Insurance Coverage Of Birth Control Is Uneven, Despite Obamacare Mandate

Health insurance coverage of contraceptives like hormonal implants, patches and vaginal rings remains inconsistent for American women, even though the Affordable Care Act requires no-cost access to birth control, according to a report published Thursday.

Women who seek contraceptives other than the pill may find that their insurers charge copayments, require prior approval from a doctor or simply don’t cover their preferred method, the Henry J. Kaiser Family Foundation and the Lewin Group discovered in a survey of 20 health insurance companies in five states.

The Obamacare birth control mandate, which promises access to FDA-approved contraceptives at no charge from the pharmacy or doctor’s office, is imperfect in practice, the survey shows. Although access to no-cost contraception has significantly increased since this part of the Affordable Care Act took effect in 2012, health insurance companies still restrict access to some forms of birth control. The survey also found that it’s difficult for many women to understand what their health plans cover, and to compare one plan to another when choosing what insurance to buy.

“For many women, the ACA’s contraceptive coverage provision has reduced their health care out-of-pocket costs and given them the opportunity to use more effective but more costly methods of contraception that had been unaffordable to them in the past,” the report says. “For some, however, their choice of plan may still result in limitations of their contraceptive options."

Insurance companies are interpreting the law and guidance from the Department of Health and Human Services in a number of different ways, the researchers conclude.

Although the Affordable Care Act requires health insurance companies to offer no-cost birth control, it doesn’t require them to cover every form of contraception, and it permits them to levy copayments and other charges to certain types, as they do with other medications and procedures. For example, a health insurance plan might cover generic oral contraceptives at no charge, but it might not do the same for all brand-name birth control drugs, or it might require a patient to obtain her pills via mail order.

A small and shrinking percentage of women remain enrolled in health plans still “grandfathered” from Obamacare rules, and some employers are allowed to deny contraception coverage for religious reasons.

The Kaiser/Lewin survey examined health insurance benefits for seven categories of female birth control, but it didn’t include oral contraceptives, the most popular form of pregnancy prevention in the U.S. among women who use birth control. The Kaiser Family Foundation and the Lewin Group studied insurance coverage of emergency contraception; hormonal implants; hormonal injections; hormonal patches; the intrauterine device, or IUD; vaginal rings; and sterilization. The unnamed insurers were located in California, Georgia, Michigan, New Jersey and Texas.

Birth Control: What’s Covered?

Note: "RMM" stands for "reasonable medication management" tools, which insurers use to control costs.
Source: Henry J. Kaiser Family Foundation

The NuvaRing, a brand-name vaginal ring that transmits hormones internally and has no generic version, was found to be the least likely method to be covered by insurance at no charge. Five of the insurers required cost-sharing and one didn’t cover NuvaRing at all, the survey found.

Insurers that limit access to methods like implants, injections, patches and rings justified their policies by noting that these forms of contraception deliver the same hormones as pills that are included in their benefits, regardless of the preferences of women and their doctors, according to the survey.

Navigating the various policies for coverage of those different forms of contraception isn’t easy for many women, the report notes. In fact, it wasn't even easy for the people conducting the survey.

“One of the cross-cutting findings of this analysis was how difficult it is to ascertain the limits on contraceptive coverage used by different carriers. The contraceptive coverage policies used by health insurance carriers were not easily accessible,” the report says. “This information is even more opaque in many of the plan materials available to policyholders.”

Furthermore, the survey revealed that health insurance companies don’t appear to have required systems in place for women to appeal and gain access to forms of contraception recommended by their physicians. The Affordable Care Act calls for insurers to provide a special system for contraception appeals that's separate from the one used for other cases.

Source: The Guttmacher Institute

Women who believe they have inappropriately been denied coverage for contraception can seek help. For those who get their insurance from an employer, a human resources professional may be able to explain the health plan's benefits and intervene with the insurer. Health insurers themselves can assist in some cases, such as when a pharmacy incorrectly charges a copayment. Additional information and guidance is available from organizations such as the National Women's Law Center and Planned Parenthood Action Fund.

