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What Are The Two Health Bills Sen. Susan Collins Wants Congress To Act On?



ROBERT SIEGEL, HOST:

Inside the latest version of the Republicans’ tax bill, the one hammered out by the Senate and the House, is a provision on health care. It amounts to a repeal of the Affordable Care Act’s individual mandate, something that could undermine the health care exchanges. It had seemed to be a sticking point for Maine Republican Senator Susan Collins. But Collins now indicates that she will back the tax bill if Congress acts on two other health measures. Maine Public Radio’s Patty Wight reports.

PATTY WIGHT, BYLINE: Senator Collins has never been a fan of the individual mandate.

(SOUNDBITE OF ARCHIVED RECORDING)

SUSAN COLLINS: Never the less, I recognize that repeal of the individual mandate would have consequences for the stability and the premiums in the individual market.

WIGHT: The nonpartisan Congressional Budget Office projects that repealing the mandate would hike premiums about 10 percent annually over the next decade and cause 13 million people to lose coverage. Collins says the solution is found in two proposed bills.

(SOUNDBITE OF ARCHIVED RECORDING)

COLLINS: Together, those two bills would more than offset the increase in premiums.

WIGHT: One bill sponsored by Republican Senator Lamar Alexander of Tennessee and Democratic Senator Patty Murray of Washington would restore payments President Trump recently ended. Those payments helped insurance companies reduce costs for people with low incomes. But Mitchell Stein, a health policy consultant, says that’s a separate issue from the mandate.

MITCHELL STEIN: To say that that will impact the negative effects of eliminating the mandate is like saying, to quote Senator Murray herself, it’s like saying you can fight a fire by giving someone a shot of penicillin.

WIGHT: The second bill that Collins wants passed is one she’s co-sponsoring with Democratic Senator Bill Nelson of Florida that would fund a reinsurance program.

STEVE BUTTERFIELD: You know, reinsurance isn’t a bad idea.

WIGHT: At least in theory, says Steve Butterfield, policy director for the Maine-based advocacy group Consumers for Affordable Health Care.

BUTTERFIELD: It’s something that you do, you know, to stabilize a market influx.

WIGHT: For example, if the individual mandate penalty goes away, younger, healthier people might forgo insurance, leaving older, sicker consumers in the market. Collins’ bill would give states funding to help pay their higher medical costs. But it’s only $10 billion over the next two years, says Butterfield.

BUTTERFIELD: You can’t permanently repeal a critical component of America’s current health care system forever and then say, well, you know, here’s a Band-Aid for two years. You guys can limp through until a future Congress fixes what we’re breaking.

WIGHT: But Collins points to an analysis by consulting firm Avalere, which found that the two bills would increase enrollment by 1.3 million people and lower premiums by 18 percent in 2019.

(SOUNDBITE OF ARCHIVED RECORDING)

COLLINS: And that is more than the 10 percent increase in premiums that would result from repealing the individual mandate.

CAROLINE PEARSON: The story’s much bigger than premiums.

WIGHT: That’s Avalere’s Caroline Pearson. She says the analysis Collins mentions did include a caveat. It did not examine the bills in the context of no individual mandate. No mandate, says Pearson…

PEARSON: Could create significant instability in the market. And it may cause some insurers to drop out of the market, which really could lead to a lack of coverage availability for some consumers.

WIGHT: Another question hanging over those bills is whether Congress will pass them. Senator Collins has a written commitment from Senate Majority Leader Mitch McConnell that he will support their passage before the end of the year. House leadership has not provided a written commitment, but Collins says she’s received assurance from the vice president. For NPR News, I’m Patty Wight.

SIEGEL: That story is part of a partnership of NPR, member stations and Kaiser Health News.

Copyright © 2017 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

High electric or internet bills? Let Joe Know shows you how to investigate

Did you have a couple of crazy electricity bills this summer?

Are you paying more for the internet than you thought you would?

What are the first steps you need to take to resolve the issues?

I took those questions to APS, SRP and CenturyLink recently.

