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Fort Calhoun, NE, United States (AHN) – The rising Missouri River flood water continues to threaten the two power plants in Nebraska. To assess the situation, the U.S. Nuclear Regulatory Commission Chairman Gregory Jaczko visited the Fort Calhoun plant on Monday morning.

The Fort Calhoun Nuclear Station, located 20 miles north of Omaha, is one of the two nuclear plants in the state being monitored by the NRC because of the threats of inundation from the Missouri River.

The Fort Calhoun plant has been closed since April for refueling. Its parking lot is flooded, plant employees need to walk on a catwalk to reach the facility. An inflatable water-filled barrier that surrounds the plant was punctured by machinery on Sunday, but the plant operators assured residents that key areas of the facility are not in danger of submersion.

However, plant employees briefly switched to diesel backup generators to keep the nuclear fuel at the site cool because the flood water got too close to electrical transformers.

The other plant, Cooper Nuclear Station, is on higher ground and continues to operate. However, reports said the station is close to shutting down because flood water had reached critical levels.

Because of residents’ worry of a nuclear disaster, rumors about the true conditions of the two plants circulate in the state.

The rumors include an alleged two-mile radius no-fly zone declared by the Federal Aviation Administration on the air space around Fort Calhoun because of a radiation leak and the declaration of a Level 4 emergency at the facility.

The plant operators denied the reports.

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New York, NY, United States (AHN) – It is not just gays who are cheering New York’s law legalizing gay marriages that passed over the weekend. The state’s tourism industry is also applauding the move, with many advertising gay marriage specials.

Mayor Michael Bloomberg is set to launch “NYC I Do,” a campaign selling the city as a premier gay wedding destination. Specials are already spreading across the state. The Le Parker Meridian has a “Love has No Boundaries/Born This Way” wedding package.

A report in May from the New York’s Senate Independent Democratic Conference estimated that 21,309 resident gay and lesbian couples would get married over the next three years, and the state would earn nearly $400 million during that time from gay and lesbian couples getting married in the state. That total included tourism, wedding bookings and state licensing fees.

The law goes into effect on July 24.

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New York State’s Martin Act makes it easier for state prosecutors to bring charges than their federal counterparts

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Chicago, IL, United States (AHN) – Former Chicago Mayor Richard Daley has joined a prominent law firm that will draw on his two decades as the city’s top executive.

Daley, 69, will serve as counsel for Katten Muchin Rosenman, which has offices in the city, as well New York, Los Angeles, Washington, D.C., and London.

The firm will use his “vast knowledge, experience and relationships globally to contribute to [its] continued growth,” according to a statement. The Democrat will not be part of work involving the city and public agencies.

Daley served as Cook County state attorney and state senator before becoming mayor. He surprised many when he announced his retirement last September after 22 years in office, the longest of any mayor, including his father. He had a choice of several law firms but opted for Katten, a firm recognized as one of the best for women and gays.

“They have an innovative yet practical approach to helping clients accomplish their goals, and they are expanding globally,” the former mayor said in a statement. “The firm also has a demonstrated commitment to giving back to the community, which is important to me.”

“We are honored that Mayor Daley has chosen to join Katten,” said Vincent Sergi, national managing partner for Katten. “In joining our firm, he clearly recognizes what we have accomplished and that we are poised for significant growth nationally and internationally. His advice and counsel will be invaluable.”

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Washington, DC, United States (KaiserHealth) – My ZIP code is a black hole for individual health insurance.

That’s what I recently discovered when I tried to find the coverage I want at an affordable price. What hubris I had.

My story started in 2009, when my position as a journalism professor at a small college was eliminated, and I lost my health benefits along with the job. In the ensuing months, as the clock ticked on my COBRA extension, I began to focus on finding a new health plan. I thought it would be a matter of dealing with mild sticker shock and doing comparative shopping. I was wrong.

