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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.

  2. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  3. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  4. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  5. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  6. 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.

  7. 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…

  8. Housing Affordability And Children's Cognitive Achievement.

    PubMed

    Newman, Sandra; Holupka, C Scott

    2016-11-01

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

  9. 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.

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...

  15. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...

  16. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...

  17. 12 CFR 1282.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 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 ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.14 Special Affordable Housing Goal. (a) Purpose of the...

  18. 75 FR 9033 - 2010-2011 Enterprise Affordable Housing Goals; Enterprise Book-Entry Procedures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-26

    ...Section 1128(b) of the Housing and Economic Recovery Act of 2008 (HERA) amended the Federal Housing Enterprises Financial Safety and Soundness Act of 1992 (Safety and Soundness Act) to provide for the establishment, monitoring and enforcement of new affordable housing goals effective for 2010 and 2011 for the Federal National Mortgage Association (Fannie Mae) and the Federal Home Loan Mortgage......

  19. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...

  20. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...

  1. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...

  2. 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:

  3. 24 CFR 1000.101 - What is affordable housing?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

  4. 24 CFR 1006.201 - Eligible 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 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...

  5. 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...

  6. 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...

  7. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  8. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  9. 24 CFR 954.306 - Rental housing: qualification as affordable housing and income targeting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... affordable housing and income targeting. 954.306 Section 954.306 Housing and Urban Development Regulations... Affordability § 954.306 Rental housing: qualification as affordable housing and income targeting. (a) Rent...: (1) Bears rents not greater than the lesser of— (i) The section 8 fair market rent for...

  10. 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...

  11. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  12. 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

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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:

  19. 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. (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:

  20. 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:

  1. 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:

  2. 24 CFR 92.252 - Qualification as affordable housing: Rental housing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Qualification as affordable housing: Rental housing. 92.252 Section 92.252 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements §...

  3. 24 CFR 92.252 - Qualification as affordable housing: Rental housing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Qualification as affordable housing: Rental housing. 92.252 Section 92.252 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements §...

  4. 24 CFR 92.252 - Qualification as affordable housing: Rental housing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Qualification as affordable housing: Rental housing. 92.252 Section 92.252 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements §...

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

    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: Rental housing. 92.252 Section 92.252 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements §...

  6. 24 CFR 92.252 - Qualification as affordable housing: Rental housing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Qualification as affordable housing: Rental housing. 92.252 Section 92.252 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements §...

  7. 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.

  8. 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…

  9. 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...

  10. 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.

  11. 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.

  12. 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.

  13. 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.

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

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Family Mortgage Limits under Section 203(b) of the National Housing Act (12 U.S.C. 1709(b)) (which may be... paragraph (a)(5)(i)(B) of this section, deed restrictions, covenants running with the land, or other similar... termination event, obtains an ownership interest in the housing. (B) Certain housing may be presumed to...

  15. 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%.

  16. 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%.

  17. 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

    ... Act to increase the availability of credit for small businesses. This survey is not required by law... Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy; Small Business Lending Fund; Proposed Collection; Comment Request ACTION: Notice and request for...

  18. 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:

  19. 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:

  20. 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:

  1. "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.

  2. 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:

  3. 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:

  4. 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:

  5. 78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Affordable Care Act; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correction to... Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended,...

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

    PubMed

    Sage, William M

    2010-08-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2013-06-01

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

  9. 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.

  10. Access To Care And Affordability Have Improved Following Affordable Care Act Implementation; Problems Remain.

    PubMed

    Shartzer, Adele; Long, Sharon K; Anderson, Nathaniel

    2016-01-01

    There is growing evidence that millions of adults have gained insurance coverage under the Affordable Care Act, but less is known about how access to and affordability of care may be changing. This study used data from the Health Reform Monitoring Survey to describe changes in access and affordability for nonelderly adults from September 2013, just prior to the first open enrollment period in the Marketplace, to March 2015, after the end of the second open enrollment period. Overall, we found strong improvements in access to care for all nonelderly adults and across income and state Medicaid expansion groups. We also found improvements in the affordability of care for all adults and for low- and moderate-income adults. Despite this progress, there were still large gaps in access and affordability in March 2015, particularly for low-income adults.

  11. 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:

  12. 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

  13. The Affordable Care Act: a primer for plastic surgeons.

    PubMed

    Chen, Jenny T; Israel, Jacqueline S; Poore, Samuel O; Rao, Venkat K

    2014-11-01

    The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change.

  14. What does the Affordable Care Act mean for nursing?

    PubMed

    Luther, Brenda; Hart, Sara

    2014-01-01

    Nurses are ethically bound to engage in efforts of improving health and healthcare delivery and, even more important, nurses recently have been called out as key leaders in the reform of healthcare delivery, including many components of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act, its history, and what healthcare will look like during and after implementation are addressed in this article. A discussion of the role and value of nurses in healthcare reform accompanies knowledge-building and action-oriented resources available to nurses and clients.

  15. 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.

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

    DOE PAGES

    Ren, Xiaoxin; Yan, Da; Hong, Tianzhen

    2015-02-16

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

  17. 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...

  18. 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...

  19. 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

  20. 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.

  1. The Affordable Care Act: A Prescription for Homeland Security Preparedness?

    DTIC Science & Technology

    2014-09-01

    purchase health insurance  Correct the inequity of Medicaid preventive coverage for new beneficiaries vs. existing beneficiaries  Design and...might incentivize choosing health insurance over penalties. D. ADDRESS MEDICAID PREVENTIVE COVERAGE INEQUITY As noted in Chapter V, § 1001 of the...Affordable Care Act (ACA), tens of millions of U.S. citizens were without health insurance coverage. Without health insurance, health care can be

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

    PubMed Central

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

    2012-01-01

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

  3. Affordable Housing for Military Families: State/Federal Inducement Program

    DTIC Science & Technology

    1989-04-01

    14 THE FEDERAL LOW INCOME HOUSING TAX CREDIT AND MILITARY FAMILY ELIGIBILITY...29 Investors ...................................... 29 Financing Low Income Housing Projects With the Tax Credit ......................... 30 Pro...SUMMARY Prov-ding decent housing for low income families is a perennial problem for public policy in the United States. The Federal government has

  4. 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

    ... 45 CFR Parts 155 and 156 RIN 0938-AR76 Patient Protection and Affordable Care Act; Establishment of... 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...

  5. 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

    ... Protection and Affordable Care Act AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final... Care Act (Pub. L. 111-148) was enacted on March 23, 2010; the Health Care and Education Reconciliation... collectively as the Affordable Care Act. The Affordable Care Act reorganizes, amends, and adds to...

  6. 77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ...This final rule implements several 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). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of......

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

    PubMed

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

    2010-09-01

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

  8. 78 FR 73204 - Announcement of Requirements and Registration for “Innovation in Affordable Housing Student...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-05

    ... Student Design and Planning Competition'' AGENCY: Office of the Assistant Secretary for Policy Development... in Affordable Housing Student Design and Planning Competition. The competition requires teams of... communities and neighborhoods; to raise practitioner and future practitioner capacity to produce more...

  9. Beyond the Light Touch: Next Steps for Improving Energy Efficiency in Multi-Family Affordable Housing

    EPA Pesticide Factsheets

    This 90-minute webinar explored the specific challenges and opportunities faced by programs that aim to improve energy efficiency in multifamily affordable housing, with an emphasis on achieving multiple benefits through deeper retrofits.

  10. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ...This final rule will implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for individuals and small employers to directly......

  11. 76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ...This proposed rule would implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for......

  12. 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...

  13. 77 FR 16501 - Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ...-AR42 Certain Preventive Services Under the Affordable Care Act AGENCIES: Internal Revenue Service... regarding certain preventive health services under provisions of the Patient Protection and Affordable Care Act (Affordable Care Act). The proposed amendments would establish alternative ways to fulfill...

  14. 78 FR 65045 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ...This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated......

  15. 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.

  16. “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

  17. 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.

  18. 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...

  19. Housing tenure and affordability and mental health following disability acquisition in adulthood.

    PubMed

    Kavanagh, Anne M; Aitken, Zoe; Baker, Emma; LaMontagne, Anthony D; Milner, Allison; Bentley, Rebecca

    2016-02-01

    Acquiring a disability in adulthood is associated with a reduction in mental health and access to secure and affordable housing is associated with better mental health. We hypothesised that the association between acquisition of disability and mental health is modified by housing tenure and affordability. We used twelve annual waves of data (2001-2012) (1913 participants, 13,037 observations) from the Household, Income and Labour Dynamics in Australia survey. Eligible participants reported at least two consecutive waves of disability preceded by two consecutive waves without disability. Effect measure modification, on the additive scale, was tested in three fixed-effects linear regression models (which remove time-invariant confounding) which included a cross-product term between disability and prior housing circumstances: housing tenure by disability; housing affordability by disability and, in a sub-sample (896 participants 5913 observations) with housing costs, tenure/affordability by disability. The outcome was the continuous mental component summary (MCS) of SF-36. Models adjusted for time-varying confounders. There was statistical evidence that prior housing modified the effect of disability acquisition on mental health. Our findings suggested that those in affordable housing had a -1.7 point deterioration in MCS (95% CI -2.1, -1.3) following disability acquisition and those in unaffordable housing had a -4.2 point reduction (95% CI -5.2, -1.4). Among people with housing costs, the largest declines in MCS were for people with unaffordable mortgages (-5.3, 95% CI -8.8, -1.9) and private renters in unaffordable housing (-4.0, 95% CI -6.3, -1.6), compared to a -1.4 reduction (95% CI -2.1, -0.7) for mortgagors in affordable housing. In sum, we used causally-robust fixed-effects regression and showed that deterioration in mental health following disability acquisition is modified by prior housing circumstance with the largest negative associations found for those

  20. Building America Case Study: Demonstration House of Cold-Climate Solutions for Affordable Housing, Minneapolis, Minnesota

    SciTech Connect

    2016-05-01

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

  1. Critical Care Implications of the Affordable Care Act

    PubMed Central

    Dogra, Anjali P.; Dorman, Todd

    2015-01-01

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

  2. Women and the Affordable Care Act of 2010.

    PubMed

    Collins, Sara R; Rustgi, Sheila D; Doty, Michelle M

    2010-07-01

    This issue brief analyzes how, over the next decade, the Affordable Care Act (ACA) is likely to stabilize and reverse women's growing exposure to health care costs. Up to 15 million women who now are uninsured could gain subsidized coverage under the law. In addition, 14.5 million insured women will benefit from provisions that improve coverage or reduce premiums. Women who have coverage through the individual insurance market and are charged higher premiums than men, who have been unable to secure coverage for the cost of pregnancy, or who have a preexisting health condition excluded from their benefits will ultimately find themselves on a level playing field with men, enjoying a full range of comprehensive benefits.

  3. The Future of the Affordable Care Act and Insurance Coverage.

    PubMed

    Glied, Sherry; Jackson, Adlan

    2017-04-01

    We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities.

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

    PubMed

    Stutz, Matthew; Baig, Arshiya

    2014-08-01

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

  5. 24 CFR 92.254 - Qualification as affordable housing: Homeownership.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements § 92.254... applicable period specified in the following table, beginning after project completion. The per unit amount... after project completion. (8) Contract to purchase. If HOME funds are used to assist a homebuyer who...

  6. 24 CFR 92.254 - Qualification as affordable housing: Homeownership.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Project Requirements § 92.254... applicable period specified in the following table, beginning after project completion. The per unit amount... after project completion. (8) Contract to purchase. If HOME funds are used to assist a homebuyer who...

  7. 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

  8. 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

    ... HUMAN SERVICES 45 CFR Part 155 RIN 0938-AR75 Patient Protection and Affordable Care Act; Exchange... state or Exchange must not prevent the application of the provisions of title I of the Affordable Care.... Introduction The Patient Protection and Affordable Care Act (Pub. L. 111-148) was enacted on March 23,...

  9. 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.

  10. 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

    ... HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards... ] entitled, ``Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors... section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive...

  11. 78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ...This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule......

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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

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

    PubMed

    Buettgens, Matthew; Blumberg, Linda J

    2012-11-01

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

  18. The Future of the Affordable Care Act and Insurance Coverage

    PubMed Central

    Jackson, Adlan

    2017-01-01

    We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA’s primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities. PMID:28207344

  19. 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

    ... for small businesses. This survey is not required by law, but the SBLF Securities Purchase Agreement... Office of Domestic Finance; Small Business, Community Development and Affordable Housing Policy; Small Business Lending Fund; Proposed Collection; Comment Request ACTION: Notice and request for...

  20. Housing affordability and mental health: does the relationship differ for renters and home purchasers?

    PubMed

    Mason, Kate E; Baker, Emma; Blakely, Tony; Bentley, Rebecca J

    2013-10-01

    There is increasing evidence of a direct association between unaffordable housing and poor mental health, over and above the effects of general financial hardship. Type of housing tenure may be an important factor in determining how individuals experience and respond to housing affordability problems. This study investigated whether a relationship exists between unaffordable housing and mental health that differs for home purchasers and private renters among low-income households. Data from 2001 to 2010 of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey were analysed using fixed-effects linear regression to examine change in the SF-36 Mental Component Summary (MCS) score of individuals aged 25-64 years, associated with changes in housing affordability, testing for an interaction with housing tenure type. After adjusting for age, survey year and household income, among individuals living in households in the lower 40% of the national income distribution, private renters in unaffordable housing experienced somewhat poorer in mental health than when their housing was affordable (difference in MCS = -1.18 or about 20% of one S.D. of the MCS score; 95% CI: -1.95,-0.41; p = 0.003) while home purchasers experienced no difference on average. The statistical evidence for housing tenure modifying the association between unaffordable housing and mental health was moderate (p = 0.058). When alternatives to 40% were considered as income cut-offs for inclusion in the sample, evidence of a difference between renters and home purchasers was stronger amongst households in the lowest 50% of the income distribution (p = 0.020), and between the 30th and 50th percentile (p = 0.045), with renters consistently experiencing a decline in mental health while mean MCS scores of home purchasers did not change. In this study, private renters appeared to be more vulnerable than home purchasers to mental health effects of unaffordable housing. Such a modified

  1. 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.

  2. 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

  3. 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...

  4. 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

  5. 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.

  6. Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    PubMed

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

    2015-09-01

    Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults.

  7. 78 FR 8456 - Coverage of Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ...This document proposes amendments to rules regarding coverage for certain preventive services under section 2713 of the Public Health Service Act, as 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 Public Health Service Act requires coverage without......

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

    SciTech Connect

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

    2016-03-01

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

  9. Leveraging the Affordable Care Act to improve the health of mothers and newborns.

    PubMed

    Grande, David; Srinivas, Sindhu K

    2013-06-01

    Health insurance in the United States is a patchwork system whereby opportunities for coverage are strongly associated with life circumstances (ie, age, income, pregnancy, parental status). For pregnant women, this situation contributes to unstable coverage before, between, and after pregnancies. The Affordable Care Act has the potential to make coverage for women of reproductive age more stable and create new opportunities to intervene on conditions associated with maternal and neonatal morbidity. In this article, we discuss the health economics of the Affordable Care Act, its implications for maternal and neonatal health, specific challenges associated with implementation, and opportunities for obstetricians to leverage the Affordable Care Act to improve the care of women.

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

    SciTech Connect

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

    2016-05-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-09-01

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

  12. Reform Americans Can Afford Act of 2010

    THOMAS, 111th Congress

    Rep. Herger, Wally [R-CA-2

    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:

  13. 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:

  14. 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.

  15. The affordable care act and treatment for "substance use disorders:" implications of ending segregated behavioral healthcare.

    PubMed

    McLellan, A Thomas; Woodworth, Abigail Mason

    2014-01-01

    The Affordable Care Act (2010) and the Mental Health Parity and Addiction Equity Act (2008) are expected to transform substance abuse prevention and treatment in the United States. In this paper, we outline the potential disruption to the existing specialty care delivery system, and describe the opportunities for treatment providers and health services researchers.

  16. 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:

  17. The Affordable Care Act and the future of clinical medicine: the opportunities and challenges.

    PubMed

    Kocher, Robert; Emanuel, Ezekiel J; DeParle, Nancy-Ann M

    2010-10-19

    The Affordable Care Act is a once-in-a-generation change to the U.S. health system. It guarantees access to health care for all Americans, creates new incentives to change clinical practice to foster better coordination and quality, gives physicians more information to make them better clinicians and patients more information to make them more value-conscious consumers, and changes the payment system to reward value. The Act and the health information technology provisions in the American Recovery and Reinvestment Act remove many barriers to delivering high-quality care, such as unnecessary administrative complexity, inaccessible clinical data, and insufficient access to primary care and allied health providers. We hope that physicians will embrace the opportunities created by the Affordable Care Act that will enable them to provide better care for their patients and lead the U.S. health system in a more positive direction. To fully realize the benefits of the Affordable Care Act for their practices and their patients, physicians will design their offices for seamless care, employing new practice models and using technology to integrate patient information with professional society guidelines to keep patients with chronic conditions healthy and out of the hospital. Under the Affordable Care Act, physicians who effectively collaborate with other providers to improve patient outcomes, the value of medical services, and patient experiences will thrive and be the leaders of the health care system.

  18. 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.

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

    SciTech Connect

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

    2016-03-01

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

  20. 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.

  1. 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.

  2. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... July 15, 2011 Part III Department of Health and Human Services 45 CFR Part 153 Patient Protection and... OF HEALTH AND HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment AGENCY: Department of Health and...

  3. 78 FR 39493 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-01

    ... requested translation of the requisite materials in non-English languages, and suggested that HHS refer to... applicable language in the Affordable Care Act. Upon publication of the Treasury final rule, we intend to... proposed to amend Sec. 155.200(a) to add a reference to indicate that, consistent with existing language...

  4. 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…

  5. 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

    ... responses to this RFI are not offers, and cannot be accepted by the Government to form a binding contract or... contract for services required to fulfill the statutory and regulatory requirements of the reinsurance..., 2011 (76 FR 41930). The Affordable Care Act instructs each State to establish or contract with...

  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. 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

  8. 76 FR 51201 - Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... From the Federal Register Online via the Government Publishing Office ] Vol. 76 Wednesday, No. 159 August 17, 2011 Part III Department of Health and Human Services 45 CFR Parts 155 and 157 Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market: Eligibility...

  9. 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:

  10. 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:

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

    NASA Astrophysics Data System (ADS)

    Indrianingrum, Lulut

    2017-03-01

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

  12. 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.