Beth McFall with APS says if you have a bill issue, start with their online energy analyzer.

She says it allows you to see spikes day by day.

Maybe it was a very hot weekend.

Or maybe there’s no explanation and it needs further investigation.

At SRP, Artie Whiting says while there’s usually a different reason, you can test the meter for accuracy.

It basically means turning off electricity.

That should stop the meter from moving.

Then turn on an appliance and if the meter is moving, there could be an issue SRP needs to know about.

When it comes to the internet, maybe it’s a billing issue.

Do you think you were promised one deal, but are paying more?

I usually use the online chat feature with any business.

That allows me to take screen shots of promises made for proof later.

Dan Cook with Century Link says it is important if you have an issue, to also have as much proof as possible backing up what you tell them.

Cook says it’s great to keep notes of who you spoke to and the date because those phone call records can be examined.

All the businesses say if you have any issues, contact their customer service departments.

 

Buffalo Bills: BuffaLowDown Launches App For iOS and Android

A one-stop shop Buffalo Bills app that merges fandom and technology together, the BuffaLowDown app features content from BuffaLowDown and is now available to download on iOS and Android.

CHICAGO, IL- Available now, BuffaLowDown for iOS and Android offers users a way to get the latest Buffalo Bills news, rumors and analysis from BuffaLowDown, all at once.

The new app provides Buffalo Bills fans with original, shareable content covering topics that include the NFL Draft, free agency and much much more.

90c55_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android90c55_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android

Features

  • Control how you view content by setting up alerts and sorting through categories including the latest news, rumors and analysis.
  • Intuitive menus make it easy to toggle between feeds from BuffaLowDown and FanSided.

BuffaLowDown is available now for free download in the U.S. as well as other regions, on both the Google Play Store and Apple App Store.

Please visit our mobile app page for more FanSided mobile apps, including FanSided 3.0.

In addition to the BuffaLowDown app on iOS and Android, FanSided continues to create a customized multidevice ecosystem for content with FanSided Daily, a fully personalized daily newsletter delivered to users’ inboxes, FanSided’s Android app, and FanSided’s iOS app.

90c55_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android

Get the BuffaLowDown App

90c55_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android90c55_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android

The FanSided network features more than 300 websites covering a variety of sports, entertainment and lifestyle topics.

Launched in 2009, FanSided is one of the industry’s fastest growing digital content networks and includes sites dedicated to every major professional sports team, all of the nation’s top college athletic programs, popular TV shows, movies and other celebrated sports, culture, tech and entertainment categories.

Boasting a roster of more than 1,500 writers, FanSided’s unique fan-focused editorial content reaches millions of dedicated readers every month online and via its stable of highly customizable apps and newsletters.

Buffalo Bills: BuffaLowDown Launches App For iOS and Android

A one-stop shop Buffalo Bills app that merges fandom and technology together, the BuffaLowDown app features content from BuffaLowDown and is now available to download on iOS and Android.

CHICAGO, IL- Available now, BuffaLowDown for iOS and Android offers users a way to get the latest Buffalo Bills news, rumors and analysis from BuffaLowDown, all at once.

The new app provides Buffalo Bills fans with original, shareable content covering topics that include the NFL Draft, free agency and much much more.

ff42f_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Androidff42f_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android

Features

  • Control how you view content by setting up alerts and sorting through categories including the latest news, rumors and analysis.
  • Intuitive menus make it easy to toggle between feeds from BuffaLowDown and FanSided.

BuffaLowDown is available now for free download in the U.S. as well as other regions, on both the Google Play Store and Apple App Store.

Please visit our mobile app page for more FanSided mobile apps, including FanSided 3.0.

In addition to the BuffaLowDown app on iOS and Android, FanSided continues to create a customized multidevice ecosystem for content with FanSided Daily, a fully personalized daily newsletter delivered to users’ inboxes, FanSided’s Android app, and FanSided’s iOS app.

ff42f_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android

Get the BuffaLowDown App

ff42f_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Androidff42f_content-screen Buffalo Bills: BuffaLowDown Launches App For iOS and Android

The FanSided network features more than 300 websites covering a variety of sports, entertainment and lifestyle topics.

