UPDATE


KHN On Call: Answers To Questions On Tax Credits, Penalties And Age Ratings

Published: Monday, March 20, 2017 @ 2:36 PM

For years, Republicans in Congress have promised to repeal and replace the Affordable Care Act, claiming that its requirement for nearly everyone to buy insurance or pay a fine is burdensome and costly, and that it doesn’t give people enough flexibility to get the coverage they need.

Now that they’re in charge, the bill they’ve released as an alternative (the American Health Care Act) would effectively eliminate the requirement to buy coverage and might open up more health care choices. It’s also under fire because it may cause millions of people to lose their coverage. According to the nonpartisan Congressional Budget Office, up to 24 million more people could be without insurance by 2026 if it passes.

So what are the differences between the ACA and the GOP alternative, and what does it all mean to you and your health care? We put some of your questions from our Twitter chat (#ACAchat) earlier this month to Alison Kodjak, NPR health policy correspondent, and Julie Rovner, chief Washington correspondent for Kaiser Health News.

Many questions came in about the elimination of the requirement to buy insurance, known as “the mandate,” and how the lack of one might affect the health insurance market.

Is the mandate in the GOP bill? It won’t work if people sign up only when they are sick.

.@sjp3121 I read mandate still there, just no fine. Is this accurate? #ACACHAT Won't work without mandate if only sign up when sick.

— ILPoliticalPug (@BarbinIL52) March 9, 2017

Kodjak: The mandate is technically still written into the law, but since no one will enforce it under this new bill, it’s unlikely to have any impact. In fact, the Internal Revenue Service has already issued some guidance that suggests it may not enforce the mandate very actively even now, before this bill becomes law. The result? People who think insurance is too expensive and don’t expect to need it are unlikely to sign up for a health plan.

Rovner: It’s true that the GOP bill technically preserves the mandate, but it eliminates the penalties. Instead, the bill would require those with a lapse in insurance of more than 63 days to pay an insurance premium that’s 30 percent higher for one year. Analysts say that could actually serve as a disincentive for healthy people to purchase insurance if they’ve had a break.

Can someone wait until they are sick to buy insurance, knowing that they would have to pay a 30 percent fine?

Thanks for doing #ACAchat. Can someone wait till they are sick to get insurance under cont cov rule even if they pay 30% more?

— AtoZ (@InOneFortyRLess) March 9, 2017

Rovner: Not exactly. There will still be standardized open enrollment periods once a year, and you will only be able to buy insurance outside of those windows if you have a life change, like moving or losing a job. But if you’re willing to wait as long as 11 months, then, yes, you can wait and buy insurance after you get sick.

Kodjak: It’s not without risk. The Department of Health and Human Services has already proposed regulations that would reduce that open enrollment period to six weeks from the current three months. So a patient may incur some health care costs while awaiting the open enrollment, and then face the 30 percent penalty when they do buy a health plan. However, if the individual has a health issue where treatment can wait, then they certainly can enroll at the correct time and then seek medical care.

We also got a lot of questions about the GOP bill’s new tax credits to help people buy insurance, and how different they would be from the structure of purchasing help in the ACA.

Explain the difference between tax credits and subsidies, and will tax credits be distributed quarterly or at the end of the year?

@NPRHealth Please explain the difference between tax credits and subsidies. Will there be quarterly tax credits or just year end? #ACACHAT

— songbirder74 (@songbirder74) March 9, 2017

Kodjak: Both the ACA and the AHCA use advanceable, refundable tax credits. That means the government each month sends the tax credit amount to your insurance company.

We refer to the Obamacare financial assistance as a “subsidy” in part because the amount fluctuates and is based on your income — the idea is to limit your health costs to a specific percentage of your income. In addition, under the ACA, there are payments to insurers to help cover the copayments and deductibles of lower-income people.

Rovner: The tax credits differ in how large they are and how they are calculated. The ACA tax credits are based on income and how much insurance costs in a given area. The GOP credits, by contrast, are based primarily on age and do not vary according to the cost of insurance in an area, so in low-cost parts of the country they will go further than in very high-cost areas.

In addition, the ACA has a series of subsidies that help those with low incomes (under 250 percent of poverty; about $50,000 for a family of three) pay their deductibles and other out-of-pocket expenses in addition to the tax credits to help pay for premiums.

Why does the GOP bill provide age-based tax credits instead of income-based ones?

#ACAchat @NPRHealth what's the policy behind providing age-based tax credits as opposed to income-based?

— molliegel (@molliegel) March 9, 2017

Kodjak: The basis for age-based tax credits is that people who are younger tend to have fewer health costs, so insurance policies are likely to be lower-priced for them than for older people.

