HEALTHCARE REBATES!!!!!

Thanks to a provision in the health care reform law, millions of consumers will be receiving rebates from their insurers this summer.

By Aug. 1, insurers that failed to meet one of the early guidelines of the Affordable Care Act are going to issue rebates averaging $127 to certain policyholders, according to estimates from the Kaiser Family Foundation.

Last year, the Affordable Care Act started requiring health insurers to spend a certain percentage of the premium payments they receive toward patient care, such as doctor's visits and hospital stays, and quality improvement activities, including discounted gym memberships or wellness brochures, instead of things like administrative and marketing costs.

[Related: 6 Dangerous Black Holes in Your Family Budget]

Under the law, large employer-sponsored plans must spend 85% of a policyholders' premiums this way, while insurance companies that cover individuals and small businesses have to spend at least 80%. If an insurer fails to meet that threshold, they must issue a refund.

Based on insurers' recent filings to the National Association of Insurance Commissioners, those rebates will total $1.3 billion altogether this year, according to Kaiser.

What health care reform is (and isn't) doing now

A large share of this money, or $426 million, will go to consumers who bought their own insurance through one of 215 plans. Nationwide, these consumers -- roughly 3.4 million people -- will each receive an average rebate of $127, Kaiser said in its report.

Most likely, they will receive a check in the mail, although the rebate could be issued as a discount on future premiums. Actual amounts will vary by insurer, by state and the extent to which the insurer fell below the threshold, Kaiser said.

[Related: 10 Ways to Save Money on Insurance]

In some states, like Alaska and Maryland, the average rebate is estimated to be near $300, while in New Mexico and Maine, the average rebate will be just $1 (not even enough for the insurer to issue a check).

Those insured through a private employer or a state or local government plan could see nothing at all. Those rebates will mostly go to the group policy holder, although the money could be passed on to employees who contributed a portion of their paycheck to their premium last year.

Kaiser calculated the averages based on insurers' early estimates. Actual rebates will be based on the reports the insurance companies submit to the federal government later this summer, Kaiser said.

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BATON ROUGE -- A second private school tuition voucher proposal is on the way to Gov. Bobby Jindal's desk, with both legislative chambers on Tuesday approving a final version of a plan that would allow corporations and individuals to recoup state general fund rebates for contributions they make to private organizations that dole out tuition grants.

Rep. Kirk Talbot, R-River Ridge, modeled the contribution rebate program after a decade-old income tax credit in Florida, where the program covers tuition vouchers for about 38,000 students. Talbot said the measure ultimately will save the state money, because the voucher amounts will be less than what state and local government now spends on a child in public schools. The handful of legislative opponents decried Talbot's pitch and said the design amounts to an irresponsible giveaway.

The final version does not include the $300 million annual cap on the program that the Senate had added on a 20-19 vote last week. That omission came as no surprise given opposition from Talbot and the Jindal administration, to say nothing of the lineup of administration-friendly senators and representatives who made up the conference committee tasked with crafting a final version for both chambers. The House approved the uncapped plan, 65-36. The Senate approved it 32-7.

House Bill 969 is part of Jindal's education agenda, though it has not been featured as prominently as a new law -- signed last week -- that will use the state's public-school financing formula to pay for private school tuition for low-income students in certain public schools.

The Talbot model would allow corporations and individuals to give unlimited amounts of money to independent, nonprofit groups that would, in turn, grant private-school tuition scholarships to students who live in households at or below 250 percent of the federal poverty level. That's about $55,000 for a family of four. The bill also would give priority to students from public schools rated a D or an F on the state's accountability assessment in cases where voucher recipients outnumber available spots in private schools. Both the income requirements and the priority tied to a student's existing school mirror Jindal's MFP vouchers.