CEO Slashes $1 Million Salary To Give Lowest-Paid Workers A Raise

Three weeks ago, Dan Price took a $930,000 pay cut.

Growing income inequality had been on his mind for months. But as he went for a hike with a friend one afternoon and listened to her describe her struggle with rising rent prices, he realized he had to do something for his own employees.

So Price, the founder and CEO of Gravity Payments in Seattle, decided to raise the minimum salary at his 120-person payment processing company to $70,000. At a company where the average pay was $48,000 per year, the move -- which was first reported by The New York Times on Monday -- affected 70 workers, 30 of whom saw their salaries double.

Most of the money for these raises will come from cutting Price's salary -- which is now $70,000 per year rather $1 million. The rest will come out of the $2.2 million the company expects to earn in profit this year.

“There’s greater inequality today than there’s been since the Great Recession,” Price told The Huffington Post on Tuesday. “I’d been thinking about this stuff and just thought, ‘It’s time. I can’t go another day without doing something about this.’”

The $70,000 figure is just below the $75,000 salary pegged in a 2010 Princeton University study as an ideal benchmark for achieving happiness. About 28 percent of Americans said they would feel successful earning at most $70,000 per year, according to a 2012 survey from the jobs site CareerBuilder.

The pay cut won’t affect Price's lifestyle much. He has saved a lot of the money he has earned since starting Gravity in 2004. He said he has no plans to replace his 12-year-old Audi, which has clocked more than 140,000 miles. And his new salary will still allow him to pick up the bar tab for his friends once a month, he said.

“There will be sacrifices,” said Price, 30. “But once the company’s profit is back to the $2.2 million level, my pay will go back. So that’s good motivation.”

In the U.S., the average CEO earns more than 350 times what the average worker does. Seattle has become a hotbed in the fight for higher wages as the city phases in a $15 minimum wage, one of the highest in the country. The city is also home to wealthy investor Nick Hanauer, a self-styled champion for higher pay who has warned his fellow billionaires that pitchfork-wielding mobs will follow them to their private jets if income inequality isn’t addressed.

Rather than see this as a charitable offer to his workers, Price sees the pay raises as an investment. In theory, workers motivated by higher salaries will ultimately attract more business and handle clients better.

“This is a capitalist solution to a social problem,” Price said. “I think it pays for itself, I really do.”

The Rich Live Longer Than The Rest Of Us

There's another way the rich are different from you and me: They live longer.

The more money you have, the healthier you are and the longer you live, according to a new study from the Urban Institute crunching data from the Centers for Disease Control.

The study divides Americans into five income groups and finds that each income group is healthier than the one below it and sicker than the one above it.

And that outcome is remarkably consistent. Bloomberg's John Tozzi points out that in almost every category of ailment, from heart disease to arthritis to kidney disease to strokes, prevalence drops almost in lock step as income rises.

The same phenomenon is true, the CDC finds, for life expectancy. This chart shows just how steps up in income lead to longer lives.

There are dozens of reasons why every bit of extra wealth and income improves health and lifespan. Access to better health care is only the most obvious. Richer people also benefit from better living conditions generally, the study's authors note.

The poor are also far more likely to be stressed, worried, sad, and angry than the rich, according to an analysis by the Brookings Institute's Carol Graham. "In the United States", she writes, "poverty is exacting a high cost."

And a separate CDC study last week found that, the higher you are on the income ladder, the less likely you are to be sleep-deprived.

In other words, being rich is the best health-care plan America offers.

Uninsured Rate Gets Lower And Lower, Thanks To Obamacare

WASHINGTON-- The Affordable Care Act was designed to slash the percentage of Americans who lack health insurance, and it's working.

The uninsured rate fell to 11.9 percent during the first quarter of this year, 1 percentage point below the rate at the close of 2014, according to the findings of a Gallup-Healthways Well-Being Index poll published Monday. The decline coincides with the start of benefits for new Obamacare enrollees at the beginning of 2015.

The latest uninsured figure from the Gallup survey is the lowest since the polling firm began tracking the number in 2008, and contributes to a remarkable decline of 5.2 percentage points in the share of people without health coverage since the end of 2013, just before the first wave of Obamacare health insurance enrollees joined the ranks of the insured.

