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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link="#0563C1" vlink="#954F72"><div class=WordSection1><p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial",sans-serif'> <img width=623 height=151 id="Picture_x0020_1" src="cid:image001.jpg@01D299E2.7472B9A0" alt="Description: Description: Description: Description: CAL/AAEM: California Chapter of the American Academy of Emergency Medicine"><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial",sans-serif'><o:p> </o:p></span></p><div style='margin-left:15.0pt;margin-top:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt' id=content><div style='border-top:solid #7F7F7F 1.0pt;border-left:none;border-bottom:solid #7F7F7F 1.0pt;border-right:none;padding:4.0pt 0in 4.0pt 0in'><p class=MsoNormal><b><span style='font-size:11.0pt;font-family:"Arial",sans-serif;color:#7F7F7F'>February 14, 2017<o:p></o:p></span></b></p></div><div style='margin-top:11.25pt;margin-bottom:11.25pt'><p class=MsoNormal><b><span style='font-size:12.5pt;font-family:"Arial",sans-serif;color:#DF0009'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:12.5pt;font-family:"Arial",sans-serif;color:#DF0009'>Uninsured rate in California drops to record low, CDC estimates <o:p></o:p></span></b></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif;color:#0070C0'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif;color:#0070C0'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif;color:#0000CC'><a href="http://www.sfgate.com/business/article/Uninsured-rate-in-California-drops-to-record-low-10932662.php"><span style='color:#0000CC'>SF Gate</span><span style='font-family:"Times New Roman",serif;color:#0000CC'><o:p></o:p></span></a></span></p><p class=MsoNormal style='margin-right:15.7pt'><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>By Catherine Ho<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The percentage of Californians without health insurance fell to a record low 7.1 percent in 2016, according to estimates released by the Centers for Disease Control on Tuesday.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The figure represents just a 1 percentage point drop from 2015, but is down significantly from the 17 percent uninsured rate in 2013, before the Affordable Care Act was implemented.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>Similarly, the percentage of Americans without health insurance dropped slightly from 9.1 percent in 2015 to 8.8 percent in 2016.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The estimates, from the CDC’s National Center for Health Statistics, are based on data for the first nine months of 2016 that was collected from about 73,000 people in 38 states.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>California was the only state among the 38 in the report that showed a significant decrease in its uninsured rate for adults between 18 and 64 — dropping from 11 percent to 9 percent.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'> California officials welcomed the news as a sign that structures created by the Affordable Care Act, the federal health care law that expanded health care coverage to roughly 20 million Americans, are working.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>“Covered California is proud to be part of the effort that is helping millions of people get the coverage and care they need,” Executive Director Peter Lee said in a statement.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>California is considered one of the most successful states in expanding health care coverage for its residents under the health care law, which is also known as Obamacare. The state has dramatically expanded its Medicaid program, Medi-Cal, adding nearly 4 million newly eligible low-income people since 2014.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>Covered California, the insurance exchange through which low-income residents and other individuals can buy insurance using federal subsidies, is growing and expects to hit 1.5 million people in 2017, up from 1.3 million in 2016.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The law’s expansion of Medicaid and its other provisions — such as prohibiting insurers from denying patients coverage because of pre-existing conditions — are driving down the uninsured rate, said Cynthia Cox, an associate director at the Kaiser Family Foundation who researches the health law’s effect on private insurers and enrollees.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>“There’s no question the (Affordable Care Act) is driving down the uninsured rate,” she said. “We’ve seen the uninsured rate fall every year since the law went into effect. The progress has slowed a bit, in the first couple years there was significant progress and now it’s more or less plateaued. But it’s still continuing to fall.”<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>President Trump and congressional Republicans are vowing to repeal the law, but they have yet to coalesce around a plan to replace it. On Tuesday, Trump renewed his promise to repeal and replace, saying in a tweet, “Obamacare continues to fail.”