#Premium Healthcare Plan

[healthgennie]

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[totalbenefits]

How income affects your Medicare drug coverage premiums

You could pay a higher monthly premium for Medicare drug coverage (Part D) depending on your income. This includes Part D coverage you get from a Medicare drug plan, a Medicare Advantage Plan with drug coverage, or a Medicare Cost Plan that includes drug coverage. This is true even if your drug coverage is through your employer. Download this bulletin to learn more about extra Medicare drug…

[macgyvermedical]

I'm in the middle of a career change and a tentative asthma diagnosis (ie. no tests yet but it's on my record and my doctor is approaching it as such). What was healthcare like before protections were in place for people with pre-existing conditions? What should I do if I can't get health insurance? Should I try to get undiagnosed or something??? My symptoms are sporadic and usually mild so I can get through it without the inhaler if I had to, I'm just worried about losing access to all healthcare (also afab 😓) and want to be prepared to navigate things since I know it was way worse for chronic illnesses before the ACA.

The ACA was gigantic and it would be hard to talk about every aspect in this post.

Generally speaking, prior to the ACA, you essentially had three options. You could get health insurance through an employer, you could get health insurance through the state (medicaid), and you could get health insurance through an individual plan.

Seems pretty similar to today, right?

Nope.

See, the easiest way to get health insurance would be through a job. But if you had a pre-existing condition, including pregnancy or even simply being AFAB, in most states nobody legally had to cover you- including your employer. And if they did, they could say "you have health insurance for everything except the treatment of your chronic condition(s)" or make you pay significantly more for your premiums. Or, y'know, both (the idea being- if you sought medical care for one thing, you might do it again, and that would cost the insurance company profit*).

When you applied for health coverage through an employer, you had to disclose every medical problem you had ever had, including one-off problems like ear infections or broken bones. Anything could be grounds for not covering you at the outset. BUT if you didn't list a problem, and it was discovered (and they really went hard to find things), that could be grounds for rescission- the process of kicking you off insurance and forcing you to pay back money that the insurance had previously paid out for you.

If you didn't have a job or made extremely- and I mean extremely- little money, you might qualify for the state-sponsored medicaid, assuming you fell into a category that medicaid covered in your state. These categories included low-income children, some parents of children who lived at or below 64% of the federal poverty line (though in some states the parents had to have income as low as 15% of the FPL (less than $4,000/year for a family of 3)), older adults who had few assets or income, people on disability, and pregnant people up to 60 days post delivery. If you were a childless, able-bodied (at least in the eyes of the government) non-pregnant adult between 19-64, even if you made next to nothing? Pretty much forget about getting medicaid.

As far as I know, there were not a ton of changes made to medicare, the other major government insurance program for people over 65 years of age or who were severely disabled).

So what about individual plans? Well, first off, there was no marketplace (you couldn't compare plans from different companies) and no guaranteed coverage. Similar to plans through an employer, there was nothing protecting you from rescission or denial for even minor medical problems.

Most states, however, allowed something called "high risk pools" i.e. people who had pre-existing conditions and were looking for insurance could pay double what "healthy" people paid in premiums (often literally thousands of dollars per month) in order to have insurance. Even with these exorbitantly expensive plans, it would often be 12 months before they would start covering any pre-existing conditions. This meant that people had to pay their premiums and also out of pocket for their chronic care management for the first year of having insurance.

So what do you do if you're one of the near quarter of Americans who didn't have insurance through their employer, didn't qualify for medicaid, and couldn't afford the private insurance market?

You went into debt, or you died.

No, like, literally. You either agreed to medical care costing 10's or even 100's of thousands of dollars, or you didn't. For yourself or for your kids. Think about that- Would you pay (read, put yourself or your family into debt) half a million dollars for a surgery that saved your life? Your kid's life? These were the kinds of decisions that had to be made.

Back to your question:

Should you try to get un-diagnosed? Well no. That's asking for a rescission if the ACA is overturned. Contact me directly if you want more personal info about planning.

*and it's not like they aren't making a 10s-of-billions profit even with the ACA protections

[creepyscritches]

Truly is a handy tool to be able to get conservatives around me infatuated with the ACA once you walk them thru the revenue generation + the fact that the wheels are not greased by their tax dollars, but Big Insurance foots the bill instead (not really footing a bill if they turn huge profits for it later, but)

The ACA is built for everyone. I have known doctors that are on ACA plans. It is not a shameful thing and it is not indicative of a financial failure to sign up. It is being a smart consumer! It is knowing your options! Sometimes it isn't the best choice for you, but arent you somewhat relieved that it's still there if your other choices fall thru? It's stability and it's something that saves your life and your loved ones lives.

A big reason the ACA is the target of so much misinformation is largely due to the fact that it is the stone that will take down Goliath, and political power is cemented by dodging those stones on campaign trails.

