Washington, D.C. — Employers in the United States this year will earn an average return on investment (ROI) of 47% from their employer-sponsored health insurance (ESI) programs, according to a new study from Avalere Health. This means for every dollar spent on ESI, employers get back $1.47 in financial benefits. The analysis from the health data firm finds that the average ROI is projected to grow to 52% in 2026, and that businesses that invest more in their ESI programs tend have a higher ROI.
While providing employees high quality health insurance is the right thing to do for workers, the report shows how it makes business sense. Avalere attributes the direct financial return for employers to lower direct medical costs, increased productivity, lower recruitment costs, stronger retention, lower short- and long-term disability costs, as well as tax benefits. More than 155 million Americans currently get their health insurance through ESI.
The study was commissioned by the U.S. Chamber of Commerce on behalf of the Protecting Americans’ Coverage Together (PACT) campaign. PACT members, including the U.S. Chamber of Commerce, Business Roundtable, The National Association of Manufacturers, Council for Affordable Health Coverage, and Vermeer Corporation, represent leading employer voices focused on strengthening the employer-sponsored insurance (ESI) system and protecting the coverage and benefits that American families depend on for their health.
The report from Avalere looks across industries at trends that drive ROI higher and lower. Avalere highlights the manufacturing industry as an example, finding American manufacturers see an ROI of 42% on their ESI programs.
“Employee-sponsored health insurance is a win-win for employers and employees,” said Katie Mahoney, Vice President of Health Policy at the U.S. Chamber of Commerce. “We know employees place a high value on quality health insurance in the workplace, and now we have more evidence that employers benefit significantly from investing in these programs as well. Employer-provided coverage is the backbone of the American health care system, and this report reinforces that any reforms should build off this model that is good for workers and companies alike.”
“Improving productivity and wellness make America more competitive and prosperous,” said Joel White, President of the Council for Affordable Health Coverage. “While employers offer health coverage to improve the health and welfare of their employees, employees and their families benefit significantly. This study shows that Congress and the Administration must work to expand job-based coverage, not weaken it.
“Manufacturers are in the business of innovating and delivering best-in-class products to their customers,” said Robyn Boerstling, Vice President, Infrastructure, Innovation and Human Resources Policy at the National Association of Manufacturers. “That philosophy extends to the benefits provided to their employees, and this report further validates that offering comprehensive and innovative health benefits is not only the right thing to do but also critical to attracting and retaining the best talent. We are proud that approximately 99% of NAM member companies offer health benefits to employees, and working Americans understand the value and competitiveness of employer-sponsored health care.”
“As an employer, knowing who we are caring for and the communities they come from gives us the advantage of providing access to quality, affordable care to our team and their families,” said Vermeer Corporation. “It is an incredibly important part of how we care for our people.”
The study, which examined employers with 100 or more employees, defined ROI as “the monetary value of benefit for each dollar employers invest in healthcare coverage. Investment in ESI may include health insurance premiums, wellness programs, direct medical expenses, administrative costs associated with processing medical claims, and other costs associated with providing health insurance. Avalere calculated the ROI derived from ESI by dividing the total employer benefits by the total costs of providing ESI.”
The full report including methodology can be found here.
For some people, tracking your daily diet can be a helpful way to make sure you're getting the right amount of fuel each day. Trying to track every single calorie might not be your best bet, though. Instead, consider tracking your macronutrients -- that's basically a fancier word for the major nutrient groups that your body needs, which are carbohydrates, fats and protein.
There are many benefits to tracking macros instead of calories. First, you'll have a more balanced diet by focusing on eating a variety of nutrients that give your body energy and help your digestive system work. Not only can this practice help you reach your health goals faster than focusing on calories alone, this method of food logging can also help you understand which types of food make you feel good or bad, which foods improve your athletic performance and which foods help you focus or make you drag. Counting macros can also help you shift your current eating habits to healthier patterns for the long-term.
You'll need to learn how to read a nutrition facts label for this approach, but the benefits far outweigh the time you'll spend grasping the concept of a macro diet.
What are macronutrients?
Macronutrients are molecules we need in large amounts, also known as the main nutrients we need to simply survive. Micronutrients, in contrast, are substances required in much smaller amounts, such as vitamins, minerals and electrolytes.
The three macronutrients are carbohydrates, proteins and fats. Despite fad diets, you do need all three: Cutting out any one macronutrient puts you at risk for nutrient deficiencies and illness.
Carbohydrates give you quick energy. When you eat carbs, your body converts them to glucose (sugar) and either uses that sugar immediately or stores it as glycogen for later use, often during exercise and in between meals. Complex carbohydrates — like starchy vegetables and whole grains — also promote digestive health because they're high in dietary fiber.
