Healthcare | BLOGH: City Paper's Blog |
Tuesday, December 4, 2018

Posted By on Tue, Dec 4, 2018 at 3:30 PM

You might not have heard that open enrollment for plans in the Affordable Care Act (ACA) marketplace ends Sat., Dec. 15.

In 2017, President Donald Trump slashed the marketing budget for open enrollment by 90 percent, and it remains that low for 2018. It's likely you haven't seen many ads to remind citizens to sign up for their government-run health insurance.

So, use this as a reminder that you have until mid-December to enroll in plans effective for the 2019 calendar year via the marketplace.

If you can't get a computer, or have trouble using one, state Sen. Jay Costa (D-Forest Hills) and state Rep. Dan Frankel (D-Squirrel Hill) are hosting a free event to help get people enrolled at the Oakland Career Center on Dec. 11. The event runs from 5-7:30 p.m. and is located at 294 Semple St. in Oakland. 

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Tuesday, June 12, 2018

Posted By on Tue, Jun 12, 2018 at 12:22 PM

click to enlarge Some Pittsburghers recently arrested while protesting for universal health care
Photo courtesy Ben Fiorillo
Protesters in Harrisburg staging a "die-in" to protest for universal health care
The push for universal healthcare is a serious movement. For Pittsburgh resident Lizzie Anderson, that means getting arrested.

Last week, Anderson and 200 others rallied in Harrisburg and called for the Pennsylvania state government to ensure no cuts were made to Medicaid or the food-stamp program. On June 4, about 30 of the protesters exited the Capitol building, and held a “die-in,” where protesters laid down in front of the doorway until they were arrested. Anderson says getting arrested was necessary to send a message to lawmakers that our current health-care system is not adequate.

“I am a therapist and work with people who can't always get therapy because of our broken health-care system,” says Anderson. “It seems in this country we need to disrupt everyday life to get the obvious done.”

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Tuesday, March 6, 2018

Posted By on Tue, Mar 6, 2018 at 3:39 PM

click to enlarge Democratic Socialists look to highlight Pittsburgh anti-abortion health-care centers as ‘fake clinics’
Photo courtesy Pittsburgh DSA
Members of Pittsburgh's Democratic Socialists of America Socialist Feminist Committee
The Pittsburgh chapter of the Democratic Socialists of America say faith-based "crisis-pregnancy centers" are using false advertising, deception and intimidation to trick women into using their services. These medical clinics don’t provide comprehensive reproductive health care, like performing abortions, but offer other medical services. However, the DSA, a progressive political group, says the centers market themselves as places to learn about pregnancy and offer consultation on abortion decisions.

For this reason, a DSA committee has labeled them as “fake clinics” and have started a campaign called “Expose Fake Clinics PGH” to teach people about the seven crisis-pregnancy centers (CPCs) in the region.

“Time is essential when pregnant and seeking health care,” says Crystal Grabowski, chair of the DSA Socialist Feminist Committee. “We hope to reach as many people as possible, so they know how to identify these fake clinics.”

There are more than 2,500 CPCs across the country according to the DSA project. Considered outreach programs, many states, including Pennsylvania, provide government funds to CPCs. Facilities can receive state funding through the Temporary Assistance for Needy Families program.

Many CPCs offer pregnancy tests, sonograms and testing for sexually-transmitted diseases, but don't offer abortions or referrals to facilities that can perform abortions. In addition, many CPCs do not provide accurate information on abortions, according to the DSA project. Some of these clinics take names like “Pregnancy Resource Centers” and appear in Google searches for “Abortions near me,” which can become a barrier for women looking for immediate information needed for a informed decision.

According to the DSA project, seven CPC networks are housed in Pittsburgh, including Women’s Choice Network, Choices Pregnancy Center and Cura Women’s Care Clinic. Many of these networks have multiple locations throughout the Pittsburgh region.

Amy Scheuring, executive director of Women’s Choice Network, says that all four of the Women’s Choice Network facilities are medical clinics facilitated by medical professionals and nurses providing service and accurate information to thousands of men and women each year.

“The term ‘crisis-pregnancy center’ is a term from out of the '80s used to describe centers that are not medical clinics,” says Scheuring. “There are many medical clinics that do not provide abortions, and they are not considered fake.”

The “Expose Fake Clinics PGH” website, which launched Feb. 25, offers clues to spot if a clinic is a CPC, like when the establishment requires an ultrasound prior to scheduling an abortion, or when the facility doesn’t offer prenatal care. The DSA project also offers information on the three clinics in the area that provide abortions: Planned Parenthood, Allegheny Reproductive Health Center and Magee-Women's Hospital of UPMC.

