This year we have been tracking the evolution of healthcare in the United States under the Trump administration, from the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA) bills failing to pass through Congress, the expiration of the Children’s Health Insurance Plan (CHIP) which covers 9 million children—many of whom have chronic health conditions—to Executive Orders undermining the Affordable Care Act (ACA; aka Obamacare) to the effect of destabalizing the insurance markets, causing confusion among consumers and higher premiums and out-of-pocket costs. More recently the U.S. Congress has been focused on tax reform, though critics have described efforts as a healthcare repeal disguised as a tax bill. This week the nonpartisan Congressional Budget Office (CBO) has scored the Senate’s Tax Cuts and Jobs Act bill that, if passed, could take effect on January 1, 2018.

For those concerned with America’s growing debt, the CBO analysis finds the $1.4 trillion would be added to the federal deficit over the next decade. Critics decry raising taxes for lower-income families while lowering

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Transgender Pride Flag

Transgender Awareness Week falls between November 14-20 every year and is meant to help raise visibility of a vulnerable and underserved community.  ‘Transgender’ is an umbrella term for people whose gender identity is different from the sex assigned at birth; ‘gender identity’ is one’s innermost concept of self as male, female, a blend of both, or neither.

Transgender and gender-nonconforming people can face significant problems with accessing health care. Finding a healthcare provider who is knowledgeable of transgender health issues can be a hurdle itself; some healthcare professionals may believe that there is something wrong with someone because they are transgender—they are wrong. Even after finding a knowledgeable and sympathetic doctor, insurance may not cover the cost of treatment. Many transgender people are on a dosage of hormones which can affect one’s blood pressure, blood sugar, or in rare cases contribute to cancer. Some cancers found in transgender people can appear atypical—trans men are at risk for ovarian and cervical cancers, and trans women can be diagnosed with prostate cancer.

Transgender/gender

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The Affordable Care Act (ACA; aka Obamacare) Health Insurance Marketplace begins its fifth Open Enrollment period today. American healthcare consumers can sign up on the federal insurance exchange at healthcare.gov or through their state marketplaces. This year, there is increased confusion and anxiety surrounding Open Enrollment due to changes (and attempted changes) made to the ACA under the Trump administration.

Previous years Open Enrollment period ran 90 days after November 1 until the end of January but has been cut to 45 days this year unless you qualify for the Special Enrollment Period, extending the enrollment period by an additional 60 days. Further limiting access to enrollment, the healthcare.gov website has scheduled weekly 12-hour maintenance outages. Advertisements encouraging public awareness in Open Enrollment are also cut, with some allocated funds being used for an anti-ACA ad campaign, and federal health representatives have been told not to engage in outreach to help more people access enrollment.

There is also considerable confusion, with many Americans being unsure as to the

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Americans may be surprised to learn that they could be paying more for their medications with their insurance copay instead of the cash price available to those without insurance. A study published last week found that Pharmacy Benefit Managers (PBMs) undermine claims that negotiated “rebates” with pharmaceutical companies are passed on to consumers. This follows a federal lawsuit filed over the summer after a California woman paid a $164 copay on a medication that can be purchased for $92 from the same pharmacy by anyone not using insurance. This practice is known as “clawback” and is instituted by PBMs who then receive the excess payments from the pharmacy.

Pharmacy Benefit Managers are being found to frequently charge a copay that exceeds a medication’s cash price for generic drugs. Moreover, pharmacists around the country are not allowed to disclose the price discrepancy to patients due to “gag clauses” in their contracts that forbid them

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Donald Trump, President of the United States, has taken steps to systematically change America’s health insurance system. He has failed on his promise to pass healthcare reform through Congress due to lack of support, mostly from the destabilization the American Health Care Act (AHCA) and Better Care Reconciliation Act (BCRA) would have caused for premium costs and uninsured rates. The morning of October 12 he signed an Executive Order undermining the Affordable Care Act (ACA) and opens the door to low-benefit insurance despite lack of Congressional support. Later that night, Trump ordered an immediate end to subsidies to insurance companies that help cover low-income Americans between 100% to 250% of the Federal Poverty Level (FPL).

Trump has repeatedly called the ACA (aka Obamacare) a “disaster” that is “failing” despite the more than 50 million uninsured in 2009 decreasing to 28 million uninsured by 2017. Since taking office the Trump administration has been

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