What's Next for Millions Rushing to Sign Up for Obamacare?

2017-10-31 14:18:16 | 日記

 


This article originally appeared on the Motley Fool.

Donald Trump ran for president on promises to repeal and replace Obamacare, but that hasn't stopped millions of Americans from signing up for healthcare insurance through the Affordable Care Act (ACA) marketplaces. So far, enrollment is already north of 4 million for 2017. Will more Americans sign up for coverage this year than ever before? And, what could health insurance reform mean for these individuals beyond 2017?

December 14 was originally the deadline to file for health insurance through the marketplaces if you wanted coverage to begin on Jan. 1. However, a late rush prompted the Department of Health and Human Services to extend the deadline to Dec. 19.

In a tweet storm earlier this week, HHS Secretary Sylvia Burwell reported that 1 million Americans had already signed up for coverage through Obamacare between December 12 and December 14. Those new enrollments will be added to the 4 million Americans who already had enrolled in Obamacare through Dec. 10. For comparison, in the same period last year, 3.75 million people had enrolled.

As of December 15, nearly 1 million people were still in the process of signing up.

Last year, 10 million Americans signed up and paid for health insurance through Obamacare, and this year's totals suggest a similar number of people will sign up this year, in spite of insurance premium increases and promises of repeal.

The pace of enrollment suggests that the majority of Americans getting their coverage aren't being frightened away by premium increases, which reach into the double digits in some areas of the country.

Last year, about 9 million people received tax credits that subsidize their insurance premiums. On average, these tax credits totaled $300 and reduced a person's monthly premium to less than $100 per month.

These tax credits are adjusted to reflect premium price changes, so most Americans aren't feeling the sting of spiking premiums this year.

What's next for Obamacare

In the past, Republicans have suggested private market solutions to replace the ACA, and on the campaign trail, Donald Trump frequently said his plan is to repeal the ACA and replace it with something else.

Trump hasn't offered up too much insight into what his replacement might look like, but he's indicated in the past that competition across state lines will be part of the solution. He's also said he plans to target sky-high drug prices, which he may do by decreasing regulation and allowing drug reimportation from countries where medicine is sold for less, such as Canada.

If Trump repeals Obamacare outright, its impact could be greatest on patients, hospitals and insurers.

Congress has said it wants to avoid a repeal that leaves currently employed people high and dry. That could mean a gradual phase-out of Obamacare, or forbidding insurers from canceling plans for a period of time.

If Trump eliminates subsidies to individuals and families, it's hospitals that could take a hit to their profitability. Currently, subsidies are linked to income, so their disappearance would probably lead to a decline in coverage for cash-strapped Americans, and a corresponding increase in hospital bad-debt expense and charity care.

Alternatively, it's insurers that could benefit most from reform. A decline in enrollment would have the biggest impact on low-income enrollees, who have, historically, been more costly to insure because of their lack of access to primary care, and their reliance on emergency rooms.

Assuming insurers gain more underwriting flexibility to craft insurance pools that are more profitable, then insurer profits could climb even as the total number of people with insurance falls.

In selecting Tom Price as Secretary of HHS, Trump appears to be a fan of Price's repeal-and-replace plan. In 2015, Price's Empowering Patients First Act offered up a blueprint for replacing Obamacare with a solution that includes "individual health pools and expanded health savings accounts, tax credits for the purchase of coverage, and lawsuit abuse reforms to reduce the costly practice of defensive medicine."

Specifically, Price's plan provides states with block grants to establish high-risk insurance pools, and it offers taxpayers tax credits linked to age, rather than income. Previously, Price's plan called for a maximum credit of $3,000 per year for individuals age 50 and up.

Looking ahead

Millions of Americans continue to enroll in Obamacare despite uncertainty, and that suggests there remains an important need for accessible insurance. It's anyone's guess what Trump's repeal-and-replace plan will ultimately look like, but it appears that it could include tax credits, risk pools, health savings accounts and competition across state lines. Whether such a policy will be a net win or loss for patients, care providers, and healthcare companies will depend on the details. With millions of people still relying on Obamacare, the stakes are high. 

