Patient Protection and Affordable Care Act

More #PPACA Red Herrings: Renewals and Benefits

Reblogged from Did You Check First?:

Click to visit the original postThe brouhaha over “keeping the plans you like” and “forcing healthy young men to buy policies with maternity benefits” are simply the latest examples of political red herrings being used by the GOP and detractors of the Patient Protection and Affordable Care Act in an attempt to dupe Americans about the facts.

FACT: If you received a cancellation notice from your insurance company, that was their decision, not the federal government’s decision, even when it came to health insurance plans that didn’t meet PPACA minimum standards.

Read more… 1,930 more words

Will Bosses be Able to Deny Women Birth Control?

Corporations are a legal construction, they are NOT “people” and as such do NOT have the same rights as individual citizens.  But, that doesn’t matter to corporate CEOs who are apparently practicers of far right religious zealotry.  To them, it’s not sufficient to sequentially discriminate against individual citizens, they now want the right to discriminate against an entire class of citizens, women, based on the CEO’s religious zealotry.  This has to stop!

If SCOTUS strikes the provision in ACA requiring employer policies to assure accessibility to contraception, is that the line they’ll draw?  Or, what happens when the next religious zealot decides it’s against his religion to provide ANY healthcare whatsoever and that they should pray the sickness away instead.  Will they rule in favor of that CEO’s views as well?

Republicans can use their revisionist history and scream as loud as they want, how this is a “christian” nation and how our founders intended to create a nation built upon those tenets, but that’s simply NOT the case. People migrated to the Americas to escape the religious discrimination and deadly purges present in Europe each time leadership shifted.  At the time of our nation’s founding there were multiple religious groups who could have vied for the “official religion” yet that’s not what happened.  Instead, our founding fathers created a “secular” nation with no official religion and no religious tests for its leadership. Instead they set into law, the tenet of religious freedom for all “men” (now interpreted for the last century to be a generic interpretation for both men and women).

Just as each individual President of  the United States of America is denied the ability to put his religion above the law and impose his religious beliefs on the citizens of this nation, NO corporate CEO should be able to put his religion above the law and discriminate against U.S. citizens he’s hired to work in various roles within his U.S. incorporated business.

If the Supreme Court chooses to bestow religious rights on legal entities, corporations, it will set the stage for our next civil war — deciding which religious entity will be our nation’s official religion.  So just like we’re seeing all that religious strife in the Middle East amongst the various religious Muslim sects, this could lead to religious strife across our nation.

Personally, I prefer a secular nation where people have constitutional rights and where corporations have rights to conduct business throughout out nation, but which are not afforded the exact same constitutional rights afforded the actual people of this nation.

NARAL Pro-Choice America on Supreme Court Decision to Hear Case on Contraception Coverage 

Today, the Supreme Court granted certiorari in two cases related to the contraception benefit in the Affordable Care Act: Sebelius v. Hobby Lobby Stores, Inc and Conestoga Wood Specialties v. Sebelius. NARAL Pro-Choice America released the following statement from President Ilyse Hogue:

“While most people agree this much ado about birth control is a waste of time that could be spent on more pressing issues in our country, we’re pleased that the Supreme Court will finally lay to rest the question of whether women’s bosses get to decide if we deserve contraceptive coverage. That this reflects an underlying obsession with controlling women’s lives seems obvious when you observe that the enemies of the new law are not pushing to deny men access to Viagra or any other number of similar medical requests covered by insurance.

“Obviously, we hope the court upholds existing rulings that – in a country where over 99 percent of women report using birth control at some point in our lives – bosses have no business imposing their own politics on their employees’ health and decisions. If we start with birth control, will bosses next get to decide whether or not we get our children vaccinated? Or whether we can use treatments from stem cell research for life-threatening diseases? Allowing this intrusion into personal decisions by their employers opens a door that won’t easily be shut.” 

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Why Are American Health Care Costs So High?

By the incomparable John Green, who says the following about his sources: “For a much more thorough examination of health care expenses in America, I recommend this series at The Incidental Economist and The Commonwealth Fund’s Study of Health Care Prices in the U.S. Some of the stats in this video also come from this New York Times story.”

