Dedicated Insurance Professionals you know and trust...like Family
Issue No. 53

January 21,  2014

 


 

 

From the Clean Water Act to taxes and immigration reform, Congress, federal regulatory agencies and the courts will be dealing with some of agriculture's top issues in 2014. 

 

With high expectations for the Farm Bill and the Water Resources Development Act to be finalized early in the new year, farmers are anxious for Congress to move immigration reform legislation that meets agriculture's labor needs. 

 

Much-needed tax reform is also key. And, among provisions most critical to farmers and ranchers is small business expensing. 

 

2014 is just beginning, and for agriculture, much is needed and on the horizon. With TACT, your need for healthcare is met! We now serve ALL of TEXAS AGRICULTURE, we are expanding and advancing and we want to hear from you! Obamacare is upon us? Are you covered? Do you have questions? Are you fielding concerns from employees and contractors?

 

We have the answers you are looking for. We have the product to meet your need. And, best of all, we are Texas and we are personal. With TACT, you are our business!

 

 

You are a partner in health care decision making and you are partnered with a coverage provider that is thriving amidst pending change.

 

 

Now serving ALL of Texas Agriculture -

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 Healthcare In The News

 

  

Obama Administration Cutting Ties with Healthcare.gov

  

 

 

The Obama administration is cutting ties with contractor CGI Federal over its handling of the problem-plagued HealthCare.gov, months after the troubled Oct. 1 launch. 

 

The decision to move from CGI Federal to Accenture was confirmed by a statement from the the U.S. Centers for Medicare and Medicaid.

 

"As CMS moves forward in our efforts to help consumers access quality, affordable health coverage, we have selected Accenture to become the lead contractor for the HealthCare.gov portal and to prepare for next year's open enrollment period," the statement read.

 

The statement continued: "We are pleased that more than 1.1 million consumers already have enrolled in a private plan in the federal Marketplace thanks to existing efforts and look forward to working with all of our contract partners to ensure a smooth transition of this work."

 

The government's contract with CGI was up at the end of February anyway, but the administration apparently is deciding not to renew it. According to the Washington Post, officials concluded CGI was not effective in fixing the myriad problems with the federal ObamaCare website. 

 

At first the administration said the problem was not having enough equipment to handle the high level of interest. But major software and design flaws quickly emerged. For example, unlike most e-commerce sites, HealthCare.gov had no way for prospective customers to browse health plans without first opening an account. That only created more computing work for the overwhelmed system to handle. 

 

The administration later acknowledged HealthCare.gov was down 60 percent of the time in October. 

 

The White House sent in a troubleshooter, management consultant Jeffrey Zients, who managed to turn things around by the end of November. Since then, more than 1 million people have signed up for coverage, and when state-run websites are counted, enrollments total more than 2 million. 

 

CGI and other contractors have told Congress that there was not enough time to properly test the system and also meet the administration's Oct. 1 deadline for launching it.

 

The Associated Press contributed to this report. 

 

 

  

 

 

  

Healthcare Changes to

Watch for in 2014

  

 

  

Courtesy USA Today

  

Pricing transparency, possible Medicaid expansion by states and the law's impact on elections are all things to watch.

  

WASHINGTON - The Affordable Care Act is in full force, as millions of uninsured Americans either now have health coverage or will get it this year.

 

But experts say that's just one of many changes to watch for in 2014, including how the law will affect elections, what the states will decide about Medicaid expansion, and what insurers will do to react to their quickly changing demographics.

 

Already, at least 1.1 million people have gained coverage through the federal exchange and the federal and state exchanges stand to enroll millions more through the cut-off date at the end of March. Beginning Jan. 1, insurers may no longer preclude people from buying insurance because of pre-existing conditions; they may not charge older people much-higher premiums than younger people; they may not charge women more than men; and they must share pricing and benefits information to their consumers in an apples-to-apples way.

 

Beyond the law's new requirements, analysts and industry officials say they anticipate a series of related changes to affect health care in 2014, including:

 

* Private exchanges. Insurers will bring more private exchanges to the workplace, and people will begin to understand they have to control their own health costs instead of relying on benefit-heavy insurance plans to do that for them, said Alan Cohen, chief strategy officer for Liazon, a company that provides private exchanges.

