A survey finds the law gives Americans access they couldn’t previously get.

BY NOAM N. LEVEY
More than 60% of working-age Americans who signed up for Medicaid or a private health plan through the Affordable Care Act are getting healthcare that they couldn’t previously get, a new nationwide survey indicates.
And consumers are broadly satisfied with the new coverage, despite some cost challenges and an ongoing Republican campaign to discredit the law.
Overall, 82% of American adults enrolled in private or government coverage through the health law said they were “somewhat” or “very” satisfied, according to the report from the nonprofit Commonwealth Fund.
“If the fundamental purpose of health insurance is to provide people with adequate access to needed healthcare, then it would seem that, on balance, the Affordable Care Act’s coverage expansions are working well for most of the people who have enrolled in them,” the report concluded.
The findings paralleled a recent nationwide survey by the nonprofit Kaiser Family Foundation, which found that two-thirds of people in a marketplace plan created through the law rated their coverage “excellent” or “good.”
Unlike the new report, the Kaiser survey did not include people newly enrolled in Medicaid through the law, which is often called Obamacare.
New Medicaid enrollees are even happier with their health coverage than Americans in commercial health plans purchased through the marketplaces, with 88% reporting they are somewhat or very satisfied, the Commonwealth Fund found.
Americans with employer-provided health plans — which have lower premiums and deductibles than many marketplace plans — are the happiest, with 90% reporting satisfaction with their coverage.
The high marks are not universal, cautioned fund Vice President Sara Collins, the report’s lead author.
Some consumers who had coverage before the health law was implemented have seen their premiums and deductibles increase as insurers have absorbed millions of new consumers, many of whom could not obtain health insurance previously because they had a preexisting medical condition.
The Commonwealth Fund, like Kaiser, has found that many Americans are concerned about the cost of their healthcare.
Nearly half of consumers in marketplace plans reported difficulty paying premiums in 2015. The fund plans to update those findings with 2016 numbers later this year.
“This [report] doesn’t mean that the law is working well for every single person,” Collins said. “But in general, it seems to be enabling people to get the healthcare that they need.”
More than 8 in 10 people said their ability to get needed care has either improved or stayed the same since they enrolled in coverage through the health law.
The law allows Americans who don't get health benefits at work to shop among plans on state-based exchanges operated by the federal government or by the states themselves.
Consumers making less than four times the federal poverty level — about $47,000 for a single adult or $97,000 for a family of four — qualify for subsidies. Insurers must provide a basic set of benefits and cannot turn away consumers, even if they are sick.
Very-low-income Americans in most states can enroll in the government's Medicaid program at virtually no cost, an option provided by the health law that leaders in 31 states and the District of Columbia have elected to make available to their residents.
The dual coverage expansions have led to the largest drop in the nation’s uninsured rate in at least half a century, surveys show.
The new Commonwealth Fund survey found that 45% of adults enrolled in a marketplace plan in 2016 and 62% of adults newly covered by Medicaid were previously uninsured.
More state leaders are now considering Medicaid expansions, including in very conservative states such as Oklahoma.
And enrollment in the marketplaces has been increasing, albeit at a slower rate than initially forecast; there are about 12 million people in marketplace plans.
But the law remains a political hot button, with Republican congressional leaders and presumptive GOP p**********l nominee Donald Trump promising full repeal.
At the same time, many insurers are seeking significant premium increases next year, in part because enrollees in marketplace plans are sicker and more expensive than they anticipated.
The Commonwealth Fund survey was conducted between Feb. 2 and April 5 among a random, nationally representative sample of 4,802 adults ages 19 to 64. It has a margin of error of plus or minus 2 percentage points. noam.levey@latimes.com  


JOE RAEDLE Getty Images
ALBERTO ABIN leaves the UniVista Insurance office in Miami after looking for a health plan under Obama-care, which allows Americans who don’t get coverage at work to shop among plans on state-based exchanges.



JOE RAEDLE Getty Images
ALINA NURIEVA, right, talks with an insurance agent in Miami as she picks a health plan in 2015.

I've lived over 80 years and have been a member of OPP for a very long time and am aware of you guys "joking" with each other. I'd like to bring to your attention a very well-written letter.

This is a pass-through post I happened upon in my niece’s timeline on Facebook, which apparently has been removed for violating some policy or other of theirs. It was written by a young lady named Kasey Rose-Hodge. I think it has sufficient merit that it should be promulgated far and wide. Herewith, I make my small contribution to that effort.

