The coronavirus pandemic and the economic fallout that has come with it boosted health insurance enrollment counselor Mark Van Arnams workload. But he wants to be even busier.

The loss of employment for 21 million Americans is a double blow for many because it also means the loss of insurance, said Van Arnam, director of the North Carolina Navigator Consortium, a group of organizations that offer free help to state residents enrolling in insurance.

Calls to the consortium have increased sharply, but he believes many more people are going without insurance and could use his help. He suspects these newly unemployed people dont realize they have options. Years of budget cuts by the federal government have hampered outreach from nonprofit groups like the consortium, so many consumers dont understand that policies are available to help them regain or maintain health coverage.

Large numbers of folks arent getting the message, said Van Arnam.

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Some newly unemployed people are taking advantage of special enrollment periods to sign up for plans offered on the Affordable Care Acts insurance marketplaces, while others find they qualify for Medicaid. Some might have the option to stay on their former employers plan, even while bearing the full cost themselves.

But the clock is ticking for some of these options.

A Special Enrollment Period For You

The ACA is a critical backstop for many of the newly unemployed.

Under the federal health law, people who experience certain life events such as moving, getting married, having a baby or, in this case, losing your job and job-based coverage qualify for a special enrollment period. They can sign up for new coverage without waiting for the open enrollment period, which generally occurs near the end of each calendar year.

Applicants must submit certain documents to prove they qualify for special enrollment, such as proof of prior job-based coverage. The Obama administration in 2016 began random checks of these documents and the Trump administration stepped up that scrutiny in response to insurers concerns that some people were gaming the system with special enrollments, waiting to sign up until they were sick, thus driving up health spending. The claim was controversial, with little evidence presented on how prevalent a problem it was.

Because of COVID-19, some navigators report, these requirements have been loosened. Specifically, the Trump administration appears to have cut back on preapproval documentation checks perhaps a nod to the difficulty of obtaining the necessary paperwork from employers since so many offices are operating remotely.

Even in good times, employees almost always need help from their HR department to identify what they needed to provide, said Deepak Madala, program manager for Enroll Virginia, a nonprofit that helps people sign up.

The administration has, reportedly, stayed vigilant in its document requirements regarding the immigration status of applicants. Undocumented immigrants are not eligible to enroll in ACA plans, Medicare, Medicaid or the Childrens Health Insurance Program.

Time Is Of The Essence

Its important to remember, too, that the clock is ticking. In general, people have 60 days after they lose their job-based insurance to use that as a reason to qualify under an ACA special enrollment period.

Those in the first tranche of layoffs would need to act quickly to get into the marketplace, said Tara Straw, a senior policy analyst with the Center on Budget and Policy Priorities.

Its also important to watch the calendar if you live in a state that runs its own marketplace and opened it for a special enrollment period because of the coronavirus outbreak. Some windows of opportunity have now closed, but in Maryland and Vermont, the deadline is June 15. Special enrollment in California is scheduled to remain open until at least June 30 and in the District of Columbia until Sept. 15.

There is no national tally of how many people have signed up for ACA coverage since January, as the federal marketplace does not release statistics. However, some states do. In California, the largest market, more than 125,000 have enrolled, more than two times the typical special enrollment rate. Smaller numbers are seen in other states.

Finally, an option few may be aware of: People who otherwise qualified for a special enrollment say, by losing job-based insurance but failed to sign up within the 60-day window because they were affected by the COVID-19 emergency perhaps they were sick or were caring for someone who was ill might qualify for additional time, according to the federal governments website, healthcare.gov. This is similar to what the government has done in cases of natural disasters, such as hurricanes.

If seeking this special enrollment, applicants may need to ask for a supervisor when calling healthcare.gov, said Straw, as front-line staff may not be as well versed in the exception.

Other Avenues

The best bet for some applicants is Medicaid, said Straw.

Thats because this joint federal-state health program doesnt require a special enrollment period. Applicants can seek to enroll at any time during the year and eligibility is based on income and other qualifying factors.

