Republican leaders in the Senate released the "discussion draft" of their health care bill, the Better Care Reconciliation Act of 2017, Thursday that would revise the Affordable Care Act. Jon Greenberg explains what changes the bill contains, with details of the cuts to Medicaid, elimination of taxes and calculation of subsidies.
Newly released Senate legislation would provide a longer timeline than the House bill for phasing out the Affordable Care Act's Medicaid expansion; would not penalize consumers for having a break in coverage; and would link premium support to income, age and geography, rather than just age and tie that assistance to "bronze" plans. Similarities between the bills include the approach to premiums for older adults, pathways for states to seek waivers from essential health benefits and repeal of coverage mandates.
Teen girls who thought they were too fat had increased odds of alcohol and tobacco use, while boys who considered themselves too skinny or fat had a higher risk of smoking or binge drinking, respectively, than peers with a positive body image. The findings in the Journal of Child and Adolescent Substance Abuse also showed a higher likelihood of smoking among girls who perceived themselves as unattractive and binge drinking among girls who perceived themselves as very attractive.
A study in the journal Metabolism: Clinical and Experimental showed that Chinese adults whose immunoglobulin E levels were in the highest quintile had a 31% increased risk of developing prediabetes, compared with those in the lowest quintile. Chinese researchers used a cohort of 8,856 adults and also found that those in the highest quintile of immunoglobulin A concentration levels were 19% more likely to have prediabetes.
Patients with type 2 diabetes and osteoporosis should be treated with medications that help protect the bones, such as dipeptidyl peptidase-4 inhibitor, glucagonlike peptide-1 receptor agonists, metformin and sulfonylureas, according to a study in The Journal of Clinical Endocrinology and Metabolism. Greek researchers reviewed past studies and guidelines, as well as key journals and abstracts, and noted that "avoiding strict targets for blood glucose levels is important for jointly managing T2D and osteoporosis for the fear of hypoglycemia, falls and fractures."
Researchers found that adults with atherosclerosis who took steps to lower their risk of complications by modifying their lifestyle, such as monitoring their blood pressure, getting enough exercise and avoiding smoking, had total average annual pharmaceutical expenditures of $1,400, compared with $4,516 among those who did little to reduce modifiable heart disease risk factors. The findings in the Journal of the American Heart Association were based on 2012 and 2013 data from the Medical Expenditure Panel Survey involving nearly 76,000 individuals.
An 11-year-old golden retriever dog named Aspen is participating in a study at Duke University Hospital to find out whether therapy dogs can help staff obtain better echocardiogram images in children with heart problems. The dogs are potentially an alternative to sedation, says pediatric cardiologist Piers Barker, and the dogs' behavior and markers of stress will also be monitored.
Researchers found that 22.8% of children and 8.7% of adults with Tourette's syndrome met the criteria for autism, compared with autism rates of 0.3% to 2.9% in the general population. The findings in the Journal of the American Academy of Child and Adolescent Psychiatry suggest that some increase in autism diagnoses among those with Tourette's "may be due to autism-like symptoms, especially repetitive behaviors that are more strongly related to obsessive-compulsive disorder," said researcher Sabrina Darrow.
The Senate's Better Care Reconciliation Act includes some provisions sought by health plans, which could be enough to prevent some companies from leaving public exchanges next year, but some are worried that steep cuts to Medicaid funding could force them to reduce services for the 75 million Americans covered under the program and cut reimbursement rates. The bill would continue cost-sharing reduction payments to insurers through 2019 and cut an annual fee paid by insurers, but it also would eliminate the individual mandate, which requires all Americans to buy health insurance or pay a financial penalty.
Sens. Rand Paul, R-Ky., Mike Lee, R-Utah, Ted Cruz, R-Texas, and Ron Johnson, R-Wis., said in a joint statement that they do not support the current version of the Senate health care bill, arguing that it does not do enough to unravel the structure of the Affordable Care Act, but they expressed willingness to negotiate. Republican leaders can only afford two defections from their party to pass the bill.
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