Debunking the Republican lie that health insurance costs have skyrocketed under Obama

Debunking the Republican lie that health insurance costs have skyrocketed under Obama.

Maybe they just have trouble with math?

The GOP has taken a new tack in its endless and expensive effort to derail the Affordable Care Act. Recently they have been sending out an email that says, “Since President Obama took office, the average family has seen their health care premiums increase by $3,500 a year…ObamaCare enrollment doesn’t start until October 1st, but health care premiums for American families have already gone up by $3,500 a year under President Obama’s policies – and are expected to skyrocket even more.” In what has got to be one of the most hilarious bits of irony of the year, the email is titled “Help spread the truth.”

Read the full article here

How the Health Care Law is Making a Difference for Nevadans

Because of the Affordable Care Act, the 78% of Nevadans who have insurance have more choices and stronger coverage than ever before. And for the 22% of Nevadans who don’t have insurance, or Nevada families and small businesses who buy their coverage but aren’t happy with it, a new day is just around the corner.

Soon, the new online Health Insurance Marketplace will provide families and small businesses who currently don’t have insurance, or are looking for a better deal, a new way to find health coverage that fits their needs and their budgets.

Open enrollment in the Marketplace starts Oct 1, with coverage starting as soon as Jan 1, 2014.  But Nevada families and small business can visit HealthCare.gov right now to find the information they need prepare for open enrollment.

Key Features of the health care law are already providing better options, better value, better health and a stronger Medicare program for the people of Nevada:

Key Features

Coverage

Costs

Care

Better Options

The Health Insurance Marketplace

Beginning Oct 1, the Health Insurance Marketplace will make it easy for Nevadans to compare qualified health plans, get answers to questions, find out if they are eligible for lower costs for private insurance or health programs like Medicaid and the Children’s Health Insurance Program (CHIP), and enroll in health coverage.

By the Numbers: Uninsured Nevadans who are eligible for coverage through the Marketplace. 

  • 473,971 (22%) are uninsured and eligible
  • 347,244 (73%) have a full-time worker in the family
  • 174,840 (37%) are 18-35 years old
  • 218,730 (46%) are White
  • 44,217 (9%) are African American
  • 157,518 (33%) are Latino/Hispanic
  • 33,012 (7%) are Asian American or Pacific Islander
  • 258,036 (54%) are male

438,826 (93%) of Nevada’s uninsured and eligible population may qualify for lower costs on coverage in the Marketplace, including through Medicaid.

Nevada has received $74,754,285 in grants for research, planning, information technology development, and implementation of its Health Insurance Marketplace.

New coverage options for young adults

Under the health care law, if your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 years old. Thanks to this provision, over 3 million young people who would otherwise have been uninsured have gained coverage nationwide, including 33,000 young adults in Nevada.

Ending discrimination for pre-existing conditions  

As many as 1,157,045 non-elderly Nevadans have some type of pre-existing health condition, including 162,452 children.  Today, insurers can no longer deny coverage to children because of a pre-existing condition, like asthma or diabetes, under the health care law. And beginning in 2014, health insurers will no longer be able to charge more or deny coverage to anyone because of a pre-existing condition.  The health care law also established a temporary health insurance program for individuals who were denied health insurance coverage because of a pre-existing condition.  1,373 Nevadans with pre-existing conditions have gained coverage through the Pre-Existing Condition Insurance Plan since the program began.

Better Value

Providing better value for your premium dollar through the 80/20 Rule

Health insurance companies now have to spend at least 80 cents of your premium dollar on health care or improvements to care, or provide you a refund.  This means that 88,491 Nevada residents with private insurance coverage will benefit from $3,977,544 in refunds from insurance companies this year, for an average refund of $75 per family covered by a policy.

Scrutinizing unreasonable premium increases 

In every State and for the first time under Federal law, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. Nevada has received $4,959,972 under the new law to help fight unreasonable premium increases.

Removing lifetime limits on health benefits 

The law bans insurance companies from imposing lifetime dollar limits on health benefits – freeing cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment because of their lifetime limits. Already, 937,000 people in Nevada, including 329,000 women and 269,000 children, are free from worrying about lifetime limits on coverage. The law also restricts the use of annual limits and bans them completely in 2014.

