Wildland firefighters win federal health benefits

DENVER (AP) — President Barack Obama will make federal health insurance available to about 8,000 temporary wildland firefighters, a White House official said Tuesday.

Despite the grueling and dangerous work they do, the 8,000 firefighters aren't covered by federal health insurance because they are temporary seasonal employees. Under federal personnel rules, such employees can't buy into federal health insurance plans.

The White House official said firefighters will get access to federal insurance plans this month. The official spoke on condition of anonymity because Obama's decision hasn't been formally announced.

Temporary seasonal firefighters make up more than half of the 15,000 wildland firefighters on the federal payroll this busy wildfire season.

Obama's decision was first reported by The Denver Post and came after stories by The Post, The Associated Press and others about the firefighters' dilemma. Obama also spoke with some firefighters during a June 29 visit to the scene of a wildfire outside Colorado Springs.

Members of a South Dakota-based hotshot crew who fought massive wildfires in Colorado and other states this year launched a petition drive seeking health benefits, largely out of anger over a colleague who was left with a $70,000 hospital bill after his son was born prematurely.

Their petition quickly gathered more than 125,000 signatures, bolstered by this year's historic fire season in the West and the ongoing national debate over health care.

"That's amazing. Wow," said Constance Van Kley, wife of firefighter Nathan Ochs, when she was told of Obama's decision. The couple had no health insurance when their son, Rudy, was born seven weeks premature in 2008.

The hospital forgave most of their $70,000 bill, but it was their experience that spurred Ochs, John Lauer and other firefighters to start their petition drive.

"When we were talking about it in our kitchen 2½ months ago, John thought he'd be working on it for about a year and there was a 5 percent chance it would go anywhere at all," Van Kley said.

"It makes me feel really hopeful that you can look at a problem, see a problem, and get this kind of response in this amount of time," she said. "We feel really heartened to know that people care about the work that firefighters do."

Lauer said he was "awestruck" by the speed of the decision.

"It really is going to make a big difference in a lot of people's lives," he said.

Rep. Diana DeGette, D-Colo., introduced legislation Tuesday that would give the firefighters access to federal insurance benefits, but Obama's move apparently makes that unnecessary.

The White House official who confirmed Obama's decision said the president had ordered the Agriculture and Interior departments, which hire the bulk of federal firefighters, and the Office of Personnel Management to open the insurance plans to firefighters.

DeGette said she was elated by the decision.

"In recent weeks, this fight has clearly reminded all of us of what we owe to the people whose sacrifice and personal risk protect our homes, our families, and our communities," she said in a written statement.

Firefighters are covered by workers compensation if they're hurt on the job, but that doesn't cover offseason health problems or help their families.

The National Federation of Federal Employees, a labor union, estimates it would cost the federal government $17.5 million a year to pay its share of premiums for seasonal firefighters working for the Forest Service, which employs about 70 percent of federal firefighters. The rest work for the Bureau of Land Management, the Bureau of Indian Affairs and other agencies.

Since 2003, 157 people have died battling wildfires in the U.S., according to the International Association of Wildland Fire. Injury statistics were unavailable.

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Health Net Federal Services, Penn State and Red Cross Promote Behavioral Health Symposium for Physicians and ...

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Health Net Federal Services Sponsors National Veterans Wheelchair Games

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Ill. health centers get $6.5M in federal awards

CHICAGO (AP) — Eleven Illinois health centers were awarded grants Wednesday under the Affordable Care Act to extend care to more patients.

The Illinois grants total nearly $6.5 million and include awards to health centers in Chicago, Bloomington, East St. Louis, Galesburg and Springfield.

The Illinois grants are part of $128.6 million in grants in 41 states announced in Detroit on Wednesday by U.S. Health and Human Services Secretary Kathleen Sebelius. The grants will go to 219 health centers across the country, extending access to more than 1.25 million additional patients.

The money allows a Chicago health center, Centro de Salud Esperanza, to see more than 2,500 new patients and hire an OB-GYN, said Daniel Fulwiler, CEO of the center in southwest Chicago.