Once the state certifies that a grant was issued, the contributor would receive a rebate, paid from the state general fund, equivalent to the amount paid in tuition. The scholarship-granting entity would be able to keep up to 5 percent for administrative costs. The contribution could reduce a filer's taxable income in the year the donation is made, but the rebate would be counted as taxable income whenever it is remitted.

Under Talbot's model, aid for kindergarten through the eighth grade would be capped at 80 percent of the state portion of the Minimum Foundation Program per-pupil financing formula. The cap would 90 percent of the state MFP portion for high school. The MFP-based voucher plan that Jindal signed last week allows grants up to the total state and local financing amount dictated by the MFP. On the Senate floor, Sen. Robert Adley, the Benton Republican who carried the measure for Talbot, noted that rebates would cost less than educating the students in public schools. Nonetheless, a legislative fiscal analysis said the Florida program has found that between 5 percent and 10 percent of the grant recipients never would have attended public schools in the first place.

As with Jindal's MFP vouchers, the students receiving the aid would have to take the same standardized tests they would take in public schools. But a student's promotion would not hinge on the results, and the participating private school would have no consequences attached to the outcome. For both tuition voucher programs, private schools will choose whether to participate. The administration has estimated that about 2,000 slots will be available in the fall, a fraction of the 380,000 eligible under the new Jindal law.

Talbot introduced his proposal last year as an income tax credit to allow contributors to reduce their state tax liability by the amount of money they give to the tuition-granting organization. The state constitution does not allow lawmakers to consider certain tax matters in even-year general sessions. Talbot has not said whether he plans to amend the plan into a tax credit when lawmakers convene in 2013 for a fiscal session.

Separately, the House Ways and Means Committee approved without objection a plan from Rep. Katrina Jackson, D-Monroe, to allow general fund rebates for direct contributions to certain public schools. Jackson put a $10 million annual cap on the bill, with reimbursements issued on a first-come, first-served basis. House Bill 1106 now moves to the House floor. Democrats had previously criticized Talbot's bill for not rewarding support for public schools, and senators rejected amendments that would have added public schools to the bill.

Jackson proposes a 75 percent reimbursement for gifts to schools assigned an F on the state accountability assessment; 50 percent for gifts to D schools; and 25 percent for gifts to B or C schools.

Jindal spokesman Kyle Plotkin said, "We're open to the intent of the bill." But Plotkin indicated the expense would have to be included in the state operating budget bill that lawmakers must adopt by their June 4 adjournment.

Bill Barrow can be reached at bbarrow@timespicayune.com.

How did breast cancer survivor Lisa Lindsay end up behind bars? She didn't pay a medical bill -- one the Herrin, Ill., teaching assistant was told she didn't owe. "She got a $280 medical bill in error and was told she didn't have to pay it," The Associated Press reports. "But the bill was turned over to a collection agency, and eventually state troopers showed up at her home and took her to jail in handcuffs."

Although the U.S. abolished debtors' prisons in the 1830s, more than a third of U.S. states allow the police to haul people in who don't pay all manner of debts, from bills for health care services to credit card and auto loans. In parts of Illinois, debt collectors commonly use publicly funded courts, sheriff's deputies, and country jails to pressure people who owe even small amounts to pay up, according to the AP.

[Related: 5 Strategies to Pay Down Credit Card Debt]

Under the law, debtors aren't arrested for nonpayment, but rather for failing to respond to court hearings, pay legal fines, or otherwise showing "contempt of court" in connection with a creditor lawsuit. That loophole has lawmakers in the Illinois House of Representatives concerned enough to pass a bill in March that would make it illegal to send residents of the state to jail if they can't pay a debt. The measure awaits action in the senate.

"Creditors have been manipulating the court system to extract money from the unemployed, veterans, even seniors who rely solely on their benefits to get by each month," Illinois Attorney General Lisa Madigan said last month in a statement voicing support for the legislation. "Too many people have been thrown in jail simply because they're too poor to pay their debts. We cannot allow these illegal abuses to continue."