Better Health

Covering preventive services with no deductible or co-pay

The health care law requires many insurance plans to provide coverage without cost sharing to enrollees for a variety of preventive health services, such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, and flu shots for all children and adults.

In 2011 and 2012, 71 million Americans with private health insurance gained preventive service coverage with no cost-sharing, including 615,000 in Nevada. And for policies renewing on or after August 1, 2012, women can now get coverage without cost-sharing of even more preventive services they need.  Approximately 47 million women, including 391,181 in Nevada will now have guaranteed access to additional preventive services without cost-sharing.

Increasing support for community health centers

The health care law increases the funding available to community health centers nationwide. In Nevada, 2 health centers operate 30 sites, providing preventive and primary health care services to 57,987 people.  Health Center grantees in Nevada have received $8,264,743 under the health care law to support ongoing health center operations and to establish new health center sites, expand services, and/or support major capital improvement projects.

Community Health Centers in all 50 states have also received a total of $150 million in federal grants to help enroll uninsured Americans in the Health Insurance Marketplace, including $451,674 awarded to Nevada health centers.   With these funds, Nevada health centers expect to hire 9 additional workers, who will assist 10,600 Nevadans with enrollment into affordable health insurance coverage.

Investing in the primary care workforce

As a result of historic investments through the health care law and the Recovery Act, the numbers of clinicians in the National Health Service Corps are at all-time highs with nearly 10,000 Corps clinicians providing care to more than 10.4 million people who live in rural, urban, and frontier communities.  The National Health Service Corps repays educational loans and provides scholarships to primary care physicians, dentists, nurse practitioners, physician assistants, behavioral health providers, and other primary care providers who practice in areas of the country that have too few health care professionals to serve the people who live there.  As of September 30, 2012, there were 36 Corps clinicians providing primary care services in Nevada, compared to 12 in 2008.

Preventing illness and promoting health

As of March 2012, Nevada had received $7,500,000 in grants from the Prevention and Public Health Fund created by the health care law. This new fund was created to support effective policies in Nevada, its communities, and nationwide so that all Americans can lead longer, more productive lives.

A Stronger Medicare Program

Making prescription drugs affordable for seniors 

In Nevada, people with Medicare saved nearly $41 million on prescription drugs because of the Affordable Care Act.  In 2012 alone, 22,122 individuals in Nevada saved over $14 million, or an average of $611 per beneficiary.  In 2012, people with Medicare in the “donut hole” received a 50 percent discount on covered brand name drugs and 14 percent discount on generic drugs.  And thanks to the health care law, coverage for both brand name and generic drugs will continue to increase over time until the coverage gap is closed.  Nationally, over 6.6 million people with Medicare have saved over $7 billion on drugs since the law’s enactment.

Covering preventive services with no deductible or co-pay

With no deductibles or co-pays, cost is no longer a barrier for seniors and people with disabilities who want to stay healthy by detecting and treating health problems early. In 2012 alone, an estimated 34.1 million people benefited from Medicare’s coverage of preventive services with no cost-sharing.  In Nevada, 166,815 individuals with traditional Medicare used one or more free preventive service in 2012.

Protecting Medicare’s solvency

The health care law extends the life of the Medicare Trust Fund by ten years.  From 2010 to 2012, Medicare spending per beneficiary grew at 1.7 percent annually, substantially more slowly than the per capita rate of growth in the economy.  And the health care law helps stop fraud with tougher screening procedures, stronger penalties, and new technology. Over the last four years, the administration’s fraud enforcement efforts have recovered $14.9 billion from fraudsters.  For every dollar spent on health care-related fraud and abuse activities in the last three years the administration has returned $7.90.

Related articles

Obamacare: Signed, Sealed, Delivering …

Watch the Obamacare videos & get the facts

Obamacare is making health care work better for all of us, even if you already have insurance. It puts the health of your family first—ensuring access to free preventive care and protecting consumers from insurance company abuses.

