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Federal Judge Says Health Insurance Companies Don’t Have to Cover Preventive Care Services

In a big blow to health insurance in the U.S., a federal judge has ruled that insurers no longer have to pay for preventive care services like cancer and heart disease screenings. The ruling comes as a result of a lawsuit brought by a group of insurers who argued that the Affordable Care Act (ACA) exceeded its authority by requiring them to cover certain preventative care services without being able to charge co-payments or deductibles.

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A federal judge’s ruling means insurers don’t have to cover preventive care for cancer and other illnesses/Rhoda Baer via Wikimedia commons
A federal judge’s ruling means insurers don’t have to cover preventive care for cancer and other illnesses/Rhoda Baer via Wikimedia commons

By Stacy M. Brown,
NNPA Newswire

In a big blow to health insurance in the U.S., a federal judge has ruled that insurers no longer have to pay for preventive care services like cancer and heart disease screenings.

The ruling comes as a result of a lawsuit brought by a group of insurers who argued that the Affordable Care Act (ACA) exceeded its authority by requiring them to cover certain preventative care services without being able to charge co-payments or deductibles.

The Affordable Care Act, or Obamacare, was signed into law in 2010 to make it easier for millions of Americans to get health insurance.

One of the law’s key provisions was the requirement that insurance companies cover certain preventative care services without cost-sharing, including immunizations, blood pressure screenings, and mammograms.

However, the recent ruling by U.S. District Judge Reed O’Connor of the Northern District of Texas has effectively invalidated this provision of the ACA.

In his ruling, Judge O’Connor wrote that the ACA’s requirement for insurers to cover preventative care services “exceeds the powers of Congress under the Commerce Clause” of the U.S. Constitution.

The ruling is likely to significantly affect health insurance in the U.S., especially for people who already have health problems like cancer or heart disease.

If insurance companies weren’t required to cover preventive care services, patients might be less likely to get the screenings and tests that could catch these health problems early.

Experts said this could lead to serious health problems and higher healthcare costs.

“The President is glad to see the Department of Justice is appealing the judge’s decision, which blocks a key provision of the Affordable Care Act that has ensured free access to preventive health care for 150 million Americans,” White House Press Secretary Karine Jean-Pierre stated.

“This case is yet another attack on the Affordable Care Act – which has been the law of the land for 13 years and survived three challenges before the Supreme Court.”

Jean-Pierre continued:

“Preventive care saves lives, saves families money, and protects and improves our health. Because of the ACA, millions of Americans have access to free cancer and heart disease screenings. This decision threatens to jeopardize critical care.

“The Administration will continue to fight to improve health care and make it more affordable for hard-working families, even in the face of attacks from special interests.”

Critics of the ruling include healthcare advocacy groups and politicians. They say it will make it more complicated and expensive for millions of Americans to get health insurance. In a statement, Dr. Patrice Harris, president of the American Medical Association, called the ruling “a clear step backward for our health system.”

“Preventative care is a cornerstone of good health,” Dr. Harris said. “It’s critical that patients have access to these services without cost-sharing to stay healthy and catch health problems early before they become more serious and more costly to treat.”

The ruling is also likely to face legal challenges in the coming months. Several states and healthcare advocacy groups have already said they will appeal the decision. They say that the Affordable Care Act’s (ACA) requirement that insurers cover preventive care services is a crucial part of the law’s goal to make more people eligible for health insurance.

In the meantime, patients and healthcare providers alike are left to grapple with the uncertain future of healthcare coverage in the U.S. Without the assurance of coverage for preventative care services, and patients may be forced to choose between paying out-of-pocket for these services or foregoing them altogether, potentially putting their health and well-being at risk.

“Once again, an extreme activist judge is taking a monumental swing at the Affordable Care Act, which has saved millions of lives and made Americans healthier for the last 13 years,” Congressional Black Caucus Chair Steven Horsford (D-Nevada) stated.

“The preventative care provisions in the law have ensured that, without concern for cost, Americans have been able to get screened for things like diabetes, breast cancer and heart disease.

“It also puts the brakes on critical preventative treatments like immunizations and PrEP for HIV.

“The impact of this ruling, especially on working Nevadans and communities of color, will result in the loss of lives, increased costs for treatment of preventable illnesses, and increased inequities in our already unbalanced health care system.”

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An Inside Look into How San Francisco Analyzes Homeless Encampments

Dozens of unhoused people are camped at Sixth and Jesse streets in San Francisco’s South of Market neighborhood. Tents made of tarps and blankets, piles of debris, and people lounging alongside the allies and walls of businesses are seen from all angles. These are some of the city’s hotspots. City crews have cleared encampments there over 30 times in the past year, but unhoused people always return.

