. 77 % wanted more information about the ACA. Greater English proficiency, more years driving a taxi, and knowledge of having or not having a pre-existing health condition (vs. not knowing) were related to higher ACA knowledge levels. Knowledge of a pre-existing condition (whether they had one or not) compared to those who lacked such knowledge was also an important predictor of the perception of whether the ACA would have a positive impact. To facilitate enrollment, efforts should focus on occupationally-focused initiatives that educate drivers at their places of work and leisure, to raise the overall knowledge levels and enrollment of the community. PMID:25976215

  18. The Impact of the Affordable Care Act on Medicare Advantage Plan Availability and Enrollment

    PubMed Central

    Afendulis, Christopher C; Landrum, Mary Beth; Chernew, Michael E

    2012-01-01

    Objective 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. Data Sources Secondary data on MA plan offerings, contract offerings, and enrollment by state and county, in 2010–2011. Study Design 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. Principal Findings 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. Conclusions The ACA-induced MA payment changes reduced the number of plan choices available for Medicare beneficiaries, but they have yet affected enrollment patterns. PMID:22578065

  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. PMID:22700946

  20. Republican States Bolstered Their Health Insurance Rate Review Programs Using Incentives From the Affordable Care Act.

    PubMed

    Fulton, Brent D; Hollingshead, Ann; Karaca-Mandic, Pinar; Scheffler, Richard M

    2015-01-01

    The Affordable Care Act (ACA) included financial and regulatory incentives and goals for states to bolster their health insurance rate review programs, increase their anticipated loss ratio requirements, expand Medicaid, and establish state-based exchanges. We grouped states by political party control and compared their reactions across these policy goals. To identify changes in states' rate review programs and anticipated loss ratio requirements in the individual and small group markets since the ACA's enactment, we conducted legal research and contacted each state's insurance regulator. We linked rate review program changes to the Centers for Medicare and Medicaid Services' (CMS) criteria for an effective rate review program. We found, of states that did not meet CMS's criteria when the ACA was enacted, most made changes to meet those criteria, including Republican-controlled states, which generally oppose the ACA. This finding is likely the result of the relatively low administrative burden associated with reviewing health insurance rates and the fact that doing so prevents federal intervention in rate review. However, Republican-controlled states were less likely than non-Republican-controlled states to increase their anticipated loss ratio requirements to align with the federal retrospective medical loss ratio requirement, expand Medicaid, and establish state-based exchanges, because of their general opposition to the ACA. We conclude that federal incentives for states to strengthen their health insurance rate review programs were more effective than the incentives for states to adopt other insurance-related policy goals of the ACA. PMID:26396089

  1. Medicaid 'welcome-mat' effect of Affordable Care Act implementation could be substantial.

    PubMed

    Sonier, Julie; Boudreaux, Michel H; Blewett, Lynn A

    2013-07-01

    The Affordable Care Act will have important impacts on state Medicaid programs, likely increasing participation among populations that are currently eligible but not enrolled. The size of this "welcome-mat" effect is of concern for two reasons. First, the eligible but uninsured constitute a substantial share of the uninsured population in some states. Second, the newly eligible population will affect states' Medicaid caseloads and budgets. Using the Massachusetts 2006 health reforms as a case study and controlling for other factors, we found that among low-income parents who were previously eligible for Medicaid in Massachusetts, Medicaid enrollment increased by 16.3 percentage points, and Medicaid participation by those without private coverage increased by 19.4 percentage points, in comparison to a group of control states. In many states the potential size of the welcome-mat effect could be even larger than what we observed in Massachusetts. Our analysis has potentially important implications for other states attempting to predict the impact of this effect on their budgets. PMID:23804584

  2. New evidence on the Affordable Care Act: coverage impacts of early medicaid expansions.

    PubMed

    Sommers, Benjamin D; Kenney, Genevieve M; Epstein, Arnold M

    2014-01-01

    The Affordable Care Act expands Medicaid in 2014 to millions of low-income adults in states that choose to participate in the expansion. Since 2010 California, Connecticut, Minnesota, and Washington, D.C., have taken advantage of the law's option to expand coverage earlier to a portion of low-income childless adults. We present new data on these expansions. Using administrative records, we documented that the ramp-up of enrollment was gradual and linear over time in California, Connecticut, and D.C. Enrollment continued to increase steadily for nearly three years in the two states with the earliest expansions. Using survey data on the two earliest expansions, we found strong evidence of increased Medicaid coverage in Connecticut (4.9 percentage points; $$p ) and positive but weaker evidence of increased coverage in D.C. (3.7 percentage points; $$p=\\mathbf{\\boldsymbol{0.08}}$$). Medicaid enrollment rates were highest among people with health-related limitations. We found evidence of some crowd-out of private coverage in Connecticut (30-40 percent of the increase in Medicaid coverage), particularly for healthier and younger adults, and a positive spillover effect on Medicaid enrollment among previously eligible parents. PMID:24395938

  3. The Affordable Care Act and Cancer Stage at Diagnosis Among Young Adults.

    PubMed

    Han, Xuesong; Zang Xiong, Ka; Kramer, Michael R; Jemal, Ahmedin

    2016-09-01

    The Affordable Care Act-dependent coverage expansion provision implemented in 2010 allows young adults to be covered under their parents' health insurance until age 26 years, and millions of young adults have gained insurance as a result. The impact of this policy on cancer patients has yet to be determined. Using 2007 to 2012 data from 18 registries of the Surveillance, Epidemiology, and End Results Program, comparing cancer patients age 19 to 25 years to a control group of patients age 26 to 34 years who were not affected by the provision, we observed a 2.0 (95% confidence interval [CI] = 0.7 to 3.4) percentage point decrease in uninsured rate and a 2.7 (95% CI = 0.6 to 4.8) percentage point increase in diagnosis at stage I disease for patients age 19-25 years. Further analyses by specific cancer site revealed that the statistically significant shifts were confined to carcinoma of cervix (21.2, 95% CI = 9.6 to 32.7 percentage points) and osseous and chondromatous neoplasms (14.4, 95% CI = 0.3 to 28.5 percentage points), which are detectable by either screening or clinical manifestation. These early observations suggest the policy has had positive benefits in cancer outcomes. PMID:27140956

  4. Veterans Affairs Health System Enrollment and Health Care Utilization After the Affordable Care Act: Initial Insights.

    PubMed

    Silva, Abigail; Tarlov, Elizabeth; French, Dustin D; Huo, Zhiping; Martinez, Rachael N; Stroupe, Kevin T

    2016-05-01

    The Affordable Care Act (ACA) was signed into law in 2010 and its individual mandate and expanded health care coverage options were implemented in 2014. These provisions may affect Veterans Affairs (VA) enrollment and health care utilization. Using data from two VA regional networks, we examined recent patterns in the number of new VA enrollees and their primary care use. Trends were assessed by enrollment priority group (based on the veteran's severity of service-connected disabilities, exposures, and income level) and a state's Medicaid expansion status. Compared to the same time period in the previous year, the number of new enrollees from low-income priority groups was higher during the open enrollment period and the increase was sharper in Medicaid non-expansion states (25-42%) than in expansion states (20-32%). In addition, low-income patients with a copay requirement who enrolled in the VA during the ACA open enrollment had a lower average number of primary care visits than counterparts who had enrolled in prior time periods (1.73 versus 1.87, p < 0.0001). Although this study is an initial step, more research is required to better understand veterans' decision making and behavior in regard to health care coverage through the ACA and related impacts on VA and non-VA health care utilization and care coordination. PMID:27136655

  5. Elected Officials Travel in Parallel Universes Regarding the Affordable Care Act.

    PubMed

    Elwood, Thomas W

    2015-01-01

    While the ink still was drying on this issue of the Journal of Allied Health, the Patient Protection and Affordable Care Act (ACA) reached the ripe old age of 5-and-1/2 years. Simply mentioning this law to a great many members of Congress is the equivalent of administering a prick with a hot needle. Depending on whose opinions are sought, this significant piece of social legislation is considered either a monumental health policy triumph (according to a majority of Democrats) or a pitiful debacle (according to a majority of Republicans) in both chambers. Their respective points of view are aided and abetted by a small army of cheerleaders on the sidelines who inhabit pundit domains in foundations, think tanks, university policy centers, and radio/TV talk shows. Except in rare instances, neither side will admit that their opponents might be correct about some aspects of the law, because there really is not much pleasure derived from doing so. Despite their many enthusiastic proclamations regarding the ACA, it is not possible for both sides of the present controversy to be entirely correct. Hence, this essay represents an effort to describe various benefits associated with this key piece of legislation, along with some of its shortcomings. PMID:26342609

  6. 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. PMID:24717753

  7. Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

    PubMed

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

    2016-09-01

    The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use. PMID:27605641

  8. 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. PMID:27605640

  9. Risk transfer formula for individual and small group markets under the Affordable Care Act.

    PubMed

    Pope, Gregory C; Bachofer, Henry; Pearlman, Andrew; Kautter, John; Hunter, Elizabeth; Miller, Daniel; Keenan, Patricia

    2014-01-01

    The Affordable Care Act provides for a program of risk adjustment in the individual and small group health insurance 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. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the third of three in this issue of the Medicare & Medicaid Research Review that describe the ACA risk adjustment methodology and focuses on the risk transfer formula. In our first companion article, we discussed the key issues and choices in developing the methodology. In our second companion paper, we described the risk adjustment model that is used to calculate risk scores. In this article we present the risk transfer formula. We first describe how the plan risk score is combined with factors for the plan allowable premium rating, actuarial value, induced demand, geographic cost, and the statewide average premium in a formula that calculates transfers among plans. We then show how each plan factor is determined, as well as how the factors relate to each other in the risk transfer formula. The goal of risk transfers is to offset the effects of risk selection on plan costs while preserving premium differences due to factors such as actuarial value differences. Illustrative numerical simulations show the risk transfer formula operating as anticipated in hypothetical scenarios. PMID:25352994

  10. Risk Transfer Formula for Individual and Small Group Markets Under the Affordable Care Act

    PubMed Central

    Pope, Gregory C; Bachofer, Henry; Pearlman, Andrew; Kautter, John; Hunter, Elizabeth; Miller, Daniel; Keenan, Patricia

    2014-01-01

    The Affordable Care Act provides for a program of risk adjustment in the individual and small group health insurance 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. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the third of three in this issue of the Medicare & Medicaid Research Review that describe the ACA risk adjustment methodology and focuses on the risk transfer formula. In our first companion article, we discussed the key issues and choices in developing the methodology. In our second companion paper, we described the risk adjustment model that is used to calculate risk scores. In this article we present the risk transfer formula. We first describe how the plan risk score is combined with factors for the plan allowable premium rating, actuarial value, induced demand, geographic cost, and the statewide average premium in a formula that calculates transfers among plans. We then show how each plan factor is determined, as well as how the factors relate to each other in the risk transfer formula. The goal of risk transfers is to offset the effects of risk selection on plan costs while preserving premium differences due to factors such as actuarial value differences. Illustrative numerical simulations show the risk transfer formula operating as anticipated in hypothetical scenarios. PMID:25352994

  11. 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. PMID:27503971

  12. 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. PMID:22497359

  13. 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…

  14. 78 FR 15409 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-11

    ... parameters for these programs. \\1\\ 77 FR 17220 (March 23, 2012). Advance payments of the premium tax credit.../Av-csr-bulletin.pdf . \\3\\ 77 FR 18310 (March 27, 2012). Federally-facilitated Exchange user fees... Affordable Care Act'' (75 FR 74864) which established standards for the MLR program. Since then, we have...

  15. 76 FR 41261 - Notice of Intent To Award Affordable Care Act (ACA) Funding, EH10-1003

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... and emergency department data, including identifying and resolving issues of access to secure records... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... collaboration has proven to be an important step in establishing access to existing hospital and...

  16. 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

    ...-State Plan Issuer Requirements C. Premiums, Rating Factors, Medical Loss Ratios, and Risk Adjustment D... authority to negotiate with each MSP ``(A) a medical loss ratio; (B) a profit margin; (C) the premiums to be... the Affordable Care Act, the Director negotiates premiums, a medical loss ratio, a profit margin,...

  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

    ...This notice provides public announcement of CDC's intent to fund Approved cooperative agreement applications previously received and competed in response to CDC Funding Opportunity, CDC-RFA-IP11-010, ``Enhanced Surveillance for New Vaccine Preventable Disease.'' It is the intent of CDC to fund the applications with Patient Protection Affordable Care Act (ACA), Section 4002, appropriations.......

  18. 24 CFR 180.671 - Assessing civil penalties for Fair Housing Act cases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Assessing civil penalties for Fair Housing Act cases. 180.671 Section 180.671 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY, DEPARTMENT OF HOUSING...

  19. Exploring Cost-Effective, High Performance Residential Retrofits for Affordable Housing in the Hot Humid Climate

    SciTech Connect

    McIlvaine, Janet; Sutherland, Karen; Schleith, Kevin; Chandra, Subrato

    2010-08-27

    In 2009, a Department of Energy Building America team led by the Florida Solar Energy Center began working with partners to find cost-effective paths for improving the energy performance of existing homes in the hot humid climate. A test-in energy audit and energy use modeling of the partner's proposed renovation package was performed for 41 affordable and middle income foreclosed homes in Florida and Alabama. HERS1 Indices ranged from 92 to 184 with modeled energy savings ranging from 3% to 50% (average of 26%). Analyses and recommendations were discussed with partners to encourage more efficient retrofits, highlight health and safety issues, and gather feedback on incremental cost of high performance measures. Ten completed renovations have modeled energy savings ranging from 9% to 48% (average 31%.) This paper presents the project's process including our findings thus far and highlights of the first home to meet the target HERS Index of 70.

  20. Relationship of Affordable Care Act Implementation to Emergency Department Utilization Among Young Adults

    PubMed Central

    Hernandez-Boussard, Tina; Morrison, Doug; Goldstein, Ben A.; Hsia, Renee Y.