Launched in 2009, FanSided is one of the industry’s fastest growing digital content networks and includes sites dedicated to every major professional sports team, all of the nation’s top college athletic programs, popular TV shows, movies and other celebrated sports, culture, tech and entertainment categories.

Boasting a roster of more than 1,500 writers, FanSided’s unique fan-focused editorial content reaches millions of dedicated readers every month online and via its stable of highly customizable apps and newsletters.

Internet Censorship Bills Won’t Help Catch Sex Traffickers

In the most illuminating part of last week’s House subcommittee hearing on the Allow States and Victims to Fight Online Sex Trafficking Act (FOSTA, H.R. 1865), Tennessee Bureau of Investigation special agent Russ Winkler explained how he uses online platforms—particularly Backpage—to fight online sex trafficking. Winkler painted a fascinating picture of agents on his team posing as johns, gaining trust with traffickers, and apprehending them. His testimony demonstrated how, with proper training and resources, law enforcement officers can navigate the online platforms where sex work takes place to find and stop traffickers, especially those trafficking children.

It was a rare moment of clarity in the debate over FOSTA and its sibling bill, the Stop Enabling Sex Traffickers Act (SESTA, S. 1693). Since these bills were introduced, there’s been little discussion of how law enforcement officers use the online platforms that the bills would threaten and how SESTA and FOSTA would make it more difficult for law enforcement to do its work. Winkler made it crystal clear how heavily his work relies on online platforms: “We’ve conducted operations and investigations involving numerous perpetrators and victims. The one constant we encounter in our investigations is use of online platforms like Backpage.com by buyers and sellers of underage sex.”

There are some differences between SESTA and FOSTA, but their impact on the Internet would be the same. A website or other online platform could be liable under both civil and criminal law, at both the state and federal levels, for the sex trafficking activities of its users. Since it can be very difficult to determine whether a given posting online is in aid of sex trafficking, the bills would almost certainly force websites to become significantly more restrictive in what sorts of content they allow. Many victims of trafficking would likely be pushed off the Internet entirely, as well as sex workers who weren’t being trafficked.

Winkler didn’t show much interest in the idea of targeting online intermediaries—and neither did fellow witness Derri Smith of End Slavery Tennessee. Understandably, their focus isn’t on holding Internet companies liable for user-generated content; it’s on prosecuting the traffickers themselves and getting trafficking victims out of horrific situations.

When Rep. Marsha Blackburn asked both Tennessee panelists what they need to successfully fight trafficking, neither panelist mentioned proposals like SESTA and FOSTA at all. They discussed more important measures aimed at finding and stopping traffickers and supporting survivors. Winkler referenced changes in state law “to make it more punishable for both buyers and sellers of sex acts with juveniles.”

Winkler isn’t the only person who’s tried to explain to Congress how law enforcement relies on online platforms to find and arrest sex traffickers. Numerous experts in trafficking have pointed out that the visibility of online platforms can both aid law enforcement in apprehending traffickers and provide safety to trafficking victims. Trafficking expert Alexandra Levy notes that the online platforms that FOSTA could undermine are the very platforms that law enforcement agencies rely on to fight trafficking:

While more visibility invites more business, it also increases the possibility that victims will be discovered by law enforcement, or anyone else looking for them. By extension, it also makes it more likely that the trafficker himself will be apprehended: exposure to customers necessarily means exposure to law enforcement.

Levy submitted a letter to the House Energy and Commerce Committee, Subcommittee on Communications and Technology, in advance of last week’s hearing, urging the Subcommittee not to go forward with a bill (.pdf) that would make it harder to apprehend traffickers and expose trafficking victims to more danger.

Freedom Network USA—the nation’s largest network of frontline organizations working to reduce trafficking—agrees (.pdf): “Internet sites provide a digital footprint that law enforcement can use to investigate trafficking into the sex trade, and to locate trafficking victims.”