71 Million Kids & Adults With Private Insurance Have Received No-Cost Preventive Care.
“HHS estimates that, as a result of the ACA, 71 million children and adults with private insurance, and 34 million Medicare beneficiaries have received no-cost preventive care. Enhanced federal matching funds in Medicaid are available to states providing all USPSTF-recommended preventive benefits without cost-sharing, but, to date, few states have made the changes required to gain the higher match rate.” “Health Reform-The Affordable Care Act Three Years Post-Enactment,” Kaiser Family Foundation, March 2013.
Discrimination By Insurance Companies For Children With Pre-Existing Conditions Was Banned.
“Coverage exclusions for children with pre-existing conditions were prohibited as of September 23, 2010. Insurers are no longer permitted to deny coverage to children due to their health status, or exclude coverage for pre-existing conditions. Protections for adults will take effect in 2014. In addition, lifetime limits on coverage in private insurance have been eliminated and annual limits are being phased out.” “Health Reform-The Affordable Care Act Three Years Post-Enactment,” Kaiser Family Foundation, March 2013.
Consumers Received $1.1 Billion in Rebates From Their Insurance Companies.
“Insurance companies that don’t spend at least 80 percent of its customers’ premium dollars on health care are required to provide rebates to policy holders. In 2012, the first year this rule was implemented, 12.8 million consumers received $1.1 billion in rebates.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
3.1 Million More Young Adults Have Health Insurance Through Their Parent’s Plan.
“Under the law, most young adults who can’t get coverage through their jobs can stay on their parents’ plans until age 26.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
Seniors Have Saved More Than $6.1 Billion on Their Prescription Drugs Since 2010.
“Seniors who hit the gap in Medicare’s prescription drug coverage, often called the ‘donut hole’ now receive 50 percent discounts on covered brand name drugs. The new health reform law will provide additional savings each year until the coverage gap is closed in 2020.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.

Learning Deficit? — GOP: “Let Detroit Go Bankrupt”

PBGCGee, I’ll bet you thought that when Romney lost the election, his philosophies died along with the end of that race.  You might also have hoped that the GOP might have learned that a clear majority of Americans didn’t care for their brand of leadership.  Well, you would be wrong.  That famous Romney quote, “Let Detroit go bankrupt” has risen once again from the dead and GOP senators like Sen. Orrin Hatch (R-UT) are espousing legislation that would ensure Detroit does go bankrupt and that they get absolutely NO federal help (other than, of course, to ensure the big money interests get their rake right off the top) as Detroit goes through bankruptcy.

Judicial activity at both the State and Federal levels presently seems skewed in favor of large investors and against public workers (teachers, police, firemen, etc.) who face losing pensions for which they worked their entire lives.  Loss of their main source of income will force those pensioners onto State and Federal safety net programs.  Please keep in mind that, while the Pension Benefit Guarantee Corporation insures private-sector pensions, it does not insure state, county, or city plans. So, when there’s no money in the bankruptcy settlement to pay pensions, Detroit’s public worker pensioners may find themselves penniless, lest they have alternate income sources.  That’s because,according to Herb Perone from Perone Communications, “there is no equivalent to the PBGC for public sector plans. Public sector plans are backed by the full faith and credit of the state.” And of course, Detroit is bankrupt.  Thus, the GOP leadership of Michigan has no faith that those retirees might vote for them, so in their book, they’re expendable. There are bigger corporate fish to fry instead, through which they can secure their political futures.

Also keep in mind, this bankruptcy filing and potential pension filching is occurring at the same time that the House of Representatives just passed a bill totally zeroing out all funding for SNAP funds (food stamps) and when they’re pumping up their chests boasting to once again shut down government if they’re not allowed to kill Obamacare, the EPA, the Consumer Protection Bureau and Dodd-Frank financial reform so they can let Wall Steet to do whatever damage they chose to create on any given day to the overall worldwide economy.

This vision of selfish anarchy and governmental impotence espoused by the GOP has to end.  We have got to get active, we’ve got to get involved, and we’ve got to get them out of our government both at the State and Federal levels if our nation is to survive.  We need to actively work at removing these vermin from public office.  If we don’t, it will be the end of our great nation, and not even the “Lord” will be able help us if the GOP manages to succeed in their efforts to dismantle the America in which we grew up.