As an experienced writer and researcher, I am used to making calls, asking questions and digging through hard-to-understand details. But it never occurred to me that the answers I uncovered about Tompkins County, N.Y. — a paradise of farmland, lakes and waterfalls close to the cultural attractions of Ithaca, home for me and Cornell University — would be so frustrating. It turns out it’s one of the state’s worst places to find good individual health coverage.

When I tell people about my dilemma, they get curious — even participatory. “Did you try a professional group?” they ask. “Did you try an online broker?” (Yes and yes.) Maybe they get caught up in my story because, unlike many people with tales of insurance woes, I’m in my fifties and healthy. My story doesn’t involve a medical condition that’s unsolvable or hard to talk about. Or maybe it’s just that my experience lights a path, however convoluted, through the insurance gobbledygook.

I started my quest with Aetna, my COBRA insurer. Under New York state law, I thought I had “conversion rights” — meaning I could convert my former employer’s group coverage, the basis for my COBRA plan, to individual coverage. Though the full monthly cost was already $565, and I worried I wouldn’t be able to afford any increases that kicked in when it became an individual plan, it was great insurance — providing excellent benefits and the ability to choose my own doctors. But it turned out my cost concerns were not even relevant. There is a caveat in the law: self-insured employers are subject to federal, not state, regulation. And because my former employer is self insured — meaning Aetna administers the plan but the college assumes all the financial risk — the conversion option did not exist.

After this idea evaporated, I explored possibilities on the website of The Freelancers Union, a professional association that offers its own health insurance in New York. Five plan choices popped up. Great, I thought. Then I clicked further to read about the plans’ residency requirements and up came a map. The right side of the state — covering 34 counties that share borders with New Jersey, Pennsylvania, Connecticut, Massachusetts, Vermont and Canada — was colored in blue. These counties are the lucky ones. Those on the left — 28 counties that border more of Pennsylvania and Canada, extending all the way to Lake Erie and Lake Ontario — were white, meaning no Freelancers Union health insurance. That’s where Tompkins County is.

This development was crushing. Somewhere along the way, the notion had lodged in my head that if I ever turned to freelance writing as my full-time job, I could get benefits through this type of organization. But — at least as far as I could tell — there are no such groups with health plans in my area.

I felt stupid. I also was getting curious, which happens whenever I feel stupid. The reporter in me wanted to know what the heck was going on. But the consumer in me needed a health plan. So I kept looking.

I tried other websites, starting with AARP. The site directs consumers to an AARP-branded Aetna plan. I entered my ZIP code and got the same response: the plan was “not available in your area.” Next, at a top-rated insurance broker site, my ZIP code brought up one result. The $561-a-month GHI policy covered annual physical and gynecologic exams, prescription drugs with a co-pay, hospitalization and outpatient surgery. But it did not cover, among other things, any other office visits; inpatient physical therapy; ER professional charges; diagnostic admissions; and diagnostic lab tests. To me, that seems like too much money to spend for what amounts to catastrophic coverage.

Curiosity was getting the better of me, so I did some random comparisons on the same website. Zip codes in the District of Columbia; Seattle; Fairbanks, Alaska; and New York City offered 80, 45, 56 and 16 insurance choices, respectively. I also tried random rural areas. Residents of Aladdin, Wyo., had 27 plan choices, starting at $380 a month. Residents of Amelia, Neb., had 87, starting at $133.05.

In search of clarity, I visited the New York state insurance website and discovered a whole new possibility: Healthy NY, a subsidized program for low-income people. Several different insurers offer the same basic menu of coverage through different regional HMOs, which charge different rates.

At first I ruled it out because I wouldn’t be able to choose my own doctors, which has always been very important to me. But I was starting to feel desperate. And I qualified for the plan because it just so happens that in January, I made less than $2,269. I never imagined I would be glad to have a dry spell with my freelancing.