The ACA isn't even enough in my opinion! It's a skeleton to build from. First flaw in US healthcare was pre-existing conditions (risk pools). The ACA can be boiled down to its most base elements as "a for-profit health care model that does not use risk pools" OR "a health care model that becomes less profitable the less sick your customers are"

THIS was the olive branch across aisles in the spirit of maintaining profitability and related capital interests.

The ACA is a springboard for next levels of development like "a health care model that thrives without relying on profit from premiums". Solidify that stage and then build up again! We MUST go in stages to ensure we do not leave people behind or drop people who need us. The ACA is a fucking tank built to carry us all, baby.

And again:

OPEN ENROLLMENT IS ACTIVE RIGHT NOW! 11/1/2024 - 1/15/2025!

There are people waiting to help you sign up!

[tomorrowusa]

Nope, Trump didn't "salvage" Obamacare as J.D. Vance claimed.

Some fact-checking from the vice presidential debate. From NPR.

During his presidency, Trump undermined the Affordable Care Act in many ways — for instance, by slashing funding for advertising and free "navigators" who help people sign up for a health insurance plan on HealthCare.gov. And rather than deciding to "save" the ACA, he tried hard to get Congress to repeal it, and failed. The Biden administration has reversed course from Trump's management of the Affordable Care Act. Increased subsidies have made premiums more affordable in the marketplaces, and enrollment has surged. The uninsurance rate has dropped to its lowest point ever during the Biden administration. The Affordable Care Act was passed in 2010 and is entrenched in the health care system. Republicans successfully ran against Obamacare for about a decade, but it has faded as a campaign issue this year.

So just the opposite of what J.D. claimed. The Trump administration didn't save Obamacare, it tried to sabotage and kill it.

People who have a weirdly nostalgic view of the Trump administration forget how he tried to kill Obamacare with help from the Republican majority 115th Congress. From its inception, Republicans in Congress have tried to kill Obamacare 70 times.

Obamacare may not be perfect, but it is superior to what existed previously. The bulk of people who hate it are connected to Big Pharma, for profit medical corporations, and the Republicans who get big campaign contributions from them.

The name Obamacare tells us a lot. It was coined as term of disparagement for the Affordable Care Act by Republicans. But it became so popular that Republicans ended up shooting themselves in the foot by eternally connecting the ACA to the Democratic president who was the driving force behind it.

Trump has had nine years to come up with a viable alternative to Obamacare. But the "stable genius" still can't put together a coherent sentence about what he'd replace it with.

For affordable healthcare, vote Democratic to improve it or vote MAGA Republican to destroy it.

[askgildaseniors]

Social Security and Medicare are two programs that help support us as we age. Social Security provides financial support in retirement, while Medicare ensures access to healthcare services.

Social Security offers income for retirees or those unable to work due to health reasons. It also extends support to families who've lost loved ones, providing survivor benefits.

Meanwhile, Medicare steps in to offer health insurance for individuals aged 65 and older, as well as those with certain disabilities or illnesses.

When it comes to enrolling, the Social Security Administration (SSA) partners with the Centers for Medicare and Medicaid Services (CMS) to guide older Americans through the process. SSA sends out enrollment packages before your Medicare enrollment period begins, typically three months before you turn 65.

If you're already receiving Social Security benefits at age 65, you'll likely be automatically enrolled in Medicare. But if not, you'll need to apply through the SSA website.

Now, on to payments. Once enrolled, most individuals pay monthly premiums for Medicare Part B, that covers outpatient treatments. Social Security simplifies this process by deducting Part B premiums directly from benefit payments. If you have Medicare Advantage or Part D plans, you can also set up deductions from your benefits.

[simply-ivanka]

What Kamala Harris Believes

The Vice President’s political record reveals the views of a California progressive.

Wall Street Journal

Democrats are rapidly unifying behind Kamala Harris as their party nominee, yet the Vice President remains relatively unknown to most Americans. That means it’s important to look at her record to see what she believes.

As VP she’s closely identified with the Biden agenda, for better or worse, and she embraced that record in remarks on Monday. She said President Biden’s first term has “surpassed the legacy” of most Presidents who have served two.

So mark her down as endorsing the spending blowouts that caused inflation, the Green New Deal, entitlement expansions and student loan forgiveness. Until she says otherwise, we should also assume she’s in favor of Mr. Biden’s $5 trillion tax increase in 2025.

The Vice President’s four years as a Senator from California are another window on her worldview. She sponsored a bill to create a $6,000 guaranteed income for families making up to $100,000. Another Harris proposal: A refundable tax credit that would effectively cap rents and utility payments at 30% of income. Liberal economists panned the subsidy because it would drive up rents.

She co-sponsored legislation with Bernie Sanders that would pay tuition at four-year public colleges for students from families making up to $125,000. This is more honest than the Administration’s back-end student loan cancellation. But it would cost $700 billion over a decade and encourage colleges to increase tuition.

Another Bernie mind-meld: Single-payer healthcare. Ms. Harris co-sponsored his Medicare for All legislation paid for by higher income taxes. She tweaked Bernie’s plan when running for President in 2019 by extending the phase-in to 10 years from four and exempting households making less than $100,000 from the “income-based premium.” But it would still put government in charge of all American healthcare over time.