Generally, Medicaid and the Childrens Health Insurance Program cover families with children, pregnant women, older adults and people with disabilities. Income eligibility varies by state. Maximum income levels vary and can be restrictive in some states, but applicants should know that the additional $600 weekly in unemployment benefits Congress approved in the CARES Act does not count toward that total (although it does for ACA plans).

Another complication: Fourteen states have not expanded their Medicaid programs under the ACA, and another, Nebraska, has enacted, but not implemented, an expansion. In those states, some people, especially adults below the poverty line with no dependent children, might not be eligible for Medicaid coverage at all. This creates a catch-22: They dont earn enough to get them over the poverty line, but they dont qualify for a subsidized ACA plan, either. These people are caught in what is called the coverage gap.

Still some good news some adults in that gap might be lifted out of it by the additional $600-a-week payment for unemployment.

The vast majority of people we see are getting coverage and reach 100% of the federal poverty level with unemployment benefits and year-to-date income, said Van Arnam in North Carolina, one of the states that have not expanded Medicaid. They are usually able to get an ACA plan with a zero or low premium, which is a big weight off their shoulders.

Staying on a former employers plan, through a law commonly known as COBRA, is also an option for some. The deadline to enroll in this has been extended until 60 days after the national COVID emergency ends, although people who wait to enroll are still liable for past premiums dating back to when they lost their coverage.

And those could be substantial. In COBRA, employees must pay the full cost of the premium although some employers are sharing that cost during the pandemic and Congress may consider a full or partial subsidy in upcoming legislation.

by

Julie Appleby, Kaiser Health News

Kaiser Health News

Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

Originally posted here:
If Youve Lost Your Health Plan In The COVID Crisis, Youve Got Options - Physician's Weekly

A restaurant in the Bronx borough of New York | Mark Lennihan/AP Photo

New York

Everyone loves small businesses, said New York City Council Member Brad Lander.

By JANAKI CHADHA

06/16/2020 05:00 AM EDT

NEW YORK As New York City begins to emerge from the coronavirus shutdown, thousands of its small businesses many already struggling before the pandemic hit will face a near-impossible road to recovery.

From Brooklyn dive bars to Soho boutiques, small businesses are written into the citys DNA. But even before the rise of Etsy and Amazon, they operated on tight margins. And while residential tenants have been able to organize their political power to bring about a sea change in Albany and New York City Hall, small business has never been a unified political force in the biggest U.S. city.

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Everyone loves small businesses, said New York City Council Member Brad Lander. Its the kind of thing that rhetorically brings right and left together, but it hasnt converted into effective political power or leverage.

Many businesses are facing months of missed rent payments, with little ability to pay off their arrears. Others are unsure if business will recover swiftly enough for them to be able to come back at all. The shift threatens to decimate commercial strips that rely on these businesses and upend a sector that generates upwards of 3 million jobs.

Yet the citys answer to business owners pleading for relief has largely been that the problem is out of its hands. The solution, city officials have said, depends on a bailout from the Trump administration, which has thus far shown little urgency to bring New York out of its coronavirus-induced fiscal turmoil. And there is no clear backup plan if that aid doesnt arrive.

The scale of this crisis simply requires the resources of the federal government, said Jonnel Doris, commissioner of the citys Department of Small Business Services, at a recent City Council hearing.

While we continue to hope that much of that need be met by the federal government hope isnt a plan," said Council Member Daniel Dromm at the same hearing.

The domino effects of the damage are already becoming apparent one recent survey of building owners said approximately 64 percent of ground-floor retail tenants didnt pay rent in May, a loss of income they warn will hurt their own ability to make mortgage payments and keep up with property tax bills.

While several piecemeal solutions have been introduced opening streets so restaurants have more space for customers, reversing funding cuts for a lease assistance program there remains little clarity how to meet the scale of the problem.

