ACA/ Obamacare cheat sheet- CNN Money - CNN.com

THE FUTURE OF HEALTH CARE

Obamacare cheat sheet

September 26, 2013: 10:41 AM ET

NEW YORK (CNNMoney)

This much is clear: Obamacare is massive and it's not easy to understand.

Many insurance regulations and taxes are already in effect, but the big push begins Oct. 1.

The goal of the Affordable Care Act is to provide affordable coverage for tens of millions of uninsured Americans, provide more comprehensive coverage, and to ultimately reduce costs.

We won't know whether it hits those goals for some time, but here's how it could affect you now.

The first thing you need to know

Most Americans must have health insurance by March 31, 2014. A lot of people will keep getting it through work, but for everyone else, states will offer an "exchange" where people can purchase insurance from competing insurance companies.

Enrollment begins Oct. 1, and coverage begins Jan. 1.

How the exchanges will work

Plans will be grouped by tier -- platinum, gold, silver, and bronze. The average cost for a silver plan will be $328 per month, but the government will kick in subsidies for those in need.

How the subsidies will work

The federal government will provide subsidies to those who earn 400% of the federal poverty level -- $94,200 for a family of four, or $45,960 for a single person.

You will pay what you owe; the government will pay the insurer the subsidy directly.

Will costs go up or down? It depends

Policies are required to have more comprehensive coverage, including mental health and maternity care, and there could be more sick people covered because of Obamacare regulations. Those forces would push insurance rates higher.

But more healthy people will sign up and there will be more competition among insurers, elements that should help lower costs.

Sick and the elderly may pay less

Insurers can't penalize you for any underlying health problems (except your smoking habit), so you may save if you had been paying more because of a medical condition.

Your choice of a doctor may be limited

To compete, plans may limit you to one-third to one-half of the doctors and hospitals you might have today.

Who will pay a penalty

If you haven't bought insurance by March 31, 2014, a penalty might be added to your tax bill: the greater of $95 per adult or 1% of household income in 2014, climbing to $695 per adult or 2.5% of income by 2016.

But some people will be exempt: people who would have to pay more than 8% of their income for health insurance and poor adults who live in states that aren't expanding Medicaid.

How Medicare is affected

Anyone on Medicare can ignore the fuss.

Impact on work plans

Employers are pulling back on benefits and they are blaming Obamacare. But companies have been shifting more of the burden to workers for years.

Meanwhile, the exchanges could provide peace of mind those worried about losing their job. After a layoff, you can usually stay on your company plan for 18 months through COBRA, but that coverage is pricey because you usually have to pick up the entire tab of roughly $16,000 a year.

Impact on small businesses

Companies with 50-plus full-time employees must start offering them health insurance or face stiff penalties. The employer mandate had been set to kick in January 2014, but was pushed back a year.

A 30-hour work week counts as full-time under Obamacare, so some started cutting worker hours to avoid the mandate.

The new law's rules don't apply to the vast majority of small businesses. As of 2010, 97% of small businesses have fewer than 50 employees.

A huge majority of those with more than 50 employees already offer benefits. But they could still be affected if their insurance isn't good enough or sufficiently cheap under new Obamacare rules.

The Affordable Care Act aka Obamacare. The more you know.... CNN.com

Obamacare: Your guide to health insurance terms

By Jen Christensen, CNN

updated 10:44 AM EDT, Thu September 26, 2013

Many people don't know common Insurance terms. Patients' uncertainty about insurance language can cost them

STORY HIGHLIGHTS

• In a recent survey only 14% knew common insurance terms
• Only 11% could calculate the cost of a hospital stay given a hypothetical plan
• Not knowing what terms mean can be costly

(CNN) -- If you don't know what all those health insurance buzz-words like "co-pay" and "premium" mean, you're not alone. Most Americans probably don't understand all the basic health care terminology, which could be a serious disadvantage when choosing a plan during open enrollment.

A recent study in the Journal of Health Economics found only 14% of those polled could identify basic health insurance terms. Only 11% of those surveyed could calculate the price of a four-day hospital visit when given a hypothetical plan.

The people surveyed all had health insurance. Presumably they had some familiarity with the terms, or thought they understood their insurance.