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Since the ruling of Grants Pass by the US Supreme Court earlier this summer, which allows cities the authority to ban people from camping or sleeping on the streets, San Francisco has been at the head of the conversation to crack down on encampments.
Since the ruling of Grants Pass by the US Supreme Court earlier this summer, which allows cities the authority to ban people from camping or sleeping on the streets, San Francisco has been at the head of the conversation to crack down on encampments.

By Magaly Muñoz

Dozens of unhoused people are camped at Sixth and Jesse streets in San Francisco’s South of Market neighborhood. Tents made of tarps and blankets, piles of debris, and people lounging alongside the allies and walls of businesses are seen from all angles.

These are some of the city’s hotspots. City crews have cleared encampments there over 30 times in the past year, but unhoused people always return.

But it’s normal to have tents set up again within less than 24 hours after an encampment sweep, David Nakanishi, Healthy Streets Operation Center Manager at the Department of Emergency Management, says. Sometimes there’s less people than before but often there is also no change.

“Most of the people that were in the encampments that want to go inside, we’ve gotten the majority of those [into shelter],” Nakanishi says. “Many of the people we encounter now, are those who have various reasons to not accept shelter, and some are already in shelter/housing”.

Since the ruling of Grants Pass by the US Supreme Court earlier this summer, which allows cities the authority to ban people from camping or sleeping on the streets, San Francisco has been at the head of the conversation to crack down on encampments.

Where neighboring cities in the Bay Area are clearing encampments a few days a week, San Francisco is sweeping 10 times a week, two per weekday.

David Nakanishi, Healthy Streets Operation Center Manager at the San Francisco Department of Emergency Management, makes a 311 report on an encampment in the Mission District. These reports allow smaller city teams to tackle individual spots where unhoused people frequent. Photo by Magaly Muñoz.

David Nakanishi, Healthy Streets Operation Center Manager at the San Francisco Department of Emergency Management, makes a 311 report on an encampment in the Mission District. These reports allow smaller city teams to tackle individual spots where unhoused people frequent. Photo by Magaly Muñoz.

Considering the controversy that plagues the city around its harsh policies, the Post decided to tag along on a ride with Nakanishi to show us how he decides what encampments make it on the city’s sweep list.

Nakanishi, having over 20 years of experience in homelessness management, drives around the busiest parts of the city almost daily. He’s tasked with arranging a weekly sweeping operation schedule for city teams to engage with unhoused folks to help get them off the streets.

So what exactly is he looking out for when deciding what encampments get swept?

It depends, he says.

Locations like schools, recreational centers, senior centers, or businesses are places he tends to want to address quickly, especially schools. These are the places where the complaints are highest and access to facilities is important for residents.

He says he also takes into account 311 calls and reports made to him by city staff. On the date of publication, over 100 calls and reports were made about encampments around the city, according to San Francisco data.

Makeshift structures built from plywood and tarps are starting to pop up more throughout the city. Certain areas under freeways are not under direct authority from San Francisco, making it harder to sweep these encampments. Photo by Magaly Muñoz.

Makeshift structures built from plywood and tarps are starting to pop up more throughout the city. Certain areas under freeways are not under direct authority from San Francisco, making it harder to sweep these encampments. Photo by Magaly Muñoz.

Nakanishi made a few 311 reports himself on the ride along, pulling over to take photos and describe the encampments into his 311 app. He says it helps him remember where to possibly sweep next or allows smaller teams in the city to engage quicker with individuals on the streets.

Nakanishi also looks at the state of the encampments. Are there a lot of bulky items, such as furniture, or makeshift structures built out of tarps and plywood, blocking areas of traffic? Is trash beginning to pile up and spill into the streets or sidewalks? Sites that meet this criteria tend to be contenders for encampment sweeps, Nakanishi says.

Street by street, he points out individuals he’s interacted with, describing their conditions, habits, and reasons for denying assistance from the city.

One man on 2nd St and Mission, who rolls around a blue recycling bin and often yells at passing pedestrians, has refused shelter several times, Nakanishi says.

People deny shelter for all kinds of reasons, he says. There’s too many rules to follow, people feel unsafe in congregate or shared shelters, or their behavioral and mental health problems make it hard to get them into proper services.

Inside a tent left by an unhoused man on Stevenson and 14th Street in San Francisco. The area smelled of human waste and leftover alcohol. Photo by Magaly Muñoz.

Inside a tent left by an unhoused man on Stevenson and 14th Street in San Francisco. The area smelled of human waste and leftover alcohol. Photo by Magaly Muñoz.

Nakanishi references another man on South Van Ness under the freeway, who city outreach have attempted to get into shelter, but his screaming outbursts make it difficult to place him without disturbing other people in the same space. Nakanishi says it might be an issue of the man needing resources like medication to alleviate his distress that causes the screaming, but the city behavioral team is in the process of outreaching him to figure that out.