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What Spurred The Coup At the Top of Tata?

2017-10-31 14:11:25 | 日記

 


This article first appeared on the Riding the Elephant site.

Ratan Tata, the veteran patriarch of India’s revered Tata empire, personally instigated and forced the sacking on October 24 of his successor, Cyrus Mistry, as chairman of Tata Sons, the group’s holding company.

This is clear from the way the coup was done, which is in line with Tata’s personal style of dealing with executives who fell out with him when he was the Tata Sons chairman for 21 years.

It was also characteristic that, as soon as Mistry had gone, an internal interview he gave last month for staff was removed from the company’s website. There, he had talked about realizing that Tata was “a unique institution with a rich and glorious history” and said, “We now needed to build the capabilities that would allow us to succeed for the next 150 years.”

From reports, it seems that Tata’s main complaint is that Mistry’s decisions and management style were doing harm to the Tata Group’s traditions and image, despite what Mistry had said in that interview.

But the way in which Mistry has been shunted out has arguably done more damage to the group’s usually stable image than he himself could have done. It will also make it extremely difficult to find a new chairman to succeed Tata, who has taken over temporarily.

There could also be long-term damage to the group’s stability, because Mistry’s family is the largest single shareholder and will be around long after Tata, 78, stops working. Mistry, 48, was the group’s sixth chairman since it was founded in 1968 and was the first to not be from the Tata family, though he shares the Tata’s Parsi religion and there are also links by marriage.

When Tata retired in December 2012 as chairman of Tata Sons, which is India’s biggest and most respected conglomerate, he was succeeded by Mistry but remained chairman of the Tata Trusts, which holds a controlling 66 percent stake in the group.

This means that Tata has continued to wield authority, rather like a supervisory board chairman. He also had enough personal pull to whip other Tata Sons board members into line and secure a six-out-of-nine majority for his coup.

I first heard suggestions in 2012 that Tata was not happy with the choice of his successor but realized that, after failing over several years to choose and groom a successor, he had to accept him because of the Mistry family’s shareholding. But Tata did not show any signs of his unhappiness starting in November 2011, when Mistry was selected, or after the handover.

Publicly, Tata has occupied himself with a series of personal and Tata Trusts investments in mostly new high-tech ventures, leaving Mistry to run Tata Sons. But behind the scenes, tensions were building.

This was inevitable, because Mistry’s job was to sort out the baggage and legacy left to him by Tata. No one bestraddled the Indian business world in the way that Tata did, presiding over $100 billion-plus in revenues, more than half from 80 countries overseas, with over 450,000 employees in 100 operating companies and interests ranging from tea to telecoms, software to hotels, wristwatches to defense rockets, coffee (Starbucks) to power and steel.

But he left big problems for Mistry to sort out. They included debt from a $13.39 billion Tata Steel investment in the U.K.’s loss-making steelmaker Corus, poor performance and a dismal new product line at Tata Motors’s India business, unsatisfactory results at the group’s Taj hotels, and other problem areas, including telecoms.

Ironically, the big company that was performing worst and needed the most basic change was Tata Motors, in which Tata had taken the most personal interest, saddling it with the disastrous Nano mini car that has produced losses since it was launched in 2009.

Offsetting that was Tata’s highly successful $2.3 billion takeover in 2008 of the U.K.’s Jaguar Land Rover, which has supplied Tata Motors with profits.

Contradictory Criticisms

Criticisms being leaked by Tata’s supporters focus contradictorily on how Mistry did not grapple enough with these problems, and how he brought in too many changes.

Similarly, on the Indian TV channels, a representative of the Tata Trusts said they were motivated to sack Mistry because of worries about profits to fund charitable works, while Harish Salve, a senior lawyer and Tata confidante, said that Mistry had been too profit-oriented for Tata as a broader-based institution.

Lord Kumar Bhattacharyya, of the U.K.’s Warwick University, who is a Tata loyalist and was involved in the choice of Mistry, told the Financial Times that he had been replaced because of a “lack of performance.” That echoed a critical article in The Economist on September 24 that contained a very detailed analysis of the group’s finances but arguably did not give Mistry enough credit for trying to balance what it called being “socially responsible but financially disappointing.”

