7 Things You Need To Know About Trumpcare

If you’re young or rich, don’t be surprised if you love the plan

Mar 19, 2017

March 19, 2017

Last week, after numerous iterations and alleged in-fighting, the GOP finally agreed on a replacement plan for Obamacare. Already dubbed “Trumpcare” or “Ryancare,” perhaps because it so closely resembles Speaker Paul Ryan’s “Better Way health care” plan of 2016, the American Health Care Act (AHCA) has failed to impress either the American Medical Association or the AARP. Even right-wing advocacy groups such as Heritage Action were not pleased.

You may have heard that the bill, if passed, will penalize people who lose coverage for as little as two months. Yet it also removes the individual mandate to purchase insurance—and thus the money that made it possible to insure millions under the Affordable Care Act (ACA). But it’s hard to suss out what’s really at stake for the majority of Americans, especially as the bill is still entirely hypothetical. Should you really be worried?

To get some perspective, we spoke with Daniel Dawes, a Georgia attorney with expertise in health policy and the author of 150 Years of Obamacare (Johns Hopkins University Press, 2016). Instrumental in the negotiations around health reform during the creation of the ACA law, Dawes organized the National Working Group on Health Disparities and Health Reform, a working group of more than 300 national organizations and coalitions that ensured the health reform law included equity provisions, reducing disparities in health status and health care.

How will the AHCA, should it pass, affect people who currently purchase their insurance through the health care exchanges under the ACA?

What the bill will do is change the health insurance exchanges to such a degree that it would negatively impact your ability to purchase affordable health insurance. It would reduce the credits that go to folks who are lower income and who are older. And, interestingly enough, those who are healthier and wealthier would benefit under the Republican plan because the essential plan is to put more of the cost of health insurance on those who are older—and, as a result, sicker.

The bill proposes encouraging people to get health savings accounts (HSAs) to pay for health care, right?

Based on the studies we’ve seen, low-income individuals would not benefit from an HSA. Just to give you an example, let’s say your pre-tax income is $5,000 a month for a family of four. You need to have spare income socked away in the account for medical expenses. Chances are, even if you have a spare $5,000 a month to put into your account, it still wouldn’t be enough to cover health care costs even for one visit to an urgent care facility.

[quote position=”left” is_quote=”true”]The essential plan is to put the costs on those who are older and sicker.[/quote]

Moreover, don’t forget you can’t use what you don’t have. So if you have $700 in the account and your medical bills are $3,000, you’re responsible for paying the remainder. So it’s clear HSAs will only benefit a small percentage of Americans. And they’re going to leave out most of the people who currently opt in to the Obamacare health care exchanges.

How will Medicaid be affected by the bill?

The bill wants to place a per capita cap. So under the Medicaid program right now, there’s this open-ended amount of money. We have been helping the greatest amount of people in need for years. Let’s say we have 100 people in the system and the cost of providing Medicaid increases because they have stage 4 cancer or heart disease. The states will fund it, but the feds will usually match that and cover the cost between 55 and 75 percent. On a per capita cap basis though, what they’re saying is, we’re going to give you a certain amount per Medicaid beneficiary. And once that’s been exhausted in terms of providing care for these individuals, that’s it. It’s no longer open-ended anymore.

Now, the state will have to figure out how in the world they will come up with the additional funds. That’s going to be a tremendous burden on the state and that’s why you’re seeing so many Republican governors a little perturbed by that policy.

What’s the difference between the subsidies the ACA provided and the tax credits the AHCA is providing?

Under the current law, the ACA, you’re able to immediately get the subsidies and use them to purchase your insurance coverage to pay for your premiums. And if you make less than 250 percent of the federal poverty level, you also are able to get a cost-sharing subsidy to help pay for any copayments you have. Under the Republican plan, they would want to get rid of the cost-sharing subsidies.

[quote position=”full” is_quote=”true”]Republican governors are a little perturbed because there’s going to be a tremendous burden on the state.[/quote]

Also, before they reach Medicare, folks who are in their 50s, actually even in their 40s to 60s, are going to experience sticker shock. They’re usually the folks who need insurance the most. For many, chronic diseases have impacted them negatively. So those are the populations who are most vulnerable.

Younger folks may love the Republican plan because it will make it cheaper on them, but older folks will suffer. Wealthier folks will love the plan, but low-income folks will suffer.

The bill would get rid of the individual mandate to purchase health insurance. What does that mean for the cost of premiums?