Now imagine what could happen when the 48 million uninsured Americans -- many of whom have never had any experience with health insurance -- are confronted with having to choose a plan to meet the requirements of Obamacare next year.

"Insurance is fundamentally complicated," said George Loewenstein, a professor of economics and psychology at Carnegie Mellon University and a co-author of the study. "I have a Ph.D. in economics and I consult with insurance companies, but there are elements I can't understand, so it didn't surprise when I saw the average person struggle with these terms."

Not knowing these terms can be expensive.

Everything you need to know

"We know from other research that people make disastrously bad insurance choices because they don't understand this basic language," Loewenstein said. "I seriously hope people will ask for help and can find good advice on finding the plan that is right for them."

Here are some terms you may want to learn before you dive into a decision about your health insurance for next year. This information is compiled from the Health and Human Services and Employee Benefits Security Administration's guidance on terms.

Complete coverage: Health care in America

1. Deductible

The amount you owe before your health insurance benefits kick in. For example, if your deductible is $500, your insurance won't pay for anything until your costs are more than $500.

2. Co-pay

A co-payment, or co-pay, is the amount the insured person pays every time he or she receives a health service. For instance, if your co-pay to see a doctor is $25, you pay that amount each time you see him or her. The insurance takes care of the rest.

3. Co-insurance

Your part of the costs of a health service that is covered by insurance. It is calculated as a percentage and you pay it in addition to whatever deductible you may owe. For example if your plan allows $100 for a doctor visit and you've already met your deductible, your co-insurance payment of 20% would be $20. The insurance plan picks up the rest of the cost.

4. Out-of-pocket maximum

The most you pay during the period of your policy (most policies go for a year) before your insurance plan begins to pay 100% of the allowed amount. This total does not include your balance-billed charges, your premium, or the health care services your plan doesn't cover. Some plans don't count the out-of-network payments, co-insurance payments, co-payments, other expenses or deductibles toward this amount, so read the plan instructions carefully.

5. Premiums

The amount you must pay for your insurance plan.

6. Claim

The bill you or your doctor or health care provider submits to your health insurance company.

7. Allowed amount

This may also be called an "eligible expense" or "negotiated rate" or "payment allowance." It is the maximum amount on which payment is based for health care services that are covered by your insurance.

8. In- and out-of-network

An in-network provider is a health care office that has contracted with the health insurance company to provide services for people on that insurance plan. An out-of-network provider is someone who does not have such a relationship with the insurance company. Typically, insurance will only cover the cost of services from health care providers who are "in-network."

9. Essential health benefits

This is the set of health care services that must be covered by certain plans starting in 2014. There are 10 categories in which insurance plans must provide services and items: Maternity and newborn care, prescription drugs, rehabilitative services and devices, lab services, ambulatory patient services, emergency services, hospitalization, wellness and preventive services, chronic disease management, and pediatric services that include vision and oral care.

10. Preventive care

Routine health care that includes regular checkups, patient counseling and screenings to prevent disease, illness and other health complications.

Sense and Sensibility - The Guardian (www.theguardian.com)

John Kerry on Syria: how a gaffe could stop a war

There are practical issues, but John Kerry's suggestion that Syria turn over its chemical weapons could give all the key players what they need

• • Jonathan Freedland
  • theguardian.com, Tuesday 10 September 2013 04.44 EDT
  • Jump to comments (685)

'We don’t yet know if John Kerry’s (pictured) apparently unplanned comment has set in train a process that will ultimately prevent armed American action. But Barack Obama described it as a “possible breakthrough” and the relief can be felt across multiple world capitals.' Photograph: Alastair Grant/AP

Write a new chapter in the diplomatic handbook. Dedicate it to the off-the-cuff remark – the gaffe, even – which averts a war.

We don't yet know if John Kerry's apparently unplanned comment in London, suggesting Syria could avoid a US military strike by turning over its stash of chemical weapons, has set in train a process that will ultimately prevent armed American action. But Barack Obama described it as a "possible breakthrough" and the relief can be felt across multiple world capitals.

Of course the practical problems are legion – one report claims that getting rid of Syria's chemical weapons stockpile could take not weeks or months but "years". Nevertheless, this latest initiative deserves to be taken seriously because it gives all the key players something they need. Crucially, it would allow the antagonists to step back from the brink without losing face.