I was not surprised to discover that, although New Yorkers in many other parts of the state can choose a Healthy NY insurer from several options, I only had one: Excellus BlueCross BlueShield. I was just glad to learn that I could get insurance. A phone call led to an additional choice, through the same insurer, that would let me see my own doctors. But it would have cost around $1,400 a month, which is the same as my mortgage. There was also a plan for sole proprietors, but I didn’t qualify.

At this point I went into full reporter mode. I called Troy Oechsner, New York state deputy superintendent for health, and asked him about my scarcity of coverage options and the high costs associated with them. He told me that some other rural areas in the state are in a similar fix, and he said, “For an insurer to get into the area of Tompkins County, where Excellus has such a large hold on the commercial market, is really difficult.”

Ah. That rings a bell. I remembered reading a very similar conclusion in a 2009 United Hospital Fund report: “Entering Central New York is entering the Excellus zone” — a 15-county region where “the region’s nonprofit BCBS plans vigorously defend their turf.” Who do they defend it against? Mostly for-profit insurers, which have a much stronger foothold in downstate areas, including greater New York City. Nonprofits have historically claimed upstate markets (which include Central New York). In my region, Excellus in particular dominates, with a strong record of well-established health-provider relationships.

Not only am I in the Excellus zone, said Oechsner, but I’ve stumbled into “the plight of the individual market in New York.” It’s a decades-long saga in which the state “traded the problem of a group of people who can’t get insurance at any price for another problem, which is that our individual rates are out-of-control expensive,” he said. In other words, the state gave up some of its power to regulate rate increases in exchange for guarantees of access to quality coverage for everyone — although as recently enacted legislation is phased in, the state is regaining more control over the increases.

I still didn’t get why the Freelancers Union insurance isn’t available to me. So I called Chief Operating Officer Ann Boger, who explained that the group’s plan in New York is linked to the service area of Empire BlueCross BlueShield. I knew from my other research that Empire can’t operate in Excellus territory without giving up the BlueCross BlueShield brand. Boger also said that offering insurance in rural areas is a challenge. “The nature of insurance is that it works best organized is around large numbers,” she added.

What about those rural areas I randomly sampled on the broker website? My answer came from Peter Newell, director of the United Hospital Fund’s Health Insurance Project. It’s simple: I didn’t compare the coverage. He talked of plans that have limited benefits, ratings for gender and age that push costs much higher than advertised, and exclusions for people with preexisting conditions. Broker websites, for all their ease of use, don’t instantly compare apples to apples. “If you compare my neighborhood to someone else’s neighborhood, you’ve got to think about those things,” said Newell.

Newell told me the federal health care reform should help me eventually — particularly with the establishment of health insurance exchanges that should yield more choices.

But for now, time has run out. I have signed up for the high deductible option in Healthy NY, with a drug benefit, for $296.48 a month. The deductible is $1,200 a year. I’m approaching this choice as a stop-gap measure, although, as I told Oechsner, I now have a strong incentive for limiting my income.

His response: “There’s no way to sugar coat it: You’re right. If you make too much money, individual health insurance in New York gets very expensive.”

I also have one foot out the door as I weigh my professional prospects. If I move, especially if I’m making a living as a freelancer, my first criterion in choosing a location will be something I’ve never before considered: the availability of good health insurance.

– Provided by Kaiser Health News.

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Washington, DC, United States (KaiserHealth) – Like many other interest groups, the medical device industry met with White House officials in the run-up to the health care battle in Congress. But while insurers, pharmaceutical firms and even the American Medical Association made agreements trading their support for specific concessions, the device makers were not able to close a similar deal.

As a result, the final health care reform bill included a 2.3 percent excise tax on device makers that’s expected to produce $20 billion over a decade to help pay for expanded health coverage.

That’s the law, or so it would seem.

But in Washington, it’s never over until it’s over. And like other medical interests who are scrambling to influence the implementation of health care reform, medical device makers are showering cash on friends in Congress and working the halls, hoping that one of five bills that would overturn the excise tax might actually make it into law.