"I think we're going to see dramatic, dramatic increases in people who use private exchanges," Cohen said. "There was a big increase this year, but it will pale in comparison to next year."

 

 

* Employer mandate. Employers will also start making changes to prepare for the requirement that companies with more than 50 employees provide health insurance for their employees, said Hector De La Torre, executive director of the Transamerica Center for Health Studies. That requirement was supposed to start Jan. 1 but was delayed a year by the Obama administration.

 

"Employers are really going to be on the clock for 2015 for their mandate kicking in," De La Torre said. "That will be interesting throughout the year as regulations come into play."

 

More employers and insurers will also start offering wellness discounts, which are meant to encourage employees to take better care of themselves in order to get lower premiums, he said.

 

* Pricing transparency. Regardless of the political storms surrounding the law, the health industry is proceeding with the assumption it is here for good, said Ceci Connolly, managing director of PWC's Health Research Institute.

 

That will lead, she said, to more transparency in the pricing of health services. The law requires insurers to tell customers how much they are expected to pay in out-of-pocket costs, but so far health care providers have not followed suit by listing prices for treatments. Some states are requiring providers to do that, Connolly said.

"Price transparency is kicking in," she said. "We really think that's going to take off in 2014."

 

* New rules and higher enrollments. Ellen Nelson, who heads up Affordable Care Act's implementation at Catamaran, a pharmacy benefit manager serving 25 million people, said she expects an "avalanche" of rules and guidance from the Department of Health and Human Services about the law and a surge in enrollments from Jan. 1 through March 31. That's the deadline for people to have insurance or pay for a fine.

 

"We expect that March 31 deadline date to get bumped out to May 1," Nelson said. "If it does, it won't be until mid-year, like June, that we'll know who has enrolled in 2014."

 

* Electronic records. Adoption of electronic records will increase in 2014 and spur industry-wide change, said Rainu Kaushal, chairwoman of the new Department of Healthcare Policy and Research at Weill Cornell Medical College. That's in part because more physicians will have to use the records to participate in Medicare.

This will lead to higher quality and efficiency, Kaushal said, because providers will be better able to track what works - and what doesn't.

 

* Shrinking networks. Insurers will continue to limit their networks of health care providers, often by using those providers with which it can negotiate better rates, said Kev Coleman, head of data and research at HealthPocket.

 

"I think this network issue is going to become one of the top stories in 2014," Coleman said.

 

For most people, he said, particularly for first-time insurance purchasers, that won't matter. "If you never see a doctor, the question's a little more academic," Coleman said. But for a person with diabetes or lymphoma, it's important to make sure specialty doctors are included in new plans.

 

* States will drive change. Medicaid, which is run by the states, will have the most impact on local price structures, said Ray Scheppach, project director for the Health Care Cost Containment Commission and a former deputy director of the Congressional Budget Office.

 

Medicaid administrators, Scheppach said, could move away from fee-for-service models to accountable care organizations and medical homes, where payment is based on low-cost, quality-outcome methods.

 

"Medicare's important, but if you start to add up the number of people in Medicaid, plus state employees, plus exchanges, the states can drive the model," he said.

Some states will also decide this year whether to expand their Medicaid programs, as allowed by the health law.

 

"There are 36 governors up (for election); that's a big collection of governors," Scheppach said. "That cedes into how many additional states expand Medicaid. I think that's the biggest issue."

 

 

Agriculture News
  
Dairy Policy Fight Delaying Farm Bill, Chairman Says
  
  

By Amber Phillips, Digital First Media

A longstanding dispute over dairy policy is holding up an agreement between U.S. House and Senate lawmakers on a new farm bill, House Agriculture Committee Chairman Frank Lucas said.

 

The most obvious sticking point "is the dairy policy," Lucas said in an interview in Washington. "We're just not quite there yet," said Lucas, who said that once a "handful of things" are resolved, a conference meeting will be held to resolve remaining issues.

 

Lawmakers have been debating the bill for more than two years. The measure governs farm subsidies, which encourage the planting of soybeans, cotton and other crops that reduce the cost of materials for commodity processors.