    2016-01-01

    Study objective The 2010 provision of the Patient Protection and Affordable Care Act (ACA) extended eligibility for health insurance for young adults aged 19 to 25 years. It is unclear, however, how expanded coverage changes health care behavior and promotes efficient use of emergency department (ED) services. Our objective was to use population-level emergency department data to characterize any changes in diagnoses seen in ED among young adults since the implementation of the ACA dependent coverage expansion. Methods We performed a difference-in-differences analysis of 2009 to 2011 ED visits from California, Florida, and New York, using all-capture administrative data to determine how the use of ED services changed for clinical categories after the ACA provision among young adults aged 19 to 25 years compared with slightly older adults unaffected by the provision, aged 26 to 31 years. Results We analyzed a total of 10,158,254 ED visits made by 4,734,409 patients. After the implementation of the 2010 ACA provision, young adults had a relative decrease of 0.5% ED visits per 1,000 people compared with the older group. For the majority of diagnostic categories, young adults’ rates and risk of visit did not change relative to that of slightly older adults after the implementation of the ACA. However, although young adults’ ED visits significantly increased for mental illnesses (2.6%) and diseases of the circulatory system (eg, nonspecific chest pain) (4.8%), visits decreased for pregnancy-related diagnoses and diseases of the skin (eg, cellulitis, abscess) compared with that of the older group (3.7% and 3.1%, respectively). Conclusion Our results indicate that increased coverage has kept young adults out of the ED for specific conditions that can be cared for through access to other channels. As EDs face capacity challenges, these results are encouraging and offer insight into what could be expected under further insurance expansions from health care reform. PMID

  1. How Might the Affordable Care Act's Coverage Expansion Provisions Influence Demand for Medical Care?

    PubMed Central

    ABRAHAM, JEAN MARIE

    2014-01-01

    Context: The Affordable Care Act (ACA) is predicted to expand health insurance to 25 million individuals. Since insurance reduces the price of medical care, the quantity of services demanded by these newly covered individuals is expected to rise. In this article I provide a comprehensive picture of the demographics, health status, and medical care utilization of the population targeted for the ACA's expansion of coverage, contrasted with that of other nonelderly, insured populations. In addition, I synthesize the current evidence regarding the causal impact of insurance on medical care demand, drawing heavily on recent evidence from Massachusetts and Oregon. Methods: Using the 2008 to 2010 Medical Expenditure Panel Survey, I conducted bivariate and multivariate analyses to examine differences between the ACA target population and other insured groups. I used the results from the descriptive analysis and quasi-experimental literature to generate “back of the envelope” estimates of the potential impact of the coverage expansion on total medical care utilization by the noninstitutionalized US population. Findings: Comparisons of the potential ACA target population with the privately and publicly insured reveal that the former is younger and more likely to be male. The ACA target population, and particularly the uninsured with incomes under 200% of the federal poverty line, reports lower rates of several medical conditions relative to those of the privately and publicly insured. Future changes in rates of inpatient hospitalization and ED use among the newly insured could vary widely, based on descriptive findings and inferences from the quasi-experimental literature. Results also suggest moderate increases in ambulatory care. Total increases in overall demand for medical care by the newly insured comprise a modest proportion of the aggregate utilization. Conclusions: With the expected increases in utilization resulting from the coverage expansion

  2. Childhood Cancer Survivors' Familiarity With and Opinions of the Patient Protection and Affordable Care Act

    PubMed Central

    Warner, Echo L.; Park, Elyse R.; Stroup, Antoinette; Kinney, Anita Y.; Kirchhoff, Anne C.

    2013-01-01

    Purpose: The Patient Protection and Affordable Care Act (ACA) offers avenues to increase insurance options and access to care; however, it is unknown whether populations with pre-existing conditions, such as cancer survivors, will benefit from the expanded coverage options. We explored childhood cancer survivors' familiarity with and opinion of the ACA to understand how survivors' insurance coverage may be affected. Materials and Methods: From April to July 2012 we conducted in-depth, semistructured telephone interviews with 53 adult survivors recruited from the Utah Cancer SEER Registry. Participants were randomly selected from sex, age, and rural/urban strata and were younger than 21 years at time of diagnosis. Interviews were recorded, transcribed, and analyzed with NVivo 9 by two coders (kappa = 0.94). We report on the 49 participants who had heard of the ACA. Results: Most survivors were unaware of ACA provisions beyond the insurance mandate. Few knew about coverage for children up to age 26 or pre-existing insurance options. Although one third believed the ACA could potentially benefit them via expanded insurance coverage, many were concerned that the ACA would lead to rising health care costs and decreasing quality of care. Survivors had concerns specific to their cancer history, including fears of future health care rationing if they developed subsequent health problems. Conclusion: Childhood cancer survivors have a low level of familiarity with the ACA and are unaware of how it may affect them given their cancer history. These survivors require targeted education to increase knowledge about the ACA. PMID:23943900

  3. Ambulatory Training for Primary Care General Internists: Innovation With the Affordable Care Act in Mind

    PubMed Central

    Rieselbach, Richard E.; Feldstein, David A.; Lee, Patrick T.; Nasca, Thomas J.; Rockey, Paul H.; Steinmann, Alwin F.; Stone, Valerie E.

    2014-01-01

    Background Although primary care general internists (PCGIs) are essential to the physician workforce and the success of the Affordable Care Act, they are becoming an endangered species. Objective We describe an expanded program to educate PCGIs to meet the needs of a reformed health care system and detail the competencies PCGIs will need for their roles in team-based care. Intervention We recommended 5 initiatives to stabilize and expand the PCGI workforce: (1) caring for a defined patient population, (2) leading and serving as members of multidisciplinary health care teams, (3) participating in a medical neighborhood, (4) improving capacity for serving complex patients in group practices and accountable care organizations, and (5) finding an academic role for PCGIs, including clinical, population health, and health services research. A revamped approach to PCGI education based in teaching health centers formed by community health center and academic medical center partnerships would facilitate these curricular innovations. Anticipated Outcomes New approaches to primary care education would include multispecialty group practices facilitated by electronic consultation and clinical decision-support systems provided by the academic medical center partner. Multiprofessional and multidisciplinary education would prepare PCGI trainees with relevant skills for 21st century practice. The centers would also serve as sites for state and federal Medicaid graduate medical education (GME) expansion funding, making this funding more accountable to national health workforce priorities. Conclusions The proposed innovative approach to PCGI training would provide an innovative educational environment, enhance general internist recruitment, provide team-based care for underserved patients, and ensure accountability of GME funds. PMID:24949177

  4. Faith-based organizations and the Affordable Care Act: Reducing Latino mental health care disparities.

    PubMed

    Villatoro, Alice P; Dixon, Elizabeth; Mays, Vickie M

    2016-02-01

    The Patient Protection and Affordable Care Act (ACA; 2010) is expected to increase access to mental health care through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino adults. The ACA will increase health coverage by expanding Medicaid eligibility to individuals living below 138% of the federal poverty level, subsidizing the purchase of private insurance among individuals not eligible for Medicaid, and requiring employers with 50 or more employees to offer health insurance. An anticipated result of this landmark legislation is improvement in the screening, diagnosis, and treatment of mental disorders in racial/ethnic minorities, particularly for Latinos, who traditionally have had less access to these services. However, these efforts alone may not sufficiently ameliorate mental health care disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental health care of Latinos by increasing help seeking, providing religion-based mental health services, and delivering supportive services that address common access barriers among Latinos. Thus, in determining ways to eliminate Latino mental health care disparities under the ACA, examining pathways into care through the faith-based sector offers unique opportunities to address some of the cultural barriers confronted by this population. We examine how partnerships between FBOs and primary care patient-centered health homes may help reduce the gap of unmet mental health needs among Latinos in this era of health reform. We also describe the challenges FBOs and primary care providers need to overcome to be partners in integrated care efforts. PMID:26845492

  5. Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act

    PubMed Central

    Vargas-Bustamante, Arturo; Mortensen, Karoline; Ortega, Alexander N.

    2016-01-01

    Objective: To examine racial and ethnic disparities in health care access and utilization after the Affordable Care Act (ACA) health insurance mandate was fully implemented in 2014. Research Design: Using the 2011–2014 National Health Interview Survey, we examine changes in health care access and utilization for the nonelderly US adult population. Multivariate linear probability models are estimated to adjust for demographic and sociodemographic factors. Results: The implementation of the ACA (year indicator 2014) is associated with significant reductions in the probabilities of being uninsured (coef=−0.03, P<0.001), delaying any necessary care (coef=−0.03, P<0.001), forgoing any necessary care (coef=−0.02, P<0.001), and a significant increase in the probability of having any physician visits (coef=0.02, P<0.001), compared with the reference year 2011. Interaction terms between the 2014 year indicator and race/ethnicity demonstrate that uninsured rates decreased more substantially among non-Latino African Americans (African Americans) (coef=−0.04, P<0.001) and Latinos (coef=−0.03, P<0.001) compared with non-Latino whites (whites). Latinos were less likely than whites to delay (coef=−0.02, P<0.001) or forgo (coef=−0.02, P<0.001) any necessary care and were more likely to have physician visits (coef=0.03, P<0.005) in 2014. The association between year indicator of 2014 and the probability of having any emergency department visits is not significant. Conclusions: Health care access and insurance coverage are major factors that contributed to racial and ethnic disparities before the ACA implementation. Our results demonstrate that racial and ethnic disparities in access have been reduced significantly during the initial years of the ACA implementation that expanded access and mandated that individuals obtain health insurance. PMID:26595227

  6. Identifying perceived barriers and benefits to reducing energy consumption in an affordable housing complex using the Community-Based Social Marketing model

    NASA Astrophysics Data System (ADS)

    Reaves, Daniel

    Energy production and consumption has a negative impact on both environmental and human health. Energy consumption can be directly impacted by human behavior, especially in the residential sector. As a result, this sector has been studied significantly; however, energy reducing behavior change research focusing on the affordable housing sector has not been studied thoroughly to date. This study seeks to implement the first two phases of the Community Based Social Marketing (CBSM) framework in an affordable housing setting. The goals were to identify the optimal behaviors for energy reduction based on phase one survey results and to identify the perceived benefits and barriers associated with those behaviors. Additionally, this study identified nuances in the CBSM process that researchers should take into consideration when implementing CBSM in an affordable housing environment.

  7. 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. PMID:22479737

  8. Hospital and Health Plan Partnerships: The Affordable Care Act's Impact on Promoting Health and Wellness

    PubMed Central

    Vu, Michelle; White, Annesha; Kelley, Virginia P.; Hopper, Jennifer Kuca; Liu, Cathy

    2016-01-01

    Background The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care. Objective To examine the ACA's impact on the health and wellness programs that have resulted from the joint ventures of hospitals and health plans based on the published literature. Method We conducted a review of the literature to identify successful mergers and best practices of health and wellness programs. Articles published between January 2007 and January 2015 were compiled from various search engines, using the search terms “corporate,” “health and wellness program,” “health plan,” “insurance plan,” “hospital,” “joint venture,” and “vertical merger.” Publications that described consolidations or wellness programs not tied to health insurance plans were excluded. Noteworthy characteristics of these programs were summarized and tabulated. Results A total of 44 eligible articles were included in the analysis. The findings showed that despite rising healthcare costs, joint ventures prevent hospitals from trading-off quality and services for cost reductions. Administrators believed that partnering would allow the companies to meet ACA standards for improving clinical outcomes at reduced costs. Before the implementation of the ACA, some employers had wellness programs, but these were not standardized and did not need to produce measurable results. The ACA encouraged improvement of employee wellness programs by providing funding for expanded health services and by mandating quality care. Successful workplace health and wellness

  9. Which moral hazard? Health care reform under the Affordable Care Act of 2010.

    PubMed

    Mendoza, Roger Lee

    2016-06-20

    Purpose - Moral hazard is a concept that is central to risk and insurance management. It refers to change in economic behavior when individuals are protected or insured against certain risks and losses whose costs are borne by another party. It asserts that the presence of an insurance contract increases the probability of a claim and the size of a claim. Through the US Affordable Care Act (ACA) of 2010, this study seeks to examine the validity and relevance of moral hazard in health care reform and determine how welfare losses or inefficiencies could be mitigated. Design/methodology/approach - This study is divided into three sections. The first contrasts conventional moral hazard from an emerging or alternative theory. The second analyzes moral hazard in terms of the evolution, organization, management, and marketing of health insurance in the USA. The third explains why and how salient reform measures under the ACA might induce health care consumption and production in ways that could either promote or restrict personal health and safety as well as social welfare maximization. Findings - Insurance generally induces health care (over) consumption. However, not every additional consumption, with or without adverse selection, can be considered wasteful or risky, even if it might cost insurers more in the short run. Moral hazard can generate welfare and equity gains. These gains might vary depending on which ACA provisions, insured population, covered illnesses, treatments, and services, as well as health outcomes are taken into account, and because of the relative ambiguities surrounding definitions of "health." Actuarial risk models can nonetheless benefit from incorporating welfare and equity gains into their basic assumptions and estimations. Originality/value - This is the first study which examines the ACA in the context of the new or alternative theory of moral hazard. It suggests that containing inefficient moral hazard, and encouraging its desirable

  10. Affordable housing through energy conservation: A guide to designing and constructing energy efficient homes

    SciTech Connect

    Not Available

    1989-06-01

    PEAR is an interactive program for residential building energy analysis utilizing a comprehensive DOE-2.1 data base for residential buildings. This data base was compiled using over 10,000 computer simulations covering five residential buildings in 45 geographical locations. This extensive data base is used by PEAR to estimate the annual energy use of houses with typical conservation measures such as ceiling, wall, and floor insulation, different window types and glazing layers, infiltration levels, and equipment efficiency. It also allows the user to include the effects of roof and wall color, movable night insulation on the windows, reflective and heat absorbing glass, an attached sunspace, and use of a night setback. Regression techniques in PEAR permit adjustments for different building geometries, window areas and orientations, wall construction, and extension of the data to over 800 US locations based on climate parameters. PEAR is designed as a user-friendly program that can be used both as a research tool by energy policy analysts, and as a nontechnical energy calculation method by architects, homebuilders, homeowners, and others in the building industry. Technical documentation of the PEAR program and the database is given elsewhere (see References). 3 refs., 11 figs., 5 tabs.

  11. 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. PMID:26207905

  12. Ninety-day waiting period limitation and technical amendments to certain health coverage requirements under the Affordable Care Act. Final rule.

    PubMed

    2014-02-24

    These final regulations implement the 90-day waiting period limitation under section 2708 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act), as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. These regulations also finalize amendments to existing regulations to conform to Affordable Care Act provisions. Specifically, these rules amend regulations implementing existing provisions such as some of the portability provisions added by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) because those provisions of the HIPAA regulations have become superseded or require amendment as a result of the market reform protections added by the Affordable Care Act. PMID:24611209

  13. Rural Affordable Care Act outreach and enrollment: what we learned during the first marketplace open enrollment period.

    PubMed

    Kwon, Linda

    2015-01-01

    As part of the Patient Protection and Affordable Care Act (Affordable Care Act) of 2010, 2 new opportunities for health care coverage were established for many uninsured individuals beginning on January 1, 2014. The first opportunity was through Medicaid expansion where states had the opportunity to expand Medicaid coverage to individuals with household incomes up to 133% of the federal poverty level. The second opportunity was through the establishment of Health Insurance Marketplaces where individuals could purchase private health plans and potentially qualify for financial assistance in paying for their plans. The Office of Rural Health Policy (ORHP) provided supplemental grant awards to help stimulate Affordable Care Act outreach and education efforts in rural communities that were being served by the Rural Health Care Services Outreach (Outreach) Grant Program. As a result, Outreach grantees enrolled 9,300 rural Americans during the initial Open Enrollment period. Valuable outreach and enrollment lessons were learned from rural communities based on discussions with the Outreach grantees who received the supplemental funding. These lessons will help rural communities prepare for the next Open Enrollment period. PMID:25494976

  14. 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 opportunity and Fair Housing Act requirements....

  15. 78 FR 7348 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-01

    ...; Exchange Standards for Employers'' (77 FR 18309). The provisions of the final rule, herein referred to as... affordability programs. We note that we expect to modify the proposed language in Sec. 155.227 (78 FR 4711) to... seeking exemptions. Similarly, we intend to modify the proposed language in Sec. 155.225 (78 FR 4710)...

  16. 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

    ... a State Consumer Partnership Exchange (Consumer Partnership Exchange). \\1\\ See 77 FR 18310, 18325-26... 27, 2012 (77 FR 18310), and is codified at 45 CFR Sec. 155.210. Section 1311(i)(3) of the Affordable... Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing, 78...

  17. 78 FR 37031 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, Premium...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ...This proposed rule sets forth 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 proposes additional standards with respect to agents and brokers. These standards, which include......

  18. 78 FR 39493 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-01

    ...This final rule implements certain functions of the Affordable Insurance Exchanges (``Exchanges''). These specific statutory functions include determining eligibility for and granting certificates of exemption from the individual shared responsibility payment described in section 5000A of the Internal Revenue Code. Additionally, this final rule implements the responsibilities of the Secretary......

  19. 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......

