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A SECOND WIND FOR HEALTH LAW? OR JUST HOT AIR?

Monday, 23 December 2013 06:34 Published in Health & Fitness

WASHINGTON (AP) -- Whether you love it or hate it or are just plain confused by it, you've got to give the health care law this much: There's plenty of drama.

The nail biting goes on. As the clock ticks toward the Jan. 1 start of insurance coverage under President Barack Obama's big, bold and bedraggled creation, there are inklings it might get a second wind.

But that could turn out to be just hot air.

Time will tell, soon, as policies take effect in new health insurance markets that have been enrolling customers - or trying - for nearly three months.

A look at the law's broad strokes, its brush with disaster and the roots of a possible rebound:

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THE GOOD

No more denying people coverage when they've been sick. No more stratospheric premiums for the previously or currently ill, either. No more cutting off insurance payments because someone has used up a year's worth of benefits. For all the headaches signing up, questionnaires are also notable for questions they do not ask: Have you been treated for cancer? What is your medical history? It won't matter anymore.

Few in the polarized debate over the health care overhaul defend the history of an insurance system that can drive people into poverty when they get sick or steer them away from treatment they need. The critics quarrel with the means more than these particular ends. And families like the fact that adult children can stay on their parents' plans until they are 26, an early consequence of the law and one of its few visible effects until now.

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THE BAD

More than 4 million people lost coverage because their policies fell short of new federal standards. Far fewer gained insurance in the new markets in that time. This happened despite Obama's repeated and now discredited pledge that people happy with their insurance could simply keep it. He partnered that assurance with a promise that people happy with their doctors could keep them, too. Not so, in many cases. Another rude awakening.

After a wave of cancellations, the government revised its rules on substandard policies to let insurance companies offer them for one more year. It's not clear how many plans will be retrieved from the dustbin as a result. Some will be allowed to buy bare-bones catastrophic plans. And people who lost their insurance can shop for new plans that in many cases will offer better terms. But better coverage will often come at a higher cost.

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THE UGLY

Ugly goes to HealthCare.gov, the federal government's buggy online insurance portal, impenetrable for weeks for many if not most who tried to see what plans they could choose from and perhaps sign up for one. It's on the mend. But until coverage begins for those who took that route, its prognosis remains uncertain.

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THE UNRAVELING

Washington can put a positive spin on almost anything, and federal officials did just that at the very start. Yes, HealthCare.gov is buckling under the user load. That's because folks love it!

The smiley face soon melted into a swamp of recriminations. Led by Republicans, of course, who feigned indignation that the law many of them despise wasn't working out so well. A more authentic response came from Democrats: the heebie-jeebies. They'd gone to bat for the law in the mighty struggle to pass it in 2010 and faced down all efforts that followed from the GOP to repeal it. With elections coming next year, Democrats are not happy.

"The president needs to man up, find out who was responsible and fire them," Rep. Rick Nolan of Minnesota steamed.

"No one is held to account," agreed Democratic Sen. Bill Nelson of Florida.

On opening day, Oct. 1, some 3 million people had tried to access the site. Merely six people signed up for coverage, according to a congressional committee's documents. The online Spanish-language portal wasn't ready as promised. But really, for weeks, the English one wasn't, either.

"No excuse for it," Obama said, repeatedly vowing to fix it.

No one has been fired. When GOP Rep. Marsha Blackburn of Tennessee asked who's to blame for the "debacle," Health and Human Services Secretary Kathleen Sebelius replied, "Hold me responsible for the debacle."

So everyone, rather unusually, was on the same page in sizing up the launch, or at least they were on the same word. It was a debacle.

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THE IMPROV

Seat-of-the-pants patches, pivots and delays began before the debut of the woebegone 1.0 website and spread well beyond it.

In July, the government postponed one of the law's central features for a year - the mandate that all businesses employing 50 or more people provide health coverage or risk a penalty.

In late November, it announced a one-year delay in the online marketplace for small businesses to find coverage for their employees. They could still get insurance from the exchanges through traditional avenues like brokers, but direct access had to wait as the government gave priority to making the portal work for individuals.

Meantime, insurance companies were sending out cancellation notices for more than 4 million individual policies that didn't meet new federal requirements, prompting an about-face by the government. Federal officials decided these substandard policies could exist for one more year. It remains to be seen how many canceled policies will be revived as a result.