For Bashar al-Assad, the prize is obvious. If he agrees to banjax the banned weapons, to use the vocabulary of the Northern Ireland decommissioning process, he can dodge the US bullet that was perhaps coming his way. Even with Kerry promising on Monday that any attack would be "unbelievably small", Assad would still prefer to avoid an American attack if he can.

For Russia, whose foreign minister, Sergei Lavrov, seized on Kerry's rhetorical flourish and turned it into an initiative, there is a double benefit. First, Vladimir Putin gets to pose as the global statesman who stayed the hand of the mighty American hyperpower. Second, Russia has its own reasons for wanting to see Syria's toxic arsenal put beyond use. Moscow has long worried about such weaponry falling into opposition jihadist hands should Assad fall. Spiriting it out of Syria dampens that danger. (Tehran is said to support the latest Russian plan for similar reasons.)

Above all, though, the scheme is a life-raft for an American president who looked to be drowning. All the signs from Congress suggested Obama was heading for defeat, at least in the House, in his quest for approval for military action. Even if he had got it, there is no denying that Obama had long been reluctant to intervene in Syria's civil war by force – for the admirable reason that he could see all the same perils pointed out by his opponents.

Indeed, he only threatened military strikes because he could see no other way both to stay true to the declaration he himself had made a year ago – that the use of chemical weapons would by a "red line" – and to enforce the long-established "norm" against such arms. (It was on these grounds that some of us sympathised with his position.) The latest plan gives him that other way: if Assad gives up his chemical weapons, then Obama can argue that both his red line and the international prohibition were honoured.

Amid the current relief, two points are worth stressing. First, though hardcore anti-interventionists will not be keen to admit it, this breakthrough – if that's what it proves to be – only came about because of the threat of US force. It will be very hard to pretend that Assad would have agreed to such a move under any other circumstances; Russia did not propose it until it suspected American missiles were on the way. For all the opposition Obama's threatened action has generated at home and abroad, that fact surely deserves to be recognised.

Second, there is no reason this initiative should end with the decommissioning of chemical weapons. If the US and Russia can make this scheme work, why can't they work together not just to prevent killing by poison gas but on a diplomatic solution that will end all the killing in Syria? If Iran is, even tacitly, brought into the circle on this process, why not keep that country involved in the wider political negotiation that is surely the only way this conflict will ever end?

Out of a moment of extreme crisis has come an opportunity. Now it's up to all sides to seize it with both hands.

New School Astronauts rejoice - CNN.com

Virgin Galactic's SpaceShipTwo completes 2nd powered flight

By Matt Smith, CNN updated 12:17 AM EDT, Fri September 6, 2013 | Filed under: Innovations

STORY HIGHLIGHTS

• SpaceShipTwo broke the sound barrier during Thursday's test
• It's expected to start commercial service in 2014 at $200,000 a seat
• "All of the test objectives were successfully completed," Virgin Galactic says

(CNN) -- Billionaire Richard Branson's planned commercial spacecraft had a successful test flight Thursday, rocketing into the skies over California after being dropped from its carrier plane, his company announced.

Branson's Virgin Galactic said SpaceShipTwo broke the sound barrier, climbed from 42,000 feet to 69,000 feet over the Mojave Desert under rocket power and descended using its tilt-wing "feathering" maneuver. It's the second powered flight for SpaceShipTwo, which is designed to carry up to six passengers on what will be suborbital flights at first.

"In addition to achieving the highest altitude and greatest speed to date, the test flight demonstrated the vehicle's full technical mission profile in a single flight for the first time ... All of the test objectives were successfully completed," the company said.

In a video showing highlights of Thursday's test flight, Branson said Virgin Galactic plans to start taking passengers aloft in 2014 -- a slight delay from the December 2013 marker he set down at Britain's Farnborough International Airshow in June

"Virgin Galactic is now gearing up for the commercial service, finalizing cabin interiors, flight suits, training programs and the multiple other details required to offer hundreds of aspiring astronauts a safe and awe-inspiring journey," he said.

More than 500 would-be astronauts, including actor Ashton Kutcher, have so far signed up for the two-hour, $200,000-a-seat flights. Virgin executives have said they expect to have 600 bookings in the first two years of service.