  20. 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

  1. 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

  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. 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

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

    PubMed

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

    2015-11-01

    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

  5. How Doula Care Can Advance the Goals of the Affordable Care Act: A Snapshot From New York City

    PubMed Central

    Strauss, Nan; Giessler, Katie; McAllister, Elan

    2015-01-01

    ABSTRACT Doula care meets each of the triple aims of the Affordable Care Act: improving health outcomes for all, improving the experience of care, and lowering costs by reducing non-beneficial and unwanted medical interventions. Cost is the greatest barrier to use of doula support. Reimbursement for doula services by private insurance, Medicaid, and Medicaid managed care organizations would significantly increase access to doulas. Widespread availability of doula care could significantly reduce cesarean rates, and increased access to community-based doula programs could reduce entrenched health disparities. PMID:26937157

  6. 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

  7. 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

    ... implementing the Mark-to-Market program in 24 CFR parts 401 and 402 (63 FR 48943). HUD accepted public comments... rule on March 22, 2000 (65 FR 15485), primarily to make regulatory changes regarding procedures other... 12, 2006, HUD issued a final rule, amending its regulations in 24 CFR parts 401 and 402 (71 FR...

  8. 24 CFR 203.439 - Mortgages on Hawaiian home lands insured pursuant to section 247 of the National Housing Act.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES SINGLE FAMILY MORTGAGE... pursuant to section 247 of the National Housing Act. (b) Claim procedure. Where the mortgage is 180 days...

  9. 7 CFR 3575.40 - Equal opportunity and Fair Housing Act requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Federal Reserve Board Regulation, 12 CFR part 202.) (b) Fair Housing Act. Certain housing-related projects... Marketing Plan and compliance with the Housing and Urban Development accessibility guidelines except for... seq.). The lender will determine that the borrower has a valid plan in effect at all times....

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

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Federal Reserve Board Regulation, 12 CFR part 202.) (b) Fair Housing Act. Certain housing-related projects... Marketing Plan and compliance with the Housing and Urban Development accessibility guidelines except for... seq.). The lender will determine that the borrower has a valid plan in effect at all times....

  11. 7 CFR 3575.40 - Equal opportunity and Fair Housing Act requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Federal Reserve Board Regulation, 12 CFR part 202.) (b) Fair Housing Act. Certain housing-related projects... Marketing Plan and compliance with the Housing and Urban Development accessibility guidelines except for... seq.). The lender will determine that the borrower has a valid plan in effect at all times....

  12. 24 CFR 180.410 - Charges under the Fair Housing Act.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... 180.410 Section 180.410 Housing and Urban Development Regulations Relating to Housing and Urban... Prior to Hearing § 180.410 Charges under the Fair Housing Act. (a) Filing and service. Within 3 days... asserted in the charge decided in a civil action under 42 U.S.C. 3612(o), in lieu of an...

  13. 24 CFR 180.410 - Charges under the Fair Housing Act.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .... 180.410 Section 180.410 Housing and Urban Development Regulations Relating to Housing and Urban... Prior to Hearing § 180.410 Charges under the Fair Housing Act. (a) Filing and service. Within 3 days... asserted in the charge decided in a civil action under 42 U.S.C. 3612(o), in lieu of an...

  14. 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. PMID:26589524

  15. Health insurance coverage among women of reproductive age before and after implementation of the affordable care act

    PubMed Central

    Jones, Rachel K.; Sonfield, Adam

    2016-01-01

    Objectives The Affordable Care Act's expansions to Medicaid and private coverage are of particular importance for women of childbearing age, who have numerous preventive care and reproductive health care needs. Study design We conducted two national surveys, one in 2012 and one in 2015, collecting information about health insurance coverage and access to care from 8000 women aged 18–39. We examine type of insurance and continuity of coverage between time periods, including poverty status and whether or not women live in a state that expanded Medicaid coverage. Results The proportion of women who were uninsured declined by almost 40% (from 19% to 12%), though several groups, including US-born and foreign-born Latinas, experienced no significant declines. Among low-income women in states that expanded Medicaid, the proportion uninsured declined from 38% to 15%, largely due to an increase in Medicaid coverage (from 40% to 62%). Declines in uninsurance in nonexpansion states were only marginally significant. Conclusions Despite substantial improvements in health insurance coverage, significant gaps remain, particularly in states that have not expanded Medicaid and for Latinas. Implications This analysis examines changes in insurance coverage that occurred after the Affordable Care Act was implemented. While coverage has improved for many populations, sizeable gaps in coverage remain for Latinas and women in states that did not expand Medicaid. PMID:26802569

  16. 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. PMID:26643627

  17. 77 FR 29235 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

    ... section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive this... FURTHER INFORMATION CONTACT: Jeff Wu at (301) 492-4416. Wakina Scott at (301) 492-4393. SUPPLEMENTARY INFORMATION: I. Background In Federal Register Doc. 2012-6594 of March 23, 2012 (77 FR 17220- 17252),...

  18. 78 FR 39869 - Coverage of Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-02

    ... Act were published on July 19, 2010 (75 FR 41726) (2010 interim final ] regulations). On August 1... services consistent with the HRSA Guidelines (76 FR 46621) (2011 amended interim final regulations), and... August 3, 2011(76 FR 46621). \\4\\ The 2012 final regulations were published on February 15, 2012 (77...

  19. 77 FR 16501 - Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... regulations implementing section 2713 of the PHS Act on July 19, 2010 (75 FR 41726). In response to comments... to the interim final rules was published on August 3, 2011, at 76 FR 46621. In the HRSA Guidelines... published on February 15, 2012 (77 FR 8725), the Departments adopted the definition of religious employer...

  20. Revisit the Higher Education Act: Make College More Affordable, Improve Teacher Preparation

    ERIC Educational Resources Information Center

    National Education Association, 2015

    2015-01-01

    First passed in 1965 to ensure that every individual has access to higher education, regardless of income, the Higher Education Act (HEA) governs the nation's student-aid programs, federal aid to colleges, and oversight of teacher preparation. This brief report discusses 4 National Education Association (NEA) priorities: (1) Make college more…

  1. Cardiovascular health outcomes of Latinos in the Affordable Housing as an Obesity Mediating Environment (AHOME) study: a study of rental assistance use.

    PubMed

    Chambers, Earle C; Rosenbaum, Emily

    2014-06-01

    Studies have shown that households subsidized with vouchers live in higher quality units and exhibit fewer physical, mental, and social problems than do their peers living in public housing. However, none of these studies have included cardiovascular outcomes. The objective of this study was to assess if use/type of rental assistance is independently associated with poor cardiovascular health among Latino adults (ages ≥ 18) who are eligible for federal low-income rental assistance and living in the Bronx, NY. Data from the cross-sectional, Affordable Housing as an Obesity Mediating Environment study, collected over 18 months (January 2011 to August 2012) were used. The prevalence of cardiovascular disease (CVD) outcomes was determined by measured high blood pressure and self-reported heart attack and/or stroke. Type of housing status was defined as: public housing units, units subsidized by section 8 vouchers, and units unassisted by either federal program. Statistical techniques used were analysis of variance and multivariate logistic regression. The prevalence of CVD was significantly higher among public housing residents than unassisted participants even in the presence of all individual level covariates. Public housing residents also have higher levels of CVD than do section 8 participants. The prevalence of CVD was similar for unassisted and section 8 participants. These findings point to the potential for health benefits arising from housing voucher use even within a fairly delimited geographic area. PMID:24190105

  2. 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

  3. 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. PMID:25811340

  4. Implications for multiple sclerosis in the era of the Affordable Care Act: the shifting managed care landscape.

    PubMed

    Mathis, A Scott; Owens, Gary M

    2014-12-01

    Multiple sclerosis (MS) is a disorder of the central nervous system that is associated with disability, reduced quality of life, extensive medical and nonmedical costs, and lost productivity. Specialty medications that are crucial to effective disease management, helping to prevent debilitating episodes of relapse, account for a substantial portion of the medical expenditures associated with MS. Although these therapies are not considered cost-effective by conventional definitions, they are comparable to one another in cost-effectiveness estimates, leaving the complex task of designing cost-efficient formulary management strategies to managed care professionals. Current epidemiologic data suggest that most patients with MS are covered by some form of healthcare insurance, but plan designs and formulary restrictions may still create access barriers for some patients. The Affordable Care Act (ACA) is recent federal legislation that seeks to provide new consumer protections, improve healthcare quality and accessibility while mitigating expenditures, and increase accountability of healthcare insurance companies. The impact of the ACA on specialty pharmaceuticals is unclear at this time, but it does appear to have already begun improving healthcare coverage across the population. Managed care professionals must work within the confines of the ACA to provide better and more affordable care that targets overall cost reductions rather than just pharmacy expenses. PMID:25734889

  5. Affordable High-Performance Homes: The 2002 NREL Denver Habitat for Humanity House, A Cold-Climate Case Study

    SciTech Connect

    2005-04-01

    Habitat for Humanity affiliates throughout the U.S. are taking the lead on an integrated systems-design approach to building homes that are more efficient, more comfortable, more affordable, and more durable than homes built with standard practices.

  6. Medicaid program; increased Federal Medical Assistance Percentage changes under the Affordable Care Act of 2010. Final rule with request for comments.

    PubMed

    2013-04-01

    This final rule implements the provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) relating to the availability of increased Federal Medical Assistance Percentage (FMAP) rates for certain adult populations under states' Medicaid programs. This final rule implements and interprets the increased FMAP rates that will be applicable beginning January 1, 2014 and sets forth conditions for states to claim these increased FMAP rates. PMID:23556184

  7. 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

  8. Access to health insurance and the use of inpatient medical care: evidence from the Affordable Care Act young adult mandate.

    PubMed

    Akosa Antwi, Yaa; Moriya, Asako S; Simon, Kosali I

    2015-01-01

    The Affordable Care Act of 2010 expanded coverage to young adults by allowing them to remain on their parent's private health insurance until they turn 26 years old. While there is evidence on insurance effects, we know very little about use of general or specific forms of medical care. We study the implications of the expansion on inpatient hospitalizations. Given the prevalence of mental health needs for young adults, we also specifically study mental health related inpatient care. We find evidence that compared to those aged 27-29 years, treated young adults aged 19-25 years increased their inpatient visits by 3.5 percent while mental illness visits increased 9.0 percent. The prevalence of uninsurance among hospitalized young adults decreased by 12.5 percent; however, it does not appear that the intensity of inpatient treatment changed despite the change in reimbursement composition of patients. PMID:25544401

  9. 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. PMID:25588235

  10. Health care transition from pediatric care to adult care: opportunities and challenges under the Affordable Care Act.

    PubMed

    Webb, Lauren; Shah, Parag K; Harisiades, James P; Boudos, Rebecca; Agrawal, Rishi

    2015-01-01

    Enrollment of young adults is foundational to the success of the Affordable Care Act (ACA). This article analyzes the implications for young adults transitioning from pediatric to adult care with the implementation of the ACA. We review the key characteristics of this population relevant to health care utilization and access as well as the impact of private insurance market reforms, health insurance marketplaces, Medicaid expansion, and workforce development provisions on this population. We then analyze how reform is impacting and will continue to impact specific populations of young adults, including individuals with disabilities, college students, immigrants, young adults who age out of the foster care system and individuals involved with the criminal justice system. Finally, we look at the socio-economic and political factors influencing outreach efforts, and make recommendations to maximize the benefits of the law for young adults to empower them to have access to care and financial security. PMID:25737348

  11. 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. PMID:27060524

  12. Wearing the crown of Solomon? Chief Justice Roberts and the Affordable Care Act "tax".

    PubMed

    Muise, Robert J; Yerushalmi, David

    2013-04-01

    Attempting to play the role of King Solomon in his PPACA decision, Chief Justice John Roberts split the baby perversely by ruling it was not a tax under the Anti-Injunction Act, which would have likely deprived the Court of jurisdiction to hear this pre-enforcement challenge to the individual mandate, but it was a tax for taxing and spending purposes even though Congress said it was a "penalty" and not a tax. And the Chief Justice had to twist further his "wisdom" to hold that it was not an unconstitutional direct tax, even though that is exactly what it is, if it is a tax in the first instance. PMID:23262766

  13. 24 CFR 248.221 - Approval of a plan of action that involves termination of low income affordability restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... involves termination of low income affordability restrictions. 248.221 Section 248.221 Housing and Urban... LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES PREPAYMENT OF LOW INCOME HOUSING MORTGAGES Prepayment and Plans of Action Under the Emergency Low Income Preservation Act of...

  14. Clinical decision support for imaging in the era of the Patient Protection and Affordable Care Act.

    PubMed

    Zafar, Hanna M; Mills, Angela M; Khorasani, Ramin; Langlotz, Curtis P

    2012-12-01

    Imaging clinical decision support (CDS) systems provide evidence for or against imaging procedures ordered within a computerized physician order entry system at the time of the image order. Depending on the pertinent clinical history provided by the ordering clinician, CDS systems can optimize imaging by educating providers on appropriate image order entry and by alerting providers to the results of prior, potentially relevant imaging procedures, thereby reducing redundant imaging. The American Recovery and Reinvestment Act (ARRA) has expedited the adoption of computerized physician order entry and CDS systems in health care through the creation of financial incentives and penalties to promote the "meaningful use" of health IT. Meaningful use represents the latest logical next step in a long chain of legislation promoting the areas of appropriate imaging utilization, accurate reporting, and IT. It is uncertain if large-scale implementation of imaging CDS will lead to improved health care quality, as seen in smaller settings, or to improved patient outcomes. However, imaging CDS enables the correlation of existing imaging evidence with outcome measures, including morbidity, mortality, and short-term imaging-relevant management outcomes (eg, biopsy, chemotherapy). The purposes of this article are to review the legislative sequence relevant to imaging CDS and to give guidance to radiology practices focused on quality and financial performance improvement during this time of accelerating regulatory change. PMID:23206649

  15. 24 CFR 906.35 - Inapplicability of section 18 of the United States Housing Act of 1937.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT PUBLIC HOUSING HOMEOWNERSHIP PROGRAMS Program Administration § 906.35 Inapplicability of section 18 of the United States Housing Act of 1937. The provisions...

  16. 24 CFR 906.35 - Inapplicability of section 18 of the United States Housing Act of 1937.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT PUBLIC HOUSING HOMEOWNERSHIP PROGRAMS Program... section 18 of the 1937 Act (42 U.S.C. 1437p) do not apply to disposition of public housing dwelling...

  17. 24 CFR 906.35 - Inapplicability of section 18 of the United States Housing Act of 1937.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT PUBLIC HOUSING HOMEOWNERSHIP PROGRAMS Program... section 18 of the 1937 Act (42 U.S.C. 1437p) do not apply to disposition of public housing dwelling...

  18. 24 CFR 906.35 - Inapplicability of section 18 of the United States Housing Act of 1937.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT PUBLIC HOUSING HOMEOWNERSHIP PROGRAMS Program... section 18 of the 1937 Act (42 U.S.C. 1437p) do not apply to disposition of public housing dwelling...

  19. 24 CFR 1000.40 - Do lead-based paint poisoning prevention requirements apply to 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 Do lead-based paint poisoning... AMERICAN HOUSING ACTIVITIES General § 1000.40 Do lead-based paint poisoning prevention requirements apply..., subparts A, B, H, J, K, M and R of this title, which implement the Lead-Based Paint Poisoning...

  20. 24 CFR 1000.40 - Do lead-based paint poisoning prevention requirements apply to affordable housing activities...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Do lead-based paint poisoning... AMERICAN HOUSING ACTIVITIES General § 1000.40 Do lead-based paint poisoning prevention requirements apply..., subparts A, B, H, J, K, M and R of this title, which implement the Lead-Based Paint Poisoning...