Four months after SESTA was introduced in Congress—and with SESTA and FOSTA’s lists of cosponsors growing by the day—lawmakers continue to flock to these bills without questioning whether they provide a real solution to sex trafficking. These bills would do nothing to stop traffickers but would push marginalized voices off of the Internet, including those of trafficking victims themselves.

Reposted from EFF’s Deeplinks blog

Millennials’ struggle with health bills could push hospitals to change

<!– –>


a1384_104884108-image1.530x298 Millennials' struggle with health bills could push hospitals to change

Jonathan and Nikia Reynolds are still deciding on a new health plan for 2018, weighing the pros and cons of a high-deductible insurance plan to try to keep their monthly premium lower.

“How it’s supposed to work, I kind of get all that stuff. … In practice, it’s usually less clear,” said Jonathan, a 34-year old Atlanta-based freelance video photographer.

At least, that’s how he felt after a late-night trip to the emergency room a couple of years ago resulted in months of confusing bills in the mail.

“I would get bills way after the fact, and it was never clear exactly what the bills were from, and how they related to what the insurance covered,” he said.

As the first generation to come of age under Obamacare, millennials are finding the new rules of consumer-driven health care tough to navigate.

More than half of millennials, 57 percent, say they have little to no understanding of how out-of pocket health costs such as co-pays, deductibles and co-insurance work, according to a new report from consumer credit firm TransUnion. By contrast, about 40 percent of baby boomers admit to limited knowledge about their benefits.

“Millennials came into the health-care market at a really volatile time, when cost-shifting was really happening … [and] deductibles have quadrupled,” said Jonathan Wiik, principal at TransUnion’s health-care unit.

For hospitals and other health providers, millennial patients — born from 1980 to 1994 — are proving to be a challenge when it comes to collecting payment for bills.

Nearly 3 in 4 millennials, 74 percent, failed to pay their medical expenses in full when first billed in 2016; that’s up from 64 percent in 2014, TransUnion’s survey said.

The vast majority cited limited savings for not paying, but nearly half of those surveyed say they’d be more apt to pay if they could get a cost estimate up front.

“They don’t pay their bills on time because they don’t understand them. That’s pretty typical of that generation — they’re not going to pay until somebody explains it to them,” said Wiik, who consults with hospitals on bill collection.

He says hospitals are starting to change the way they have traditionally billed, by trying to prepare patients for what their out of pocket costs will be ahead of treatment, and working out flexible payment plans to allow patients to pay over time.

But the hospitals have a long way to go.

“I don’t think any millennial pays their bills on paper,” Wiik said. “That’s how hospitals are billing right now. … It’s a big gap that the industry’s going to have to help fill.”

Jonathan Reynolds is hoping not to see any hospital bills in the mail any time soon.

“I know health care is complicated,” he said, but it’s high time for real “simplification of how deductibles and co-pays are explained, and just the process of billing itself.”

a1384_104884108-image1.530x298 Millennials' struggle with health bills could push hospitals to change



Internet Censorship Bills Wouldn’t Help Catch Sex Traffickers …

SESTA and FOSTA Could Hide Trafficking from Law Enforcement

In the most illuminating part of last week’s House subcommittee hearing on the Allow States and Victims to Fight Online Sex Trafficking Act (FOSTA, H.R. 1865), Tennessee Bureau of Investigation special agent Russ Winkler explained how he uses online platforms—particularly Backpage—to fight online sex trafficking. Winkler painted a fascinating picture of agents on his team posing as johns, gaining trust with traffickers, and apprehending them. His testimony demonstrated how, with proper training and resources, law enforcement officers can navigate the online platforms where sex work takes place to find and stop traffickers, especially those trafficking children.

It was a rare moment of clarity in the debate over FOSTA and its sibling bill, the Stop Enabling Sex Traffickers Act (SESTA, S. 1693). Since these bills were introduced, there’s been little discussion of how law enforcement officers use the online platforms that the bills would threaten and how SESTA and FOSTA would make it more difficult for law enforcement to do its work. Winkler made it crystal clear how heavily his work relies on online platforms: “We’ve conducted operations and investigations involving numerous perpetrators and victims. The one constant we encounter in our investigations is use of online platforms like Backpage.com by buyers and sellers of underage sex.”