  13. The Experience With Smoke-Free Policies in Affordable Multiunit Housing in North Carolina: A Statewide Survey.

    PubMed

    Stein, Anna H; Baker, Laura E; Agans, Robert P; Xue, Wei; Collins, Nina M; Suttie, Janet L

    2015-08-25

    Purpose . Previous surveys of housing operators have identified concerns about enforcement, legal issues, and loss of market share as the main barriers to implementing smoke-free policies in multiunit housing. The purpose of this study was to examine enforcement practices as well as economic and legal outcomes in smoke-free affordable multiunit housing. Design . Cross-sectional. Setting . Affordable multiunit housing in North Carolina. Subjects . Affordable multiunit housing properties (n = 1063, 57% response rate). Measures . Property representatives completed a written survey with questions regarding the existence of smoke-free policies, smoke-free policy implementation and enforcement practices, and smoking-related costs. Analysis . Descriptive statistics, χ(2) goodness-of-fit test, and t-test. Results . A total of 16.5% of properties had policies that prohibited smoking in all residential units. Half (49.8%) of smoke-free properties reported no violations to their policies in the past 12 months. Legal actions to enforce policies were rarely needed and were successful when they did occur. Compared to smoking-allowed properties, smoke-free properties did not experience a loss of market share in terms of occupancy rate (t = .09; p = .93) or residents moving away (χ(2) =. 5; p = .48). Conclusion . Housing operators' concerns about enforcement, legal issues, and loss of market share associated with smoke-free policies are largely unfounded among affordable housing properties in North Carolina. Public health professionals should use messaging strategies that refute these concerns to encourage more properties to adopt smoke-free policies.

  14. 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

  15. 76 FR 59703 - Notice of Intent To Award Affordable Care Act (ACA) Funding, RFA-TP-08-001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... (ACA) Funding, RFA- TP-08-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Affordable Care Act (ACA) funding to Preparedness and Emergency Response Research Centers (PERRCs). This... award Affordable Care Act (ACA) appropriations to the following 4 Preparedness and Emergency...

  16. House Reservists Pay Adjustment Act of 2009

    THOMAS, 111th Congress

    Rep. Brady, Robert A. [D-PA-1

    2009-03-24

    04/23/2009 Received in the Senate and Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  17. 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:

  18. 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:

  19. Healthy Housing Council Act of 2009

    THOMAS, 111th Congress

    Sen. Reed, Jack [D-RI

    2009-09-10

    09/10/2009 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (text of measure as introduced: CR S9266-9268) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. Coverage of certain preventive services under the Affordable Care Act. Final rules.

    PubMed

    2013-07-02

    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. Among these services are women's preventive health services, as specified in guidelines supported by the Health Resources and Services Administration (HRSA). As authorized by the current regulations, and consistent with the HRSA guidelines, group health plans established or maintained by certain religious employers (and group health insurance coverage provided in connection with such plans) are exempt from the otherwise applicable requirement to cover certain contraceptive services. These final regulations simplify and clarify the religious employer exemption. These final regulations also establish accommodations with respect to the contraceptive coverage requirement for group health plans established or maintained by eligible organizations (and group health insurance coverage provided in connection with such plans), as well as student health insurance coverage arranged by eligible organizations that are institutions of higher education. These regulations also finalize related amendments to regulations concerning Affordable Insurance Exchanges.

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

    PubMed

    2013-06-04

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

  6. 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

    ...The U.S. Office of Personnel Management (OPM) is issuing a proposed rule to implement the Multi-State Plan Program (MSPP). OPM is establishing the MSPP pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will......

  7. 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.

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

    PubMed

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

    2014-07-05

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

  9. 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.

  10. 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.

  11. Enrollment in Health Insurance Through the Marketplace After Implementation of the Affordable Care Act in Texas.

    PubMed

    Gong, Gordon; Huey, Cassandra C; Johnson, Coleman; Curti, Debra; Philips, Billy U

    2016-10-01

    One of the goals of the Affordable Care Act aims to provide affordable health insurance through the health insurance exchange marketplace (the Marketplace). This study explores enrollments in the Marketplace in Texas and in rural vs urban areas in the East, South, and West regions of the state. Data are derived from the US Census Bureau and the Department of Health and Human Services. A total of 92.7% of eligible non-elderly adult Texans (NEATs) had enrolled in Marketplace insurance as of February 2015. Rural residents were less likely than urban residents to use the Marketplace. Most enrollees (85%) had received tax credits, and 58.6% had received cost-sharing reductions. The number of uninsured NEATs was reduced by 710,000 by 2014, which is equivalent to two-thirds of the enrollees in the Marketplace. One-third of the enrollees previously had private or employer-based insurance before enrollment into the Marketplace.

  12. 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.

  13. 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

    ...This document announces the effective date of a regulatory provision published in the Federal Register by OPM on March 11, 2013 (78 FR 15559), entitled ``Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance...

  14. 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.

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

    PubMed

    De Ville, Kenneth

    2011-01-01

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

  16. Implementing the Patient Protection and Affordable Care Act: the time is now.

    PubMed

    Wojcik, Steven E

    2013-01-01

    Employers all across the country should be in full swing as they prepare to implement the tougher parts of the Patient Protection and Affordable Care Act's (ACA) employer provisions, which are about to come online and take effect in 2014. This article reviews these more challenging requirements and their complications, including how employer calculations over whether to continue to offer coverage might vary by industry characteristics. The author then looks further ahead to the "Cadillac" tax and discusses how this liability may affect every employer's decision about its health care strategy leading up to 2018.

  17. Commercial pressures on professionalism in american medical care: from Medicare to the Affordable Care Act.

    PubMed

    Marmor, Theodore R; Gordon, Robert W

    2014-01-01

    Since the passage of Medicare, the self-regulation characteristic of professionalism in health care has come under steady assault. While Canadian physicians chose to relinquish financial autonomy, they have enjoyed far greater professional autonomy over their medical judgments than their U.S. counterparts who increasingly have their practices micromanaged. The Affordable Care Act illustrates the ways that managerial strategies and a market model of health care have shaped the financing and delivery of health care in the U.S., often with little or no evidence of their effectiveness.

  18. 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).

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

    PubMed Central

    Mattke, Soeren; Liu, Hangsheng; Orr, Patrick

    2016-01-01

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

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

    PubMed

    Jha, Saurabh; Baker, Tom

    2012-12-01

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

  1. Women’s Health and the Affordable Care Act: High Hopes Versus Harsh Realities?

    PubMed Central

    Fendrick, A. Mark; Zochowski, Melissa; Dalton, Vanessa K.

    2014-01-01

    Our population-based survey of 1078 randomly sampled US women, aged 18 to 55 years, sought to characterize their understanding of and attitudes toward the Affordable Care Act (ACA). Most women, especially socially disadvantaged groups, had negative or uncertain attitudes toward the ACA and limited understanding of its health benefits, including its relevance for their own health service coverage and utilization. Our findings are important for continued research, policy, and practice, with implications for whether, when, and how improved coverage will translate to improved access and outcomes for US women. PMID:24922171

  2. 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.

  3. 46 CFR 175.118 - Vessels operating under an exemption afforded in the Passenger Vessel Safety Act of 1993 (PVSA).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Passenger Vessel Safety Act of 1993 (PVSA). 175.118 Section 175.118 Shipping COAST GUARD, DEPARTMENT OF... Vessels operating under an exemption afforded in the Passenger Vessel Safety Act of 1993 (PVSA). (a) The Passenger Vessel Safety Act of 1993 (PVSA) contained an allowance for the exemption of certain...

  4. 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…

  5. 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…

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

    PubMed

    Beronio, Kirsten; Glied, Sherry; Frank, Richard

    2014-10-01

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

  7. Knowledge and perceptions of the Affordable Care Act by uninsured patients at a free clinic.

    PubMed

    Petrany, Stephen M; Christiansen, Matthew

    2014-05-01

    The Affordable Care Act (ACA) has as one of its main objectives to reduce the number of uninsured Americans. The understanding of the ACA reforms by uninsured patients will likely influence the degree of success in achieving this objective. This study assessed the basic knowledge and opinions regarding the ACA of patients at a free clinic and the impact of a brief educational intervention on respondents' knowledge and opinions. One hundred uninsured adult patients completed a brief survey about the ACA before and after viewing a video outlining the major features of the act. The study cohort initially performed worse than national polls on all knowledge questions. Significant improvement was observed after the educational video. Our study suggests a need for educational efforts directed at those individuals most likely to benefit from the ACA. We demonstrated that a brief intervention during a routine office visit may improve knowledge of the ACA.

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

    PubMed

    Mechanic, David

    2012-02-01

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

  9. 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.

  10. 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.

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

    PubMed

    Hall, Mark A; Lord, Richard

    2014-10-22

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

  12. Energy-efficiency design and inspection guides for affordable housing construction

    SciTech Connect

    Ternes, M.P.; Livengood, S.E.; Wendt, R.L.

    1997-12-01

    This paper focuses on the general methods used in guides developed for the energy efficient design and inspection of new and revitalized housing projects for military family housing. The methods and guides can also benefit the wider market of public and other housing. Inspections performed on military and public housing units were used to identify energy deficiencies. The most common problems found were related to disconnected and deteriorated forced air distribution duct work and poor system design resulting in significant air leakage. Design and inspection guides are summarized for new construction and revitalization projects. 7 refs., 7 figs.

  13. The Legacy of the 1968 Fair Housing Act.

    PubMed

    Massey, Douglas S

    2015-06-01

    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.

  14. 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.

  15. 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.

  16. 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.

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

    PubMed

    2013-02-25

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

  18. Evaluating the "Keep Your Health Plan Fix": Implications for the Affordable Care Act Compared to Legislative Alternatives.

    PubMed

    Saltzman, Evan; Eibner, Christine

    2014-01-01

    President Obama's promise that Americans could keep their existing health care plans under the Affordable Care Act (ACA) has received increased scrutiny in the wake of millions of Americans having their plans cancelled. These cancellations primarily occurred in the individual or nongroup market, where individuals purchase health care plans directly from an insurer instead of through an employer. Many such plans do not meet the minimum coverage requirements of the ACA, leading insurers to send plan-cancellation notices to their enrollees. This study describes a comparative analysis of three proposals to remedy the situation: one by the White House, another by Senator Mary Landrieu (D-LA), and a third by Representative Fred Upton (R-MI). The proposals are evaluated based on their potential impact on the ACA-compliant market and the cost and coverage of health insurance. The possibility of each proposal causing a "death spiral," in which rising premiums and decreasing enrollment undermine the viability of the ACA-compliant market, is also addressed. The authors find that the three proposals vary from slight to moderate impact on ACA premiums, enrollment, and federal spending, but none of them would result in the unraveling of the ACA-compliant market.

  19. Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act

    PubMed Central

    Corman, Juliane; Levin, David

    2016-01-01

    Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans’ support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political debate has changed. Where it had been about the government provision of healthcare as an abstract principle, it became a debate imbued with evaluations of the implementation of the ACA itself. This spawned a new line of research examining the consequences of the ACA’s implementation on public attitudes toward government provision of healthcare. The change in support for government provision of healthcare and the new post-ACA research highlight a need for a long-term examination of trends in support over the past two decades that will provide context for the new studies. This study provides that examination. PMID:27257309

  20. The Effect of the Affordable Care Act Medicaid Expansion on Migration.

    PubMed

    Goodman, Lucas

    2017-01-01

    The expansion of Medicaid to low-income nondisabled adults is a key component of the Affordable Care Act's strategy to increase health insurance coverage, but many states have chosen not to take up the expansion. As a result, for many low-income adults, there has been stark variation across states in access to Medicaid since the expansions took effect in 2014. This study investigates whether individuals migrate in order to gain access to these benefits. Using an empirical model in the spirit of a difference-in-differences, this study finds that migration from non-expansion states to expansion states did not increase in 2014 relative to migration in the reverse direction. The estimates are sufficiently precise to rule out a migration effect that would meaningfully affect the number of enrollees in expansion states, which suggests that Medicaid expansion decisions do not impose a meaningful fiscal externality on other states.

  1. The essential health benefits provisions of the Affordable Care Act: implications for people with disabilities.

    PubMed

    Rosenbaum, Sara; Teitelbaum, Joel; Hayes, Katherine

    2011-03-01

    In establishing minimum coverage standards for health insurance plans, the Affordable Care Act includes an "essential health benefits" statute that directs the U.S. Secretary of Health and Human Services not to make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life. This issue brief examines how this statute will help Americans with disabilities, who currently are subject to discrimination by insurers based on health status and health care need. The authors also discuss the complex issues involved in implementing the essential benefits provision and offer recommendations to federal policymakers for ensuring that people with disabilities receive the full insurance benefits to which they are entitled.

  2. 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.

  3. 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.

  4. How health navigators legitimize the Affordable Care Act to the uninsured poor.

    PubMed

    Vargas, Robert

    2016-09-01

    Health navigators are a new health care workforce created by the Affordable Care Act (ACA) to assist low-income minority populations with acquiring health insurance. Given the high levels of distrust among the poor toward government and the medical profession, this article asks: How do health navigators build the legitimacy necessary to persuade low-income uninsured clients to enroll in health insurance? Through ethnography of face-to-face interaction between navigators and the uninsured poor in Chicago, this study shows that successful navigators deployed a combination of cultural repertoires for building trust and legitimacy. These repertoires included ceding control of the conversation, creating ethnic solidarity, and disassociating themselves from government bureaucrats or self-serving insurance employees. These findings demonstrate the usefulness of cultural sociology for understanding health insurance provision to the poor, ACA outreach efforts, and the more general study of how occupations legitimize themselves to clients.

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

    PubMed

    McFarlane, Deborah R

    2015-01-01

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

  6. 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.

  7. Mitigating the effects of churning under the Affordable Care Act: lessons from Medicaid.

    PubMed

    Rosenbaum, Sara; Lopez, Nancy; Dorley, Mark; Teitelbaum, Joel; Burke, Taylor; Miller, Jacqueline

    2014-06-01

    Through a combination of three needs-based public programs--Medicaid, the Children's Health Insurance Program, and tax credits for purchasing private plans in the new marketplaces--the Affordable Care Act can potentially ensure continuous coverage for many low- and moderate-income Americans. At the same time, half of individuals with incomes at less than twice the poverty level will experience a form of "churning" in their coverage; as changes occur in their life or work circumstances, they will need to switch among these three coverage sources. For many, churning will entail not only changes in covered benefits and cost-sharing, but also in care, owing to differences in provider networks. Strategies for mitigating churning's effects are complex and require time to implement. For the short term, however, the experiences of 17 states with policies aimed at smoothing transitions between health plans offer lessons for ensuring care continuity.

  8. 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.

  9. The Health Insurance Gap After Implementation of the Affordable Care Act in Texas.

    PubMed

    Gong, Gordon; Huey, Cassandra C; Johnson, Coleman; Curti, Debra; Philips, Billy U

    2017-03-01

    Households with incomes between 18% and 99% of the federal poverty level (FPL) are ineligible for Medicaid or enrollment in the health insurance exchange marketplace in Texas, resulting in the health insurance gap. We sought to determine the number of non-elderly adult Texans (NEATs) aged between 18 and 64 years in the insurance gap in rural vs urban areas in East Texas, West Texas, and South Texas. Data were obtained from the US Census Bureau website. In 2014, there were 1,101,000 NEATs in the insurance gap, accounting for 24.5% of all uninsured persons in Texas. The gap was significantly higher in rural vs urban areas in East and South Texas and in Texas as a whole. Large coverage gaps in states like Texas not expanding Medicaid under the Affordable Care Act pose major hurdles to reducing the number of uninsured individuals in these states.

  10. Health insurers' financial performance and quality improvement expenditures in the Affordable Care Act's second year.

    PubMed

    McCue, Michael J; Hall, Mark

    2015-02-01

    The Affordable Care Act requires health insurers to rebate any amounts less than 80%-85% of their premiums that they fail to spend on medical claims or quality improvement. This study uses the new comprehensive reporting under this law to examine changes in insurers' financial performance and differences in their quality improvement expenditures. In the ACA's second year (2012), insurers' median medical loss ratios continued to increase and their median administrative cost ratios dropped, producing moderate operating margins in the group markets but a small operating loss in the individual market, at the median. For-profit insurers showed larger changes, in general, than did nonprofits. For quality improvement, insurers reported spending a significantly greater amount per member in their government plans than they did on their self-insured members, with spending on commercial insurance being in between these two extremes. The magnitude and source of these differences varied by corporate ownership.

  11. The Affordable Care Act's payment and delivery system reforms: a progress report at five years.

    PubMed

    Abrams, Melinda; Nuzum, Rachel; Zezza, Mark; Ryan, Jamie; Kiszla, Jordan; Guterman, Stuart

    2015-05-01

    In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions intended to resolve underlying problems in how health care is delivered and paid for in the United States. These provisions focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for systemwide improvement. This brief describes these reforms and, where possible, documents their initial impact at the ACA's five-year mark. While it is still far too early to offer any kind of definitive assessment of the law's transformation-seeking reforms, it is clear that the ACA has spurred activity in both the public and private sectors, and is contributing to momentum in states and localities across the U.S. to improve the value obtained for our health care dollars.

  12. 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.

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

    PubMed

    Mechanic, David; Olfson, Mark

    2016-01-01

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

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

    PubMed Central

    Wise, Paul H.; Halfon, Neal

    2014-01-01

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

  15. 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.

  16. Opportunities for social work under the Affordable Care Act: A call for action.

    PubMed

    Lynch, Sean; Greeno, Catherine; Teich, Judith; Delany, Peter

    2016-10-01

    The Affordable Care Act (ACA) has profoundly restructured American health care. Numerous social work authors have commented on the importance of the ACA's reforms to social work practice, education, and research. This article summarizes the literature, adds relevant information, and makes recommendations for future actions. The policy, opinion, and peer-reviewed literatures were systematically reviewed. Sixty-three publications appeared between 2010 and 2015 are included. Five themes emerged, as follows: 1) the crucial provisions of the ACA, 2) the natural affinity of social work and the ACA reforms, 3) curricular adaptations needed to address changing workforce needs, 4) areas for continued social work advocacy, and 5) opportunities for high-impact social work research. This article provides a comprehensive introduction to the ACA, its reforms, and opportunities for social work to assume a high visibility leadership role in implementing the reforms, with particular emphasis on needed curricular changes and opportunities for research.

  17. 75 FR 29877 - Affordable Housing Program Amendments: Federal Home Loan Bank Mortgage Refinancing Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ..., including the Hope for Homeowners Program and the Administration's Home Affordable Refinance Program (HARP... is eligible for refinancing under HARP, but is not likely to know if the household has other options if it is not eligible for HARP. Even if the household could not qualify for an eligible...

  18. 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

    ... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... pursuant to the Native American Housing Assistance and Self-Determination Reauthorization Act of 2008. The.... SUPPLEMENTARY INFORMATION: I. Background The Native American Housing Assistance and...

  19. 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

  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.

  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. 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.

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

    PubMed Central

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

    2015-01-01

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

  4. Excluding Exceptions: Housing Non-Affordability and the Oppression of Environmental Sustainability?

    ERIC Educational Resources Information Center

    Hoggart, K.; Henderson, S.

