Despite President Barack Obama’s promise that those who like their health plans will be able to keep it, residents across the country are being notified they must switch to a more comprehensive, and often more expensive, policy that complies with the federal law.

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Fullerton resident Jennifer Harris thought she had a great deal, paying $98 a month for an individual plan through Health Net Inc. She got a rude surprise this month when the company said it would cancel her policy at the end of this year. Her current plan does not conform with the new federal rules, which require more generous levels of coverage.

Now Harris, a self-employed lawyer, must shop for replacement insurance. The cheapest plan she has found will cost her $238 a month. She and her husband don’t qualify for federal premium subsidies because they earn too much money, about $80,000 a year combined.

“It doesn’t seem right to make the middle class pay so much more in order to give health insurance to everybody else,” said Harris, who is three months pregnant. “This increase is simply not affordable.”

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Results display 10 at a time. Most of the contacts require a phone call to schedule an appointment.

It seems you need a navigator to help you find a navigator. No problem.

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“We took some bread crumbs and left an entire meal on the table,” said Senator Lindsey Graham, Republican of South Carolina. “This has been a really bad two weeks for the Republican Party”–From the online version of last night’s New York Times

I will take comments on this submitted by email only to KSHarmon[at]mindspring[dot]com.

The massive retirement and health benefits arm of the Southern Baptist Convention, GuideStone Financial Services, has made good on its threat to pivot from advocacy to litigation in defending beleaguered church health plans.

In its first-ever federal lawsuit, GuideStone has partnered with The Becket Fund for Religious Liberty and Locke Lord LLP to file a class-action lawsuit against what Becket described as “the federal government’s mandate that [GuideStone clients] provide employees with free access to abortion-inducing drugs and devices.”

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…it is still foolish to ignore the leverage that the individual mandate gives opponents of Obamacare. America’s healthcare system for the elderly (Medicare, plus Medicaid for nursing-home care) is already edging the country toward generational war because Washington will sooner or later be forced to choose between drastic limitations on coverage in those programs or drastic increases in taxes on the decreasing portion of working Americans. Now we’re adding a parallel obligation on younger workers to subsidize healthcare for fiftysomethings.

What to do? The path of least political resistance is to tough it out, hoping younger households will be unable to figure out what’s happening, or simply unwilling to throw in their lot with opponents of gay marriage, marijuana reform and the like. Alternatively, we could start paying attention to the building crisis as younger households scramble ever harder for a middle-class living standard.

And none too soon, because the signs of generational conflict are already appearing.

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Asthma ”” the most common chronic disease that affects Americans of all ages, about 40 million people ”” can usually be well controlled with drugs. But being able to afford prescription medications in the United States often requires top-notch insurance or plenty of disposable income, and time to hunt for deals and bargains.

The arsenal of medicines in the Hayeses’ kitchen helps explain why. Pulmicort, a steroid inhaler, generally retails for over $175 in the United States, while pharmacists in Britain buy the identical product for about $20 and dispense it free of charge to asthma patients. Albuterol, one of the oldest asthma medicines, typically costs $50 to $100 per inhaler in the United States, but it was less than $15 a decade ago, before it was repatented.

“The one that really blew my mind was the nasal spray,” said Robin Levi, Hannah and Abby’s mother, referring to her $80 co-payment for Rhinocort Aqua, a prescription drug that was selling for more than $250 a month in Oakland pharmacies last year but costs under $7 in Europe, where it is available over the counter.

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In the end, we have incentives for insurers not to compete, for customers not to care about price, and for insurers to drive up the cost of care. Not much of a marketplace, is it?

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Obamacare is not primarily an entitlement program. The entitlement component ”” the exchange subsidies ”” will involve about 2 percent of Americans during the first year. (Others will be added to Medicaid, which has been around since 1965.) About 20 million Americans will eventually get subsidized insurance ”” a check that goes not to the individual but to insurance companies. The remaining 170 million Americans will not experience Obama­care as a sugary treat but as a series of complex regulatory changes that may make their existing insurance more costly, less generous and less secure.