Republicans prefer the fixed credits in part because they are cheaper, and more predictable, than the income-based credits under the Affordable Care Act. That’s because those ACA credits rise as premiums rise, giving insurers little incentive to keep their premiums low. Republicans hope that by restraining the government’s financial help to patients, insurance companies will offer cheaper policies that better match the cost of the tax credits.

Rovner: Younger adults, on average, need less health care than older adults. The ACA limited the differential in premiums for older adults to three times more than the amount charged to younger adults. The GOP bill would change that so older adults could be charged five times more. The change would make insurance less expensive for younger people, likely enticing more of them to enroll, and lowering premiums for all, at least marginally, according to the Congressional Budget Office. But it would dramatically increase premiums for older adults, particularly those aged 55-64, just under the age to qualify for Medicare.

Which brings us to this question, which represents several we received about how the AHCA appears to disproportionately penalize people ages 55-64.

Do I face a penalty for waiting to buy health insurance until I’m eligible for Medicare in three years? I’m concerned that I’ll be stuck with an expensive plan.

@SabrinaCorlette If I'm 62 and I decide 5:1 health insurance is too expensive and I wait for Medicare, no penalty for me, right? #ACAchat

— Anne Paulson (@KrampusSnail) March 9, 2017

Kodjak: No 30 percent penalty if you wait for Medicare, but remember, if you get sick while you’re waiting, you could be in financial trouble.

Rovner: That is correct. Also, remember, if you fail to sign up for Medicare when you first become eligible at age 65, you would also pay a premium penalty. It’s 10 percent per year, forever.

Got more questions? We’ll keep answering them as the GOP bill moves through Congress. Send them to us via Twitter at #ACAchat or via email at KHNHelp@kff.org.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

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What is Earth Day? 5 things to know

Published: Sunday, April 22, 2018 @ 4:24 AM

WATCH: Origin of Earth Day

Sunday is Earth Day 2018, and more than one billion people across the globe are expected to celebrate with environmentally friendly events.

But what exactly is Earth Day? Here's what you need to know:

>> Read more trending news 

1. When did Earth Day start?

The first Earth Day celebration took place 48 years ago, in 1970, after a devastating oil spill in America brought environmental issues to the forefront of public consciousness. According to the Environmental Protection Agency, 22 million people across the country came out in support of environmental reform.

"That day left a permanent impact on the politics of America," Gaylord Nelson wrote in the April 1980 edition of the EPA Journal. "It forcibly thrust the issue of environmental quality and resources conservation into the political dialogue of the nation.

"It showed political and opinion leadership of the country that the people cared, that they were ready for political action, that the politicians had better get ready, too. In short, Earth Day launched the environmental decade with a bang."

Since then, celebrations have only grown. This year, organizers estimate more than one billion people in 192 countries will participate in events the world over. The day is celebrated each year on April 22.

>> Target’s Earth Day car seat recycling program offers 20 percent off new car seat, stroller

2. Is there a theme for Earth Day 2018?

This year, organizers are focusing on curbing plastic pollution.

"Our goals include ending single-use plastics, promoting alternatives to fossil fuel-based materials, promoting 100 percent recycling of plastics, corporate and government accountability and changing human behavior concerning plastics," the Earth Day Network, which partners with tens of thousands of organizations in 192 countries to organize Earth Day events, said on its website.

The organization also said it "will educate millions of people about the health and other risks associated with the use and disposal of plastics, including pollution of our oceans, water, and wildlife, and about the growing body of evidence that decomposing plastics are creating serious global problems."

Read more here.

>> Antarctica's ice retreating 5 times faster than normal, study reveals

3. How are people celebrating?

In Tokyo, thousands of people will attend beach cleanups, concerts, art exhibits, classes and other events coordinated by the Green Room Festival, according to the Earth Day Network. In India's Karnataka state, a "no plastic" event will feature workshops led by "organizations that are champions of environmental sustainability in fields including electric vehicles, solar power and zero-waste living," the network said. Cleanups also were scheduled in Palm Beach, Florida; New York; New Jersey and other locations across the United States and worldwide.

Read more here.

4. What are businesses doing?

Google marked Earth Day with a "video doodle" featuring primatologist Jane Goodall. 

>> Click here to watch

“It is so important in the world today that we feel hopeful and do our part to protect life on Earth," Goodall said. "I am hopeful that this Earth Day Google Doodle will live as a reminder for people across the globe that there is still so much in the world worth fighting for. So much that is beautiful, so many wonderful people working to reverse the harm, to help protect species and their environments. And there are so, so many young people, like those in JGI’s Roots & Shoots program, dedicated to making this a better world. With all of us working together, I am hopeful that it is not too late to turn things around, if we all do our part for this beautiful planet.”

Read more about the doodle here.

Apple also joined in on the celebrations, announcing on April 19 that "for every device received at Apple stores and apple.com through the Apple GiveBack program from now through April 30, the company will make a donation to the nonprofit Conservation International."