This year, the U.S. Supreme Court will hear a case that centers around CPCs. The National Institute of Family and Life Advocates (NIFLA), a pro-life nonprofit, is the plaintiff in that case and is seeking to overturn California's Reproductive Freedom, Accountability, Comprehensive Care and Transparency Act, which requires CPCs to provide women with accurate information about birth control and abortion. NIFLA claims the California law goes against its First Amendment right to freedom of speech.

Grabowski, of the Pittsburgh DSA, says the group’s campaign gives pregnant women in the Pittsburgh region another tool to safeguard themselves against places which may not provide all the available health-care information.

“As a socialist feminist, we think abortion is health care,” Grabowski said. “We deserve to know and have accurate resources available.”

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Friday, February 12, 2016

Posted By on Fri, Feb 12, 2016 at 11:00 AM

It’s no secret that last year was a bad year for the Allegheny County Jail. Two deaths in one day in May (the culmination of 11 deaths over less than two years) led Allegheny County Chief Executive Rich Fitzgerald to announce the county would not be renewing the contract of Corizon, the jail’s for-profit health-care provider.

click to enlarge New members of Allegheny County Jail Oversight Board nominated
Photo by Ryan Deto
Terri Klein, left, and Earlene Coleman
These deaths also caught the attention of another then-county government member, former county councilor Terri Klein, who represented District 11. Klein began to participate in jail-related activities while serving on council, including speaking at a public forum regarding health care at the jail.

Klein, who did not run for re-election last fall, has now been nominated by Fitzgerald to serve on the county’s Jail Oversight Board and was positively recommended by the appointment committee on Feb. 10.

“I am very interested in the health department within the jail and making sure there is timely care given to inmates,” says Klein.

Klein, who holds a degree in public health and works as a physical therapist, says she has a special interest in women’s health and would bring that to the board. She also said she would like to see the jail focus more attention on diversionary programs implemented at the jail, so non-violent offenders don’t necessarily have to serve their terms inside jail walls.

She adds that she is pleased to see Allegheny Health Network (which provided physicians to the county jail under the new agreement) has increased visit frequency compared to Corizon.

Advocacy group Allegheny County Jail Health Justice Project relaunched their efforts last month and continues to call for the firing of warden Orlando Harper. Julian Johnson, of the Justice Project, also questioned in January why the jail has not installed an electronic medical-record system, something that Corizon failed to implement.

Also nominated to serve on the Jail Oversight Board, and positively recommended by the appointment committee, is Rev. Earlene Coleman, of Bethlehem Baptist Church in McKeesport.

Coleman says she became interested in goings-on at the jail after being asked to give a speech for a jail GED graduation ceremony. She says this made her passionate about recidivism, something she wants to focus on if appointed.

“I would like to look at the process of rebuilding inmates to go out successfully into society, not come back to the jail,” says Coleman.

County council will vote on the approval of Klein and Coleman at the Feb. 16 council meeting at 5 p.m. in the Gold Room of the Allegheny County Courthouse.

The county’s Jail Oversight Board meets the first Thursday of every month at 4 p.m. in Conference Room 1 of the county courthouse. Meetings are open to the public.

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Tuesday, January 26, 2016

Posted By on Tue, Jan 26, 2016 at 4:49 PM

Health-insurance enrollment event at Pittsburgh's City-County Building tomorrow
Photo from

Six days remain until this year's Jan. 31 Affordable Care Act (ACA) Open Enrollment deadline, and the mayor's Healthy Together campaign wants to make last-minute sign-ups accessible.

Health-care "navigators" from the Consumer Health Coalition, a local organization that helps people sign up for insurance, will be on hand at the City-County Building in Downtown from 1 p.m. to 5 p.m on Wed., Jan. 27.

"Families are encouraged to stop by for support navigating the health-care enrollment process — the event and enrollment help are provided at no cost," the mayor's office stated in a press release.

The mayor's office began its Healthy Together campaign under a grant it received from the National League of Cities in August 2014. The campaign is a partnership between Mayor Peduto, the Consumer Health Coalition, Allies for Children, Enroll America and the Allegheny County Health Department, and it aims to enroll all the city's children in health coverage — whether through Pennsylvania's Children's Health Insurance Program (CHIP) or through an ACA Marketplace plan.