  1. 24 CFR 1000.40 - Do lead-based paint poisoning prevention requirements apply to affordable housing activities...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Do lead-based paint poisoning... AMERICAN HOUSING ACTIVITIES General § 1000.40 Do lead-based paint poisoning prevention requirements apply..., subparts A, B, H, J, K, M and R of this title, which implement the Lead-Based Paint Poisoning...

  2. 24 CFR 1000.40 - Do lead-based paint poisoning prevention requirements apply to affordable housing activities...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Do lead-based paint poisoning... AMERICAN HOUSING ACTIVITIES General § 1000.40 Do lead-based paint poisoning prevention requirements apply..., subparts A, B, H, J, K, M and R of this title, which implement the Lead-Based Paint Poisoning...

  3. Should the Affordable Care Act's preventive services coverage provision be used to widely disseminate whole genome sequencing to Americans?

    PubMed

    Payne, Perry W

    2014-02-01

    I argue that the provision of the Patient Protection and Affordable Care Act (ACA) of 2010, which eliminates cost sharing for preventive services, should be utilized as a pathway for reimbursing whole genome sequencing (WGS) and making it widely available to most Americans. This act provides multiple routes for determining which preventive services receive this designation. Three of these routes should be considered as pathways for reimbursing WGS, including approval by the United States Preventive Services Task Force, inclusion in the guidelines of the American Academy of Pediatrics Bright Futures Project, and classification as a preventive service for women by the Institute of Medicine. There are valid arguments against the expansion of this technology, including inadequate national and state laws prohibiting genetic discrimination, informed consent limitations, and potentially expensive genome interpretations. These concerns should not inhibit the wide dissemination of this technology, as current efforts by the NIH and industry to expand the use of genome sequencing demonstrate. The ACA should be used as a tool to prevent disparities in access to genome information in the United States and avoid the development of a two-tiered health system based on those with and without genome sequence data. PMID:24193604

  4. 77 FR 19154 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... be open to the public; however, public attendance may be limited to the space available. Members of... Native American Programs, Office of Public and Indian Housing, Department of Housing and Urban... Reauthorization Act of 2008: Negotiated Rulemaking Committee AGENCY: Office of the Assistant Secretary for...

  5. 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

    ... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... Native American Housing Assistance and Self-Determination Reauthorization Act of 2008. The primary... CONTACT: Rodger J. Boyd, Deputy Assistant Secretary for Native American Programs, Office of Public...

  6. 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

    ... Americans. NAHASDA eliminated several separate assistance programs and replaced them with a single block... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... Native American Housing Assistance and Self-Determination Reauthorization Act of 2008. The...

  7. 75 FR 60482 - Proposed Extension of Information Collection Request Submitted for Public Comment; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ... 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 Care Act Enrollment Opportunity...

  8. The Equal Credit Opportunity Act and Credit Rights in Housing.

    ERIC Educational Resources Information Center

    Board of Governors of the Federal Reserve System, Washington, DC.

    Designed for the general public and possibly suitable also for high school economics students, this pamphlet describes the provisions of the Equal Credit Opportunity Act. The act prohibits discrimination because of race, color, religion, national origin, sex, marital status, and age when applying for a mortgage or home improvement loan. The…

  9. Affordable Health Choices Act

    THOMAS, 111th Congress

    Sen. Harkin, Tom [D-IA

    2009-09-17

    09/17/2009 Placed on Senate Legislative Calendar under General Orders. Calendar No. 161. (All Actions) Notes: For further action, see H.R.3590, which became Public Law 111-148 on 3/23/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. Affordable College Textbook Act

    THOMAS, 113th Congress

    Sen. Durbin, Richard [D-IL

    2013-11-14

    11/14/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S8051-8052) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  11. Student Loan Affordability Act

    THOMAS, 113th Congress

    Sen. Reed, Jack [D-RI

    2013-05-14

    06/06/2013 Cloture on the motion to proceed to measure not invoked in Senate by Yea-Nay Vote. 51 - 46. Record Vote Number: 143. (consideration: CR S3977-3978) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  12. Leveraging The Affordable Care Act To Enroll Justice-Involved Populations In Medicaid: State And Local Efforts

    PubMed Central

    Bandara, Sachini N.; Huskamp, Haiden A.; Riedel, Lauren E.; McGinty, Emma E.; Webster, Daniel; Toone, Robert E.; Barry, Colleen L.

    2016-01-01

    The Affordable Care Act provides an unprecedented opportunity to enroll criminal justice–involved populations in health insurance, particularly Medicaid. As a result, many state and county corrections departments have launched programs that incorporate Medicaid enrollment in discharge planning. Our study characterizes the national landscape of programs enrolling criminal justice–involved populations in Medicaid as of January 2015. We provide an overview of sixty-four programs operating in jails, prisons, or community probation and parole systems that enroll individuals during detention, incarceration, and the release process. We describe the variation among the programs in terms of settings, personnel, timing of eligibility screening, and target populations. Seventy-seven percent of the programs are located in jails, and 56 percent use personnel from public health or social service agencies. We describe four practices that have facilitated the Medicaid enrollment process: suspending instead of terminating Medicaid benefits upon incarceration, presuming that an individual is eligible for Medicaid before the process is completed, allowing enrollment during incarceration, and accepting alternative forms of identification for enrollment. The criminal justice system is a complex one that requires a variety of approaches to enroll individuals in Medicaid. Future research should examine how these approaches influence health and criminal justice outcomes. PMID:26643624

  13. Community Health Center Utilization Following the 2008 Medicaid Expansion in Oregon: Implications for the Affordable Care Act

    PubMed Central

    Hatch, Brigit; Bailey, Steffani R.; Cowburn, Stuart; Marino, Miguel; Angier, Heather; DeVoe, Jennifer E.

    2016-01-01

    Objectives To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon’s 2008 Medicaid expansion (the Oregon Experiment). Methods We conducted a retrospective cohort study with electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those who maintained (n = 788) or lost (n = 944) insurance coverage. We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period. Results Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage. Conclusions Individuals who maintained coverage through Oregon’s Medicaid expansion increased long-term utilization of CHCs, whereas those with unstable coverage did not. Policy implications This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention. PMID:26890164

  14. Four Years Later: Rural Mothers' and Employers' Perspectives on Breastfeeding Barriers Following the Passage of the Affordable Care Act.

    PubMed

    Majee, Wilson; Jefferson, Urmeka T; Goodman, Laurel R; Olsberg, Joshua E

    2016-01-01

    For the working rural mother, one key source of support for breastfeeding is the employer. The purpose of this article was to examine workplace barriers and facilitators to breastfeeding in a small rural American community following the passage of the Affordable Care Act in 2010. We used a qualitative research design: semi-structured interviews with major employers and low-income working breastfeeding mothers, and a focus-group with another group of employed and unemployed breastfeeding low-income mothers. While some businesses accommodate breastfeeding mothers, few actively promote breastfeeding. Lack of compliance with the new law, inadequate breastfeeding information for mothers, and lack of support from co-workers and supervisors emerged as the main barriers to successful workplace breastfeeding. To improve workplace breastfeeding support significantly there is need for authentic collaboration among maternal-child and rural health agencies and businesses in creating breastfeeding-tolerant, flexible, and forward-looking work environments that, at a minimum, satisfy the law. PMID:27524755

  15. The U.S. Health Care Crisis Five Years After Passage of the Affordable Care Act: A Data Snapshot.

    PubMed

    Hellander, Ida

    2015-01-01

    Despite passage of the Affordable Care Act in 2010, the U.S. health care crisis continues. While coverage has been expanded, the reform will leave 27 million people uninsured in 2024, according to the Congressional Budget Office. Much of the new coverage is of low actuarial value with high cost-sharing requirements, creating barriers to access. Choice of physician is restricted to narrow networks of providers. Recent measures of uninsurance, underinsurance, access to care, and health care costs are given. Changes in Medicare, particularly privatization and the rise of specialty drug tiers that limit access to medically necessary medications, are reviewed. Data on a new wave of consolidation among hospitals, medical groups, insurers, and drug companies are presented. The rise of ultra-high-price drugs, such as Solvadi, is raising pharmaceutical costs, particularly in Medicaid, the program for low-income Americans. International health comparisons continue to show the United States performing poorly in relation to other countries. Recent polling data are presented, showing support for more fundamental reform. PMID:26251349

  16. Leveraging The Affordable Care Act To Enroll Justice-Involved Populations In Medicaid: State And Local Efforts.

    PubMed

    Bandara, Sachini N; Huskamp, Haiden A; Riedel, Lauren E; McGinty, Emma E; Webster, Daniel; Toone, Robert E; Barry, Colleen L

    2015-12-01

    The Affordable Care Act provides an unprecedented opportunity to enroll criminal justice-involved populations in health insurance, particularly Medicaid. As a result, many state and county corrections departments have launched programs that incorporate Medicaid enrollment in discharge planning. Our study characterizes the national landscape of programs enrolling criminal justice-involved populations in Medicaid as of January 2015. We provide an overview of sixty-four programs operating in jails, prisons, or community probation and parole systems that enroll individuals during detention, incarceration, and the release process. We describe the variation among the programs in terms of settings, personnel, timing of eligibility screening, and target populations. Seventy-seven percent of the programs are located in jails, and 56 percent use personnel from public health or social service agencies. We describe four practices that have facilitated the Medicaid enrollment process: suspending instead of terminating Medicaid benefits upon incarceration, presuming that an individual is eligible for Medicaid before the process is completed, allowing enrollment during incarceration, and accepting alternative forms of identification for enrollment. The criminal justice system is a complex one that requires a variety of approaches to enroll individuals in Medicaid. Future research should examine how these approaches influence health and criminal justice outcomes. PMID:26643624

  17. Routine HIV screening in North Carolina in the era of the Affordable Care Act: update on laws, reimbursement, and tests.

    PubMed

    White, Becky L; Carter, Yvonne L; Records, Katherine; Martin, Ian B K

    2013-11-01

    Eighteen percent of the 1.2 million human immunodeficiency virus (HIV)-infected individuals in the United States are undiagnosed, with North Carolina accounting for the eighth largest number of new HIV diagnoses in 2011. In an effort to identify more HIV-infected individuals by reducing physician barriers to HIV testing, the Centers for Disease Control and Prevention have expanded their HIV screening recommendations to adolescents and adults without HIV risk factors or behaviors, eliminated federal requirements for pretest counseling, and modified the informed consent process. In 2010, the Office of National AIDS (acquired immunodeficiency syndrome) Policy released the first-ever national HIV/AIDS strategy, with the goal of reducing new infections, increasing access to care, improving HIV outcomes, and reducing HIV racial/ethnic disparities. In 2013, the US Preventive Services Task Force released A-level recommendations recommending nonrisk-based HIV screening for adults and adolescents that are consistent with the recommendations of the Centers for Disease Control and Prevention. In concert with these federal recommendations, the majority of states have modified their consent and counseling requirements. The implementation of the Patient Protection and Affordable Care Act will add requirements and incentives for federal (Medicare), state (Medicaid), and private (insurance) payers to reimburse physicians and patients for nonrisk-based HIV screening. PMID:24192596

  18. 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. PMID:24583487

  19. 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. PMID:27017638

  20. Students implement the Affordable Care Act: a model for undergraduate teaching and research in community health and sociology.

    PubMed

    Green, Brandn; Jones, Kristal; Boyd, Neil; Milofsky, Carl; Martin, Eric

    2015-06-01

    The implementation of the Affordable Care Act (ACA) provides an opportunity for undergraduate students to observe and experience first-hand changing social policies and their impacts for individuals and communities. This article overviews an action research and teaching project developed at an undergraduate liberal arts university and focused on providing ACA enrollment assistance as a way to support student engagement with community health. The project was oriented around education, enrollment and evaluation activities in the community, and students and faculty together reflected on and analyzed the experiences that came from the research and outreach project. Student learning centered around applying concepts of diversity and political agency to health policy and community health systems. Students reported and faculty observed an unexpected empowerment for students who were able to use their university-learned critical thinking skills to explain complex systems to a wide range of audiences. In addition, because the project was centered at a university with no health professions programs, the project provided students interested in community and public health with the opportunity to reflect on how health and access to health care is conditioned by social context. The structure and pedagogical approaches and implications of the action research and teaching project is presented here as a case study for how to engage undergraduates in questions of community and public health through the lens of health policy and community engagement. PMID:25312869

  1. Drug Abuse Resistance Education Act of 1990. House of Representatives, 101st Congress, 2d Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    This document is a congressional report on the Drug Abuse Resistance Education Act of 1990, House of Representatives (H.R.) 5064 which requires the Secretary of Education to reserve $15 million from the appropriations made for the Drug Free Schools and Communities Act for grants to consortia of local educational agencies and other agencies to…

  2. 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

    ..., to the Assistant Secretary for Fair Housing and Equal Opportunity. On December 17, 2007 (72 FR 71429... URBAN DEVELOPMENT Redelegation of Authority Under Section 3 of the Housing and Urban Development Act of... Housing and Equal Opportunity (FHEO) has been delegated authority under Section 3 of the Housing and...

  3. Learning from the Past--Preparing for the Future: Addressing Fair and Affordable Housing Issues in the Chicago Region.

    ERIC Educational Resources Information Center

    Lewis, James H.

    This conference paper discusses the current situation of racial differences in housing in the Chicago (Illinois) area with regard to the ramifications of the "Miliken v. Bradley" (1974) case. The Miliken case closed the door on busing and school desegregation plans crossing school district lines and in many cases, crossing municipal boundaries. It…

  4. Chlamydia screening for sexually active young women under the Affordable Care Act: new opportunities and lingering barriers.

    PubMed

    Loosier, Penny S; Malcarney, Mary-Beth; Slive, Lauren; Cramer, Ryan C; Burgess, Brittany; Hoover, Karen W; Romaguera, Raul

    2014-09-01

    The Affordable Care Act of 2010 (ACA) contains a provision requiring private insurers issuing or renewing plans on or after September 23, 2010, to provide, without cost sharing, preventive services recommended by US Preventive Services Task Force (grades A and B), among other recommending bodies. As a grade A recommendation, chlamydia screening for sexually active young women 24 years and younger and older women at risk for chlamydia falls under this requirement. This article examines the potential effect on chlamydia screening among this population across private and public health plans and identifies lingering barriers not addressed by this legislation. Examination of the impact on women with private insurance touches upon the distinction between coverage under grandfathered plans, where the requirement does not apply, and nongrandfathered plans, where the requirement does apply. Acquisition of private health insurance through health insurance Marketplaces is also discussed. For public health plans, coverage of preventive services without cost sharing differs for individuals enrolled in standard Medicaid, covered under the Medicaid expansion included in the ACA, or those enrolled under the Children's Health Insurance Program or who fall under Early, Periodic, Screening, Diagnosis and Treatment criteria. The discussion of lingering barriers not addressed by the ACA includes the uninsured, physician reimbursement, cost sharing, confidentiality, low rates of appropriate sexual history taking by providers, and disclosures of sensitive information. In addition, the role of safety net programs that provide health care to individuals regardless of ability to pay is examined in light of the expectation that they also remain a payer of last resort. PMID:25118966

  5. How Does Religious Affiliation Affect Women’s Attitudes Toward Reproductive Health Policy? Implications for the Affordable Care Act

    PubMed Central

    Patton, Elizabeth W.; Hall, Kelli Stidham; Dalton, Vanessa K.