Then there was the paper-phone-Web conundrum.

With the online system ailing, Obama urged people to apply by mail and phone and used the megaphone of the presidency to give out the toll-free number, 800-318-2596.

But snail mail, if helping in a pinch, wasn't proving to be an efficient substitute for the streamlined process envisioned by the law. Kelly Fristoe, an insurance agent in Wichita Falls, Texas, told AP he'd submitted 25 paper applications in two months and hadn't received any responses by early December, despite assurances from Washington that all paper applications received in October had been processed.

The same week that federal health officials told reporters there were no problems with paper applications, they were quietly discouraging further use of paper in contacts with enrollment counselors, insurance brokers and others. It was time to get back to the website as time grew ever shorter to apply by Dec. 23 for coverage starting Jan. 1.

As December progressed, another batch of improvisation emerged.

The government announced a one-month extension of a special insurance program for nearly 86,000 people who cannot get any other coverage because of pre-existing illness. The program should not be needed in the new year because coverage can no longer be denied to the previously sick. But the risk of insurance gaps from the troubled rollout prompted officials to keep the program around a while longer to be safe.

Similarly, Washington ordered insurers to provide coverage on Jan. 1 for any customer who pays by New Year's Eve. The industry went the government one better, extending the deadline until Jan. 10. The administration also allowed some of those with canceled policies to sign up for catastrophic insurance.

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THE REBOUND?

On Dec. 1, the government reported progress fixing the website. Now people had a 19-in-20 chance of finding it in operation. You could click more than 99 times out of 100 and not see pages crash. Some 50,000 people could use it at once. But did that mean smooth signups? Not necessarily.

The user experience was clearly much better, but that's only half of it. The back end, where insurance companies take in the information for processing, was problematic. Insurers complained of errors, garble and duplication, a data tangle that the government blamed mostly on a bug affecting Social Security numbers - soon overcome, officials said.

By the middle of the month, things were looking up, though not rosy.

On Dec. 20, Obama said more than a million people had been able to sign up for coverage, a big improvement over the 365,000 who'd had coverage three weeks earlier. But even as he announced the new number at a news conference, some applicants were having problems with the website.

Officials are braced for a late surge of insurance hunters. And for the 2014 installments of a drama seemingly without end.

© 2013 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

Quinn, Rams sack Bucs 23-13, finish strong at home

Sunday, 22 December 2013 15:55 Published in Sports
ST. LOUIS (AP) — The St. Louis Rams wore throwback jerseys from their Super Bowl title season, then Robert Quinn outdid one of those former stars.
 
Quinn got three of St. Louis' seven sacks and set a franchise season record in a 23-13 victory over the Tampa Bay Buccaneers on Sunday.
 
The Rams won without left tackle Jake Long, who injured his knee on the first series. Coach Jeff Fisher believes Long tore a knee ligament.
 
Quinn leads the NFC with 18 sacks. He broke Kevin Carter's franchise record of 17 sacks in that 1999 Super Bowl title season.
 
Zac Stacy rushed for 104 yards on 33 carries and a touchdown, and two other rookies also had big games for the Rams (7-8), who matched their victory total from last year. Stedman Bailey scored on a 27-yard reverse, and Alec Ogletree forced two fumbles.
 
Ogletree stripped Bobby Rainey early in the second quarter. Bailey scored his first career touchdown on the next snap on the reverse to put the Rams up for good at 14-7.
 
The Buccaneers (4-11) managed just 170 total yards, setting a season low for the second straight week. Vincent Jackson had five catches for 98 yards.
 
Rainey opened the scoring with a 1-yard run in the first quarter and Stacy scored on a 1-yard run early in the second quarter.
 
There were thousands of empty seats for an unattractive matchup with attendance announced at 54,423 — about 12,000 shy of capacity.
 
James Laurinaitis added two sacks and Greg Zuerlein kicked three field goals, including a season-best 54-yarder in the third quarter after Tampa Bay had cut the deficit to a point.
 
The Buccaneers are 1-6 on the road, the lone win in overtime at Seattle after an 0-8 start to the season. Tampa Bay finishes at New Orleans next week.
 
Quinn's first sack helped force the Bucs to settle for a 35-yard field goal by Rian Lindell to cut the Rams' lead to 14-10 at the half.
 
