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WASHINGTON — The White House on Monday will issue new rules that strongly discourage employers from cutting health insurance benefits or increasing the costs of coverage to employees, administration officials say.
The rules limit the changes that employers can make if they want to be exempt from certain provisions of the health care law passed by Congress in March. Many employers want the exemption because it allows them to keep their existing health plans intact with a minimum of changes. More than 170 million Americans have employer-sponsored insurance.
The administration said the rules would allow a smooth transition to a new, more competitive insurance market that works better for consumers. But in some respects, the rules appear to fall short of the sweeping commitments President Obama made while trying to reassure the public in the fight over health legislation.
In issuing the rules, the administration said this was just one goal of the legislation, allowing people to “keep their current coverage if they like it.” It acknowledged that some people, especially those who work at smaller businesses, might face significant changes in the terms of their coverage, and it said they should be able to “reap the benefits of additional consumer protections.”
The law provides a partial exemption for certain health plans in existence on March 23, when Mr. Obama signed the legislation. Under this provision, known as a grandfather clause, plans can lose the exemption if they make significant changes in deductibles, co-payments or benefits.
About half of employer-sponsored health plans will see such changes by the end of 2013, the administration says in an economic analysis of the rules.
The rules allow employers and insurers to increase benefits. But, in a summary of the rules, the administration said, “Plans will lose their grandfather status if they choose to make significant changes that reduce benefits or increase costs to consumers.”
Some provisions of the new law apply to all health plans. In general, they cannot cancel coverage when a person becomes ill, and they cannot impose lifetime limits on benefits.
But “grandfathered health plans” are exempt from other requirements. In general, they do not have to provide “essential health benefits” specified by the federal government and they do not have to provide free preventive care.
Under the rules, a health insurance plan can lose its exemption if it eliminates all benefits for a particular condition or if it increases deductibles or co-payments by more than the rate of medical inflation plus 15 percentage points.
Likewise, a health plan loses its exemption if an employer reduces its contribution so that its share of the total cost of coverage declines by more than 5 percentage points. If, for example, an employer is paying 60 percent of the cost of family coverage, it would run afoul of the rules if it cut its share to 50 percent.
An employer would also lose its exempt status if it increased co-payments for doctor’s visits to $45, from $30 — a 50 percent increase — while medical inflation was 8 percent.
Some health plans require consumers to pay a percentage of the bill, rather than a fixed dollar amount. An insurer loses its special protection if it makes any increase in this percentage — if, for example, it requires patients to pay 25 percent of the bill for surgery, rather than the 20 percent charged in the past.
A health plan would also run afoul of the rules if it eliminated coverage for services needed to diagnose or treat a particular condition. As an example, the rules describe a health plan that covers a combination of counseling and prescription drugs for treatment of a particular mental illness. The plan would lose its exemption if it eliminated benefits for counseling.
Some insurers cap the amount they will pay for covered services each year. If they want to retain their grandfathered status, they cannot reduce any annual dollar limit that was in place on March 23.
About 133 million Americans are in group health plans from employers with 100 or more employees, the administration said, and most “will not see major changes to their coverage as a result of this regulation.”
by Sue Halpern
As just about every sentient being knows, Apple Computer launched its “revolutionary,”1 “game changing,”2 “magical”3 tablet computer, the iPad, on April 3. This was after years of rumors, dating back almost a decade,4 but starting in earnest in February 2006,5 when Apple filed a number of patent applications that hinted at its intentions to move into touch computing. Though this turned out to be the prelude to the iPhone, tablet rumors began building again throughout the summer and fall of 2008 and into 2009,6 despite consistent denials from the company. By following the age-old dating protocol—flirt, be coy, don’t call back, flirt some more—Apple successfully turned up the dial on desire: here was a device that, sight unseen, large numbers of people wanted and believed they had to have, even without knowing precisely what it was or what it did.
In October 2009, at about the same time that rumors about the phantom Apple tablet were beginning to swirl, but before they coalesced into a media suck, the bookstore chain Barnes and Noble issued a product announcement of its own. It was getting into the electronic book reader business (again, ten years after its failed RockBook launch) with a small device called the Nook, reminiscent of Amazon’s popular electronic book reader, the Kindle, whose dominance it meant to challenge. Though The Wall Street Journal gamely live-blogged the launch, which took place in a basement conference room at the Chelsea Piers sports complex in Manhattan, and despite an overrun of holiday preorders for the Nook, once Apple revealed, right around Christmas, that it was planning a major product announcement at the beginning of the new year, excitement that another player had entered the e-book arena dulled.