    2015-01-01

    Structured Abstract Background Supreme Court cases challenging the Affordable Care Act (ACA) mandate for employer-provided reproductive health care have focused on religiously based opposition to coverage. Little is known about women’s perspectives on such reproductive health policies. Study Design Data were drawn from the Women’s Health Care Experiences and Preferences survey, a randomly selected, nationally representative sample of 1078 US women age 18–55. We examined associations between religious affiliation and attitudes toward employer-provided insurance coverage of contraception and abortion services, and the exclusion of religious institutions from this coverage. We used chi-square and multivariable logistic regression for analysis. Results Respondents self-identified as Baptist (18%), Protestant (Other Mainline, 17%), Catholic (17%), Other Christian (20%), Religious, Non-Christian (7%) or no affiliation (21%). Religious affiliation was associated with proportions of agreement for contraception (p = 0.03), abortion (p <0.01), and religious exclusion (p <0.01) policies. In multivariable models, differences in the odds of agreement varied across religious affiliations and frequency of service attendance. For example, compared to non-affiliated women, Baptists and Other Nondenominational Christians (but not Catholics) had lower odds of agreement with employer coverage of contraception (OR 0.63, 95% CI 0.4-0.1 and OR 0.57, CI 0.4–0.9, respectively); women who attended services weekly or more than weekly had lower odds of agreement (OR 0.53, 95% CI 0.3–0.8 and OR 0.33, CI 0.2–0.6, respectively), compared to less frequent attenders. Conclusions Recent religiously motivated legal challenges to employer-provided reproductive health care coverage may not represent the attitudes of many religious women. PMID:25727764

  6. Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act

    PubMed Central

    Huntoon, Kristin M.; McCluney, Colin J.; Scannell, Christopher A.; Wiley, Elizabeth A.; Bruno, Richard; Andrews, Allen; Gorman, Paul

    2011-01-01

    Context Over one year after passage of the Patient Protection and Affordable Care Act (PPACA), legislators, healthcare experts, physicians, and the general public continue to debate the implications of the law and its repeal. The PPACA will have a significant impact on future physicians, yet medical student perspectives on the legislation have not been well documented. Objective To evaluate medical students' understanding of and attitudes toward healthcare reform and the PPACA including issues of quality, access and cost. Design, Setting, and Participants An anonymous electronic survey was sent to medical students at 10 medical schools (total of 6982 students) between October–December 2010, with 1232 students responding and a response rate of 18%. Main Outcome Measures Medical students' views and attitudes regarding the PPACA and related topics, measured with Likert scale and open response items. Results Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided. Conclusion The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment. PMID:21931604

  7. The HHS-HCC Risk Adjustment Model for Individual and Small Group Markets under the Affordable Care Act

    PubMed Central

    Kautter, John; Pope, Gregory C; Ingber, Melvin; Freeman, Sara; Patterson, Lindsey; Cohen, Michael; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses are 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. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the second of three in this issue of the Review that describe the Department of Health and Human Services (HHS) risk adjustment methodology and focuses on the risk adjustment model. In our first companion article, we discuss the key issues and choices in developing the methodology. In this article, we present the risk adjustment model, which is named the HHS-Hierarchical Condition Categories (HHS-HCC) risk adjustment model. We first summarize the HHS-HCC diagnostic classification, which is the key element of the risk adjustment model. Then the data and methods, results, and evaluation of the risk adjustment model are presented. Fifteen separate models are developed. For each age group (adult, child, and infant), a model is developed for each cost sharing level (platinum, gold, silver, and bronze metal levels, as well as catastrophic plans). Evaluation of the risk adjustment models shows good predictive accuracy, both for individuals and for groups. Lastly, this article provides examples of how the model output is used to calculate risk scores, which are an input into the risk transfer formula. Our third companion paper describes the risk transfer formula. PMID:25360387

  8. The HHS-HCC risk adjustment model for individual and small group markets under the Affordable Care Act.

    PubMed

    Kautter, John; Pope, Gregory C; Ingber, Melvin; Freeman, Sara; Patterson, Lindsey; Cohen, Michael; Keenan, Patricia

    2014-01-01

    Beginning in 2014, individuals and small businesses are 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. The risk adjustment methodology includes the risk adjustment model and the risk transfer formula. This article is the second of three in this issue of the Review that describe the Department of Health and Human Services (HHS) risk adjustment methodology and focuses on the risk adjustment model. In our first companion article, we discuss the key issues and choices in developing the methodology. In this article, we present the risk adjustment model, which is named the HHS-Hierarchical Condition Categories (HHS-HCC) risk adjustment model. We first summarize the HHS-HCC diagnostic classification, which is the key element of the risk adjustment model. Then the data and methods, results, and evaluation of the risk adjustment model are presented. Fifteen separate models are developed. For each age group (adult, child, and infant), a model is developed for each cost sharing level (platinum, gold, silver, and bronze metal levels, as well as catastrophic plans). Evaluation of the risk adjustment models shows good predictive accuracy, both for individuals and for groups. Lastly, this article provides examples of how the model output is used to calculate risk scores, which are an input into the risk transfer formula. Our third companion paper describes the risk transfer formula. PMID:25360387

  9. 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. PMID:25132244

  10. 77 FR 37233 - Consolidated Delegation of Authority for the Office of Housing-Federal Housing Administration (FHA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ... Disposition Reform Act of 1994 (Pub. L. 103-233, 12 U.S.C. 1701 note); (9) The Housing Development Grant...- 116); and all provisions of the Multifamily Assisted Housing Reform and Affordability Act (MAHRA) (42... requirement contained in section 941(b) of the Dodd-Frank Wall Street Reform and Consumer Protection Act...

  11. Affordable housing through energy conservation: a guide to designing and constructing energy efficient homes. Data base for simplified energy analysis

    SciTech Connect

    Not Available

    1983-06-01

    The DOE-2.1a data base for the five residential prototypes has been analyzed by means of a computer program and reduced to a set of matrices that cover 45 locations. The matrix method for calculating the heating and cooling loads for residential buildings was developed by analyzing the data base load results and running test models to determine the effect of each building component independently of the rest of the building. All of the residential data that we have produced by doing DOE-2.1a computer simulations, including the window sensitivity data, was processed through the matrix program and was broken down into six basic components for each prototype: 1) ceiling insulation, 2) wall insulation, 3) foundation insulation, 4) infiltration (in air changes per hour), 5) window pane, sash type, gap, and area, and 6) the floor area of the house. These six components were manipulated separately for heating and cooling.

  12. Final Rules for Grandfathered Plans, Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, Dependent Coverage, Appeals, and Patient Protections Under the Affordable Care Act. Final rules.

    PubMed

    2015-11-18

    This document contains final regulations regarding grandfathered health plans, preexisting condition exclusions, lifetime and annual dollar limits on benefits, rescissions, coverage of dependent children to age 26, internal claims and appeal and external review processes, and patient protections under the Affordable Care Act. It finalizes changes to the proposed and interim final rules based on comments and incorporates subregulatory guidance issued since publication of the proposed and interim final rules. PMID:26595941

  13. 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

    ...The Bureau of Land Management (BLM) proposes to sell a 5-acre public land parcel located in the southern portion of the Las Vegas Valley in Clark County, Nevada, under the authorities of Sections 203 of the Federal Land Policy and Management Act of 1976 (FLPMA), as amended, and the BLM land sale conveyance regulations. In compliance with Section 7b of the Southern Nevada Public Land Management......

  14. Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade.

    PubMed

    Manchikanti, Laxmaiah; Caraway, David L; Parr, Allan T; Fellows, Bert; Hirsch, Joshua A

    2011-01-01

    The Patient Protection and Affordable Care Act (the ACA, for short) became law with President Obama's signature on March 23, 2010. It represents the most significant transformation of the American health care system since Medicare and Medicaid. It is argued that it will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The length and complexity of the legislation and divisive and heated debates have led to massive confusion about the impact of ACA. It also became one of the centerpieces of 2010 congressional campaigns. Essentials of ACA include: 1) a mandate for individuals and businesses requiring as a matter of law that nearly every American have 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 about 34 million Americans who are currently uninsured - subsidized through Medicaid and exchanges; 3) extensive new requirements on the health insurance industry; and 4) numerous regulations on the practice of medicine. The act is divided into 10 titles. It contains provisions that went into effect starting on June 21, 2010, with the majority of provisions going into effect in 2014 and later. The perceived major impact on practicing physicians in the ACA is related to growing regulatory authority with the Independent Payment Advisory Board (IPAB) and the Patient Centered Outcomes Research Institute (PCORI). In addition to these specifics is a growth of the regulatory regime in association with further discounts in physician reimbursement. With regards to cost controls and projections, many believe that the ACA does not fix the finances of our health care system - neither public nor private. It has been suggested that the Congressional Budget Office (CBO) and the administration have used creative accounting to arrive at an alleged deficit reduction; however, if everything is included appropriately and

  15. 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

    .... SUPPLEMENTARY INFORMATION: I. Background The Native American Housing Assistance and Self-Determination... Rulemaking Committee Meeting published on February 22, 2010 at (75 FR 7579). The NAHASDA Reauthorization... implement aspects of the 2008 Reauthorization Act that require rulemaking. On January 5, 2010 (75 FR...

  16. 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

    ...The proposed information collection requirement described below will be 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. The purpose of this information collection submission is to implement the requirement that public housing agencies have available upon request,......

  17. 24 CFR 203.43h - Eligibility of mortgages on Indian land insured pursuant to section 248 of the National Housing Act.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES SINGLE FAMILY MORTGAGE... mortgages on Indian land insured pursuant to section 248 of the National Housing Act. A mortgage covering...

  18. 75 FR 80066 - Technical Suitability of Products Program Section 521 of the National Housing Act; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... URBAN DEVELOPMENT Technical Suitability of Products Program Section 521 of the National Housing Act... Development, 451 7th Street, SW., Washington, DC 20410; e-mail Colette.Pollard@hud.gov or telephone (202) 402... Housing Programs, Department of Housing and Urban Development, 451 7th Street SW., Washington, DC...

  19. 24 CFR 203.438 - Mortgages on Indian land insured pursuant to section 248 of the National Housing Act.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES SINGLE FAMILY MORTGAGE INSURANCE Contract Rights... receive insurance benefits, a mortgagee shall be entitled to receive such benefits on a mortgage...

  20. Mammography Screening in a Large Health System Following the U.S. Preventive Services Task Force Recommendations and the Affordable Care Act

    PubMed Central

    Nelson, Heidi D.; Weerasinghe, Roshanthi; Wang, Lian; Grunkemeier, Gary

    2015-01-01

    Background Practice recommendations for mammography screening were issued by the U.S. Preventive Services Task Force in 2009 and expansion of insurance coverage was provided under the Patient Protection and Affordable Care Act soon thereafter, yet the influence of these changes on screening practices in the United States is not known. Methods To determine changes in mammography screening and their associations with new practice recommendations and the Affordable Care Act, we examined patient-level data from 249,803 screening mammograms from January 1, 2008 through December 31, 2012 in a large community-based health system in the northwestern United States. Associations were determined by an intervention analysis of time-series data method. Results Among women screened, 64% were age 50-74 years; 84% self-identified as white race; 62% had commercial insurance; and 70% were seen in facilities located in metropolitan areas. Practice recommendations were associated with decreased screening volumes among women age <40 (-37.4 mammograms/month; -39.4% change; P<0.001), 40-49 (-106.0 mammograms/month; -11.2% change; P<0.001), and ≥75 (-54.7 mammograms/month; -10.0% change; P<0.001), but not women age 50-74. Implementation of the Affordable Care Act was associated with increased screening among women age 50-74 (+184.3 mammograms/month; +7.2% change; P=0.001), but not women <40 or ≥75; increases for age 40-49 were of borderline statistical significance (+56.9 mammograms/month; +6% change; P=0.06). Practice recommendations were also associated with decreased screening for women with commercial insurance, while the Affordable Care Act was associated with increased screening for women with Medicare, Medicaid, or other noncommercial sources of payment. Conclusions Mammography screening volumes in a large community health system decreased among women age <50 and ≥75 in association with new U.S. Preventive Services Task Force practice recommendations, while insurance coverage

  1. 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

    ... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning July 1, 2012, is 1\\5/8\\ percent. The interest rate for debentures issued under any other provision of the Act is the rate in effect on the date that...

  2. 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

    ... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning July 1, 2011, is 3 percent. The interest rate for debentures issued under any other provision of the Act is the rate in effect on the date that the...

  3. 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

    ... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning July 1, 2013, is 1\\3/4\\ percent. The interest rate for debentures issued under any other provision of the Act is the rate in effect on the date that...

  4. 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

    ... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section 221(g)(4) of the Act during the 6-month period beginning July 1, 2010, is 3\\3/8\\ percent. The interest rate for debentures issued under any other provision of the Act is the rate in effect on the date that...

  5. Americans' Experiences with ACA Marketplace and Medicaid Coverage: Access to Care and Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February–April 2016.

    PubMed

    Collins, Sara R; Gunja, Munira; Doty, Michelle M; Beutel, Sophie

    2016-05-01

    The fourth wave of the Commonwealth Fund Affordable Care Act Tracking Survey, February--April 2016, finds at the close of the third open enrollment period that the working-age adult uninsured rate stands at 12.7 percent, statistically unchanged from 2015 but significantly lower than 2014 and 2013. Uninsured rates in the past three years have fallen most steeply for low-income adults though remain higher compared to wealthier adults. ACA marketplace and Medicaid coverage is helping to end long bouts without insurance, bridge gaps when employer insurance is lost, and improve access to health care. Sixty-one percent of enrollees who had used their insurance to get care said they would not have been able to afford or access it prior to enrolling. Doctor availability and appointment wait times are similar to those reported by insured Americans overall. Majorities with marketplace or Medicaid coverage continue to be satisfied with their insurance. PMID:27224966

  6. Job Training Partnership Act. Report (to Accompany H.R. 5320). House of Representatives, 97th Congress, 2d Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    The Job Training Partnership Act is intended to establish programs to prepare youth and unskilled adults for entry into the labor force and to afford job training to those economically disadvantaged individuals who are in special need of such training to obtain productive employment. The act is organized into five titles. This document contains an…

  7. 75 FR 81659 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ...; Affordable Care Act Enrollment Opportunity Notice--Prohibition on Lifetime Limits ACTION: Notice. SUMMARY... Administration (EBSA) sponsored information collection request (ICR) titled, ``Affordable Care Act Enrollment... INFORMATION: The Patient Protection and Affordable Care Act (the Affordable Care Act)......

  8. Sexual Abuse Act of 1986. House of Representatives, Ninety-Ninth Congress, Second Session.

    ERIC Educational Resources Information Center

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

    This is a report on House bill H.R. 4745, the Sexual Abuse Act of 1986, which would amend title 18 of the United States Code to modernize and reform federal rape statutes. The document opens with the actual text of the amendment. A section on the background of current federal rape law discusses the crime of rape as primarily a state, not federal,…

  9. To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.

    THOMAS, 113th Congress

    Rep. Bachmann, Michele [R-MN-6

    2013-01-03

    05/22/2013 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 78. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  10. 75 FR 66977 - Housing Trust Fund

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-29

    ... rule published on December 4, 2009 (74 FR 63938). The allocation formula will be renumbered and... National Affordable Housing Act of 1992, the HOME program is the largest Federal block grant program that...-assisted housing. Section 1338(c)(9) of FHEFSSA requires an eligible recipient of a grant from a...

  11. 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. PMID:25674797

  12. 78 FR 66653 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-06

    ... 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive this notice...: Authority: Section 2718 of the Public Health Service Act (42 U.S.C. 300gg-18, as amended). Sec. 158.232 0 6...: This correcting amendment is effective November 6, 2013. FOR FURTHER INFORMATION CONTACT: Jeff Wu,...

  13. 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

    ... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section 221(g... rate for debentures issued under any other provision of the Act is the rate in effect on the date that... endorsed (or initially endorsed if there are two or more endorsements) for insurance, whichever rate...

