Tag: Health

Firefighter Cancer Registry Act of 2017 (H.R. 931)

It’s no surprise that some professions come with a higher rate of cancer diagnoses than others and registries are becoming a common way to study this issue. While registries like the Veterans Affairs’ “Burn Pit Registry” seeks to document an occurrence of an occupational hazard, there is no question that our nation’s firefighters are frequently exposed to smoke, chemicals, and other fire-related hazards. This bill will set up a registry to collect, compile, and analyze the actual rate of cancer among firefighters. There are state registries already, but just like we learn in high school statistics class, the larger the pool of information, the more accurate your analysis will be.

The owner of this registry, so-to-speak, will be the Secretary of Health and Human Services (HHS Secretary) but will be carried out with the help of the Center for Disease Control (CDC). This registry will be used to make and improve current actions which study cancer diagnoses in firefighters. The information will be collected, put into a more simple format for study, stored, and then released as public information… don’t worry though, all personal identifying information will be removed before public release. This is pretty standard and a no-brainer.

The bill suggests things that should be reported in the registry, such as:

  1. Some sort of identifying information (this helps keep information consolidated and avoid duplicate entries)
  2. Age of firefighter
  3. Position (volunteer, paid-on-call, or career)
  4. Number of years on the job and all other job information prior to, during, or after service
  5. The number of fires attended (or an estimate if not available) and the type of building (residential vs commercial)
  6. Other risk factors to include smoking or other drug use
  7. Physical exam and medical history that is related to the cancer diagnosis

Because this is a national registry, it will be given the ability to link to State registries in order to get information like the date of the diagnosis, source of that information, and details on the type and stage of cancer.

The HHS Secretary is directed to create a plan to “maximize participation” from all demographics of firefighters. Who knows what plan that could be. I get mail every few months to remind me to continue my participation in a Veteran-related study. It usually includes some sort of trinket and a thank you note. The plan should also state a minimum target for participation as being included in the registry will be voluntary. After all, what good is a study if only 5% of the people eligible actually participate? A formula should be created to standardize estimations of how many fires were attended if exact numbers aren’t available. The Secretary is also directed to seek feedback from non-Federal experts (like cancer doctors, public health experts, actual firefighters, etc) on how the information should be used and how the registry can be improved. Finally, the information will be required to be made public in a format that does not include personal identifying information and with no cost to anyone who wishes to view it.

The Congressional Budget Office (CBO) estimates that this will cost about $10 million to create and maintain between fiscal years 2018 – 2022. This bill gives the registry $2.5 million each fiscal year for a total of $12.5 million by the end of 2022. It passed in the House of Representatives by a voice vote on September 12, 2017 and will be sent to the Senate for approval.

S. 544 : Changing the Veteran’s Choice Program

The Veteran’s Choice Program is not without its flaws. News agencies far and wide have reported on inefficiency, ridiculous eligibility criteria, and general messiness. Perhaps some would be glad to see it expire in August 2017 as scheduled, but considering that wait times and care services are still not where they should be across the board, we may be better off hoping that President Trump signs this bill into law. Instead of expiring three years after enactment of the original bill, the Veteran’s Choice Program will continue as long as there is money in the fund. Initially, 10 billion was allocated, but President Trump’s proposed budget would add 3.5 billion for the program. Given this fact and the president’s promises to take care of Veteran’s, it would be unlikely that he would veto this bill.

In addition to changing the termination date of the Choice Program, this bill, which amends the Veterans Access, Choice, and Accountability Act of 2014, will also allow for the Choice Program to recoup money from third parties (insurance companies) for provided medical care that is not service-connected. This will clearly help extend the budget of the program and ensure that the appropriate parties pay for care.

VA medical records will also be able to be send to outside agencies for the purpose of providing medical care. Any other use of the records will be prohibited. If you have ever tried to get records sent from one government agency to another, especially the VA, you know what a pain it can be!

These changes may not seem like much but they are certainly a step in the right direction. For some, the Choice Program works, for others, it does not. Each improvement provides more Veterans with the care that they need.

Trump: Environmental Evil-Doer or Regulatory Foe?

“Let’s destroy the earth with pollution!” … Said no respectable (or non-cartoon) person ever. Even still, President Trump has managed to send that message to his political rivals. Okay, to be fair, they pulled that message to the extreme, willingly, of course. Either way, here we are, beginning the debate (again) on whether or not we are destroying the earth in favor of the almighty dollar.