The main problem with Obamacare is not its addictive generosity; it is its poor, unsustainable design. Its finances depend on forcing large numbers of young and healthy people to buy insurance ”” yet it makes their insurance more costly and securing coverage less urgent. (Because you can get coverage during each year’s enrollment period at the same price whether you’re healthy or sick, the incentive to buy coverage when healthy is much diminished.)

Heavy insurance regulations will lead some employers to restructure their plans, dump employees into the public exchanges or make greater use of part-time workers. In order to meet a few worthy goals ”” helping the poor buy insurance and covering preexisting conditions ”” Obamacare seems destined to destabilize much of our current health system.

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Even though its most virulent critics raise the spectre of “Canadian-style” health care, “Obamacare” does little to change the enduring differences between the two health care system. What, exactly, does “Obamacare” look like compared to Canada?…

Not cost containment: The sharpest critics of Obamacare argue it does little to address the fundamental challenge of cost control. The new law includes a review of Medicare reimbursement and the expansion of Accountable Care Organizations to reward cost-effective care. But it doesn’t grapple in a systematic fashion with the overall inefficiencies in health care delivery and financing, the administrative burden of multiple payers, providers and plans, and the cost pressures of defensive medicine. Governments in Canada know that health care is a searing financial responsibility, but they have at their disposal cost containment measures ”“ monopoly fee negotiations with providers, global budgets for hospitals ”“ that remain unfathomable in the American context.

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Consumers seeking more information on their new options under the Affordable Care Act were met with long delays, error messages and a largely non-working federal insurance exchange and call center Tuesday morning.

Heavy Internet traffic and system problems plagued the launch of the health insurance exchanges, a key pillar of President Barack Obama’s health care law. Some of the issues appeared to subside just after 12 p.m. Central time, with some users reporting success in viewing new insurance products offered in Illinois as part of the law.

But others continued to have problems into Tuesday afternoon. For most of Tuesday, attempts to log on to the system were met with error messages: “We have a lot of visitors on our site right now, and we’re working to make your experience here better. Please wait here until we send you to the log-in page. Thank you for your patience.”

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The federal government on Sunday morning barreled toward its first shutdown in 17 years after the Republican-run House, choosing a hard line, voted to attach a one-year delay of President Obama’s health care law and a repeal of a tax to pay for it to legislation to keep the government running.

The votes, just past midnight, followed an often-angry debate, with members shouting one another down on the House floor. Democrats insisted that Republicans refused to accept their losses in 2012, were putting contempt for the president over the good of the country and would bear responsibility for a shutdown. Republicans said they had the public on their side and were acting to protect Americans from a harmful and unpopular law that had already proved a failure.

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Health insurance under Obamacare will cost individuals at least $2,988 a year on average, a price that Republican opponents may target as out-of-reach for many Americans who don’t qualify for U.S. subsidies.

While the $249 monthly payment is intended to be discounted through tax credits, less than half of people now buying insurance on their own may get that help….

The law’s long-term success “will depend on the changes that are made over the next couple of years to address the affordability issue,” said Brian Wright, an insurance analyst at Monness Crespi Hardt & Co. in New York. “If you have modifications that can help address those issues, then it will ultimately be successful. If not, then it’s an open question.”

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Administrators at the Cleveland Clinic announced on Wednesday that the health care giant would be cutting as much as $300 million from its 2014 budget, and that the cuts will likely include layoffs.

“Health care reform has really changed things, and the burden of cost is going to be falling on patients,” spokeswoman Eileen Shiel told The Plain Dealer. “We want to make sure we can keep care affordable.”

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Under the Affordable Care Act, more insurance plans are expected to start covering the cost of obesity treatments, including counseling on diet and exercise as well as medications and surgery. These are treatments that most insurance companies don’t cover now.

This move is a response to the increasing number of health advocates and medical groups that say obesity should be classified as a disease.