As a San Francisco Democrat, Ms. Harris shares the state’s hostility to fossil fuels. She used her power as California Attorney General to launch an investigation into Exxon Mobil over its carbon emissions. In 2019 she endorsed a nationwide ban on oil and gas fracking, which would cost tens of thousands of jobs and cause power outages like those that often occur in her home state. Expect this to be a GOP talking point in Pennsylvania.

One question to ask is whether the Vice President wants to restructure the Supreme Court. She said in 2019 she was “open” to adding more Justices, but that idea doesn’t poll well. Does she agree with Mr. Biden’s mooted plan to endorse “reforms” to the High Court that would make the Justices subject to Congressional supervision?

Mr. Biden famously put Ms. Harris in charge of border policy, and we know how that has turned out. Rather than push for border policy changes, her first instinct was to blame the rush of migrants on “root causes” in developing countries, including corruption, violence, poverty and “lack of climate adaptation and climate resilience.”

Climate change makes the U.S. border a sieve? Apparently so. “In Honduras, in the wake of hurricanes, we must deliver food, shelter, water and sanitation to the people,” Ms. Harris declared. “And in Guatemala, as farmers endure continuous droughts, we must work with them to plant drought-resistant crops.” These “root causes” take decades to address, and in the meantime she had nothing to say about actual border security.

Ms. Harris’s foreign policy views aren’t well known, or perhaps even well formed, apart from promoting Mr. Biden’s policies. While she has backed the Administration’s military assistance to Ukraine, she has equivocated about support for Israel. In March she chastised Israel for not doing enough to ease a “humanitarian catastrophe.” Leaks to the press say officials at the National Security Council toned down her speech’s criticism of Israel.

She lambasted the Trump Administration for killing Islamic Revolutionary Guard Corps Gen. Qassem Soleimani, claiming it could lead to bigger war in the Mideast. The killing chastened Iran’s rulers instead, at least until the Biden Administration began to ease sanctions and tried to repeat the 2015 nuclear deal.

It will be especially important for the press to ask Ms. Harris about her national security views. If her handlers control her as much as White House advisers have Mr. Biden, we’ll know they’re afraid that the Vice President might not be able to handle the scrutiny.

A fair conclusion from all of this is that Ms. Harris is a standard California progressive on most issues, often to the left of Mr. Biden. Perhaps as she reintroduces herself to the public in the coming weeks, she will modify some of those views. She would be wise to do so if she wants to win.

Given the rush by Democrats to anoint Ms. Harris as their nominee, the press has a particular obligation to tell the public about who she is and what she really thinks. Does she believe California is a model for the country?

[wyn-n-tonic]

Re: Insurance.

I have one of the best healthcare policies available and I pay $20 a month in premiums for it. Before this insurance, I had horrible plans offered to me that cost $65 to $200 PER PAYCHECK and had ridiculous copays and deductibles and all this other shit I had to meet that made no sense. My insurance now? $20 a month and my plan is copay only. That means when I go to the doctor, I only pay $30. I don't get a bill in the mail afterward. When I had my biopsies? I paid $40 for my specialist copay but I didn't get a bill after, I only got a letter stating that my insurance paid all $10,000 of my biopsies. When I was much younger, I had to go off medication that I am supposed to be on for the rest of my life because I lost insurance and the meds cost $350/month. I pay $3 with my insurance. And people are like, "Well, now that you have it so good, don't you want to gatekeep this level of care?" NO. I. DON'T. I want everybody to have this level of care and this level of access. We're bled dry via our taxes and none of that goes back to us. I want every single person who needs medical care to be able to get it. I think that's important. Because I know people who say that if they get diagnosed with cancer, they won't fight because the bills will be too much and their family will be left with nothing. That's RIDICULOUS. EVERYBODY DESERVES HEALTHCARE!!!!

[morlock-holmes]

Also, part of healthcare in America is gambling with your health.

"If you're relatively healthy, you might want to consider a low-premium, high deductible plan"

Meaning (generalizing from the marketplace prices I've seen) you'll save about $5,000 a year if you don't have any emergencies and lose about $9,000 if you do.

Don't worry, I'm sure nobody would choose these plans because they don't have an extra $5,000 a year to throw at monthly premiums even though they're likely to need serious medical care in the near future...

Not to mention, I'm sure nobody just decides to forgo the premiums at all and just not have insurance because of the cost...

[so-much-for-subtlety]

I have a high deductible health plan which means that my monthly premium is low, but I have to pay for healthcare myself until a certain limit where insurance kicks in (at first it will pay 70-80% and then at another limit it will pay 100%).

For the first time ever it looks like I’m going to hit either one or both of those limits this year, which kind of rationalizes me to get as much as possible out of my plan.

I have things I’ve been putting off for years that I think I’m gonna get seen this year, I’m gonna be like the million dollar man where they can rebuild me stronger! faster! better!