In addition, Apple "debuted Daisy, a robot that can more efficiently disassemble iPhone to recover valuable materials," according to a company press release.

“At Apple, we’re constantly working toward smart solutions to address climate change and conserve our planet’s precious resources,” Lisa Jackson, Apple’s vice president of environment, policy and social Initiatives, said in a statement. “In recognition of Earth Day, we are making it as simple as possible for our customers to recycle devices and do something good for the planet through Apple GiveBack. We’re also thrilled to introduce Daisy to the world, as she represents what’s possible when innovation and conservation meet.”

Read more here.

>> Tips for celebrating the 20th anniversary of Disney's Animal Kingdom

5. How can I get involved?

There are multiple ways to get into the Earth Day spirit, from participating in a local event to changing your bills from paper to paperless. Here are some suggestions from the Earth Day Network:
  • Urge your local elected officials or businesses to make a substantial tree planting commitment by starting a letter-writing campaign or online petition.

  • Lead a recycling drive to collect as much plastic, metal, and glass as possible.

  • Pick up trash at a local park or beach.

  • Set up a screening of an environmentally themed movie. Consider supplementing the screening with a speaker who can lead a Q&A following the film.

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Stray dog named Publix rescued, then adopted by his guardian angel

Published: Saturday, April 21, 2018 @ 11:45 AM

400778 02: A Publix Super Market is seen early February 8, 2002 in Norcross, GA. (Erik S. Lesser/Getty Images)
Erik S. Lesser/Getty Images
400778 02: A Publix Super Market is seen early February 8, 2002 in Norcross, GA. (Erik S. Lesser/Getty Images)(Erik S. Lesser/Getty Images)

A stray dog who lingered around a former Publix grocery store in metro Atlanta for a year has finally found a loving home. The story behind the adoption is heartwarming.

The animal shelter PAWS Atlanta posted Publix's story Friday on its Facebook page. Shelter staff said a woman came rushing to the office Thursday as it was closing, asking if they had Publix.

>> Read more trending news 

Publix was a dog that shelter staff and concerned residents had been trying to rescue for a year. In December, shelter staff were able to rescue the dog and house him at the shelter. The woman who visited the facility Thursday evening knew the dog well; she called him Buddy. She said the dog would visit her shop and she would feed him, and the two had developed a close bond. When the dog disappeared in December, she had feared the worst.


The woman was overjoyed to learn that PAWS Atlanta had Publix, after a friend alerted her when she saw the photo of the dog on the shelter's Instagram feed.

Shelter staff said Publix was thrilled to see the woman who had been so kind to him, and that they'd never seen Publix so happy or animated.

The woman decided to adopt Publix, making for the happiest of endings for all involved.

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When sports and games meet happy hour... Get to know Dayton Sportcial

Published: Thursday, September 10, 2015 @ 6:00 AM
Updated: Friday, April 20, 2018 @ 1:12 PM

Love playing sports, then unwinding at the bar and making new friends? Dayton Sportcial is the social sports league for you. Photo contributed by Dayton Sportcial.
Love playing sports, then unwinding at the bar and making new friends? Dayton Sportcial is the social sports league for you. Photo contributed by Dayton Sportcial.

From childhood playground games to picnic pastimes, Dayton Sportcial combines fun and recreation with camaraderie and community building.  

Sportcial — the brainchild of Raph Carranza and PJ Falter — organizes a variety of leagues, tournaments and special events in and near downtown Dayton.

>> 4 AWESOME adult sports leagues in Dayton to join this spring and summer

>> PHOTOS: Dayton Beer Olympics

Fifth Street Brewpub teamed up with Dayton Sportcial to host a local Beer Olympics on Sunday, February 25, in conjunction with the closing ceremony for the 2018 Olympic Winter Games in Pyeong Chang. TOM GILLIAM PHOTOGRAPHY(Tom Gilliam)

Leagues that are currently under way include:

• Kickball (Kettering Field)

• Cornhole (Dayton Beer Company)

• Volleyball (Lohrey Recreation Center)

Fifth Street Brewpub teamed up with Dayton Sportcial to host a local Beer Olympics on Sunday, February 25, in conjunction with the closing ceremony for the 2018 Olympic Winter Games in Pyeong Chang. TOM GILLIAM PHOTOGRAPHY(Tom Gilliam)

Leagues that are coming soon:

An eight-week skee-ball league gets under way at DK Effect on May 2 and a seven-week Wiffle ball league starts on May 16 at Bomberger Park. 

Sportcial organizes a variety of leagues, tournaments and special events in and near Downtown Dayton. CONTRIBUTED

How it got started

It all began in 2015 after Carranza and Falter played on a softball team together for the first time.  