CNN's Joe Sutton contributed to this report.

Find a way: Diana Nyad - CNN.com

'Never, ever give up:' Diana Nyad completes historic Cuba-to-Florida swim

By Matt Sloane, Jason Hanna and Dana Ford, CNN

updated 8:23 AM EDT, Tue September 3, 2013

STORY HIGHLIGHTS

• Diana Nyad sits down with CNN Chief Medical Correspondent Dr. Sanjay Gupta
• "You are never too old to chase your dreams," she says after 53-hour swim
• Nyad becomes first person to swim from Cuba to Florida without shark cage
• This was Nyad's fifth and final attempt to make 103-mile swim

Key West, Florida (CNN) -- "Find a way."

That's the mantra Diana Nyad said she had this year. And that's exactly what she did.

On Monday, Nyad became the first person to swim from Cuba to Florida without a protective cage, willing her way to a Key West beach just before 2 p.m. ET, nearly 53 hours after jumping into the ocean in Havana for her fifth try in 35 years.

Shortly after conquering the Straits of Florida, the 64-year-old endurance swimmer sat down with CNN Chief Medical Correspondent Dr. Sanjay Gupta.

"It's all authentic. It's a great story. You have a dream 35 years ago -- doesn't come to fruition, but you move on with life. But it's somewhere back there. Then you turn 60, and your mom just dies, and you're looking for something. And the dream comes waking out of your imagination," Nyad said.

The swim wasn't easy.

"With all the experience I have, especially in this ocean, I never knew I would suffer the way I did," she said. "For 49 hours the wind just blew like heck, and it was rough."

At one point, she was vomiting because she had so much salt water in her system and was shivering. She sang lullabies to help her relax.

"It was really rough that first day, Saturday, after the start and I just said: 'Forget about the surface up. Get your hands in somehow, and with your left hand, say, push Cuba back, and push Florida towards you,'" Nyad said.

Through it all, she held her mantra close: "You don't like it. It's not doing well. Find a way."

'You are never too old'

Dozens of onlookers -- some in kayaks and boats, many others wading in the water or standing on shore -- gathered to cheer Nyad on as she finished the more than 100-mile swim.

She pumped her fist as she walked onto the beach toward an awaiting medic before being guided to an ambulance.

"I got three messages," an exhausted and happy Nyad told reporters. Her face was sunburned and swollen.

"One is we should never, ever give up. Two is you never are too old to chase your dreams. Three is it looks like a solitary sport, but it's a team," she said.

The swim was a long-awaited triumph for Nyad, who was making her fifth attempt since 1978 and her fourth since turning 60.

The first four tries were marked by gut-wrenching setbacks; if the rough, strength-sapping seas didn't force her to quit, an hours-long asthma attack or paralyzing and excruciating jellyfish stings did.

But for this swim, besides donning a suit meant to protect her against her jellyfish nemesis, she wore a special mask to prevent jellyfish stings to her tongue, a key factor in her failed attempt last year.

Nyad, who was 29 when she first tried the swim, said last week that she wanted to show that "you can dream at any age."

"This time, I am 64. So, the years of my life are shorter to the end," she said at a news conference in Havana on Friday. "So this time I am, all the way across ... going to think about all those life lessons that came up during the swim."

Fatigue almost seemed poised to derail her again early Monday.

About 7:30 a.m. ET, she was slurring her speech because of a swollen tongue and lips, her support team reported on its website.

As the team called her around dawn for her first feeding since midnight, she took longer than normal to reach the support boat, the report said.

Divers swam ahead of her, collecting jellyfish and moving them out of Nyad's path.

Swimmer's challenge: Cross 103 miles of shark-infested water

When instructed Monday morning to follow the path that's been cleared for her, she flashed her sense of humor, replying, "I've never been able to follow it in my life," according to the website.

'Tell me what your dreams are'

Nyad's home stretch followed an overnight in which she became so cold, the team didn't stop her for feeding until first light "in the hopes that swimming would keep her warm," the website said.

Every stroke she swam put her deeper into record territory. On Sunday night, she broke Penny Palfrey's record for the farthest anyone has managed on the trek without a shark cage.