"It's a super exciting day for us," Fulwiler said. The Chicago clinic becomes a federally qualified health center with the award, which will allow the center to get OB-GYN malpractice insurance coverage through the government. The expense of malpractice insurance has prevented the center from hiring an OB-GYN in the past, Fulwiler said.

Health center officials said they are pleased the grants came ahead of the Supreme Court decision expected later this month on key aspects of the federal health care law that critics have labeled "Obamacare." The Supreme Court could overturn the entire law, among other possible outcomes, which might jeopardize future grant funding.

The Illinois health organizations awarded grants are:

VNA Health Care in Aurora, $489,195.

Chestnut Health Systems in Bloomington, $595,833.

Beloved Community Family Wellness Center in Chicago, $608,333.

Centro de Salud Esperanza in Chicago, $595,833.

Erie Family Health Center Inc. in Chicago, $975,000.

The Board of Trustees of the University of Illinois in Chicago, $483,003.

Southern Illinois Healthcare Foundation in East Saint Louis, $431,094.

Greater Elgin Family Care Centerin Elgin, $525,000.

Knox County Health Department in Galesburg, $595,833.

Community Nurse Health Association in La Grange, $602,460.

Board of Trustees of Southern Illinois University in Springfield, $595,833.

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Health Net Federal Services Launches Veteran and Military Spouse Employment Initiative

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$21M in federal grants for 5 Kansas health centers

KANSAS CITY, Mo. (AP) — Five community health centers in Kansas will receive about $21 million in federal grants for expansion projects, the U.S. Department of Health and Human Services said Tuesday.

The grants are from the Affordable Care Act, which provides about $9.5 billion to expand services over five years and $1.5 billion to support construction and renovation projects at community health centers, the department said in a release.

The number of patients being served by community health centers is expected to grow by about 1.3 million patients nationwide during the next two years, the department said.

"For many Americans, community health centers are the major source of care that ranges from prevention to treatment of chronic diseases," Secretary Kathleen Sebelius said in the release.

The grants nationwide are from two capital programs for community health centers. One program provides about $629 million to 171 health centers for longer-term projects to expand their facilities. The second group of awards provides about $99 million to 227 health centers to take care of more urgent facility and equipment needs.

The Kansas centers receiving money for long term expansion plans are Prairiestar Health Center in Hutchinson, which will get $5 million; Community Health Center of Southeast Kansas, $4.7 million; the Hunter Health Clinic in Wichita, $4.6 million; Konza Prairie Community Health Center in Junction City, $4.5 million; and the Salina Health Education Foundation, which will receive about $2.7 million.

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Court could dent US federal power in health case

A rejection of President Barack Obama's health reform would mark a rare rebuke by a conservative Supreme Court eager to limit the powers of the US federal government, analysts say.

The stakes are high, a "wrecking operation," according to Justice Ruth Bader Ginsburg, who noted that "the more conservative approach would be salvage rather than throwing out everything."

After three days of historic debates in the highest court in the land this week, the conservative justices who hold a narrow 5-4 majority seemed inclined to relegate the Democratic president's signature reform to the scrap heap of history.

A decision from the nine justices is due in June. But, in light of their exchanges, the conservatives appeared set to rule as unconstitutional the law's linchpin requirement mandating that nearly every American must be insured.

The remainder of the reform, all 2,700 pages of it, could also go down with it -- greater medical coverage for the poorest, insurance for all Americans regardless of health condition and insurance for 32 million Americans who lack coverage.

But a decision to strike down the Affordable Health Care for America Act would be "even more radical" than the court's 5-4 split decision in the 2010 Citizens United case that paved the way for unlimited corporate funding of election campaigns, said Thomas Mann of The Brookings Institution.

"The prospect is so breathtaking in its audacity that it may lead (Chief Justice John) Roberts to pull back and write a narrow decision upholding the law," Mann told AFP, adding that a repeal of the reform would "call into question much of what the federal government does routinely."

The fate of the law may rest in the hands of Justice Anthony Kennedy, who plays the role of swing vote in many major Supreme Court cases.