President Trump’s latest executive order (today, March 28, 2017) starts off with language that most of us agree on:

“It is further in the national interest to ensure that the Nation’s electricity is affordable, reliable, safe, secure, and clean, and that it can be produced from coal, natural gas, nuclear material, flowing water, and other domestic sources, including renewable sources. “

The President goes on to ask for a review, change, and revocation of regulations and procedures that are not required by law and that can get in the way of otherwise safe processing of energy sources. Still not bad really… the average household (yours included) has to update things every once in a while which might mean getting rid of a few rules. Theeeeeeeen, he begins to cite all of these executive orders from President Obama reports on guidance for energy emissions that will no longer be in effect. It sounded like bad juju to me too! However, a short review of the Obama actions reveals that nothing to terrible is being changed just yet.

The first Obama executive order to be nixed has some wonderful language about modernizing infrastructure and recommending that government agencies take steps to lessen the risk that they will contribute to climate change. Data.gov was established by this order and seems like a neat tool for the rest of us who aren’t waist-deep in this sort of stuff everyday. Sadly, information updates to the site under many topics seems to have stopped. The “climate” section hasn’t had a new entry since 2015. So I guess we won’t miss this one too much! There are a couple of councils that were created regarding climate change, but one that was ordered six months ago has apparently missed some suspense dates and I can’t even tell if this council (Climate and National Security Working Group) is staffed. You can’t miss what isn’t there! Trump has ordered that the Interagency Working Group on Social Cost of Greenhouse Gases be disbanded as well. Here’s my question… why were there so many councils on the same topic? I’m all about preserving our environment but as they say, too many hands in the pot will spoil the sauce. Anyone in the military will tell you about having meetings about meetings. LOL. It’s real. It has happened… and it feels like the same thing here. Because he disbanded the Greenhouse Gas group, he is tossing out their work as well. Ready for another saying from your grandma? He might just be tossing the baby out with the bath water. These types of reports are incredibly detailed and are written for specialists and experts in their field. I’m pretty much lost in the sauce (spoiled or not) when I read them. Nevertheless, the old standards and guidance of social cost of emissions from 2003 will go back into effect. Finally, he orders an end to the ban on leasing government land for the purpose of coal mining.

I’m still holding my breath on where this will go. It will depend largely on the agency administrators who are tasked with trimming down the regulation in their area. As for me, I will continue to do what I can: recycle, conserve gas, and pray my family remembers to turn off lights when they aren’t needed!

P.S. If you remember the cartoon Captain Planet and the Planeteers from the 90s… I wouldn’t tell the Captain about this… he’s gonna be pretty peeved. And now you have the theme stuck in your head just like me. You’re welcome. 😉

Veterans 2nd Amendment Protection Act (H.R. 1181)

It’s no secret that the mental health of our Veterans is a hot topic; not only how to manage it, but also the consequences of it. As a Veteran and a caregiver to my Veteran husband who was injured in Iraq, I understand first-hand why it is so important that we study and improve on services for our men and women in the military. That being said, the rights of some Veterans are being taken away because the VA has determined they are “mentally incompetent” to manage their own finances. This determination could be for many different reasons but it results in the appointment of someone to oversee their VA compensation (often a loved one or friend) and the denial to own a firearm. You read that properly. A man or woman who has served our country honorably and fought to keep them safe could potentially lose the right to bear arms, a right afforded to them in the 2nd Amendment.

Enter H.R. 1181, the Veterans 2nd Amendment Protection Act. With a vote of 240-175, the bill was passed in the House today. The bill seeks to correct language about gun ownership that is too broad. The U.S. Code which outlines criminal acts, makes owning a gun a crime for anyone who has been “adjudicated as a mental defective.” Under this new bill, if passed, a judge, magistrate, or someone “of judical authority” must determine that a Veteran is a danger to themself or others.

I am not going to slam the VA here. After five years in Army administration, I know how hard it can be to ensure that you are following regulation to the letter of the law (there is rarely room for “spirit of the law”). However, in an attempt to do so, the VA has reported thousands of names of Veterans to the FBI’s National Instant Background Check System which would prevent them from buying a gun. This may not seem like a bad idea, except a Veteran who can’t manage their bills properly are now kept from claiming a right that they, ironically, had to make use of during their service.  Some reports say that 167,000 Veterans are listed because of their inability to manage finances; still others list it at 257,000. Whatever the number, it is unfair to take away such a right under these circumstances. Forgetting that your cable bill is due every month does not equal being a danger to anyone.