"We know that usually if there’s an uninsured child, there’s an uninsured parent," says Betty Cruz of the mayor's office. "And while kids can get enrolled in health care year-round, families are limited to the open-enrollment period. We really want to make sure during this final push that families know there are resources like the Consumer Health Coalition."

According to Enroll America, a national outreach organization and a partner of the Healthy Together campaign:
  • Four out of 5 Pennsylvanians who have signed up for coverage have received some kind of financial assistance to reduce their health-insurance costs. And, for those who remain uninsured, a fine of at least $695 may apply on next year’s taxes.

  • For those with qualifying income ($16,243 for a single person, $33,465 for a family of four), Pennsylvania’s HealthChoices program may be available to provide coverage with no monthly premium.
As for data released last week, a little more than 415,000 Pennsylvanians — 78,213 in Pittsburgh — had enrolled in a Federal Marketplace plan. 

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Tuesday, January 19, 2016

Posted By on Tue, Jan 19, 2016 at 4:04 PM

click to enlarge Allegheny County Jail Health Justice Project to relaunch tonight
CP File Photo by Ashley Murray
Protesters spoke out against poor healthcare services at the Allegheny County Jail last May.
Since the May 2015 announcement that the Allegheny County Jail was discontinuing services with its former for-profit health-care provider, Corizon, there have been no reported deaths inside the jail walls.

During Corizon’s two-year tenure there were 11 deaths, more than twice the national average in jails. The county took health-care operations in house staring in September 2015, with help from Allegheny Health Network and a $3 million increase in the jail's health-care budget.

But the Allegheny County Jail Health Justice Project, which launched in protest of the high death toll, is far from done advocating for inmates’ rights. Tonight, the group is relaunching its efforts to maintain accountability for the alleged mistreatment of inmates by county officers and health-care professionals.

Activist Julia Johnson, who heads the health-justice project, says that tonight's meeting will review the group’s accomplishments, update people on new goals, and recruit people for outreach efforts. Johnson says a new documentation project will gather stories of medical abuses within the jail from former and current inmates and their family members and friends.

“There have been significant leaps forward,” Johnson says regarding health care at the jail. “But we are still very critical that the county is not listening to citizens' requests. We feel they are still being ignored.”

The relaunch will also focus on continuing initiatives by the justice project. Johnson says the group is still calling for the firing of Allegheny County Jail warden Orlando Harper and for a large review of correctional officers' practices. 

Johnson says that there some issues at the jail that have not been addressed, like the implementation of electronic medical records. According to the minutes of the December 2015 Jail Oversight Board meeting, an electronic medical-record system has not been implemented and "currently, everything is hand written on paper," even though an electronic system was supposed to be created back when Corizon was the health-care provider.

Johnson says that without an electronic system, records and medical information for inmates change hands too slowly and that such delays could have been a factor in the death of Frank Smart, who died in January 2015 after one day in custody, after not receiving his seizure medication.

“We need to put pressure from all sides to let the county know that this is important and people need to be held accountable,” she says.

The jail health-justice meeting begins at 6:30 p.m. at New Voices Pittsburgh offices, 5907 Penn Ave. Suite 340, East Liberty.

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Friday, January 8, 2016

Posted By on Fri, Jan 8, 2016 at 3:30 PM

According to a small University of Pittsburgh School of Medicine trial, published in the January issue of The Journal of Pain and Symptom Management, doctors give more compassionate nonverbal cues when treating seriously ill white patients than black patients.

African Americans are about 1.5 times more likely to say they would want more life-sustaining measures than white patients. But they are two to three times more likely to receive end-of-life treatment. The study was conducted to examine this disparity.

"So there's kind of a gap. We know they're a little more likely to want it, but they're a lot more likely to get it," says the study's senior author Amber Barnato, associate professor of clinical and translational medicine. "One of the things I wondered was, is there something about the way doctors interact with black and white patients that might contribute to this observation."

For the trial, researchers conducted a simulation where 33 attending physicians interacted with pretend patients. The actors in the simulation were diagnosed with terminal metastatic cancer and all read the same script. Doctors were not told the study was about race. 

"A simple hypothesis I had was, what if doctors just assume that black patients want life support so they don't ask about it," says Barnato. "That would be a statistical discrimination problem. They're basically saying, 'I think I've noticed in my lifetime that blacks are more likely to have life support, so I'm going to guess this next one wants it.' But that's not at all what we found."

Instead, the researchers found that the doctors had the same verbal communication with each patient whether they were black or white. However, they noticed that there was a difference in nonverbal communication.