Bailey has gotten involved in the offense the last few weeks and stepped up with Tavon Austin, his former teammate at West Virginia, sidelined for a second straight week by a left ankle injury. The reverse was his first career NFL TD and first rushing at least before college, and he had three catches for 44 yards.
 
Bailey was just as prolific as Austin in college, scoring 27 touchdowns as a senior.
 
Sloppy play helped the Bucs keep it close in the first half. Quarterback Kellen Clemens fumbled on a scramble at the Tampa Bay 4 to burn a scoring opportunity, with Gerald McCoy knocking it loose and Keith Tandy recovering. On the Rams' next snap, Dekoda Watson stripped Stacy and Lavonte David recovered at the Bucs 47.
 
Tampa Bay had first and goal at the Rams 9 near the end of the half before sacks by Laurinaitis and Quinn on consecutive plays pushed the Buccaneers back 16 yards.

No. 23 Missouri edged at end by Illinois 65-64

Saturday, 21 December 2013 23:50 Published in Sports
ST. LOUIS (AP) — When Jabari Brown made a 3-pointer with 14.9 seconds left, No. 23 Missouri celebrated as if it had won its fifth consecutive Braggin' Rights game against Illinois.
 
This time, though, there was a different ending.
 
Johnathan Williams III fouled with 4.6 ticks remaining, and Tracy Abrams made both free throws to give the Illini a 65-64 victory.
 
Missouri's Tony Criswell heaved a last-ditch attempt from half-court, but the shot fell harmlessly into the stands.
 
"We just had to make a play," Jordan Clarkson said. "We had to make a stop at the end of the game. We just didn't finish the game the way we wanted to."
 
Clarkson finished with 25 points, six rebounds and a career-best eight assists. Earnest Ross added 13 for the Tigers (10-1), who entered the game as the lone unbeaten school in the Southeastern Conference.
 
The Tigers scored their fewest points of the season one game after its previous low in a 66-60 win against Western Michigan.
 
Missouri coach Frank Haith said the Illini were the more physical team.
 
"It was a hard-fought game," he said. "It was like two heavyweight fighters going at it, and I think you've got to adjust to the game when it's going to be officiated like that in terms of the physicality of the game. And they did a better job of that than we did."
 
Missouri bungled its final play after Abrams' free throws, as Criswell's inbounds pass was slightly behind a streaking Clarkson. The ball caromed off Clarkson's arm before Criswell ended up with the ball for the final shot.
 
"It was a tough pass to catch," Clarkson said. "I was coming down full speed and the ball went behind me a little bit and slipped out of my hand. Tony just got it and I feel like we got a good shot at the basket. That was the only shot we could get."
 
Abrams finished with a season-best 22 points and Rayvonte Rice added 14 points for Illinois (10-2), which leads the annual series between the schools 21-12. Abrams finished 7 for 10 at the line.
 
The Illini were unranked for the pre-Christmas game for the first time in four years, and perhaps learned from a loss at No. 15 Oregon their last time out.
 
The last four years, the schools entered with a combined 72-7 record. The teams combined for 15 lead changes, setting up the frenzied final seconds.
 
"We just got to do the little things," Brown said. "We missed free throws, we had some turnovers. We don't win or lose the game on that last play. It was an accumulation of things."
 
Among those attending were Hall of Fame baseball manager Whitey Herzog, Missouri Gov. Jay Nixon and the football coaches from both schools, Missouri's Gary Pinkel and Illinois' Bob Beckman.
 
The schools traded runs in the second half that kept it tight, 10-1 by Missouri to go up by near the midway point and 9-0 by Illinois with a pair of three-point plays by Abrams for a two-point lead with 6:17 to go.
 
Illinois climbed out of an early hole behind 3-point shooting, hitting six of its first 10 — by six players — and led 31-27 at the half. Missouri led 8-0 and had a nine-point cushion at 15-6 after Rice's second foul with 13:47 to go in the half.
 
Illinois answered with a 10-0 run the next 3½ minutes, including 3-pointers from Kendrick Nunn and Abrams, and scored seven in a row late in the half for a six-point lead ended by Clarkson's driving basket with five seconds to go.
 
"That was a really good ballgame, I think," Haith said. "Two good teams, playing hard. It comes down to two free throws to lose the game. I like where our team is at."

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