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Plugging Obamacare’s biggest hole poses dilemma for Democrats

Democratic lawmakers are grappling with how to extend health insurance to millions of poor Americans in states that have refused Obamacare’s Medicaid expansion, believing their upcoming party-line “human infrastructure” package represents the best chance to plug the health law’s biggest gap.

After months of behind-the-scenes discussions, Democrats are coalescing around three options for closing the coverage gap in the Medicaid expansion holdout states, according to nine sources on and off the Hill. These approaches, which would leverage the existing Obamacare insurance marketplaces or require the Biden administration to create a new coverage program, each carry risks. And lawmakers still don’t see a clear path forward as they face a narrowing window to assemble a massive package of Democratic priorities.

“The question has always been how to do it. It’s a pretty challenging question,” said House Ways and Means Chair Richard Neal (D-Mass.), whose tax-writing panel is helping craft a fix.

Tackling the Medicaid gap would fulfill President Joe Biden’s pledge to extend coverage to the 2.2 million low-income adults in the 12 states where Republican officials have resisted the program for nearly a decade. It would also give Democratic lawmakers from those holdout states — like Raphael Warnock of Georgia, who’s leading efforts in the Senate to close the Medicaid gap — an achievement to campaign on, with control of both chambers up for grabs in next year’s midterms and health care remaining an important issue for voters.

The costly effort faces competition from other Democratic health care priorities that are jostling for position in infrastructure legislation, including an expansion of Medicare’s benefits and permanently increasing financial aid to people who purchase coverage on the ACA’s health insurance marketplaces.

The debate over how best to spend limited health care dollars could force Democrats to choose between leveraging their control of Washington to shore up the ACA, or making a play for swing voters by adding coverage of dental, vision and hearing to Medicare. Closing the Medicaid coverage gap polls high with Democratic supporters, though independents and Republicans in a recent Kaiser Family Foundation poll said expanding Medicare benefits is a bigger priority.

“I’m very keenly aware that poor people are the first to get squeezed out when there’s a budget problem,” said Rep. Lloyd Doggett (D-Texas), whose home state has the nation’s highest uninsured rate. “I’m really pushing to say: At least do something for people who’ve been left out for more than a decade and have nothing to show for the Affordable Care Act. But it’s a challenging sell.”

Yet, momentum for plugging the coverage gap has grown in recent weeks, after key Democratic leaders have embraced the effort. Congressional staff are still hashing out thorny policy questions over how to expand coverage to poor adults in the Medicaid expansion holdout states, but no clear preferred policy has emerged amid concerns over potential drawbacks. Some approaches could take years to set up, cost more than leaders want to spend or inadvertently penalize states that already expanded Medicaid.

Advocates and Democratic lawmakers from Medicaid expansion holdout states say this month marks the first critical deadline in the effort, as congressional budget writers seek to finalize the parameters for infrastructure legislation the party can pass through reconciliation without Republican votes. While that budget resolution won’t include the details of which health policies make the final cut, it could provide the first sign of whether lawmakers are working with enough money to fund a Medicaid gap fix.

The House is largely leading efforts to craft the policy, sources said. Options under consideration include:

— Allowing low-income adults to get free private coverage through Obamacare’s insurance marketplaces. Financial assistance for the marketplaces has been closed off to people earning below the poverty line, about $ 13,000 for an individual, because Obamacare’s drafters expected they would be covered by Medicaid expansion. However, a 2012 Supreme Court decision made the expansion optional for states, creating the coverage gap Democrats are trying to close.

— Directing the Department of Health and Human Services to stand up a new Medicaid-like program for people who would otherwise be covered by Medicaid expansion in the holdout states. Warnock, whose election helped secure Democratic control of the Senate and faces voters again next year, plans to introduce legislation as soon as next week that would back this approach and substantially boost financial incentives for holdout states to expand Medicaid, according to a draft bill obtained by POLITICO.

— A hybrid model that could address concerns about either of the two approaches, according to a senior Democratic aide. People could quickly receive free coverage on the marketplaces until federal officials can create a new program that would likely provide better benefits.