Protein helps you grow, repair injuries, build muscle and fend off infections, to name a few functions. Proteins are made of amino acids, which are the building blocks of many structures in your body. You need 20 different amino acids, nine of which are essential amino acids, meaning your body can't produce them on its own and you must obtain them from food.
High-protein foods include poultry, beef, fish, soy, yogurt, cheese and other dairy products. If you stick with a plant-based diet, some starches, vegetables and beans are also good sources of protein.
Dietary fat is required for your body to do its many jobs. You need fat to absorb the fat-soluble vitamins (A, D, E and K), to insulate your body during cold weather and to go long periods of time without eating. Dietary fat also protects your organs, supports cell growth and induces hormone production.
Now playing: Watch this:
Baby Formula Shortage Explained: What You Can Do
How many calories does each macronutrient have?
Each macronutrient corresponds to a specific calorie amount per gram:
Carbohydrates have 4 calories per gram
Proteins have 4 calories per gram
Fats have 9 calories per gram
How many macros should I eat?
There's really no answer to this question: Every person is different, and as such, every person's preferable macronutrient intake will be different. However, the federal dietary recommendations suggest this macronutrient ratio:
45 to 60% carbohydrate
20 to 35% fats
Remainder from protein
The federal suggestion is based on the fact that carbs serve as the body's main fuel source, and are the easiest macronutrient for the body to convert from food into energy. The metabolic processes for fat and protein are much more complex and take longer, which wouldn't serve you well when you need quick energy.
Your macro ratio depends on your health and fitness goals, as well as how your body responds to particular foods. For example, many people thrive on a low-carb diet, but the thought of a low-carb diet for myself makes me shudder. I perform at my best when I eat about 50% carbohydrates.
Similarly, you may do well on a high-protein diet, while someone else might experience digestive discomfort from consuming too much protein.
Note that some people, especially those on the keto diet, count net carbs instead of total carbs. To get net carbs, subtract the grams of fiber from the total grams of carbs. Why count net carbs? Our bodies don't digest fiber, so it doesn't get absorbed by the small intestine and doesn't provide your body with any energy. In that sense, calories from fiber don't really count.
How to calculate macronutrients
Now you know what macros are and how many calories they have. Next, you'll need to do some math. That's because your intake ratio is written in percentages but nutrition information is provided in grams. I'll use my macro intake as an example.
1. First, you need to know how many calories you eat (or want to eat) each day. I eat roughly 2,300 calories per day.
2. Next, determine your ideal ratio. I like to eat about 50% carbs, 25% fat and 25% protein.
3. Then, multiply your total daily calories by your percentages.
4. Finally, divide your calorie amounts by its calorie-per-gram number.
Here's how I would calculate my calories for each macronutrient:
Carbs: 2,300 x 0.50 equals 1,150. I eat 1,150 calories worth of carbs each day (hello, extra slice of toast).
Protein: 2,300 x 0.25 equals 575, so I get 575 calories worth of protein.
Fats: 2,300 x 0.25 equals 575. I also get 575 calories comprised of dietary fat.
To calculate the actual gram amounts:
Carbs (four calories per gram): 1,150 divided by 4 equals 287.5 grams of carbs.
Protein (four calories per gram): 575 divided by 4 equals 143.75 grams of protein
Fat (nine calories per gram): 575 divided by 9 equals 63.8 grams of fat.
If you don't like math, don't fret. The internet is home to a range of macronutrient calculators that will do the math for you.
Price: Free, but you must provide your email address to get your results.
IIFYM stands for "If It Fits Your Macros" -- a phrase and popular hashtag used by the macro-tracking community to refer to their flexible dieting approach.
This calculator is one of the most comprehensive available. It collects lifestyle and health information that many calculators don't, such as how active you are at work, what kind of cravings you have and whether you have any medical conditions.
Healthy Eater's macro calculator calculates your macronutrient ratio based on your age, gender, height, weight and activity level. You can customize your ratio based on whether you want to reduce your weight, lose 10% body fat, maintain or gain weight.
I like this macro calculator because you can see your ratio in terms of all day, three meals, four meals or five meals.
The Legion Athletics macro calculator is another very detailed calculator. It takes into account your weight, your body fat percentage, and your activity level. From there, this calculator determines your lean body mass, basal metabolic rate and total daily energy expenditure.
The upside to this calculator is that you get a more accurate ratio because it considers more factors. The downside is that you need to know your body composition before using it.
