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Save articles for later Add articles to your saved list and come back to them any time. One decision stands out from all others in what has been a grim year for Prime Minister Anthony Albanese – and it holds a clue as to what he may do next. Albanese ends 2024 in a dire position for a leader who must face the people in just a few short months: the economy is weak, the federal budget is back in deficit and his personal popularity is down. But his allies name his move to overhaul personal tax cuts in January, delivering bigger benefits to millions of workers, as the best example of what he did right this year. Albanese began the year with a bold move by breaking an election pledge to leave the “stage three” personal tax cuts intact after years of argument about a tax package that had been written into law by the Coalition five years earlier. Opposition Leader Peter Dutton railed against the Labor changes and called for an election to be held to decide the matter, only to retreat when polls showed that most Australians liked the idea of a $313 billion package with bigger tax cuts for more workers on low and middle incomes. Albanese won the policy and the politics. He took a risk and it paid off. The tax cuts went ahead as scheduled in July with the Labor brand stamped all over them. If there was a reward from the electorate, however, it evaporated before the summer was over. Just as Albanese seemed to be taking the initiative, the Labor primary vote went into reverse . It fell from 35 per cent in December to 34 per cent in February and 32 per cent in March. This became the pattern of the year. Nothing seemed to work for Albanese. His readiness to do radio interviews, while Dutton avoided scrutiny, did not appear to create a lasting bond with listeners. His speaking style, with mangled sentences instead of sharp messages, made it harder for him to cut through. Worse, the government never seemed to galvanise Australians with a sense of political mission. It unveiled more assistance for childcare, an age limit for social media, subsidies for energy bills, a wage boost for aged care workers and changes to prescriptions to make medicines cheaper. And it drifted down in the polls. “Labor and Albanese appear so dour, a government of grinding necessity,” says Paul Strangio, the emeritus professor of politics at Monash University. “The sense of missed opportunity is all the greater since they are in office at a time when the public shows signs of being fed up with business as usual. Albanese doesn’t appear to know how to harness or manage that sentiment.” Strangio highlighted this challenge in an essay for Inside Story in September and says there has been no shift in the pattern in the final months of the year. “Growth in office has been a hallmark of many of Australia’s best prime ministers,” he says. “Albanese is yet to demonstrate this.” While Albanese was elected to parliament in 1996 and watched John Howard govern for 11 years, there is no sign he is learning a lesson from the Howard era. “When Howard was in trouble during his first term, he drew upon his deep-seated convictions to strike out in a bold direction,” Strangio says. The result was a high-stakes election on the GST. Prime Minister Anthony Albanese and Chinese President Xi Jinping hold hands for the G20 group photo in Rio de Janeiro in November. Credit: Alex Ellinghausen On international affairs, however, Albanese has moved easily into overseas meetings and global summits. He lowered the temperature with China, resumed leadership meetings with Chinese President Xi Jinping and helped restart exports of beef, barley and lobster. This added billions of dollars to Australian industry. There was no economic dividend, and possibly no political payoff, from his effort to secure the release of WikiLeaks founder Julian Assange from the United States and the five remaining members of the Bali Nine from Indonesia. Even so, he pursued the talks to bring Australians home. The defeat of the Indigenous Voice in October 2023 still reverberates around Australian politics – and polling shows a slide in Labor support from that moment – but the government points to other achievements in this term, such as legislating a climate target to cut greenhouse gas emissions, to counter claims it has too little to show for its time in office. One minister says Australians will back the prime minister when the election arrives because of his personal qualities and what he offers in hard policy. “We are closer to making sure voters see this as a choice between Peter Dutton and Anthony Albanese,” he says. Labor strategists say this is not just about what Albanese has delivered during this term, but about the “forward offer” of policies for the next three years. Prime Minister Anthony Albanese and Opposition Leader Peter Dutton. Credit: Alex Ellinghausen In this assessment, from those closest to Albanese, the prime minister is just getting started in winning voters with new policy measures and attacking Dutton on Coalition vulnerabilities, such as its nuclear energy plan. But Albanese has been subject to relentless attacks from left and right while trying to hold the middle ground on the Middle East. Greens leader Adam Bandt accused him of complicity in genocide over the war in Gaza, while Dutton accused him of deserting Israel and being weak on antisemitism. The conservative media picked up on the claim and rammed it home. When arsonists committed what police called a “likely act of terrorism” at the Adass Israel synagogue in Melbourne in early December, Albanese condemned the antisemitism in a statement and on radio. But he was scheduled to fly to Perth and did not divert the aircraft to Melbourne, which meant he took several days to visit the destruction and stand with the Jewish community. Prime Minister Anthony Albanese visited Adass Israel synagogue in Melbourne on Tuesday, December 10. Credit: Justin McManus The symbolic show of support seemed too slow, even if the actual support was strong. Albanese gave no quarter to protesters who called antisemitic chants, and he made sure that laws were passed to ban the “doxxing” used to reveal personal details of Jewish Australians. He arranged more funding to protect synagogues and schools. This was not enough, however, when the government was infuriating Israel by voting at the United Nations for a ceasefire in Gaza in a motion that did not condemn Hamas, listed by Australian authorities as a terrorist group. “I don’t subscribe to the view that he has been weak on antisemitism,” says Strangio. “To me, this is an idea prosecuted by dogmatic elements – especially the Murdoch media – and doesn’t allow for the diabolical challenge it has been for the government to strike a position that doesn’t aggravate the polarisation of community opinion but maintains some degree of social cohesion.” Australians, meanwhile, felt their household incomes shrinking in real terms. Although wages moved ahead of inflation in recent quarters, they remain down in real terms since the election. With the Reserve Bank seeking to reduce inflation, the government could not risk spending more money to help voters. The pressure on households generated pain in the polls. Voters are clearly sceptical about Albanese. Thirty-one per cent said in early December that he was doing a good job, but 