Source: Gallup

African-Americans, Hispanics and people with low incomes saw the greatest gains in insurance coverage, Gallup found.

Some of the increase in the proportion of Americans with health coverage likely is related to the improving job market, and the health benefits provided by employers, Gallup notes. But the pollsters conclude that Obamacare is mostly responsible for the current trend because the uninsured rate is lower than it was in early 2008, when the economy was in recession.

About 12 million people are covered by private health insurance obtained via the exchanges, according to the Department of Health and Human Services. A separate analysis published by the department last month estimates that 16 million fewer Americans are uninsured because of the Obamacare coverage expansion, including the exchanges and Medicaid.

Were more states to expand Medicaid under Obamacare, the uninsured rate would fall more sharply, as it did in Indiana earlier this year. Previous surveys showing state-by-state numbers illustrate that Obamacare's effect on the uninsured is diminished by states' refusal to expand Medicaid.

Although Montana appears poised to adopt the Medicaid expansion this month, efforts in states such as Alaska, Missouri, Tennessee and Utah this year have been stymied by Republican opposition. Almost 5.5 million people had enrolled into Medicaid because they qualified under the expansion in 28 states and the District of Columbia, the Department of Health and Human Services reported Friday.

The sharp reduction in the uninsured rate since Obamacare benefits began to take effect last year could soon be undone, however. The Supreme Court is slated to rule in June ona lawsuit, King v. Burwell, that claims the Affordable Care Act's subsidies can only be provided in 13 states and the District of Columbia, which operate their own health insurance exchange marketplaces, not in the federally run exchanges in the rest of the country.

A high court ruling for the plaintiffs would invalidate the subsidies received by more than 85 percent of exchange enrollees and destabilize the insurance markets in states with federal exchanges. The Rand Corp. estimates this would result in 9.6 million people becoming uninsured.

Why Walking Meetings Can Be Better Than Sitting Meetings

Walking meetings are a kind of a big deal at LinkedIn. On any given day you can find workers strolling and talking together on the bike path at the company’s Mountain View, California, headquarters. The path takes about 20-25 minutes to circle -- perfect for a half-hour one-on-one with a colleague.

The walk and talks have obvious benefits. Desk-bound office workers can all use a bit more exercise. Sitting too much is killing us. Yet the walking meeting’s upsides go far beyond the physical. Walking helps break down formalities, relaxes inhibitions and fosters camaraderie between colleagues -- and less eye contact can fuel more personal conversation. Meeting on the go also minimizes distractions -- no phones, no email, no texts, no colleagues interrupting you.

Perhaps most intriguing, walking leads to more creative thinking, according to a recent study from researchers at Stanford University.

With sit-downs indoors, you face each other across a table. “You feel like you’re at the principal’s office,” Igor Perisic, LinkedIn’s vice president of engineering told The Huffington Post. “That’s not what you want.”

Perisic recounted a time when he and a colleague were trying to solve an issue with LinkedIn’s search function. They spent hours in a room with a white board trying to work it out. Still he felt that he was missing something.

“So we went out on a walk and talked about it,” Perisic said. When they got back indoors, they had the solution. “And it seemed like the obvious choice.”

You can find many big-shot fans of the walk and talk -- including Facebook chief Mark Zuckerberg, Twitter co-founder Jack Dorsey and this guy named Barack Obama. There’s even a TED Talk devoted solely to the topic.

Obama (left) is reportedly a big fan of the walking meeting.

We all intuitively understand that it's nice to get some fresh air outside, but new research shines a light on why walking could be especially good in a work environment.

When we walk we let our guard down, said Marily Oppezzo, who researched walking and creativity, along with her professor Daniel Schwartz, when she was a doctoral student at Stanford’s Graduate School of Education. Their paper was published online last year in the Journal of Experimental Psychology: Learning, Memory, and Cognition.

“Walking releases your filter,” said Oppezzo, now a post-doc at Stanford’s School of Medicine. Ideas you hold back in a conference room come spilling out when you’re moving.