You choose whether you want to gain, lose or maintain your current weight, and you can use the sliders at the bottom to adjust your ratio if the automatic recommendation isn't ideal for you.
How to track your macros
Your macro numbers aren't very helpful if you don't put them to use.
"Tracking macros" refers to the process of logging all your meals throughout the day and breaking down your macro ratio to ensure you're eating according to your goals. It sounds scary, but again, the web comes to the rescue with a slew of digital macro-tracking programs.
The free version of MyFitnessPal doesn't allow you to enter gram amounts for macros, only percentages. If you're comfortable with percentages only, then MFP is a great free option because of its barcode scanning feature and massive database of foods and drinks.
With a premium subscription, you can track by gram amounts and percentages, and you can see macro breakdowns for each meal and snack. A premium subscription also gets you extra features like food analyses (quality of what you're eating), food timestamps (when you eat what) and weekly reports.
MyMacros Plus is another great app with a large food database and barcode scanning feature.
You can also track your body weight and enter custom foods for homemade recipes so you don't have to log the individual ingredients. My favorite thing about MyMacros Plus is that it's usable without the internet, so you can track macros even when you're offline.
Tip: Food databases are helpful, but they often include multiple entries with different information for the same item, which can get confusing. It might be easier to manually log the macronutrients in your meals instead of relying on the food database.
The Cronometer tracker tracks vitamins and minerals in addition to macros. It also allows you to track important biometrics, such as blood pressure, cholesterol, sleep, mood, pulse and more — but you first need this information on hand to use the features.
If you do have access to that information, Cronometer provides insight into long-term trends and a clear snapshot of your overall health. While Cronometer is impressive, it can be a bit overwhelming if you only want to track macros, and not the rest of the metrics it offers.
Know that you don't need to track macros to be healthy, lose weight, build muscle or reach any other health goal. The only time you actually need to track macros is if your doctor told you so.
In fact, logging your every bite can be frustrating and time-consuming, but it's worth noting that you'll get pretty good at eyeballing portions if you make tracking a habit.
Tracking macros can definitely be useful for some things, such as preparing for a bodybuilding show or optimizing athletic performance. It can also be helpful if you want to implement "flexible dieting," or the practice of eating any foods you want, as long as they fit into your macronutrient ratio.
Counting your macros may also be the key to finally eating less processed foods, as processed and packaged foods tend to be high in fats and carbs (and not often high in protein), and adding in more superfoods. Many people who want to create a calorie deficit to lose weight prefer tracking macronutrients instead of counting calories, as it takes the emphasis off of weight loss and shifts the focus to nutrition. This is helpful for creating long-term healthy habits.
Additionally, many people enjoy tracking macros because it helps them understand what types of foods work best for their bodies. Give it a try to see if it works for your lifestyle, but don't feel like you ever need to track your macros.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
Core exercises don’t need to be bodyweight-only, and this quick kettlebell abs workout proves that adding resistance to the mix can be a great way to challenge those all-important muscles.
In this video, the fifth installment of Sweat With SELF’s new kettlebells series, you’ll complete a 20-minute core workout that’s focused on your rectus abdominis (the muscles that run vertically along the front of your abdomen) and your obliques (the muscles along the sides of your abdomen). Lee Jimenez, a certified kettlebell level one instructor and ACE-certified personal trainer, and ACE-certified personal trainer Tiffany Ragozzino will take you through the routine, which includes three rounds of four kettlebell exercises.
After a quick warm-up—where you’ll get the blood flowing throughout your body with exercises like the cat-cow, bird-dog, and plank walk-out—you’ll get into your abs workout. You’ll complete each exercise—the single-arm assisted sit-up, Russian twist, plank pull-through, and side-bend/windmill progression—for 45 seconds, resting for 15 before going right to the next move. After all 4 exercises are finished, you’ll rest for 60 seconds before starting again from the top.
These kettlebell core exercises help you build both strength and stability in your rectus abdominis and your obliques through motions like rotating or flexing (say, when you’re performing the Russian twist or sit-up) as well as through resisting movement (like when you’re keeping your body steady during the plank pull-through). Working all of the functions of your core is important in any strength-training routine, since it better mimics the actions of your core in everyday life—which is super important for injury prevention.
Throughout the course of this workout, you’ll be encouraged to progress at your own pace and build ownership over these moves. In the first round, for instance, try to familiarize yourself with the movement patterns and get more comfortable performing them. The second round builds on that—to do so, you’ll sub in a windmill progression in place of the side bend—and the third round really encourages you to give it all you’ve got.