57 per cent said he was doing a poor job. His net rating in the Resolve Political Monitor, minus 26 per cent, was four times worse in December than it had been in February. The verdict is more savage from some of his own Labor colleagues. “He’s tough on the weak issues and weak on the tough issues,” says one caucus member. The complaint is that Albanese can take a strong line on something that is secondary to most Australians – like the release of the last of the Bali Nine – but struggle on the problems that will decide the election. Most of all, the cost of living. Cautious in choosing his battles before the election, Albanese risks leaving voters with the sense that he does not know what to fight for. “I like Anthony Albanese, and I regard him as a friend, but I find his government underwhelming,” says independent MP Andrew Wilkie. “And that would be the view of many of my constituents. It is fair to add that politics in general has become underwhelming. I’m not suggesting for a moment that Peter Dutton is any better.” Albanese tried through the year to outline practical policies – including a rush in December to pass dozens of laws through parliament. This included the Help to Buy scheme to offer $5.6 billion in federal equity for young people buying their first homes, as well as the Build to Rent scheme to attract investment into new homes. Also in December came the $1 billion early education fund for childcare and the “three-day guarantee” to make it easier for new parents to receive childcare subsidies. The Coalition opposes the move, which could help Albanese in a cost-of-living battle. Albanese can point to other measures that help with costs. The changes to student loans will help young Australians by reducing their debts by $3 billion, with the promise of more change if the government holds power at the election. Again, the Coalition opposes the move. This leaves some observers wanting a bolder vision. Saul Eslake, an independent economist, says Australia needs ambitious reform to lift living standards over the long term. Dutton has no significant economic policy, other than his nuclear plan, and Albanese is not revealing anything too risky. “I sort of despair, really, that the government has shown no inclination to argue for an ambitious second-term reform agenda,” says Eslake. “And it’s almost too late now. Albanese seems not to have the vision or the rhetorical capacity to do this stuff.” Leaders are not only judged on what they do, but what they choose not to do. A shadow has fallen over Anthony Albanese’s prime ministership in 2024. Credit: Alex Ellinghausen Will the prime minister lift his fortunes after a difficult year? Watch for some policy moves early in 2025 to convince voters to stick with him rather than take a risk with Dutton. The Labor strategy seeks to copy the approach taken at the last election: to kick with the wind in the final quarter. One of the prime minister’s allies says the critics of today forget the mistakes of the critics from three years ago, when Albanese was not given much credit for lining up a victory that swept Labor into power. “On the big calls he was proven right,” he says. This year has been no triumph for Albanese. But the contest is not over. Cut through the noise of federal politics with news, views and expert analysis. Subscribers can sign up to our weekly Inside Politics newsletter .
Watch out, Moo Deng . A new baby hippo has made a holiday entrance and she is soaking up the social media spotlight . The Metro Richmond Zoo in Virginia has announced the addition of a baby pygmy hippopotamus, born on Dec. 9. Five days after birth, the yet-to-be-named baby pygmy weighed about 15 pounds, according to a news release . The baby pygmy was born to Metro Richmond Zoo's hippos Iris and Corwin − the hippos' third calf in four-and-a-half years, according to a news release . This is also the second time Iris and Corwin have welcomed a baby around the holidays. The baby pygmy's birth was unique, as it was Iris' first time giving birth in water, according to a news release . Though most common hippos give birth in water, pygmy hippos can also give birth on land. Iris gave birth in the hippo enclosure indoor pool. Keepers and a few guests were present to witness the birth. The baby's natural instincts, per a news release , were to kick and swim around the water. Holiday deals: Shop this season’s top products and sales curated by our editors. Following the birth, Iris and the baby were moved into a hay-bedded enclosure outside of the zoo's exhibit for bonding. They will re-enter the exhibit soon. More news: Why do we love Moo Deng, Pesto and other baby zoo animals? Psychologists explain What's with the hippo hype? The hype around the new pygmy follows a summer full of love for Moo Deng , a pygmy hippo born at the Khao Kheow Open Zoo in Thailand in July. Videos and photos of Moo Deng yelling at her zoo keepers, enjoying baths, and resting in water buckets have garnered millions of views on social media. In November, Moo Deng even participated in the U.S. 2024 presidential election , casting her "vote" for President-elect Donald Trump. When presented with two fruit baskets, one with Kamala Harris' name and the other with Trump's name, Moo Deng munched and crunched on the Trump cake. Just a few months after Moo Deng's birth, a female pygmy calf named Haggis claimed social media fame. Born in October, Haggis resides at the Royal Zoological Society of Scotland's Edinburgh Zoo. Pygmy hippos, thought of as the common hippo's smaller cousin, have been endangered since 2016. They are about half the size of common hippos, weighing less than one-fourth the full size of an adult common hippo. Pygmies are native to West Africa, and their average life expectancy is 27 years. Greta Cross is a national trending reporter at USA TODAY. Follow her on X and Instagram @gretalcross. Story idea? Email her at gcross@gannett.com .DraftKings promo code + NFL odds and expert picks for Saints vs. Packers on MNF: Bet $5, Get $150 in bonus bets | Sporting News
The House Ethics Committee has just released its report on former Rep. Matt Gaetz that includes an array of shocking findings, including that the Florida representative paid multiple women , including a 17-year-old girl, for sex, as well as purchased and used illegal drugs. The committee concluded that Gaetz violated multiple state laws related to sexual misconduct while in office, including the state’s statutory rape law. “The Committee determined there is substantial evidence that Representative Gaetz violated House Rules and other standards of conduct prohibiting prostitution, statutory rape, illicit drug use, impermissible gifts, special favors or privileges, and obstruction of Congress,” panel investigators wrote. While ethics reports have previously been released after a member’s resignation, it is extremely rare. Gaetz has repeatedly denied all wrongdoing, and on Monday filed a lawsuit seeking to block the report’s release, saying it contains “untruthful and defamatory information” that would “significantly damage” his “standing and reputation in the community.” Matt Gaetz withdraws from consideration for attorney general citing 'distraction' to Trump transition House Ethics Committee made 'no agreement' on releasing Matt Gaetz report after meeting The release of the report comes after at least one Republican