A fix to save struggling small businesses has long eluded politicians, even as theyve lamented the demise of beloved mom-and-pop shops. The sheer variety of small businesses means they come with disparate problems and often competing interests, defying a simple solution. The small business agencys 3 million jobs number is based on businesses that have up to 125 employees, but a spokesperson said 62 percent of small businesses in the city have fewer than five.

Now, as the pandemic plunges many local stores into even worse straits, enacting a workable solution has only become more difficult.

There is no silver bullet, said former City Council Speaker Christine Quinn, who worked on various small business-related initiatives during her time in the Council. Its a great issue to be rhetorical on and itll get you cheers. Its a harder issue to follow up on.

The most pressing probelm for many businesses now is catching up with rent payments, which have often remained their largest fixed cost as sales have plunged. But the need for financial assistance for businesses is coming up against the city and states own budget woes.

While some business leaders have floated property tax reductions for landlords in exchange for commercial tenant relief, the city has shown little inclination to back a policy that would curb its tax revenue at a time when its facing steep shortfalls. And while state lawmakers have in recent years pushed tax hikes to fund various budget priorities, enacting such a measure to help small businesses has not been a prominent topic of discussion in Albany.

Even before the pandemic, small businesses were a fractured political bloc. Residential tenant groups organized for years around a series of changes to rent laws, enough to make their concerns a central issue in elections to the state Senate that turned the body from Republican to Democrat. Within months, the new tenant-friendly legislators overturned decades of laws that had favored landlords.

Small businesses havent had the same political agency.

"What's ended up happening with small businesses is they've self-organized politically in their respective industries and more in their racial or ethnic groups where they've found common purpose, and oftentimes thats geographic," said Neal Kwatra, a Democratic operative who's advised Gov. Andrew Cuomo, Mayor Bill de Blasio and prominent labor groups.

"Those groups are pretty effective in their own districts, their own neighborhoods," he added. "I think the challenge is where you have a citywide impact like this and all of them are affected."

The de Blasio administration created a new role last month for former Small Business Services Commissioner Gregg Bishop, focused on seeking private and philanthropic sources for relief. A spokesperson said the agency has connected businesses to $65 million in assistance through lenders and philanthropic funding, but could not say how many businesses have received funding through this effort. Bishop said at a hearing earlier this year he estimated small businesses in the city will eventually need between $1.5 and $2 billion in relief.

Many city businesses have had some help from the federal Small Business Administrations Paycheck Protection Program, but owners say its been difficult to navigate. Congress recently enacted changes that extend the length of time owners have to spend the funds and allow owners to spend a larger percentage on overhead costs. But the majority of the loan still has to go towards labor, and missed rent has continued to be a major issue.

Even though theres a moratorium for eviction proceedings, the rent bill is really accumulating, said Randy Peers, president and CEO of the Brooklyn Chamber of Commerce. This is going to be the big challenge, because even if you open your doors in the next few weeks, thats three months worth of rent, that in itself can put businesses out of business.

A recent survey from the Brooklyn Chamber of Commerce found 46 percent of businesses missed their May rent payments. A similar survey from the hospitality alliance found 87 percent of bars and restaurants couldnt make rent last month.

Jagdish Shetty, owner of Samudra Restaurant in Jackson Heights, hasnt been able to pay rent since the shutdown order went into effect. Takeout and delivery havent come close to the business the restaurant was bringing in before the pandemic, he said, but he hasnt yet obtained relief through the federal program, and his landlord hasnt cut him a break.

A lot of people used to come here, people used to come from all over. Now, nobody comes, he said. But you still have to pay rent. Theyre not lowering the rent or anything, so Im going to have to close the restaurant.

Lander, whose Park Slope district is overflowing with indie coffee shops and artisanal boutiques, said the majority of small businesses hes spoken to havent been able to strike deals with their landlords, leaving them vulnerable to permanent closure and potentially sparking a surge in commercial vacancies.