Tackling Problems

Mistry was trying to sort out the problems. Last year, he began to close or sell the U.K. steel interests, a move that now seems to have been put on hold, partly because of Brexit’s impact on investments.

There were changes in the Taj hotel group, which sold at least one big investment, and Tata Power plans to sell stakes in Indonesian coal mines. There has also been an increasingly bitter legal dispute with Japan’s NTT DoCoMo, a mobile phone operator, over a $1.2 billion arbitration award.

Possibly most contentious has been the plan to sell or close Corus and the DoCoMo clash, neither of which really fit with the Tata gradualist ethos. There have been some criticisms of the way that the Corus affair was handled, but there were substantial talks with the U.K. government before the initial decision was announced. The DoCoMo row certainly worried the Indian government, which feared it would put off potential Japanese investors.

Profits actually improved under Mistry. Total net profit in 16 listed companies where Tata Sons is a shareholder amounted to $5 billion in the financial year ending in March, according to S&P Capital IQ data. This was 21 percent higher than in Tata’s last year in charge, the Financial Times reported. But this relied heavily on Tata Consultancy Services (TCS), the group’s information-technology cash cow, which accounted for 69 percent of total earnings.

Excluding TCS, net profit for the 16 companies fell 42 percent, reflecting Tata Steel’s heavy U.K. losses and a sharp decline in earnings for Tata Motors’s core Indian business. The rest of the companies included many bad performers.

Beyond all that, there have been suggestions that Mistry was leading the group into his Pallonji family’s main investment area: infrastructure projects. Tata has little or no experience in this area, where bribes and other corruption could cause problems for the group’s “clean” image.

Ratan Tata is also known to have been unhappy about a group executive council of new recruits that was set up by Mistry in 2013, introducing a new tier of authority below the Tata board. Significantly, that council was closed down Monday.

A Luxury Mistry Did Not Have

None of this is very exceptional, however, and in fact is very similar to what Tata did when he became the group’s chairman in 1991. He centralized power in the group’s Mumbai headquarters and, one by one, removed men who were running key parts of the business, including Tata Steel and the Taj hotels.

No one interfered with him because he was the chairman of the Tata Trusts as well as Tata Sons. That was a luxury that Mistry did not have, and he did not have time to prove that he could perform long term as well, if not better, than Tata had done.

It is not yet clear what finally led Tata to decide his successor had to go. Mohan Parasaran, a senior lawyer and Tata adviser, said on NDTV television Tuesday that he had been consulted a month ago by Ratan Tata about the legality of removing Mistry, who declined an invitation to resign.

Even those who think it was right for Mistry to go criticize Ratan Tata’s way of handling it. “I am not at all happy about the development, which looks very ugly to say the least,” V.R. Mehta, one of the Tata trustees, told NDTV.

That just about sums up the problem that Tata has created for himself and for the group, by deciding it was better to sack Mistry than try to work with him and his new ideas.

John Elliott writes from New Delhi. His latest book is Implosion: India’s Tryst With Reality (HarperCollins, India).

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VW Scandal Could Pose Bigger Threat to German Economy Than Greek Crisis

2017-10-30 14:18:13 | 日記

 


The Volkswagen emissions scandal has rocked Germany's business and political establishment and analysts warn the crisis at the car maker could develop into the biggest threat to Europe's largest economy.

Volkswagen is the biggest of Germany's car makers and one of the country's largest employers, with more than 270,000 jobs in its home country and even more working for suppliers.

Volkswagen Chief Executive Martin Winterkorn paid the price for the scandal over rigged emissions tests when he resigned on Wednesday and economists are now assessing its impact on a previously healthy economy.

"All of a sudden, Volkswagen has become a bigger downside risk for the German economy than the Greek debt crisis," ING chief economist Carsten Brzeski told Reuters.

"If Volkswagen's sales were to plunge in North America in the coming months, this would not only have an impact on the company, but on the German economy as a whole," he added.