    2005-01-01

    This paper explores the provision of homes for less wealthy households in rural England. By allowing 'exceptions' to UK planning law to provide low-income housing for local residents, the national government seeks to secure dwellings for the less wealthy and so sustain socially mixed rural villages. This paper explores how the production of homes…

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

    PubMed

    2016-10-13

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

  6. Coverage of certain preventive services under the Affordable Care Act. Interim final rules.

    PubMed

    2014-08-27

    This document contains interim 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. Among these services are women's preventive health services, as specified in guidelines supported by the Health Resources and Services Administration (HRSA). As authorized by the current regulations, and consistent with the HRSA Guidelines, group health plans established or maintained by certain religious employers (and group health insurance coverage provided in connection with such plans) are exempt from the otherwise applicable requirement to cover certain contraceptive services. Additionally, under current regulations, accommodations are available with respect to the contraceptive coverage requirement for group health plans established or maintained by eligible organizations (and group health insurance coverage provided in connection with such plans), and student health insurance coverage arranged by eligible organizations that are institutions of higher education, that effectively exempt them from this requirement. The regulations establish a mechanism for separately furnishing payments for contraceptive services on behalf of participants and beneficiaries of the group health plans of eligible organizations that avail themselves of an accommodation, and enrollees and dependents of student health coverage arranged by eligible organizations that are institutions of higher education that avail themselves of an accommodation. These interim final regulations augment current regulations in light of the Supreme Court's interim order in connection with an

  7. 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.

  8. The Patient Protection and Affordable Care Act: impact on mental health services demand and provider availability.

    PubMed

    Pearlman, Shoshannah A

    2013-01-01

    The Patient Protection and Affordable Care Act (ACA) will greatly increase the demand for mental health (MH) services, as 62.5 million Americans from relatively high-need populations will be newly eligible for MH benefits. Consequently, the supply of MH care provider services is expected to proportionately decrease by 18% to 21% in 2014. ACA funding does not demonstrate the ability to increase turnout of psychiatrists sufficiently to meet the need. Available data indicate that the numbers of advanced practice psychiatric nurses (APPNs) continue to increase at a much greater rate, but information from either a clinical perspective or a market perspective is complicated by the weak distinctions that are made between nurse practitioners (NPs) and other nonphysician care professionals. The following recommendations are made: (a) some of the ACA funding for research into efficient and effective care delivery systems should be allocated to acquiring data on APPNs in leadership roles or clinical settings in which they are ultimately responsible for management of MH care, as differentiated from settings in which they provide support for psychiatrists; and (b) since the available data indicate nurse practitioners achieve good outcomes and are more economically viable than psychiatrists, placement of psychiatric-mental health nurse practitioners in community settings should be recognized as a realistic solution to the shortfall of MH services.

  9. 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

  10. Media Messages and Perceptions of the Affordable Care Act during the Early Phase of Implementation.

    PubMed

    Fowler, Erika Franklin; Baum, Laura M; Barry, Colleen L; Niederdeppe, Jeff; Gollust, Sarah E

    2017-02-01

    Public opinion about the Affordable Care Act (ACA) has been polarized since the law's passage. Past research suggests these conditions would make any media influence on the public limited at best. However, during the early phase of implementation, locally broadcast ACA-related media messages-in the form of paid health insurance and political advertisements and news media stories-abounded as advocates, insurance marketers, and politicians sought to shape the public's perceptions of the law. To what extent did message exposure affect ACA perceptions during the first open enrollment period? We merge data on volumes of messaging at the media market level with nationally representative survey data to examine the relationship between estimated exposure to media messaging and the public's perceptions of how informed they were about and favorable toward the ACA in October 2013. We find that higher volumes of insurance advertising and local news coverage are associated with participants' perceptions of being informed about the law. Volumes of insurance advertising and of local news coverage are also associated with participants' favorability toward the law, but the relationship varies with partisanship, supporting the growing body of research describing partisan perceptual bias.

  11. The Affordable Care Act reduces emergency department use by young adults: evidence from three States.

    PubMed

    Hernandez-Boussard, Tina; Burns, Carson S; Wang, N Ewen; Baker, Laurence C; Goldstein, Benjamin A

    2014-09-01

    The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19-25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young adults used ED services, we used 2009-11 state administrative records from California, Florida, and New York to compare changes in ED use in young adults ages 19-25 before and after the ACA provision was implemented with changes in the same period for people ages 26-31 (the control group). Following implementation of the ACA provision, the younger group had a decrease of 2.7 ED visits per 1,000 people compared to the older group--a relative change of -2.1 percent. The largest relative decreases were found in women (-3.0 percent) and blacks (-3.4 percent). This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults ages 19-25 across the three states in 2011. When we compared the probability of ever using the ED before and after implementation of the ACA provision, we found a minimal decrease (-0.4 percent) among the younger group compared to the older group. This suggests that the change in the number of visits was driven by fewer visits among ED users, not by changes in the number of people who ever visited the ED.

  12. 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.

  13. The problem of choice: From the voluntary way to Affordable Care Act health insurance exchanges.

    PubMed

    Mulligan, Jessica

    2017-03-28

    This article takes a genealogical and ethnographic approach to the problem of choice, arguing that what choice means has been reworked several times since health insurance first figured prominently in national debates about health reform. Whereas voluntary choice of doctor and hospital used to be framed as an American right, contemporary choice rhetoric includes consumer choice of insurance plan. Understanding who has deployed choice rhetoric and to what ends helps explain how offering choices has become the common sense justification for defending and preserving the exclusionary health care system in the United States. Four case studies derived from 180 enrollment observations at the Rhode Island health insurance exchange conducted from March 2014-January 2017 and interviews with enrollees show how choice is experienced in this latest iteration of health reform. The Affordable Care Act (ACA) of 2010 created new pathways to insurance coverage in the United States. Insurance exchanges were supposed to unleash the power of consumer decision-making through marketplaces where health plans compete on quality, coverage, and price. Consumers, however, contended with confusing insurance terminology and difficult to navigate websites. The ethnography shows that consumers experienced choice as confusing and overwhelming and did not feel "in charge" of their decisions. Instead, unstable employment, changes in income, existing health needs, and bureaucratic barriers shaped their "choices."

  14. 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.

  15. 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

  16. Determinants of Receipt of Recommended Preventive Services: Implications for the Affordable Care Act

    PubMed Central

    Kenney, Genevieve M.; Goin, Dana

    2014-01-01

    Objectives. We examined preventive care use by nonelderly adults (aged 18–64 years) before the Affordable Care Act (ACA) and considered the contributions of insurance coverage and other factors to service use patterns. Methods. We used data from the 2005–2010 Medical Expenditure Panel Survey to measure the receipt of 8 recommended preventive services. We examined gaps in receipt of services for adults with incomes below 400% of the federal poverty level compared with higher incomes. We then used a regression-based decomposition analysis to consider factors that explain the gaps in service use by income. Results. There were large income-related disparities in preventive care receipt for nonelderly adults. Differences in insurance coverage explain 25% to 40% of the disparities in preventive service use by income, but education, age, and health status are also important drivers. Conclusions. Expanding coverage to lower-income adults through the ACA is expected to increase their preventive care use. However, the importance of education, age, and health status in explaining income-related gaps in service use indicates that the ACA cannot address all barriers to preventive care and additional interventions may be necessary. PMID:24432932

  17. 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.

  18. 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.

  19. An early look at changes in employer-sponsored insurance under the Affordable Care Act.

    PubMed

    Blavin, Fredric; Shartzer, Adele; Long, Sharon K; Holahan, John

    2015-01-01

    Critics frequently characterize the Affordable Care Act (ACA) as a threat to the survival of employer-sponsored insurance. The Medicaid expansion and Marketplace subsidies could adversely affect employers' incentives to offer health insurance and workers' incentives to take up such offers. This article takes advantage of timely data from the Health Reform Monitoring Survey for June 2013 through September 2014 to examine, from the perspective of workers, early changes in offer, take-up, and coverage rates for employer-sponsored insurance under the ACA. We found no evidence that any of these rates have declined under the ACA. They have, in fact, remained constant: around 82 percent, 86 percent, and 71 percent, respectively, for all workers and around 63 percent, 71 percent, and 45 percent, respectively, for low-income workers. To date, the ACA has had no effect on employer coverage. Economic incentives for workers to obtain coverage from employers remain strong.

  20. Interrelation of preventive care benefits and shared costs under the Affordable Care Act (ACA).

    PubMed

    Dixon, Robert Brent; Hertelendy, Attila J

    2014-08-01

    With the implementation of the Affordable Care Act (ACA), access to insurance and coverage of preventive care services has been expanded. By removing the barrier of shared costs for preventive care, it is expected that an increase in utilization of preventive care services will reduce the cost of chronic diseases. Early detection and treatment is anticipated to be less costly than treatment at full onset of chronic conditions. One concern of early detection of disease is the cost to treat. In reality, the confluence of early detection may result in greater overall expenditures. Even with improved access to preventive care benefits, cost-sharing of other health services remains a major component of insurance plans. In order to treat identified conditions or diseases, cost-sharing comes into play. With the greater adoption of cost-sharing insurance plans, expenditures on the part of enrollee are anticipated to rise. Once the healthcare recipients realize the implication of early identification and resultant treatment costs, enrollment in preventive care may decline. Healthcare legislation and regulation should consider the full spectrum of care and the microeconomic costs associated with preventive treatment. Although the system at large may not realize the immediate impact, behavioral shifts on the part of healthcare consumers may alter healthcare. Rather than the current status quo of treating presenting conditions, preventive treatment is largely anticipated to require more resources and may impact the consumer's financial capacity. This report will explore how these two concepts are co-dependent, and highlight the need for continued reform.

  1. Implementing the Affordable Care Act in North Carolina: the rubber hits the road.

    PubMed

    Silberman, Pam

    2013-01-01

    The health insurance mandate, perhaps the best-known provision of the Patient Protection and Affordable Care Act of 2010 (ACA), is slated to go into effect on January 1, 2014. Yet most people do not know how the ACA will affect them. More than one-third of people in a recent national poll were unaware that new health insurance marketplaces will make it easier to purchase coverage or that some people will qualify for subsidies to help them purchase coverage. The ACA includes many other provisions that will have a profound impact on our health care delivery system. Some changes are already helping to break down silos in the delivery of care. Groups of health care professionals are working together to manage the health of populations. The ACA places a much greater emphasis on measuring quality and on paying health professionals and health care institutions based on the value of the services they provide. In addition, the ACA makes greater investments in prevention and in population health management. This issue brief highlights some of the health system changes that have taken place over the past 3 years, as well as some of the potential changes that are yet to come relating to insurance coverage, access to care, quality of care, rising health care costs, and overall population health.

  2. Plastic Surgeons’ Perceptions of the Affordable Care Act: Results of a National Survey

    PubMed Central

    Israel, Jacqueline S.; Chen, Jenny T.; Rao, Venkat K.

    2015-01-01

    Background: The Affordable Care Act (ACA) aims to expand coverage to the uninsured, improve quality, and contain costs. The goal of this study was to ascertain how plastic surgeons perceive the ACA. Methods: An electronic questionnaire was e-mailed to members of the American Society of Plastic Surgeons between May and June 2014. The survey was anonymous and voluntary and included questions to assess understanding and opinions of the ACA. Results: The survey was sent to 3070 members of the American Society of Plastic Surgeons, and the response rate was 17%. Sixty-eight percent agree or strongly agree that they understand the basic concepts of the ACA. The majority of respondents disagree (38% strongly disagree, 31% disagree) with the notion that the ACA will positively affect their practice, and 51% agree with the statement, “I do not support the ACA, and I believe it did too much.” Two thirds (66%) believe that the ACA deserves a grade of D or F. When answers were analyzed across demographics, 42% of respondents with “Academic” practice background identify with the statement, “I support the ACA but I think it needs more work,” compared to 15% of those who selected “Solo Practice” (p <0.001). Conclusions: The ACA will affect all specialties, including plastic surgery. The results of this survey suggest that many plastic surgeons believe that they have a baseline understanding of current health-care reform. The majority of surveyed surgeons do not support the Act. It is imperative that plastic surgeons possess the knowledge of the ACA; its changes, both current and impending, will likely affect patient mix, coverage of procedures, and reimbursement. PMID:25674374

  3. 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

    ... Tracking Network. This network builds on ongoing efforts within the public health and environmental sectors... Public Tracking Network as a potential data tool for laboratories. This award was proposed in the grantee... Network. Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Section...

  4. AIDS Drug Assistance Programs: managers confront uncertainty and need to adapt as the Affordable Care Act kicks in.

    PubMed

    Martin, Erika G; Meehan, Terence; Schackman, Bruce R

    2013-06-01

    With the Affordable Care Act set to expand insurance coverage to millions more Americans next year, existing discretionary health programs that receive federal support might find themselves competing for funds as the health reform law is fully implemented. To assess the implications the Affordable Care Act might have for discretionary health programs, we focused on state AIDS Drug Assistance Programs, which provide free medications to low-income HIV patients. We conducted semistructured interviews with program managers from twenty-two states. Many of the managers predicted that their programs will change focus to provide "wrap-around services," such as helping newly insured clients finance out-of-pocket expenses, including copayments, deductibles, and premiums. Although program managers acknowledged that they must adapt to a changing environment, many said that they were overwhelmed by the complexity of the Affordable Care Act, and some expressed fear that state AIDS Drug Assistance Programs would be eliminated entirely. To remain viable, such programs must identify and justify the need for services in the context of the Affordable Care Act and receive sufficient political support and funding.

  5. 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.

  6. 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

  7. 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.

  8. Expansion of Coverage under the Patient Protection and Affordable Care Act and Primary Care Utilization

    PubMed Central

    Hofer, Adam N; Abraham, Jean Marie; Moscovice, Ira

    2011-01-01

    Context: Provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA) expand Medicaid to all individuals in families earning less than 133 percent of the federal poverty level (FPL) and make available subsidies to uninsured lower-income Americans (133 to 400 percent of FPL) without access to employer-based coverage to purchase insurance in new exchanges. Since primary care physicians typically serve as the point of entry into the health care delivery system, an adequate supply of them is critical to meeting the anticipated increase in demand for medical care resulting from the expansion of coverage. This article provides state-level estimates of the anticipated increases in primary care utilization given the PPACA's provisions for expanded coverage. Methods: Using the Medical Expenditure Panel Survey, this article estimates a multivariate regression model of annual primary care utilization. Using the model estimates and state-level information regarding the number of uninsured, it predicts, by state, the change in primary care visits expected from the expanded coverage. Finally, the article predicts the number of primary care physicians needed to accommodate this change in utilization. Findings: This expanded coverage is predicted to increase by 2019 the number of annual primary care visits between 15.07 million and 24.26 million. Assuming stable levels of physicians’ productivity, between 4,307 and 6,940 additional primary care physicians would be needed to accommodate this increase. Conclusions: The PPACA's health insurance expansion parameters are expected to significantly increase the use of primary care. Two strategies that policymakers may consider are creating stronger financial incentives to attract medical school students to primary care and changing the delivery of care in ways that lead to operational improvements, higher throughput, and better quality of care. PMID:21418313

  9. HIV-Infected Patient Knowledge, Attitudes, and Beliefs Regarding the Affordable Care Act.

    PubMed

    Rozin, Irina; Sayles, Harlan; Anderson, Matthew J; Furl, Renae; Stimpson, Jim P; Swindells, Susan; Bares, Sara H

    2015-06-01

    We evaluated patient knowledge, attitudes, and beliefs regarding changes present with the Affordable Care Act (ACA). HIV-infected adults attending an academic medical center HIV clinic in Omaha, Nebraska were asked to complete a self-administered survey between November 2013 and March 2014. Information collected included demographics, knowledge regarding healthcare reform policies, as well as attitudes and beliefs regarding the potential impact of the ACA on patient access to healthcare. Basic descriptive statistics were used to assess demographic characteristics of respondents and outcomes of interest. Chi-square tests were used for comparisons of interest among participants; some trends were evaluated with Cochran-Armitage trend tests. Four hundred and six patients completed the questionnaire. Of the respondents 90% were between the ages of 27 and 64, 61% were white, 27% had no health insurance, and 21% reported that they felt they had or will eventually benefit from the ACA. The proportion who responded "I don't know" to this question decreased over the study period (p=0.036). Overall, 57% reported they do not believe that they are informed enough to make decisions about the ACA. In answering four knowledge-based questions, only 3% answered all of them correctly. Knowledge about the ACA was significantly associated with perception of benefit (p=0.018). HIV-infected patients are not well informed about the ACA and few perceive that they will benefit from healthcare reform. Targeted education and outreach are necessary to reduce the knowledge gap for this population that stands to benefit greatly from the ACA.

  10. Faith-Based Organizations and the Affordable Care Act: Reducing Latino Mental Healthcare Disparities

    PubMed Central

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

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) is expected to increase access to mental healthcare through provisions aimed at increasing health coverage among the nation's uninsured, including 10.2 million eligible Latino non-elderly 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 healthcare disparities for Latinos. Faith-based organizations (FBOs) could play an integral role in the mental healthcare 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 healthcare 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 medical homes (PCMH) 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 PCMH providers need to overcome in order to be partners in integrated care efforts. PMID:26845492

  11. 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

  12. 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

    ... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... Native American Programs, Office of Public and Indian Housing, Department of Housing and Urban... statutory amendments to the Native American Housing Assistance and Self-Determination Act of 1996 (25...

  13. 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

    ... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... to the Native American Housing Assistance and Self-Determination Reauthorization Act of 2008. The... Housing Assistance and Self-Determination Reauthorization Act of 2008 (Pub. L. 110-411, approved...

  14. 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

    ... 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.... SUPPLEMENTARY INFORMATION: I. Background The Native American Housing Assistance and Self-Determination Act...

  15. 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.

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Multifamily Housing Mortgage and Housing Assistance Restructuring Program (Mark to... Housing Reform and Affordability Act of 1997 as extended by the Market to Market Extension Act of...

  17. 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

  18. 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

  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. 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.

  1. 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

    ... Development. Public housing authorities must have on hand and available for inspection policies related to... other interested parties informally or through the Freedom of Information Act. Written documentation...

  2. 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......

  3. 76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... and other business cooperatives provide possible models for the successful development of CO-OPs... to promote integrated models of care and enhance competition in the Affordable Insurance Exchanges... met. Starting in 2014, individuals and small businesses will be able to purchase private...

  4. Medicaid Expansion under the Affordable Care Act. Implications for Insurance-related Disparities in Pulmonary, Critical Care, and Sleep

    PubMed Central

    Douglas, Ivor S.; Cooke, Colin R.