"With the white patients, they were more likely to stand right at the patient's bedside and touch them in a sympathetic manner than when it was a black patient," says Barnato. "If body language is a significant tool for building trust or rapport, then if they're standing further away, that could lead to this cascading misunderstanding that could result in the patient and their family not trusting their doctor."

Barnato says the racial bias demonstrated in the study could play a role in the difference between how likely black and white patients are to receive life-sustaining measures. But it's not unique to end of life care or even the medical profession, where racial bias has long been found in doctors interacting with patients who are of a different race than their own.

"No matter how good we are as people, and how thoughtful we are, we all have implicit biases. And the thing about implicit biases is they operate really fast. They're not under our conscious control," says Barnato. "And that's why there's been all this research done trying to understand why police are more likely to shoot unarmed black people than they are white people."

While Barnato says the problem is complex, she says there are steps that could be taken in the medical profession to address implicit bias. And these kinds of practices could be used in other fields as well.

"What we could do is we could train doctors to have some intention. This is like a mindfulness process. It takes a habitual breaking of these fast unconscious behaviors," says Barnato. "These are things that individual physicians can do. But the first thing they have to do is accept the possibility that they would [carry a bias]."

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Thursday, January 7, 2016

Posted By on Thu, Jan 7, 2016 at 4:31 PM

click to enlarge Q&A with Enroll America President Anne Filipic as ACA open-enrollment deadline nears
Photo by Ashley Murray
Enroll America President Anne Filipic (right) speaks with local Affordable Care Act "navigators" about the final push before open enrollment deadline.

There are three weeks left in the third open-enrollment period under the Affordable Care Act, and Anne Filipic, president of the national nonprofit Enroll America, is encouraging "navigators" to use the remaining time they have to reach as many uninsured people as possible. About a dozen local workers (some called navigators, who receive grant funding to do often-individualized ACA outreach via local nonprofits like the YWCA, Consumer Health Coalition and the East Liberty Family Health Care Center), as well as local county and city representatives, listened to and engaged with Filipic about the successes and barriers of the ACA in Western Pennsylvania. Filipic's message to the stakeholders in the YWCA conference room: Success in Allegheny County has been great, with  6 percent decrease in the uninsured population since 2013, but there are still those, especially in low-income communities of color, who need to be reached by the campaign.

"You guys are certainly making tremendous progress," she told the room, in regard to 412,000 Pennsylvanians insured under the Affordable Care Act. "This isn't about an advertising campaign or handing out fliers. It's about one-on-one in-person assistance."

Filipic sat down with City Paper to talk more about the ACA deadlines.

What deadlines should people be aware of?

To enroll in the health-insurance marketplace, to get coverage for this year, Jan. 31 is your deadline for coverage. That is obviously coming up, so we just really encourage everyone not to wait until that last day, but to check out your options now. You can go to to learn more about the options available to you.

In your meeting today, you talked about something called a "Plan Explorer" tool and called it “an enormous breakthrough for consumers.” Can you tell me what that is?

First, I think a little bit of context about why it’s such an important tool: One of the great things about the Affordable Care Act and health-insurance marketplaces is it actually allows consumers to compare plans side by side. Before the ACA was passed, if you were on the individual market, it was a very tough thing to try to dig through your options. So the health-insurance marketplace allows you to sort of make those apples-to-apples comparisons. For the first couple years, a lot of the easily accessible information for consumers were premium levels, which is a really important part — that’s the amount that you’re paying every month to get that coverage. But it’s not the full picture. Thinking about deductibles and out-of-pocket costs and also thinking about ‘is your doctor covered by these different plans?’ [are also important]. So the Plan Explorer actually allows consumers to plug in some basic information about their health status and specific doctors they want to see, and it allows them to then compare plans based on that information. So it provides information not only about the monthly premium, but also based on your information, what we might estimate your yearly costs to be.

Is this run by the government or Enroll America?

The Plan Explorer is run by Enroll America. You can go and plug in some information, and if you’re ready to enroll, you can actually enroll through our website on the spot.

According to some recent numbers, nearly one million Pennsylvanians are still uninsured. Who are these Pennsylvanians?

What we’re seeing, and this is really true nationally but also true in Pennsylvania, is that with people of all backgrounds, we find folks who are uninsured. But there are specific communities who are more likely to be uninsured, particularly communities of color, lower-income folks and young people. And that’s certainly true of what we see in Pennsylvania as well. We want to get the word out to everybody, but we look for opportunities to partner with those organizations that may help us reach those individuals who perhaps are more likely to be uninsured.

