The Affordable Care Act requires employers to provide health insurance to everyone working more than 30 hours a week starting in 2014. This new regulation presents an issue in the academic world, as many adjunct faculty members across the country are having their working hours cut.
Every Friday, KBIA's Health & Wealth Desk talks about the week's most interesting articles and reports on rural health, wealth and society issues.
'Redneck reality' and rural portrayal in cable television
Entertainment newspaper The A.V. Club muses on A&E's popular reality show Duck Dynasty, saying the show is the 21st century incarnation of old rural-themed sitcoms that once dominated network television. Think Petticoat Junction, The Beverly Hillbillies, and Hee-Haw. It's an interesting read, but we were especially interested with the author's take on ways the television shows have to negotiate the rural-urban political disparities.
While the rural-themed programming of days gone by tended to depict the small Southern town as a bucolic haven for good-hearted folk, redneck reality is more apt to acknowledge the social and economic ills of the subcultures it depicts. These shows are sanitized for the protection of viewers with blue-state sensibilities; when they occur at all, political discussions tend to center on generalized platitudes about freedom and family, rather than specifics that might turn off half the potential audience.
Did headlines about death rates at rural hospitals tell the wrong story? The Daily Yonder is killing it with their opinion pieces this week.
Case in point: A new report made headlines last week, saying death rates are rising at rural, geographically isolated hospitals. But an opinion writer for the Yonder says news reports are not telling the real story of these so-called critical access hospitals:
The patients in the small rural hospital with heart attack, heart failure or pneumonia have become a select population. A large proportion has decided that they are through paying all the human costs of the miracles of modern medicine. They have made the decision to stay in familiar surroundings near home and family.
The researchers found that 13.3% of the patients at critical access hospitals with one of the three conditions died, compared to 11.4 % of the medical center patients. Given all the terrible tools that modern medical centers have to work with, I’m amazed they only manage a small difference in patient survival over the most basic, little country hospitals in America.
In his proposed budget, President Barack Obama wants to delay cuts to federal payments to hospitals, keeping the payments intact for an extra year. That could affect the debate over expanding Medicaid in Missouri.
Through what’s called the disproportionate share hospital payments or DSH payments, the federal government gives money to hospitals that provide a lot of free care to patients who are uninsured and can’t afford services. The Affordable Care Act, though, includes significant cuts to DSH payments.
Governor Jay Nixon says he could support the House Republicans’ alternate Medicaid proposal, but only if some crucial changes are made. He met with the GOP caucus today to discuss his Medicaid expansion proposal and their plans to reform the system. Nixon told reporters that any proposal still needs to expand Medicaid to 138 percent of the federal poverty level.
Rep. Jay Barnes (R-Jefferson City) was in one of the committees that struck down Rep. Hummel's Medicaid expansion proposal. Barnes has since introduced his own version of the expansion -- outlined in House Bill 700.
Not knowing what the online health insurance marketplace looks like might be problematic for Missourians.
As part of the Affordable Care Act, Missouri’s uninsured can choose to buy insurance from the state’s health exchange come October. The exchange is an online marketplace where anyone who isn’t already insured will be able to compare and purchase private insurance plans. Some uninsured Missourians would be eligible for help with the cost, too.
Missouri has missed the deadline to create its own marketplace or start a state-federal partnership. So, the federal government is setting it up. The problem is, even though the marketplace is supposed to be open for enrollment in about six months, no one knows what it looks like yet.
“We’re losing time that could be useful in helping people understand and prepare [for the exchange],” said Catina O’Leary, the director of Health Literacy Missouri, a nonprofit group that’s working to make health care topics more understandable for Missourians. “It would be really great if we could manage people’s expectations and start training on what they’re going to need to know.”
Missouri Foundation for Health's Ryan Barker presented and took questions from the Columbia community about the state's Medicaid expansion debate on Monday, March 11, 2013. The forum, held at the ARC in Columbia, is the sixth Barker has held this year.
The St. Louis-based nonprofit, nonpartisan group Missouri Foundation for Health held a community forum in Columbia at the ARC Monday night about the state’s Medicaid expansion debate. The foundation’s director for health policy Ryan Barker presented the pros and cons of the expansion to an audience of about 45 people, before opening up the floor to questions.