"Now the big question is: will the court go backward, would it rule three-quarters of a century of jurisprudence and go back to the pre-New Deal era" of economic programs in the 1930s, asked American University historian Allan Lichtman.

The court would then replicate the profoundly ideological maneuver of a conservative court under president Franklin Roosevelt in 1935, when it nullified the National Industrial Recovery Act intended to help stimulate economic recovery through a public works program.

In 1936, the Supreme Court also declared a farming subsidy law known as the Agricultural Adjustment Act unconstitutional.

"I think there are number of justices that would like to go back to the 20s when the Supreme Court rigidly held the federal government," Lichtman said.

He said a repeal of so-called Obamacare "would be a signal that this court is interested in turning back the New Deal revolution in constitutional interpretation and much more rigidly control what the federal government can do, in regulation and in welfare."

For lawyer Simon Lazarus of the National Senior Citizens Law Center, "these five conservative justices have to decide clearly if they want to go back to that kind of a cliff."

Kennedy will probably see his decision followed by Roberts, the conservative chief justice who is seeking a true majority on the key ruling.

"Roberts and Kennedy seemed to be aware of the enormity of taking such a political step," Lazarus said, who has backed the Obama administration on the health reform.

Constitutional law expert Elizabeth Papez, a litigation partner at Winston & Strawn, noted that "if they strike the whole law, they would affirm very clear limits on the federal government's commerce power."

Critics have charged that the so-called individual mandate of the law is a violation of the US Constitution's Commerce Clause, which gives Congress the power to regulate interstate commerce.

"It was a very, very, very partisan bill that has created a partisan controversy in the US," said Randy Barnett, professor at Georgetown Law and lawyer for the National Federation of Independent Business, a plaintiff in the case.

He said the text was passed by a "solely party vote" in Congress when Obama's fellow Democrats held a majority in both chambers.

Conservative Justice Antonin Scalia admitted during the hearings that the 26 states suing the federal government have Republican governors.

"It came as a Republican proposal to cover the uninsured," recalled George Washington University law professor Jonathan Siegel.

"Now it's embraced by a Democrat president, the Republicans have turned against it. That's just politics; the Supreme Court is supposed to be above that kind of thing."

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Health program losing federal funds, clinics

FORT WORTH, Texas (AP) — Delia Henry was tired but had no idea her blood sugar was high when she went to Planned Parenthood for her annual gynecological exam. The clinic referred her to a doctor, who diagnosed her with diabetes.

The 31-year-old nursing student said she would have skipped the exam since she has no insurance, but she had just signed up for Texas' Women's Health Program, which provides cancer screenings, contraceptives and basic health care to about 130,000 low-income women through Medicaid.

But under a state law taking effect Wednesday, Henry and other eligible women won't be able to get care at Planned Parenthood clinics — which treat about 44 percent of the program's patients — or other facilities with ties to abortion providers, meaning those women will have to find new health-care providers.

The $40 million program is at the center of a faceoff between conservative Republican lawmakers and the federal government, which provides 90 percent of the program's funding. Although Texas already forbids taxpayer money from going to organizations that provide abortions, the law will cut off clinics with any affiliation to a provider, even if it's just a shared name, employee or board member.

"The program is vital. But now when women call another clinic and are told they have to wait to get an appointment, it will deter them from going and will be detrimental to their health," said Henry, of Austin, who credits the program with saving her life. "It infuriates me what the lawmakers are doing. You have to question: Do they really care?"

The nonpartisan Center for Public Policy Priorities, which works to alleviate poverty, said poor women would have difficulty finding new doctors who participate in the program. Doctors and clinics must be qualified Medicaid providers and enrolled in organizations that manage the program.

Plus, more than a dozen facilities that provided health care to poor women recently closed because of budget cuts. Lawmakers last year slashed state funding for women's health and family planning programs by $73.6 million, cutting services to 160,000 women. They also took $10 million out of a another family planning budget line and shifted responsibility for providing those services onto the managed care organizations that administer Medicaid in Texas.

That means clinics run by local hospitals have already seen an increase in patients. Those health clinics, including nine run by Parkland Hospital in Dallas, expect to be even more crowded after next week.