He suggested the state look at creating new revenue sources through tax hikes and floated a long-term tax break for landlords who provide rent relief.

There is not enough urgency ... We have to move quickly if were going to save a set of existing small businesses, said Lander. Everyones waiting and hopefully the federal government will provide some money, but if they dont, the state could plausibly take some steps.

A coalition of progressive advocacy groups that have backed measures like commercial rent regulation agreed that tax hikes should be seriously considered, at a time when rent relief is so desperately needed and the availability of federal funding remains unclear.

But there hasnt been a groundswell of support behind any one proposal that would accomplish this, and different groups have been pushing different priorities.

Jessica Walker, president of the Manhattan Chamber of Commerce, said her group wants state lawmakers to reform business interruption insurance, which for the most part does not currently cover pandemics but would be helpful to many struggling businesses if it were available.

When the pandemic first hit, she and other chambers of commerce were looking at proposals that would have the city or state play more of a role in providing relief funds.

It just was too costly, the city and state just dont have the money, so its definitely a tough issue, said Walker. Insurance reforms, the group decided, were a more realistic way to go, she said.

Peers said all the players involved in missed rent payments commercial tenants, but also their landlords, banks holding mortgages and government, which needs property tax revenue should carry part of the weight.

Some creative solution has got to involve a shared burden by all four of those actors because they all have a stake in the equation, he said.

But its unclear such a shared solution will emerge in time to save many of the businesses devastated by the virus.

We are definitely going to lose a lot of them, regardless of how much we do, because some were on thin ice during an era of prosperity, said Kathy Wylde, head of the pro-business Partnership for New York City. They are not going to survive, no matter what anybody does.

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Swaths of New York City small businesses face extinction in the wake of coronavirus - Politico

DUBLIN--(BUSINESS WIRE)--ResearchAndMarkets.com published a new article on the health and wellness industry "$71 Billion U.S. Weight Loss Market Pivots to Survive the COVID-19 Pandemic"

The US weight loss market grew to $78 billion in 2019. However, this growth was halted by the COVID-19 outbreak which caused weight loss centers, doctors offices and clinics to close their doors. As a result, the market is forecast to decline by 9% in 2020.

The pandemic has caused significant changes in consumer behavior including a shift in the traditional diet season from January to May to the summer and fall as well as a trend towards stocking up on frozen over fresh foods. In addition, many consumers are now accessing weight loss and exercise programs online from their own homes. This has forced many weight loss services to accelerate the move to virtual delivery in order to survive.

To see the full article and a list of related reports on the market, visit "$71 Billion U.S. Weight Loss Market Pivots to Survive the COVID-19 Pandemic"

About ResearchAndMarkets.com

ResearchAndMarkets.com is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.

Research and Markets also offers Custom Research services providing focused, comprehensive and tailored research.

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$71 Billion U.S. Weight Loss Market Pivots to Survive the COVID-19 Pandemic - ResearchAndMarkets.com - Business Wire

There is a myth that weight loss is all about boiled and diet food. This is not at all true. Weight loss meals can be high on calories and healthy carbs too. All you need to do is to pick the right kind of foods to include in your diet. There are so many food options that are nutritious and can help to maintain your calorie count of the day. If you are looking to add some snacks in your diet, then peanuts should be your pick. Yes, they are extremely rich in protein, fat, fibre and other healthy nutrients. Also, peanuts are a versatile food. You can add in your desserts, cakes, confectionery and have it as snacks. Also Read - A handful of peanuts a day can keep heart disease and cancer away

According to a study published in The Journal of Nutrition, taking food rich in protein can help you burn more calorie. Peanuts are not only high in protein, but also has high fibre content, which can make you feel fuller for a longer period of time and prevent overeating. You can even have these nuts between your meals to reduce binge eating on unhealthy and junk food. They also help in easy bowel movement due to the fibre content. Also Read - Boost your metabolism with these iron-rich nuts this summer

But some people have raised questions on how a food high in calories and fat can help in reducing weight. Several studies suggest that having peanuts in a controlled amount is good for losing weight and managing it. How? Well, it is true that peanuts contain a high amount of calories, but you may not be able to absorb them all. As per experts, your teeth Also Read - Here is why Rujuta Diwaker wants you to have peanuts

cannot break peanuts into small pieces which is necessary for digestion. Therefore, your body absorbs fewer calories and the leftover is excreted through waste.