[healthgennie]

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[sonicenvy]

I had another conversation with someone who didn't have health insurance today about ACA that she didn't know existed as an option. Ever since I got my first ACA plan last year after turning 26 I have been a big ACA fan because this piece of landmark legislation is the reason I have health insurance instead of being in thousands of dollars of medical debt. It bugs the ever living shit out of me whenever I see internet leftists saying things like "the ACA didn't do anything because it is not medicare for all." It really speaks to me about the privilege that these people likely have because they're not noticing the amount of monumental positive change and harm reduction that was made by the bill.

The ACA is a bill that is comprehensive, and walks, talks, and chews gum at the same time, and I think a lot of people who are either a.) too young to remember how health insurance in this country worked before the ACA or b.) have not had to get government subsidized health insurance because they have always had either their parents' insurance or employer insurance really and truly don't get it. I am obviously too young to remember how healthcare worked before the ACA because I am under 30, but I do have a mom who works in healthcare and lots of older relatives that talk about it a lot so I was pretty familiar with the concept despite this.

I am low-income, in school, and have an employer that doesn't offer me employer subsidized plans, so the ACA quickly became pretty important to me as a person with lifelong disability, higher than normal cancer predisposition and a need for lifelong psychiatric care.

Also, if you are in your 20s but under 26 and still on your parents' health insurance? Bam! You are directly benefiting from the ACA. Before the ACA you would not have been able to be on your parents insurance plan in your 20s.

Some things that the ACA did:

Made it affordable for people who are above the medicaid income limit and/or self-employed to independently purchase health insurance. Before the ACA premiums for independently purchased health plans could be $500+ for individual plans! If you were one of the many Americans who worked multiple part-time jobs that did not provide PT employees with insurance, you were basically fucked and uninsured. If you were a small business or self-employed, you were also fucked. The creation of the healthcare dot gov health insurance marketplace, which is open to anyone was a massive success of the bill, and millions of Americans benefit from it. During open enrollment (or after a specific life event such as "turned 26," or "became unemployed") a person can log on to health care dot gov, see a wide range of plans, and purchase one. The government then provides you with a premium subsidy (which is what your employer does for you if you have an employer plan) to lower the cost of the premium. Subsidies are calculated based on a person's income so people with lower incomes get higher subsidies.

Obviously there is some nuance, and a coverage gap with ACA plans for individuals who make above $60,000 (and are not a small business obtaining a group contract with an insurance company) where premiums are still very expensive because they are ineligible for the majority of the premium tax subsidy, which is a major ACA weakness, but for everyone in the $30,000-$55,000 gap and for owners of small businesses that want to offer plans for their employees, the benefits are huge. I am able to get a PPO with a low deductible, low OOP for less than $200/mo in premiums! There is exactly zero way that I would have been able to do that if I were trying to get insured pre-ACA.

Made it so that insurance companies could not discriminate against patients with so-called pre-existing conditions — so basically if you are disabled, the insurance company can no longer: a.) decline to provide you coverage or b.) increase your premiums/ reduce your plan benefits because you have a disability or get something like, oh, idk, FUCKING CANCER. Like there were people who got cancer and found out that their insurer dropped them because they did not want to pay out for expensive cancer treatment. That was a thing that was legal for health insurance companies to do before the ACA, and they fucking did that. The pre-existing conditions clause was one of the biggest benefits that has been touted since the beginning of the bill's conception and passage. Under the ACA, all health insurance companies are banned from denying plan applications for any reason, or from revoking plan coverage for any reason that isn't "patient stopped paying their premium." Made it so that children could stay on their parents' health insurance plans until they were 26 instead of being booted at 18. Made it so that all plans must provide some level of coverage for a list of specific EHBs (Essential Health Benefits) such as "emergency room care," "prenatal and pregnancy related care," "preventative care such as doctor recommended cancer screenings for patients" "office visits with general practitioners," etc.

If you have an marketplace plan or medicare/medicaid, that plan MUST provide you with contraceptives at no cost to you regardless of whether or not you have met your deductible. Democrats also wanted this to be true for all other plans, but unfortunately in 2014, whacko religious conservatives got themselves an exemption for "companies with fervently held religious beliefs against contraception" from providing this coverage in their employer subsidized plans in the bullshit case of Burwell v. Hobby Lobby Stores, Inc., which was decided by a conservative majority vote in the Supreme Court. A case which had other broad and shitty implications btw, and which is yet another example of why allowing weird conservatives to get elected to the presidency is bad for America. btw, in the original intention of the ACA they wanted to also include mandatory coverage for abortion services. Unfortunately, the Republicans (and a group of stupid pro-life dems who suck, and to my knowledge are not in congress now) torpedoed this provision despite Nancy Pelosi's best efforts and refused to pass the bill at all as long as this provision remained in it. Reason #10000000 Republicans suck.