Disregard Those AFP Scare-Ads for Healthcare Answers

Americans for Prosperity have begun running “scare” ads to convince people to take action against their own interests.  Their goal is to sufficiently lie about what Obamacare does or doesn’t offer in an effort to get low-knowledge citizens to support the #GOP’s plan to gut meaningful healthcare protections for American families across our nation.

Take a moment to watch this great ad from AmericansUnited refuting claims being made in one of those Americans for Prosperity scare ads:

Resources:

Oh, and when one of your neighbors claims “Obamacare is going to cause insurance premiums to skyrocket” … tell them it only takes one quick search on the terms “insurance premium drops” to prove them absolutely WRONG:

And then there’s the Obamacare side effect — job mobility — once healthcare exchanges are in place, one will no longer being tethered to a job one hates only because one needs the healthcare benefits provided by that job:

Heller Has No Clue How Congress Works and He Apparently Can’t Read Either

I found the letter below, from Senator Heller, in my inbox this morning.  I am astonished!  For someone who’s been in Congress for as long as he has, you’d think he’d understand how things work.  Congress passes a bill delineating all parameters of how things will work under that particular  bill and then the President signs that bill into law.  It’s clear that Senator Dean Heller (R-NV) doesn’t understand that and thinks the President can just waive any provision in any law on any whim of the day via Executive Order (you know … those same orders they’re always complaining about).

Yesterday, Senator Heller sent a letter to President Barack Obama asking that he require House and Senate Leadership and the Executive Branch be subject to ObamaCare’s healthcare exchanges even though Congress, during the creation of ObamaCare, specifically exempted Members of Senate and House Leadership and their staffs in the provisions of that bill.

Mr. Heller, can say he’s been “vocal,” but he failed to even make that argument when the bill passed BOTH houses of Congress.  HR3590, the Patient Protection and Affordable Care Act (PPACA), deemed “Obamacare” by the GOP, had 506 Amendments, none of which were introduced by Heller.  If you want something different than what’s being offered, thou must introduce an Amendment, or having failed to do so or not having an opportunity to do so, thou must convince a party in the opposite house of Congress to do so for you.  You can’t just wait until all is said and done and then ask the President to do something that YOU should know HE cannot legally do!  And, if all else fails, thou must introduce a bill that would modify the implemented law.

Well, Senator Heller along with Senator Vitter have finally gotten around to submitting a bill.  But—like all bills, it was referred to committee for investigation and action.  If he doesn’t want it to die in committee (like most bills d0), then Senator Heller, who’s in the minority, needs to work his butt off to get enough Senators from the majority side to support his bill and vote it out of committee.  He should know that.  That’s the way Congress works.  Playing cry-baby about this or that is childish, and writing the President about it, is not the way the process works.  Plus, pursuing such antics as writing a cry-baby letter to the President only serves to ensure his bill will never make it out of committee, nor will it see the light of the floor for a vote.

And then there’s the section of Public Law 111-148, Sections 1312(D)(i) and 1312(D)(II)  he specifically references in his letter:

(D) MEMBERS OF CONGRESS IN THE EXCHANGE.
(i) REQUIREMENT.—Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are
    (I) created under this Act (or an amendment made by this Act); or
    (II) offered through an Exchange established under this Act (or an amendment made by this Act).
(ii) DEFINITIONS.—In this section:
(I) MEMBER OF CONGRESS.—The term ‘‘Member of Congress’’ means any member of the House of Representatives or the Senate.
(II) CONGRESSIONAL STAFF.—The term ‘‘congressional staff’’ means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.

I don’t know about you, but to me, it clearly says members of both the House and the Senate are covered by this section and will receive their health care coverage through the Health Care Exchanges once they’re up and running.  Senator Heller should learn to read and accurately quote the law before he wastes time and effort sending a childish, cry-baby letter to the President when he thinks he’s not getting his way.