 

The bill also subsidizes crop insurers and funds consumer purchases, its biggest expense.

 

 

 

Under a bill passed by the Senate in June, a new program offering farmers profit-margin insurance for dairy products would require producers who voluntarily enter the program to agree to cut milk production once prices fall below a set limit.

 

Producers who ignore the agreement would receive less from the government. Money saved would buy dairy products for distribution to the poor -- another way to reduce inventories.

House Version:

Language endorsing that approach was stripped from the House version of the bill at the urging of Speaker John Boehner, an Ohio Republican.

 

House Democrats including Agriculture Committee ranking member Collin Peterson of Minnesota supported the Senate provision. Peterson has said supply management is needed to deal with price swings and to protect small farmers.

 

Other unresolved issues include potential changes to country-of-origin labels on meat products, farm-subsidy payment limits, and a proposal to ban states or localities from passing laws requiring specific production practices to be followed in other jurisdictions as a condition for sale within their own boundaries.

 

Those issues will be dealt with in a meeting of the full farm-bill conference committee, according to Senator Charles Grassley, a Republican from Iowa who is not a conferee.

 

Boehner and the leaders of the House Agriculture Committee, Lucas and Peterson, spoke Jan. 3 by phone, according to several aides familiar with the call. They reiterated their positions on dairy, the aides said. No deal was reached.

'Just Tough'

"It's just tough, it's just tough," Lucas said before House and Senate Agriculture Committee leaders met. "If you're between your ranking member and your speaker, that's a tough position to be in a conference committee."

 

A farm conference is expected soon.

Food Stamps

The dairy snag is unrelated to debates over food stamps, the biggest USDA program. Negotiators are "pretty much" agreed on the program, Stabenow, a Michigan Democrat, said last month.

 

Lawmakers are coalescing around a reduction in food stamp costs of about $8 billion to $10 billion over a decade, much closer to the Senate's goal of a $4 billion reduction than the House plan for $39 billion.

 

Supporting the Senate language on the dairy issue is the National Milk Producers Federation, which represents dairy marketing cooperatives.

 

The International Dairy Foods Association has warned against that approach, saying it could lead to occasional price spikes that would harm trade and consumers.

 

The previous farm bill was passed in 2008, and an extension of that law expired Sept. 30. That may force the Agriculture Department to reinstate farm programs governed by a 1949 law, potentially doubling dairy prices.

 

The Senate farm bill is S.954. The House bill is H.R. 2642.

 

Courtesy - Bloomberg Politics

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Five Reasons to Care About the Farm Bill -
even if your aren't a farmer
  
  

The farm bill isn't just for farmers. Even if you don't know a baler from a brush hog, the legislation being debated by Congress this month will affect you.

  

Since Congress let the five-year agricultural law expire last year, it's likely to be one of the first big pieces of legislation they take up this year.

  

To be sure, there's lots in the bill for America's farmers. 

President Obama has called for replacing an unpopular program that gives farmers subsidies regardless of how much money they make or crops they produce with a more straightforward crop insurance program.

  

But the farm bill affects regular people, too. 

Here are five reasons you should care about it even if you aren't a farmer:

  

Millions will probably lose food stamp benefits:

The farm bill ties together rural and urban America by encompassing the government's food welfare system. And in 2014, it's a matter of how much, not if, lawmakers will cut into the program to save money. 


Democrats are calling for about $5 to $8 billion in cuts, setting back the estimated 47 million Americans who rely on food stamps by $90 a month per family. Republicans want to trim $40 billion from the program. The fight over food stamp spending is a major sticking point in the farm bill.


The price of milk could go up:

Remember fears of a dairy cliff in 2013? That stemmed from a provision in the farm bill that requires the government to buy certain dairy products from farmers to help establish the price.

  

If Congress doesn't pass a farm bill in time, it might have to buy up the whole supply of milk thanks to an obscure 1949 law, driving the price of milk way up. That could happen again in 2014, but it probably won't.  

  

Even so, milk could still cost more as making it becomes less profitable for farmers and demand outweighs supply.


The price of olive oil could go up:

An section in the farm bill that ultimately failed to pass the House this June set up quality control for olive oil imports, something its supporters say will help American producers better sell their product. 