Choose your kettlebell wisely for these moves—you don’t want to go too heavy, which can cause your form to falter and overstress related muscles, like your lower back. A light- to moderate-weight kettlebell will likely be your best bet. (For more information on how to choose the best kettlebell for you, check out our introduction to kettlebells video.)
Ready to light up your core? Grab a kettlebell, block off 20 minutes, and give this kettlebell abs workout a try.
WASHINGTON (AP) — At the center of the nationwide baby formula shortage is a single factory: Abbott Nutrition’s plant that has been closed for more than three months because of contamination problems.
On Monday, U.S. officials announced a deal with Abbott that paves the way to restart production at the Sturgis, Michigan, facility, the largest in the U.S. and source of leading brands like Similac.
But it’s not yet clear how soon the site will be up and running. And even bigger questions remain unanswered, including what caused the contamination and whether U.S. regulators could have alleviated the current formula shortage by stepping in sooner. The plant shutdown exacerbated ongoing supply chain problems among U.S. formula makers.
WHAT CAUSED THE SHUTDOWN?
In mid-February, Abbott announced it was recalling various lots of three powdered infant formulas from the plant, after federal officials began investigating rare bacterial infections in four babies who were fed formula. Two of the infants died. But it’s not certain the bacteria came from the plant; strains found at the plant didn’t match the two available samples from the babies.
The company halted production while Food and Drug Administration inspectors conducted a six-week investigation of the plant.
A preliminary report released in March found traces of a bacteria — cronobacter— on several surfaces throughout the plant, though not in areas used to make the powder. Plant records showed Abbott had detected the bacteria eight times in its products or facility since 2019.
Inspectors also flagged other problems, including standing water on the floor and employees who didn’t properly sanitize their hands.
WHAT IS CRONOBACTER?
The bacteria occurs naturally in soil, water and other parts of the environment. Infections with cronobacter are rare but can be fatal in babies. Almost all previous outbreaks in the U.S. have been linked to powdered baby formulas, which don’t undergo the same high temperatures used to kill germs in many other foods.
Sometimes the bacteria can get into powdered formula after its opened at home if a dirty scoop is used or it is mixed with water that’s contaminated with the germ, according to the Centers for Disease Control and Prevention.
Cronobacter typically causes fever in infants and can sometimes lead to dangerous blood infections or swelling of the brain.
The four reported illnesses were in Minnesota, Ohio and Texas between September and January.
WHAT ROLE DID ABBOTT’S FORMULA PLAY IN THE ILLNESSES?
It’s still not yet clear. The FDA hasn’t released a final ruling on the problems at the plant and whether they are linked to the infections.
“There are many factors involved in this ongoing investigation and we’re just not in a position to make any definitive statement,” FDA Commissioner Robert Califf said Monday..
Food safety experts say the case underscores the challenges of tracing foodborne illnesses.
Because there were only two samples collected from the four cases, “Right from the get-go we were limited in our ability,” to link the baby formula to the illnesses, said the FDA’s food director Susan Mayne. “We simply don’t have the evidence to demonstrate that causality.”
Abbot says the lack of a strain match indicates “there is no evidence to link our formulas to these infant illnesses.”
SHOULD THE FDA HAVE STEPPED IN SOONER?
The FDA is facing intense scrutiny about what steps it took — and didn’t — in the months before the recall.
FDA inspectors visited the factory in late September for a routine inspection, around the time that the first bacterial infection was reported in Minnesota. Although inspectors uncovered several violations— including standing water and unsanitary conditions — they didn’t find any bacteria and let the plant stay open. It’s unclear if inspectors were even aware of the first reported illness.
After three more cases were reported, the FDA returned to the plant in January and detected the bacteria.
The FDA mainly focuses on assuring the safety of the food supply, with extra regulations and standards on foods for babies and children. But former FDA officials say the agency is supposed to consider potential shortages that result from shutting down plants.
In previous cases, the FDA has worked with companies to shift production to other facilities or find alternative supplies.
The FDA is doing that now under a new policy that eases imports of baby formula from foreign manufacturers. But both the agency and the White House are facing questions on why that step wasn’t taken sooner.
“We always believe we can do better in terms of the time frame,” Califf said.
Rep. Rosa DeLauro, D-Conn., reported last month that a whistleblower had contacted the FDA in October with allegations about unsafe conditions and practices at the plant, including falsifying plant records and failing to properly test formula for contamination. She said the FDA did not interview the whistleblower until late December. Califf is scheduled to answer questions from DeLauro and other lawmakers on Thursday.
WHEN WILL THE PLANT RESTART PRODUCTION?