Not everyone thinks this is a good idea. But this summer, the American Medical Association determined that . They followed in the footsteps of the , a health advocacy group that called obesity a disease back in 2008.

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The next big movement in Massachusetts health care may come not from the state’s world-famous hospitals or its cutting-edge research labs, but from houses of worship.

Stepping up pressure on the health care industry to control spiraling costs, which are crimping family and government budgets, the Greater Boston Interfaith Organization will host a forum next Tuesday at Temple Israel in Boston’s Longwood Medical Area to grill hospital and insurance leaders about the affordability of medical care.

Top executives of major hospital groups, such as Partners HealthCare System, Beth Israel Deaconess Medical Center, and Steward Health Care System, and leading insurers, such as Blue Cross Blue Shield of Massachusetts and Tufts Health Plan, have accepted invitations to the event, which is scheduled for 7 to 9 p.m.

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Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect, millions will have to upgrade their policies to meet the benefit standards laid out by the Affordable Care Act. The measure will be in full swing this January.

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Less than two months before the health insurance exchanges open nationwide, more Americans disapprove (49%) than approve (41%) of the Affordable Care Act. An additional 11% have no opinion. As this landmark legislation enters the next phase in its implementation process, it remains divisive. With the exception of a bounce likely caused by President Barack Obama’s re-election in November 2012, Americans have been more disapproving than approving of the healthcare law.

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A leaked memo from Forever 21 said it’s reducing “a number of full-time non management positions,” including stock associates, sales associates, store maintenance associates, accessory specialists and cashiers. Effective on Sunday, they would have been reclassified as part-time employees, with the memo adding their hours will not exceed 29.5 hours per week. Those employees’ existing medical, dental, vision and other voluntary plans will end on Aug. 31 and they won’t be accruing paid time off.

Ahead of the Affordable Care Act mandate requiring companies with at least 50 employees to provide health care coverage to full-time employees (anyone working at least 30 hours a week), Forever 21”²s latest move has ignited a heated debate on social media.

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That sets up one of the recurring problems in health-care policy, which is that the more you do to control costs, the more people will hate you. Insurers found this out in the 1990s, when HMOs managed to save a lot of money without doing any measurable harm to care, but the American people loathed them for it. Various provisions in the Affordable Care Act ”” or any serious cost-control effort ”” will end up proving it again.

This will present a useful test for seeing who’s serious about controlling health-care costs. Conservative economists, for instance, almost universally hate the fact that employer-provided health benefits aren’t taxed, and that public-sector workers have bargained so aggressively for generous benefits. John McCain’s 2008 health plan relied on ending the employer deduction entirely and converting it to a capped deduction for individuals ”” which is a much more violent version of this kind of change.

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In the near future, he said, United Methodist annual conferences may be able to reduce health coverage costs by allowing local churches to send lower-paid clergy and lay employees to the exchanges.

However, [Andrew Q.] Hendren warns that conferences also should be wary of sending too many church employees onto the exchanges or they may have too small a pool of people to buy affordable insurance.

“The conferences will have to balance that potential savings with the risk to the remaining smaller plan made up of a few large churches and small churches with higher paid clergy and lay employees,” he said. “The smaller plan may be less cost-effective, and appointment frictions may develop as local churches may prefer premium tax-credit-eligible clergy over higher paid clergy ”” two concerns in a connectional system like ours.”

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The White House on Tuesday delayed for one year a requirement under the Affordable Care Act that businesses provide health insurance to employees, a fresh setback for President Obama’s landmark health-care overhaul as it enters a critical phase.

The provision, commonly known as the employer mandate, calls for businesses with 50 or more workers to provide affordable quality insurance to workers or pay a $2,000 fine per employee. Business groups had objected to the provision, which now will take effect in January 2015.

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Healthy consumers could see insurance rates double or even triple when they look for individual coverage under the federal health law later this year, while the premiums paid by sicker people are set to become more affordable, according to a Wall Street Journal analysis of coverage to be sold on the law’s new exchanges.