"Dear creepy heterosexual men guarding our bathrooms,

My entire life, I've been told to fear you in one way or another. I've been told to cover my body as to not distract you in school, to cover my body to help avoid unwanted advances or comments, to cover my body as to not tempt you to sexually assault me, to reject your unwanted advances politely as to not anger you. I've been taught to never walk alone at night, to hold my keys in my fist while walking in parking lots, to check the backseat of my car, to not drink too much because you might take advantage of me. I've been told what I should and shouldn't do with my body as to not jeopardize my relationships with you.

I've been warned not to emasculate you, to let "boys be boys", to protect your fragile ego and to not tread on your even more fragile masculinity. I've been taught to keep my emotions in check, to let you be the unit of measure for how much emotion is appropriate and to adjust my emotions accordingly. I've been taught that you're allowed to categorize women into mothers/sisters/girlfriends/wives/daughters but any woman outside of your protected categories is fair game.

So to those of you who think you're being helpful by "protecting" me and my fellow women, you're like a shark sitting in the Lifeguard chair. I wasn't uncomfortable until you showed up at the pool and the only potential predator I see is you.

Your mothers, sisters, girlfriends, wives and daughters don't need you to walk them to the bathroom for safety. Your fathers, brothers, friends and sons need to walk themselves away from their own double standards. Women are sexually harassed and sexually assaulted on school campuses, on the street, at their jobs, on the Internet, in their own homes, in ANY public place. And it has been excused or ignored for so long because of what you and I are taught from the first years of our interactions with each other: You, as a male, are not accountable for your own actions. It's MY responsibility, as a female, to not "provoke" you. But then you get to Knight-In-Shining-Armor your way through life for those in your protected categories and I am expected to applaud you. Why the outrage now over bathrooms? Why aren't you outraged every single day?

If you're telling me that there are high volumes of boys and men out there, in schools or in general, who are just waiting for a "loop hole" to sexually assault girls and women, we have bigger problems on our hands than bathrooms. The first problem would be your apparent lack of knowledge of how often it happens OUTSIDE of bathrooms, with no "loop holes" needed. This isn't about T*********r bathroom access. This is about you not trusting the boys and men in your communities and/or fearing that they're all secretly predators. Why do you have this fear? How many fathers have panicked when their daughters started dating because they "know how teenaged boys can be because they used to be one"? How many times have girls been warned "boys are only after one thing"? A mother can bring her young son into the women's restroom and that's fine but a father bringing his young daughter into the men's restroom is disturbing because men are assumed to be predators and "little girls" shouldn't be exposed to that.

So instead of picking up your sword and heading to Target or the girls' locker room to defend our "rights", why don't you start somewhere that could actually make a difference? Challenge your children's schools to end sexist dress codes and dress codes that sexualize girls as young as age 5. Advocate for proper (or any) sex education classes in all public schools by a certain grade level. Focus more on teaching your sons not to rape vs teaching your daughters how to avoid being raped. Stop asking "How would you feel if that was your mother or sister?" It shouldn't take the comparison to clue you in to what's right or wrong. Question why you're more worried about your daughter being around men than your son being around women in bathrooms and dressing rooms. Stop walking by Victoria's Secret with no problem but covering your son's eyes if a woman is breastfeeding in public. Stop treating your daughter's body as some fortress you're sworn to protect as if that's all she's got to offer the world". - Kasey Rose-Hodge

I didn't know it was customary for presidents and their families to show the money spent on vacations. And just what does it have to do with Melania posing in her underwear? Oh, and by the way, Melania was screwing Donald when he was still married to wife number two. I think that used to be called adultery and, if nothing else, conservatives would shun them. I guess it no longer matters eh!

And hey, did you see the picture of Michelle with her dress bunched in the front! Looks like she has a dick huh. Why don't we talk about that instead of the slut Donald is married to!

I know you have to support Donald Loki. But compared to Melania Michelle is nothing but a class act. Do you think Melania doesn't burn through Donalds money? What do you think she's going to do when she's got a hold of the taxpayer purse! Melania is a gold digger and your bitching about Michelle? Give me a break...