Volkswagen sold nearly 600,000 cars in the United States last year, around 6 percent of its 9.5 million global sales.

The U.S. Environmental Protection Agency said the company could face penalties of up to $18 billion, more than its entire operating profit for last year.

Although such a fine would be more than covered by the 21 billion euros ($24 billion) the company now holds in cash, the scandal has raised fears of major job cuts.

The broader concern for the German government is that other car makers such as Daimler and BMW could suffer fallout from the Volkswagen disaster. There is no indication of wrongdoing on the part of either company and some analysts said the wider impact would be limited.

The German government said on Wednesday that the auto industry would remain an "important pillar" for the economy despite the deepening crisis surrounding Volkswagen.

"It is a highly innovative and very successful industry for Germany, with lots of jobs," a spokeswoman for the economy ministry said.

But analysts warn that it is exactly this dependency on the automobile sector that could become a threat to an economy forecast to grow at 1.8 percent this year. Germany is already having to face up to the slowdown in the Chinese economy.

"Should automobile sales go down, this could also hit suppliers and with them the whole economy," industry expertMartin Gornig from the Berlin-based DIW think tank told Reuters.

In 2014, roughly 775,000 people worked in the German automobile sector. This is nearly two percent of the whole workforce.

In addition, automobiles and car parts are Germany's most successful export -- the sector sold goods worth more than 200 billion euros ($225 billion) to customers abroad in 2014, accounting for nearly a fifth of total German exports.

"That's why this scandal is not a trifle. The German economy has been hit at its core," said Michael Huether, head of Germany's IW economic institute.

"MADE IN GERMANY"

There are also voices, however, that say the impact on the economy as a whole should not be exaggerated.

"I don't think that the German automobile industry will be lumped altogether," Commerzbank chief economist Joerg Kraemer told Reuters.

"There won't be a recession just because of a single company," Kraemer added.

The German BGA trade association also tried to calm the public by saying there were no signs that customers abroad were starting to doubt quality and reliability of German companies.

"There isn't a general suspicion against goods labeled 'Made in Germany'," BGA managing director Andre Schwarztold Reuters.

But he acknowledges there is a degree of concern among German companies that the scandal over cheating on U.S. diesel emission could have a domino effect on their businesses, eroding the cherished 'Made in Germany' label.

Some observers also see some irony in the scandal.

While the German economy defied the eurozone debt crisis and, so far, the economic slowdown in China, it could now be facing the biggest downside risk in a long while from one of its companies.

"The irony of all of this is that the threat could now come from the inside, rather than from the outside," Brzeski said.


Uber's deregulated business violates equality law | David Perry

2017-10-30 13:55:12 | 日記

 

 

Uber has dodged another regulation. Last week, news broke that Uber is getting sued… again, this time by two disabled men in Jackson, Mississippi. The plaintiffs allege that as wheelchair users they are highly independent, but rely on commercial transportation – whether public or private – to get around the city, as neither drives. They take buses. They take taxis. But they can’t take Uber, they claim, because it doesn’t offer Wheelchair Accessible Vehicles (WAVs) to the half million residents of Jackson. This violates both the ADA and California disability law (where Uber is located).

From Uber to AirBNB to TaskRabbit, the gig economy presents itself as the hyper-flexible way to work, to get things done, and to find the professional services you need. Through promoting “sharing,” using other people’s property like cars and apartments or services like driving, repair skills, these companies have created broadly profitable industries that successfully dodge decades of red tape and other bureaucratic roadblocks.

Over the last three decades and more, access to public space and public infrastructure has been a major goal – and victory – for the disability rights movement. Thanks to numerous state and federal laws, all government services – from trains and buses to court documents and DMVs – must be made accessible. Private businesses, at least once they get to a certain size, have to provide access to their product. A restaurant needs accessible seating. A hotel needs accessible entrances and rooms. Taxis need put some WAVs on the road.