There are some differences between SESTA and FOSTA, but their impact on the Internet would be the same. A website or other online platform could be liable under both civil and criminal law, at both the state and federal levels, for the sex trafficking activities of its users. Since it can be very difficult to determine whether a given posting online is in aid of sex trafficking, the bills would almost certainly force websites to become significantly more restrictive in what sorts of content they allow. Many victims of trafficking would likely be pushed off the Internet entirely, as well as sex workers who weren’t being trafficked.

Winkler didn’t show much interest in the idea of targeting online intermediaries—and neither did fellow witness Derri Smith of End Slavery Tennessee. Understandably, their focus isn’t on holding Internet companies liable for user-generated content; it’s on prosecuting the traffickers themselves and getting trafficking victims out of horrific situations.

When Rep. Marsha Blackburn asked both Tennessee panelists what they need to successfully fight trafficking, neither panelist mentioned proposals like SESTA and FOSTA at all. They discussed more important measures aimed at finding and stopping traffickers and supporting survivors. Winkler referenced changes in state law “to make it more punishable for both buyers and sellers of sex acts with juveniles.”

Winkler isn’t the only person who’s tried to explain to Congress how law enforcement relies on online platforms to find and arrest sex traffickers. Numerous experts in trafficking have pointed out that the visibility of online platforms can both aid law enforcement in apprehending traffickers and provide safety to trafficking victims. Trafficking expert Alexandra Levy notes that the online platforms that FOSTA could undermine are the very platforms that law enforcement agencies rely on to fight trafficking:

While more visibility invites more business, it also increases the possibility that victims will be discovered by law enforcement, or anyone else looking for them. By extension, it also makes it more likely that the trafficker himself will be apprehended: exposure to customers necessarily means exposure to law enforcement.

Levy submitted a letter to the House Energy and Commerce Committee, Subcommittee on Communications and Technology, in advance of last week’s hearing, urging the Subcommittee not to go forward with a bill (.pdf) that would make it harder to apprehend traffickers and expose trafficking victims to more danger.

Freedom Network USA—the nation’s largest network of frontline organizations working to reduce trafficking—agrees (.pdf): “Internet sites provide a digital footprint that law enforcement can use to investigate trafficking into the sex trade, and to locate trafficking victims.”

Four months after SESTA was introduced in Congress—and with SESTA and FOSTA’s lists of cosponsors growing by the day—lawmakers continue to flock to these bills without questioning whether they provide a real solution to sex trafficking. These bills would do nothing to stop traffickers but would push marginalized voices off of the Internet, including those of trafficking victims themselves.

Take Action

Tell Congress: SESTA and FOSTA are the wrong solution

Internet Censorship Bills Wouldn’t Help Catch Sex Traffickers

SESTA and FOSTA Could Hide Trafficking from Law Enforcement

In the most illuminating part of last week’s House subcommittee hearing on the Allow States and Victims to Fight Online Sex Trafficking Act (FOSTA, H.R. 1865), Tennessee Bureau of Investigation special agent Russ Winkler explained how he uses online platforms—particularly Backpage—to fight online sex trafficking. Winkler painted a fascinating picture of agents on his team posing as johns, gaining trust with traffickers, and apprehending them. His testimony demonstrated how, with proper training and resources, law enforcement officers can navigate the online platforms where sex work takes place to find and stop traffickers, especially those trafficking children.

It was a rare moment of clarity in the debate over FOSTA and its sibling bill, the Stop Enabling Sex Traffickers Act (SESTA, S. 1693). Since these bills were introduced, there’s been little discussion of how law enforcement officers use the online platforms that the bills would threaten and how SESTA and FOSTA would make it more difficult for law enforcement to do its work. Winkler made it crystal clear how heavily his work relies on online platforms: “We’ve conducted operations and investigations involving numerous perpetrators and victims. The one constant we encounter in our investigations is use of online platforms like Backpage.com by buyers and sellers of underage sex.”