    2014-01-01

    The Affordable Care Act was intended to address systematic health inequalities for millions of Americans who lacked health insurance. Expansion of Medicaid was a key component of the legislation, as it was expected to provide coverage to low-income individuals, a population at greater risk for disparities in access to the health care system and in health outcomes. Several studies suggest that expansion of Medicaid can reduce insurance-related disparities, creating optimism surrounding the potential impact of the Affordable Care Act on the health of the poor. However, several impediments to the implementation of Medicaid’s expansion and inadequacies within the Medicaid program itself will lessen its initial impact. In particular, the Supreme Court’s decision to void the Affordable Care Act’s mandate requiring all states to accept the Medicaid expansion allowed half of the states to forego coverage expansion, leaving millions of low-income individuals without insurance. Moreover, relative to many private plans, Medicaid is an imperfect program suffering from lower reimbursement rates, fewer covered services, and incomplete acceptance by preventive and specialty care providers. These constraints will reduce the potential impact of the expansion for patients with respiratory and sleep conditions or critical illness. Despite its imperfections, the more than 10 million low-income individuals who gain insurance as a result of Medicaid expansion will likely have increased access to health care, reduced out-of-pocket health care spending, and ultimately improvements in their overall health. PMID:24708065

  5. 78 FR 12833 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... Qualified Health Plan SHOP Small Business Health Options Program SSA Social Security Administration The Act Social Security Act The Code Internal Revenue Code of 1986 USP United States Pharmacopeia...

  6. 76 FR 73990 - Redelegation of Fair Housing Act Complaint Processing Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Redelegation of Fair Housing Act Complaint Processing Authority AGENCY: Office of the Assistant Secretary for Fair Housing and Equal Opportunity, HUD. ACTION: Notice of redelegation of...

  7. The health reform monitoring survey: addressing data gaps to provide timely insights into the affordable care act.

    PubMed

    Long, Sharon K; Kenney, Genevieve M; Zuckerman, Stephen; Goin, Dana E; Wissoker, Douglas; Blavin, Fredric; Blumberg, Linda J; Clemans-Cope, Lisa; Holahan, John; Hempstead, Katherine

    2014-01-01

    The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the Affordable Care Act (ACA) during the period before federal government survey data for 2013 and 2014 will be available. Based on a nationally representative, probability-based Internet panel, the HRMS provides quarterly data for approximately 7,400 nonelderly adults and 2,400 children on insurance coverage, access to health care, and health care affordability, along with special topics of relevance to current policy and program issues in each quarter. For example, HRMS data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts. This raises concerns about some people's ability to evaluate trade-offs when choosing health insurance plans. Assisting people as they attempt to enroll in health coverage will require targeted education efforts and staff to support those with low health insurance literacy.

  8. The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations.

    PubMed

    Kominski, Gerald F; Nonzee, Narissa J; Sorensen, Andrea

    2017-03-20

    The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.

  9. 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

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

    PubMed

    Collins, Lydia N

    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.

  11. 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

  12. 76 FR 71474 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Amendments...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ...This proposed rule would make several revisions to the regulations governing the Indian Housing Block Grant (IHBG) Program and the Title VI Loan Guarantee Program. HUD negotiated the proposed rule with active Tribal participation under the procedures of the Negotiated Rulemaking Act of 1990, pursuant to the Native American Housing Assistance and Self-Determination Reauthorization Act of 2008.......

  13. 77 FR 71513 - Native American Housing Assistance and Self-Determination Reauthorization Act of 2008: Amendments...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ...This final rule revises the regulations governing the Indian Housing Block Grant (IHBG) program and the Title VI Loan Guarantee program. HUD negotiated this rule with active tribal participation under the procedures of the Negotiated Rulemaking Act of 1990, pursuant to the Native American Housing Assistance and Self-Determination Reauthorization Act of 2008. These regulatory changes implement......

  14. The Evolution and Significance of the Proposed Fair Housing Amendments Act of 1979.

    ERIC Educational Resources Information Center

    Weaver, Robert C.

    1979-01-01

    The history of effective fair housing legislation is traced from its beginning in the late 1930s through the passage of the Civil Rights Act of 1964 and subsequent passage of Title VIII in 1968. The effects of the proposed Fair Housing Amendments Act of 1979 on Title VIII's deficiencies are discussed. (RLV)

  15. 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

  16. In The Affordable Care Act's Shadow: The Fate Of The Children's Health Insurance Program.

    PubMed

    Oberlander, Jonathan; Jones, David K; Spivack, Steven; Singer, Phillip M

    2016-10-01

    The Children's Health Insurance Program (CHIP) is a success story. CHIP has contributed greatly to ensuring affordable insurance and access to medical services for millions of children. The 2015 two-year extension of CHIP funding appeared to confirm its longstanding status as a bipartisan program. Yet that appearance obscures important changes in CHIP politics. In recent years, there have been calls to end the program, and its bipartisan coalition has frayed. In this article we analyze CHIP's funding extension, explore its shifting political environment, and discuss the implications for the program's future.

  17. 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

  18. 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

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

    PubMed

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

    2015-04-01

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

  20. Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.

    PubMed

    2011-08-03

    This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.

  1. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Act. (a) In addition to protecting employees who file complaints, institute proceedings, or testify in proceedings under or related to the Act, section 11(c) also protects employees from discrimination occurring... seek the assistance of other public agencies which have responsibility in the field of safety...

  2. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Act. (a) In addition to protecting employees who file complaints, institute proceedings, or testify in proceedings under or related to the Act, section 11(c) also protects employees from discrimination occurring... seek the assistance of other public agencies which have responsibility in the field of safety...

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

    PubMed

    2012-07-20

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

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

    PubMed

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

    2015-01-01

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

  5. 21st Century FHA Housing Act of 2009

    THOMAS, 111th Congress

    Rep. Adler, John H. [D-NJ-3

    2009-07-09

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

  6. Wounded Warrior and Military Survivor Housing Assistance Act of 2010

    THOMAS, 111th Congress

    Rep. Paulsen, Erik [R-MN-3

    2010-07-30

    09/29/2010 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  7. Rural Housing Preservation and Stabilization Act of 2010

    THOMAS, 111th Congress

    Rep. Kanjorski, Paul E. [D-PA-11

    2010-04-14

    04/28/2010 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  8. Frank Melville Supportive Housing Investment Act of 2009

    THOMAS, 111th Congress

    Rep. Murphy, Christopher S. [D-CT-5

    2009-03-23

    07/23/2009 Received in the Senate and Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Notes: For further action, see S.1481, which became Public Law 111-374 on 1/4/2011. Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  9. 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

    ... 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 Urban... under section 3 of the Housing and Urban Development Act of 1968 and HUD's implementing regulations...

  10. Patient Protection and Affordable Care Act of 2010: Summary, Analysis, and Opportunities for Advocacy for the Academic Emergency Physician

    PubMed Central

    Kline, Jeffrey A.; Walthall, Jennifer D.H.

    2010-01-01

    The Patient Protection and Affordable Care Bill, commonly referred to as the “Health Care Bill” or the “Health Care Reform Bill,” became enacted in March, 2010. This article is a review and analysis of the sections of this Act that are relevant to researchers and teachers of emergency care. The purpose of this document is to serve as a citable reference for interested parties and a reference to quickly locate the sections of the Bill relevant to academic emergency physicians. When appropriate, text was copied verbatim from the bill. The source of the downloaded Act, and the page numbers of the text sections, are provided to help the reader to find the sections described. This review is presented in two parts. Part 1 presents 11 sections extirpated from the Act, with short interpretations of the significance of each section. Part II presents an analysis of the sections that the authors believe represent opportunities for emergency care researchers and teachers to make the most impact, through active involvement with the various departments and agencies of the federal government that will be charged with interpreting and implementing this Act. The Act contains sections that could lead to new funding opportunities for research in emergency care, especially for comparative clinical trials and clinical studies that focus on integration and efficiency of health care delivery. The Act will establish several new institutes, centers, and committees that will create policies highly relevant to emergency care. The authors conclude that this Act can be expected to have a profound influence on research and training in emergency care. PMID:20653573

  11. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice... Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs... Older Americans Act Title VI Native American program awardee. The purpose of these grants will be...

  12. 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…

  13. Gain in Insurance Coverage and Residual Uninsurance Under the Affordable Care Act: Texas, 2013–2016

    PubMed Central

    Pickett, Stephen; Marks, Elena

    2017-01-01

    Objectives. To examine the effects of the Affordable Care Act’s (ACA’s) Marketplace on Texas residents and determine which population subgroups benefited the most and which the least. Methods. We analyzed insurance coverage rates among nonelderly Texas adults using the Health Reform Monitoring Survey-Texas from September 2013, just before the first open enrollment period in the Marketplace, through March 2016. Results. Texas has experienced a roughly 6–percentage-point increase in insurance coverage (from 74.7% to 80.6%; P = .012) after implementation of the major insurance provisions of the ACA. The 4 subgroups with the largest increases in adjusted insurance coverage between 2013 and 2016 were persons aged 50 to 64 years (12.1 percentage points; P = .002), Hispanics (10.9 percentage points; P = .002), persons reporting fair or poor health status (10.2 percentage points; P = .038), and those with a high school diploma as their highest educational attainment (9.2 percentage points; P = .023). Conclusions. Many population subgroups have benefited from the ACA’s Marketplace, but approximately 3 million Texas residents still lack health coverage. Adopting the ACA’s Medicaid expansion is a means to address the lack of coverage. PMID:27854535

  14. 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.

  15. 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...

  16. 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

    ... Privacy Act; System of Records: Records of the Office of White House Liaison, State-34 SUMMARY: Notice is... Office of White House Liaison, State-34, pursuant to the provisions of the Privacy Act of 1974, as... White House Liaison, State-34, to ensure Privacy Act of 1974 compliance: Purpose. The...

  17. 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.

  18. Gaining ground: Americans' health insurance coverage and access to care after the Affordable Care Act's first open enrollment period.

    PubMed

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

    2014-07-01

    A new Commonwealth Fund survey finds that in the wake of the Affordable Care Act's first open enrollment period, significantly fewer working-age adults are uninsured than just before the sign-up period began, and many have used their new coverage to obtain needed care. The uninsured rate for people ages 19 to 64 declined from 20 percent in the July-to-September 2013 period to 15 percent in the April-to-June 2014 period. An estimated 9.5 million fewer adults were uninsured. Young men and women drove a large part of the decline: the uninsured rate for 19-to-34-year-olds declined from 28 percent to 18 percent, with an estimated 5.7 million fewer young adults uninsured. By June, 60 percent of adults with new coverage through the marketplaces or Medicaid reported they had visited a doctor or hospital or filled a prescription; of these, 62 percent said they could not have accessed or afforded this care previously.

  19. 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

    ... 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...

  20. 7 CFR 3575.40 - Equal opportunity and Fair Housing Act requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 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...

  1. 7 CFR 3575.40 - Equal opportunity and Fair Housing Act requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 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...

  2. Reducing Health Care Disparities for Minority Women in the Era of the Affordable Care Act: Opportunities within Primary Care.

    PubMed

    Karliner, Leah; Marks, Angela; Mutha, Sunita

    2016-01-01

    Despite improvements in overall health of the American population, disparities persist, particularly for minority women. The Affordable Care Act (ACA) offers the potential to reduce disparities through expanded insurance coverage, greater access to high-quality care, and bolstered prevention efforts in the context of new models of care such as the patient-centered medical home (PCMH). We use case studies representing three clinical conditions (breast cancer, HIV, and coronary heart disease) to present strategies for how a PCMH could reduce disparities for minority women. The case studies highlight the opportunity that further implementation of the ACA provides to improve screening, risk assessment, and prevention for a range of conditions that impact the health of minority women, as well as areas ripe for future investigation.

  3. The Affordable Care Act's preventive services mandate: breaking down the barriers to nationwide access to preventive services.

    PubMed

    Cogan, John Aloysius

    2011-01-01

    The Affordable Care Act (ACA) transforms the U.S.'s public and private health care financing systems into vehicles for promoting public health by making evidence-based preventive services available nationwide through individual and group health plans, Medicare, and Medicaid. The ACA accomplishes this transformation by breaking down two barriers: (1) the public health-health care divide, which led to a dominance of curative medicine over preventive health measures and (2) ERISA preemption, which created an obstacle to the provision of a uniform set of evidence-based preventive services that could be made available to the U.S. population through individual and group health plans. As a result, prevention measures with proven effectiveness will now be provided on a national and uniform basis to a majority of Americans, with the potential to improve health outcomes and reduce costs.

  4. 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

  5. Impact of Patient Protection and Affordable Care Act on academic radiology departments' clinical, research, and education missions.

    PubMed

    Mansoori, Bahar; Vidal, Lorenna L; Applegate, Kimberly; Rawson, James V; Novak, Ronald D; Ros, Pablo R

    2013-10-01

    The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment.

  6. Affordable Care Act Qualified Health Plan Enrollment for AIDS Drug Assistance Program Clients: Virginia's Experience and Best Practices

    PubMed Central

    Rodney, Robert C.; Rhodes, Anne; Bailey, Steven; Dillingham, Rebecca

    2016-01-01

    Abstract With the implementation of the Affordable Care Act (ACA) in 2014, many safety net resources, including state AIDS Drug Assistance Programs (ADAPs), incorporated ACA Qualified Health Plans (QHPs) into their healthcare delivery model. This article highlights the benefits of the ACA for persons living with HIV. It also describes the range of strategies employed by state ADAPs to enroll patients in QHPs. The Virginia ADAP ACA implementation experience is described to illustrate one ADAP's shift to purchasing QHPs in addition to providing direct medications. Virginia ADAP is in a Medicaid nonexpansion state and funds the full costs of the QHP premiums, deductibles, and medication copayments. Virginia's experience is applicable to other Medicaid nonexpansion states and to state ADAPs in Medicaid expansion states, who are looking for options for their Medicaid ineligible clients. This article provides practical details of Virginia ADAP's ACA implementation as well as insights and best practices at both the state and clinic level. PMID:27346694

  7. Affordable Care Act Qualified Health Plan Enrollment for AIDS Drug Assistance Program Clients: Virginia's Experience and Best Practices.

    PubMed

    McManus, Kathleen A; Rodney, Robert C; Rhodes, Anne; Bailey, Steven; Dillingham, Rebecca

    2016-09-01

    With the implementation of the Affordable Care Act (ACA) in 2014, many safety net resources, including state AIDS Drug Assistance Programs (ADAPs), incorporated ACA Qualified Health Plans (QHPs) into their healthcare delivery model. This article highlights the benefits of the ACA for persons living with HIV. It also describes the range of strategies employed by state ADAPs to enroll patients in QHPs. The Virginia ADAP ACA implementation experience is described to illustrate one ADAP's shift to purchasing QHPs in addition to providing direct medications. Virginia ADAP is in a Medicaid nonexpansion state and funds the full costs of the QHP premiums, deductibles, and medication copayments. Virginia's experience is applicable to other Medicaid nonexpansion states and to state ADAPs in Medicaid expansion states, who are looking for options for their Medicaid ineligible clients. This article provides practical details of Virginia ADAP's ACA implementation as well as insights and best practices at both the state and clinic level.

  8. Growth and variability in health plan premiums in the individual insurance market before the Affordable Care Act.

    PubMed

    Gruber, Jonathan

    2014-06-01

    Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.

  9. 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...

  10. 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... 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...

  11. 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...

  12. 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...

  13. 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...

  14. Current Challenges to the United States' AIDS Drug Assistance Program and Possible Implications of the Affordable Care Act

    PubMed Central

    McManus, Kathleen A.; Engelhard, Carolyn L.; Dillingham, Rebecca

    2013-01-01

    AIDS Drug Assistance Programs, enacted through the Ryan White Comprehensive AIDS Resources Emergency Act of 1990, are the “payer of last resort” for prescription medications for lower income, uninsured, or underinsured people living with HIV/AIDS. ADAPs face declining funding from the federal government. State funding of ADAP is discretionary, but some states increased their contributions to meet the gap in funding. The demand for ADAP support is increasing as people living with HIV are living longer; the antiretroviral therapy (ART) guidelines have been changed to recommend initiation of treatment for all; the United States is increasing HIV testing goals; and the recession continues. In the setting of increased demand and limited funding, ADAPs are employing cost containment measures. Since 2010, emergency federal funds have bailed out ADAP, but these are not sustainable. In the coming years, providers and policy makers associated with HIV care will need to navigate the implementation of the Affordable Care Act (ACA). Lessons learned from the challenges associated with providing sustainable access to ART for vulnerable populations through ADAP should inform upcoming decisions about how to ensure delivery of ART during and after the implementation of the ACA. PMID:23573418

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ... 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...

  16. Insurance Enrollment at a Student-Run Free Clinic After the Patient Protection and Affordable Care Act.

    PubMed

    McGeehan, Megan; DeMaria, Rebecca; Charney, Pamela; Batavia, Ashita S

    2017-03-04

    The Patient Protection and Affordable Care Act (ACA) aims to increase insurance coverage through government subsidies. Medical student-run free clinics (SRFC) are an important entry point into the healthcare system for the uninsured. SRFCs do not have a standardized approach for navigating the complexities of enrollment. The Weill Cornell Community Clinic (WCCC) developed a unique enrollment model that may inform other SRFCs. Our objective is to describe enrollment processes at SRFCs throughout New York City, and to evaluate enrollment outcomes and persistent barriers to coverage at WCCC. We surveyed SRFC leadership throughout NYC to understand enrollment processes. We evaluated enrollment outcomes at WCCC through chart review and structured phone interviews. Subjects included WCCC patients seen in clinic between October 1, 2013 and September 30, 2015 (N = 140). Demographic information, method of insurance enrollment, and qualitative description of enrollment barriers were collected. SRFCs in New York City have diverse enrollment processes. 48% (N = 42) of WCCC patients obtained health insurance. Immigration status was a barrier to coverage in 21% of patients. Failure to gain coverage was predicted by larger household size (p = 0.02). Gender and employment status were not associated with remaining uninsured. The main barriers to enrollment were inability to afford premiums and lack of interest. Insurance enrollment processes at SRFCs in New York City are mostly ad hoc and outcomes are rarely tracked. Following implementation of the ACA, WCCC stands out for its structured approach, with approximately half of eligible WCCC patients gaining coverage during the study period.

  17. 24 CFR 180.700 - Action upon issuance of a final decision in Fair Housing Act cases.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Action upon issuance of a final decision in Fair Housing Act cases. 180.700 Section 180.700 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY,...

  18. 24 CFR 180.700 - Action upon issuance of a final decision in Fair Housing Act cases.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Action upon issuance of a final decision in Fair Housing Act cases. 180.700 Section 180.700 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY,...

  19. 24 CFR 180.700 - Action upon issuance of a final decision in Fair Housing Act cases.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Action upon issuance of a final decision in Fair Housing Act cases. 180.700 Section 180.700 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY,...

  20. 24 CFR 180.700 - Action upon issuance of a final decision in Fair Housing Act cases.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Action upon issuance of a final decision in Fair Housing Act cases. 180.700 Section 180.700 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY,...

  1. 24 CFR 180.700 - Action upon issuance of a final decision in 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 Action upon issuance of a final decision in Fair Housing Act cases. 180.700 Section 180.700 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY,...

  2. 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

    ... 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 Act..., Deputy Assistant Secretary for Native American Programs, Office of Public and Indian Housing,...

  3. 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

    ... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on debentures... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section...

  4. 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

    ... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on debentures... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section...

  5. 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

    ... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on debentures... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section...