joined all five Democrats on the panel earlier this month in a secret vote to release the report about their former colleague despite initial opposition from GOP lawmakers, including House Speaker Mike Johnson, to publishing findings about a former member of Congress, the Associated Press reported. Here are the five most shocking findings in the House report on Gaetz: The report states that between 2017-2020, Gaetz paid "tens of thousands of dollars" across at least 20 occasions to women that the committee determined "were likely in connection with sexual activity and/or drug use." The committee found that the sexual encounters were often organized by his friend Joel Greenberg, a former Seminole County tax collector who is serving an 11-year prison sentence for underage sex trafficking, and wire fraud. Greenberg, who cooperated with federal investigators, said he set up the rendezvous through the website SeekingArrangement.com “Mr. Greenberg told the Committee that Representative Gaetz was aware that the women they had sex with and paid had met Mr. Greenberg through the ‘sugar dating’ website,” the panel wrote. The report said Gaetz made payment to women using multiple platforms, including PayPal, Venmo and CashApp. The report states many of the women interviewed "were clear that there was a general expectation of sex" and text messages show Gaetz would ask the women "to bring drugs to their rendezvous". “Nearly every young woman that the Committee interviewed confirmed that she was paid for sex by, or on behalf of, Representative Gaetz,” the panel wrote. One woman "said that she brought cocaine to at least one event with Representative Gaetz and that she witnessed him taking cocaine or ecstasy on at least five occasions," the report reads. After Gaetz’s attempt to block the release of the report failed, he began posting excerpts of testimony from the women he was found to have paid for sex on social media. He highlighted that one woman said she never "charged" money, but was simply given money. “Giving funds to someone you are dating — that they didn’t ask for — and that isn’t ‘charged’ for sex is now prostitution?!?” he wrote in one post. “There is a reason they did this to me in a Christmas Eve-Eve report and not in a courtroom of any kind where I could present evidence and challenge witnesses.” One of the sexual encounters during that time period involved a 17-year-old girl, the committee said. The woman told the committee she had sex with Gaetz twice at a July 2017 party when she was 17. “The Committee received testimony that Victim A and Representative Gaetz had sex twice during the party, including at least once in the presence of other party attendees,” the committee wrote. “Victim A recalled receiving $400 in cash from Representative Gaetz that evening, which she understood to be payment for sex. At the time, she had just completed her junior year of high school.” The then-17-year-old did not tell Gaetz she was a minor at the time, and he did not ask her age, the committee found. The committee did not receive any evidence Gaetz was aware of her age. The woman told congressional investigators she was under the influence of ecstasy at the party and that she recalled seeing Gaetz use cocaine at the party. Gaetz has denied having sex with a minor. “I NEVER had sexual contact with someone under 18,” the Florida Republican wrote on X last week. “Any claim that I have would be destroyed in court - which is why no such claim was ever made in court. The committee investigation also focused on September 2018 trip to the Bahamas, in which they say Gaetz violated the House Gift Rule, a set of rules for members of the House of Representatives regarding gifts, benefits, and hospitality The report said that for that trip Gaetz accepted gifts of transportation and lodging in excess of permissible amounts. Gaetz traveled to the Bahamas with two other men and six women. He flew to the Bahamas on a commercial airline but returned on a private plane, the committee found. “The attendees stated that this was a social trip — they sunbathed, chartered a boat, and went to dinners and to a casino as a group. Representative Gaetz engaged in sexual activity with at least four of the women on the trip,” the committee wrote. Committee investigators concluded that between 2017 to 2020, Gaetz “used or possessed illegal drugs, including cocaine and ecstasy, on multiple occasions.” “There is substantial evidence that Representative Gaetz used cocaine, ecstasy, and marijuana. At least two women saw Representative Gaetz using cocaine and ecstasy at different events,” the committee wrote. “Additionally, nearly every witness interviewed observed Representative Gaetz using marijuana.” The committee wrote that Gaetz appeared to set up a “pseudonymous e-mail account from his House office in the Capitol complex for the purpose of purchasing marijuana.” Gaetz denied using illicit drugs in written correspondence to the committee, the report said. He also categorically stated to the committee that the allegations he “may have engaged in sexual misconduct including violations of federal laws relating to sex trafficking and state laws relating to prostitution and statutory rape,” were “false” Gaetz also repeatedly denied having ever paid for sex, but when given the opportunity to put that assertion in writing Gaetz refused to respond, asserting that “asking about [his] sexual history as a single man with adult women is a bridge too far," according to the report. Gaetz did broadly address the allegation that he engaged in sexual activity with a minor in a Sept. 2024 letter to the Committee, writing: “Your correspondence of September 4 asks whether I have engaged in sexual activity with any individual under 18. The answer to this question is unequivocally NO. You can apply this response to every version of this question, in every forum.” The Committee said they found substantial evidence that Gaetz attempted to obstruct the Committee’s investigation into his wrongdoings by withholding relevant information, providing irrelevant documents in an overall effort to delay the investigation. "Representative Gaetz pointed to evidence that would “exonerate” him yet failed to produce any such materials," the report said. "Gaetz continuously sought to deflect, deter, or mislead the Committee in order to prevent his actions from being exposed." This was most notable in regards to the Committee’s specific requests regarding the Bahamas trip. The committee said Gaetz intentionally withheld information relating to his return trip via private plane. "Representative Gaetz clearly understood that he had acted contrary to House Rules by accepting private plane travel but chose to try to cover up his actions rather than comply with the Committee’s request," the report said. "Despite asserting he wanted an opportunity to address the allegations against him Gaetz declined to provide testimony voluntarily and did not appear when subpoenaed." The committee said that Gaetz was given ample time to review and produce documents requested at various points in the Committee’s investigation, but he chose to hand over documents that were largely irrelevant from time periods after most of the relevant conduct occurred. DAILY NEWSLETTER: Sign up here to get the latest news and updates from the Mirror US straight to your inbox with our FREE newsletter.