Apart from weight loss, peanuts also contain some healthy fats, which are good for your heart health. Take a look at some of the health benefits of peanuts:

Improve heart health

Peanuts contain more healthful monounsaturated and polyunsaturated fats than saturated fats. This makes peanuts a heart-heathy food. A 2014 study published in Nutrition Journal found that eating 46 g of peanuts or peanut butter each day improved heart health for people with diabetes. So, dont forget to include peanuts in your diet.

Manage blood sugar levels

Peanuts are excellent for diabetics or people with a risk of diabetes. They have a low glycemic index (GI), which means they do not cause big spikes in blood sugar levels. Foods with a GI of 55 or lower are known as low-GI foods, and those with 70 as high-GI foods. And, peanuts have a GI score of 23, which makes it a low-GI food.

Improve functioning of your nervous system

Peanuts contain copper, a mineral that is considered as an essential micronutrient for your body. Copper is necessary for several important

physiological processes. It forms a crucial part of enzymes that keeps a check on the energy production and neural activity in your brain. In the nervous system, copper is also needed for neurons to create the myelin sheath that protects their axons and increases the speed of neural transmission.

Published : June 16, 2020 9:09 pm | Updated:June 16, 2020 10:17 pm

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Weight loss and other health benefits of peanuts - TheHealthSite

With stay-at-home orders being lifted and the beaches opening, the holidays over and bathing suit season right around the corner, many of us are thinking about those extra pounds we'd like to lose in time for summer. And, as always, there are a host of diet and weight loss options to choose from, including the latest new hot diet trend intermittent fasting.

If you haven't already heard about it, intermittent fasting means cycling between periods of fasting and eating. There are several options for intermittent fasting, including fasting for 16 hours each day; fasting two days per week; fasting every other day; or fasting during the day and eating a huge meal at night. Any and all of these are being touted by many in the media and diet industry as the latest and most effective way to lose weight.

But is intermittent fasting really a good option for weight loss? Not so, according to Steven Santangelo, D.O., a primary care doctor with Virtua Health System.

"As far as a diet that includes intermittent fasting, I generally don't recommend that for my patients for weight loss as this can actually slow down their metabolism and make it more difficult to lose weight," he said. "I emphasize a healthy diet that is well balanced and includes regular exercise."

Dr. Santangelo also advises his patients plan their weight loss with realistic goals over a long period of time, and he encourages them see a Virtua nutritionist or dietitian.

"Even if you have a healthy lifestyle, you will always learn something if you meet with one of our dietitians."

And when it comes to exercise, Dr. Santangelo suggests at least 150 minutes per week.

"You need to do more than just take the dog for a quick walk," he said. "Plan to get out 4-5 times a week and get your heart rate up for 30 minutes."

The bottom line? Intermittent fasting is not a magic bullet for sustained weight loss. A healthy diet and a consistent exercise routine are still the tried-and-true way to lose those extra pounds and keep them off for good.

To make an appointment with a Virtua Primary Care physician call 1-888-847-8823 or go to the Virtua website.

To schedule a consultation with a Virtua nutritionist, call 1-888-847-8823.