  6. 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

    ... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on debentures... provisions of the National Housing Act (the Act). The interest rate for debentures issued under section...

  7. 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…

  8. 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:

  9. 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:

  10. 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:

  11. The Changing Dynamics Of US Health Insurance And Implications For The Future Of The Affordable Care Act.

    PubMed

    Graves, John A; Nikpay, Sayeh S

    2017-02-01

    The introduction of Medicaid expansions and state Marketplaces under the Affordable Care Act (ACA) have reduced the uninsurance rate to historic lows, changing the choices Americans make about coverage. In this article we shed light on these changing dynamics. We drew upon multistate transition models fit to nationally representative longitudinal data to estimate coverage transition probabilities between major insurance types in the years leading up to and including 2014. We found that the ACA's unprecedented coverage changes increased transitions to Medicaid and nongroup coverage among the uninsured, while strengthening the existing employer-sponsored insurance system and improving retention of public coverage. However, our results suggest possible weakness of state Marketplaces, since people gaining nongroup coverage were disproportionately older than other potential enrollees. We identified key opportunities for policy makers and insurers to improve underlying Marketplace risk pools by focusing on people transitioning from employer-sponsored coverage; these people are disproportionately younger and saw almost no change in their likelihood of becoming uninsured in 2014 compared to earlier years.

  12. Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs.

    PubMed

    Nowak, Sarah A; Eibner, Christine; Adamson, David M; Saltzman, Evan

    2014-01-01

    This study examines the likely effects of the Affordable Care Act (ACA) on average annual consumer health care spending and the risk of catastrophic medical costs for the United States overall and in two large states that have decided not to expand their Medicaid programs (Texas and Florida). The ACA will have varied impacts on individuals' and families' spending on health care, depending on income level and on estimated 2016 insurance status without the ACA. The authors find that average out-of-pocket spending is expected to decrease for all groups considered in the analysis, although decreases in out-of-pocket spending will be largest for those who would otherwise be uninsured. People who would otherwise be uninsured who transition to the individual market under the ACA will have higher total health care spending on average after implementation of the ACA because they will now incur the cost of health insurance premiums. The authors also find that risk of catastrophic health care spending will decrease for individuals of all income levels for the insurance transitions considered; decreases will be greatest for those at the lowest income levels. Case studies found that in Texas and Florida, Medicaid expansion would substantially reduce out-of-pocket and total health care spending for those with incomes below 100 percent of the federal poverty level, compared with a scenario in which the ACA is implemented without Medicaid expansion. Expansion would reduce the risk of high medical spending for those covered under Medicaid who would remain uninsured without expansion.

  13. Community Health Centers Play a Critical Role in Caring for the Remaining Uninsured in the Affordable Care Act Era.

    PubMed

    Wallace, Steven P; Young, Marie-Elena; Rodriguez, Michael A

    2016-10-01

    Federally Qualified Health Centers--commonly referred to as Community Health Centers (CHCs)--serve as a safety net for people who did not gain health insurance under the Affordable Care Act (ACA), including those immigrants not eligible for Medicaid or health insurance exchange coverage. ACA-driven changes in health insurance coverage, funding, and related policy have created new challenges for these safety net organizations. This policy brief reports the findings from analyses of the U.S. HRSA Uniform Data System and interviews conducted in 2014-16 with the leadership of 31 CHCs. The CHCs were located in communities with high concentrations of immigrants and uninsured residents, in states that either expanded Medicaid (California and New York) or that chose not to expand it (Georgia and Texas). The study found that most CHCs now see more patients, including significant numbers without insurance. The ACA has brought new resources to CHCs but has also reinforced challenges, including the need for stable revenue streams, sufficient staffing support, and assistance in leveraging new reimbursement mechanisms. Policy recommendations to address these challenges include continuing core federal funding, insuring the remaining uninsured, addressing workforce challenges, and preparing CHCs for alternative payment mechanisms.

  14. 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.

  15. The Great Recession and Health Spending among Uninsured U.S. Immigrants: Implications for the Affordable Care Act Implementation

    PubMed Central

    Bustamante, Arturo Vargas; Chen, Jie

    2014-01-01

    Objective We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. Data Source Uninsured U.S. citizens and noncitizens from the 2005–2006 and 2008–2009 Medical Expenditure Panel Survey. Study Design The probability of reporting any health spending and the natural logarithm of health spending are our main dependent variables. We compare health spending across population categories before/during the GR. Subsequently, we implement two-part regression analyses of total and specific health-spending measures. We predict average health spending before/during the GR with a smearing estimation. Principal Findings The probability of reporting any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported higher spending during the GR (27 percent). Average reductions in total spending were driven by the decline in the share of the population reporting any spending among citizens and noncitizens. Conclusions Our study findings suggest that recent immigrants could be forgoing essential care, which later translates into higher spending. It portrays the vulnerability of a population that would remain exposed to income shocks, even after the Affordable Care Act (ACA) implementation. PMID:24962550

  16. Health insurance coverage in the Houston-Galveston area under the patient protection and affordable care act.

    PubMed

    Begley, Charles; Deshmukh, Ashish; Eschbach, Karl; Fouladi, Negin; Liu, Qian June; Reynolds, Thomas

    2012-11-01

    This study projects the number of nonelderly people who could gain coverage under the Patient Protection and Affordable Care Act (PPACA) for the period from 2014 through 2020 in the 13-county Houston-Galveston area region. The major PPACA provisions aimed at expanding coverage as well as the populations targeted by those provisions are described. Projections of the impact of PPACA on coverage in the area are based on estimates of growth in the size of targeted populations in each county and the anticipated responses of those populations to the major provisions of PPACA. The projections indicate that, if fully implemented, PPACA could cut the uninsurance rate in the region by half, from 26% in 2010 to 13% in 2020. This change translates into health insurance coverage for approximately 2 million additional people, from the current 4.2 million to a projected 5.9 million. The number of Medicaid enrollees could increase by an estimated 600,000 (a 79% increase), although private insurance coverage, which could increase by as much as 1 million enrollees (a 30% increase), will remain the primary source of coverage for most people. Coverage gains from PPACA will vary considerably by county, depending on the age-income-citizenship characteristics of the population, current uninsurance rates, and the rate of population growth.

  17. The role of perceived need and health insurance in substance use treatment: implications for the Affordable Care Act.

    PubMed

    Ali, Mir M; Teich, Judith L; Mutter, Ryan

    2015-07-01

    The expansions in insurance coverage under the Patient Protection & Affordable Care Act (ACA) that took full effect in 2014 have been projected to increase the number of users of behavioral health services. By analyzing data from the 2008-2012 National Survey on Drug Use and Health, this paper examines whether health insurance expansion may result in an increase in substance use disorder (SUD) treatment utilization. The study sample includes 18,600 adults with SUD but no diagnosable mental health condition. The analysis finds that over 80% of that population receives no treatment and 97% do not perceive a need for treatment. When they do receive treatment, they are more likely to receive mental health treatment. Using multinomial logistic regression, the study finds that having Medicaid or private insurance is associated with higher likelihood of receiving SUD treatment, but only when individuals perceive a need for it, compared to being uninsured and not perceiving a need for treatment (the reference category). These results indicate that increased service utilization is associated with perceiving a need for substance abuse treatment, implying that outreach initiatives to raise awareness about SUD and the effective role of substance use treatment are needed to enhance the impact of the structural changes to the substance abuse treatment system resulting from the ACA.

  18. THE AFFORDABLE CARE ACT AND INCENTIVIZED HEALTH WELLNESS PROGRAMS--A TALE OF FEDERALISM AND SHIFTING ADMINISTRATIVE BURDEN.

    PubMed

    Sirpal, Sanjeev

    2014-01-01

    The Patient Protection and Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. The proposed rules are promulgated by the Department of Health and Human Services (HHS), the Department of Labor, and the Treasury Department, and seek to encourage appropriately designed, consumer-protective wellness programs in group health coverage. This legislative landscape raises significant federalism concerns insofar as it largely shifts the responsibility for administration of health incentive programs to the states. Little attention has been paid to the shifting "administrative burden" that would thereby ensue. This paper will address the distribution of power in the American federal system vis-à-vis subnational counterparts in the wake of rampant, recent health care reform efforts. This paper will therefore explore the willingness of the national government to delegate policymaking responsibility to state governments in the context of an important aspect of healthcare reform. This, in turn, can be used to assess the distribution of powers between governmental levels--a subject that has received little systematic inquiry to date. Finally, this paper will explore the degree of administrative burden shifting that may likely occur as a result of these changes in health reform and what potential impacts it may have on individual health.

  19. Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States.

    PubMed

    Courtemanche, Charles; Marton, James; Ukert, Benjamin; Yelowitz, Aaron; Zapata, Daniela

    2017-01-01

    The Affordable Care Act (ACA) aimed to achieve nearly universal health insurance coverage in the United States through a combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions, most of which took effect in 2014. This paper estimates the causal effects of the ACA on health insurance coverage in 2014 using data from the American Community Survey. We utilize difference-in-difference-in-differences models that exploit cross-sectional variation in the intensity of treatment arising from state participation in the Medicaid expansion and local area pre-ACA uninsured rates. This strategy allows us to identify the effects of the ACA in both Medicaid expansion and non-expansion states. Our preferred specification suggests that, at the average pre-treatment uninsured rate, the full ACA increased the proportion of residents with insurance by 5.9 percentage points compared to 2.8 percentage points in states that did not expand Medicaid. Private insurance expansions from the ACA were due to increases in both employer-provided and non-group coverage. The coverage gains from the full ACA were largest for those without a college degree, non-whites, young adults, unmarried individuals, and those without children in the home. We find no evidence that the Medicaid expansion crowded out private coverage.

  20. Clinicians' awareness of the Affordable Care Act mandate to provide comprehensive tobacco cessation treatment for pregnant women covered by Medicaid.

    PubMed

    Tong, Van T; England, Lucinda J; Malarcher, Ann; Mahoney, Jeanne; Anderson, Britta; Schulkin, Jay

    The Affordable Care Act (ACA) requires states to provide tobacco-cessation services without cost-sharing for pregnant traditional Medicaid-beneficiaries effective October 2010. It is unknown the extent to which obstetricians-gynecologists are aware of the Medicaid tobacco-cessation benefit. We sought to examine the awareness of the Medicaid tobacco-cessation benefit in a national sample of obstetricians-gynecologists and assessed whether reimbursement would influence their tobacco cessation practice. In 2012, a survey was administered to a national stratified-random sample of obstetricians-gynecologists (n = 252) regarding awareness of the Medicaid tobacco-cessation benefit. Results were stratified by the percentage of pregnant Medicaid patients. Chi-squared tests (p < 0.05) were used to assess significant associations. Analyses were conducted in 2014. Eighty-three percent of respondents were unaware of the benefit. Lack of awareness increased as the percentage of pregnant Medicaid patients in their practices decreased (range = 71.9%-96.8%; P = 0.02). One-third (36.1%) of respondents serving pregnant Medicaid patients reported that reimbursement would influence them to increase their cessation services. Four out of five obstetricians-gynecologists surveyed in 2012 were unaware of the ACA provision that required states to provide tobacco cessation coverage for pregnant traditional Medicaid beneficiaries as of October 2010. Broad promotion of the Medicaid tobacco-cessation benefit could reduce treatment barriers.

  1. The Effect of the Affordable Care Act on Enrollment and Premiums, With and Without the Individual Mandate.

    PubMed

    Eibner, Christine; Price, Carter C

    2012-01-01

    This article describes the results of an analysis using RAND's COMPARE (Comprehensive Assessment of Reform Efforts) microsimulation model to predict the effects of a possible Supreme Court decision invalidating the individual mandate provision in the Patient Protection and Affordable Care Act of 2010 while keeping the other parts of the law intact. The authors predict the effects of such a decision on health insurance coverage overall and for subgroups based on income. They also estimate where people will obtain insurance in scenarios with and without the mandate and how the elimination of the individual mandate will affect insurance premiums. The analysis predicted that, if the individual mandate were to be eliminated: (1) 12.5 million people who would have otherwise signed up for coverage will be uninsured. (2) Premium prices in the non-group market will increase by 2.4 percent. (3) Total government spending will increase modestly, from $394 billion to $404 billion in 2016. (4) The amount of government spending per newly insured individual will more than double, from $3,659 to $7,468. The study estimates a smaller effect on premiums than comparable studies because the RAND team uses a method that accounts for the difference in the age composition of enrollees with and without the mandate.

  2. 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.

  3. Perceptions of Occupational Therapists on the Patient Protection and Affordable Care Act: Five Years After Its Enactment.

    PubMed

    Yuen, Hon K; Spicher, Hillary S; Semon, Madelyn R; Winwood, Leah M; Dudgeon, Brian J

    2017-01-01

    This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.

  4. Predictors of Payer Mix and Financial Performance Among Safety Net Hospitals Prior to the Affordable Care Act.

    PubMed

    Sommers, Benjamin D; Stone, Juliana; Kane, Nancy

    2016-01-01

    The objective of this study was to use audited hospital financial statements to identify predictors of payer mix and financial performance in safety net hospitals prior to the Affordable Care Act. We analyzed the 2010 financial statements of 98 large, urban safety net hospital systems in 34 states, supplemented with data on population demographics, hospital features, and state policies. We used multivariate regression to identify independent predictors of three outcomes: 1) Medicaid-reliant payer mix (hospitals for which at least 25% of hospital days are paid for by Medicaid); 2) safety net revenue-to-cost ratio (Medicaid and Medicare Disproportionate Share Hospital payments and local government transfers, divided by charity care costs and Medicaid payment shortfall); and 3) operating margin. Medicaid-reliant payer mix was positively associated with more inclusive state Medicaid eligibility criteria and more minority patients. More inclusive Medicaid eligibility and higher Medicaid reimbursement rates positively predicted safety net revenue-to-cost ratio. University governance was the strongest positive predictor of operating margin. Safety net hospital financial performance varied considerably. Academic hospitals had higher operating margins, while more generous Medicaid eligibility and reimbursement policies improved hospitals' ability to recoup costs. Institutional and state policies may outweigh patient demographics in the financial health of safety net hospitals.

  5. Health literacy and the Affordable Care Act: a policy analysis for children with special health care needs in the USA

    PubMed Central

    Keim-Malpass, Jessica; Letzkus, Lisa C; Kennedy, Christine

    2015-01-01

    Children with special health care needs (CSHCN) represent populations with chronic health conditions that are often high utilizers of health care. Limited health literacy has emerged as a key indicator of adverse health outcomes, and CSHCN from limited health literacy families are particularly vulnerable. The purpose of this policy analysis is to outline key provisions in the Affordable Care Act (ACA) that incorporate health literacy approaches for implementation and have implications for CSHCN in the USA. Several key provisions are incorporated in the ACA that involve health literacy and have implications for CSHCN. These include: expansion of public insurance coverage and simplifying the enrollment process, provisions assuring equity in health care and communication among all populations, improving access to patient-centered medical homes that can offer care coordination, ensuring enhanced medication safety by changing liquid medication labeling requirements, and provisions to train health care providers on literacy issues. More research is needed to determine how provisions pertaining to health literacy in the ACA are implemented in various states. PMID:25897270

  6. 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.

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

    PubMed

    2012-02-15

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

  8. 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

    ... Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA). 1.42-3 Section 1.42-3 Internal Revenue... pursuant to section 721 of the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA... section are effective for loans made after August 8, 1989....

  9. 26 CFR 1.42-3 - Treatment of buildings financed with proceeds from a loan under an Affordable Housing Program...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA). 1.42-3 Section 1.42-3 Internal Revenue... pursuant to section 721 of the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA... section are effective for loans made after August 8, 1989....

  10. 26 CFR 1.42-3 - Treatment of buildings financed with proceeds from a loan under an Affordable Housing Program...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA). 1.42-3 Section 1.42-3 Internal Revenue... pursuant to section 721 of the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA... section are effective for loans made after August 8, 1989....

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA). 1.42-3 Section 1.42-3 Internal Revenue... pursuant to section 721 of the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA... section are effective for loans made after August 8, 1989....

  12. 26 CFR 1.42-3 - Treatment of buildings financed with proceeds from a loan under an Affordable Housing Program...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA). 1.42-3 Section 1.42-3 Internal Revenue... pursuant to section 721 of the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA... section are effective for loans made after August 8, 1989....

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

    PubMed Central

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

    2010-01-01

    The introduction of antiretroviral therapy in resource-poor settings is effective in suppressing HIV-1 replication and prolonging life of infected individuals. This has led to a demand for affordable HIV-1 drug resistance assays, since treatment failure due to development of drug resistance is common. This study developed and evaluated an affordable “in–house” genotyping assay to monitor HIV-1 drug resistance in Africa, particularly South Africa. An “in-house” assay using automated RNA extraction, and subtype C specific PCR and sequencing primers was developed and successfully evaluated 396 patient samples (viral load ranges 1,000->1.6million RNA copies/ml). The “in-house” assay was validated by comparing sequence data and drug resistance profiles from 90 patient and 10 external quality control samples to data from the ViroSeqTM HIV-1 Genotyping kit. The “in-house” assay was more efficient, amplifying all 100 samples, compared to 91 samples using Viroseq. The “in house” sequences were 99.2%) homologous to the ViroSeq sequences, and identical drug resistance mutation profiles were observed in 96 samples. Furthermore, the “in-house” assay genotyped 260 of 295 samples from seven African sites, where 47% were non-subtype C. Overall, the newly validated “in-house” drug resistance assay is suited for use in Africa as it overcomes the obstacle of subtype diversity. PMID:19917318

  14. Social, Reproductive, and Attitudinal Factors Associated with U.S. Women's Disagreement with the Passage of the Affordable Care Act

    PubMed Central

    Nadella, Samantha Paturu; Zochowski, Melissa K.; Patel, Divya; Dalton, Vanessa K.

    2015-01-01

    Abstract Background: Notably absent from research and public and policy dialogue on the Affordable Care Act (ACA) and reproductive health care are women's perspectives and a broader understanding of factors that shape ACA attitudes. We investigated social, reproductive, and attitudinal factors associated with women's disagreement with the passage of the ACA. Methods: Data were drawn from the Women's Health Care Experiences and Preferences Study, our population-based internet survey of 1,078 randomly sampled United States women ages 18–55 years conducted in September 2013. Items measured ACA attitudes, including disagreement with the ACA's passage. We examined relationships between ACA disagreement, sociodemographic and reproductive characteristics, health service experiences, and reproductive health care and policy attitudes with logistic regression. Results: Among women who had heard of the ACA (n=888), 35% disagreed with it and 38% did not know how they felt. Black women (adjusted odds ratio [aOR] 0.12, 95% confidence interval [CI] 0.03–0.55) and women with incomes of >$75k (aOR 0.38, CI 0.17–0.88), Medicare/Medicaid insurance (aOR 0.24, CI 0.10–0.61), and infrequent religious service attendance (aOR 0.57, CI 0.35–0.93) were less likely to disagree with the ACA's passage, compared with their counterparts. Republican party affiliation was the strongest predictor of ACA disagreement (aOR 17.10, CI 9.12–32.09). Negative beliefs about the ACA's ability to improve access to preferred care and regarding employers' and the government's roles in reproductive health care were positively associated with ACA disagreement. Conclusions: Many women who could benefit from the ACA disagree with or do not know how they feel about its passage, which may influence participation in ACA benefits and services. PMID:26125483

  15. 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

  16. 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

  17. 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.