METAIRIE, La. (AP) — Dejounte Murray plans to return to the New Orleans Pelicans ' lineup on Wednesday night for the first time since fracturing his left hand in a season-opening victory over Chicago on Oct. 23. And when Murray takes the court against the Toronto Raptors , his mother will be on his mind. After practice on Tuesday, Murray discussed his impending return and disclosed more details about the previously unspecified “personal matters” that caused him to leave the team during the final days of the preseason. His mother had a stroke, he said. “It was tough to leave and go deal with that. As she got better, she wanted me to come play,” Murray said of his last-minute decision to start against Chicago. He added that his hand injury near the end of that game was God's way of telling him, “‘Nah, you need to stay with your mom.’” “I was more concerned about my mother. That was my priority,” Murray continued. “I wasn’t really worried about my recovery.” Murray's mother has recovered well, he said, while he is “healthy and ready to help this team.” “I’m ready to hoop. Play for my mother — she’s going to be watching," Murray said. “I’m ready to compete, bring that winning spirit.” The Pelicans (4-14) certainly could use the help, having lost 14 of 16 games since opening the season with a pair of victories. Injuries have ravaged the roster. At times, all five starters have been out. Star power forward Zion Williamson has missed 12 games this season — one with an illness and 11 with a hamstring injury. Herb Jones has been sidelined by a shoulder strain and Brandon Ingram's status is in doubt after he sat out practice on Tuesday with calf soreness that also sidelined him during a loss on Monday night at Indiana. But at least two starters — Murray and fellow guard CJ McCollum — are expected to play against the Raptors. “I don’t care how many games we’ve lost. I just know every time I step on the floor I feel like we can win games,” said Murray, who had 14 points, 10 assists and eight rebounds in his lone game with the Pelicans. "That’s just my mentality, and I feel like it can carry over to a lot of guys.” AP NBA: https://apnews.com/hub/NBAPunk Attacks Woman With Baby Stroller, Showing Why Subways Don't Have Fire Extinguishers Anymore
NoneA new study from the University of Michigan (UMich) researchers sheds light on a light bulb that looks similar to an ordinary filament bulb but produces twisted light, known to physicists as elliptically polarized light. Filament bulbs and other commonly used light sources emit linearly polarized (when light waves vibrate in one plane) or unpolarized light (when light waves vibrate in all directions at once). However, when it comes to making vision systems for robots or autonomous vehicles twisted light technology is an important requirement. This is because it will enable them to differentiate between colors, textures, surfaces, and directions. “These findings, for example, could be important for an autonomous vehicle to tell the difference between a deer and a human, which emit light with similar wavelengths but different helicity because deer fur has a different curl from our fabric,” Nicholas Kotov, one of the study authors and an expert in chemical engineering at UMich, said . The science of creating elliptically polarized light According to the researchers, twisted light can be produced using the same technology as the 100-year-old Edison bulb (filament light bulb) technology. “We gradually noticed that we actually have a very old way to generate these photons—not relying on photon and electron excitations, but like the bulb Edison developed,” said Jun Lu, first author of the study and a postdoctoral research fellow at UMich. The fundamental rules of physics suggest that all objects (including you and your cat) that have a body temperature above absolute zero temperature (i.e. >-273.15°C or -459.67°F) release photons. However, some objects absorb the same number of photons they emit at a given temperature, and this phenomenon is called blackbody radiation. During their study, the UMich team twisted tungsten wires and carbon nanotubes to create a unique light emitter. An important point to note here is that the length of each twist matches the wavelength of the emitted light. This resulted in the creation of a twisted light similar to the one a twisted blackbody would produce. What’s even more interesting is that a blackbody generally emits unpolarized light, but in this case, the twisted emitter produces elliptically polarized light. “The advancements in physics of blackbody radiation by chiral nanostructures are central to this study. Such emitters are everywhere around us,” Kotov said. Not just twisted but bright as well Scientists have attempted to produce twisted light in the past also, but this is the first time such a bright twisted light has been created. Lu and his team claim that their device emits elliptically polarized light 100 times brighter than methods previously discovered. Moreover, “While brightness is the main advantage of this method for producing twisted light, up to 100 times brighter than other approaches, the light includes a broad spectrum of both wavelengths and twists,” the UMish team added. They believe that in the future, their twisted light technology may allow robots and autonomous vehicles to have a vision like mantis shrimp, a marine animal known for its ability to see a wide range of UV and infrared light, and its expertise in detecting twists and patterns. The study is published in the journal Science .Dundee manager Tony Docherty is optimistic about the club's new partnership with Mexican powerhouse Monterrey, which he believes could give them a significant edge over their Scottish Premiership competitors. The excitement comes on the heels of signing 19-year-old midfielder Cesar Garza on-loan last weekend, a promising talent with a wealth of potential. Garza, who plays as a defensive midfielder, joins Dundee after gaining valuable first-team experience with Monterrey, a club renowned for its success in the CONCACAF Champions League, having won the title five times. His arrival on Tayside ahead of a January loan is seen as a strategic move that could bolster Dundee’s midfield options significantly, something Docherty has credited owners Tim Keyes and John Nelms for making happen. The partnership between Dundee and Monterrey, established the Dark Blues' hierarchy on November 21, is part of a broader initiative to enhance the club's recruitment strategy. This collaboration aims not only to bring in young talents like Garza but also to create a clear pathway for promising players from Monterrey’s academy to transition into European football. Keyes and Nelms have emphasised that this deal is a vital step in expanding Dundee's global reach and competitiveness. Earlier this year, Dundee also entered into a similar agreement with English Championship club Burnley, showcasing their commitment to building a robust network of partnerships that can facilitate player development and recruitment. Read more: Aberdeen FC's vision for a 'community' stadium faces political hurdles Rangers’ Castore to Umbro kit supplier switch explained “He’s one that we identified, a really talented young player," said the Dundee boss. "He was part of the Mexico Under-20 CONACAF Championship winning team. “He’s played 12 times for Monterrey and he’s someone that we thought he fits in with our kind of style of play. He’s a really combative midfielder, real passion, really loves getting in about it, tackling and winning things. “He’s a good character. Obviously our experience with Antonio Portales and the amount that we’ve watched him, we’re confident we’re bringing in a really good player there and again, it will increase competition for places. “Antonio was a young player at Monterrey himself, so he knows, he’s been here, he’s settled in. “He’s come in and he’s met the rest of the boys and he’ll train with us over the next couple of days, but really excited to get him in the building. “The thing I really need to commend the club on, particularly John and Tim, we’re always thinking outside the box. Where can we look at another market? “We did that through the research we did looking at Antonio when we brought him and Diego Pineda across and we’ve continued to look in that market and we’ve established a partnership with a fantastic club in Monterrey. “The by-product of that is that we’ll get good players in, they’ll get good experience coming and playing in Scotland and it’s just another way you’re trying to be a wee bit ahead of the game.”