In 1997, Australian Susie Maroney completed the swim from within a shark cage. She was 22 at the time.

Nyad set out from Havana at 8:59 a.m. Saturday with a crew of 35, including divers to watch for sharks.

In her first attempt to cross the Straits of Florida in 1978, rough seas left her battered, delirious and less than halfway toward her goal.

She tried again twice in 2011, but her efforts ended after an 11-hour asthma attack and jellyfish stings.

Last year, she abandoned an attempt about halfway through after severe jellyfish stings and a lightning storm put her in danger.

Nyad was a swimming sensation before these attempts. In the 1970s, she won multiple swimming marathons and was one of the first women to swim around the island of Manhattan.

She was 8 years old when she first dreamed about swimming across the Straits of Florida. At the time, Nyad was in Cuba on a trip from her home in Florida in the 1950s, before Fidel Castro led a Communist takeover in Cuba and the country's relations with the United States soured.

The Los Angeles woman had said this was going to be her final attempt.

"I decided, this one no matter what happened, I don't want that experience again -- like right now, tonight -- talking to you about the journey is worth everything. It is. But I didn't want to be here packing up again," Nyad told CNN's Gupta.

She demurred when he described her as a hero but said she hopes she can serve as some sort of inspiration.

"I think that a lot of people in our country have gotten depressed, pinned in, pinned down with living lives they don't want," Nyad said.

She continued: "I do write all the time about -- you tell me what your dreams are. What are you chasing? It's not impossible. Name it."

14-year-old swims solo across Lake Ontario

CNN's Patrick Oppmann from Havana, Cuba, and John Zarrella and David Simpson contributed to this report.

Like you really needed a reason - CNN.com

6 ways getting horizontal makes you healthy

By Valerie Reiss, upwave.com

updated 7:05 AM EDT, Tue September 3, 2013

Sex improves sleep, happiness, Kegel strength -- just about anything you can think of

STORY HIGHLIGHTS

• Healthy sex life could help you look years younger down the road
• Anthropologist found that regular sex improves problem-solving skills, fosters creativity
• If you don't have much of a libido, it can mean there's a problem
• Erectile dysfunction is clearly linked to poor cardiovascular health, studies show

Editor's note: upwave is Turner Broadcasting's new lifestyle brand designed to entertain the health into you! Visit upwave.com for more information and follow upwave on Twitter, Facebook, YouTube,Pinterest and Instagram @upwaveofficial.

(upwave.com) -- We all know sex feels good, but does it also do our health good? The answer is a big, loud, bed-shaking, "Yeah, baby!"

"Your sexual health is a reflection of your overall health," says Ian Kerner, a New York City-based sex counselor and author of "She Comes First."

Researchers delving into the science of sex have found that getting down does everything from improve self-esteem to lower the risk of certain diseases. Conversely, if you don't have much of a libido, it can mean there's a problem.

"If you're not feeling sexual, that's usually an indication that something else is going on in your life," says Kerner. "You could be depressed, out of shape, you might not be eating right, you might be stressed out."

Identifying and addressing those issues is essential, says Kerner, because our sexual experience ripples into virtually every aspect of our lives.

upwave: How much sex is considered exercise?

Sexual activity offers some of these off-the-charts benefits, not available in pill form:

It might help your heart

Yep, a strong erection equals a strong heart. According to a 2008 study published in the Journal of the American College of Cardiology, erectile dysfunction (ED) is clearly linked to poor cardiovascular health.

Researchers studied 2,300 men and found that subjects with ED had a 58% higher risk of coronary heart disease. Though there are other causes of ED, if you find your... um, "friend" flagging, guys, get to your doc posthaste and you could potentially save your heart.

upwave: Does skipping sex improve sports performance?

It may decrease your risk of prostate cancer

A 2004 study published in the Journal of the American Medical Association found that of 29,000 male subjects, those who had 21 ejaculations a month (whether with a partner or, um, alone) were significantly less likely to get prostate cancer later in life than those who had only four to seven a month.

It can help your job

Anthropologist Helen Fisher found that regular sex improves problem-solving skills, heightens creativity and fosters better cooperation (among other things) by releasing dopamine and oxytocin -- aka the happy-making chemicals in the brain.

upwave: Health benefits of kissing

It makes you look younger

That afterglow is no illusion: One study out of Scotland kept tabs on 3,500 European and American women and men who looked young for their age (seven to 12 years younger than they actually were). After tracking these lucky people for 10 years, researchers found that the No. 1 factor they had in common was regular exercise.