  18. A cross-jurisdictional evaluation of insurance coverage among HIV care patients following the Affordable Care Act.

    PubMed

    Hood, Julia E; Buskin, Susan E; Anderson, Bridget J; Gagner, Alexandra; Kienzle, Jennifer; Maggio, David; Markey, Katie; Reuer, Jennifer; Benbow, Nanette; Wortley, Pascale

    2017-04-01

    The impact of the Affordable Care Act (ACA) on HIV care patients, aged 18-64, was evaluated in three jurisdictions with Medicaid expansion (Chicago, New York State, and Washington) and three jurisdictions without Medicaid expansion (Georgia, Texas, and Virginia) using data from the Medical Monitoring Project. Multivariate regression models were used to evaluate insurance status that was reported pre- and post-ACA; self-reported impact of ACA on HIV care was explored with descriptive statistics. The likelihood of having insurance was significantly greater post-ACA compared to pre-ACA in Chicago (aRR = 1.33, 95%CI = 1.20, 1.47), Washington (aRR = 1.15, 95%CI = 1.08, 1.22), and Virginia (aRR = 1.14, 95%CI = 1.00, 1.29). In Washington and Chicago, the likelihood of being Medicaid-insured was greater post-ACA compared to pre-ACA implementation (Chicago: aRR = 1.25, 95%CI = 1.03,1.53; Washington: aRR = 1.66 95% CI = 1.30, 2.13). No other significant differences were observed. Only a subset of HIV care patients (range: 15-35%) reported a change in insurance that would have coincided with the implementation of ACA; and within this subset, a change in medical care costs was the most commonly noted issue. In conclusion, the influence of ACA on insurance coverage and other factors affecting HIV care likely varies by jurisdiction.

  19. 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

  20. States' implementation of the Affordable Care Act and the supply of physicians waivered to prescribe buprenorphine for opioid dependence

    PubMed Central

    Knudsen, Hannah K.; Lofwall, Michelle R.; Havens, Jennifer R.; Walsh, Sharon L.

    2015-01-01

    Background Although the Affordable Care Act (ACA) is anticipated to affect substance use disorder (SUD) treatment, its impact on the supply of physicians waivered to treat opioid dependence with buprenorphine has not been considered. This study examined whether states more supportive of ACA, meaning those that had opted to expand Medicaid and establish a state-based health insurance exchange, experienced greater growth in physician supply than less supportive states. Methods Buprenorphine physician supply, including total physician supply, supply of 30-patient physicians, and supply of 100-patient physicians per 100,000 state residents, was measured from June 2013 to May 2015. State characteristics were drawn from multiple secondary sources, with states categorized as ACA-supportive, ACA-hybrid (where states either expanded Medicaid or established a state-based exchange), or ACA-resistant (where states took neither action). Mixed effects regression was used to estimate state-level growth curves to test whether rates of growth varied by states' approaches to implementing ACA. Results The supply of waivered physicians grew significantly over the two-year period. Rates of growth were significantly lower in ACA-hybrid and ACA-resistant states relative to growth in ACA-supportive states. Average buprenorphine physician supply at baseline varied by region, the percentage of residents covered by Medicaid, and the supply of specialty SUD treatment programs. Conclusions This study found a positive impact of the ACA on growth in the supply of buprenorphine-waivered physicians in US states. Future research should address whether the ACA affects the number of patients receiving buprenorphine, Medicaid spending, and the quality of treatment services delivered. PMID:26483356

  1. 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.

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ..., Washington, DC 20410; telephone number 202-401- 7914 (this is not a toll-free number). Hearing or speech... Reauthorization Act of 2008: Negotiated Rulemaking Committee Meeting AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD. ACTION: Notice of negotiated rulemaking committee meeting. SUMMARY:...

  3. 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

    ..., Washington, DC 20410; telephone number 202-401- 7914 (this is not a toll-free number). Hearing or speech... Reauthorization Act of 2008: Negotiated Rulemaking Committee Meeting; Correction AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD. ACTION: Notice of Negotiated Rulemaking Committee...

  4. 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

    ... deaf (TDD) may call the Federal Information Relay Service (FIRS) at 1-800-877-8339 to contact the above... Disposal Boundary Final Environmental Impact Statement and approved by Record of Decision on December 23, 2004. The BLM has completed a site specific Determination of National Environmental Act...

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

    ERIC Educational Resources Information Center

    Levin, Arthur, J.; Silard, John

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

  6. The impact of the Affordable Care Act on hospital-led community health evaluation in the U.S. Appalachian Ohio region.

    PubMed

    Franz, Berkeley; Skinner, Daniel; Kelleher, Kelly

    2017-04-03

    In recent years, policy developments in the United States have dramatically changed how nonprofit hospitals interact with surrounding communities. However, despite the importance of these changes encoded in Internal Revenue Service regulations, little is known about how these requirements have affected how nonprofit hospitals are approaching community health evaluation. We present qualitative findings from interviews with hospital employees and consultants overseeing preliminary rounds of community health needs assessments, as required by the Affordable Care Act. The sample comes from the Appalachian region of Ohio, an area targeted because of significant health challenges. Our findings suggest that the Affordable Care Act has led hospitals to formalize their processes, focus on developing an evidence base, cultivate local partnerships, and reflect on the role of the hospital in public health.

  7. Implementation of the affordable care act: a case study of a service line co-management company.

    PubMed

    Lanese, Bethany

    2016-09-19

    Purpose The purpose of this paper is to test and measure the outcome of a community hospital in implementing the Affordable Care Act (ACA) through a co-management arrangement. RQ1: do the benefits of a co-management arrangement outweigh the costs? RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? Design/methodology/approach A case study of a 350-bed non-profit community hospital co-management company. The quantitative data are eight quarters of quality metrics prior and eight quarters post establishment of the co-management company. The quality metrics are all based on standardized national requirements from the Joint Commission and Centers for Medicare and Medicaid Services guidelines. These measures directly impact the quality initiatives under the ACA that are applicable to all healthcare facilities. Qualitative data include survey results from hospital employees of the perceived effectiveness of the co-management company. A paired samples difference of means t-test was conducted to compare the timeframe before co-management and post co-management. Findings The findings indicate that the benefits of a co-management arrangement do outweigh the costs for both the physicians and the hospital ( RQ1). The physicians benefit through actual dollar payout, but also with improved communication and greater input in running the service line. The hospital benefits from reduced cost - or reduced penalties under the ACA - as well as better communication and greater physician involvement in administration of the service line. RQ2: does physician alignment aid in the effective implementation of the ACA directives set for hospitals? The hospital improved in every quality metric under the co-management company. A paired sample difference of means t-test showed a statistically significant improvement in five of the six quality metrics in the study. Originality/value Previous research indicates the potential effectiveness of

  8. 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

  9. The income divide in health care: how the Affordable Care Act will help restore fairness to the U.S. health system.

    PubMed

    Collins, Sara R; Robertson, Ruth; Garber, Tracy; Doty, Michelle M

    2012-02-01

    The new Commonwealth Fund Health Insurance Tracking Survey of U.S.Adults finds nearly three of five adults in families earning less than 133 percent of the federal poverty level were uninsured for a time in 2011; two of five were uninsured for one or more years. Low- and moderate-income adults who were uninsured during the year were much less likely to have a regular source of health care than people in the same income range who were insured all year. In addition, uninsured lower-income adults were more likely than insured adults in the same income group to cite factors other than medical emergencies as reasons for going to the emergency room. These included needing a prescription drug, not having a regular doctor, or saying that other places cost too much. The Affordable Care Act will substantially narrow these inequities through an extensive set of affordable coverage options starting in 2014.

  10. 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.

  11. 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:

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

    PubMed

    2013-02-27

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

  13. 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

    ... programs authorized under the Native American Housing Assistance and Self-Determination Act of 1996. Changes to these programs were made by the Native American Housing Assistance and Self-Determination... Boyd, Deputy Assistant Secretary for Native American Programs, Office of Public and Indian...

  14. 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

    ... URBAN DEVELOPMENT Privacy Act; Notice of Revision of System of Records, the Single Family Housing... Federal Register about one of its record systems, the Single Family Housing Enterprise Data Warehouse... (202) 402-8087 or Mary Jo Sullivan, System Owner, Director, Office of Single Family Program...

  15. 76 FR 579 - Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... conditions requiring HUD's annual Quality Control for Rental Assistance Subsidy Determinations (``QC'') study... Assistance and Self-Determination Act of 1996 (25 U.S.C. 4101 et seq.); and the Quality Housing and...

  16. A window of opportunity: maximizing the effectiveness of new HCV regimens in the United States with the expansion of the Affordable Care Act.

    PubMed

    Haley, Sean J; Kreek, Mary Jeanne

    2015-03-01

    Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease management. New, highly effective HCV treatment regimens in combination with the medical home model could reduce disease prevalence. We sought to address challenges posed by comorbidities in patients with chronic HCV infection and limitations within our health care system, and recommend solutions to maximize the public benefit from ACA and the new drug regimen.

  17. A Window of Opportunity: Maximizing the Effectiveness of New HCV Regimens in the United States With the Expansion of the Affordable Care Act

    PubMed Central

    Kreek, Mary Jeanne

    2015-01-01

    Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease management. New, highly effective HCV treatment regimens in combination with the medical home model could reduce disease prevalence. We sought to address challenges posed by comorbidities in patients with chronic HCV infection and limitations within our health care system, and recommend solutions to maximize the public benefit from ACA and the new drug regimen. PMID:25602859

  18. Interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.

    PubMed

    2010-06-17

    This document contains interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan.

  19. 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.

  20. 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

    ... Assistance Act, 49 U.S.C. 31105, front pay appropriate where employee was unable to work due to major depression resulting from the retaliation); Brown v. Lockheed Martin Corp., ALJ No. 2008-SOX-49, ] 2010...

  1. “Will Employers Drop Health Insurance Coverage because of the Affordable Care Act?” Health Affairs 32(9): 1522–1530

    PubMed Central

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

    2014-01-01

    Since the passage of the Affordable Care Act, there has been considerable speculation about how many employers will stop offering health insurance once the major coverage provisions of the Act take effect. While some observers predict little aggregate effect, others believe that 2014 marks the beginning of the end for our current system of employer- sponsored insurance. We address the question “how will employer health insurance offering respond to health reform?” using theoretical and empirical evidence. First, we describe economic models of why employers offer insurance. Second, we recap the relevant provisions of health reform and use our economic framework to consider how they may affect employer offers. Third, we review the various predictions that have been made on this subject. Finally, we offer some observations on interpreting early data from 2014. PMID:24019355

  2. 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

    ... 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 and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF...

  3. 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

    ... 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 and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF...

  4. 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

    ... 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 and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF...

  5. 24 CFR 1000.42 - Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Are the requirements of section 3 of the Housing and Urban Development Act of 1968 applicable? 1000.42 Section 1000.42 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF...

  6. l-Leucine acts as a potential agent in reducing body temperature at hatching and affords thermotolerance in broiler chicks.

    PubMed

    Han, Guofeng; Yang, Hui; Bahry, Mohammad A; Tran, Phuong V; Do, Phong H; Ikeda, Hiromi; Furuse, Mitsuhiro; Chowdhury, Vishwajit S

    2017-02-01

    Thermal manipulation (TM) of incubation temperature causes metabolic alterations and contributes to improving thermotolerance in chicks post hatching. However, there has been no report on amino acid metabolism during TM and the part it plays in thermotolerance. In this study, we therefore first analyzed free amino acid concentrations in the embryonic brain and liver during TM (38.6°C, 6h/d during embryonic day (ED) 10 to ED 18). It was found that leucine (Leu), phenylalanine and lysine were significantly decreased in the embryonic brain and liver. We then chose l-Leu and other branched-chain amino acids (l-isoleucine (L-Ile) and l-valine (l-Val)) for in ovo injection on ED 7 to reveal their roles in thermoregulation, growth, food intake and thermotolerance in chicks. It was found that in ovo injection of l-Leu, but not of l-Ileu or l-Val, caused a significant decline in body temperature at hatching and increased food intake and body weight gain in broiler chicks. Interestingly, in ovo injection of l-Leu resulted in the acquisition of thermotolerance under high ambient temperature (35±1°C for 180min) in comparison with the control thermoneutral temperature (28±1°C for 180min). These results indicate that the free amino acid concentrations during embryogenesis were altered by TM. l-Leu administration in eggs caused a reduction in body temperature at hatching, and afforded thermotolerance in heat-exposed young chicks, further suggesting that l-Leu may be one of the key metabolic factors involved in controlling body temperature in embryos, as well as in producing thermotolerance after hatching.

  7. How the Affordable Care Act Has Improved Americans’ Ability to Buy Health Insurance on Their Own: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016.

    PubMed

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

    2017-01-01

    Issue: Since 2001, long before the passage of the Affordable Care Act (ACA), the Commonwealth Fund Biennial Health Insurance Survey has examined health coverage and consumers’ experiences buying insurance and using health care. Goals: To examine long-term trends and to make comparisons before and after passage of health reform. Methods: Analysis of the Commonwealth Fund Biennial Health Insurance Survey, 2016. Findings and Conclusions: There have been dramatic improvements in people’s ability to buy health plans on their own following the passage of the ACA. For adults with family incomes less than $48,500, uninsured rates dropped about 17 percentage points below their 2010 peak. Lower-income whites, blacks, and Latinos have experienced drops this large, though Latinos are uninsured at higher rates. Among working-age adults who had shopped for plans in the individual market and ACA marketplaces over the prior three years, the percentage who reported it was very difficult to find affordable plans fell by nearly half from 2010, prior to the ACA reforms, to 2016. Coverage gains are helping working-age Americans get the care they need: the number of adults who reported problems getting needed health care and filling prescriptions because of costs fell from a high of 80 million in 2012 to an estimated 63 million in 2016.

  8. State trends in premiums and deductibles, 2003-2009: how building on the Affordable Care Act will help stem the tide of rising costs and eroding benefits.

    PubMed

    Schoen, Cathy; Stremikis, Kristof; How, Sabrina K H; Collins, Sara R

    2010-12-01

    Rapidly rising health insurance costs have strained U.S. families and employers in recent years. This issue brief examines data for all states on changes in private employer premiums and deductibles for 2003 and 2009. The analysis finds that premiums for businesses and their employees increased 41 percent across states from 2003 to 2009, while per-person deductibles jumped 77 percent in large as well as small firms. If these trends continue at the rate prior to enactment of the Affordable Care Act, the average premium for family coverage will rise 79 percent by 2020, to more than $23,000. The authors describe how health reform offers the potential to reduce insurance cost growth while improving value and protection. If reforms succeed in slowing premium growth by 1 percentage point annually in all states, by 2020 employers and families together will save $2,323 annually for family coverage, compared with projected trends.

  9. 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.

  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.

  11. Critical Anthropology of Global Health "takes a stand" statement: a critical medical anthropological approach to the U.S.'s Affordable Care Act.

    PubMed

    Horton, Sarah; Abadía, Cesar; Mulligan, Jessica; Thompson, Jennifer Jo

    2014-03-01

    The Affordable Care Act (ACA) of 2010--the U.S.'s first major health care reform in over half a century-has sparked new debates in the United States about individual responsibility, the collective good, and the social contract. Although the ACA aims to reduce the number of the uninsured through the simultaneous expansion of the private insurance industry and government-funded Medicaid, critics charge it merely expands rather than reforms the existing fragmented and costly employer-based health care system. Focusing in particular on the ACA's individual mandate and its planned Medicaid expansion, this statement charts a course for ethnographic contributions to the on-the-ground impact of the ACA while showcasing ways critical medical anthropologists can join the debate. We conclude with ways that anthropologists may use critiques of the ACA as a platform from which to denaturalize assumptions of "cost" and "profit" that underpin the global spread of market-based medicine more broadly.

  12. Health Insurance Challenges in the Post-Affordable Care Act (ACA) Era: a Qualitative Study of the Perspective of Low-Income People of Color in Metropolitan Detroit.

    PubMed

    Patel, Minal R; Jensen, Alison; Ramirez, Erminia; Tariq, Madiha; Lang, Ian; Kowalski-Dobson, Theresa; Pettway, Joslyn; Famulare, Michelle; Lichtenstein, Richard

    2017-02-07

    Low-income people of color are at risk of remaining uninsured due to a variety of factors. This study examined Affordable Care Act (ACA)-related and other health insurance enrollment experiences, observations, navigation needs, and experiences maintaining health insurance coverage among low-income communities of color in an economically disadvantaged community (Metropolitan Detroit). We conducted nine focus groups (n = 87) between May and June 2015. Participants were recruited through community-based organizations serving our key populations of interest. Using an inductive thematic analysis approach, codes and themes were generated. Findings from six themes demonstrated that although health insurance is perceived as important, confusion and frustration persist around health plan benefits and coverage, eligibility requirements and key provisions of the ACA, and enrollment. Individuals face difficulties justifying the cost of health insurance. More focused insurance outreach efforts are needed to achieve the ultimate goal of improving the health of low-income communities of color.

  13. Partisan Politics or Public-Health Need? An empirical analysis of state choice during initial implementation of the Affordable Care Act.

    PubMed

    Mayer, Martin; Kenter, Robert; Morris, John C

    2015-01-01

    States' policy decisions regarding the Affordable Care Act (ACA) of 2010 have often been explained as predominantly, if not solely, partisan. Might rival explanations also apply? Using a cross-sectional 50-state regression model, we studied standard political variables coupled with public-health indicators. This work differs from existing research by employing a dependent variable of five additive measures of ACA support, examining the impact of both political and socioeconomic indicators on state policy decisions. Expanding on recent empirical studies with our more nuanced additive index of support measures, we found that same-party control of a state's executive and legislative branches was indeed by far the single best predictor of policy decisions. Public-health indicators, overwhelmed by partisan effect, did not sufficiently explain state policy choice. This result does not allay the concerns that health policy has become synonymous with health politics and that health politics now has little to do with health itself.

  14. Touch Affordances

    NASA Astrophysics Data System (ADS)

    Slegers, Karin; de Roeck, Dries; Arnall, Timo

    The workshop “Touch Affordances” addresses a concept relevant to human computer interactions based on touch. The main topic is the challenge of applying the notion of affordances to domains related to touch interactions (e.g. (multi)touch screens, RFID & NFC, ubiquitous interfaces). The goals of this workshop are to launch a community of researchers, designers, etc. interested in this topic, to create a common understanding of the field of touch affordances and to generate ideas for new research areas for intuitive touch interactions. The workshop will be highly interactive and will have a creative, generative character.