"As more clinics close, more patients come to Parkland requesting services," said Paula Turicchi, the hospital's senior vice president for women and infants specialty health. "And we will have to weigh what services we can continue to provide."

Gov. Rick Perry pledged last week to find state money to keep the program afloat, but he hasn't offered specifics. U.S. Health and Human Services Secretary Kathleen Sebelius said Friday that the federal funding would be phased out this year because the Texas law violates federal Medicaid regulations requiring that women be allowed to choose a qualified health-care provider. Perry disputes that claim, saying Medicaid rules give states the right to determine which clinics are qualified.

His administration said it would go into a deeper deficit to keep the program running. But that doesn't prevent the law from creating at least a temporary shortage of health-care clinics.

"No one should think this solution is adequate," the Center for Public Policy Priorities said of the governor's plan.

Texas is among several states where Republican-controlled legislatures have voted to cut off Planned Parenthood's funding. Wisconsin has withheld funding for family planning and breast cancer screenings. Lawmakers in Indiana and Kansas voted to bar Planned Parenthood from receiving Medicaid or other federal funding, but judges blocked the laws. North Carolina's Legislature voted to withhold state and federal money for non-abortion services, such as contraception and teen pregnancy programs, but a judge blocked that law, too.

In Texas, supporters of the law taking effect Wednesday argue that it will keep taxpayer money out of organizations that support abortion, which they believe should be banned in the state.

Planned Parenthood issued a statement saying that if Perry had found state funding to support women's health, he should "immediately restore the $73 million for breast and cervical cancer screenings, HIV tests, birth control and health screenings that was eliminated." The organization kicked off a "Don't Mess with Texas Women" bus tour last week to raise awareness and has not said if it is considering a lawsuit to block the Texas law.

Patients caught in the middle are clearly frustrated.

Alexis Lohse, 31, of Fort Worth, said she lost her health insurance when she quit her job to return to college and was about to enroll in the Women's Health Program before hearing about the impending loss of federal funds.

"I'm working hard every day raising two kids and taking classes at night while my husband works two part-time jobs ... and (our financial situation) is a balancing act," she said. "It's frustrating that my choices are being limited."

___

Associated Press writer Chris Tomlinson in Austin contributed to this report.

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Gerard Anderson: Health Care Spending Compared to Defense Budget and Federal Budget Deficit

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Lesbian federal worker wins health benefits case

SAN FRANCISCO (AP) — The government cannot deny health benefits to the wife of a lesbian court employee by relying on the 1996 law that bars government recognition of same-sex unions, a federal judge has ruled.

In Wednesday's ruling, U.S. District Judge Jeffrey White said the government's refusal to furnish health insurance to Karen Golinski's wife is unjustified because the Defense of Marriage Act unconstitutionally discriminates against same-sex married couples.

Golinski, a staff lawyer for the 9th U.S. Circuit Court of Appeals, has been trying to secure spousal benefits for her wife, Amy Cunninghis, since shortly after the couple got married during the brief window in 2008 when same-sex marriages were legal in California. Her boss, Chief Judge Alex Kozinski, approved her request, but the Office of Personnel Management ordered Golinski's insurer not to process her application.

After Golinski sued, the Department of Justice originally opposed her in court but changed course last year after President Barack Obama and Attorney General Eric Holder said they would no longer defend the Defense of Marriage Act.

"The Court finds that DOMA, as applied to Ms. Golinski, violates her right to equal protection of the law ... by, without substantial justification or rational basis, refusing to recognize her lawful marriage to prevent provision of health insurance coverage to her spouse," White wrote in a 43-page decision that marks the third time in less than two years a federal court has declared the act unconstitutional.

When White heard the case in December, the head of the Justice Department's civil division, Tony West, joined her lawyers from the gay rights legal group Lambda Legal in arguing on Golinski's behalf, leaving the job of defending DOMA to a lawyer hired by a House of Representatives group. The lawyers representing the Bipartisan Legal Advisory Group convened by House Speaker John Boehner did not immediately respond to an email to their offices sent after business hours Wednesday.