Both the FDA and Abbott say they are working as quickly as possible to restart manufacturing at the plant. But FDA officials say the onus is on Abbott to demonstrate its Michigan plant meets rigorous safety standards.
Former FDA officials say fixing the type of problems uncovered at Abbott’s plant takes time, and infant formula facilities receive more scrutiny than other food types. Companies need to exhaustively clean the facility and equipment, retrain staff, repeatedly test and document that there is no contamination.
Even after the facility opens, Abbott says it will take eight-to-ten weeks before new products start shipping to stores. The company continues to produce baby formula at its other plants in the U.S. and overseas.
Kristie L. Kahl: Can you explain how maintaining a healthy lifestyle helps before a diagnosis, during treatment and beyond that?
Dr. Navya Nair: Absolutely. So maintaining a healthy lifestyle is just so important in all stages, cancer prevention, and even after a diagnosis and while someone's undergoing treatment. So a healthy diet. So well balanced diet with lots of fruits and vegetables, lean meats, getting regular cardiovascular exercise, avoiding toxins like tobacco, limiting alcohol use can reduce your risk of ever getting a cancer diagnosis. So for example, we know that tobacco use is directly linked to lung cancer risk. Having a healthy BMI reduces your risk of getting endometrial cancer. So these are how some of these healthy lifestyles can prevent you from getting a cancer.
Now, you also asked how this can help once someone has a diagnosis and they're in treatment. You know, having a healthy body allows you to get through some of these really tough treatments. And, you know, I often explained to my patients that a big cancer surgeries often is like running a marathon and having a really fit body before allows you to get through that better and have less complications. And much like surgery, chemotherapy, radiation, these are all things very tough on the body that having a strong body. And the other important part that I didn't talk about yet is having a healthy mind and having strong support systems outlets for stress and anxiety. In some kind of practice of reflection, whether you do yoga meditation, is mental health is just as important as physical health, especially when dealing with cancer.
Kahl: Absolutely. So from the exercise standpoint, we know exercise is good. But can you give some examples of how people can stay active because I think there's always a misperception that you know, we you need to run a mile or two miles but I think we can go simpler than that. So can you give us some examples for our patients?
Nair: Absolutely. Yes, so it's important to get a heart rate up. So however you like to do that. So for some people they like to run. Some people hate to run maybe you prefer to swim or both. Go for vigorous walks. Go for a bike ride. The goal is to get your heart rate up for 30 to 60 minutes about three to four times a week.
Kahl: Absolutely. And then similarly with diet, why is diet important when it comes to when you're in treatment, but also those long-term effects? And are there examples of the types of diets that our patients should be seeking?
Nair: So really, it's a well-balanced diet with, you know, balance of the different food groups. And certain things like if we're looking at patients, risks and outcomes related to surgery, having a healthy amount of protein in your diet improves your ability to recover from surgery. But the goal is really having a well-balanced diet and maintaining that as much as you can during and after treatment.
Kahl: Absolutely. And so to bring it all together, what is your biggest piece of advice for a patient with a gynecologic cancer who is maybe interested in making changes toward a healthier lifestyle, now that they've received a diagnosis?
Nair: I would say my biggest advice would be to pick one or two things that that you want to try to change. Don't try to change everything at once. Because it's too hard on any one person. So pick one or two things that you're interested in changing. Try to do that. It often works better when people make a change as a family unit. So if you are trying to eat healthier, or go for more regular exercise, try to make that a family activity, because it's more likely to stick if you do that together.
Tina Passione needed health insurance in a hurry in December. The newly retired 63-year-old was relocating to suburban Atlanta with her husband to be closer to grandchildren. Their house in Pittsburgh flew off the market, and they had six weeks to move out 40 years of memories.
Passione said she went online to search for the federal health insurance marketplace, clicked on a link, and entered her information. She promptly got multiple calls from insurance brokers and bought a plan for $384 a month. Later, though, when she went to a pharmacy and doctor offices in Georgia, she was told she did not have insurance.
In fact, it said it right on her card: “THIS IS NOT INSURANCE.”
Passione is one of 10 consumers who told KHN that they thought they were buying insurance but learned later that they had been sold a membership to a Houston-based health care sharing ministry called Jericho Share. The ministry formed in 2021 when House of Prayer and Life Inc., a half-century-old Christian congregation, assumed the name Jericho Share, according to Texas business filings.