Lots more that I'm not naming here, but I hope you get the idea. My point is that even though ACA was not a medicare for all bill, it was a landmark (and very needed) piece of healthcare reform legislation that changed a lot about the landscape of health insurance in America. Tragically, right wing and far left smearing of it has obscured the truth about the many good things that the bill did do. Was it perfect? Absolutely the fuck not! Even Obama himself admits this. What it was was a major victory against injustices in the system, and a massive piece of harm reduction legislation, and I wish that more Americans credited it for the things it did do.

Dems managed to get the bill passed with the vast majority of their highest priorities still in it despite major republic ratfuckery combined with a minority of independents and dems who sucked. Pelosi walked circles around these fuckers day and night to get this bill passed, and I for one am deeply grateful. Because of the ACA I can get the healthcare that I desperately need as a disabled person with higher than normal cancer risk. I can get my desperately needed medications and see all of my doctors because of this piece of legislation. I was able to get surgery to remove CANCER from my body becuase of this legislation, so yeah, fuck everyone going "the ACA is bad because it's not perfect medicare for all." Girl (gender neutral), I (and many other people) would not be surviving if it were not for this bill, and I for one, think that that is a whole heck of a lot better than all of us dying because y'all want to wait for perfect legislation. Harm reduction is good and is an important step on the road to bigger and better change. Universal health care has risen to more popular and broad public opinion/knowledge because the ACA passed.

Yeah, anyways this is rant about how fucking stupid anti-ACA people are. To deny the gains of meaningful healthcare reform is a clear sign of privilege, ignorance, and tunnel vision that lets perfect be the enemy of good or better.

This is also a post about a clear and obvious way that Dems are infinitely different (and better) than republicans. Voting dem is harm reduction. Not voting, voting third party or protest write in voting is a vote for republicans. And republicans??? They give exactly zero shits about anyone other than themselves. They support stupid and insane religious conservative politics, and look to fuck over the American people (and everyone else abroad) at every turn because they don't believe in helping people; their convictions are all about hate, prejudice, fearmongering, and a right-wing Christian Theocracy. They would rather see millions of people die than give dems a win, because they are spiteful and hateful. They want us to be afraid, disengaged, disorganized and fighting one another, because their ideas, convictions and beliefs are deeply unpopular, and if we organize against them, they will lose.

[coochiequeens]

No one is entitled to biological offspring and how can they include surrogacy in the Act without implying that couples are entitled to women to be surrogates?

A trio of Democratic senators are introducing a "Right to IVF Act" that would, among other things, force private health insurance plans to cover assisted reproduction treatments such as in vitro fertilization (IVF), egg freezing, and gestational surrogacy.

The measure provides no exception or accommodations for religious objections, all but ensuring massive legal battles over the mandate should it pass.

The "sweeping legislative package" (as the senators describe it) combines several existing pieces of legislation, including the Access to Family Building Act and the Family Building Federal Employees Health Benefit Fairness Act sponsored by Sen. Tammy Duckworth (D–Ill.), the Veteran Families Health Services Act from Sen. Patty Murray (D–Wash.), and the Access to Infertility Treatment and Care Act from Sen. Cory Booker (D–N.J.).

Booker's contribution here is probably the most controversial. It requires coverage for assisted reproduction from any health care plan that covers obstetric services.

A Reverse Contraception Mandate

Remember the Affordable Care Act's contraception mandate, which required private health insurance plans to cover birth control (allegedly) at no cost to plan participants? It spawned some big legal battles over the rights of religious employers and institutions not to offer staff health plans that included birth control coverage.

Booker's Access to Infertility Treatment and Care Act is a lot like the Obamacare contraception mandate, except instead of requiring health care plans to cover the costs of avoiding pregnancy it would require them to cover treatments to help people become pregnant.

The bill states that all group health plans or health insurance issuers offering group or individual health insurance must cover assisted reproduction and fertility preservation treatments if they cover any obstetric services. It defines assisted reproductive technology as "treatments or procedures that involve the handling of human egg, sperm, and embryo outside of the body with the intent of facilitating a pregnancy, including in vitro fertilization, egg, embryo, or sperm cryopreservation, egg or embryo donation, and gestational surrogacy."

Health insurance plans could only require participant cost-sharing (in the form of co-pays, deductibles, etc.) for such services to the same extent that they require cost-sharing for similar services.

What Could Go Wrong?

It seems like it should go without saying by now but there is no such thing as government-mandated healthcare savings. Authorities can order health care plans to cover IVF (or contraception or whatever) and cap point-of-service costs for plan participants, but health insurers will inevitably pass these costs on to consumers in other ways—leading to higher insurance premiums overall or other health care cost increases.

Yes, IVF and other fertility procedures are expensive. But a mandate like this could actually risk raising IVF costs.