July 16, 2013

The Honorable Barack Obama President of the United States The White House 1600 Pennsylvania Avenue, N.W. Washington, D.C. 20006

Dear Mr. President,

Since the inception of ObamaCare, I have been very vocal in my concern about the cost and quality of care associated with health care exchanges. While Members of Congress and their staff are included under Section 1312(D)(i) and 1312(D)(II), Members of Senate and House Leadership and their staff, as well as the Executive Branch, are exempted from going into the exchange. The fact that lawmakers exempted themselves serves as further evidence that I do not stand alone in my concern about these health care exchanges.

However, it is only fair that lawmakers and all Congressional staff are beholden to the same laws as every other American. As you may recall, I wrote to you regarding this issue in 2009 to encourage you to require that any health care bill you sign include a provision that all elected officials enroll in the government-run health insurance plan, including the President. As a Member of the House Ways and Means Committee during the health care debate, I introduced an amendment to the bill that would require all Members of Congress and their dependents who choose to receive health care coverage do so through the exchange.

Now, on the eve of the deadline to enter these exchanges, some elected officials and their staff still are not included in the health care law.  Senator Vitter and I introduced legislation in May ensuring that those who wrote the Affordable Care Act (ACA) and mistakenly left themselves out could now be included in the exchanges.  Unfortunately, a hearing or floor action has not been scheduled.   Perhaps now is the time for the Administration to consider making use of the Executive Order to ensure that all Senate and House Leadership and their staff, as well as the Executive Branch, are covered under the health insurance exchange created by the ACA.  This would help ensure fairness is maintained across the board. I appreciate your leadership on this issue to make sure the $1.5 billion being delegated to the Department of Health and Human Services under your budget leaves no one out, including yourself

These individuals need to be held accountable for the law which they created.  Since you have been selective in what is enforced in the ACA, I ask that you use this same power to include all elected officials, including yourself, in the health care exchange through the use of Executive Order.

Sincerely,

DEAN HELLER

U.S. Senator

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HHS launches Health Insurance Marketplace educational tools

The Obama administration today kicked off the Health Insurance Marketplace education effort with a new, consumer-focused HealthCare.gov website and the 24-hours-a-day consumer call center to help Americans prepare for open enrollment and ultimately sign up for private health insurance.  The new tools will help Americans understand their choices and select the coverage that best suits their needs when open enrollment in the new Health Insurance Marketplace begins October 1.

“The new website and toll-free number have a simple mission: to make sure every American who needs health coverage has the information they need to make choices that are right for themselves and their families—or their businesses,” said Health and Human Services Secretary Kathleen Sebelius.

“The re-launched Healthcare.gov and new call center will help consumers prepare for the new coverage opportunities coming later this year,” said Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner. “In October, HealthCare.gov will be the online destination for consumers to compare and enroll in affordable, qualified health plans.”

The Health Insurance Marketplace is Coming Soon

HealthCare.gov is the destination for the Health Insurance Marketplace.  Americans may now access new educational information and learn what they can do to begin to get ready for open enrollment this fall.  The website will add functionality over the summer so that, by October, consumers will be able to create accounts, complete an online application, and shop for qualified health plans.  For Spanish speaking consumers, CuidadoDeSalud.gov will also be updated to match HealthCare.gov’s new consumer focus.

Key features of the website, based on consumer research and online commercial best practices include integration of social media, sharable content, and engagement destinations for consumers to get more information.  The site will also launch with web chat functionality to support additional consumer inquiries.

The website is built with a responsive design so that consumers may access it from their desktops, smart-phones, and other mobile devices. In addition, the website is available via an application interface atwww.healthcare.gov/developers.

Between now and the start of open enrollment, the Marketplace call center will provide educational information and, beginning Oct. 1, 2013, will assist consumers with application completion and plan selection.  In addition to English and Spanish, the call center provides assistance in more than 150 languages through an interpretation and translation service.  Customer service representatives are available for assistance via a toll-free number at 1-800-318-2596 and hearing impaired callers using TTY/TDD technology can dial 1-855-889-4325 for assistance.

To view the new look and new focus of the website, visit www.HealthCare.gov.

HHS is on target for open enrollment in the Marketplace, which begins Oct. 1, 2013, and other key milestones approaching in the months ahead.  Coverage will begin Jan. 1, 2014.

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