American drag racing invented motorsport’s unique Christmas treeBy Vanessa G. Sánchez, KFF Health News (TNS) LOS ANGELES — President-elect Donald Trump’s promise of mass deportations and tougher immigration restrictions is deepening mistrust of the health care system among California’s immigrants and clouding the future for providers serving the state’s most impoverished residents. At the same time, immigrants living illegally in Southern California told KFF Health News they thought the economy would improve and their incomes might increase under Trump, and for some that outweighed concerns about health care. Community health workers say fear of deportation is already affecting participation in Medi-Cal, the state’s Medicaid program for low-income residents, which was expanded in phases to all immigrants regardless of residency status over the past several years. That could undercut the state’s progress in reducing the uninsured rate, which reached a record low of 6.4% last year. Immigrants lacking legal residency have long worried that participation in government programs could make them targets, and Trump’s election has compounded those concerns, community advocates say. The incoming Trump administration is also expected to target Medicaid with funding cuts and enrollment restrictions , which activists worry could threaten the Medi-Cal expansion and kneecap efforts to extend health insurance subsidies under Covered California to all immigrants. “The fear alone has so many consequences to the health of our communities,” said Mar Velez , director of policy with the Latino Coalition for a Healthy California. “This is, as they say, not their first rodeo. They understand how the system works. I think this machine is going to be, unfortunately, a lot more harmful to our communities.” Alongside such worries, though, is a strain of optimism that Trump might be a boon to the economy, according to interviews with immigrants in Los Angeles whom health care workers were soliciting to sign up for Medi-Cal. Since Election Day, community health worker Yanet Martinez said, people are more reluctant to hear her pitch for subsidized health insurance or cancer prevention screenings. “They think I’m going to share their information to deport them,” Martinez said. (Vanessa G. Sánchez/KFF Health News/TNS) Clinics and community health workers encourage immigrants to enroll for health coverage through Medi-Cal and Covered California. But workers have noticed that fear of deportation has chilled participation. (Vanessa G. Sánchez/KFF Health News/TNS) Community health workers like Yanet Martinez encourage people to enroll for health benefits. But many California immigrants fear that using subsidized services could hurt their chances of obtaining legal residency. (Vanessa G. Sánchez/KFF Health News/TNS) Since Election Day, community health worker Yanet Martinez said, people are more reluctant to hear her pitch for subsidized health insurance or cancer prevention screenings. “They think I’m going to share their information to deport them,” Martinez said. (Vanessa G. Sánchez/KFF Health News/TNS) Selvin, 39, who, like others interviewed for this article, asked to be identified by only his first name because he’s living here without legal permission, said that even though he believes Trump dislikes people like him, he thinks the new administration could help boost his hours at the food processing facility where he works packing noodles. “I do see how he could improve the economy. From that perspective, I think it’s good that he won.” He became eligible for Medi-Cal this year but decided not to enroll, worrying it could jeopardize his chances of changing his immigration status. “I’ve thought about it,” Selvin said, but “I feel like it could end up hurting me. I won’t deny that, obviously, I’d like to benefit — get my teeth fixed, a physical checkup.” But fear holds him back, he said, and he hasn’t seen a doctor in nine years. It’s not Trump’s mass deportation plan in particular that’s scaring him off, though. “If I’m not committing any crimes or getting a DUI, I think I won’t get deported,” Selvin said. Petrona, 55, came from El Salvador seeking asylum and enrolled in Medi-Cal last year. She said that if her health insurance benefits were cut, she wouldn’t be able to afford her visits to the dentist. A street food vendor, she hears often about Trump’s deportation plan, but she said it will be the criminals the new president pushes out. “I’ve heard people say he’s going to get rid of everyone who’s stealing.” Although she’s afraid she could be deported, she’s also hopeful about Trump. “He says he’s going to give a lot of work to Hispanics because Latinos are the ones who work the hardest,” she said. “That’s good, more work for us, the ones who came here to work.” Newly elected Republican Assembly member Jeff Gonzalez, who flipped a seat long held by Democrats in the Latino-heavy desert region in the southeastern part of the state, said his constituents were anxious to see a new economic direction. “They’re just really kind of fed up with the status quo in California,” Gonzalez said. “People on the ground are saying, ‘I’m hopeful,’ because now we have a different perspective. We have a businessperson who is looking at the very things that we are looking at, which is the price of eggs, the price of gas, the safety.” Gonzalez said he’s not going to comment about potential Medicaid cuts, because Trump has not made any official announcement. Unlike most in his party, Gonzalez said he supports the extension of health care services to all residents regardless of immigration status . Health care providers said they are facing a twin challenge of hesitancy among those they are supposed to serve and the threat of major cuts to Medicaid, the federal program that provides over 60% of the funding for Medi-Cal. Health providers and policy researchers say a loss in federal contributions could lead the state to roll back or downsize some programs, including the expansion to cover those without legal authorization. California and Oregon are the only states that offer comprehensive health insurance to all income-eligible immigrants regardless of status. About 1.5 million people without authorization have enrolled in California, at a cost of over $6 billion a year to state taxpayers. “Everyone wants to put these types of services on the chopping block, which is really unfair,” said state Sen. Lena Gonzalez, a Democrat and chair of the California Latino Legislative Caucus. “We will do everything we can to ensure that we prioritize this.” Sen. Gonzalez said it will be challenging to expand programs such as Covered California, the state’s health insurance marketplace, for which immigrants lacking permanent legal status are not eligible. A big concern for immigrants and their advocates is that Trump could reinstate changes to the public charge policy, which can deny green cards or visas based on the use of government benefits. “President Trump’s mass deportation plan will end the financial drain posed by illegal immigrants on our healthcare system, and ensure that our country can care for American citizens who rely on Medicaid, Medicare, and Social Security,” Trump spokesperson Karoline Leavitt said in a statement to KFF Health News. During his first term, in 2019, Trump broadened the policy to include the use of Medicaid, as well as housing and nutrition subsidies. The Biden administration rescinded the change in 2021. KFF, a health information nonprofit that includes KFF Health News, found immigrants use less health care than people born in the United States. And about 1 in 4 likely undocumented immigrant adults said they have avoided applying for assistance with health care, food, and housing because of immigration-related fears, according to a 2023 survey . Another uncertainty is the fate of the Affordable Care Act, which was opened in November to immigrants who were brought to the U.S. as children and are protected by the Deferred Action Childhood Arrivals program. If DACA eligibility for the act’s plans, or even the act itself, were to be reversed under Trump, that would leave roughly 40,000 California DACA recipients, and about 100,000 nationwide , without access to subsidized