In October, city outreach teams engaged with 495 unhoused people. 377 of those engaged refused shelter and only 118 accepted placements, according to city data. That number of monthly referrals is consistent throughout the entirety of 2024 so far.

Nakanishi has long advocated for the well-being of unhoused people, he explains. In 2004, he was working with the Department of Public Health and told then-Mayor Gavin Newsom that there needed to be more housing for families. Nakinishi was told it was easier to deal with individuals first and the city “will get there eventually.” 20 years later, family housing is still not as extensive as it could be, and the waiting list to get placements for families is a mile long with over 500 names.

In 2020, he was a Senior Behavioral Health Clinician at a hotel in the city during the pandemic. He says in 2021 he collaborated with DPH to provide vaccines to those staying in the makeshift hotel shelters once those became available.

Nakanishi strips apart a solo tent on Stevenson and 14th Street in San Francisco. He discards items, like tarps and cardboard, so that people cannot reuse them to make another sleeping structure. Photo by Magaly Muñoz.

Nakanishi strips apart a solo tent on Stevenson and 14th Street in San Francisco. He discards items, like tarps and cardboard, so that people cannot reuse them to make another sleeping structure. Photo by Magaly Muñoz.

Despite the constant media attention that city outreach is inhumanely treating homeless people, so much so that it has led to lawsuits against San Francisco from advocates, Nakanishi says not a lot of people are seeing the true conditions of some encampments.

He describes soiled clothing and tents, drenched in urine, and oftentimes rodents or bug infestations in places where people are sleeping. He’s asked homeless advocates- often those who are the most critical about the city’s work- who have shown up to observe the sweeps if those are conditions the city should allow people to be subjected to, but not many have answers for him, Nakanishi says.

The city’s “bag and tag” policy allows city workers to throw away items that are “soiled by infectious materials” such as bodily fluids and waste.

Sweep operations are conducted at 8am and 1pm Monday through Friday. People at the encampments are given 72 hour notice to vacate, but some don’t leave the area until the day of the sweep.

City outreach workers come out the day before and day of to offer resources and shelter to those interested. The Department of Public Works discards any trash that is left over from the sweep and washes down the area.

Nakanishi told the Post that the only time the city takes tents or personal possessions from residents is when folks become physically violent towards workers and police take the items as evidence. Other items taken are bagged and tagged in accordance with city policy.

Stories from local newspapers such as the San Francisco Standard and the Chronicle show instances of SFPD handcuffing residents while their items are thrown in the trash or disposing of personal possessions without reason.

Advocates have long been pushing for a more competent and compassionate process if the city is going to choose to continue sweeping unhouse people.

No matter the lawsuits and constant criticisms from allies, the encampment sweeps are not slowing down, even with the cold weather quickly approaching the coastal city.

Nakanishi says there aren’t a lot of large encampments left in San Francisco so now they do runs of streets in order to stretch out the sweeps as much as possible.

It’s calculated strategies and years of first hand knowledge that make this job work, “It takes dedication to the work, caring for the people and the community, and persistence, patience and sometimes good luck to make the positive changes for the people on the street,” Nakanishi says.

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Activism

Oakland Post: Week of November 13 – 19, 2024

The printed Weekly Edition of the Oakland Post: Week of November 13 – 19, 2024

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To enlarge your view of this issue, use the slider, magnifying glass icon or full page icon in the lower right corner of the browser window.

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LIVE! — TOWN HALL ON RACISM AND ITS IMPACT — THURS. 11.14.24 5PM PST

Join us for a LIVE Virtual Town Hall on the Impact of Racism hosted by Post News Group Journalist Carla Thomas and featuring Oakland, CA NAACP President Cynthia Adams & other Special Guests.
Thursday, November 14, 2024, 5 p.m. – 6:30 p.m. PST

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Join us for a LIVE Virtual Town Hall on the Impact of Racism hosted by Post News Group Journalist Carla Thomas and featuring Oakland, CA NAACP President Cynthia Adams & other Special Guests.
Thursday, November 14, 2024
5 p.m. – 6:30 p.m. PST

Discussion Topics:
• Since the pandemic, what battles have the NAACP fought nationally, and how have they impacted us locally?
• What trends are you seeing concerning Racism? Is it more covert or overt?
• What are the top 5 issues resulting from racism in our communities?
• How do racial and other types of discrimination impact local communities?
• What are the most effective ways our community can combat racism and hate?

Your questions and comments will be shared LIVE with the moderators and viewers during the broadcast.

STREAMED LIVE!
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YOUTUBE: youtube.com/blackpressusatv
X: twitter.com/blackpressusa

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