Under the system right now, you have a group of healthy folks included with the sicker folks who are spreading the risk. If you don’t have the individual mandate and you allow healthier individuals to exit, it will cause a death spiral in the market. And if you think a high-risk pool would be the solution, what insurance company would ever want to participate in that type of marketplace? I’m not a huge fan of these high-risk pools because they have a detrimental effect on the most vulnerable among us.

You think you’ve seen sticker shock with the ACA? We’re looking at a $3,200 premium on average. If it’s repealed, we’re looking at an increase to $4,700. It would cut the number of insured individuals in our country across the board.

How does the bill affect mental health care?

The ACA was the greatest expansion of mental health protections than we have ever seen in this country, including mental health and substance abuse addiction coverage. The ACA mandates mental health coverage and, in addition to that coverage, it mandates rehabilitation and habilitation coverage for individuals who have a substance abuse issue that’s impacted their cognitive or bodily ability. The ACA also expanded protections for folks who have no health coverage. All of these are in jeopardy under the Republican bill.

A lot of the major changes won’t take effect until closer to 2020. Why is that?

To counter any severe or negative impacts expected to happen under this bill because most think tanks, either conservative or liberal leaning, as well as the Congressional Budget Office, have already scored these and found these proposals would result in higher uninsurance rates and greater costs to the consumer. There’s a political strategy to push this out until after the 2018 elections and the 2020 presidential election.

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Photo credit: Leigh Prather/Shutterstock.com – Dogs often react with great fear to July 4th celebrations. Border collies such as this dog are especially sensitive to loud noises.

Health, Well-being

Every dog has its day, but it’s not the Fourth of July

How to protect anxious pups from holiday booms.

Good Partner

6/25/2026
Christine Calder

The Fourth of July can be a miserable day for dogs. The fireworks make scaredy-cats out of many canines.

That’s because dogs, like humans, are hardwired to be afraid of sudden, loud noises. It is what keeps them safe. Some dogs, though, take that fear to the extreme with panting, howling, pacing, whining, hiding, trembling and even self-injury or escape. And, unlike humans, they don’t know that the fanfare on the Fourth is not a threat. Dogs hear the fireworks and process it as if their world is under siege.

How a dog responds to noises may be influenced by breed, with German shepherd dogs more likely to pace, while border collies or Australian cattle dogs are more likely to show their fear by hiding.

While we veterinarians don’t know exactly why some dogs are afraid of fireworks and others not, many dogs that react to one noise often react to others. Therefore, early intervention and treatment are essential in protecting the welfare of these terrified dogs. Here’s how you can protect your dog from fireworks.
- Take your pet to the vet. If your dog is afraid of fireworks, the first step is to have your veterinarian evaluate him or her, especially if your dog’s noise sensitivity is relatively new. One 2018 study found a link between pain and noise sensitivities in older dogs, indicating that muscle tension or sudden movements in response to a loud noise may aggravate a tender area on the body and thus create an association between the loud noise and pain, causing fear of that particular noise to develop or escalate.
- Create a “safe haven” in your home with a secure door or gate, preferably away from outside windows or doors. Close the blinds or curtains to reduce outside noises, and play some classical music to help reduce stress by creating a relaxing environment for your dog during the show. A white noise machine or box fan may also help reduce anxiety, along with a pheromone like Adaptil sprayed on bedding, a bandanna, a collar or from a diffuser plugged into the wall.
- Consider noise-canceling headphones such as Mutt Muffs to muffle the sounds and further reduce noise sensitivities.
- Find a food your pet will love. This could be cut pieces of boiled chicken or squeeze cheese. Sit with your pet and feed him with each boom. You can also use a long-lasting food-dispensing or puzzle toy to release food continuously during the show. This is to help your dog make a positive association with the noises for the future.
- Consider anxiety wraps, fabric wraps that exert a gentle pressure on your dog’s body. These may help to lower heart rate and other clinical signs of fear and anxiety, operating on the belief that they swaddle a scared animal and thus calm its fears. These work best, however, in conjunction with a complete behavior treatment plan including medication or behavior modification, or both.
- When it comes to comforting your dog, the jury is still out. It is difficult, however, to reinforce an emotional response with comfort. Therefore, it is OK to pet your dog when frightened by a noise event so long as the dog appears to be comforted and not more distressed by the attention.
This article originally appeared on The Conversation. You can read it here.
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Photo credit: Alex Cofaru/Shutterstock.com – A girl in a field of flowers.

Health, Well-being

Pollen is getting worse, but you can make things better with these tips from an allergist

Simple steps can ease spring allergy misery

Good Partner

6/25/2026
Kara Wada

Blooming flowers signal the beginning of spring, but for millions of people, they also signal the onset of the misery: allergy and asthma season. Itchy, watery eyes; sneezing, runny nose; cough and wheezing are triggered by an overreaction of the body to pollen.