There are some differences between SESTA and FOSTA, but their impact on the Internet would be the same. A website or other online platform could be liable under both civil and criminal law, at both the state and federal levels, for the sex trafficking activities of its users. Since it can be very difficult to determine whether a given posting online is in aid of sex trafficking, the bills would almost certainly force websites to become significantly more restrictive in what sorts of content they allow. Many victims of trafficking would likely be pushed off the Internet entirely, as well as sex workers who weren’t being trafficked.

Winkler didn’t show much interest in the idea of targeting online intermediaries—and neither did fellow witness Derri Smith of End Slavery Tennessee. Understandably, their focus isn’t on holding Internet companies liable for user-generated content; it’s on prosecuting the traffickers themselves and getting trafficking victims out of horrific situations.

When Rep. Marsha Blackburn asked both Tennessee panelists what they need to successfully fight trafficking, neither panelist mentioned proposals like SESTA and FOSTA at all. They discussed more important measures aimed at finding and stopping traffickers and supporting survivors. Winkler referenced changes in state law “to make it more punishable for both buyers and sellers of sex acts with juveniles.”

Winkler isn’t the only person who’s tried to explain to Congress how law enforcement relies on online platforms to find and arrest sex traffickers. Numerous experts in trafficking have pointed out that the visibility of online platforms can both aid law enforcement in apprehending traffickers and provide safety to trafficking victims. Trafficking expert Alexandra Levy notes that the online platforms that FOSTA could undermine are the very platforms that law enforcement agencies rely on to fight trafficking:

While more visibility invites more business, it also increases the possibility that victims will be discovered by law enforcement, or anyone else looking for them. By extension, it also makes it more likely that the trafficker himself will be apprehended: exposure to customers necessarily means exposure to law enforcement.

Levy submitted a letter to the House Energy and Commerce Committee, Subcommittee on Communications and Technology, in advance of last week’s hearing, urging the Subcommittee not to go forward with a bill (.pdf) that would make it harder to apprehend traffickers and expose trafficking victims to more danger.

Freedom Network USA—the nation’s largest network of frontline organizations working to reduce trafficking—agrees (.pdf): “Internet sites provide a digital footprint that law enforcement can use to investigate trafficking into the sex trade, and to locate trafficking victims.”

Four months after SESTA was introduced in Congress—and with SESTA and FOSTA’s lists of cosponsors growing by the day—lawmakers continue to flock to these bills without questioning whether they provide a real solution to sex trafficking. These bills would do nothing to stop traffickers but would push marginalized voices off of the Internet, including those of trafficking victims themselves.

Take Action

Tell Congress: SESTA and FOSTA are the wrong solution

GOP’s tax bills would trigger Medicare cuts and four other big health changes

Having failed to repeal and replace the Affordable Care Act, Congress is now working on a tax overhaul. But it turns out the tax bills in the House and Senate would also reshape health care.

Here are five big ways the tax bill could affect health policy:

1. Repeal the requirement for most people to have health insurance or pay a tax penalty.

Republicans failed to end the so-called individual mandate this year, when they attempted to advance their health overhaul. Now the idea is back, at least in the Senate’s version. The measure would not remove the requirement for people to have insurance, but would eliminate the fine for people who choose to remain uninsured.

The Congressional Budget Office estimated that dropping the requirement would result in 13 million fewer people having insurance over 10 years.

It also estimated that premiums would rise 10 percent more per year than without this change. That is because healthier people would be most likely to drop insurance in the absence of a fine, so insurers would have to raise premiums to compensate for sicker customers. Those consumers would then be left with fewer affordable choices, the CBO predicted.

State officials worry that insurers will leave the individual market if there is no requirement for healthy people to sign up, but they still must sell to people who know they will need care.