When a lot of people are paying out of pocket for fertility treatments, medical professionals have an incentive to keep costs affordable in order to attract patients. If everyone's insurance covers IVF and patients needn't bother with comparing costs or weighing costs versus benefits, there's nothing to stop medical providers from raising prices greatly. We'll see the same cost inflation we've seen in other sectors of the U.S. healthcare marketplace—a situation that not only balloons health care spending generally (and gets passed on to consumers one way or another) but makes fertility treatments out of reach for people who don't have insurance that covers such treatments.

Raising costs isn't the only issue here, of course. There's the matter of more government intervention in private markets (something some of us are still wild-eyed enough to oppose!).

Offering employee health care plans that cover IVF could be a good selling point for recruiting potential employees or keeping existing employees happy. But there's no reason that every employer should have to do so, just because lawmakers want IVF to be more accessible.

It's unfair to employers—big or small, religious or non-religious—to say they all must take on the costs of offering health care plans that cover pricey fertility treatments. And Booker's bill contains no exceptions for small businesses or for entities with religious or ethical objections.

A lot of religious people are morally opposed to things like IVF and surrogacy. This measure would force religious employers to subsidize and tacitly condone these things if they wanted to offer employees health care plans with any obstetrics coverage at all.

As with any government intervention in free markets, there's the possibility that this fertility treatment mandate would distort incentives. IVF can certainly be an invaluable tool for folks experiencing infertility. But it's also very expensive and very taxing—emotionally and physically—for the women undergoing it, with far from universal success rates. The new mandate could encourage people who may not be good candidates for IVF to keep trying it, perhaps nudging them away from other options (like adoption) that might be better suited to their circumstances.

'Access' Vs. Whatever This Is

Since Roe v. Wade was overturned, many Americans have worried that the legal regime change would pave the way for outlawing things like contraception or IVF, too. Encoding into law (or legal precedent) the idea that fertilized eggs are people could have negative implications for these things, even if many conservative politicians pledge (and demonstrate) that IVF and birth control are safe. In response, some progressive politicians—perhaps genuinely concerned, perhaps sensing political opportunity (or why not both?)—have started talking a lot about the need to protect access to IVF across the country.

As much as I agree with this goal, I think IVF's legality is better off as a state-by-state matter. That said, the "protect IVF nationwide" impulse wouldn't be so bad if "protecting access" simply meant making sure that the procedure was legal.

But as we've seen again and again over the past couple decades, Democrats tend to define health care and medicine "access" differently.

The new Right to IVF Act would establish a national right to provide or receive assisted reproduction services. In their press release, the senators say this last bit would "pre-empt any state effort to limit such access and ensur[e] no hopeful parent—or their doctors—are punished for trying to start or grow a family." OK.

But that's not all it would do. The bill's text states that "an individual has a statutory right under this Act, including without prohibition or unreasonable limitation or interference (such as due to financial cost or detriment to the individual's health, including mental health), to—(A) access assisted reproductive technology; (B) continue or complete an ongoing assisted reproductive technology treatment or procedure pursuant to a written plan or agreement with a health care provider; and (C) retain all rights regarding the use or disposition of reproductive genetic materials, including gametes."

Note that bit about financial cost. It's kind of confusingly worded and it's unclear exactly what that would mean in practice. But it could give the government leeway to directly intervene if they think IVF is broadly unaffordable or to place more demands on individual health care facilities, providers, insurance plans, etc., to help cover the costs of IVF for people whom it would otherwise be financially out of reach.

This is the distilled essence of how Democrats go too far on issues like this. They're not content to say "People shouldn't be punished for utilizing/offering IVF" or that the practice shouldn't be illegal. They look at authoritarian or overreaching possibilities from the other side (like banning or criminalizing IVF) and respond with overreaching proposals of their own.

The proble with increasing access to IVF is what happens when the couple needs a surrogate to have biological offspring? Will they beg and pester the women in their lives? Will the affordable IVF compensate surrogates fairly?

[sugdenlovesdingle]

The monthly premium for my health insurance now: €139,20

The monthly premium for my health insurance from January 1st (if I don't change anything): €144,90

Welcome to the Netherlands - where we have healthcare for all*

*all who can afford to drop €200+ a month on their premium so it actually covers the things they need.

The insurance I have now is the basic deal that everyone has to have + dental. I'm considering dropping that and pray I don't get a cavity next year.

The basic plan doesn't cover the insoles I need to walk without pain. I should get new ones fitted every year but that's 250 euro and I don't have that much money to spare - ever - so I'm still wearing the ones from last year and the year before.

And on top of all that you have to pay €385 of your healthcare costs a year yourself no matter what. Rich or poor, you have to pay the 385.

In short - fuck this country, fuck the vvd, fuck everyone who voted for these assholes, fuck everyone who is planning on voting for them, and fuck everyone who is planning on voting for Omtzigt because he's just as bad.

Nieuwe bestuurscultuur me reet!

[insert-witty-user-name-here]

50+ Good Things from the Biden Administration

Just a list of 50+ good things the Biden Administration has done in the last 4 years because I’ve been hearing too much rhetoric that it doesn’t matter who you vote for. It does make a difference. 