  14. 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

    ... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section 221(g... rate for debentures issued under any other provision of the Act is the rate in effect on the date that... endorsed (or initially endorsed if there are two or more endorsements) for insurance, whichever rate...

  15. 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

    ... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section 221(g... rate for debentures issued under any other provision of the Act is the rate in effect on the date that... endorsed (or initially endorsed if there are two or more endorsements) for insurance, whichever rate...

  16. 77 FR 35981 - Notice of Intent To Award Affordable Care Act (ACA) Funding, HM10-1001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-15

    ... Service Act, for prevention, wellness and public health activities including prevention research and... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... of Public Health Laboratories (APHL) to educate public health laboratories about the...

  17. 75 FR 423 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-05

    ... Americans. NAHASDA eliminated several separate assistance programs and replaced them with a single block... URBAN DEVELOPMENT Native American Housing Assistance and Self-Determination Reauthorization Act of 2008... develop regulatory changes to programs authorized under the Native American Housing Assistance and...

  18. 77 FR 39452 - Native American Housing Assistance and Self-Determination Act of 1996: Notice of Intent To...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-03

    ... assistance is provided to Native Americans. NAHASDA eliminated several separate assistance programs and... URBAN DEVELOPMENT 24 CFR Chapter IX Native American Housing Assistance and Self-Determination Act of... Grant (IHBG) program authorized under the Native American Housing Assistance and Self-Determination...

  19. 78 FR 54416 - Native American Housing Assistance and Self-Determination Act of 1996: Announcement of Negotiated...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-04

    ...) changed the way that housing assistance is provided to Native Americans. NAHASDA eliminated several... URBAN DEVELOPMENT 24 CFR Chapter IX Native American Housing Assistance and Self-Determination Act of... FR 35178), HUD announced in the Federal Register the list of proposed members for the...

  20. 77 FR 26029 - Privacy Act of 1974; Notice of a New System of Records, Department of Housing and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ... Records About Individuals,'' July 25, 1994 (59 FR 37914). Authority: 5 U.S.C. 552a; 88 Stat. 1896; 42 U.S... URBAN DEVELOPMENT Privacy Act of 1974; Notice of a New System of Records, Department of Housing and Urban Development--Veterans Affairs Supportive Housing (HUD-VASH), HUD/PIH.02 AGENCY: Office of...

  1. 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

    ... CFR parts 1, 6, 8, or 146, the General Counsel shall file a notice of proposed adverse action with the... 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...

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... CFR parts 1, 6, 8, or 146, the General Counsel shall file a notice of proposed adverse action with the... 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...

  3. 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

    ..., for programs authorized by the Public Health Service Act, for prevention, wellness and public health... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... states and local health departments to develop and implement tracking networks within their...

  4. 75 FR 48974 - Notice of Intent To Award Patient Protection and Affordable Care Act Funding to Approved But...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-12

    ...: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION... the scope of health care coverage for Americans. Cost savings through disease prevention is an..., for programs authorized by the Public Health Services Act, for prevention, wellness and public...

  5. Virginia Wilderness Act of 1987. House of Representatives, One Hundredth Congress, First Session, October 13, 1987

    SciTech Connect

    Not Available

    1987-01-01

    The House Agricultural, Interior, and Insular committees' joint report on H.R. 2878 recommends passage with a number of amendments. In addition to designating 27,700 acres to be part of the National Wilderness Preservation System, the bill repeals an earlier air quality act. The report notes reservations about some of the areas on the part of the Forest Service, but concludes that the limited amount of timber involved would not be significant. There is an analysis of each section of the bill, a summary of committee hearings, and a brief review of the bill's potential impact on the budget and existing law.

  6. The Affordable Care Act and integrated behavioral health programs in community health centers to promote utilization of mental health services among Asian Americans.

    PubMed

    Huang, Susan; Fong, Susana; Duong, Thomas; Quach, Thu

    2016-06-01

    The Affordable Care Act has greatly expanded health care coverage and recognizes mental health as a major priority. However, individuals suffering from mental health disorders still face layered barriers to receiving health care, especially Asian Americans. Integration of behavioral health services within primary care is a viable way of addressing underutilization of mental health services. This paper provides insight into a comprehensive care approach integrating behavioral health services into primary care to address underutilization of mental health services in the Asian American population. True integration of behavioral health services into primary care will require financial support and payment reform to address multi-disciplinary care needs and optimize care coordination, as well as training and workforce development early in medical and mental health training programs to develop the skills that aid prevention, early identification, and intervention. Funding research on evidence-based practice oriented to the Asian American population needs to continue. PMID:27188196

  7. Achieving Public Health Goals Through Medicaid Expansion: Opportunities in Criminal Justice, Homelessness, and Behavioral Health With the Patient Protection and Affordable Care Act

    PubMed Central

    Klingenmaier, Lisa

    2013-01-01

    States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system—particularly when they struggle with behavioral health diagnoses—are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care. PMID:24148039

  8. The Affordable Care Act's new tools and resources to improve health and care for low-income families across the country.

    PubMed

    Schoen, Cathy; Hayes, Susan L; Riley, Pamela

    2013-10-01

    The Commonwealth Fund Scorecard on State Health System Performance for Low-Income Populations, 2013, finds wide gaps by income in access to care, quality of care received, and health outcomes in all states, and major differences between states in health system performance for people with below-average incomes. The Affordable Care Act provides state and local leaders with unprecedented opportunity along with new tools and resources to raise the standard for everyone and to begin to close the geographic and income divide. This issue brief reviews provisions of the law that have the potential to benefit low- and modest-income individuals, including those that expand health insurance coverage; strengthen primary care and improve care coordination; bolster the capacity of providers serving low-income communities; move toward greater accountability for the quality and cost of care; and invest in public health. It concludes by highlighting some of the challenges that lie ahead. PMID:24143851

  9. American Society of Clinical Oncology policy statement: opportunities in the patient protection and affordable care act to reduce cancer care disparities.

    PubMed

    Moy, Beverly; Polite, Blase N; Halpern, Michael T; Stranne, Steven K; Winer, Eric P; Wollins, Dana S; Newman, Lisa A

    2011-10-01

    Patients in specific vulnerable population groups suffer disproportionately from cancer. The elimination of cancer disparities is critically important for lessening the burden of cancer. The Patient Protection and Affordable Care Act provides both opportunities and challenges for addressing cancer care disparities and access to care. The American Society of Clinical Oncology (ASCO) advocates for policies that ensure access to cancer care for the underserved. Such policies include insurance reform and the reduction of economic barriers to quality health care. Building on ASCO's prior statement on disparities in cancer care (2009), this article summarizes elements of the health care law that are relevant to cancer disparities and provides recommendations for addressing major provisions in the law. It outlines specific strategies to address insurance reform, access to care, quality of care, prevention and wellness, research on health care disparities, and diversity in the health care workforce. ASCO is committed to leading efforts toward the improvement of cancer care among the most vulnerable patients. PMID:21810680

  10. Overview of the Affordable Care Act's impact on military and veteran mental health services: nine implications for significant improvements in care.

    PubMed

    Russell, Mark C; Figley, Charles R

    2014-01-01

    On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Implications of the ACA on mental health care for 9.7 million military active-duty, reserve, and family members and 22.2 million veterans, as well as 1.3 uninsured veterans, is reviewed in light of a major crisis. The authors trace historical roots of the ACA to the World War II generation and efforts to transform the mental health care system by implementing hard-won war trauma lessons. The authors posit 9 principles reflected in the ACA that represent unfulfilled generational war trauma lessons and potential transformation of the military and national mental health care systems. PMID:24669877

  11. 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. PMID:26742596

  12. Genetic counselors and health literacy: the role of genetic counselors in developing a web-based resource about the Affordable Care Act.

    PubMed

    Mann, Sylvia; Mui, Pauline; Boomsma, Jennifer; Hasegawa, Lianne

    2015-06-01

    The Western States Genetic Services Collaborative (WSGSC) recognized the need for clear and understandable information about the Affordable Care Act (ACA) for families throughout the life course. The genetic counselors working in the WSGSC developed, tested, and implemented a web resource ( http://www.westernstatesgenetics.org/ACA_home.htm ) to help families navigate information about the ACA tailored to their life situation. The training and experience of genetic counselors provide the skills needed to translate complicated information, like that of the ACA, into formats that the general public can comprehend. The website went public in October 2013, and it has been positively received. The development of this website is a good case study in how genetic counseling skills can be applied to public health education and improving health literacy. PMID:25502406

  13. 24 CFR 1000.42 - Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Development Act of 1968 (12 U.S.C. 1701u) and HUD's implementing regulations in 24 CFR part 135, to the... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable? 1000.42 Section 1000.42 Housing...

  14. 24 CFR 1000.42 - Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Development Act of 1968 (12 U.S.C. 1701u) and HUD's implementing regulations in 24 CFR part 135, to the... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable? 1000.42 Section 1000.42 Housing...

  15. 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

    ... Development Act of 1968 (12 U.S.C. 1701u) and HUD's implementing regulations in 24 CFR part 135, to the... 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...

  16. 24 CFR 1000.42 - Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Development Act of 1968 (12 U.S.C. 1701u) and HUD's implementing regulations in 24 CFR part 135, to the... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable? 1000.42 Section 1000.42 Housing...

  17. 24 CFR 1000.42 - Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Development Act of 1968 (12 U.S.C. 1701u) and HUD's implementing regulations in 24 CFR part 135, to the... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable? 1000.42 Section 1000.42 Housing...

  18. 77 FR 57544 - Native American Housing Assistance and Self-Determination Reauthorization Act of 1996: Request...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-18

    ... Americans. NAHASDA eliminated several separate assistance programs and replaced them with a single block... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... Housing Block Grant program authorized by the Native American Housing Assistance and...

  19. Freedom of conscience and health care in the United States of america: the conflict between public health and religious liberty in the patient protection and affordable care act.

    PubMed

    West-Oram, Peter

    2013-09-01

    The recent confirmation of the constitutionality of the Obama administration's Patient Protection and Affordable Care Act (PPACA) by the US Supreme Court has brought to the fore long-standing debates over individual liberty and religious freedom. Advocates of personal liberty are often critical, particularly in the USA, of public health measures which they deem to be overly restrictive of personal choice. In addition to the alleged restrictions of individual freedom of choice when it comes to the question of whether or not to purchase health insurance, opponents to the PPACA also argue that certain requirements of the Act violate the right to freedom of conscience by mandating support for services deemed immoral by religious groups. These issues continue the long running debate surrounding the demands of religious groups for special consideration in the realm of health care provision. In this paper I examine the requirements of the PPACA, and the impacts that religious, and other ideological, exemptions can have on public health, and argue that the exemptions provided for by the PPACA do not in fact impose unreasonable restrictions on religious freedom, but rather concede too much and in so doing endanger public health and some important individual liberties. PMID:23539432

  20. Microsimulation of Private Health Insurance and Medicaid Take-Up Following the U.S. Supreme Court Decision Upholding the Affordable Care Act

    PubMed Central

    Parente, Stephen T; Feldman, Roger

    2013-01-01

    Objective To predict take-up of private health insurance and Medicaid following the U.S. Supreme Court decision upholding the Affordable Care Act (ACA). Data Sources Data came from three large employers and a sampling of premiums from http://ehealthinsurance.com. We supplemented the employer data with information on state Medicaid eligibility and costs from the Kaiser Family Foundation. National predictions were based on the MEPS Household Component. Study Design We estimated a conditional logit model of health plan choice in the large group market. Using the coefficients from the choice model, we predicted take-up in the group and individual health insurance markets. Following ACA implementation, we added choices to the individual market corresponding to plans that will be available in state and federal exchanges. Depending on eligibility for premium subsidies, we reduced the out-of-pocket premiums for those choices. We simulated several possible patterns for states opting out of the Medicaid expansion, as allowed by the Supreme Court. Principal Findings The ACA will increase coverage substantially in the private insurance market and Medicaid. HSAs will remain desirable in both the individual and employer markets. Conclusions If states opt out of the Medicaid expansion, this could increase the federal cost of health reform, while reducing the number of newly covered lives. PMID:23398372

  1. Reasons Why Individuals Remain Uninsured Under the Affordable Care Act: Experiences of Patients at a Student-Run Free Clinic in Michigan, a Medicaid Expansion State.

    PubMed

    Desmond, Brian S; Laux, Molly A; Levin, Carolyn C; Huang, Jiaxin; Williams, Brent C

    2016-04-01

    Since the enactment of the Affordable Care Act (ACA), many people remain uninsured. While studies have examined this population, few have explored patients' experiences seeking insurance. To elucidate these individuals' perspectives, we surveyed patients (n = 80) at the University of Michigan Student-Run Free Clinic concerning their activity accessing insurance. Over half of respondents had sought insurance in the past 6 months; 57 % of respondents qualified for Medicaid by self-reported income (≤138 % FPL) and all but one were eligible for tax credits on the Health Insurance Marketplace. However, only 35 % of apparently Medicaid-eligible respondents had recently applied. There was no significant difference in the rate of applying for those above the income cutoff (p = 0.901). Perceived expense of plans and belief of ineligibility for Medicaid discouraged respondents from actively seeking insurance. Personalized outreach emphasizing new Medicaid eligibility requirements and tax credits may be needed to facilitate Medicaid enrollment for some uninsured persons under the ACA. PMID:26512012

  2. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    PubMed

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application. PMID:20844424

  3. Meeting the Tobacco Cessation Coverage Requirement of the Patient Protection and Affordable Care Act: State Smoking Cessation Quitlines and Cost Sharing

    PubMed Central

    Bailey, Linda; Leischow, Scott J.

    2015-01-01

    Objectives. We explored whether various key stakeholders considered cost sharing with state telephone-based tobacco cessation quitlines, because including tobacco cessation services as part of the required essential health benefits is a new requirement of the Patient Protection and Affordable Care Act (ACA). Methods. We analyzed qualitative data collected from interviews conducted in April and May of 2014 with representatives of state health departments, quitline service providers, health plans, and insurance brokers in 4 US states. Results. State health departments varied in the strategies they considered the role their state quitline would play in meeting the ACA requirements. Health plans and insurance brokers referred to state quitlines because they were perceived as effective and free, but in 3 of the 4 states, the private stakeholder groups did not consider cost sharing. Conclusions. If state health departments are going to initiate cost-sharing agreements with private insurance providers, then they will need to engage a broad array of stakeholders and will need to overcome the perception that state quitline services are free. PMID:26447918

  4. Repellent Plants Provide Affordable Natural Screening to Prevent Mosquito House Entry in Tropical Rural Settings—Results from a Pilot Efficacy Study

    PubMed Central

    Mng'ong'o, Frank C.; Sambali, Joseph J.; Sabas, Eustachkius; Rubanga, Justine; Magoma, Jaka; Ntamatungiro, Alex J.; Turner, Elizabeth L.; Nyogea, Daniel; Ensink, Jeroen H. J.; Moore, Sarah J.