Veteran Hill watchers say that may be a long shot, so to hedge its bets, the industry is also lobbying the Internal Revenue Service to write rules exempting hundreds of devices from the excise tax — even though the health law says the exemption should be limited to items widely purchased by the public from retailers. The outcome of that under-the-radar battle is far from certain.

The medical device business and its lobbyists have a strong record of winning concessions and at least partially deflecting the costs of health insurance coverage expansion. An early Senate “framework” version of the health bill pushed by Democrat Max Baucus of Montana, for example, would have nailed the industry with a $40 billion excise tax bill over ten years beginning in 2010. Shocked at the price tag, the device manufacturers’ trade group, the Advanced Medical Technology Association (AdvaMed), pushed back, aided by industry giants Medtronic Inc., Johnson & Johnson, 3M Co., and others.

With the help of a bipartisan group of lawmakers, the device makers succeeded in cutting the tax in half in the final health care law, which also delayed the start date for the tax until 2013, three years later than in the Baucus proposal.

Manufacturers, however, maintain that even the smaller tax in the health care law is catastrophic for them. So the industry is targeting Capitol Hill anew and working the regulatory process, searching for concessions.

Five industry-supported bills currently before Congress would completely overturn the excise tax on medical devices, the most widely supported of which are bills introduced by Sen. Orrin Hatch, R-Utah, and Rep. Erik Paulsen, R-Minn. Hatch’s bill has- Republican co-sponsors. Paulsen’s House bill has 119 co-sponsors, including three Democrats.

Hatch, who has been one of the health care law’s fiercest opponents, says the tax on medical devices will increase insurance premiums and the cost of care. Relying on an excise tax “to fund Obamacare will cripple an important engine of opportunity, job growth and innovation,” Hatch said in a January news release.

CAMPAIGN CONTRIBUTIONS FROM INDUSTRY

In 2009 and 2010, both Hatch and Paulsen were major beneficiaries of medical device industry money.

Hatch was not up for re-election that cycle but received more than $90,000 in campaign donations from the medical supply industry, which made him the trade group’s third largest political beneficiary, according to the Center for Responsive Politics. The political action committee of the AdvaMed association alone contributed $10,584 to Hatch’s campaign, and $3,150 to Paulsen’s.

The political action committees of individual companies also chipped in. The PAC of Boston Scientific, a major manufacturer of heart and other medical devices, contributed $7,000 to Paulsen’s campaign and $5,000 to Hatch’s. Medtronic, the world’s largest medical device maker — which is based in Paulsen’s home state — donated $3,000 to Paulsen and $5,000 to Hatch.

Paulsen spokesman Tom Erickson said the bill is a response to job loss fears, not industry campaign donations, and that more than 400 medical device companies are based in Minnesota. A Hatch spokesman said the senator’s bill reflects his political philosophy: “It’s something he has felt strongly about for a long time, that taxes are counterproductive,” spokesman Mark Eddington said.

Hatch and Paulsen are only two of the friends the device industry is counting on for help.

In late March, Democrat Amy Klobuchar of Minnesota and Republican Scott Brown of Massachusetts launched a new Senate medical technology caucus to increase awareness about issues facing the industry. Both represent states with significant medical device manufacturers and have been major beneficiaries of industry money.

Boston Scientific, which in 2010 had $7.8 billion in sales, is based in Brown’s state. In 2010, Brown received more than $30,000 in campaign donations from the medical supply industry, which is dominated by the device makers. Klobuchar received more than $40,000 in contributions.

“These businesses not only spark medical breakthroughs, they save lives,” Klobuchar said in comments released on the day the new caucus was launched. “Every day in every state small medical technology companies are driving the innovation agenda we need to compete in a global economy. I will continue to work to make sure that Minnesota remains a leader in health care innovation by developing innovative products while maintaining patient safety.”