“We started talking about playing in another league that was more social but, after asking around, we found out that a previous league had closed up shop,” Carranza said. “Having moved around a lot, we agreed that the easiest way to make friends was through fun games. We decided then that we should revive the idea.”  

Since its inception, more than 600 unique players – 1,500 total registrants – have participated in one or more of the many Sportcial leagues.  

“We find that a problem with a lot of adult leagues is competitiveness,” Falter said. “Don’t get me wrong, competition can be fun, but our primary goal is connecting people and building community. We find that by really focusing on sports that are not mainstream, people are put at ease, don’t fear embarrassment, and are more likely to let go and have fun.” 

>> 7 things to get excited about this Dayton Dragons season 

Sportcial organizes a variety of leagues, tournaments and special events in and near Downtown Dayton. CONTRIBUTED

How you win in Sportcial?

Carranza and Falter share how they gauge Sportcial’s success:  

How well did we connect people?

“We’ll see people who play or played on different teams having a drink or working together on a project around town. We have some very inspiring people that play in our leagues and they are doing great things in the community. Through our leagues and events, people have a low-pressure way of connecting and finding others who have similar motivations. Seeing the personal and professional relationships grow let’s us know we are succeeding – we just had our first engagement of two players that met in our league.”  

How well did we create community?

“Dayton is our home. All of our leagues and bars are downtown – that’s on purpose. Our players drive from Springfield to Springboro to play, and we want to showcase our city. We’ve had players tell us they didn’t particularly care about downtown, but now love coming downtown, and have even moved downtown. The city of Dayton is making some big strides, and we’re happy we can show off all the great things going on downtown.”  

How well did we build business?

“The success of the businesses we bring our party to is our success. We bring 100-plus people to a bar on a weeknight. One of our bars experiences a 167-percent increase in sales when we’re there. That is awesome, but an even more telling impact is seeing Sportcial shirts out on the town after our events and, even more so, them coming back to that bar when we aren’t there. We also spend our money locally. In addition to for-profits, we push the success of organizations that align with our mission. UpDayton, Generation Dayton, city of Dayton, and Brigid’s Path are some of the groups that we work with.”  

>> 5 reasons to get into the Dayton disc golf scene

Sportcial organizes a variety of leagues, tournaments and special events in and near Downtown Dayton. CONTRIBUTED

GIVE IT A TRY  

Upcoming Leagues  

May 2: Skee-ball  

May 16: Wiffle ball  

May 16: Sportcial Golf: Basics, Bogeys and Beers  

June 4: Industry League  

June 13: Cornhole: Recreational  J

une 14: Cornhole: Competitive  

June 14: Ultimate Frisbee: For Starters  

June 21: Kickball  

Sunday FunDays  

For those who want the fun with less commitment – one-day events that can fit into most people’s schedule that involve some sort of game that takes you outside of your comfort zone.  

April 22: Day at the Races  

May 20: Dayton Dragons Game  

June 10: Skydiving  

June 24: Ice cream bike ride  

July 22: River Float  

More info: WebsiteFacebook

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Why these ‘rowdy’ Dayton kids made a real ruckus in the Oregon District

Published: Friday, April 20, 2018 @ 2:32 PM

Stivers School for the Arts students took part in a New Orleans-style second line to raise awareness of DVAC’s 24th Annual Art Auction.
Photo: Amelia Robinson
Stivers School for the Arts students took part in a New Orleans-style second line to raise awareness of DVAC’s 24th Annual Art Auction.(Photo: Amelia Robinson)

Oregon District diners simply were not ready. 

A dozen or so rambunctious Dayton kids roamed up and down the district 

and in and out of its restaurants, bars and shops Thursday evening.

>> 10 reasons we love Fifth Street and the Oregon District, and why you should, too

The Stivers School for the Arts students swayed and stepped to the theme from the HBO show “Treme” that two classmates played on a trombone and a trumpet.   

The New Orleans-style second line of student artists was led by Eva Buttacavoli, the executive director of the Dayton Visual Arts Center.

>> Diverse cast of Dayton kids taking on Cinderella and her glass slipper this weekend

>> The region’s premiere arts event showcases the best Dayton has to offer

They carried some of the artwork included in DVAC’s 24th Annual Art Auction, which will take place at 6 p.m. Friday, April 27 at Ponitz Center, 741 W. Washington St., Dayton. 

Tickets for the event are $50 for DVAC members, $60 for nonmembers and $75 at the door. 

INFO & TICKETS: daytonvisualarts.org | 937-224-3822

We were with the students as they made a ruckus in the name of art in a handful of Fifth Street businesses that included  Bonnett’s Book Store; Blind Bob’s; Lucky’s Taproom, Goodwill, Lily’s Bistro and Corner Kitchen.

Buttacavoli gave away free tickets to surprised diners and shoppers along the way. 

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