Increased access to healthcare and specifically codified protections for LGBTQ+ patients against discrimination. (x) 

Strengthened women's reproductive rights by increasing access to reproductive health care, improving confidentiality to protect against criminalization for patients receiving reproductive care, and revoked Medicaid waivers from states that would exclude providers like Planned Parenthood, and more. (x)

Expanded healthcare and benefits for veterans through the PACT Act (x)

Cemented protections for pregnant and postpartum workers through the Pregnant Workers Fairness Act and PUMP for Nursing Mothers Act. 

Improved access to nursing homes for those who receive Medicaid services and established, for the first time, a national minimum staffing requirement for nursing homes to ensure those in their care receive sufficient support.  (x) 

Lowered healthcare costs for those with Medicare which capped insulin for seniors at $35 a month, made vaccines free, and capped seniors’ out of pocket expenses at the pharmacy through the Inflation Reduction Act. 

Fully vaccinated 79% of American adults against COVID-19 (I know this is old news now this is a big deal) 

Banned unfair practices that hide housing fees from renters and homebuyers when moving into a new home (x) 

Reduced the mortgage insurance premium for Federal Housing Administration (FHA) mortgages and clarified that inflated rents caused by algorithmic use of sensitive nonpublic pricing and supply information violate antitrust laws. (x) 

Increased protections for those saving for retirement from predatory practices. (x)

Helped millions of households gain access to the internet through the Affordable Connectivity Program. (x) 

Restored net neutrality (net neutrality is a standard which ensures broadband internet service is essential and prohibits interna providers from blocking, engaging in paid prioritization, and more.) (x)

Increased protections for loan holders as well as increased access to loans (x)

Cut fees that banks charge consumers for overdrawing on their accounts. (x)

Reaffirmed HUD’s commitment to remedy housing discrimination under the Fair Housing Act (which was– surprise, surprise– halted under the Trump administration). (x)

Rejoined the Paris Climate Accords.  

Listed more than 24 million acres of public lands across the country as environmentally protected and has channeled more than $18 billion dollars toward conservation projects. (And revoked the permit for the Keystone XL pipeline amongst others). 

Invested $369 billion to reduce greenhouse emissions and promote clean energy technologies through the Inflation Reduction Act. Through the tax incentives under the Inflation Reduction Act, renewable energy (such as wind, solar, and hydropower) has surpassed coal-fired generation in the electric power sector for the first time, making it the second-biggest source of energy behind natural gas. (x)

Strengthened protections against workplace assault through the Speak Out Act. (x) 

Increased protections for workers during the union bargaining process (x)

Is making it easier for passengers to obtain refunds when airlines cancel or significantly change their flights, significantly delay their bags, or fail to provide extra services when purchased. (x)  

Invested $1.2 trillion into roads, waterlines, broadband networks, airports and more allowing for more bridges, railroads, tunnels, roads, and more through the Inflation Reduction Act (which also added 670,000 jobs). (idk about you but I like driving on well maintained roads and having more rail options).  

Strengthened overtime protections for federal employees (x)

Raised the minimum wage for federal workers and contractors to $15. (x)

Strengthened protections for farmworkers by expanding the activities protected from retaliation by the National Labor Relations Act and more. (Previously anti-retaliation provisions under the National Labor Relations Act applies mostly to only U.S. citizens) (x)

Invested $80 billion for the Internal Revenue Service to hire new agents, audit the wealth, modernize its technology, and more. Additionally, created $300 billion in new revenue through corporate tax increases. (x) 

Lowered the unemployment rate to 3.5% — the lowest in 50 years. 

Canceled over $140B of student debt for nearly 40 million borrowers. (x)

Strengthened protections for sexual assault survivors, pregnant and parenting students, and LGBTQ+ students in schools through an updated Title IX rule. This updated rule strengthens sexual assault survivors rights to investigation– something that had been gutted under the Trump administration, strengthens requirements that schools provide modifications for students based on pregnancy, prohibits harassment based on sexual orientation or gender identity, and more. (x)

Revoked an order that limited diversity and inclusion training. (x)

Cracked down on for profit colleges. (x)

Reaffirmed students’ federal civil rights protections for non-discrimination based on race, national origin, disability, religion, sexual orientation, gender in schools. Specifically, the Department of Education made clear students with disabilities’ right to school, limiting the use of out of school suspensions and expulsions against them. (x) (x) 

Enhanced the Civil Rights Data Collection, a national survey that captures data on students’ equal access to educational opportunities. These changes will improve the tracking of civil rights violations for students, critical for advocates to respond to instances of discrimination. 