The House medical technology caucus was revamped in February. According to the industry newsletter MedCity, its new website was launched on the same day that Paulsen, who chairs the group together with Anna Eschoo, D-Calif., addressed the Minnesota life sciences trade group LifeScience Alley.

In the halls of Congress, the medical device manufacturers have long pushed the jobs refrain, first to deflect taxes, and second to fend off scrutiny from the U.S. Food and Drug Administration, which regulates devices. Dr. Josh Makower, the founder of Exploramed, a medical device incubator – who frequently testifies before Congress – said the excise tax will particularly hurt small firms, many of which rely solely on investment capital for years before turning a profit.

“The saddest thing is that these small companies are exactly the ones that are delivering new innovations,” Makower told iWatch News in an e-mail response to questions.

REVOLVING DOOR

In pushing its interests, the device industry benefits from the revolving door connecting K Street with Capitol Hill.

In December, former AdvaMed executive Brett Loper, who lobbied against the excise tax, was named House Speaker John Boehner’s chief policy officer. Elizabeth Kegler, the association’s vice president of government affairs, is a former health policy advisor to Sen. Chuck Grassley, R-Iowa.

Advamed spent almost $1.5 million lobbying Congress on behalf of its members in 2010. First quarter lobby disclosure records for 2011 will not be available until late April, but medical device industry activity suggests the industry has likely not slowed its spending.

Despite device industry campaign donations, powerful allies, and support for the Paulsen bill in the House, George Schutzer, a tax lobbyist and attorney at the Washington firm Patton Boggs, said he doubts Congress is ready to overturn the device tax. A win for the medical device industry would “open the flood gates” for challenges to the health reform bill by other parts of the medical industry, Schutzer said, and would most likely result in an Obama veto.

As a result, the medical device industry has taken the fight beyond Congress to the Internal Revenue Service, which will administer the tax.

That part of the struggle appears to be splitting the industry as manufacturers try to protect their market niches. Although the medical device category includes big-ticket items generally sold to hospitals, including artificial hearts, pacemakers, coronary stents and artificial joints, it also includes a wide range of less expensive items ranging from tongue depressors to examination gloves.

The health law exempts from the excise tax eyeglasses, contact lenses, and any device the Treasury Department determines is generally purchased by the general public at retail for individual use. Certain sectors of the device industry, however, contend that devices from wheelchairs and scooters to home oxygen systems fit the exemption criteria.

In written comments to the IRS, which is expected to publish tax guidance for device manufacturers, DJO Global, the largest U.S. supplier of orthopedic devices, asked for an exemption on all items classified by Medicare as durable medical equipment, prosthetics and orthotics, including bone-growth stimulators and electrotherapy devices. The American Association for Home Care, which represents the home medical care industry, wrote that it believes all durable medical equipment, including complex power wheel chairs, should be exempt.

“Durable medical equipment and home medical equipment fit that exemption language to a tee,” said Jay Witter, senior director of government affairs at the American Association for Home Care, in an interview. Witter quoted a 2009 fact sheet released by former Speaker Nancy Pelosi that said wheelchairs would be exempt, and that the excise tax would apply only to sales of medical devices to hospitals and other institutions. The comment period on the exemption ended in late March; the IRS did not respond to questions on when it might decide who gets the exemption and who doesn’t.

Witter said it is unclear whether wheelchairs and other durable medical equipment were included in revenue calculations that projected $20 billion in revenue from the tax over a decade’s time. But since the majority of home health customers are covered by Medicare, which pays set rates, Witter said the cost of the excise tax cannot be passed on to consumers.

Diana Zuckerman, president of the National Research Center for Women & Families, a think tank that focuses on health issues, said the idea that all durable medical equipment should be exempt from the excise tax is absurd and could impair funding for the health care law.

“If they get what they want, the whole health care bill collapses,” said Zuckerman. “There is too much money involved to get rid of the excise tax or to substantially lower it.”