To gauge walking’s effect on creativity, Schwartz and Oppezzo had test subjects walk and sit, and then asked them to find alternate uses for everyday items like tires or buttons. One person suggested using a button as a doorknob for a dollhouse, a tiny strainer, something to drop behind you to keep your path, for example.

They found that people who walked were able to come up with more unique ideas, both while they were walking and immediately afterward. And, it didn’t matter much if they walked on a treadmill or outside.

“Walking opens up the free flow of ideas,” they write in their paper.

This doesn’t mean you should convert all your conference rooms into gyms. Sometimes you’re going to need to sit down.

The Stanford researchers found that sitting is the better option when you have to solve a problem for which there is only one right answer. For example, they asked test subjects to come up with a single word that combines with the words “cottage, Swiss, and cake.” The sitters were better able to figure out the answer: cheese.

LinkedIn’s Perisic said that sometimes he needs to be near a whiteboard to work on a project. For difficult conversations -- say, letting someone know their performance isn’t measuring up -- he likes to talk in a more formal setting. “It’s tough to have the conversation outside.”

Mark Zuckerberg (left) and Jeff Weiner are both big fans of the walk and talk.

Still, Perisic, who oversees about 220 people, can often be found walking with someone on his team. And his CEO, Jeff Weiner, has been positively evangelical on the subject.

“It's energizing to get outside for a 30 minute walk a few times a day,” he said in a recent interview published on LinkedIn. “[It] just changes the whole state of things.”

Other Silicon Valley companies get the whole walking thing, too. Facebook just put in a half-mile loop on the roof of its new headquarters in Menlo Park, California, and workers there do a lot of walking meetings.

LinkedIn’s walking tradition was born more out of necessity than a careful review of research. During the firm’s early days, when it was growing quickly, it was really hard to book a conference room, Weiner told Bloomberg recently. “We had a lot of people and not enough space.”

A colleague suggested walking meetings as a fix -- solve the space issue and get some exercise. “It was very practical,” Weiner said.

The company's expanded since then, and it now has more space. But no one’s going back inside.

The Future Of Driving, In One Provocative Chart

In the future, only rich people will own cars and only robots will drive them.

That’s the takeaway from a new research note from Morgan Stanley auto analyst Adam Jonas. Like Tesla Motors CEO Elon Musk, he predicts that improvements in self-driving technology will eventually lead to bans on human driving on most roads.

Ride-hailing services such as Uber and Lyft, which have already been widely adopted in major urban centers, have paved the way for cities, and eventually suburbs, to adopt mega-fleets of public vehicles that will taxi passengers around. This will dramatically lower the cost per ride to about 25 cents per mile, which is roughly one-tenth of what a traditional taxi costs, Jonas said. He provides no clear timeline for when this might occur.

By contrast, wealthy people -- at least in the near-term -- will own self-driving vehicles, a fact on which Mercedes-Benz and Tesla seem to be banking.

Again, Jonas provides no clear timeline. But an increasing number of luxury carmakers are already adding autonomous features to their vehicles. In October, Tesla's Musk estimated that fully driverless cars will be on the road by 2023.

Here’s how the chart breaks down:

• Quadrant 1: Today, most drivers own or lease their own vehicles, which they drive themselves. Autonomous driving technology is only beginning to emerge.
• Quadrant 2: Over the past few years, ride-hailing services such as Uber, Lyft and Sidecar have alleviated the need to own a car in many major cities, making a driver much more accessible. Jonas said this is a logical step toward the so-called mega-fleets of public, autonomous cars.
• Quadrant 3: Over the next decade, rich people will likely swap out the cars they drive for cars that drive themselves. Already, Tesla is planning to roll out a version of its Model S sedan that has limited autopilot features sometime this summer. The latest version of the car, announced on Wednesday, starts at $67,500 after a Federal Tax Credit.
• Quadrant 4: This is the final evolution in the car industry and there is no clear date for when this will come to fruition. But with few exceptions, most people will be driven by cars that are either a public utility or part of a privately-owned fleet that users subscribe to use. At this point, laws will likely restrict human driving to select roads, Jonas wrote. Other forms of public transportation, such as subway systems, may become obsolete.