Debt collectors typically avoid filing suit against debtors, a representative with the Illinois Collectors Association tells the AP. "A consumer that has been arrested or jailed can't pay a debt. We want to work with consumers to resolve issues," he said.

Yet Illinois isn't the only state where residents get locked up for owing money. A 2010 report by the American Civil Liberties Union that focused on only five states -- Georgia, Louisiana, Michigan, Ohio, and Washington -- found that people were being jailed at "increasingly alarming rates" over legal debts. Cases ranged from a woman who was arrested four separate times for failing to pay $251 in fines and court costs related to a fourth-degree misdemeanor conviction, to a mentally ill juvenile jailed by a judge over a previous conviction for stealing school supplies.

According to the ACLU: "The sad truth is that debtors' prisons are flourishing today, more than two decades after the Supreme Court prohibited imprisoning those who are too poor to pay their legal debts. In this era of shrinking budgets, state and local governments have turned aggressively to using the threat and reality of imprisonment to squeeze revenue out of the poorest defendants who appear in their courts."

[Related: Spring Cleaning for Your Financial Records]

Some states also apply "poverty penalties," including late fees, payment plan fees, and interest when people are unable to pay all their debts at once, according to a report by the New York University's Brennan Center for Justice. Alabama charges a 30 percent collection fee, for instance, while Florida allows private debt collectors to add a 40 percent surcharge on the original debt. Some Florida counties also use so-called collection courts, where debtors can be jailed but have no right to a public defender.

"Many states are imposing new and often onerous 'user fees' on individuals with criminal convictions," the authors of the Brennan Center report wrote. "Yet far from being easy money, these fees impose severe -- and often hidden -- costs on communities, taxpayers, and indigent people convicted of crimes. They create new paths to prison for those unable to pay their debts and make it harder to find employment and housing as well to meet child-support obligations."

Such practices, heightened in recent years by the effects of the recession, amount to criminalizing poverty, say critics in urging federal authorities to intervene. "More people are unemployed, more people are struggling financially, and more creditors are trying to get their debt paid," Madigan told the AP.

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Winning the lottery once in a lifetime is pretty lucky. Winning the lottery twice in the same day? Virginia Pike is one of the few people that can describe that feeling.

The Berryville, Va., resident had two tickets that matched five of the six Powerball numbers in an April 7 drawing so that each ticket was worth $1 million.

"I'm in shock!" Fike said in a news release from the Virginia lottery.

In early April, Fike stopped at an Olde Stone Truck Stop in Virginia with her numbers ready and purchased two tickets.

"I picked numbers based on my parents' anniversary and their ages at that time, divided by the year they were married," Fike said in the release. "I just love the jackpot games and I play when I can afford it."

The jackpot that week was at $80 million. In order to win the jackpot, the ticket holder has to match the five numbers and the sixth Powerball number.

After the drawing, it was announced that no one had won the jackpot, but 14 people nationwide had matched five of the numbers and were entitled to $1 million prizes each. Two of the winning tickets were in Virginia.

Pike was in the hospital keeping her mother company.

"I saw a scroll on TV about there being two $1 million winners. I looked at my mom and said 'Wouldn't it be funny if it was us?'" she said.
When she stopped by a convenience store, Pike had the clerk check her tickets and she discovered that she had won both of Virginia's $1 million prizes.

Per Virginia state lottery rules, winners split the jackpot, regardless of how many there are, but non-jackpot prizes from matching part of the winning sequence are not split and can be won multiple times.

"It's not that uncommon for people to buy tickets in games with the same number, but this is the biggest prize we've ever had in Virginia of two tickets in the same drawing," Virginia Lottery spokesman John Hagerty told ABCNews.com.
Pike was presented with a check for $2 million on Friday at the truck stop where she purchased the ticket. Winners in Virginia are required to come forward and be identified. She will receive $1.4 million after taxes. The store also received a $200,000 bonus for selling the two winning tickets.
Pike did not respond to a request for comment from ABCNews.com.