###

About Virtua Health:Virtua Health is committed to helping the people of South Jersey be well, get well, and stay well by providing the complete spectrum of advanced, accessible, and trusted health care services. Virtua's 14,000 colleagues provide tertiary care, including a renowned cardiology program, complemented by a community-based care portfolio. In addition to five hospitals, two satellite emergency departments, and more than 280 other locations, Virtua brings health services directly into communities through home health, rehabilitation, mobile screenings, and its paramedic program. Virtua has 2,850 affiliated doctors and other clinicians, and its specialties include orthopedics, advanced surgery, and maternity. Virtua is affiliated with Penn Medicine for cancer and neuroscience, and the Children's Hospital of Philadelphia for pediatrics. As a not-for-profit, Virtua is committed to the well-being of the community and provides innovative outreach programs that address social challenges affecting health, from addiction and other behavioral issues to lack of nutritious food and stable housing. A Magnet-recognized health system ranked by U.S. News and World Report, Virtua has received many awards for quality, safety, and its outstanding work environment. For more information, visit ThisIsVirtua.org. To help Virtua make a difference, visit GiveToVirtua.org.

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Is intermittent fasting the best way to lose quarantine weight? - Patch.com

Angela Deem has been rocking a new look on 90 Day Fianc: Happily Ever After. The reality star shocked viewers by losing an impressive amount of weight since her last appearance on 90 Day Fianc. With Angela looking thinner than ever, fans are also wondering if she underwent any plastic surgery while she was away from the cameras. Heres a look at Angelas weight loss journey plus what she has been doing to turn the clock back.

Angela is looking to start an exciting new chapter in thecurrent season of 90 Day Fianc: HappilyEver After. Now that she has lost a significant amount of weight, Angelaand her husband, Michael Ilesanmi, are trying to start a family.

In a recent episode of Happily Ever After, the couple dealt with some drama after the 53-year-old experienced a menstrual cycle for the first time in two years.

Michael was hopeful that Angela is ready to have children,though whether or not they can actually get pregnant is another issuealtogether. The good news is that we already know Angela and Michael tied theknot in January, so we know things worked out for the best.

While Angela has big plans for her future with Michael, fans couldnt help but notice that she looks like a completely different person than the last time she appeared in the hit reality franchise. In fact, fans were quick to point Angelas new look on social media and many were surprised by her transformation.

Angelas biggest storyline going into the new season, ofcourse, is her dramatic weight loss. Angela has lost an impressive amount ofweight since fans last saw her, and some of her weight loss may have somethingto do with her new hobby.

On 90 Day Fianc: Happily Ever After, Angela revealed that she has been taking dance lessons with her daughter, Skyla Deem. Angela may not be able to twerk just yet, but she is definitely getting some good cardio in with her daughter and the hard work is paying off.

We do not know how much weight Angela has lost in recentmonths, but she is down at least 40 pounds. She is noticeably smaller in hermidsection and her hips look like they have shrunk a little as well. It isunclear if dancing is the only thing Angela is doing, but there is no denyingthe results.

The weight loss has resulted in a completely new look for Angela,but some of her transformation may have more to do with the recent plasticsurgery she has undergone.

While Michael was busy working on his visa to come to the United States, Angela decided to go under the knife for a quick procedure. As 90 Day Fianc: Happily Ever After fans are aware, Angela had some Botox done on her face to make her look younger.

The procedure removed many of Angelas wrinkles anddefinitely made her look younger than 54. Although Angela looks great, Michaelwas not happy when he found out how much the procedure cost.

RELATED: 90 Day Fianc Sneak Peek: Angela Still Doesnt Trust Michael on Happily Ever After

Angela spent $2,000 on the Botox, which did not sit well with Michael. On the latest episode of Happily Ever After, Michael told Angela that he loves her no matter what she looks like on the outside.

That said, Angela is trying to recoup some of the money shespent on plastic surgery by selling t-shirts with the slogan, Botox Baby.There is no telling if Angela will be successful, but it is good to see herfully embracing getting the fact that she has had work done.

Fans can watch the drama unfold when new episodes of 90 Day Fianc: Happily Ever? After air Sunday nights on TLC.

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'90 Day Fianc': Angela Deem Shows Off Impressive Weight Loss, Did She Have Plastic Surgery Too? - Showbiz Cheat Sheet