  15. 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

    ... URBAN DEVELOPMENT 24 CFR Part 1000 Native American Housing Assistance and Self-Determination... Housing and Urban Development, 451 7th Street SW, Room 10276, Washington, DC 20410-0500. 2. Electronic... American Programs, Office of Public and Indian Housing, Department of Housing and Urban Development,...

  16. 75 FR 59735 - Privacy Act of 1974; Notification of a New Privacy Act System of Records, Rapid Re-Housing for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    ... example, the local site interviewer will be able to review data for study participants only for his or her... will VPN access. These steps will be documented as part of termination process. The site interviewers...: Notification of a new SORN. SUMMARY: Housing Urban Development (HUD) proposes to establish a new Privacy Act...

  17. The Latino Physician Shortage: How the Affordable Care Act Increases the Value of Latino Spanish-Speaking Physicians and What Efforts Can Increase Their Supply.

    PubMed

    Daar, David A; Alvarez-Estrada, Miguel; Alpert, Abigail E

    2017-03-31

    The United States Latino population is growing at a rapid pace and is set to reach nearly 30% by 2050. The demand for culturally and linguistically competent health care is increasing in lockstep with this growth; however, the supply of doctors with skills and experience suited for this care is lagging. In particular, there is a major shortage of Latino Spanish-speaking physicians, and the gap between demand and supply is widening. The implementation of the Affordable Care Act (ACA) has increased the capacity of the US healthcare system to care for the growing Latino Spanish-speaking population, through health insurance exchanges, increased funding for safety net institutions, and efforts to improve efficiency and coordination of care, particularly with Accountable Care Organizations and the Hospital Readmissions Reduction Program. With these policies in mind, the authors discuss how the value of Latino Spanish-speaking physicians to the healthcare system has increased under the environment of the ACA. In addition, the authors highlight key efforts to increase the supply of this physician population, including the implementation of the Deferred Action for Childhood Arrivals Act, premedical pipeline programs, and academic medicine and medical school education initiatives to increase Latino representation among physicians.

  18. Family Leave Legislation in the U.S. House: Voting on the Family and Medical Leave Act of 1990.

    ERIC Educational Resources Information Center

    Monroe, Pamela A.; And Others

    1995-01-01

    A model of roll call voting by House members on the Family and Medial Leave Act (FMLA) of 1990 was tested. Found that support for the FMLA was tied to a range of dispositional and contextual demand variables: conservatism, presidential support, etc. The model accurately predicted 90% of the votes. (RJM)

  19. 78 FR 47336 - Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-05

    ... URBAN DEVELOPMENT Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban Development (HUD) and the Department of Health and Human Services (HHS): Matching Tenant Data in... attained by HUD through the matching program. The most recent renewal of the current matching...

  20. 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…

  1. Repellent plants provide affordable natural screening to prevent mosquito house entry in tropical rural settings--results from a pilot efficacy study.

    PubMed

    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 mode

  2. 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

  3. Firearms Fairness and Affordability Act

    THOMAS, 111th Congress

    Sen. Baucus, Max [D-MT

    2009-03-18

    03/18/2009 Read twice and referred to the Committee on Finance. (text of measure as introduced: CR S3376) (All Actions) Notes: For further action, see H.R.5552, which became Public Law 111-237 on 8/16/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  4. Affordable Care Act and Women

    MedlinePlus

    ... care for older women, and ends the gender discrimination that requires women to pay more for the ... Preventive Health Services Improved Medicare Coverage Ending Gender Discrimination in Premiums Expanded Insurance Coverage Endnotes Download "rb. ...

  5. Challenges and opportunities in building a sustainable rural primary care workforce in alignment with the Affordable Care Act: the WWAMI program as a case study.

    PubMed

    Allen, Suzanne M; Ballweg, Ruth A; Cosgrove, Ellen M; Engle, Kellie A; Robinson, Lawrence R; Rosenblatt, Roger A; Skillman, Susan M; Wenrich, Marjorie D

    2013-12-01

    The authors examine the potential impact of the Patient Protection and Affordable Care Act (ACA) on a large medical education program in the Northwest United States that builds the primary care workforce for its largely rural region. The 42-year-old Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) program, hosted by the University of Washington School of Medicine, is one of the nation's most successful models for rural health training. The program has expanded training and retention of primary care health professionals for the region through medical school education, graduate medical education, a physician assistant training program, and support for practicing health professionals.The ACA and resulting accountable care organizations (ACOs) present potential challenges for rural settings and health training programs like WWAMI that focus on building the health workforce for rural and underserved populations. As more Americans acquire health coverage, more health professionals will be needed, especially in primary care. Rural locations may face increased competition for these professionals. Medical schools are expanding their positions to meet the need, but limits on graduate medical education expansion may result in a bottleneck, with insufficient residency positions for graduating students. The development of ACOs may further challenge building a rural workforce by limiting training opportunities for health professionals because of competing demands and concerns about cost, efficiency, and safety associated with training. Medical education programs like WWAMI will need to increase efforts to train primary care physicians and increase their advocacy for student programs and additional graduate medical education for rural constituents.

  6. Patient turnover and nursing employment in Massachusetts hospitals before and after health insurance reform: implications for the Patient Protection and Affordable Care Act.

    PubMed

    Shindul-Rothschild, Judith; Gregas, Matt

    2013-01-01

    The Affordable Care Act is modeled after Massachusetts insurance reforms enacted in 2006. A linear mixed effect model examined trends in patient turnover and nurse employment in Massachusetts, New York, and California nonfederal hospitals from 2000 to 2011. The linear mixed effect analysis found that the rate of increase in hospital admissions was significantly higher in Massachusetts hospitals (p<.001) than that in California and New York (p=.007). The rate of change in registered nurses full-time equivalent hours per patient day was significantly less (p=.02) in Massachusetts than that in California and was not different from zero. The rate of change in admissions to registered nurses full-time equivalent hours per patient day was significantly greater in Massachusetts than California (p=.001) and New York (p<.01). Nurse staffing remained flat in Massachusetts, despite a significant increase in hospital admissions. The implications of the findings for nurse employment and hospital utilization following the implementation of national health insurance reform are discussed.

  7. 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

  8. Insurance Receipt and Readiness for Opportunities under the Affordable Care Act: A National Survey of Treatment Providers for Substance Use Disorders.

    PubMed

    Aletraris, Lydia; Edmond, Mary Bond; Roman, Paul M

    2017-04-13

    This study measures the readiness of substance use disorder (SUD) treatment to use opportunities under the Affordable Care Act by examining Medicaid and private insurance acceptance between 2011 and 2013, as well as center characteristics associated with acceptance. Data for this study were from a random sample of SUD treatment centers in the United States. Interviews were conducted on site and face to face, with administrative and clinical directors. We employed logistic regression analyses to examine Medicaid acceptance and private insurance acceptance. We found that 59% of centers accepted Medicaid and 55% accepted private insurance. Accredited centers were more likely to accept Medicaid. A 12-step orientation and greater reliance on female clients were negatively associated with Medicaid acceptance. Larger centers and centers with a greater percentage of counselors with advanced degrees had greater odds of accepting private insurance. Centers that offered residential treatment had lower odds of accepting either Medicaid or private insurance. For private insurance acceptance, having a specific track for homeless patients lowered the odds of acceptance, as did having a greater percentage of Hispanic clients. Newly insured individuals under the ACA may have difficulty finding a program that accepts insurance. Future research should examine effects of Medicaid expansion on SUD treatment delivery.

  9. Why Uninsured Free Clinic Patients Don't Apply for Affordable Care Act Health Insurance in a Non-expanding Medicaid State.

    PubMed

    Kamimura, Akiko; Tabler, Jennifer; Chernenko, Alla; Aguilera, Guadalupe; Nourian, Maziar M; Prudencio, Liana; Ashby, Jeanie

    2016-02-01

    Even after the introduction of the Patient Protection and Affordable Care Act (ACA), uninsured visits remain high, especially in states that opted out of Medicaid expansion. Since the ACA does not provide universal coverage, free clinics serve as safety nets for the un- or under-insured, and will likely continue serving underserved populations. The purpose of this study is to examine factors influencing intentions to not apply for health insurance via the ACA among uninsured free clinic patients in a state not expanding Medicaid. Uninsured primary care patients utilizing a free clinic (N = 551) completed a self-administered survey in May and June 2015. Difficulty obtaining information, lack of instruction to apply, and cost, are major factors influencing intention not to apply for health insurance through the ACA. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of perceived barriers to applying for health insurance through the ACA. Age is an important factor impacting individuals' intentions not to apply for health insurance through the ACA, as older patients in particular need assistance to obtain relevant information about the ACA and other resources. A number of unchangeable factors limit the free clinics' ability to promote enrollment of health insurance through the ACA. Yet free clinics could be able to provide some educational programs or the information of resources to patients. In particular, non-US born English speakers, Spanish speakers, and older adults need specific assistance to better understand health insurance options available to them.

  10. Utilization of and Adherence to Oral Contraceptive Pills and Associated Disparities in the United States: A Baseline Assessment for the Impact of the Affordable Care Act of 2010.

    PubMed

    Lin, Hsien-Chang; Lee, Hsiao-Yun

    2015-01-01

    This study investigated sociological factors that may influence women's utilization of and adherence to oral contraceptive pills. This was a retrospective cross-sectional study using the 2010-2012 Medical Expenditure Panel Survey. Female adults aged 18-50 years were included. Logistic regression was performed to discern women's decisions to use oral contraceptive pills or not. Ordinary least squares and Poisson regressions were conducted to examine the number of oral contraceptive pills received, refill frequency, and annual out-of-pocket expenditure on oral contraceptive pills. Covariates were based on the Andersen model of health care utilization. Among the study sample (weighted n = 207,007,531), 14.8% were oral contraceptive pill users. Factors positively related to oral contraceptive pill use included non-Hispanic white ethnicity, younger age, not currently married, having private insurance, residing in the Midwest, higher education level, and higher annual family income. Being non-Hispanic white and having a higher education level were positively related to oral contraceptive pill adherence. Our findings therefore demonstrate disparities in oral contraceptive pill utilization and adherence, especially according to women's race/ethnicity and educational level. This study serves as a baseline assessment for the impact of the Affordable Care Act on oral contraceptive pill utilization and adherence for future studies.

  11. Educating the Psychology Workforce in the Age of the Affordable Care Act: A Graduate Course Modeled after the Priorities of the Patient-Centered Outcomes Research Institute (PCORI).

    PubMed

    Hoerger, Michael

    2015-11-01

    The Affordable Care Act (ACA) represents a paradigm shift in the U.S. healthcare system, which has implications for psychology programs producing the next generation of trainees. In particular, the ACA has established the Patient-Centered Outcomes Research Institute (PCORI), which has been tasked with developing national priorities and funding research aimed at improving healthcare quality by helping patients and providers to make informed healthcare decisions. PCORI's national priorities span five broad domains: person-centered outcomes research, health disparities research, healthcare systems research, communication and dissemination research, and methodologic research. As these national priorities overlap with the knowledge and skills often emphasized in psychology training programs, initiatives by training programs to bolster strengths in these domains could place trainees at the forefront of this emerging research paradigm. As a part of a new Masters program in behavioral health, our program developed a health psychology course modeled around PCORI's five national priorities, and an initial evaluation in a small sample supported student learning in the five PCORI domains. In summary, the current report has implications for familiarizing readers with PCORI's national priorities for U.S. healthcare, stimulating debate surrounding psychology's response to the largest healthcare paradigm shift in recent U.S. history, and providing a working model for programs seeking to implement PCORI-related changes to their curricula.

  12. Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Amendment to interim final rules with request for comments.

    PubMed

    2010-11-17

    This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

  13. 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;…

  14. Affordable Care?

    PubMed

    Goldstein, Adam O

    2015-01-01

    Once a year, Stuart, a long-haul truck driver, visited a physician to get a signature on the forms that allowed him to continue driving his 18-wheeler. Over 8 years, he had never seen the same physician twice, in large part because of a lack of health insurance. Upon seeing him for the first time, I assured him that we could make financial arrangements, and he subsequently became my continuity patient. Two years later, we both looked forward to his impending 65th birthday, allowing Medicare to ease his fiscal health care burdens. His unexpected death made me ponder how a lack of access to affordable health care profoundly affects patients and their clinicians.

  15. 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

    ... Dollarhide, 2nd Chief, Peoria Tribe of Indians of Oklahoma, Miami, Oklahoma. Earl Evans, Tribal Councilor.... Michael Reed, Chief Executive Officer, Cocopah Indian Housing and Development, Somerton, Arizona. S. Jack... Housing Authority, Hugo, Oklahoma. Michael Thom, Vice Chairman, Karuk Tribe, Happy Camp,...

  16. 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).

  17. 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.

  18. Transportation, Housing and Urban Development, and Related Agencies Appropriations Act, 2011

    THOMAS, 111th Congress

    Rep. Olver, John W. [D-MA-1

    2010-07-26

    08/02/2010 Received in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 503. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  19. 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:

  20. 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:

  1. Remarks by James P. Turner, Acting Assistant Attorney General, Civil Rights Division, before the First Annual Conference, National Fair Housing Alliance, Washington, D.C.

    ERIC Educational Resources Information Center

    Turner, James P.

    This speech by an official of the U.S. Department of Justice reports on the steps that the Department is taking through its Civil Rights Division to enforce the new Fair Housing Act Amendments, and discusses how the Act fosters a cooperative interagency approach to enforcement. Between passage of the Act and its effective date of March 12, 1989,…

  2. 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

    ... No 17. Were savings accomplished by the bulk purchase method? Yes No 18. Did the Executive Director... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE... Housing Act of 1949) 7 CFR part 1944, subpart I provides the specific details of this grant program....

  3. 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

    ... No 17. Were savings accomplished by the bulk purchase method? Yes No 18. Did the Executive Director... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE... Housing Act of 1949) 7 CFR part 1944, subpart I provides the specific details of this grant program....

  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, 2012 CFR

    2012-01-01

    ... No 17. Were savings accomplished by the bulk purchase method? Yes No 18. Did the Executive Director... Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, RURAL BUSINESS-COOPERATIVE... Housing Act of 1949) 7 CFR part 1944, subpart I provides the specific details of this grant program....

  5. Employer Self-Insurance Decisions and the Implications of the Patient Protection and Affordable Care Act as Modified by the Health Care and Education Reconciliation Act of 2010 (ACA).

    PubMed

    Eibner, Christine; Girosi, Federico; Miller, Amalia; Cordova, Amado; McGlynn, Elizabeth A; Pace, Nicholas M; Price, Carter C; Vardavas, Raffaele; Gresenz, Carole Roan

    2011-01-01

    The Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (ACA) changes the regulatory environment within which health insurance policies on the small-group market are bought and sold. New regulations include rate bands that limit premium price variation, risk-adjustment policies that will transfer funds from low-actuarial-risk to high-actuarial-risk plans, and requirements that plans include "essential health benefits." While the new regulations will be applied to all non-grandfathered fully insured policies purchased by businesses with 100 or fewer workers, self-insured plans are exempt from these regulations. As a result, some firms may have a stronger incentive to offer self-insured plans after the ACA takes full effect. In this article we identify factors that influence employers' decisions to self-insure and estimate how the ACA will influence self-insurance rates. We also consider the implications of higher self-insurance rates for adverse selection in the non-self-insured small-group market and whether enrollees in self-insured plans receive different benefits than enrollees in fully-insured plans. Results are based on data analysis, literature review, findings from discussions with stakeholders, and microsimulation analysis using the COMPARE model. Overall, we find little evidence that self-insured plans differ systematically from fully insured plans in terms of benefit generosity, price, or claims denial rates. Stakeholders expressed significant concern about adverse selection in the health insurance exchanges due to regulatory exemptions for self-insured plans. However, our microsimulation analysis predicts a sizable increase in self-insurance only if comprehensive stop-loss policies become widely available after the ACA takes full effect and the expected cost of self-insuring with stop-loss is comparable to the cost of being fully insured in a market without rating regulations.

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

    ERIC Educational Resources Information Center

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

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

  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. 76 FR 70921 - Implementation of the Fair Housing Act's Discriminatory Effects Standard

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ...-related activities on the basis of race, color, religion, sex, disability, familial status, or national... upon persons of a particular race, color, religion, sex, familial status, national origin or handicap... increasing housing patterns that segregate by race, color, religion, sex, familial status, national...

  9. Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009

    THOMAS, 111th Congress

    Sen. Reed, Jack [D-RI

    2009-04-02

    04/02/2009 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (text of measure as introduced: CR S4358-4368) (All Actions) Notes: For further action, see S.896, which became Public Law 111-22 on 5/20/2009. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  10. 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:

  11. 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:

  12. 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...

  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, 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...

  14. 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...

  15. 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...

  16. 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...

  17. The impact of comparative effectiveness research on interventional pain management: evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient-Centered Outcomes Research Institute.

    PubMed

    Manchikanti, Laxmaiah; Falco, Frank J E; Benyamin, Ramsin M; Helm, Standiford; Parr, Allan T; Hirsch, Joshua A

    2011-01-01

    The Patient-Centered Outcomes Research Institute (PCORI) was established by the Affordable Care Act of 2010 to promote comparative effectiveness research (CER) to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis. The development of PCORI is vested in the Medicare Modernization Act (MMA) and the American Recovery and Reinvestment Act (ARRA). The framework of CER and PCORI describes multiple elements which are vested in all 3 regulations including stakeholder involvement, public participation, and open transparent decision-making process. Overall, PCORI is much more elaborate with significant involvement of stakeholders, transparency, public participation, and open decision-making. However, there are multiple issues concerning the operation of such agencies in the United States including the predecessor of Agency for Healthcare Research and Quality (AHRQ), the Agency for Healthcare Policy and Research (AHCPR), AHRQ Effectiveness Health Care programs, and others. The CER in the United States may be described at cross-roads or at the beginnings of a scientific era of CER and evidence-based medicine (EBM). However the United States suffers as other countries, including the United Kingdom with its National Health Services (NHS) and National Institute for Health and Clinical Excellence (NICE), with major misunderstandings of methodology, an inordinate focus on methodological assessment, lack of understanding of the study design (placebo versus active control), lack of involvement of clinicians, and misinterpretation of the evidence which continues to be disseminated. Consequently, PCORI and CER have been described as government-driven solutions without following the

  18. 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:

  19. 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…

  20. Public Law No. 100-430, Fair Housing Amendments Act of 1988, 13 September 1988.

    PubMed

    1988-01-01

    Among other things, this Act amends the US Civil Rights Act of 1968 to extend protections against discrimination based on familial status to include pregnant women and adopting parents. It also prohibits discrimination based on familial status in the sale or rental of homes and makes it unlawful for anyone engaged in residential real estate-related transactions to discriminate in the provision or terms of a transaction because of sex and familial status, among other things.

  1. Secret weapon. [The Energy Act's assault against in-house utility demand side management (DSM)

    SciTech Connect

    Howard, J.H.