Health care sharing ministries are faith-based organizations whose members agree to share medical expenses. The ministries grew in popularity before the Affordable Care Act’s mandate for having insurance coverage was repealed because they offered a cheaper alternative to insurance. But they are not insurance, largely not regulated as such, and don’t necessarily cover members’ medical bills. Massachusetts is the lone state that requires ministries to regularly report data, and only about half of claims submitted to ministries there were deemed eligible for payment. This spring, the Colorado legislature passed similar requirements that await the governor’s signature.
The Better Business Bureau gives Jericho Share an F rating, its lowest, and its website shows more than 100 complaints filed in less than a year. Texas Department of Insurance documents show two complaints, from February and March, about Jericho Share. The department responded to both by saying it regulates insurance, which ministries are not, and forwarding them to the state attorney general’s office. The attorney general’s office did not respond to KHN questions about the status of the complaints.
John Oxendine, a lawyer who was elected four times as Georgia’s insurance commissioner, responded to KHN’s inquiries made to Jericho Share. He is currently facing federal charges of conspiracy to commit health care fraud that he said are unrelated to Jericho Share. He denied any wrongdoing. If Jericho memberships are being sold to consumers in misleading ways, “that’s a good way for a broker to get fired,” he said.
“Jericho Share does not tolerate any type of misrepresentation or unethical conduct on the part of its programs,” according to a statement sent through Oxendine. “Whenever we become aware of inappropriate conduct, we take appropriate action to remedy the situation.”
Consumers can always cancel their Jericho Share plans, Oxendine said. Many consumers who spoke to KHN did cancel their plans and receive refunds, but several said the process to do so was frustrating. Some were left to sort out payment for bills they incurred while they thought they were insured. At least seven of the people KHN spoke with said they ended up with Jericho Share after beginning their health insurance searches on Google.
Encountering such issues while shopping for health insurance is not uncommon, said JoAnn Volk, co-director of Georgetown University’s Center on Health Insurance Reforms. She co-authored a 2021 report that found “misleading marketing practices” were directing consumers to alternative health plans, like ministries, that can cost more than marketplace plans and offer fewer protections.
“It’s especially unfortunate because people have set out to buy comprehensive coverage,” Volk said.
Susan Fauman, 47, a metalsmith from Germantown, New York, relied on her spouse’s insurance coverage but wanted her own insurance policy before submitting her divorce paperwork last fall. Fauman said her Google search landed her on a series of what the advertising industry calls “lead-generating” websites: nongovernmental webpages that connect insurance brokers to consumers.
None of the consumers KHN spoke with could say with certainty which site ultimately connected them to the brokers who sold them Jericho Share memberships. ObamacarePlans.com and AffordableHealthPlans.org are among the lead-generating websites that show up on Google when someone searches with terms such as “Obamacare insurance” or “healthcare marketplace.” Those site listings are actually advertisements that resemble ordinary Google search results but are labeled with the word “Ad” and are placed above the most relevant search result: the federal government’s official health insurance marketplace, healthcare.gov.
Google spokesperson Christa Muldoon said companies that advertise on searches related to the Affordable Care Act must prove they are licensed to sell insurance via the federal or state marketplaces.
Those marketplaces let consumers shop for comprehensive health insurance, tell them whether they qualify for financial assistance, and connect consumers with enrollment assistance, if needed. By contrast, lead-generating websites typically just sell the personal information provided by consumers to insurance brokers and agents who can sell other types of plans.
Fauman said she unwittingly put her information into what turned out to be several lead-generating websites. She was soon inundated with phone calls from insurance brokers, she recalled.
Eager to get insurance, Fauman said, she bought a plan for about $330 a month, plus a $99 sign-up fee. She said the broker — who, she later realized, never named the plan — said she’d have basically no copays and no restrictions on where to get care. But he did not tell her it was a health care sharing ministry, she said, or that it wasn’t insurance — something she didn’t know to ask about. When she received her Jericho Share card with its disclaimer, she thought, “What the hell did I sign up for?”
Ministries and aggressive insurance marketing practices have raised eyebrows before, and the Washington state attorney general issued a consumer alert last year about “ads and websites posing as the official health insurance marketplace.” But Georgetown University’s Volk said large-scale crackdowns would likely require cooperation by multiple state regulators because states are the default enforcers of insurance rules. The Federal Trade Commission did bring a case against a Florida-based operation in 2018, alleging it collected over $195 million by enrolling consumers in “worthless plans.” The case is ongoing.
And it’s not always clear who can and should be protecting consumers in this complicated space that covers public and private insurance, interstate commerce, websites, and health care sharing ministries.
The Centers for Medicare & Medicaid Services manages the healthcare.gov website. “When CMS sees an ad we think is misrepresenting HealthCare.gov, we share it immediately with the search engines,” deputy administrator Ellen Montz said in a statement.