health insurance. On Dec. 9, a federal court in North Dakota issued an order blocking DACA recipients from accessing Affordable Care Act health plans in 19 states that had challenged the Biden administration’s rule. Clinics and community health workers are encouraging people to continue enrolling in health benefits. But amid the push to spread the message, the chilling effects are already apparent up and down the state. “¿Ya tiene Medi-Cal?” community health worker Yanet Martinez said, asking residents whether they had Medi-Cal as she walked down Pico Boulevard recently in a Los Angeles neighborhood with many Salvadorans. “¡Nosotros podemos ayudarle a solicitar Medi-Cal! ¡Todo gratuito!” she shouted, offering help to sign up, free of charge. “Gracias, pero no,” said one young woman, responding with a no thanks. She shrugged her shoulders and averted her eyes under a cap that covered her from the late-morning sun. Since Election Day, Martinez said, people have been more reluctant to hear her pitch for subsidized health insurance or cancer prevention screenings. “They think I’m going to share their information to deport them,” she said. “They don’t want anything to do with it.” This article was produced by KFF Health News , which publishes California Healthline , an editorially independent service of the California Health Care Foundation . ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.Tech Gifts That Will Make You the Holiday MVP—Cool Gadgets Everyone Wants in 2024
Laughter filled the air as guests assembled small wood crosses on a recent afternoon at Friends of the Carpenter in Vancouver’s Fruit Valley neighborhood. Staff and volunteers circulated to chat with participants and offer homemade cupcakes. Since 1997, Friends of the Carpenter has been a safe place for people to relax, grab a bite to eat and learn skills. With new leadership, the faith-based nonprofit is looking to rejuvenate the space and open even more doors for guests in need of community and support. Mike Hammond, the organization’s new executive director, said he is focused on expanding the wood shop, as well as laundry and shower facilities. “Our heart is to really leverage the space that we’ve been blessed with for the good of our community,” Hammond said. “As long as I’m here, I’m going to do everything in my power to make sure that happens.” New pathway When Hammond took the helm in April, he began rebranding the organization and refining its message to better define its role within the community. “We’ve had some really good peaks and then some small dips. But that’s life as a nonprofit,” Hammond said. Hammond’s background as a pastor, combined with a lifelong passion for woodworking, made Friends of the Carpenter fit like a glove. A cornerstone of Friends of the Carpenter is its woodworking shop, where people of all ages and backgrounds can gain skills in carpentry and other trades. The program serves a myriad group — students eager to explore science, technology, engineering and math, as well as adults interested in honing their woodworking expertise. Looking ahead, Hammond plans to expand the program in 2025 with the introduction of a makers’ program, which is still in its early stages. “It’s going to be for people coming from socially excluded spaces,” Hammond said. “This will be for those who have lived experiences, whether that’s on the streets, from communities of color, or the queer community — people who want a traditional pathway to woodworking but may not have opportunities in other settings.” Hammond is also working to secure funding to bring in guest instructors from these communities. The nonprofit recently purchased a CNC machine, which is computer operated and can be used to cut, print and create goods. In addition to the woodworking program, the organization runs a day center that provides meals, a safe place to hang out, showers and a laundry room. Currently, these services are available three days a week, but Hammond’s goal for next year is to extend them to five days, which will require additional funding and volunteer support. A safe place to be Nancy Cralley’s fingers gently traced the intricate details of a piece of wood she crafted with a friend to look like a lighthouse. Its smooth surface is a testament to her hours of careful work. Cralley, 82, began visiting the nonprofit a couple of years ago. Initially, she would drop off her son. But after a few visits, she realized it could be a good fit for her, too. Now, the two regularly visit to enjoy arts and crafts, morning devotions and meals. “This is a venue where everyone is welcome,” Cralley said. “It’s a place for people, like my son, to come and make friends and a place for homeless people to go during the day. It gives people pleasure and a purpose.” Staff and volunteers say they strive to create a warm and welcoming place for all guests. “We make sure people are seen and heard,” Program Coordinator Danielle Gain said. “We greet people by their first names and make sure they feel important and wanted. This place is a safe space for people to come, hang out and get resources.” While chatting with The Columbian, a man walked in looking for a program that wasn’t offered that day. But staff member Stacy Price still warmly welcomed him to the day center to grab a bite to eat and coffee. Later, the man was found sipping a warm cup of coffee and chatting with others in the day center. “We want to make sure that people feel welcomed, safe and included. We do not want faith-based equaling hate or exclusion. We want faith-based equaling love and inclusion,” Hammond said. “We want to be able to make this a space for everybody.” This story was made possible by Community Funded Journalism , a project from The Columbian and the Local Media Foundation . Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.com/cfj .None
The ASX share market is an excellent place to find opportunities that pay and create a second income. Owning a piece of a business is very rewarding – everyone at that company is working to help generate profit. By investing in certain stocks, I'm hopeful that I can receive a stream of cash that becomes a significant size of money compared to my work earnings and eventually grows to more than that. There are plenty of shares to choose from that pay dividends, but I'm looking for a few other things as well. The last few years have shown how important it is to have investments that can help offset inflation. I want to own a group of investments that have a habit of regularly growing their payout to shareholders. A growing dividend can help organically accelerate the passive income growth towards a certain target. It's obvious, but if the dividend is growing, then it isn't being cut. If I'm investing for passive income, I want to be confident that those cash payments will continue even during a downturn. Additionally, a growing dividend could suggest that the underlying earnings are regularly growing, which could translate into capital growth with the ASX share investment. Owning ASX shares for the long term reduces the amount of capital gains tax events and, therefore, reduces how much tax I need to pay because I'm not regularly selling shares and paying over part of my gains to the ATO. It helps keep my capital in my portfolio. I've already held positions in some of the ASX shares in my portfolio for many years, and I plan to keep them for decades longer and watch the dividends roll in. So, which stocks have I been buying to unlock the for a second income? One of the biggest positions in my portfolio is the investment conglomerate ( ), which has grown its annual ordinary dividend every year since 2000. Another of my larger positions is the industrial property owner and building products manufacturer ( ), which also owns a large stake in Soul Pattinson. Brickworks has grown its dividend every year for the past decade. I also have sizeable (and growing) positions in businesses ( ), ( ) and ( ). There are also a few other ASX dividend shares in my portfolio, but these are the core five (at the moment) that make up a large percentage of my dividend portfolio with the aim of a second income.After weeks of fear and bewilderment about the drones buzzing over parts of New York and New Jersey , U.S. Senator Chuck Schumer is urging the federal government to deploy better drone-tracking technology to identify and ultimately stop the airborne pests. The New York Democrat is calling on the Department of Homeland Security to immediately deploy special technology that identifies and tracks drones back to their landing spots, according to briefings from his office. Schumer’s calls come amid growing public concern that the federal government hasn’t offered clear explanations as to who is operating the drones, and has not stopped them. National security officials have said the drones don’t appear to be a sign of foreign interference. “There’s a lot of us who are pretty frustrated right now,” said Rep. Jim Himes, D-Conn., the top Democrat on the House Intelligence Committee, on Fox News Sunday. “The answer ‘We don’t know’ is not a good enough answer.” President-elect Donald Trump posted on social media last week: “Can this really be happening without our government’s knowledge? I don’t think so. Let the public know, and now. Otherwise, shoot them down.” Certain agencies within the Department of Homeland Security have the power to “incapacitate” drones, U.S. Secretary of Homeland Security Alejandro Mayorkas told ABC’s George Stephanopoulos on Sunday. “But we need those authorities expanded,” he said, without saying exactly how. The drones don’t appear to be linked to foreign governments, Mayorkas said. “We know of no foreign involvement with respect to the sightings in the Northeast. And we are vigilant in investigating this matter,” Mayorkas said. Last year, federal aviation rules began requiring certain drones to broadcast their identities. It’s not clear whether that information has been used to determine who is operating the drones swarming locations in New York and New Jersey. Mayorkas’ office didn’t immediately respond to questions about whether they’ve been able to identify drones using this capability. Schumer is calling for recently declassified radar technology to be used to help determine whether an object is a drone or a bird, identify its electronic registration, and follow it back to its landing place. New York Gov. Kathy Hochul on Sunday said federal officials were sending a drone detection system to the state. “This system will support state and federal law enforcement in their investigations,” Hochul said in a statement. The governor did not immediately provide additional details, including where the system will be deployed. Dozens of mysterious nighttime flights started last month over New Jersey, raising concerns among residents and officials. Part of the worry stems from the flying objects initially being spotted near the Picatinny Arsenal, a U.S. military research and manufacturing facility and over Trump’s golf course in Bedminster. Drones are legal in New Jersey for recreational and commercial use, but they are subject to local and Federal Aviation Administration regulations and flight restrictions. Operators must be FAA certified.
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( MENAFN - PR Newswire) CAPE TOWN, South Africa, Dec. 16, 2024 /PRNewswire/ -- Envision Energy, a world leader in renewable energy solutions, proudly announces a contract with the EDF Group, to supply three battery energy storage systems (BESS) for the Oasis 1 cluster of projects, amounting to 257 MW of capacity and 1028 MWh of storage. This marks the largest battery energy storage system (BESS) order in South Africa and positions Envision Energy as the first energy storage system supplier in the region to secure a GWh-scale order. These projects are integral to South Africa's inaugural Battery Energy Storage Independent Power Producer Procurement Programme (BESIPPPP). EDF, in collaboration with co-sponsor Mulilo, and equity partners Pele Energy Group and Gibb-Crede, under the Oasis Consortium, successfully secured three projects: Oasis Aggeneis, Oasis Mookodi, and Oasis Nieuwehoop power plants, located in the Northern Cape Province. Each project includes a 5% ownership interest for local communities through a Community Trust. Financial Close was reached on 20 November 2024 and the projects are set to be operational by end of 2026. Envision Energy will equip these facilities with a full suite of AC and DC energy storage equipment, including station SCADA and EMS systems. The DC side will feature Envision's standard 20-foot, 5 MWh storage units powered by high-safety, high-performance 315Ah cells. Additionally, Envision will provide 15 years of comprehensive lifecycle operation and maintenance (O&M) services. Kane Xu, Senior Vice President and President of International Product Lines at Envision Energy, commented on the initiative: "Battery storage technology is a cornerstone of sustainable energy systems, and we are delighted to contribute our leading technology to this milestone project in South Africa. Once operational, it will effectively address the frequent load management of the current South African power grid, enhance grid stability, and reduce reliance on coal-fired power plants, supporting South Africa's transition to a more sustainable energy system." As the largest battery energy storage initiative in South Africa, these facilities will significantly enhance the country's power infrastructure. They are designed to alleviate grid congestion, increase renewable energy integration, and engage in the power market through energy arbitrage and ancillary services, aiding South Africa's low-carbon energy transition and goal of achieving carbon neutrality by 2050. "We look forward to constructing this project with our industrial partners Envision Energy and Huadong, chosen for their expertise with energy storage products, and ability to deliver a reliable and effective system," said Gregoire de Montgolfier, EDF Renewables Projects Director. EDF Group, the world's largest nuclear operator and a leading global power company, continues to expand its renewable energy portfolio with an aim to reach 60 GW of net renewable capacity by 2030. Envision Energy stands out as a premier provider of cutting-edge energy storage products renowned for their superior battery quality, intelligent design, and the ease and speed of their deployment. With full-stack technical capabilities and a commitment to in-house research and manufacturing, Envision boasts end-to-end control from manufacturing to deployment, including full lifecycle asset management to drive innovation in systematic grid-forming solutions, to ensure grid safety and stability. As of late 2023, Envision has grown its global footprint across the globe with over 200 BESS projects, delivering more than 15 GWh and securing upwards of 25 GWh in ongoing orders. In 2024, Envision Energy was recognized as a Tier 1 Global Energy Storage Manufacturer by Bloomberg NEF for the third consecutive quarter, positioning the company among the top leaders in the energy storage sector worldwide. MENAFN15122024003732001241ID1108995673 Legal Disclaimer: MENAFN provides the information “as is” without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the provider above.A study of hot spots for collisions between ships and whales around the world, including Canadian waters, offers a map for measures to prevent the deadly strikes that could drive some species to extinction, one of the British Columbia-based authors says. Chloe Robinson said reported strikes represent a fraction of their true extent, and a lack of protection measures leaves whales vulnerable as global shipping expands. The study found shipping takes place across 92 per cent of the ranges for humpback, blue, fin and sperm whales worldwide, but measures to reduce vessel strikes have been implemented in less than seven per cent of high-risk areas. “That could really spell, you know, potential extinction for some of these species,” said Robinson, director of whales for Ocean Wise, a B.C.