Think about the world prior to the ADA. Restaurants and hotels had no obligation to have ramps, so a single step might effectively tell disabled diners or lodgers to keep out. Once inside, there was no expectation of being able to use a restroom, order from a menu, or have seating at an appropriate height. Of course, even if a restaurant was accessible, a disabled person might not being able to find a ride to get there, depending on their needs. Before the ADA, lack of accessibility could quite literally trap people in their homes. Now, though, we have ramps and power doors, curb cuts and lifts on buses. The regulations that made this possible may be a bad word among some business folk, conscious of costs, but they’ve made society much more equitable for disabled Americans.

Enter the sharing economy. Uber claims that it’s not providing transportation, but that it’s just a “transportation network provider” (TNP). Their app, they say, is fully accessible for disabled users. Each individual driver is an independent subcontractor, meanwhile, so Uber maintains that unlike a taxi company, it’s not legally required to put sufficient WAVs on the roads to meet demand. That was a cute argument when they were a small niche firm. Now that they have crushed taxi industries across America, they are effectively denying access to car transport for disabled would-be riders.

There is another lawsuit pending against Uber in Chicago. There are 400 wheelchair-accessible taxis in the Chicago fleet. Uber now provides many more rides per day than taxis in the area, so it stands to reason that they need more than 400 WAVs to meet demand. Instead, they have 40. Though they recently agreed to raise the number to 53. They don’t guarantee, of course, that these 53 will be available for hire for any particular number of hours per week, because they are just a “network provider,” not a transportation company. According to Charles Petrof, Senior Attorney at the disability-rights center Access Living in Chicago and co-counsel with the law firm of Much Shelist in the suit, these 53 vehicles are just woefully inadequate. He told me, “The odds that a vehicle you can use are so low that you’re not going to bother to sign up for it.”

Bruce Darling, executive director of the Center for Disability Rights New York State, told me that he “cut its teeth on fighting for access in transportation,” working with the direct action group ADAPT in the 1980s. Then the fight was to get lifts on busses, which happened. Today, the problem is corporations like Uber. Not only do they exclude huge communities such as in Jackson, Darling told me, but their attempts at accessible transit are “Little boutique pilot things. I’m not impressed. Disabled Americans are all over. If they were committed to access, they’d be committed to access all over. Instead, they are fighting us every step of the way.” The disability rights community thought public transportation and accessible taxis was largely a solved issue, but Uber, Lyft, and the others threaten to undo decades of progress.

The City of Chicago would not comment on a lawsuit between two private individuals, but an official did tell me that they are hearing from many individuals that the new accessible ride-sharing system is helping. An Uber spokesperson emailed me a statement reading, “We take this issue seriously, and we are committed to increasing mobility and freedom for all riders and drivers, which of course includes members of our communities with disabilities. There is always more to be done and we will continue working hard to expand access to affordable, reliable transportation options for all." Uber has not, to this point, responded to requests for a more substantive dialogue about the ADA and accessibility.

Ride sharing is not the only culprit. If you build a hotel, you are obligated to comply with ADA regulations about accessibility. Rent out your apartment to AirBNB and all bets are off. The company requires you to describe your space accurately and doesn’t allow you to discriminate against disabled guests (although I’ve heard numerous reports of alleged discrimination), but there’s no affirmative requirement for AirBNB to ensure sufficient numbers of accessible lodging options within a given area.  My car is not wheelchair accessible, but I could drive for Uber. I could rent out my home, despite the fivesteps in front of my house. For that matter, if I charged you a fee for eating dinner in my home, I wouldn’t have to comply with disability law to make it accessible (though I would likely violate other food-related laws).

In the gig economy, profits pour in based on dodging the requirements of the regulatory state that enforce equal accessibility, pay, lack of discrimination, and basic economic justice. When vulnerable populations complain, they are brushed off with token responses and denial of legal culpability.  Bruce Darling, the veteran activist, makes it clear he doesn’t think it has to be this way. “It is possible to provide equal access,” he says, when it comes to gig/sharing methods of doing business. But too often, disability wasn’t even on the radar as companies rushed to exploit deregulated business models. Darling says, of these companies, “They didn’t look at the needs up front, had they done that, it would have been a lot easier. We are the afterthought.”