For now, Virginia's newest millionaire is basking in her shocking win.

"I must be dreaming," Pike said. "I look forward to helping to take care of my parents and paying some bills."

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Healthcare in New Orleans

In the wake of Hurricane Katrina, the city is in a state of mental health uncertainty.  Those that were fragile then are certainly apparently suffering and they are not doing it in silence.  What happened to the healthcare.  I have thought about this and I wonder, after a tragedy such as this wouldn't the people that were left behind and those that lost loved ones during the horrific course of events require some sort of assistance.  Thousands have lost their homes, their employment and their families.  How are they supposed to surive without help.  I say it is the greatest miscarraige of porwer.  In the city of New Orleans, we seem to have lost what we need so desperatly.  Bring back our mental healthcare so we can heal.

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Americans Cutting Back on Drugs and Doctor Visits

Patients cut back on prescription drugs and doctor visits last year, a sign that many Americans are still struggling to pay for health care, according to a study released Wednesday by a health industry research group.

A community health center in Aurora, Colo. Prescriptions fell 1.1 percent last year, and nearly three times that for older people.

The report, issued by the IMS Institute for Healthcare Informatics, said 2011 was also a breakthrough year for the drug industry, which introduced 34 new medicines, the most in a decade, to treat diseases including cancer, multiple sclerosis, hepatitis C and others.

The number of prescriptions issued to patients declined by 1.1 percent compared with 2010, and visits to the doctor fell by 4.7 percent, the report said. Visits to the emergency room, by contrast, increased by 7.4 percent in 2011, an increase that the report’s authors said was linked to the loss of health insurance resulting from long-term unemployment.

Michael Kleinrock, director of research development at the institute, which consults for the drug industry, said his research showed that some people with health insurance at the start of the recession actually increased their visits to the doctor out of fear they were about to lose insurance.

But as the economy has failed to strongly recover, “we’re now seeing more people reset their expectations about how often they will use medicine,” he said.

The study found that older Americans, in particular, used fewer medicines: prescriptions for patients 65 and older declined by 3.1 percent last year. The biggest declines were in prescriptions to treat high blood pressure and osteoporosis, according to the report. Mr. Kleinrock said older Americans appeared to be rationing their care as they struggled to pay rising bills on fixed incomes.

“We’re reaching a tipping point where patients will actually take that increased cost and use less medicine,” he said.

Older Americans used fewer prescription drugs even as their out-of-pocket costs fell, the study found. The total out-of-pocket spending on medicines dropped to $9.7 billion, from $11.5 billion in 2010, for those enrolled in the Medicare Part D prescription drug program, available to people 65 and older.

The average co-payment for Medicare Part D recipients fell by $2.66, to $23.31. The report attributed the lower costs to Medicare Part D drug subsidies that began taking effect in 2010 as part of the new health care law.

Leigh Purvis, a senior strategic policy adviser who studies drug prices for the AARP, noted that the drugs that older patients seemed to be cutting back on, including those to treat high blood pressure and cholesterol, “are drugs where you don’t necessarily develop symptoms when you stop taking them.” As a result, she said, some patients may view such drugs as expendable.

She also noted that while the overall cost had decreased as more Americans took generic drugs, the prices for brand-name drugs had jumped in recent years, driving up costs for people with medical conditions that require them to take drugs without a generic equivalent.

Even as fewer Americans were using prescription drugs, the opposite was true for young adults aged 19 to 25. Prescriptions for those patients rose by 2 percent compared with 2010, a change that Mr. Kleinrock said was because the health care law allowed adult children under 26 to be covered by their parents’ health care plan.

The federal government has estimated that 2.5 million people have taken advantage of that benefit, which took effect in September 2010. The IMS study found that the biggest increases among young adults were for antidepressants and drugs to treat attention deficit hyperactivity disorder.