A White House spokesperson didn’t comment on whether Biden is pushing lawmakers to address Medicaid expansion in the human infrastructure package, which is expected to also include investments in child care, education and combating climate change. The spokesperson referred POLITICO to a recent tweet from domestic policy chief Susan Rice that said Biden “is ready to work with Congress this year to close the coverage gap.”

Biden’s budget called for creating a federal-run health insurance option to cover people in the Medicaid expansion gap, but the White House hasn’t publicly weighed in on the approaches Congress is considering. Policymakers see complications with each idea.

For instance, relying on the Obamacare markets could give the new enrollees skimpier benefits than what they would receive through Medicaid. It could also require the government to provide costly subsidies to private insurers to cover out-of-pocket health costs that Medicaid would typically cover. But creating a new federal program would take time to set up.

Those drafting the legislation are trying to ensure they don’t inadvertently reward states that refused expansion or incentivize expansion states to drop coverage so that the federal government will foot the entire bill.

“To the extent you give more incentives and benefits to irresponsible states, then some of the responsible states will say: ‘I want that, too,’ which adds to the cost,” Doggett said. “How do you justify excluding states from a federal Medicaid program?”

Matthew Fiedler, a fellow at the USC-Brookings Schaeffer Initiative for Health Policy whose research focuses on the Medicaid coverage gap, and other experts said they’re not concerned about states dropping Medicaid expansion, given that the federal government picks up 90 percent of the cost. Still, Medicaid experts believe policymakers must provide the right balance of “carrots and sticks” to discourage states from dropping out.

Whatever approach lawmakers choose will have to pass muster with the Senate parliamentarian, who interprets whether policies satisfy strict reconciliation rules. However, lawmakers and outside experts are optimistic any policy would survive because changes to the Obamacare markets and Medicaid expansion have previously been pushed through the fast-track budget process.

The effort recently received a major boost from the powerful Congressional Black Caucus, Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus — as well as House Majority Whip Jim Clyburn. The groups argue that closing the coverage gap would be “one of the single most important steps” toward reducing the stark racial inequities in America’s health care system.

It would also give red state Democrats a concrete win to take to their voters.

“By this time next year, by the time you guys run for re-election next year, you’ll be able to run on Medicaid expansion,” Clyburn recently told lawmakers in Alabama’s statehouse. “I think we [can] get that done — I know I’m gonna raise hell to get it done.”

Top Fed official warns Delta variant poses threat to global recovery

Top Fed official warns Delta variant

A top Federal Reserve official has warned the spread of the Delta coronavirus variant and low vaccination rates in some parts of the world poses a threat to the global recovery as she urged caution in removing monetary support for the US economy.

“I think one of the biggest risks to our global growth going forward is that we prematurely declare victory on Covid,” Mary Daly, the president of the Federal Reserve Bank of San Francisco, said in an interview with the Financial Times.

“We are not through the pandemic, we are getting through the pandemic.”

Daly, who is a voting member of the Federal Open Market Committee this year, pointed to the struggles to contain the virus in Japan and other countries. Surging infections and lagging inoculation campaigns abroad were constraining the economic rebound and could have negative ramifications for the US, she said.

“If the global economy . . . can’t get . . . higher rates of vaccination, really get Covid behind [us], then that’s a headwind on US growth,” Daly said. “Good numbers on the vaccinations are terrific, but look at all the pockets where that isn’t yet happening.”

Daly’s warning came as investors sought out safe havens in droves this week, sending US government bond prices soaring. Treasury yields have fallen sharply as a result, with the benchmark 10-year note trading at its lowest level since February. Global stocks fell on Thursday.

Many market participants attributed the sharp drop in Treasury yields to technical factors. But a growing chorus has expressed concern that the economy will struggle to maintain the red-hot growth rates that have accompanied the reopening to date, and predicted that the recent jump in inflation will quickly fall away.

“In the United States the news has been pretty positive, but the global news hasn’t been all that positive,” Daly said. “It’s been good but it hasn’t been terrific. Markets respond to those things, and that can of course lower yields because they’re pricing in the risk there.”

She added: “What you’ve seen is an increasing sense of the downside risk to the global economy.”

The Fed’s June meeting appears to have been a catalyst for recent market moves. Central bank officials predicted they would be raising interest rates sooner and more aggressively than they had forecast earlier this year.