Warm Seas Lead to Extensive Coral Bleaching
acquired February - March 2016
For all of the apparent hardness of their skeletons, corals are rather fragile. Corals thrive under very specific conditions; in particular, they grow best within a small window of temperatures. If the water gets too hot or too cold, corals start to bleach and sometimes die.
The past two years have been the two hottest in the global temperature record, and coral reefs around the world are suffering because of it. The potent El Niño has amplified the problem. As a result, national and international science agencies have declared one of the worst global coral bleaching events on record.
“We are currently experiencing the longest global coral bleaching event ever observed,” said Mark Eakin, coordinator of NOAA’s Coral Reef Watch, in a February 2016 statement. “We may be looking at a 2- to 2.5-year-long event. Some areas have already seen bleaching two years in a row.”
Bleaching occurs when the algae that live inside corals (and give them some of their colors) are expelled due to stress, such as higher-than-normal water temperatures or pollution. The loss of the algae means the loss of a food source for the corals. Under extreme bleaching, corals become more susceptible to disease. Bleaching does not necessarily mean death for a reef, but it can often lead to it.
The images above and below are maps of sea surface temperature anomalies (SSTAs) in various regions over the past year. The maps do not depict absolute temperatures; instead, they show how much water temperatures were above (red) or below (blue) the long-term average for the same months from 2003 to 2012. Gray areas are too close to land and coastal shallows for a clear signal in this data set.
The map at the top of this page shows sea surface temperature anomalies for the southwestern Pacific Ocean for February and March 2016. The map below depicts equatorial Atlantic, Caribbean, and Pacific waters around the Americas in October and November 2015. The final map is a global view of SSTAs from November 2015 through February 2016, the peak of this winter’s El Niño.

acquired October - November, 2015
The maps were built with data from the Microwave Optimally Interpolated SST product, a NASA-supported effort at Remote Sensing Systems. The research team combines measurements from the U.S. Navy’s WindSAT instrument on the Coriolis satellite and the AMSR2 instrument on Japan’s GCOM-W. The sensors observe emissions of microwaves and infrared light from the sea surface, capturing the temperature of the top few millimeters of the water.
Temperatures on these maps show above-average readings, but do not necessarily look extreme in the areas around the reefs. But keep in mind that corals are sensitive to relatively minor changes in temperature. Researchers from NOAA also point out that sustained heat stress over a long period of time—weeks to months—is more damaging than brief, extreme events.
Researchers from Australia’s Coral Bleaching Taskforce have reported that nearly 93 percent of the Great Barrier Reef has been affected in some way by the bleaching event. Temperatures around the reef most recently peaked in February and March 2016. After conducting aerial and in-water surveys, scientists observed that 81 percent of the reefs between Cairns, Australia, and Papua-New Guinea have been severely bleached, with another 18 percent partially bleached. Some reports suggest 50 percent of the corals might be dead already. Along the central latitudes of the reef system, 33 percent of the reefs were severely bleached, with another 56 partly affected. In the southernmost reaches, 1 percent was severely bleached and 74 percent had some level of distress. The central and southern portions were actually aided a bit by Cyclone Winston. The severe storm churned up enough cold water to reduce surface water temperatures and moderate the bleaching.
In the Caribbean and the reefs of the Florida Keys, bleaching events were most severe in the fall of 2015. Reefs around the Hawaiian Islands, Fiji, and other Pacific islands have been severely stressed and bleached. With 2016 global temperatures already setting records, there is concern that bleaching could occur again in 2016.

acquired November 2015 - February, 2016
References and Related Reading
The Conversation (2016, April 6) Coral Bleaching Taskforce: more than 1,000 km of the Great Barrier Reef has bleached. Accessed May 18, 2016.
The Conversation (2016, April 26) Great Barrier Reef bleaching stats are bad enough without media misreporting. Accessed May 18, 2016.
NOAA (2016, February 23) El Niño prolongs longest global coral bleaching event. Accessed May 18, 2016.
NOAA Climate.gov (2016, May 6) Great Barrier Reef suffers through record-breaking bleaching event. Accessed May 18, 2016.
Science (2016, April 19) Survey confirms worst-ever coral bleaching at Great Barrier Reef. Accessed May 18, 2016.
NASA Earth Observatory image by Jesse Allen, using multi-satellite microwave sea surface temperature data from Remote Sensing Systems. Caption by Michael Carlowicz.
Instrument(s):
Coriolis - WindSat
GCOM-W1 - AMSR-2