Every spring, trees and grasses release billions of buoyant pollen granules into the air, using the wind to disperse across the countryside in an effort to reproduce. It’s all about survival; plants that release more pollen have the survival advantage.

As an adult and pediatric allergist-immunologist in the Midwest, the onset of spring signals my busy season treating hundreds of patients for their seasonal allergy and asthma symptoms. If you suffer through the season, know that you are not alone. Throughout history, pollen has taken the fun out of spring for many. In modern times, however, medical science has identified practices and treatments that help.

Older than the dinosaurs, as wide as the world

Fossilized specimens of pollen granules have been found predating dinosaurs and alongside Neanderthals.

And, sinus and asthma symptoms and treatments are documented throughout history and across the globe. People just didn’t know exactly how to treat the symptoms, or exactly what was causing them.

For example, over 5,000 years ago, the Chinese used the berries of the horse tail plant, ma huang (Ephedra distachya), to relieve congestion and decrease mucous production associated with “plant fever” – a condition affecting people during the fall.

In Egypt, the “Papyrus Ebers,” written around 1650 B.C., recommended over 20 treatments for cough or difficulty breathing, including honey, dates, juniper and beer.

Although Homer’s “Iliad” describes the loud noise of breathing in battle as “asthma,” Aretaeus of Cappadocia of the second century A.D. is credited with the first clinical description more consistent with modern understanding of this condition. He wrote of those who suffered that:

“They open the mouth since no house is sufficient for their respiration, they breathily standing, as if desiring to draw in all the air which they possibly can inhale… the neck swells with the inflation of the breath, the precordia (chest wall) retracted, the pulse becomes small and dense,” and if the symptoms persist, the patient “may produce suffocation after the form of epilepsy.”

Tobacco leaves were exported to Europe for experimentation in treating the symptoms of spring time coughing and sneezing. Jeep 2499/Shutterstock.com

By the time Columbus landed, indigenous populations in Central and South American were utilizing ipecacuanha, a root found in Brazil with expectorant and emetic properties and balsam, which is still used in some cold remedies today. Coca and tobacco leaves, used medicinally by the Incas, were later exported to Europe for additional experimentation for the treatment of rhinitis and asthma.

Aside from the “plant fever” described in China, the first written description of seasonal respiratory symptoms is credited to Rhazes, a Persian scholar, around 900 A.D. He described the nasal congestion that coincided with the blooming of roses, termed “rose fever.”

Symptoms noticed, but no cause identified

As scientific advancement was stifled during the Middle Ages, in large part due to the plague, it wasn’t until 900 years later, in 1819, that Dr. John Bostock published a description of his own seasonal allergies. But he didn’t know what was causing them.

Having suffered from “summer catarrh” since childhood, Bostock persisted in his study of the condition, despite an initial lackluster response from the medical community.

In the nine years between his first and second publications, he found only 28 additional cases consistent with his own seasonal allergy symptoms, which perhaps demonstrates the lower prevalence of the condition at the time. He noted that nobility and the privileged classes were more often afflicted by seasonal allergies. This was thought to be the consequence of wealth, culture and an indoor life.

Societal changes with their roots in the Industrial Revolution, including increased exposure to air pollution, less time spent outdoors, increased pollen counts and improved hygiene, all likely contributed to the increased prevalence of allergies that we continue to see today. They also helped form the hygiene hypothesis, which states that in part decreased exposure to particular bacteria and infections could be leading to the increase in allergic and autoimmune diseases.

The source of seasonal symptoms at the time was also thought to be caused by the smell of new hay. This led to the coining of the term “hay fever.”

Bostock instead suspected the recurring symptoms were triggered by the summer heat, since his symptoms improved when he spent the summer on the coast. It would later became common for nobility and aristocrats to spend allergy season in coastal or mountain resorts to avoid bothersome symptoms.

Identifying the true culprit

Through methodical study and self-experimentation, Dr. Charles Blackley identified that pollen was to blame for allergy symptoms. He collected, identified, and described various pollens and then determined their allergic properties by rubbing them into his eyes or scratching them on his skin. He then noted which ones resulted in redness and itching. This same technique is used in skin prick testing by allergists today.

Inspired by discoveries related to vaccination, Dr. Leonard Noon and John Freeman prepared doses of pollen extracts for injection in an effort to desensitize patients with allergic rhinitis in the early 1900s. This effective treatment, called allergy immunotherapy, also known as allergy shots, is still used today.