At the Nook event, there was a lot of talk about the book industry and the future of books and the promise of e-books. Stephen Riggio, the CEO of Barnes and Noble, pointed out that publishing was still big business; at $30 billion a year, it was bigger than both the music and film industries.7 He also observed that readers wanted books on demand, which is what the Nook—with its access to the Barnes and Noble catalog, as well as to the more than one million scanned public domain books already on offer through various online sites, and, most likely, to the millions of books promised by the pending Google Books settlement as well—would give them.
Fighting back tears, Celia Alejandra Alvarez, 30, described how she was detained in a workplace raid, physically abused, and incarcerated without medical care in February 2009.
“It’s true what’s happening in Arizona; we are discriminated against,” said Alvarez to a roomful of people. She said in an interview that her experience is an example of the climate that led to SB 1070 and the danger that this law poses to other families.
Alvarez, Silvia Rodríguez, Alma Mendoza, Silvia Herrera, and 10-year-old Katherine Figueroa were invited to testify at a special hearing on the impact of the new Arizona law SB 1070 by Congressman Raúl Grijalva (D-Arizona). During their visit they also met with members of the Obama administration’s labor department.
The delegation’s concerns were not limited to the potential impact of the law that will take effect July 29. The women’s testimony also underscored concerns about civil rights violations and abuse by the Maricopa County Sheriff’s Office that have been taking place in Arizona since the federal government signed a 287(g) agreement with that agency. The agreement, which has been limited since then, allowed the sheriff’s office to train 160 of its deputies to enforce immigration laws.
“I asked myself why did I suffer so much. I was only working. Each check I won was earned through my own sweat. My job was to clean highways and streets no matter if it was sunny or cold,” said Alvarez.
Alvarez filed a lawsuit in February against the Maricopa County Sheriff’s Office after being detained in a worksite raid at a landscaping company. She alleged that a deputy dislocated her jaw while trying to pull her out of her hiding place, and another one hit her with a clipboard for talking to other people who were being detained.
“I only have one question for President Obama and Congress: Aren’t we all human? My blood is red, and I imagine yours is too. And I ask myself, why do you ask us for papers to work and not to go to war?” said Alvarez.
by Dick Meister
Organized labor and its allies are rightly alarmed over the high incidence of on-the-job accidents that have killed or maimed many thousands of workers. But they haven't forgotten - nor should we forget - the on-the-job violence that also afflicts many thousands.
Consider this: Every year, almost two million American men and women are the victims of violent crime at their workplaces. That often forces the victims to stay off work for a week or more and costs their employers more than $60 billion a year in lost productivity.
The crimes are the tenth leading cause of all workplace injuries. They range from murder to verbal or written abuse and threatening behavior and harassment, including bullying by employers and supervisors.
Women have been particularly victimized. At least 30,000 a year are raped or otherwise sexually assaulted while on the job. The actual total is undoubtedly much higher, since it's estimated that only about one-fourth of such crimes are reported to the police.
Estimates are that more than 900,000 of all on-the-job crimes go unreported yearly, including a large percentage of what's thought to be some 13,000 cases annually that involve boyfriends or husbands attacking women at their workplaces.
by Dick Meister
How inviting it looks, the fruit laid out for us in grocery stores and supermarkets in a profusion of bright color. Red, green, yellow, orange, purple . . . Cherries, grapes, berries. Apples and oranges, bananas, peaches – oh, especially the peaches. Or maybe you prefer apricots, maybe melons, or something else from nature's overflowing cornucopia.
And the vegetables, their color subdued, but their variety and quantity as great as the fruit – yellow corn, green peas, carrots, potatoes, squash. And lettuce, of course, and cauliflower, and so much more.
It's a daily show of the great abundance of food that springs from the fertile soil of many, many farms and is rushed to stores and markets for our choosing.
But what of the people who clamber up and down ladders, reaching high in trees to pluck fruit for us? Who pluck it from bushes or vines? Reaching, stretching and picking. Reach, stretch, pick. Reach, stretch, pick . . . Their dirty, sweaty work seems endless.
And what of those who wield short-handled hoes as they scurry over dirt fields like spiders, bent double, rhythmically bending and straightening. Bending and straightening as they move swiftly along dirt rows to deftly free vegetables from the earth's grasp.