    2011-01-01

    Sustained malaria control is underway using a combination of vector control, prompt diagnosis and treatment of malaria cases. Progress is excellent, but for long-term control, low-cost, sustainable tools that supplement existing control programs are needed. Conventional vector control tools such as indoor residual spraying and house screening are highly effective, but difficult to deliver in rural areas. Therefore, an additional means of reducing mosquito house entry was evaluated: the screening of mosquito house entry points by planting the tall and densely foliated repellent plant Lantana camara L. around houses. A pilot efficacy study was performed in Kagera Region, Tanzania in an area of high seasonal malaria transmission, where consenting families within the study village planted L. camara (Lantana) around their homes and were responsible for maintaining the plants. Questionnaire data on house design, socioeconomic status, malaria prevention knowledge, attitude and practices was collected from 231 houses with Lantana planted around them 90 houses without repellent plants. Mosquitoes were collected using CDC Light Traps between September 2008 and July 2009. Data were analysed with generalised negative binomial regression, controlling for the effect of sampling period. Indoor catches of mosquitoes in houses with Lantana were compared using the Incidence Rate Ratio (IRR) relative to houses without plants in an adjusted analysis. There were 56% fewer Anopheles gambiae s.s. (IRR 0.44, 95% CI 0.28–0.68, p<0.0001); 83% fewer Anopheles funestus s.s. (IRR 0.17, 95% CI 0.09–0.32, p<0.0001), and 50% fewer mosquitoes of any kind (IRR 0.50, 95% CI 0.38–0.67, p<0.0001) in houses with Lantana relative to controls. House screening using Lantana reduced indoor densities of malaria vectors and nuisance mosquitoes with broad community acceptance. Providing sufficient plants for one home costs US $1.50 including maintenance and labour costs, (30 cents per person). L. camara

  5. 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…

  6. 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

    ... public without advance registration. Public attendance may be limited to the space available. Members of..., Office of Public and Indian Housing, Department of Housing and Urban Development, 451 Seventh Street, SW... Public and Indian Housing, HUD. ACTION: Notice of negotiated rulemaking committee meeting. SUMMARY:...

  7. The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

    PubMed

    Zamani-Hank, Yasamean

    2016-08-01

    The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $667 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-of-pocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA. (Population Health Management 2016;19:272-278). PMID:26565514

  8. 7 CFR Exhibit E to Subpart I of... - Guidance for Recipients of Self-Help Technical Assistance Grants (Section 523 of Housing Act of...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Housing Act of 1949) 7 CFR part 1944, subpart I provides the specific details of this grant program. The... expenses authorized by 7 CFR part 1944, subpart I? Yes No 5. Was a record of long distance telephone calls... Assistance Grants (Section 523 of Housing Act of 1949) E Exhibit E to Subpart I of Part 1944...

  9. 7 CFR Exhibit E to Subpart I of... - Guidance for Recipients of Self-Help Technical Assistance Grants (Section 523 of Housing Act of...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Housing Act of 1949) 7 CFR part 1944, subpart I provides the specific details of this grant program. The... expenses authorized by 7 CFR part 1944, subpart I? Yes No 5. Was a record of long distance telephone calls... Assistance Grants (Section 523 of Housing Act of 1949) E Exhibit E to Subpart I of Part 1944...

  10. 7 CFR Exhibit E to Subpart I of... - Guidance for Recipients of Self-Help Technical Assistance Grants (Section 523 of Housing Act of...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Housing Act of 1949) 7 CFR part 1944, subpart I provides the specific details of this grant program. The... expenses authorized by 7 CFR part 1944, subpart I? Yes No 5. Was a record of long distance telephone calls... Assistance Grants (Section 523 of Housing Act of 1949) E Exhibit E to Subpart I of Part 1944...

  11. 7 CFR Exhibit E to Subpart I of... - Guidance for Recipients of Self-Help Technical Assistance Grants (Section 523 of Housing Act of...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Housing Act of 1949) 7 CFR part 1944, subpart I provides the specific details of this grant program. The... expenses authorized by 7 CFR part 1944, subpart I? Yes No 5. Was a record of long distance telephone calls... Assistance Grants (Section 523 of Housing Act of 1949) E Exhibit E to Subpart I of Part 1944...

  12. 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 half of the…

  13. Women at risk: why increasing numbers of women are failing to get the health care they need and how the Affordable Care Act will help. Findings from the Commonwealth Fund Biennial Health Insurance Survey of 2010.

    PubMed

    Robertson, Ruth; Collins, Sara R

    2011-05-01

    Women have greater health care needs than men, and generally play larger roles in the health care of family members. Rising health care costs combined with sluggish income growth has contributed to losses in health insurance among women and rising rates of problems gaining necessary health care and paying medical bills. Women who seek coverage in the individual insurance market face additional hurdles--few plans offer maternity coverage and, in most states, insurance carriers charge higher premium rates to young women than men of the same age. The Affordable Care Act is bringing change for women through required free coverage of preventive care services, small business tax credits, new affordable coverage options, and insurance market reforms, including bans on gender rating. When the law is fully implemented in 2014, nearly all the 27 million working-age women who went without health insurance in 2010 will gain affordable and comprehensive benefits. PMID:21638798

  14. Rental Housing.

    ERIC Educational Resources Information Center

    American Association of Retired Persons, Washington, DC. Consumer Housing Information Service for Seniors.

    This is one of a series of booklets prepared as a resource for trained Housing Information Volunteers to provide impartial information to older people who have questions of concern about how to find safe, comfortable, affordable housing; how to cut household expenses or use their homes to earn extra income; home maintenance and home improvement;…

  15. 24 CFR 401.408 - Affordability and use restrictions required.

    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 PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.408 Affordability and use restrictions required....

  16. 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

    ... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... of the Native American Housing Assistance & Self-Determination Negotiated Rulemaking Committee. The... CONTACT: Rodger J. Boyd, Deputy Assistant Secretary for Native American Programs, Office of Public...

  17. 24 CFR 572.120 - Affordability standards.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Affordability standards. 572.120...) Homeownership Program Requirements-Implementation Grants § 572.120 Affordability standards. (a) Initial... annual incomes of eligible families using reasonable standards and procedures consistently applied.)...

  18. Plastic Pollution Research and Control Act. House of Representatives, One Hundredth Congress, First Session, October 8, 1987

    SciTech Connect

    Not Available

    1987-01-01

    The House report on H.R. 940 recommends passage with amendments to a bill designed to regulate the sea disposal of plastic materials. The bill addresses domestic garbage management and implements an international agreement regulating the disposal of ship garbage disposal. The report includes the amended text of the Act, a summary of the background and legislative history. Title I deals with disposal from ships and the MARPOL Convention; Title II, the problem of plastic driftnet fishing. The report concludes with changes which the bill will impose on existing law, penalties for violations, and legal actions available under the Act.

  19. Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2013

    THOMAS, 112th Congress

    Rep. Latham, Tom [R-IA-4

    2012-06-20

    06/29/2012 Received in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 440. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  20. 78 FR 45903 - Native American Housing Assistance and Self-Determination Act of 1996: Negotiated Rulemaking...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-30

    ... rulemaking committee members. On June12, 2013 at 78 FR 35178, HUD announced in the Federal Register the list.... Annette Bryan, Executive Director, Puyallup Nation Housing Authority, Tacoma, Washington. Heather...

  1. Native American Housing Assistance and Self-Determination Reauthorization Act of 2014

    THOMAS, 113th Congress

    Rep. Pearce, Stevan [R-NM-2

    2014-03-27

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

  2. Revising and Extending Title VIII of the Public Health Service Act. Conference Report to Accompany S. 2574. House of Representatives, 98th Congress, Second Session.

    ERIC Educational Resources Information Center

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

    Revisions and extensions of Title VIII of the Public Health Service Act are presented in this conference report of the U.S. House of Representatives. It is proposed that the Act be cited as the "Public Health Service Act Amendments of 1984." The texts of proposed amendments, including revisions of the language of the legislation, are presented for…

  3. To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges.

    THOMAS, 112th Congress

    Rep. Upton, Fred [R-MI-6

    2011-03-29

    05/05/2011 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 39. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  4. 7 CFR Exhibit E to Subpart I of... - Guidance for Recipients of Self-Help Technical Assistance Grants (Section 523 of Housing Act of...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 13 2013-01-01 2013-01-01 false Guidance for Recipients of Self-Help Technical Assistance Grants (Section 523 of Housing Act of 1949) E Exhibit E to Subpart I of Part 1944 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND...

  5. High-speed Rail Development Act of 1994. Introduced in the House of Representatives, One Hundred Third Congress, Second Session, August 10, 1994

    SciTech Connect

    1994-12-31

    The House report on H. R. 4867, the High-Speed Rail Development Act of 1994, authorizes activities to assist in the implementation of steel-wheel high-speed rail transportation. The Bill authorizes preconstruction activities for corridor planning.

  6. Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2015

    THOMAS, 113th Congress

    Rep. Latham, Tom [R-IA-3

    2014-05-27

    06/12/2014 Received in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 430. (All Actions) Notes: For further action, see H.R.83, which became Public Law 113-235 on 12/16/2014. Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  7. Housing Rights for Victims of Domestic and Sexual Violence Act of 2011

    THOMAS, 112th Congress

    Sen. Franken, Al [D-MN

    2011-11-17

    11/17/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (text of measure as introduced: CR S7707-7708) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  8. 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

    ... limited to the space available. Members of the public may be allowed to make statements during the meeting... Public and Indian Housing, HUD. ACTION: Notice of negotiated rulemaking committee meeting. SUMMARY: This... CONTACT: Rodger J. Boyd, Deputy Assistant Secretary for Native American Programs, Office of Public...

  9. Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2014

    THOMAS, 113th Congress

    Rep. Latham, Tom [R-IA-3

    2013-07-02

    07/30/2013 Committee of the Whole House on the state of the Union rises leaving H.R. 2610 as unfinished business. (All Actions) Notes: For further action, see H.R.3547, which became Public Law 113-76 on 1/17/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. 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...

  11. 24 CFR 1000.144 - Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 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...

  12. 24 CFR 1000.145 - Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of section 205(a)(2)? 1000.145 Section 1000.145... AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.145 Are Mutual Help homes developed...

  13. 24 CFR 1000.145 - Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Are Mutual Help homes developed under the 1937 Act subject to the useful life provisions of section 205(a)(2)? 1000.145 Section 1000.145... AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.145 Are Mutual Help homes developed...

  14. 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...

  15. 75 FR 77002 - Proposed Extension of Information Collection Request Submitted for Public Comment; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-10

    ... for Public Comment; Affordable Care Act Internal Claims and Appeals and External Review Procedures for... Patient Protection and Affordable Care Act (Affordable Care Act) that are discussed below. A copy of the... collection requests (ICRs) contained in the rule described below that relates to the Affordable Care Act....

  16. Motor Vehicle Safety Authorization Act of 1986. House of Representatives, Ninety-Ninth Congress, Second Session, September 17, 1986

    SciTech Connect

    Not Available

    1986-01-01

    The House Committee on Energy and Commerce suggests several amendments to H.R. 2248, which authorizes National Highway Traffic Safety Administration appropriations for 1987-1988. The legislation addresses such safety issues as the requirement that dealers inform potential buyers of true odometer readings, tire registration, bumper strength, and defects. The report covers automobile recalls of the past decade, the need for safety standard equality certification for imports, and state safety inspection programs. Oversight hearings and findings of the committee also addressed mandatory seat belt use. The bill affects the National Traffic and Motor Vehicle Safety Act of 1966 and the Motor Vehicle Information and Cost Savings Act. The report notes several areas of compromise.

  17. 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…

  18. Monitoring of Student Right To Know and Campus Security Act of 1990. Report To Accompany H. Res. 470. House of Representatives, 104th Congress, 2d Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Economic and Educational Opportunities.

    This report to accompany House Resolution 470 expresses the sense of Congress that the Department of Education should play a more active role in the monitoring of and enforcing compliance with the Higher Education Act of 1965 related to campus crime. The report makes reference to the Campus Crime and Security Awareness Act, enacted as part of the…

  19. The impact of failed housing policy on the public behavioral health system.

    PubMed

    Martone, Kevin

    2014-03-01

    The author describes the crisis in affordable housing for individuals with serious mental illness who have extremely low incomes and outlines implications for the behavioral health system. Studies have shown that nowhere in the United States can an individual with serious mental illness who is receiving Supplemental Security Income afford housing. This has contributed to compliance issues with the Americans With Disabilities Act. The failure of housing policy to effectively address the needs of individuals with serious mental illness who are in poverty is largely to blame for the most visible and costly failures attributed to the behavioral health system: institutionalization, incarceration, and chronic homelessness. It is critical for the behavioral health field to advocate for housing policies to address the housing affordability crisis. PMID:24584525

  20. DNA Identification Act of 1993. House of Representatives, One Hundred Third Congress, First Session

    SciTech Connect

    Not Available

    1993-01-01

    Report 103-45 on the DNA Identification Act of 1993 is intended to amend H.R. 829 (to amend title I of the Omnibus Crime Control and Safe Streets Act of 1968 to authorize funds received by States and units of the local government to be expended to improve the quality and availability of DNA records; to authorize the establishment of a DNA identification index; and for other purposes). The report states that the Committee on the Judiciary recommends Bill H.R. 829 pass with the amendment contained in this report. This report explains the amendment, the committee vote on H.R. 829, background behind H.R. 829, quality control concerns, proficincy testing, the significance of DNA matches, and databanking and privacy. Also included is a section-by-section analysis of H.R. 829 and committee oversight findings.

  1. Liars and Ghosts in the House of Congress: Frank's "Ad Hominem" Arguments in the Case against the Defense of Marriage Act.

    ERIC Educational Resources Information Center

    Clarke, Lynn E.

    2000-01-01

    Offers a critical analysis of Rep. Barney Frank's speech delivered in the House of Representatives concerning the "Defense of Marriage Act." Argues that Frank attempts to persuade colleagues by advancing two "ad hominem" arguments, one of which could potentially shift the focus from the need to defend marriages from same-sex couples towards the…

  2. Higher Education Act. Hearing before the Subcommittee on Postsecondary Education of the Committee on Education and Labor. House of Representatives, One Hundredth Congress, Second Session (Winooski, Vermont).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    The Subcommittee on Postsecondary Education of the Committee on Education and Labor, House of Representatives met at St. Michael's College in Vermont to conduct the first hearing for the reauthorization of the Higher Education Act (due to take place in three years). Statements were heard on general higher education problems and financial aid from…

  3. Family and Medical Leave Act of 1989. Report Together with Minority, Supplemental, Additional, and Individual Views. House of Representatives, 101st Congress, 1st Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    The House Committee on Education and Labor recommended passage of the Family and Medical Leave Act as amended and submitted the following regarding the legislation: (1) a synopsis of committee action in the 101th, 100th, 99th, and 98th Congresses; (2) background and need for the legislation, based primarily on previous testimony heard by the…

  4. 76 FR 11283 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-01

    ...; Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-Grandfathered Plans... Administration (EBSA) sponsored information collection request (ICR) titled, ``Affordable Care Act Internal... Affordable Care Act added Public Health Service Act section 2719, which provides rules relating to......

  5. 76 FR 73988 - Redelegation of Authority Under Section 561 of the Housing and Community Development Act of 1987

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ....104(a)). On December 17, 2007 (72 FR 71425), the Assistant Secretary for FHEO redelegated certain... URBAN DEVELOPMENT Redelegation of Authority Under Section 561 of the Housing and Community Development... Programs, Office of Fair Housing and Equal Opportunity, Department of Housing and Urban Development,...

  6. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... unit cannot refuse to lease the unit to a Section 8 Program certificate or voucher holder (24 CFR part... at 24 CFR 5.609 (except that when determining the income of a homeowner for an owner-occupied..., in order to calculate adjusted income, exclusions from income set forth at 24 CFR 5.611 shall...

  7. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... unit cannot refuse to lease the unit to a Section 8 Program certificate or voucher holder (24 CFR Part... at 24 CFR 5.609 (except that when determining the income of a homeowner for an owner-occupied..., in order to calculate adjusted income, exclusions from income set forth at 24 CFR 5.611 shall...