Former speaker and Minority Leader Nancy Pelosi issued a statement saying White's ruling demonstrated "that the House is not united in this case, that the BLAG lawyers do not speak for Congress, and that BLAG's intervention remains a waste of taxpayer resources."

Wednesday's ruling is the latest in an unbroken string of judicial setbacks for the Defense of Marriage Act, which Congress approved when states first started considering allowing gay and lesbian couples to get married. The law defines marriage as a union between a man and woman, and prohibits the government from granting benefits such as Social Security and Medicaid to same-sex couples.

A federal judge in Massachusetts, where same-sex marriage has been legal since 2004, ruled in July 2010 that the law is unconstitutional because it interferes with the right of a state to define the institution. A year later, 20 of the 24 bankruptcy judges based in Los Angeles ruled that the act violated the civil rights of a married gay couple who were denied the right to file a shared bankruptcy plan.

Last week, the Obama administration said it was extending its decision to stop defending the law to issues affecting actively serving military personnel and veterans in same-sex relationships.

In ordering the government to allow Golinski to enroll her wife in a family health plan, White rejected all of the arguments the House group advanced in defense of DOMA, such as that it was necessary to foster stable unions among men and women, and for Congress to act slowly on an issue on which the public remains divided.

White's decision "acknowledges that DOMA violates the Constitution and that my marriage to Amy is equal to those marriages of my heterosexual colleagues," Golinski said. "This decision is a huge step toward equality."

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Health Insurers in Arizona Face Federal Scrutiny

Health insurance companies in Arizona are facing scrutiny from Washington as federal authorities have taken over reviews of rate increases of 10 percent or more from the state.

The Arizona Republic reported that federal regulators have called one company’s most recent rate increase unreasonable and vowed thorough reviews of 32 other health-insurance plans that are pursuing double-digit rate increases.

On Sept. 1, the U.S. Department of Health and Human Services took over reviews of health-insurance rate increases of 10 percent or more from the Arizona Department of Insurance when the federal agency said Arizona was among the states that didn’t have regulations in place for effective rate review.

The federal government does not have the authority to reject or modify health-insurance rate increases in Arizona because state law does not allow such oversight.

But consumers might see some rate relief under the new federal health care law. The Affordable Care Act requires that 80 to 85 percent of revenue collected by insurance companies be spent on medical care instead of administrative costs and profit. Insurers that don’t meet that ratio must issue rebates to customers beginning later this year.

Still, some observers question whether the federal law ultimately will result in long-term rate relief for Arizona consumers.

Federal authorities said last week that Trustmark Life Insurance Co.’s plan to raise health-insurance rates on Arizona consumers by 13 percent is unreasonable and called on the company to rescind, refund or justify the rate increase.

The federal agency has started similar reviews and posted detailed rate information on 32 other health-insurance plans that will raise rates from 14 to 44 percent this year for thousands of Arizona consumers.

Trustmark representatives disputed the conclusions from the federal agency. It said its rates are driven by rising costs and increased use of medical care. The company added that because it is a smaller insurer, the amount of money it spends on medical care can swing widely from year to year.

The company said it will maintain compliance with the nation’s new health care law.

The federal oversight of Arizona’s health-insurance industry has generated a backlash among insurers.

Insurance companies have urged the Arizona Department of Insurance to beef up its rate review so that companies don’t have to submit paperwork to the federal government when they seek to increase rates.

Erin Klug, spokeswoman for the Arizona Department of Insurance, said insurers want to avoid sending duplicate paperwork to the federal government and the Arizona agency.

Under Arizona law, health insurers that sell policies to individuals still must submit paperwork to the Department of Insurance detailing proposed rate changes. Insurers that sell small-group policies only need to provide a certificate each year that indicates their filings comply with Arizona law.

Klug said her agency is using proceeds from a $1 million federal grant to investigate how the state can improve its rate-review process to pass muster with the new federal requirements. The Department of Insurance expects to submit proposed changes to the Governor’s Regulatory Review Council.

Copyright 2012 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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