But speaking to the FT, Daly — who is considered one of the more dovish Fed officials — said there should be no doubt that the central bank would stick to the monetary policy framework it adopted in August 2020. This promised a more lenient approach to temporary overshoots in inflation in the pursuit of full employment.

“Chair [Jay] Powell said this so clearly in his press conference and I think that’s the light to follow here,” Daly said. “That’s the message I keep saying: we’re fully committed to our framework. That means eliminating shortfalls in employment and delivering average inflation of 2 per cent, and that is still absolutely paramount.”

Daly’s comments come at a pivotal time for Fed policymaking, as it discusses removing some of the massive monetary support for the recovery introduced at the start of the pandemic.

Minutes from the June FOMC meeting, released on Wednesday, showed some policymakers believed the Fed could soon start trimming its $ 120bn per month of asset purchases. But while Daly said the debate around “tapering” was warranted, the central bank had to “keep our eye on the long-term goals, which are full employment and price stability, and really be patient enough and persevere enough to deliver on those commitments which we’ve made to the American people”.

Furthermore, Daly argued increasing interest rates from their current level close to zero would have to wait until after the asset purchases had been wound down. Other more hawkish Fed officials have suggested there could be some overlap.

“We’re ready to taper at the appropriate time,” she said. “Then I’d like to see, how is that going? How does the economy respond to that? Because we can forecast, we can project, but we need to know in order to actually say, ‘oh, OK, now it’s time to move on to the next phase’, which is discussing policy normalisation and the fed funds rate coming up a bit.”

Daly said the split among Fed officials on how quickly to remove support for the economy, which was revealed in the minutes, was healthy as officials brought their “different perspectives” to the table and were not operating in an “echo chamber”.

For her part, the San Francisco Fed president indicated she is not quite ready to move to a post-pandemic environment.

“I think there’s always this excitement that ‘Oh my gosh: look, the vaccinations are working, this could be the end’. But it would be premature to say that we’ve achieved a victory here.”

Author: James Politi in Washington and Colby Smith in New York
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Covid Indian variant: Evidence virus poses bigger risk to children – 'could be disastrous'

Concerns have been rising over the spread of the Indian Covid variant, particular in Bolton – currently the most infected place in the country. And it seems the spike in cases has been driven by school age children. Figures from the end of last week show rates among five to nine year olds and 10 to 14 year olds were the highest recorded rates for both age groups, making up a third of all cases in Bolton.
The infection rate was 600.4 cases per 100,000 across the whole five to 14 age range for the week ending May 14.

This was double Bolton’s rate of 301.5 and almost double the previous highest rate for that age group – 318.1 on November 6.

“The emerging evidence is certainly suggesting strongly that the Indian variant of the virus poses a far greater risk to children than any of the previous strains,” Hussain Abdeh, Clinical Director and Superintendent Pharmacist of Medicine Direct, told Express Health.

He added: “The Indian variant is by far the most contagious strain of COVID we have seen in the UK to date.”

READ MORE: Cancer symptoms: One sensation on the toilet that may be indicative of a growing tumour

As a precaution, Abdeh said it would be wise to reintroduce remote learning until there’s more information regarding how effective the current UK vaccines are against the highly contagious Indian Variant.

He continued: “Last year, children were among the largest carrier groups for the virus, but this posed a greater threat to the adults they came into contact with.

“If the Indian variant takes a firm hold in the UK, it could be disastrous to have more than 20 children from different households in the same room as each other.

“All it would take would be for one person to develop symptoms and it could pose a serious health risk to an entire school.”

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Singapore recently made the decision to shift all primary, secondary and junior colleges to full home-based learning.

Singapore’s Health Minister One Ye Kung said the decision was made because the B1617 strain (the Indian variant) appeared to affect children more.

He said: “I did speak with him (Director of Medical Services, Kenneth Mak) before coming to this press conference.

“He did mention it will appear the B1617 strain appears to affect children more.

“So you’ll notice that for schools the response has been different compared to say last year.

“So once we detect infection, but outside of school, the Ministry of Education (MOE) has been very fast actually to put the school on home-based learning for the next few days and test the entire school.

“So that is also a precaution that has been put in recently in view of the different behaviour of this strain of virus.”