This isn’t going to be the last lawsuit faced by Uber, its rivals, and other companies seeing profit in deregulated business models. I hope the legal battles push such companies towards a new commitment to justice and equality. The internet and app-based sharing economy is, in the scope of business history, still very new. There’s still time to hold such companies accountable to the core principles of equal access, reasonable accommodation, and disability justice in the workplace.

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The Key Issues for IMF Chief Christine Lagarde in Nigeria

2017-10-28 16:42:25 | 日記

 


The International Monetary Fund’s (IMF) managing director Christine Lagarde met with President Muhammadu Buhari on Tuesday as part of a four-day visit to Nigeria.

Lagarde dismissed suggestions that she was visiting Nigeria to agree a new IMF loan for the country, which has been hit hard by the global slump in oil prices. Her visit comes at a time of economic scrutiny in Nigeria. It is only a few weeks after Buhari’s first budget, in which he announced huge increases in capital expenditure and foreign borrowing as Nigeria tries to move away from its dependency on oil. As well as her discussions with Buhari, Lagarde is due to meet with Nigeria’s Finance Minister Kemi Adeosun and address the National Assembly on Wednesday afternoon.

Newsweek spoke with experts to look at what the Nigerian government and Lagarde might discuss.

1. Lifting foreign exchange restrictions

In a bid to deal with falling oil prices—which had hit as low as $39 a barrel in December 2015—the Central Bank of Nigeria (CBN) has taken several steps to reduce access to foreign currency and retain the value of the naira. These include restrictions on the importing of 41 categories of items—which covers hundreds of arbitrary items, from soap to toothpicks—that could leave Nigerian companies without adequate raw materials to make their products. “This is obviously not what the IMF, or any free market-oriented economist, would advise the Nigerian government to do,” says Malte Liewerscheidt, senior analyst on Nigeria at U.K.-based risk consultancy Verisk Maplecroft. Indeed, the IMF has been openly critical of measures the CBN has taken in recent months and Lagarde is likely to ram this point home in her meetings with government officials and stakeholders.

2. Scrutinizing the budget

In his maiden budget announced on December 22, 2015, Buhari announced plans to raise spending by 20 percent in 2016, with $31 billion going towards improving infrastructure and the economy. The Nigerian president said he would seek 900 billion naira ($4.5 billion) of overseas funding and claimed that oil would make up just 820 billion naira ($4.1 billion) of the 3.9 trillion naira ($19.6 billion) forecast for 2016. “Everyone agrees that the revenue assumptions are a little bit optimistic,” says Manji Cheto, vice president of political risk analysts Teneo Intelligence. “Nigeria has not particularly had a great history in non-oil revenue accumulation so obviously that’s a major downside risk.” Following her meeting with Buhari on Tuesday, Lagarde tweeted that she was “impressed” with the government’s response to low oil prices, but the challenge, according to Cheto, will be whether the budget can actually be implemented.

3. Ending corruption in the government

Buhari was elected on a pledge to stamp out corruption in the Nigerian government and recover billions of dollars allegedly misused or stolen by previous government officials. He has taken a number of steps in this direction, notably the arrest of Sambo Dasuki, Nigeria’s former national security advisor, on charges of allegedly stealing $2 billion of government funds earmarked for arms to fight the militant group Boko Haram. A December 2015 report by corruption watchdog Transparency International, however, found that 75 percent of Nigerians believed that corruption in the government had increased over the past 12 months. Lagarde praised Buhari’s “very important” fight against corruption and encouraged the president to deliver upon his ambitious agenda.

4. Boko Haram’s impact on the economy

As well as its human cost, Boko Haram’s six-year insurgency in northeast Nigeria has had a devastating economic impact on the country. Kashim Shettima, the governor of the militants’ home state of Borno, estimated in September 2015 that the cost of rebuilding infrastructure destroyed by the group would exceed $1 billion. Boko Haram’s attacks have internally displaced more than two million people, whom Buhari pledged would start returning to their homes in 2016. But as long as Boko Haram is still active and capable of carrying out attacks, the issue of rebuilding the northeast will remain unresolved. “Unless they can get a degree of stability in the north, the question of economic development is not a question at all,” says Cheto.