The report also found that several important new medicines were introduced in 2011, including those that improve care for people with hepatitis C, multiple sclerosis and several types of cancer. All told, the report found, the new treatments could help an estimated 2.5 million people who are newly diagnosed with medical conditions each year, and about 20 million people who currently live with the diseases.

For Two Food Giants, Defining Fresh Fruit Is Not Cut and Dried

Pineapples and papayas are the weapons of choice in a global fruit fight under way in federal court in Manhattan. The point of the struggle? Deciding whether the fruit in plastic containers on refrigerated shelves in grocery store produce sections is fresh — or processed.

According to licensing deals, Del Monte Foods has the right to sell canned fruit and vegetables.

The dispute sets Fresh Del Monte against Del Monte Foods. The two companies were created out of what had been a single Del Monte after the takeover of its corporate owner, RJR Nabisco, in 1989.

Under the terms of two licensing agreements between the two companies, Fresh Del Monte has the right to sell “fresh fruit, fresh vegetables and fresh produce” under the Del Monte name, while Del Monte Foods has the right to sell canned and preserved fruits, vegetables and produce.

That might seem like a fairly straightforward division of the spoils, but the two companies have fought over those terms ever since, each accusing the other of encroaching on its turf. The bitter arguing, the turnover of lawyers and the stacks of legal briefs have come to resemble the case at the heart of Charles Dickens’s “Bleak House.”

In the current lawsuit, being heard before Judge Sidney H. Stein in Federal District Court in Manhattan, Fresh Del Monte charges that Del Monte Foods breached the contracts between them by selling various cut and prepared fruit products under the names Orchard Select, Fruit Naturals and SunFresh. The fruit is sold in plastic tubs on refrigerated shelves in produce sections of grocery and convenience stores.

Fresh Del Monte argues that by selling those products in the produce section — sometimes with the words “must be refrigerated” on the labels — Del Monte Foods is misleading and confusing consumers, who may mistake the contents of the packages for fresh fruits.

If the products need to be refrigerated to prevent spoiling, Fresh Del Monte argued in its court filings, they would be fresh fruit under the terms of the licensing agreement.

And in any case, Raoul Kennedy, the company’s litigator, argued in court, the contract and a previous court opinion gives Fresh Del Monte, not Del Monte Foods, the exclusive right to sell refrigerated pineapple and other fruits, including melons, berries, papayas and bananas “peeled, cut and cored.”

Mr. Kennedy said that if Del Monte Foods wanted to sell peanut butter in the produce section, Fresh Del Monte would not have a problem with it because consumers would not mistake peanut butter for “fresh melon.”

“We’re talking about things that have this carefully contrived perception of freshness to deliberately confuse people,” he said.

In keeping with the spirit of the fight, Del Monte Foods portrayed the lawsuit in court filings as “a classic case of sour grapes.”

Arturo J. Gonzalez, a lawyer for Del Monte Foods, told the jurors that although the company had been selling cut, processed and refrigerated fruit products since 1998, it had heard no complaint from Fresh Del Monte until 2008, when the fresh produce company’s sales began slipping. “We beat them in the market,” Mr. Gonzalez said. “Their product just doesn’t sell.”

As evidence he cited a January 2009 e-mail from a Fresh Del Monte employee, describing to a national account executive how the Shaw’s grocery stores in his neighborhood had moved the company’s products to the lowest refrigerated shelves and replaced them with Del Monte Foods’ Superfruit cups “by the hundreds.”

“When I talk to the produce guys at the stores, they say our stuff just doesn’t sell,” he wrote.

Mr. Gonzalez said Fresh Del Monte had offered no empirical evidence that consumers mistook Fruit Naturals or any other of his client’s refrigerated and preserved fruit products for fresh fruit. Most people, he said, know that fruit visibly packed in liquid and labeled as containing sodium bicarbonate and other preservatives is not fresh.