But UK Prime Minister Boris Johnson confirmed on Wednesday the Covid vaccines are effective against this strain of the virus, including the Indian variant.

Speaking at Prime Minister’s Questions he said: “We have increasing confidence that vaccines are effective against all variants including the Indian variant.”

A recent study showed the AstraZeneca vaccine to be 97 percent effective against the Indian variant.

Research published by the Indraprastha Apollo Hospital in Delhi, involved nearly 3,300 people in India and discovered only two hospitalisations with Covid.

The participants were vaccinated with the AstraZeneca jab and they worked in healthcare.

The European Medicines Agency (EMA) also said last week the Covid vaccines developed by Pfizer/BioNTech and Modern appear to be effective against the Indian variant.

Author:
This post originally appeared on Daily Express :: Health Feed
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Rosie Huntington-Whiteley stuns as she poses in just a towel in sexy bathroom snap

Author: Dorothy Howbrook
This post originally appeared on Showbiz – The Scottish Sun

MODEL Rosie Huntington-Whiteley proves she can even make a towel look good.

The blonde stunner, 34, is engaged to Hollywood actor Jason Statham, 53, and the pair share three-year-old son Jack together.

Model Rosie Huntington-Whiteley proves she can even make a towel look good

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Model Rosie Huntington-Whiteley proves she can even make a towel look goodCredit: Instagram

Rosie looks natural in these gorgeous bathroom snaps

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Rosie looks natural in these gorgeous bathroom snapsCredit: Instagram

Rosie and the Fast & Furious star have been dating since 2010 and got engaged in 2016.

On their decision to not rush into marriage she has previously said that it wasn’t a “huge priority.”

She shared: “We’re looking forward to that time. It’s also not a huge priority for us; we’re so happy.

“I think it will be fun to do it when the baby’s grown up a bit and he can be involved in the wedding.”

The blonde stunner is engaged to Hollywood actor Jason Statham

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The blonde stunner is engaged to Hollywood actor Jason StathamCredit: Splash News

Rosie recently revealed that she was most taken with how grounded and humble Jason was when she first met him.

She said: “I remember calling my friend the next day and just being like, ‘Wow, he’s so unexpectedly not who I thought he’d be.

“He’s so grounded and humble, he’s really fun and charismatic and energetic.’”

The 34-year-old modelling a line of loungewear she helped create

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The 34-year-old modelling a line of loungewear she helped createCredit: M&S

Rosie shows off her sensatonal figure in this red two-piece

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Rosie shows off her sensatonal figure in this red two-pieceCredit: Instagram

The beauty likes sharing sexy holiday pictures on social media

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The beauty likes sharing sexy holiday pictures on social mediaCredit: Instagram

Jason Statham joined by Rosie Huntington-Whiteley for blue carpet premiere of prehistoric shark drama The Meg in LA

‘Signed my bout agreement like this’: Bellator fan favorite Loureda poses in pink bikini as name & date revealed for next fight

MMA stunner Valerie Loureda has wowed fans with a stunning bikini contract signing snap, as her next opponent and the date of their fight have also been revealed.

The Bellator star uploaded a sensational poolside shot to Twitter which showed her relaxing head down and showing off her body in all its glory. 

“Just signed my bout agreement bout agreement like dis,” read the caption. 

And naturally, her followers weren’t able to contain their emotions.

Leaving them in no further suspense, details of the 22-year-old’s next appearance in the octagon have now been revealed. 

On May 7, at the Mohegan Sun Arena in Uncasville, Connecticut, the Miami native will face Hannah Guy as part of the Bellator 258 card – as reported by Maxim.

While Taekwondo master Loureda has already put together a 3-0 flyweight record with the MMA promotion since debuting in 2019, this will be 2-1 Guy’s debut for them.

In the main event, Sergio Pettis will challenge bantamweight champion Juan Archuleta while ex-UFC stars Anthony “Rumble” Johnson and the recently-released Yoel Romero do battle at light-heavyweight.

All focus will be on Loureda further down the bill, however. 

Last year, she was named the hottest fighter of 2020 by ex-UFC middleweight champion-turned-pundit Michael Bisping on his podcast and set pulses alight with a celebratory video.
Also on rt.com ‘Hottest fighter of 2020’: MMA stunner Loureda thanks ex-UFC champ Bisping after twerking in tight dress to celebrate gong (VIDEO)
But as she says herself, she is more than “just an ig model”, and also made the top 10 Bellator finishes in the same year through her savage buzzer-beating KO of Tara Graff.