Ironically, the states most likely to see this kind of insurance-market disruption are reliably Republican. An analysis by the Los Angeles Times suggested that the states with the fewest insurers and the highest premiums — including Alaska, Iowa, Missouri, Nebraska, Nevada, and Wyoming — would be left with no coverage or options too expensive for most consumers in the individual market.

2. Repeal the medical expense deduction.

The House-passed tax bill, although not the Senate’s, would eliminate taxpayers’ ability to deduct medical expenses that exceed 10 percent of their adjusted gross income.

The medical expense deduction is not widely used — just under 9 million tax filers took it on their 2015 tax returns, reported the IRS. But those who use it generally have high medical expenses, often for a disabled child, a chronic illness or costly long-term care not covered by insurance.

Among those most opposed to ending the deduction is the senior advocacy group AARP. It called eliminating the deduction “a health tax on millions of Americans with high medical costs — especially middle-income seniors.”

3. Trigger major cuts to the Medicare program.

The tax bills include no specific Medicare changes, but analysts note that passing them in their current form would trigger another law to kick in. That measure requires cuts to federal programs if the budget deficit is increased.

Because the tax bills in the House and Senate would add $1.5 trillion to the deficit over the next 10 years, both would result in automatic cuts under the Statutory Pay-As-You-Go Act of 2010, known as PAYGO. According to the CBO, if Congress passes the tax bill and does not waive the PAYGO law, federal officials “would be required to issue a sequestration order within 15 days of the end of the session of Congress to reduce spending in fiscal year 2018 by the resultant total of $136 billion.”

Cuts to Medicare are limited under the PAYGO law, so the Medicare reduction would be limited to 4 percent of program spending, which is roughly $25 billion of that total. Cuts of a similar size would be required in future years. Most of that would likely come from payments to providers.

4. Change tax treatment for graduate students and those paying back student loans.

The House bill, though not the Senate’s, would for the first time require graduate students to pay tax on the value of tuition that universities do not require them to pay.

Currently, graduate students in many fields, including science, often are paid a small stipend for teaching while they pursue advanced degrees. Many are technically charged tuition that’s waived as long as they work for the university.

The House tax bill would eliminate that waiver and require them to pay taxes on the full value of the unpaid tuition, which would result in many students with fairly low incomes seeing very large tax bills.

The House tax bill would also eliminate the deduction for interest paid on student loans. This would disproportionately affect young doctors.

According to the Association of American Medical Colleges, 75 percent of the medical school class of 2017 graduated with student loan debt, with nearly half owing $200,000 or more.

5. Change or eliminate the tax credit that encourages pharmaceutical companies to develop drugs for rare diseases.

Congress created the so-called Orphan Drug Credit in 1983, as part of a package of incentives to entice drug makers to develop drugs to treat rare diseases, those affecting fewer than 200,000 people. With such a small market, it doesn’t make sense for companies to spend the millions necessary to develop treatments.

To date, about 500 drugs have come to market using the incentives, although drug makers have sometimes manipulated the credit for extra gain.

The House bill would eliminate the tax credit; the Senate bill would scale it back. Sen. Orrin Hatch (R., Utah), chairman of the tax-writing Finance Committee, was an original sponsor of the orphan drug law.

The drug industry has been relatively quiet about the potential loss of the credit, but the National Organization for Rare Disorders called the change “wholly unacceptable” and said it “would directly result in 33 percent fewer orphan drugs coming to market.“

 Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.





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Bills announce team’s Family Day sponsored by Independent Health & Fan Appreciation Day

The Buffalo Bills will host Family Day sponsored by Independent Health, the Official Health and Wellness Partner of the Buffalo Bills, in the team’s December 10th matchup vs. the Indianapolis Colts and then hold Fan Appreciation Day the following Sunday on December 17th when the team squares off with the Miami Dolphins.

In addition, when the Bills face the Colts, the team will be wearing all red, color rush uniforms. Fans are encouraged to wear red in support of the team.