I thoroughly support background checks and preventing those who are dangerous from owning a gun. I will add that where there is a will, there is, unfortunately sometimes, a way. We cannot prevent all gun violence, or violence using any weapon, however, laws are an important defense against it. Nevertheless, we have to give our Veterans a fair chance. Just because you are bruised, doesn’t mean you are broken.








American Health Care Act: Premium Tax Credits (Proposed Bill)

We start today’s installment of the health care bill translation with discussion about advanced tax credits. I know, that sent chills of excitement down your spine, didn’t it!?! Either way, under the Affordable Care Act, any tax credits for health care that were advanced and overpaid had to be paid back to the government. There is no real surprise there and it seems only fair, right? Well, there was a plan in place on how much the government would get back, a limit on repayment. For the years 2018 and 2019, there will now be no limit. If you are given an advanced tax credit for health care, you will be required to pay back any and all over-payments, regardless of the amount and personal income. This still seems fair but perhaps it would also be a good idea to work on calculating payments and credits more accurately.

For the purposes of this tax credit, the term “Qualified Health Plan” would now include plans that are not offered on State exchanges. It would not include a grandfathered or grandmothered health plan or one that includes coverage for abortions unless it was necessary to save the life of the mother. Women can still opt to buy separate insurance that would cover abortion but they cannot use or claim any tax credits for that plan. Should any side effects, illness, or injury occur because of an abortion, the treatment of those things would be able to be treated by a health plan that is paid for by credits.

Advanced payments of tax credits will not be made for any health insurance plan that is not part of the State exchange. If you wish to claim the credits for non-exchange plans, you will need to include a statement with your tax return showing that it is a qualified health plan, the months you were covered, the adjusted monthly premium for a silver plan at the second lowest cost (wow that is getting specific), and any other information requested in the  future. These requirements for information will not apply to any coverage starting in January 2020.

Seniors are seeing another raise in their health care premiums through this bill starting in the 2019 tax year. Should they be eligible to receive any premium tax credits, the percentage of personal income that they are required to pay towards premiums increases with age once you get income above 150% of the poverty line.

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And really, this doesn’t just affect seniors. The older you are, the more  you will pay. Have a younger spouse? Well that won’t help either! My husband is 12 years older than me. Filing a joint return means that his age is the one they base the required percentage off of. That could mean 2% or more difference and it would be another 30 years before we are both in the same bracket and that won’t matter because the premium tax credits will be gone after the 2019 tax year. Why does age matter for tax credits anyway? Isn’t a dollar still a dollar no matter whose pocket it is in?

Next up… Small Business Tax Credit…

American Health Care Act: Buh-Bye Random Taxes (Proposed Health Care Bills)

Several pages of the American Health Care Act repeal a few taxes and even a deduction. Unfortunately, only a couple of them will directly affect the American consumer. If the bill passes, we can say buh-bye to the so-called “Tanning Tax.” The 10% tax is paid by the person who actually hops inside the tanning bed. The 3.8% Investment Income Tax will go away as well. According to businessinsider.com, just over 40% of Americans are invested in the stock market, but it really depends on how much each person holds in stock as to whether or not they really feel a boost. As with all of the other repeals discussed in this post, these taxes will end December 31, 2017.

The IRS code does not allow health insurance companies to deduct pay paid to an  employee that goes over $500k. There are a few exceptions but now this won’t be a problem. They can pay a CEO a buttload of money and deduct it as a payroll expense. In case you are wondering, buttload is a technical term…

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Now that we can all legitimately use “buttload,” let’s get back to all of the fun money that companies will be saving after 2017!

Prescription drug makers and importers will no longer be paying the special tax imposed upon them. Could this lead to lower prescription drug costs? We can only hope.

And finally, health insurance companies pay another tax that has to do with how much they collect in monthly premiums. The tax was suspended for this year and if this bill makes it through without changing this, the tax will formally end at the end of the year.

These tax cuts could be a positive thing, as long as they translate to lower costs to the consumer. I’ll be honest, I’m not entirely sure why the Investment Income Tax is addressed in health care legislation, but random stuff happens like this all the time.Perhaps you could argue that the tax that would have been paid could be used to pay monthly insurance premiums but I just don’t see Americans who need help the most carrying a stock portfolio that makes that kind of money. But, I’ve been wrong before.

‘Til tomorrow, when I will bring you another buttload of information!