That victory was marked with a racy cage dance, much to the delight of Loureda’s growing army of fans. 
Also on rt.com Bellator babe Loureda lands top-10 finish of the year for brutal KO which she celebrated with racy cage dance (VIDEO)

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Sofia Richie Poses For Selfie With Mystery Man After Being Spotted Holding Hands With Him On A Date

Fans are wondering if Sofia Richie officially has a new boyfriend, after the 22-year-old model posted a photo with a handsome mystery man on her MAIN Instagram page.

A mystery man has made his debut on Sofia Richie[1]‘s Instagram page. On March 26, the 22-year-old model shared a photo of herself getting cozy with the handsome stranger — well, a stranger to most fans — in the elevator. He leaned in behind Sofia, who was looking chic in a gold satin pajama suit as she snapped the mirror selfie. Of course, this set off speculation that Sofia has a new boyfriend!

Sofia simply captioned the photo with a sunflower emoji, and didn’t tag her mysterious companion. However, fans tried to do that job for her by dropping the Instagram handle for Elliot Grainge, the founder of 10k Projects (the music label that represents artists like Trippie Redd[2] and Iann Door[3]).

While we can’t confirm the identify of the person in the photo above, Elliot was the person whom Sofia was spotted holding hands[4] with outside of a restaurant in West Hollywood on March 24. Sofia was also seen kissing a mystery man[5] on a Miami beach in early February, although his identity wasn’t confirmed at the time.

Sofia has a special connection to Elliot. He’s not just a record executive, but is also the son of Universal Music Group’s Chairman and CEO, Sir Lucian Grainge. Sofia’s father, famous singer-songwriter Lionel Richie[6], is friends with Lucian and has also released a few albums through Universal Music.

Sofia Richie, Elliot Grainge
Sofia Richie holds hands with record executive Elliot Grainge outside a restaurant in West Hollywood on March 24, 2021. [BACKGRID]

Elliot’s age isn’t public information (his Instagram account is also set to private), but he was 26 years old when he offered a two-album contract extension to former client Tekashi 6ix9ine[7]  the controversial rapper’s sentencing in Dec. 2019, Variety[8] reported in Dec. 2019. Before Elliot, Sofia was romantically linked to Cha Cha Matcha founder Matthew Morton, but their fling “fizzled out” after not going “on an actual date since [Nov. 2020],” a source close to Sofia EXCLUSIVELY told[9] HollywoodLife in Dec. 2020.
Sofia’s apparent new romance comes in the wake of a headline-making claim that her ex before Matthew, Scott Disick[10], made on Keeping Up with the Kardashians. During the show’s final season premiere on March 18, Scott claimed that Sofia gave him “an ultimatum[11]” before their breakup: she allegedly wanted him to “choose” between her or his ex and the mother of his children, Kourtney Kardashian[12].

However, we learned that Sofia saw the situation a bit differently. “She’s really moved on from their breakup and is focused on doing her own thing and being happy. Even if Scott truly feels like Sofia gave him an ultimatum, then that’s his perspective but she never felt that she did,” an insider EXCLUSIVELY told[13] HollywoodLife after the premiere aired.

References

  1. ^ Sofia Richie (hollywoodlife.com)
  2. ^ Trippie Redd (hollywoodlife.com)
  3. ^ Iann Door (hollywoodlife.com)
  4. ^ holding hands (hollywoodlife.com)
  5. ^ kissing a mystery man (hollywoodlife.com)
  6. ^ Lionel Richie (hollywoodlife.com)
  7. ^ Tekashi 6ix9ine (hollywoodlife.com)
  8. ^ Variety (variety.com)
  9. ^ EXCLUSIVELY told (hollywoodlife.com)
  10. ^ Scott Disick (hollywoodlife.com)
  11. ^ an ultimatum (hollywoodlife.com)
  12. ^ Kourtney Kardashian (hollywoodlife.com)
  13. ^ EXCLUSIVELY told (hollywoodlife.com)

Jade Boren