The number-two factor? Yep: a healthy, active sex life. In fact, most of the study participants had sex two to three times a week, all in the context of a committed relationship.

(Word to your mother -- and anyone else in the "sex should be meaningful" camp: Casual sex had no such beauty correlation.)

upwave: Is faking an orgasm good for my sex life?

It eases stress

Right before orgasm, women often go into "a trance-like state," says Kerner, activating parts of the brain that greatly help with stress-relief. That's why he recommends regularly indulging in "comfort sex," the kind of nookie that happens in the same place, at the same time, using the same position.

It may not be enthralling, but it can help women quickly go into a deeply relaxed state.

It wakes up the brain

Just as important as comfort sex, says Kerner, are regular doses of the kind of sex that stimulates the imagination with fantasy and excitement.

"Sexual arousal is a combination of physiological and psychological arousal," Kerner says. "We often lose the mental component that's all about stimulating the imagination and the mind."

He also emphasizes the benefits of corralling all the "sensual pathways to sex -- sight, sound, touch, taste, smell."

So he encourages not only regular sex -- once a week, at least -- but also a sex life that includes it all: comfort, adventure and all the senses.

upwave: No more BUTS! Foreplay

The pro-sex studies seem practically endless: Sex improves sleep,happiness, Kegel strength -- just about anything you can think of. So if you're in a sexual rut, do what you need to do to get out of it.

"Walk around for half an hour and [view] the world as a sexual being," suggests Kerner. "Appreciate sexy people, smells, all of it."

If you haven't been feeling sexual lately, figure out why. See your doc if you suspect the cause might be medical. Otherwise, address it by going to the gym, getting a new outfit, whatever.

"When they start having healthy, connected sex, it's amazing how people's lives brighten up," says Kerner. "They become inspired to lose weight and take care of themselves, they feel loved, more satisfied, and they're less likely to be distracted by workplace irritations.

"Having a healthy sex life contributes to your health in so many ways."

This article was originally published on upwave.com

© 2013 upwave, All Rights Reserved.

Domestic Manufacturing Improves - www.theguardian.com

US manufacturing expands at fastest rate since July 2011

Institute of Supply Management poll better than forecast, although concerns remain over Fed's quantitative easing plans

• Dominic Rushe in New York

Transportation was one of the industries that reported growth in August. Photo: Andy Clark/ Reuters

US manufacturing expanded in August at the fastest pace since June 2011, according to a closely watched poll of the sector.

Economic activity in the manufacturing sector expanded for the third consecutive month, according to the Institute of Supply Management (ISM). The ISM poll of purchasing managers rose to 55.7% from 55.4% in July – readings above 50% indicate growth in the manufacturing sector.

The poll was better than forecast and comes before the latest monthly job figures are released by the Labor Department on Friday. Of the 18 manufacturing industries measured by the ISM, 15 reported growth – including textile mills, food and beverage, computer and electronic products and transportation equipment. Only one industry, miscellaneous manufacturing, reported contraction in August.

However, respondents to the survey remained cautious, one calling improvements "slight" in a remark quoted by ISM. "Tight government spending still affecting business," reported one transportation equipment executive. "Military slowdown affecting business," said a computer and electronics executive.

The ISM report comes amid concerns about the Federal Reserve's plans to pull back on quantitative easing, its $85bn-a-month bond-buying programme aimed at encouraging investment.

"Following any economic report these days, all roads lead to the effect, or lack thereof, on Fed asset purchases. So in that regard, today's report does nothing to dissuade the Fed from pulling back on purchases. As for the broader economic impact, today's report is entirely consistent with the moderate expansion we've been experiencing," Dan Greenhaus, chief global strategist at broker BTIG, wrote in a note to investors.

The next big test of the strength of the US economy comes on Friday, with the release of the latest non-farm payroll report. US employers slowed the pace of hiring in July, adding 162,000 new jobs – down from 188,000 in June. But the unemployment rate continued to fall, reaching 7.4%, its lowest level in more than four years.