Another thing that people have been talking a lot about this year are the premium increases. For example, locally Highmark and UPMC premiums have risen. Can you talk about why that happened and how that affects consumers who are looking to get coverage?

One of the first things to understand is that before the ACA was passed, premiums were actually skyrocketing on a much larger scale each year. Part of what we’re seeing now is that new issuers are coming in and finding their place in the marketplace. You sort of go from community to community, and people are finding different experiences in terms of the premium rates. I will say that when you look at the national average, over 7 out of 10 individuals can still find coverage for under $100 a month, when you factor in financial assistance. There truly are affordable options out there. That is a helpful stat to understand, but what people really care about is 'what is available to me?' Whether you have shopped in the past or have coverage you’re happy with or if this is the first time you’re looking at it, shop around, check out your options. Yes, the plan you enrolled in last year, perhaps the premium has gone up, but likely there’s another option there for you that will really fit your needs.

Can you talk about the transition from former Gov. Corbett’s Healthy PA program to Gov. Tom Wolf’s straight Medicaid expansion? (Enroll America's Pennsylvania director Neil Deegan jumped in to answer this question.)

There are obviously differences between Healthy PA and HealthChoices, which is what we have now. The most important thing to note though is that over 500,000 Pennsylvanians have received coverage through the expanded Medicaid program. When you think about the number of Pennsylvanians who were uninsured and the fact that the expansion of Medicaid, regardless of Healthy PA and HealthChoices, has only been on the scene since January of last year, over 500,000 Pennsylvanians having no-cost coverage through that program, [that] is remarkable. It’s a great success and it’s been a huge benefit to half a million Pennsylvanians who wouldn't have had health coverage otherwise.

In the meeting you mentioned that uninsured numbers in Allegheny County have dropped 6 percent. Can you give me a snapshot of what Western Pennsylvania looks like in terms of ACA sign-ups and the uninsured?

Deegan: What we’re seeing in Western PA is in 2013, the uninsured rate was right around 13 percent. Before this open-enrollment period that we’re in began, we saw the uninsured rate right around 7 percent. So you’re seeing a 6-percent drop. To give a sense of how that compares to national numbers, in 2013, the national rate was right around 16 percent, and in 2015, between 10 and 11 percent. So you guys have been ahead of the ball in terms of having more members of your community insured. But it’s great that even though you started with a lower uninsured rate, you have seen a drop that’s consistent with what we’re seeing nationally. We do see, as I mentioned, communities of color are more likely to be more uninsured. We do see that here. The African-American community is certainly a priority for our work in Allegheny County, and certainly young people as well. In terms of pure enrollment numbers, in July 2015 just about 42,800 in Allegheny County had enrolled in the Marketplace. At that time, it was about 10 percent of the total enrollees in Pennsylvania. And Allegheny County has about 10 percent of the uninsured in PA. Again, you guys are sort of ahead of the curve, or right about what you would expect to see.

I read that for last open enrollment there were 472,000 Pennsylvanians who signed up for coverage under the ACA, but by June it had dropped. Why was there a drop off?

Filipic: What you’re seeing is that after you get out of the open-enrollment period, we start looking at not just the raw enrollment numbers, but at people paying their premiums. Again, this is a process for all of us who use health insurance — we pay our premium each month. If you stop doing that, you’re going to drop out of the system. So part of what you see is a little bit of natural attrition as the year goes on and some people haven’t paid their premiums. But that’s one of the reasons that it’s really great to have an open enrollment each year because it gives those folks and the folks who haven’t taken action [a chance] to get back into the system, or get into for the first time.

What advice would you have for people who are now like, ‘Oh crap! There’s three weeks left before the deadline. How do I get insurance?”

The first thing I'd say is check out your options and know that there are affordable options out there. Eighty-two percent of people who have enrolled in coverage in PA in the past couple years have gotten financial help. Then I’d encourage you to go to our website where we have tools like our calculator, so you can get a sense of what you would expect to pay; our Plan Explorer to get a full picture of the plans available to you; or the connector to find in-person application assistance. Jan. 31 is the deadline, but i’d encourage everyone to take action today so they can get all of their questions answered.

Do you have anything you'd like to add?

One last thing I would mention is that as people are considering their options, I would also let them know that if you choose not to take action, that consumers will face a fine of $695, or 2.5 percent of their income. It has gone up. This is the law of the land and it's really important that everyone gets health coverage, but I always want to make sure folks know that piece of the equation, too.

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