Louise Rasho, a spokesperson for MediaAlpha, which operates ObamacarePlans.com, said in an email that the company’s code of conduct does not allow brokers who buy customer leads to mislead consumers. It periodically monitors calls to ensure compliance. She also noted the site has disclaimers saying that it is not a government website.
Craig Sturgill of Excel Impact LLC, which owns AffordableHealthPlans.org, said that if the company learns a broker has broken the law or used questionable tactics, it terminates contracts and takes “further action” as necessary. “As a digital marketing company, we aren’t necessarily in the business of deeply educating consumers from beginning-to-end about all of their available options,” Sturgill said in an email. “Our role is to connect consumers to advisors who can and should effectively educate consumers.”
The broker callback number that consumer Hemani Hughes said she used to correct the spelling of her name on her Jericho Share plan — before she realized it was a ministry — is listed on the websites of the Better Business Bureau and the Utah Insurance Department as belonging to Florida-based Prosperity Health LLC. In an email, Prosperity Health’s registered business agent, Ahmed Shokry, said it had “never sold Health Shares.”
Hughes, a 49-year-old communications strategist in Kansas, said she was sold a Jericho Share plan in February after specifically telling a broker she did not want a health care sharing ministry plan. Hughes said she realized after her call that the broker never mentioned the plan by name, saying only that she was signing up for a “national PPO” and walking her through the copays.
When Hughes realized it was a health care sharing ministry, she said, she called to cancel her plan. She was met with what she described as “a pretty manipulating and very belligerent gantlet of customer service reps and hold times” over multiple calls.
At one point, Hughes said, the people she was speaking with told her it was irresponsible to go without insurance — even though Jericho Share itself is not insurance.
Hughes outlined her story in a complaint she filed with the Better Business Bureau. Jericho Share responded to the consumer watchdog that it was contacting Hughes directly to protect her private health information and said, “We are working very diligently to investigate this complaint thoroughly.” Hughes ultimately received a refund.
Passione said she filed her complaint with the Better Business Bureau after she couldn’t get a straight answer about payment for her doctor appointments and prescriptions. In March, Passione canceled her Jericho Share plan and signed up for COBRA coverage through her former employer for $782 a month.
“A bit expensive, but at least I know what I am getting,” Passione said.
She said she was reimbursed by Jericho Share for one month’s payment and is waiting to hear whether her credit card company can recoup payments she made in January and February.
Fauman, who also filed a complaint, received a refund, too, but spent two months uninsured and avoided calling her doctor while she sorted out the situation.
“I was afraid of what it was going to cost me,” Fauman said.
She eventually got marketplace insurance with the help of a “navigator,” someone trained to help consumers enroll in coverage without earning a commission. After subsidies, Fauman’s premium is around $95 a month, costing her about $2,800 less a year than what she said her Jericho Share plan would have — and her new plan is actually insurance.
Where to Buy Marketplace Insurance To find a health insurance plan, visit the federal marketplace, healthcare.gov, or call 800-318-2596.
[Update: This article was revised at 11:15 a.m. ET on June 8, 2022, to report lawyer John Oxendine’s unrelated indictment charges.]
Shelves normally meant for baby formula sit nearly empty at a store in downtown Washington, DC, on May 22, 2022.
Samuel Corum | AFP | Getty Images
Abbott Nutrition on Saturday resumed baby formula production at its Sturgis, Michigan, plant, a move toward addressing a nationwide shortage.
The company has been given the green light from the U.S. Food and Drug Administration after meeting "initial requirements" as part of a May 16 consent decree.
The company said it will restart the production of EleCare, a formula for children who struggle to digest other products, along with other specialty and metabolic formulas.
Abbott aims for an initial EleCare product release around June 20 and is working to meet guidelines to resume production of Similac and other formulas.
"We understand the urgent need for formula and our top priority is getting high-quality, safe formula into the hands of families across America," a spokesperson for Abbott said in a statement. "We will ramp production as quickly as we can while meeting all requirements."
While supply problems started early in the Covid-19 pandemic, issues worsened in part due to the February closure of the Michigan plant amid scrutiny over contamination.
FDA investigations began after four infants were hospitalized with bacterial infections from drinking its powdered formula. Two of the babies died.
"The FDA is continuing to work diligently to ensure the safe resumption of production of infant formula at Abbott Nutrition's Sturgis, Michigan, facility," the FDA said in a statement.
"The agency expects that the measures and steps it is taking, and the potential for Abbott Nutrition's Sturgis, Michigan, facility, to safely resume production in the near-term, will mean more and more infant formula is either on the way to or already on store shelves moving forward," the FDA said.