TAX DEDUCTION WINDFALL?

As device manufactures plead for exemptions, hospitals and group purchasing organizations worry that those who remain on the hook for the tax may simply pass it on in higher prices to hospitals and other purchasers. Curtis Rooney, president of the Health Industry Group Purchasing Association, said the excise tax could even wind up being a windfall for medical device manufacturers.

In a letter to the IRS, Rooney’s organization, along with the American Hospital Association, the Federation of American Hospitals and the Catholic Health Association of the United States, wrote that device manufacturers should be prohibited from passing on the excise tax to consumers, especially if they are allowed to deduct the excise tax when calculating their federal income tax.

Allowing device manufacturers to write off the tax and pass along the cost, the letter says, would “permit a financial ‘double-dip’ that could leave device companies in a better financial position than before the [health law] was enacted.”

Asked if device manufacturers planned to increase the prices charged to hospitals and other consumers to make up for excise tax, an AdvaMed spokeswoman declined to answer. She instead referred to a comment by David Nexon, the association’s senior executive vice president: “Each AdvaMed member company will have to individually decide how to best deal with the damaging effects of the tax. For some, that might mean cutting R&D, reducing staff or other measures. Those are tough business decisions that will have to be made if this tax goes forward and go to the heart of why we opposed the tax in the first place.”

iWatch News is the investigative news report of the Center for Public Integrity, a nonprofit group focused on investigative journalism.

– Provided by Kaiser Health News.

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Trollhattan, Sweden (AHN) – Beleaguered automaker Saab has requested changes to guarantees from Swedish authorities, the latest effort by the beleaguered automaker to resolve financial issues.

Saab has asked Sweden’s National Debt Office to approve an agreement reducing state credit guarantees for loans from the European Investment Bank, according to Swedish media. The company, which Dutch automaker Spyker Cars bought from General Motors last year, is seeking a foreign investor to help it with an infusion of cash.

Swedish Finance Minister Anders Borg told SVT on Thursday that Saab is seeking to resolve its liquidity issues with difficult solutions. He added that the company had to show the government taxpayers would not in end bear the brunt of the problem.

Production at Saab’s facilty in Trollhattan remains suspended. Suppliers stopped delivering parts early thie month, forcing the company to halt production. A few days of resumption ended in another production stoppage despite assurances from the Victor Muller, chief executive of Spyker and chairman of Saab, that the situaiton was a “small glitch.”

Russian banker Vladimir Antonov, a former Spyker chairman who acquired the automaker’s luxury brand unit in February, is said to have asked Swedish authorities approval to buy Saab real eastate in Trollhattan.

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The Massachusetts state pension fund, which oversees $49.5 billion of assets, will begin bypassing middlemen by directly investing as much as $500 million in hedge funds.

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Lansing, MI, United States (AHN) – Michigan has joined a growing list of states cutting unemployment benefits.

Late Monday night Gov. Rick Snyder signed a bill into law that cuts extended benefits from 26 to 20 weeks.

Michigan is one of 32 states that have had to borrow money from the federal government to continue paying unemployment claims. With its own state fund wiped out, Michigan has borrowed $3.96 billion from the federal government.

The Republican-led legislature passed the bill to help to minimize the amount of a tax increase the state needs to impose on businesses to continue paying jobless benefits.

State officials in Michigan and elsewhere worry that tax hikes on businesses now might further hamper hiring.

The cut in the maximum number of weeks workers can collect state unemployment benefits in Michigan takes effect next year.

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CitiMortgage Inc. has agreed to a $2 million settlement in a class action, a news release said. A class action was filed in U.S. District Court for the Eastern District of Washington against EMC Mortgage Corp., Keller Rohrback LLP announced. Last September, Ohio’s attorney general said a motion to dismiss the state’s lawsuit against HomEq Servicing was denied.

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