The exchanges, the centerpiece of President Barack Obama’s health-care law, look likely to offer few if any of the cut-rate policies that healthy people can now buy, according to the Journal’s analysis. At the same time, the top prices look to be within reach for many people who previously faced sky-high premiums because of chronic illnesses or who couldn’t buy insurance at all.

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Almost a third of 32 hospitals and health systems involved in an experiment aimed at changing the way medical providers are paid may exit the program, a potential threat to the Affordable Care Act’s ambitious cost-saving goals.

Depending on the number of patients involved, “it really shows a critical cost-containment approach in the Affordable Care Act is running into real problems,” said Robert Blendon, a health-policy professor at Harvard University’s School of Public Health, in a telephone interview today.

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The price of the Charleston Crab House’s $26.99 “World Famous Crab House Crab Pot” could go up next year, but not because of the price of crabs or a potential seafood shortage. It’s about health care.

John Keener, who owns both Charleston Crab House locations, on James Island and on Meeting Street, is one of many Charleston restaurateurs trying to make sense of the federal Affordable Care Act and how his business will be affected.

Two things are certain: Keener will need to offer his employees health insurance starting in 2014, and he will likely pass the associated costs of that coverage onto his customers.

Read it all from the local paper.

Sandra Duck thinks she’s the victim of an undeclared Medicaid boycott. And she’s probably right.

When her artificial right hip became infected with the superbug MRSA in late 2009, Dr. Dale Mitchum, a general surgeon, drained, cleaned and closed the infected area. But when the infection returned in early 2010, Mitchum knew Duck needed another hip replacement surgery, which he couldn’t perform. He tried to find an orthopedic surgeon who would operate. More than a year later, he’s still trying.

“I cannot find a living soul that will touch her,” he said recently. “And I’ve tried everywhere, from Tallahassee to Pensacola.”

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Many part-timers are facing a double whammy from President Obama’s Affordable Care Act.

The law requires large employers offering health insurance to include part-time employees working 30 hours a week or more. But rather than provide healthcare to more workers, a growing number of employers are cutting back employee hours instead.

The result: Not only will these workers earn less money, but they’ll also miss out on health insurance at work.

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My read of the evidence is that the Affordable Care Act will have a much tougher first year than was initially anticipated but it won’t be the catastrophe that Republicans hope. The exceptions will be a handful of states where Republican governors have purposefully made it a catastrophe, but that’s likely to make the Republican governors look bad, particularly if the law is working smoothly in states that have tried to make it a success.

Conservative commentary on the law, with its continuous predictions of explosive premium hikes (and continuous omissions of the offsetting subsidies) and gleeful celebration anytime anything looks to be going wrong, is risking the mistake that the Obama administration made early on with the sequester. When the predictions of pain and chaos didn’t instantly come true, the whole narrative shifted in an instant.

Republicans have done a very good job prepping the country for the pain of Obamacare. They’ve not done a good job prepping the country for the people who will be helped by Obamacare.

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Senate Finance Committee Chairman Max Baucus, one of the health reform law’s chief authors, says he’s worried about a “huge train wreck coming down” if the Obama administration doesn’t improve its public outreach about the legislation.

Baucus, a Montana Democrat who is up for reelection in 2014, sharply criticized the administration’s outreach efforts in a budget hearing on Wednesday. He told Health and Human Services Secretary Kathleen Sebelius that people and businesses “have no idea what to do, what to expect” from the law.

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Yummy Mummy, a little boutique on New York’s Upper East Side, has suddenly become a health care provider/online superstore. The company has been hiring like crazy, and just opened an online call center and a warehouse in Illinois. Yummy Mummy even hired somebody to talk to customers’ health insurance companies.

And new moms now seem more likely to splurge on fancy new breast pumps. Caroline Shany, a Yummy Mummy customer, spent her own money to buy a breast pump for her first baby. She may buy another one now because insurance will pick up the tab.

“Why not?” she says.

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