Sophie’s Well-Timed Failure

Until recently, Simba (cat), Sophie (cat), my daughter (human), and I (human) all lived together. Despite our best efforts over a couple of years, Sophie and Simba never became good friends. They tolerated each other. So when my daughter got her own apartment, Simba followed her soon afterwards.

This was a photo-worthy moment when they lived together specifically because it was
the only time we had ever seen Sophie (top) and Simba (bottom) peacefully in proximity of each other.

I am off to the GI Rights Network Conference early tomorrow morning. It will be my first event representing Quaker House.

Knowing that I would be working straight through today with both a court hearing and document review work, the original plan was for me to bring Sophie over to my daughter’s place later tonight. There were visions of a happy sleep-over type reunion. But, court ran long, and we decided that I would just bring Sophie by on my way to document review, mid-morning.

All seemed to go well. Sophie immediately ignored Simba and began exploring the new surroundings.

I got a text from my daughter later: “Sophie has been very unhappy lol.” I called her. “Maybe if you came by and said ‘hi’ to her.” So, I stopped by on the way home from document review. Things had gotten so bad between Sophie and Simba that Sophie had her own room in the bathroom, complete with litter box, food, water, and Cat TV playing on the laptop — which she refused to watch. And, she was angry at anyone who came into the (one and only) bathroom.

This obviously was not going to work for my several-day absence. So, I took her back home where my daughter would check in on her. It was obvious the second she figured out that she had won the battle to go home. Picking her up was a bit tricky because of her expressions of anger. But once she realized she was out the door, she completely relaxed, and she thoroughly enjoyed the ride home.

It was good that court ran long and we had most of a day to figure out that the situation would not work rather than a catastrophe developing later, either when I was on the way to the airport or already several states away.

Now, to packing.

105 days until Sophie and I are unpacking in Quaker House.

American Health Care Act Local NC Voting Record

However you feel about the American Health Care Act, here is how local representatives voted.

House of Representatives voting record (May 4, 2017) Burlington and Fayetteville, NC, representatives:

NC 6th Congressional District
Mark Walker voted for this bill

NC 8th Congressional District
Richard Hudson voted for this bill

NC 9th Congressional District
Robert Pittenger voted for this bill

It remains to be seen what will happen in the Senate with votes from Richard Burr and Thom Tillis.

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Some excerpts of the summary of the bill from the Congressional web site: (underlining added by me)

“(Sec. 111) The bill lowers, from 133% to 100% of the official poverty line, the minimum family-income threshold that a state may use to determine the Medicaid eligibility of children between the ages of 6 and 19. In addition, the bill reduces the Federal Medical Assistance Percentage (FMAP) for Medicaid home- and community-based attendant services and supports.”

“(Sec. 112)  Under current law, any alternative benefit plan offered by a state Medicaid program is required to provide specified essential health benefits. The bill eliminates this requirement beginning in 2020. (“Essential health benefits” include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative services, laboratory services, preventative and wellness services, and pediatric services.)”

“(Sec. 114)  The bill allows a state to delay or deny an individual’s initial eligibility for Medicaid benefits without providing a reasonable opportunity to submit evidence of a satisfactory immigration status or pending official verification of such status. A state that elects to provide a reasonable period for an individual to provide such evidence may not receive payment for amounts expended on the individual’s medical assistance during that period. ”

“(Sec. 115) With respect to states that did not expand Medicaid coverage under PPACA [ie, NC], the bill: (1) with specified limitations, provides for additional federal funding for certain health care services; and (2) through 2022, increases the applicable FMAP. A non-expansion state that subsequently expands Medicaid coverage under PPACA shall become ineligible for this funding.”

“(Sec. 132) The bill amends the SSAct to establish and make appropriations for the Patient and State Stability Fund to provide funding to states through 2026, including to: provide financial assistance to high-risk individuals so they may enroll in health insurance, stabilize health insurance premiums, promote participation and increase options in the health insurance market, pay providers for services, and provide financial assistance to enrollees to reduce out-of-pocket costs. Funding is allocated to states based on each state’s share of incurred claims and uninsured individuals below the poverty line. To receive funding, states must provide matching funds at a rate that grows from 7% in 2020 to 50% in 2026.”

“(Sec. 133) Health insurers must increase premiums by 30% for one year for enrollees in the individual or small group market who had a break in coverage of more than 62 days in the previous year.”

“(Sec. 134) Beginning in 2020, health insurance benefits no longer must conform to actuarial tiers.”

“(Sec. 135) The bill increases the ratio by which health insurance premiums may vary by age, from a three to one ratio to a five to one ratio. This ratio may be preempted by states.”

“(Sec. 206) This section repeals the penalties for certain large employers who do not offer full-time employees and their dependents minimum essential health coverage under an employer-sponsored health plan (commonly referred to as the employer mandate). The repeal is effective for months beginning after December 31, 2015.”

“(Sec. 207) This section delays the implementation of the excise tax on high cost employer-sponsored health coverage (commonly referred to as the Cadillac tax) until 2025. (Under current law, the tax goes into effect in 2020.)”

“(Sec. 241) The section repeals a provision that prohibits certain health insurance providers from deducting remuneration paid to an officer, director, or employee in excess of $500,000.”

“(Sec. 251) This section repeals the 3.8% tax on the net investment income of individuals, estates, and trusts with incomes above specified amounts.” The full text reads: “Subtitle A of the Internal Revenue Code of 1986 is amended by striking chapter 2A.” From the tax code section that would be struck, 2A, the “specified amounts” requiring a 3.8% Medicare tax on income from investments, estates, trusts is triggered when there is an adjusted gross income (ie, after deductions) above $250,000 for a joint return or above $200,000 for an individual return.