<o:p></o:p></span></p><p class=MsoNormal style='margin-right:30.95pt'><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal style='margin-right:30.95pt'><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal style='margin-right:30.95pt'><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p></div><div style='border-top:solid #7F7F7F 1.0pt;border-left:none;border-bottom:solid #7F7F7F 1.0pt;border-right:none;padding:4.0pt 0in 4.0pt 0in'><p class=MsoNormal><b><span style='font-size:11.0pt;font-family:"Arial",sans-serif;color:#7F7F7F'>March 6, 2017<o:p></o:p></span></b></p></div><div style='margin-top:11.25pt;margin-bottom:11.25pt'><p class=MsoNormal><b><span style='font-size:12.5pt;font-family:"Arial",sans-serif;color:#DF0009'><o:p> </o:p></span></b></p></div><p class=MsoNormal><b><span style='font-size:12.5pt;font-family:"Arial",sans-serif;color:#DF0009'>House Releases ACA Repeal, Replace Bill That Transforms Medicaid</span></b><span style='font-family:"Arial",sans-serif;color:#0070C0'><o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif;color:#0070C0'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif;color:#0070C0'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif;color:#0000CC'><a href="http://www.medscape.com/viewarticle/876718?nlid=113272_3901&src=wnl_newsalrt_170306_MSCPEDIT&uac=116715AZ&impID=1303030&faf=1"><span style='color:#0000CC'>Medscape</span><span style='font-family:"Times New Roman",serif;color:#0000CC'><o:p></o:p></span></a></span></p><p class=MsoNormal style='margin-right:15.7pt'><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>By Robert Lowes<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The Medicaid program, almost 52 years old, would undergo drastic changes in a much-anticipated House Republican bill to repeal and replace the Affordable Care Act (ACA) that was released today.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>Called the American Health Care Act, the bill would repeal the ACA's expansion of Medicaid eligibility and the extra federal match dollars that come with it by December 31, 2019. But in a concession to the 31 states that chose to expand their Medicaid programs, the bill would preserve the extra federal funding after 2019 for beneficiaries who had enrolled under ACA expansion beforehand, and who do not have a break in eligibility for more than 1 month thereafter.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>As revealed in a leaked draft last month, the bill also would convert open-ended federal contributions to state Medicaid programs into a fixed, per-capita cap. Congressional Democrats oppose this new formula, saying that it would underfund state programs, forcing them to kick beneficiaries off the rolls, trim benefits, and cut reimbursement to physicians and hospitals.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>Giving states more control of their Medicaid programs is another feature of the bill. It would erase the ACA requirement that state Medicaid plans provide the same essential benefits as those mandated for private health plans sold on the ACA exchanges.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><b><span style='font-family:"Arial",sans-serif'>Cadillac Tax Postponed Until 2025<o:p></o:p></span></b></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The American Health Care Act makes one significant departure from the draft version leaked in February. That version called for taxing generous employer-sponsored health plans just as the ACA does with its so-called Cadillac tax, scheduled to take effect in 2020. The bill released today does not create a new tax on employer-sponsored health plans, but instead delays the ACA's Cadillac tax until 2025.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The rest of the bill largely preserves the provisions first revealed in the leaked draft. The American Health Care Act would:<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoListParagraph style='mso-margin-top-alt:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt;margin-left:30.0pt;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-family:"Arial",sans-serif'><span style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-family:"Arial",sans-serif'>Give Americans refundable tax credits ranging from $2000 to $4000 a year per individual, based on age, to buy private health coverage. They are capped at $14,000 for a family. In a change from the draft version, tax credits begin to shrink once annual income surpasses $75,000 ($150,000 for joint tax filers).<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoListParagraph style='mso-margin-top-alt:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt;margin-left:30.0pt;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-family:"Arial",sans-serif'><span style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-family:"Arial",sans-serif'>Repeal the penalty for individuals who do not obtain coverage.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoListParagraph style='mso-margin-top-alt:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt;margin-left:30.0pt;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-family:"Arial",sans-serif'><span style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-family:"Arial",sans-serif'>Prohibit, as the ACA does, insurers from denying coverage to individuals with pre-existing conditions, or charging them more.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoListParagraph style='mso-margin-top-alt:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt;margin-left:30.0pt;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-family:"Arial",sans-serif'><span style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-family:"Arial",sans-serif'>Preserve the ACA provision that allows young adults to remain on their parents' plan until age 26.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoListParagraph style='mso-margin-top-alt:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt;margin-left:30.0pt;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-family:"Arial",sans-serif'><span style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-family:"Arial",sans-serif'>Eliminate ACA taxes on such things as medical devices, prescription drugs, over-the-counter medications, and certain health insurers.