  

The legislation would require olive oil from other countries to meet the same standards as olive oil produced in the U.S. 

  

But a Congressional Budget Office report indicated setting up such an inspection program would cost "tens of millions of dollars annually." If this farm bill includes the same provision, the cost of your favorite European olive oil could go up.

  

Your kids could get healthier snacks in schools:

One part of the farm bill critics can agree on is a program that helps bring fresh produce straight from farms to schools.

 

The government's agriculture department encourages schools to buy "unprocessed locally grown and locally raised agricultural products," and a version of the farm bill passed by the Senate in June increases subsidies to schools to do just that.

 

You end up paying for it one way or another:

At 700 pages, the farm bill is a massive piece of legislation. And it's costly, too. 

 

The Senate proposed spending about $955 billion over the next decade on the farm bill, and the House wants to spend less at $921 billion. Both those bills are still cheaper than passing no farm bill, which would put agricultural policy over the next decade at $973 billion. 

So either way, Congress is going to save taxpayers money. But as Politifact points out, a few billion dollars isn't much when talking about a bill that cost almost $1 trillion. 

 

  

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 Healthful Hint

  

Take Control of Your Health

 

 

Courtesy, UCLA Health - The Mirror

There is something magical about the beginning of a new year. For some, it may be the excitement and anticipation of things to come in 2014: the birth of a grandchild or great-grandchild, marriage, travel, or planned family gatherings.

 

Alternatively, it might be the sense of closure after difficult times last year, such as loss of a loved one or coping with new illness. Maybe it is both, maybe it's neither. Regardless, saying goodbye to 2013 and hello to 2014 marks a time to reflect and plan.

 

You may have already made New Year's resolutions for 2014, including:

* Eat more vegetables and less fat.

* Get more exercise.

* Spend more time with family.

* Learn a new skill.

 

Resolutions or not, many people have aspirations for 2014. Planning for your health and wellness in the New Year is important, but I also like to remind my patients and others to give equal care and consideration to planning for their wishes in the event of illness. It might not be as much fun, but it is every bit as important.

 

Let's start by introducing a few of the terms and documents that are used to help discuss and record your wishes.

 

Advance Directives

The Advance Care Directive is a legal document that has five parts. First, identify whom you would want to appoint for your Power of Attorney for Health Care - your "agent." This is the person you want to make your medical decisions if you are unable to make them for yourself. It's a good idea to designate a second person in case your first choice is unavailable.

 

 

The second part is where you give individual instructions (aka living will). Here, you state your general wishes about end-of-life care.

 

In part three, you document your wishes with regard to organ donation.

 

Part four allows you to designate your primary physician.

Part five has signatures, witnesses, and notary.

 

Remember that advance directives only go into effect if a physician has determined that you are unable to make your own decisions.

 

POLST

POLST, or Physician Orders for Life-Sustaining Treatment, is a form that documents what medical treatments you would want in specific situations. It has four parts.

Part A asks what your wishes are if your heart stops.

 

In part B you state your wishes about other medical interventions, ranging from comfort measures only to full treatment in the ICU with a breathing tube.

 

Part C discusses feeding tubes or artificial nutrition wishes.

 

Part D has signatures.

Both of these documents should be vital components of your health record.

 

Although it can be anxiety provoking to make decisions about unforeseen health events, it should be comforting to know that your wishes will be understood and respected.

 

Recommendations are to focus on discussing what is most important to you right now. Remember, this is a moving target; your needs may change as your life and health changes. The New Year is an ideal time to review your wishes and discuss them with your physician and loved ones.

 

Here's to a happy and healthy New Year!  

 

 
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In This Issue
Obama Administration Cutting Ties with Healthcare.gov
Healthcare Chages in 2014
Dairy Policy Fight Delaying Farm Bill
5 Reasons to Care About the Farm Bill
Take Control of Your Health
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Dalhart Consumers Fuel Association
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Sunray Coop
Sunray, TX

Jim Turner
Dalhart Consumers Fuel Association
Dalhart, TX
 
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Levelland, TX

Cary Eubanks
Slaton Coop Gin
Slaton, TX

Dean Sasser
Farmers Coop Elevator
Levelland, TX



 

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