  8. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... unit cannot refuse to lease the unit to a Section 8 Program certificate or voucher holder (24 CFR Part... at 24 CFR 5.609 (except that when determining the income of a homeowner for an owner-occupied..., in order to calculate adjusted income, exclusions from income set forth at 24 CFR 5.611 shall...

  9. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... unit cannot refuse to lease the unit to a Section 8 Program certificate or voucher holder (24 CFR Part... at 24 CFR 5.609 (except that when determining the income of a homeowner for an owner-occupied..., in order to calculate adjusted income, exclusions from income set forth at 24 CFR 5.611 shall...

  10. 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…

  11. Preventive Care Benefits (Affordable Care Act)

    MedlinePlus

    ... people Unemployed people Immigrants Taxes, Penalties & Exemptions Health care & taxes The penalty for not having coverage Exemptions ... in the SHOP Marketplace The Small Business Health Care Tax Credit Renew or change SHOP coverage How ...

  12. Preventive Care for Children (Affordable Care Act)

    MedlinePlus

    ... GetCovered: My Story State by State Widgets & Badges Preventive Care for Children Many insurers are now required ... for mothers and vaccinations for kids. 26 Covered Preventive Services for Children Alcohol and Drug Use assessments ...

  13. Keep Student Loans Affordable Act of 2013

    THOMAS, 113th Congress

    Sen. Reed, Jack [D-RI

    2013-06-27

    07/17/2013 Motion to proceed to consideration of measure made in Senate. (consideration: CR S5717-5718) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. Affordable Tutoring of Our Children Act

    THOMAS, 111th Congress

    Sen. Snowe, Olympia J. [R-ME

    2009-03-31

    03/31/2009 Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S4071) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Affordable Mortgage for Homeowners Act of 2011

    THOMAS, 112th Congress

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

    2011-12-19

    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:

  16. Preserve Access to Affordable Generics Act

    THOMAS, 113th Congress

    Sen. Klobuchar, Amy [D-MN

    2013-02-04

    07/23/2013 Committee on the Judiciary Subcommittee on Antitrust, Competition Policy and Consumer Rights. Hearings held. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  17. Homeowner Flood Insurance Affordability Act of 2013

    THOMAS, 113th Congress

    Sen. Menendez, Robert [D-NJ

    2013-12-17

    01/15/2014 Motion to proceed to consideration of measure made in Senate. (consideration: CR S335, S344-360) (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:

  18. 75 FR 81662 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ...; Affordable Care Act Advance Notice of Rescission ACTION: Notice. SUMMARY: The Department of Labor (DOL... information collection request (ICR) titled, ``Affordable Care Act Advance Notice of Rescission,'' to the..._PRA_PUBLIC@dol.gov . SUPPLEMENTARY INFORMATION: The Patient Protection and Affordable Care Act...

  19. 75 FR 81662 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ...; Affordable Care Act Patient Protection Notice ACTION: Notice. SUMMARY: The Department of Labor (DOL) hereby... collection request (ICR) titled, ``Affordable Care Act Patient Protection Notice,'' to the Office of... Security Administration (EBSA). Title of Collection: Affordable Care Act Patient Protection Notice....

  20. 77 FR 26046 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ...; Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-Grandfathered Plans... Administration (EBSA) sponsored information collection request (ICR) titled, ``Affordable Care Act Internal...: Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-grandfathered...

  1. 76 FR 66950 - Privacy Act; Notice of Revision of System of Records, the Single Family Housing Enterprise Data...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... initiative supports HUD mission to create strong, sustainable, inclusive communities and quality affordable homes. This notice deletes and supersedes prior notice published in the Federal Register at 73 FR 24604..., ``Federal Responsibilities for Maintaining Records About Individuals,'' July 25, 1994 (59 FR...

  2. H. R. 3253: This Act may be cited as the Pollution Prevention, Community Recycling, and Incinerator Control Act, introduced in the US House of Representatives, One Hundred Second Session, First Session, August 2, 1991

    SciTech Connect

    Not Available

    1991-01-01

    This bill was introduced into the US House of Representatives on August 2, 1991 to amend the Solid Waste Disposal Act. Attention focuses on establishing certain requirements with respect to solid waste and hazardous waste incinerators. Separate sections address the following: moratorium on municipal solid waste incinerators; municipal solid waste incinerators; municipal solid waste incinerator ash management; prohibition on incineration of certain materials; requirements relating to hazardous waste incinerators; and hazardous waste incinerators.

  3. Affordable Vehicle Avionics Overview

    NASA Technical Reports Server (NTRS)

    Cockrell, James J.

    2015-01-01

    Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters

  4. Affordable Vehicle Avionics Overview

    NASA Technical Reports Server (NTRS)

    Cockrell, James J.

    2015-01-01

    Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters.

  5. H.R. 3821, The Equity and Choice Act Hearing. Hearing before the Subcommittee on Elementary, Secondary, and Vocational Education of the Committee on Education and Labor, House of Representatives, Ninety-Ninth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    This document presents the proceedings of a House of Representatives hearing on the Equity and Choices Act, a proposed amendment to the Education Consolidation and Improvement Act, Chapter 1. The Equity and Choices Act would provide the parents of educationally disadvantaged children with a voucher and the permission to use it at any public or…

  6. Technology, Education and Copyright Harmonization Act of 2001. Hearing before the Subcommittee on Courts, the Internet, and Intellectual Property of the Committee on the Judiciary on S. 487. House of Representatives, One Hundred Seventh Congress, First Session.

    ERIC Educational Resources Information Center

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

    This document presents the proceedings from a legislative hearing before the Subcommittee on Courts, the Internet, and Intellectual Property of the Committee on the Judiciary, House of Representatives on S. 487, the Technology, Education, and Copyright Harmonization Act of 2001, popularly known as the TEACH Act. The TEACH Act amends sections…

  7. Achieving health care affordability.

    PubMed

    Payson, Norman C

    2002-10-01

    Not all plans are jumping headlong into the consumer-centric arena. In this article, the CEO of Oxford Health Plans discusses how advanced managed care can achieve what other consumer-centric programs seek to do--provide affordable, quality health care. PMID:12391815

  8. California's “Bridge to Reform”: Identifying Challenges and Defining Strategies for Providers and Policymakers Implementing the Affordable Care Act in Low-Income HIV/AIDS Care and Treatment Settings

    PubMed Central

    Hazelton, Patrick T.; Steward, Wayne T.; Collins, Shane P.; Gaffney, Stuart; Morin, Stephen F.; Arnold, Emily A.

    2014-01-01

    Background In preparation for full Affordable Care Act implementation, California has instituted two healthcare initiatives that provide comprehensive coverage for previously uninsured or underinsured individuals. For many people living with HIV, this has required transition either from the HIV-specific coverage of the Ryan White program to the more comprehensive coverage provided by the county-run Low-Income Health Programs or from Medicaid fee-for-service to Medicaid managed care. Patient advocates have expressed concern that these transitions may present implementation challenges that will need to be addressed if ambitious HIV prevention and treatment goals are to be achieved. Methods 30 semi-structured, in-depth interviews were conducted between October, 2012, and February, 2013, with policymakers and providers in 10 urban, suburban, and rural California counties. Interview topics included: continuity of patient care, capacity to handle payer source transitions, and preparations for healthcare reform implementation. Study team members reviewed interview transcripts to produce emergent themes, develop a codebook, build inter-rater reliability, and conduct analyses. Results Respondents supported the goals of the ACA, but reported clinic and policy-level challenges to maintaining patient continuity of care during the payer source transitions. They also identified strategies for addressing these challenges. Areas of focus included: gaps in communication to reach patients and develop partnerships between providers and policymakers, perceived inadequacy in new provider networks for delivering quality HIV care, the potential for clinics to become financially insolvent due to lower reimbursement rates, and increased administrative burdens for clinic staff and patients. Conclusions California's new healthcare initiatives represent ambitious attempts to expand and improve health coverage for low-income individuals. The state's challenges in maintaining quality care and

  9. The Legacy of the U. S. Public Health Services Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years After President Clinton’s Apology

    PubMed Central

    Mays, Vickie M.

    2013-01-01

    This special issue addresses the legacy of the United States Public Health Service Syphilis Study on health reform, particularly the Affordable Care Act (ACA). The 12 manuscripts cover the history and current practices of ethical abuses affecting American Indians, Latinos, Asian Americans and African Americans in the United States and in one case, internationally. Commentaries and essays include the voice of a daughter of one of the study participants in which we learn of the stigma and maltreatment some of the families experienced and how the study has impacted generations within the families. Consideration is given in one essay to utilizing narrative storytelling with the families to help promote healing. This article provides the reader a roadmap to the themes that emerged from the collection of articles. These themes include population versus individual consent issues, need for better government oversight in research and health care, the need for overhauling our bioethics training to develop a population level, culturally driven approach to research bioethics. The articles challenge and inform us that some of our assumptions about how the consent process best works to protect racial/ethnic minorities may be merely assumptions and not proven facts. Articles challenge the belief that low participation rates seen in biomedical studies have resulted from the legacy of the USPHS Syphilis Study rather than a confluence of factors rooted in racism, bias and negative treatment. Articles in this special issue challenge the “cultural paranoia” of mistrust and provide insights into how the distrust may serve to lengthen rather than shorten the lives of racial/ethnic minorities who have been used as guinea pigs on more than one occasion. We hope that the guidance offered on the importance of developing a new framework to bioethics can be integrated into the foundation of health care reform. PMID:23630410

  10. The Legacy of the U. S. Public Health Services Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years After President Clinton's Apology.

    PubMed

    Mays, Vickie M

    2012-11-01

    This special issue addresses the legacy of the United States Public Health Service Syphilis Study on health reform, particularly the Affordable Care Act (ACA). The 12 manuscripts cover the history and current practices of ethical abuses affecting American Indians, Latinos, Asian Americans and African Americans in the United States and in one case, internationally. Commentaries and essays include the voice of a daughter of one of the study participants in which we learn of the stigma and maltreatment some of the families experienced and how the study has impacted generations within the families. Consideration is given in one essay to utilizing narrative storytelling with the families to help promote healing. This article provides the reader a roadmap to the themes that emerged from the collection of articles. These themes include population versus individual consent issues, need for better government oversight in research and health care, the need for overhauling our bioethics training to develop a population level, culturally driven approach to research bioethics. The articles challenge and inform us that some of our assumptions about how the consent process best works to protect racial/ethnic minorities may be merely assumptions and not proven facts. Articles challenge the belief that low participation rates seen in biomedical studies have resulted from the legacy of the USPHS Syphilis Study rather than a confluence of factors rooted in racism, bias and negative treatment. Articles in this special issue challenge the "cultural paranoia" of mistrust and provide insights into how the distrust may serve to lengthen rather than shorten the lives of racial/ethnic minorities who have been used as guinea pigs on more than one occasion. We hope that the guidance offered on the importance of developing a new framework to bioethics can be integrated into the foundation of health care reform. PMID:23630410

  11. 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

    ... Budget (OMB) Guidelines on the Conduct of Matching Programs (June 19, 1989, 54 FR 25818), and OMB... Housing and Urban Development (HUD) and the United States Department of Agriculture (USDA) AGENCY: Office..., U.S. Department of Agriculture, 14th and Independence Avenue, SW., Washington, DC 20250,...

  12. 77 FR 57639 - Privacy Act; System of Records: Records of the Office of White House Liaison, State-34

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-18

    ... the current system will retain the name ``Records of the Office of White House Liaison'' (64 FR 922... may do so by writing to the Director, Office of Information Programs and Services, A/GIS/IPS...: Director, Office of Information Programs and Services, A/GIS/IPS, Department of State, SA-2, 515...

  13. 77 FR 28741 - The Housing and Economic Recovery Act of 2008 (HERA): Changes to the Section 8 Tenant-Based...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-15

    .... HUD published a notice in the Federal Register on November 24, 2008, at 72 FR 71037, that provided... FR 59892. HUD stated in relevant part as follows: The Department believes that Congress' adoption of... receiving any Public Housing funds, the units may be assisted under the PBV program. (See 70 FR...

  14. H. R. 3430: Food Contamination Prevention Act. Introduced in the House of Representatives, One Hundredth Congress, First Session, October 6, 1989

    SciTech Connect

    Not Available

    1989-01-01

    This bill was introduced in the House of Representatives on October 6, 1989 for the purpose of amending the Solid Waste Disposal Act to regulate the transportation in commerce of solid waste food by prohibiting certain vehicles from transporting both waste and food, and by requiring health and safety standards for certain vehicles used to transport certain waste and food. Hazardous waste, medical waste, and terminal waste cannot be transported in any vehicle that is also used to transport food, food additives, drugs, or cosmetics.

  15. Black Lung Benefits Restoration Act of 1992. Introduced in the House of Representatives, One Hundred Second Congress, Second Session, September 21, 1992

    SciTech Connect

    1992-12-31

    The House report by the Committee on Education and Labor provides legislative text to make improvements in the Black Lung Benefits Act. The report is for Bill number H.R. 1637. The payments of benefits to coal miners totally disabled due to pneumoconiosis, and to the windows and dependents of those who died with such disability, or from the disease. Coal workers` pneumoconisosis is caused by the inhalation of coal mine dust. A Congressional Budget Office cost estimate of funding the bill is included.

  16. Student Adjustment Act of 2001 (H.R. 1918 IH). House of Representatives, 107th Congress, 1st Session.

    ERIC Educational Resources Information Center

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

    The purpose of this bill is to amend the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 to permit states to determine state residency for higher education purposes and to amend the Immigration and Nationality Act to cancel the removal and adjust the status of certain alien college-bound students who are long-term U.S.…

  17. H. R. 2880: This Act may be cited as the Community Right-to-Know More Act of 1991, introduced in the US House of Representatives, One Hundred Second Congress, First Session, July 11, 1991

    SciTech Connect

    Not Available

    1991-01-01

    This bill was introduced into the US House of Representatives on July 11, 1991 to amend the Solid Waste Disposal Act to reduce the use of toxic chemicals and to require additional reporting on certain chemicals. Title I- Expansion of Toxics Release Inventory is amended by adding the following new subtitle: Subtitle I- Toxics Use Reduction and Reporting. It is further amended by adding at the end of subtitle K the following new part: Part B- Toxics Use Reduction. The reporting requirements under Title III are also amended for generators of hazardous waste and generators of large quantities of solid waste.

  18. H. R. 3058: This Act may be cited as the Tire Recycling and Recovery Act of 1991, introduced in the US House of Representatives, One Hundred Second Congress, First Session, July 25, 1991

    SciTech Connect

    Not Available

    1991-01-01

    This bill was introduced into the US House of Representatives on July 25, 1991 to amend the Solid Waste Disposal Act in order to provide for a scrap tire management and recovery program. The objectives of this legislation are to provide temporary federal incentives to eliminate scrap tire piles through environmentally sound methods, including recycling, recovery and reuse. All future scrap tires are to be managed by the states through programs that will manage and minimize the buildup of scrap tire piles in the future.

  19. H. R. 871: This Act may be cited as the Tire Recycling Incentives Act, introduced in the House of Representatives, One Hundred Second Congress, First Session, February 6, 1991

    SciTech Connect

    Not Available

    1991-01-01

    There is a need to encourage greater recycling of scrap tires. Americans generate more than 250 million scrap tires annually. Currently, 2 1/2 to 3 billion scrap tires are stockpiled across America. H.R.871 was introduced into the US House of Representatives on February 6, 1991 to amend the Solid Waste Disposal Act to require producers and importers of tires to recycle a certain percentage of scrap tires each year. This legislation calls for the administrator of the EPA to establish a recycling credit system for carrying out these recycling requirements, and to establish a management and tracking system for such tires.

  20. Affordances and the musically extended mind.

    PubMed

    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