Antihistamines first became available in the 1940s, but they caused significant sedation. The formulations with fewer side effects that are used today have only been available since the 1980s.

Pollen counts likely to grow

Pollen on a street in Atlanta, March 31, 2019. Lynne Anderson, CC BY-SA

Though recognized by ancient civilizations, seasonal allergic rhinitis and allergic asthma have only increased in prevalence in recent history and are on the rise, now affecting 10 to 30 percent of the world’s population.

Fueled by warmer temperatures and increased carbon dioxide levels, pollen seasons are longer, and pollen counts are higher. Many experts believe this will worsen in the coming years due in large part to climate change.

To keep you and your loved ones safe from pollen, close windows and change out of clothes exposed to pollen as soon as you come indoors. Monkey Business Images/Shutterstock.com

What can you do? Often, those who are allergic need a multifaceted approach.
- Find out what allergens are causing your symptoms. Take note of when your symptoms start by making a note in a calendar or planner.
- Minimize exposure to allergens. Track pollen counts. When pollen counts are high, keep the windows closed at home and in the car. After spending time outdoors, shower and change clothing to prevent ongoing exposure to pollen.
- Take a pro-active approach to treating symptoms. Starting medications before symptoms develop can prevent symptoms from getting out of control. This can also decrease the amount of medication needed overall. Long acting non-sedating antihistamines are helpful for itching and sneezing. Nasal corticosteroid sprays are more helpful for stuffy noses.
- Consider a visit to see a board certified allergist/immunologist. She or he can help you determine which particular pollens maybe the source of your symptoms.
- Explore the role of immunotherapy with your doctor. Immunotherapy changes the immune response through administration of small regimented doses of allergens over time. This induces a state of tolerance, eventually helping people become less allergic over time.
While pollen season is coming, taking a multifaceted approach can provide much needed relief from the symptoms that have plagued humankind throughout the millennia.

This article originally appeared on The Conversation. You can read it here.
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Photo credit: Canva – 3D printing can help dental patients.

Care, Health

22-year-old gives out toothy smiles by providing free 3D-printed dentures to those in need

He could make dentures within a day.

Erik Barnes

6/25/2026

Much like anything else, the cost of dental care has risen as need grows. A report from the American Dental Association found that, in 2024, dental spending grew by $7 billion from 2023. A young engineer is making a difference, though. He has helped put a smile back on the faces of folks in need by providing free dentures made with 3D printers.

Connor Gibson isn’t a dentist or even an expert on 3D printers. He’s a Tennessee community college student who wants to help people. While studying engineering at Walters State Community College, Gibson volunteered with Remote Area Medical (RAM). RAM is a nonprofit that provides mobile clinics offering free medical, vision, and dental care through volunteers.

An issue that bites

A common issue the clinics found was that many people needed dentures. The cost of dentures can be very pricey, ranging from $452 dollars to over $6,500 depending on the patient’s needs and their insurance coverage. Another issue was availability. Even if a patient could afford dentures, it could take weeks or even months before they could be delivered.

But Gibson had an idea. He thought that if he could 3D print pairs of dentures, it would save money and time. After all, having a 3D printer on-site would allow the dentures to be made within hours rather than weeks. A patient could get a free set of dentures the same day as their visit.

Great idea…but how?

There was a setback: Gibson had no experience in dentistry or 3D printing at all. In spite of his inexperience, Gibson used his engineering and design skills to teach himself how to use a 3D printer. He also got dental experts to teach him how to make dentures the old fashioned way. This way, he was sure to accurately recreate every detail via 3D printing. After taking an impression, Gibson was then able to design specific dentures per patient.

“Honestly, if you told me three years ago this is what I would be doing, I would have called you crazy,” Gibson said to CNN. “I made it my mission and studied up like I was doing a test, studying up on videos and documents — anything I could find on how to make a denture using this specific software and how to 3D print it.”

After Gibson successfully completed a pair of 3D-printed dentures for the first time, he knew it was something special. Seeing the tears of joy on the patient’s face was enough to confirm he was doing the right thing.

“That first delivery was really a huge eureka moment,” Gibson said. “To see that raw, human emotion and just know that I played a change in this person’s life… it’s very humbling, and I’m beyond blessed.”

Gibson has since been helping RAM develop more denture mobile clinics that can quickly develop dentures for patients who drop in.

How to find low-cost dental care near you

If you or someone you know needs low-cost to free dental care, there are options. In addition to Medicare, Medicaid, and CHIP, you can find local and state programs online. You can also dial 2-1-1 for information.

Another option dental schools and dental hygiene schools that provide supervised, low-cost care from their students.

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