Abbott Nutrition is the largest baby formula manufacturer in the U.S.
Bariatric surgery patients tended to maintain healthier lifestyle habits compared with peers who were eligible but had not received this treatment, according to data from the National Health and Nutrition Examination Survey (NHANES).
People approximately 7 years out of bariatric surgery reported more moderate-to-vigorous physical activity (MVPA) than those who were eligible but did not undergo the operation (average 147.9 minutes per week vs 97.4 minutes per week), as well as lower total energy intake (1,746 calories per day vs 2,040 calories per day).
Yet they did not significantly perform better in meeting physical activity requirements (23.1% vs 20.3%) or eating healthy (Healthy Eating Index score 50.0 vs 48.0), according to propensity-matched analyses by Young-Rock Hong, PhD, MPH, of the University of Florida in Gainesville, and colleagues. Their report was published in JAMA Network Open.
The surgical group also fared worse than a nonsurgical group at normal weight in healthy eating and meeting physical activity requirements, the latter defined as engaging in at least 150 minutes a week of moderate-intensity or 75 minutes a week of vigorous-intensity aerobic physical activity.
There was still room for improvement in postbariatric lifestyle, study authors concluded. "Taken together, our findings suggest that postsurgical patients may need more continual support for engaging in healthy lifestyle behaviors to maintain the effects of the surgery," they wrote.
Strong support from physicians of those patients may be needed to ensure more success following bariatric surgery. The authors also highlighted issues such as stigma faced by those experiencing obesity while exercising, as well as both physical and mental health challenges following such a major operation.
Hong's group said that over 200,000 people get bariatric surgery per year, and about half gain back about 17-22 lbs within the first 2 years following their surgery.
"While regaining lost weight is not necessarily harmful, a deeper understanding of postoperative lifestyle patterns is needed to help inform preoperative education programs and postsurgical interventions to maximize the clinical benefits of bariatric surgery," the authors noted.
For their cross-sectional study, the investigators relied on nationally representative NHANES data from 2015 to 2018 including validated measures of diet and physical activity-related assessments.
Of the 4,659 participants, the average age was 46.1 years old, 58.8% were women, 12.7% were Black, and 68.6% were white.
Just 132 participants had undergone bariatric surgery. As a group, these individuals were older and more likely female or white compared with their 1,621 peers eligible for bariatric surgery, according to the American Society for Metabolic and Bariatric Surgery guidelines, who did not get the procedure.
The study left room for confounding and recall bias. Another limitation was the authors' inability to adjust for time since surgery and the exact surgery undergone.
Hong had no disclosures.
Co-authors reported personal relationships with WW International and Novo Nordisk and grants from the National Institutes of Health.
There's a chance your health insurance company owes you some cash.
Depending on how you get your coverage, you may be one of the 8.2 million policyholders expected to get a piece of $1 billion in premium rebates this fall from various insurers, according to a preliminary analysis from the Kaiser Family Foundation.
The amount is down from $2 billion issued in 2021 and a record $2.5 billion in 2020.
"In the last couple of years we've seen some really large rebates — twice the size of this year's amount," said Cynthia Cox, a vice president at the foundation and director of its Affordable Care Act program. "But I'd say $1 billion is still significant."
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Generally, you're more likely to see a rebate if you have an individual policy (including through a state health exchange or the federal one) or participate in a small- or large-group plan. (Many of the biggest U.S. employers choose to self-insure, which means their plans don't have to adhere to certain requirements placed on insurance companies. Different rules also apply to Medicare and Medicaid coverage.)
So why are the rebates going out?
Basically, insurance companies that sell group or individual policies must adhere to a "medical loss ratio" requiring them to spend at least 80% of premiums paid by enrollees on health-care costs and certain other expenses related to patient health. (For large group plans, the ratio is 85/15.) If that threshold is not met, enrollees are reimbursed the difference.
Each year, the ratio is calculated based on a rolling three-year average. So the rebates this year derive from insurance companies' financial data from 2019, 2020 and 2021.
This year's refunds — which will go to eligible participants enrolled last year — work out to about $141 per plan participant in the individual market, $155 in the small group market and $78 in large group plans, according to the Kaiser analysis. However, that amount can vary widely, depending on your location and insurer.
Insurers typically either send a check to policyholders or deduct the rebate from premiums (and send a check to individuals no longer enrolled but owed some money). Be aware that if you are in a group plan, your employer may split the rebate with you, Cox said.
If you're entitled to a rebate, you should receive it by Sept. 30.