    1993-01-15

    With all the attention focused on electric transmission and reform of the Public Utility Holding Company Act, few people noticed new provisions in the Energy Policy Act protecting small business from unfair utility competition in demand-side management. Congressional staffers reportedly received more mail supporting a ban on unfair utility competition than for all of the rest of the energy bill. As a result, the Act directs state utility commissions to consider the effect of DSM programs on small business and to assure that utility actions would not provide such utilities with unfair competitive advantages over such small businesses. It also requires a report by the Federal Trade Commission on the competitive effects of DSM programs and whether any unfair, deceptive, or predatory acts or practices exist, or are likely to exist, from implementation of such programs. Where did this anti-utility weapon come from What does it do And, now that it has been adopted into law, how can electric utilities deal with it

  2. Community Environmental Response Facilitation Act (CERFA) Report, Youngs Lake Housing Area, Renton, WA

    DTIC Science & Technology

    1994-04-01

    FOR DA’TE ,"ET OF 1"=80’ PM307.70.01/ A301 -1 Fit Young$ Lake Housing Areo Previous Owners ft- SDA 20 Amigus 1972 0.42 A M I I!-I I II *I I II 7HZ !I...ST # A , AUTE{: USAEC/SFIM-AELC-RMI Aiý-, 2J aor (MS. BARRY -DSN 584-1659)DiPC0 aPER TELFXJoN 14 JULY 94 GB -I-. 0.. .i i - - ; ; m ~ 0 0 0 0 0 0, ,0...ouamM w mm O ace o a • •ea m’ w .~ a . nlu me •emle. D iamm. wmu~qlm. S OL (~. ak)j.REPRT .AONLY (L e 2. REPORT DATE TYPE AND DATES COVERED- SJArl1994

  3. 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.

  4. Advancing Greenhouse Gas Reductions through Affordable Housing

    EPA Pesticide Factsheets

    James City County, Virginia, is an EPA Climate Showcase Community. EPA’s Climate Showcase Communities Program helps local governments and tribal nations pilot innovative, cost-effective and replicable community-based greenhouse gas reduction projects.

  5. To amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to ensure that certain tenants are able to return to affordable housing after a major disaster.

    THOMAS, 111th Congress

    Rep. Lowey, Nita M. [D-NY-18

    2010-07-30

    08/02/2010 Referred to the Subcommittee on Economic Development, Public Buildings and Emergency Management. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. Amendments to Ocean Dumping Act. House of Representatives, One Hundredth Congress, Second Session, August 3, 1988

    SciTech Connect

    Not Available

    1988-01-01

    The amendment to the bill (H.R. 4338) recommended by the Committee on Merchant Marine and Fisheries prohibits the ocean disposal of sewage sludge and other industrial wastes by the end of 1992 and imposes special fees on such disposal beginning in 1989. Section 1 of the bill amends the Marine Protection, Research, and Sanctuaries Act of 1972 to prohibit the dumping of sewage sludge or industrial waste into the ocean without having obtained from the Administrator of the Environmental Protection Agency a permit imposing a special disposal fee for each dry ton dumped. The bill provides that the administrator may waive the fee requirement for permittees who have entered into a compliance agreement with the Administrator which phases out and terminates ocean dumping of sewage sludge by 1993, and sets forth a schedule for the implementation of an alternate sludge disposal system. The bill directs the Administrator to report to the Congress at 6-month intervals on land-based disposal options for sewage sludge and the progress made by permittees toward the cessation of ocean dumping of such sludge, and requires congressional review of the reports. The Committee on Rules recommends passage.

  7. Tongass Timber Reform Act. House of Representatives, One Hundredth Congress, Second Session, May 4, 1988

    SciTech Connect

    Not Available

    1988-01-01

    The primary purpose of H.R. 1516, as ordered reported, is to make Forest Service management of the Tongass National Forest in Alaska consistent with the management of the other 155 forests in the National Forest System. The legislation repeals Section 705(a) of the Alaska National Interest Lands Conservation Act (ANILCA, P.L. 96-487). Unique and applicable only to the Tongass, Section 705(a) requires that the Forest Service supply timber at the rate of 4.5 billion board feet per decade and establishes a permanent appropriation of at least $40 million annually to be spent on road building and other timber related operations. The legislation also directs the Forest Service to achieve fundamental reforms in two long-term contracts for Tongass timber. Finally, so that land management status can be reviewed for permanent protection in the pending revision of the Tongass Land Management Plan (TLMP), H.R. 1516 establishes a 5-year moratorium on commercial timber harvesting on 1.7 million acres of lands with special fish and wildlife, subsistence, recreation, and other values.

  8. 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…

  9. 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…

  10. 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…

  11. Handicapped Children's Protection Act: Hearing before the Subcommittee on Select Education of the Committee on Education and Labor, House of Representatives, Ninety-Ninth Congress, First Session on H.R. 1523 to Amend the Education of the Handicapped Act.

    ERIC Educational Resources Information Center

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

    The proceedings of a 1985 House of Representatives hearing to amend Section 615 of the Education of the Handicapped Act are presented. The hearing focused on questions of paying for attorneys fees in special education due process decisions. Statements are presented by representatives of policy makers, parents, and professional associations…

  12. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Montana, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Montana will fall to 3 percent; without the law, it would remain at 18 percent. The model projects that total state government spending on health care will be 3 percent higher for the combined 2011-2020 period because of the ACA.

  13. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Illinois, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Illinois will fall to 3 percent; without the law, it would remain near 15 percent. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.

  14. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For California, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in California will fall to 4 percent; without the law, it would remain at 20 percent. The model projects that total state government spending on health care will be 7 percent higher for the combined 2011-2020 period because of the ACA.

  15. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Texas, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Texas will fall to 6 percent; without the law, it would remain at 28 percent, the highest in the nation. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.

  16. 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…

  17. 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

    ... paid in cash, the debenture interest rate for purposes of calculating a claim shall be the monthly... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on...

  18. 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

    ... paid in cash, the debenture interest rate for purposes of calculating a claim shall be the monthly... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on...

  19. 78 FR 4427 - Mortgage and Loan Insurance Programs Under the National Housing Act-Debenture Interest Rates

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-22

    ... paid in cash, the debenture interest rate for purposes of calculating a claim shall be the monthly... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on...

  20. 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

    ... paid in cash, the debenture interest rate for purposes of calculating a claim shall be the monthly... Interest Rates AGENCY: Office of the Assistant Secretary for Housing--Federal Housing Commissioner, HUD. ACTION: Notice. SUMMARY: This notice announces changes in the interest rates to be paid on...

  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

    ... FOR EQUAL OPPORTUNITY, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT EMPLOYMENT AND BUSINESS OPPORTUNITY CONSOLIDATED HUD HEARING PROCEDURES FOR CIVIL RIGHTS MATTERS Proceedings Prior to Hearing § 180.415 Notice...

  2. 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:

  3. 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:

  4. 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:

  5. Preserve Access to Affordable Generics Act

    THOMAS, 111th Congress

    Sen. Kohl, Herb [D-WI

    2009-02-03

    02/02/2010 By Senator Leahy from Committee on the Judiciary filed written report. Report No. 111-123. Minority views filed. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. 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:

  7. 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:

  8. Preventive Care Benefits (Affordable Care Act)

    MedlinePlus

    ... Using This Site | Plain Writing 中文 | Kreyòl | Français | Deutsch | ગુજરાતી | हिंदी | Italiano | 日本語 | 한국어 | Polski | ... Using This Site | Plain Writing 中文 | Kreyòl | Français | Deutsch | ગુજરાતી | हिंदी | Italiano | 日本語 | 한국어 | Polski | ...

  9. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Connecticut, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Connecticut will fall to 5 percent; without the law, it would remain at 11 percent. The model projects that total state government spending on health care will be 10 percent lower for the combined 2011-2020 period than it would be without the ACA, mostly because of federal subsidies for residents who would have been covered by Connecticut's state-run health insurance program (State-Administered General Assistance).

  10. 76 FR 39119 - Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of Housing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ... URBAN DEVELOPMENT Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of... ED. SUMMARY: In accordance with the Privacy Act of 1974 (5 U.S.C. 552a), as amended by the Computer... Program In accordance with the Computer Matching and Privacy Protection Act of 1988 (Pub. L. 100-503),...

  11. 75 FR 67755 - Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of Housing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... URBAN DEVELOPMENT Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of... the Computer Matching and Privacy Protection Act of 1988 (Pub. L. 100-503), and the Office of... accordance with the Computer Matching and Privacy Protection Act of 1988 (Pub. L. 100-503), as amended,...

  12. 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... was issued under the authority of the Budget and Accounting Act of 1921, as amended; the Budget and Accounting Act of 1950, as amended; the Debt Collection Act of 1982, as amended; and, the Deficit...

  13. 12 CFR 1282.19 - Affordability-Rent level definitions-tenant income is not known.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... very low-, low-, or moderate-income families where the income of the family in the dwelling unit is not...) For moderate-income, maximum affordable rents to count as housing for moderate-income families shall... affordable rents to count as housing for low-income families shall not exceed the following percentages...

  14. 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

  15. 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.

  16. 76 FR 56781 - Privacy Act of 1974; Notice of a Computer Matching Program Between the Department of Housing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... Street, SW., Room 6138, Washington, DC 20410, telephone number (202) 402-6732. (These are not toll free telephone numbers). A telecommunications device for hearing- and speech-impaired individuals (TTY) is..., reduce and correct fraud and abuse in rental housing assistance programs. In meeting this objective,...

  17. Acquisition Reform in House and Senate Passed Versions of the FY2016 National Defense Authorization Act (H.R. 1735)

    DTIC Science & Technology

    2015-07-02

    1 Because the House Armed Services Committee’s focus on small business predates the current reform effort, and because small... business provisions also affect only a specific segment of the industrial base, not the overall acquisition system, such sections were excluded from...responsibilities for acquiring business systems Streamlining/ Improving effectiveness 860/864a a Require best value for acquiring personal protective

  18. 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

    ... (PHA) plan; the voucher program; and the capital and operating funds with respect to emergency funds... discretion to decide whether to operate a PBV program (and this rule does not remove that authority), the PHA... housing and voucher programs are intended to operate as separate, and mutually exclusive, subsidy...

  19. Your affordable solar home

    SciTech Connect

    Hibshman, D.

    1983-01-01

    The economy of solar principles can put home ownership within the reach of many more people. Featuring six designs that can be built for $20,000 or less, this illustrated guide outlines a variety of options. It includes a solar primer to explain the process and practice of solar heating and cooling systems; floor plans and cutaway drawings; prefabricated and kit houses; log and timber, domes, and post-and beam houses; the pros and cons of mobile homes; and the story of a small community that dealt creatively with the housing shortage. 26 references, 56 figures, 5 tables.

  20. Affordances: Ten Years On

    ERIC Educational Resources Information Center

    Brown, Jill P.; Stillman, Gloria

    2014-01-01

    Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…

  1. 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

  2. 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.…

  3. Amends to Ocean Dumping Act. Introduced in the House of Representatives, One Hundredth Congress, Second Session, June 30, 1988

    SciTech Connect

    Not Available

    1988-01-01

    The House report accompanying H.R. 4338 describes the proposed bill, including its purpose and the legislative background, reviews the hearings and committee findings, and summarizes potential economic impacts and effects on the budget. The purpose of this amendment is to prohibit the ocean disposal of sewage sludge and other industrial wastes by December 31, 1992, and to impose special fees on such ocean disposal after December 31, 1988.

  4. Housing Options for Older Adults: A Guide for Making Housing Decisions

    MedlinePlus

    ... limited income. 4 Housing Options for Older Adults Personal Considerations—Questions to Ask About Home Ownership: ■ Is ... or affordable rental units may not be available. Personal Considerations—Questions to Ask About Rental Housing: ■ If ...

  5. 1978 Age Discrimination Act Amendments. Explanation of 1978 Age Discrimination Act Amendments. Report of Committee on Conference, Including Text of H.R. 5383. Text of Age Discrimination Act, as Amended. Report of House Labor Committee. Report of Senate Human Resources Committee. Union Labor Report No. 1596, Special Supplement, Part 2.

    ERIC Educational Resources Information Center

    Bureau of National Affairs, Inc., Washington, DC.

    This booklet explains and reproduces the text of the 1978 amendments to the Age Discrimination in Employment Act (ADEA). It also gives the actual committee on conference report as well as reports of the House labor committee and the Senate human resources committee. In its introductory explanation, the booklet discusses the most publicized…

  6. House to house, shelter to shelter: experiences of black women seeking housing after leaving abusive relationships.

    PubMed

    Wilson, Patty R; Laughon, Kathryn

    2015-01-01

    Locating safe and affordable housing is a vital step for women who decide to leave their abuser. Without housing, many women, particularly those who live in poverty, are forced to remain in abusive relationships, accept inadequate or unsafe housing, or become homeless (Menard, 2001; Moses, 2010). Women who choose to leave their abusers are faced with multiple barriers in establishing their independence such as limited financial resources, mental illness, and the lack of affordable housing (Botein & Hetling, 2010), putting them at risk of revictimization. This pilot study explores the narratives of Black mothers currently residing at an emergency intimate partner violence shelter to discover their experiences in seeking housing after leaving abusive relationships with a focus on housing instability and mental health. Utilizing a qualitative descriptive design, four major themes emerged: (a) unstable/insecure housing over time, (b) limited support,

  7. "Affordable" Private Schools in South Africa. Affordable for Whom?

    ERIC Educational Resources Information Center

    Languille, Sonia

    2016-01-01

    The paper sets out to challenge the notions of "affordable" private schools in the context of South Africa. It is guided by one main question: "affordable private schools for whom?" It argues that, contrary to claims by its public and private proponents, affordable private schools in South Africa do not cater for poor children.…

  8. Retrospective Study of DoD Pilot Housing Programs

    DTIC Science & Technology

    1993-09-01

    Low - Income Housing Tax Credits for landlords offering low - income housing. In many communities the number of military families in this income category...that it felt would most likely meet the • • m | .4 stated objective of providing additional affordable, low - and moderate- income housing in its area...housing affordable to persons of low and moderate income . 7 ’ Pilot Housing Program funds were used to cover administrative costs associated with that

  9. 24 CFR 266.100 - Qualified housing finance agency (HFA).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Qualified housing finance agency... AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Housing Finance Agency Requirements § 266.100 Qualified housing finance agency (HFA). (a)...

  10. Price-Anderson Amendments Act of 1986. House of Representatives, Ninety-Ninth Congress, Second Session. August 5, 1986

    SciTech Connect

    Not Available

    1986-01-01

    The committee recommends several amendments to H.R. 3653, a bill designed to improve nuclear insurance procedures. Among the amendments are the inclusion of storage, handling, transportation, treatment, or disposal of, or research and development on and changes dealing with reimbursement procedures and limits. The bill reauthorizes the Price-Anderson Act, but limits liability and creates industry-wide liability in the event of a major accident. The report covers background information and hearings, summarizes the 15 amendments and each section how the bill will effect relevant changes in the Atomic Energy Act of 1954. Dissenting views argue against setting a liability cap on nuclear waste accidents because it discourages safety consciousness on the part of contractors and because there is no precedent in liability insurance for limiting liability.

  11. A concurrent resolution expressing the sense of the Congress that stable and affordable housing is an essential component of an effective strategy for the prevention, treatment, and care of human immunodeficiency virus, and that the United States should make a commitment to providing adequate funding for the development of housing as a response to the acquired immunodeficiency syndrome pandemic.

    THOMAS, 111th Congress

    Sen. Menendez, Robert [D-NJ

    2009-09-15

    09/15/2009 Referred to the Committee on Banking, Housing, and Urban Affairs. (text of measure as introduced: CR S9381) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  12. A resolution expressing the sense of the Senate that stable and affordable housing is an essential component of an effective strategy for the prevention, treatment, and care of human immunodeficiency virus, and that the United States should make a commitment to providing adequate funding for the development of housing as a response to the acquired immunodeficiency syndrome pandemic.

    THOMAS, 112th Congress

    Sen. Menendez, Robert [D-NJ

    2011-05-04

    05/04/2011 Referred to the Committee on Banking, Housing, and Urban Affairs. (text of measure as introduced: CR S2692) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  13. Extension of Education of the Handicapped Act: Hearings Before the Subcommittee on Select Education of the Committee on Education and Labor, House of Representatives, 94th Congress, 1st Session on Part X, Education and Training of the Handicapped and H.R. 7217, Education for All Handicapped Children Act of 1975 (April 9 and 10, and June 9, 1975).

    ERIC Educational Resources Information Center

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

    Presented is the text of hearings in the House of Representatives on Part X of the "Education and Training of the Handicapped Act" and the "Education for All Handicapped Children Act of 1975". Included are the texts of both bills and statements by persons such as Edwin Martin of the Bureau of Education for the Handicapped, Carl…

  14. 78 FR 19917 - Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ...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......

  15. Lens window simplifies TDL housing

    NASA Technical Reports Server (NTRS)

    Robinson, D. M.; Rowland, C. W.

    1979-01-01

    Lens window seal in tunable-diode-laser housing replaces plan parallel window. Lens seals housing and acts as optical-output coupler, thus eliminating need for additional reimaging or collimating optics.

  16. Affordability of Defense Acquisition Programs

    DTIC Science & Technology

    2015-02-01

    the Office of Director, Cost Assessment and Program Evaluation (CAPE). The DPP is a particularly useful tool for assessing the affordability of DOD...within the Service programming communities. • The Defense Program Projection is a valuable tool for DOD’s use in assessing affordability; however, in... tool for assessing the affordability of future acquisition in the spirit of the Better Buying Power initiative. A. Ground Rules, Assumptions, and

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

    PubMed

    1988-01-01

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

  18. The Carl D. Perkins Vocational and Applied Technology Education Act Amendments of 1990. Conference Report To Accompany H.R. 7. House of Representatives, 101st Congress, 2d Session.

    ERIC Educational Resources Information Center

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

    This document reports the committee of the conference's recommendation that the U.S. House of Representatives recede from its disagreement to the U.S. Senate amendment on the Carl D. Perkins Vocational and Applied Technology Education Act amendments of 1990. The first section provides materials the Senate would have inserted in the amendments. The…

  19. Hearings on the Reauthorization of the Higher Education Act of 1965: Access to College and Program Simplification. Hearings before the Subcommittee on Postsecondary Education of the Committee on Education and Labor. House of Representatives, One Hundred Second Congress, First Session.

    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 on two occasions, on the first to hear witnesses on how the reauthorization of the Higher Education Act of 1965 can help low income students overcome challenges to obtain postsecondary education; and on the second to hear how student…

  20. The Rehabilitation Act Amendments of 1986. Hearing before the Subcommittee on Select 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.

    The transcript of the 1986 House of Representatives hearings on amendments to the Rehabilitation Act of 1973 contains verbatim testimony and committee questions, prepared statements, letters, and supplemental material. The Amendments require state plans to address rehabilitation engineering services, the development of mechanisms to provide…