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoListParagraph style='mso-margin-top-alt:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt;margin-left:30.0pt;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-family:"Arial",sans-serif'><span style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-family:"Arial",sans-serif'>Allow individuals and families to almost double the amount they can contribute to health savings accounts, and give them more flexibility in spending those dollars.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoListParagraph style='mso-margin-top-alt:7.5pt;margin-right:15.0pt;margin-bottom:7.5pt;margin-left:30.0pt;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><span style='font-family:"Arial",sans-serif'><span style='mso-list:Ignore'>-<span style='font:7.0pt "Times New Roman"'> </span></span></span><![endif]><span style='font-family:"Arial",sans-serif'>Give states $100 billion worth of grants over 10 years to set up high-risk insurance pools for individuals with costly, pre-existing conditions; reduce out-of-pocket expenses; promote access to preventive services; and otherwise make healthcare more affordable.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'>The House Energy and Commerce Committee has scheduled a so-called markup session this Wednesday to discuss portions of the bill under its jurisdiction, consider amendments, and vote on sending it to the House floor. The House Ways and Means Committee will mark up the rest of the bill the same day. In January, the House and Senate, both controlled by Republicans, passed legislation that would allow this ACA repeal-and-replace measure to sidestep a Democratic filibuster in the Senate and pass in that chamber with only 51 votes.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal style='margin-right:15.75pt'><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal style='margin-right:15.75pt'><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><strong><span style='font-family:"Arial",sans-serif'>Jeff Wells</span></strong><span style='font-family:"Arial",sans-serif'><br>Deputy Editor, CAL/AAEM News Service<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Arial",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><strong><span style='font-family:"Arial",sans-serif'>Brian Potts</span></strong><b><span style='font-family:"Arial",sans-serif'> MD, MBA</span></b><span style='font-family:"Arial",sans-serif'><br>Managing Editor, CAL/AAEM News Service<br><br></span><o:p></o:p></p></div><p class=MsoNormal style='background:#D9D9D9'><span style='font-size:7.5pt;font-family:"Verdana",sans-serif'>Contact us at: <span style='color:#0000CC'><a href="mailto:calaaem.news.service1@gmail.com"><span style='color:#0000CC'>calaaem.news.service1@gmail.com</span></a></span><br><br>For more articles, visit our <span style='color:blue'><a href="http://www.calaaem.org/news_archives.php"><span style='color:blue'>archives</span></a></span>. <br><br></span><span style='font-size:9.0pt;font-family:"Arial",sans-serif'><a href="mailto:somcaaem@uci.edu"><span style='font-size:7.5pt;font-family:"Verdana",sans-serif;color:black;text-decoration:none'>To</span></a></span><span style='font-size:7.5pt;font-family:"Verdana",sans-serif;color:#0070C0'><a href="https://maillists.uci.edu/mailman/listinfo/calaaem"><span style='color:#0070C0;text-decoration:none'> </span><span style='color:blue'>unsubscribe</span></a></span><span style='font-size:7.5pt;font-family:"Verdana",sans-serif'> from this list, visit our mail server.<br><br>Copyright (C) 2015. The California Chapter of the American Academy of Emergency Medicine (CAL/AAEM).</span> <span style='font-size:7.5pt;font-family:"Verdana",sans-serif;color:#0000CC'><a href="http://www.calaaem.org"><span style='color:#0000CC'>http://www.calaaem.org</span></a></span><span style='font-size:7.5pt;font-family:"Verdana",sans-serif'>. All rights reserved.<br><br>CAL/AAEM, a nonprofit professional organization for emergency physicians, operates the CAL/AAEM News Service solely as an educational resource for physicians. Dissemination of an article by CAL/AAEM News Service does not imply endorsement, agreement, or recommendation by CAL/AAEM News Service, CAL/AAEM, or AAEM.<br><br><o:p></o:p></span></p><p class=MsoNormal style='background:#D9D9D9'><b><span style='font-size:7.5pt;font-family:"Verdana",sans-serif'>Follow CAL/AAEM on Facebook and Twitter:<o:p></o:p></span></b></p><p class=MsoNormal style='background:#D9D9D9'><span style='font-size:7.5pt;font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal style='background:#D9D9D9'><a href="http://www.facebook.com/pages/CalAAEM/172577489479442?sk=wall&filter=12" target="_blank"><span style='color:black;text-decoration:none'><img border=0 width=28 height=28 id="Picture_x0020_6" src="cid:image002.jpg@01D299E2.7472B9A0"></span></a> <a href="https://twitter.com/#!/CALAAEM"><span style='color:windowtext;text-decoration:none'><img border=0 width=30 height=30 id="Picture_x0020_7" src="cid:image003.jpg@01D299E2.7472B9A0"></span></a> <a href="http://escholarship.org/uc/uciem_westjem"><span style='color:windowtext;text-decoration:none'><img border=0 width=112 height=30 id="Picture_x0020_4" src="cid:image004.jpg@01D299E2.7472B9A0"></span></a><o:p></o:p></p><p class=MsoNormal style='background:#D9D9D9'><span style='color:black'><o:p> </o:p></span></p></div>
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