Provided guidance on how colleges and universities can still uphold racial diversity in higher education following the Supreme Court decision overturning affirmative action. (x) 

Issued a federal pardon to all prior Federal offenses of simple possession of marijuana. Additionally, the DEA is taking steps to reclassify marijuana as a Schedule III substance instead of a Schedule I, limiting punishment for possession in the future. (x) 

Changed drug charges related to crack offenses, now charging crack offenses as powder cocaine offenses. This is a big step towards ending the racial disparity that punishes crack offenses with greater severity than offenses involving the same amount of powder cocaine. (x) 

Lowered the cost of local calls for incarcerated people through the Martha Wright-Reed Just and Reasonable Communications Act as well as increased access for video calls (especially impactful for incarcerated people with disabilities). (x) 

Enacted policing reforms that banned chokeholds, restricted no-knock entries, and restricted the transfer of military equipment to local police departments. (x)

Established the National Law Enforcement Accountability Database (NLEAD) which will better track police officer misconduct. This database will vet federal law enforcement candidates who have a history of misconduct from being rehired and will make it easier and faster to charge police officers under the Death in Custody Reporting Act. (x) 

Added disability as a protected characteristic alongside race, gender, religion, and sexual orientation. Under the law, police officers are prohibited from profiling people based on these characteristics. …It sadly happens anyway but now there’s an added legal protection which means a mechanism to convict police officers should they break the law. (x) 

Required federal prisons to place incarcerated individuals consistent with their chosen pronouns and gender identity. (x) 

Expanded gun background checks by narrowing the “boyfriend” loophole to keep guns out of the hands of convicted dating partners, strengthening requirements for registering as a licensed gun dealer (closing the “gun show loophole”), and more through the Bipartisan Safer Communities Act.  (x) 

Increased mental health programs within police departments to support officers experiencing substance use disorders, mental health issues, or trauma from their duties. (x)

Lifted Trump era restrictions on the use of consent decrees. The Justice Department uses consent decrees to force local government agencies (like police departments) to eliminate bad practices (such as widespread abuse and misconduct) that infringe on peoples’ civil rights. (x) 

Improved reporting of hate crimes through the COVID-19 Hate Crimes Act (x) 

Nominated the first Black woman to sit on the Supreme Court 

Confirmed 200 lifetime judges to federal courts, confirming historic numbers of women, people of color, and other judges who have long been excluded from our federal court system. (64% are women, 63% are people of color) 

Designated Temporary Protected Status (TPS) status for immigrants from Cameroon, Haiti, ​​El Salvador, Haiti, Honduras, Nepal, Nicaragua, Sudan, and more. (x) 

Ended the discriminatory Muslim and African bans (x). 

Provided a pathway to citizenship for spouses of U.S. citizens that have been living in the country without documentation. (x) 

Expanded healthcare to DACA recipients (x) 

This one is… barely a win but not by fault of the Biden Administration. The Department of Homeland Security as of Feb 2023 has reunited nearly 700 immigrant children that were separated from their families under Trump’s Zero Tolerance Policy. From 2017-2021, 3,881 children were separated from their families. About 74% of those have been reunited with their families: 2,176 before the task force was created and 689 afterward. But that still leaves nearly 1,000 children who remain tragically separated from their families from under the Trump Administration. (x)

(okay this one is maybe only exciting for me who’s a census nerd) Revised federal standards for the collection of race and ethnicity data, allowing for federal data that better reflect the country’s diversity. Now, government forms will include a Middle Eastern/ North African category (when previously those individuals would check “white”). Additionally, forms will now have combined the race & ethnicity question allowing for individuals to check “Latino/a” as their race (previously Latine individuals would be encouraged to check “Latino” for ethnicity and “white” for race… which doesn’t really resonate with many folks). (x) (I know this sounds boring but let me tell you this is BIG when it comes to better data collection– and better advocacy!).

Rescinded a Trump order that would have excluded undocumented immigrants from the 2020 Census which would have taken away critical funds from those communities. 

Required the U.S. federal government and all U.S. states and territories to recognize the validity of same-sex and interracial civil marriages by passing the Respect for Marriage Act, repealing the Defense of Marriage Act.

Reversed Trump’stransgender military ban. 

Proposed investments in a lot of programs including universal pre-k, green energy, mental health programs across all sectors, a national medical leave program for all workers and more. (x) 

Last… let’s also not forget all the truly terrible things Trump did when he was in office. If you need a reminder, scroll this list, this one mostly for giggles + horror, for actual horror about what a Trump presidency has in store, learn about ‘Project 2025’ from the Heritage Foundation. I know this post is about reasons to vote FOR Biden but let’s not forget the many, many reasons to vote for him over Trump. 

So, there it is, 50+ reasons to vote for Biden in the 2024 Election. 

Check your voter registration here, make a plan to vote, and encourage your friends to vote as well. 

All in all, yeah… there’s a lot of shitty things still happening. There’s always going to be shit but things aren’t going to change on their own. And that change starts (it certainly doesn’t end) with voting. 

Go vote in November. 

[lazywitchling]

My employer: "As part of our healthcare plan, we're now offering free access to Calm's entire premium content!"

Me: "Bare minimum of employee mental health, but okay. That's cool I guess."

The website: "Get Calm for your business! We send you stats on how your employees are using our app!"

Me: "HAHAHAHAHAHA yeah no absolutely not."