-based organization that provided data for the paper published in the peer-reviewed journal Science. “A recent study estimated anything up to 20,000 whales are killed a year through ship strikes, globally, and that’s just an estimate, a best-case estimate.” Robinson said she was surprised to see Swiftsure Bank, off the west coast of Vancouver Island, emerge as a risk hot spot for strikes of fin, blue and humpback whales. The area is a “migration highway” for humpbacks, she noted. The study also identified a hot spot for the same three species in the Gulf of St. Lawrence between Quebec, New Brunswick and Newfoundland. “This is something that Ocean Wise has been looking into because a lot of the management measures occur offshore and not sort of within the Gulf of St. Lawrence itself and even the St. Lawrence Seaway, (which) leads down to the Great Lakes,” she said. “That was a huge hot spot, which was really interesting for me.” Robinson said there have been smaller studies on the risk of ship strikes in different regions, but the study published Thursday is the first to map the distribution of the four whale species, using a variety of data sources, then compare it with the Automatic Identification System, a tool used for tracking vessels worldwide. “This was really the first of its kind to map these two on top of each other,” she said. The researchers found the highest levels of risk in the Indian, western North Pacific and Mediterranean, while it also identified high-risk areas in the eastern North Pacific, North and South Atlantic Ocean along with the South China Sea. The Southern Ocean was the only region that did not contain any ship-strike hot spots due to low levels of shipping, despite high use by whales, the study found. Robinson said the findings support a strong case for maritime authorities to adopt measures such as whale alert systems, speed limits and no-go zones. “We know where there are areas where there are lots of whales and lots of ships, so this is where we need to target for management,” she said in an interview. Robinson said Canada is home to many “eyes on the water” and researchers exploring innovative techniques for monitoring whales. But the country lacks mandatory mitigation measures, and it’s not alone. “Next to none of the measures globally are mandatory. So, having voluntary measures (is) great, provided people comply,” Robinson said. Ocean Wise launched an alert system in 2018 that notifies large vessels of the presence of whales in Pacific Northwest waters, and Robinson said about 80 per cent of mariners from Washington state up to Alaska have signed up. The WhaleReport alert system mainly functions in what she describes as “inshore” waters around busy ports in Seattle, Vancouver and Prince Rupert. The Port of Vancouver has also seen a high rate of compliance for its ECHO program, Robinson noted. The program encourages vessels to take voluntary steps, such as slowing down or staying farther away from whales, in order to reduce underwater noise and the potential for strikes in busy shipping areas. Robinson favours a multi-pronged approach to reducing ship strikes, but she said one single measure she believes could have a big impact would be equipping vessels with an infrared camera to detect whales within several kilometres. “Maybe some mariners ... respond better to knowing there 100 per cent is a whale 200 metres in front of your vessel, versus, ‘slow down, there might be a whale here.'” Robinson said such cameras can cost between US$50,000 and $75,000. But the cost was a “drop in the bucket” of major companies’ profits, she said. The cameras also present a public-relations opportunity for businesses to advertise themselves as operating in a more whale-friendly manner, Robinson said. “I know people who have had to go and have therapy after killing a humpback whilst at the helm,” she added. “I think there’s a lot to be said (for) the long-term benefits of this kind of technology.” The study also found areas with lower traffic that could provide refuge for whales, especially with added protections. It shows the Arctic Ocean, for example, has very few high-risk areas for vessel strikes, and Robinson said some researchers view it as potential sanctuary. But without protections, Robinson said Arctic waters could become the next high-risk hot spot as sea ice melts with climate change, opening up shipping routes. “Knowing the plans to expand shipping routes into these areas to cut shipping time, make things faster, right through prime whale habitat, I think this is a really good opportunity to get ahead of the issue before it becomes an issue,” she said. Whales play crucial roles in their ecosystems, including cycling nutrients that support other species, and they’re a boon for tourism, Robinson said. They’re also “magical” creatures that people feel connected to, she said, and they remain vulnerable after many species were hunted to the brink of extinction. This report by The Canadian Press was first published Nov. 22, 2024. Brenna Owen, The Canadian Press
North America Healthcare Revenue Cycle Management Market Set for Exceptional Growth in the Forecast 2024-2032 12-25-2024 03:33 PM CET | Health & Medicine Press release from: Cognate Insights North America Healthcare Revenue Cycle Management Market Latest Market Overview The North America Healthcare Revenue Cycle Management (RCM) market is anticipated to experience substantial growth, reaching USD 20.5 billion in 2024. The market is projected to grow at a CAGR of 9.5% from 2024 to 2032, driven by the increasing adoption of RCM solutions in healthcare settings, a surge in healthcare costs, and the growing need for optimized financial operations in medical institutions. Revenue cycle management solutions play a critical role in managing the financial processes within healthcare organizations, from patient intake to payment collection, ensuring efficiency, accuracy, and compliance with regulations. The market's growth is further fueled by innovations in technology, regulatory changes, and a growing demand for cost-effective healthcare solutions. The North America Healthcare Revenue Cycle Management Market has experienced steady growth in recent years and is expected to continue expanding at a strong pace from 2024 to 2032. This analysis offers a comprehensive overview, providing valuable insights into key trends and developments within the North America Healthcare Revenue Cycle Management industry. These findings equip business leaders with the necessary knowledge to devise more effective strategies and enhance profitability. Furthermore, the report serves as a useful resource for new and emerging businesses, helping them make informed decisions as they navigate the market and seek growth opportunities. Major Players of North America Healthcare Revenue Cycle Management Market are: GOJO Industries (United States) - USD 1.2 billion revenue in 2023. 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Renuka Rayasam | (TNS) KFF Health News In April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online baby message boards and other social media forums , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the Patient Advocate Foundation . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the American College of Obstetricians and Gynecologists . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to spread out one-time payments over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the Peterson-KFF Health System Tracker . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the 100 million U.S. people with health care debt, 12% attribute at least some of it to maternity care, according to a 2022 KFF poll . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said Joy Burkhard , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the timing of the pregnancy , plan benefits, and health complications, said Erin Duffy , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said Sabrina Corlette , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, Lacy Marshall , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Related Articles Health | Which health insurance plan may be right for you? Health | California case is the first confirmed bird flu infection in a US child Health | UC campus and hospital worker strike continues across university system Health | Phillips 66 indicted on charges it dumped tainted water from Carson refinery into sewer system Health | US towns plunge into debates about fluoride in water Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.
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