“Bills fans are the most loyal and dedicated fans in the NFL, and as an organization, we want to say thank you for supporting this team and our new coaching staff in 2017,” said Brent Rossi, EVP of Marketing and Brand Strategy for Pegula Sports and Entertainment. “Family Day is our opportunity to make a regular season game at New Era Field more affordable and fun for families, while Fan Appreciation Day allows us to thank fans in Western New York, as well as the fans all across the country that support us on the road, at Bills Backers bars and in their homes.”

Fans in attendance on Family Day will receive a winter scarf as the gameday giveaway. As a part of Family Day, the Bills will be offering a special ticket package that includes:

-(4) 200 level tickets

-(4) hot dogs

-(4) bags of chips

-(4) bottled water/soda

-Purchase through ticketmaster.com (look for it under “ticket packages”)

Family Day will also feature a number of expanded gameday features that includes a synthetic ice skating rink, Santa and his elves, and a giant snow globe photo opportunity in the ADPRO Sports Training Center. The team’s Billevard will also feature a live ice sculpting.

The Bills final regular season home game on December 17th vs. the Miami Dolphins will be Fan Appreciation Day.

As a way of thanking fans for their support during the 2017 season, the Bills are giving away over 1,000 prizes in stadium and through the My One Buffalo app. The grand prize is a pair of Super Bowl tickets that will be given away through the My One Buffalo app. Fans will have to download the app and register to win. In addition, hot chocolate, popcorn and hot pretzels will be available to fans at half-price.

5 Ways the Tax Bills Affect Health Policy

Having failed to repeal and replace the Affordable Care Act, Congress is now working on a tax overhaul. But it turns out the tax bills in the House and Senate also aim to reshape health care.

Here are five big ways the tax bill could affect health policy:

1. Repeal the requirement for most people to have health insurance or pay a tax penalty.

Republicans tried and failed to end the so-called individual mandate this year when they attempted to advance their health overhaul legislation. Now the idea is back, at least in the Senate’s version of the tax bill. The measure would not technically remove the requirement for people to have insurance, but it would eliminate the fine people would face if they choose to remain uninsured.

The Congressional Budget Office has estimated that dropping the requirement would result in 13 million fewer people having insurance over 10 years.

It also estimates that premiums would rise 10 percent more per year than they would without this change. That is because healthier people would be most likely to drop insurance in the absence of a fine, so insurers would have to raise premiums to compensate for a sicker group of customers. Those consumers, in turn, would be left with fewer affordable choices, according to the CBO.

State insurance officials are concerned that insurers will drop out of the individual market entirely if there is no requirement for healthy people to sign up, but they still have to sell to people who know they will need medical care.

Ironically, the states most likely to see this kind of insurance-market disruption are those that are reliably Republican. An analysis by the Los Angeles Times suggested that the states with the fewest insurers and the highest premiums — including Alaska, Iowa, Missouri, Nebraska, Nevada, and Wyoming — would be the ones left with either no coverage options or options too expensive for most consumers in the individual market.

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2. Repeal the medical expense deduction.

The House-passed tax bill, although not the Senate’s, would eliminate taxpayers’ ability to deduct medical expenses that exceed 10 percent of their adjusted gross income.

The medical expense deduction is not widely used — just under 9 million tax filers took it on their 2015 tax returns, according to the Internal Revenue Service. But those who do use it generally have very high medical expenses, often for a disabled child, a serious chronic illness or expensive long-term care not covered by health insurance.

Among those most vehemently against getting rid of the deduction is the senior advocacy group AARP. Eliminating the deduction, the group said in a statement, “amounts to a health tax on millions of Americans with high medical costs — especially middle income seniors.”

3. Trigger major cuts to the Medicare program.

The tax bills include no specific Medicare changes, but budget analysts point out that passing it in its current form would trigger another law to kick in. That measure requires cuts to federal programs if the federal budget deficit is increased.

Because the tax bills in both the House and Senate would add an additional $1.5 trillion to the deficit over the next 10 years, both would result in automatic cuts under the Statutory Pay-As-You-Go Act of 2010, known as PAYGO. According to the CBO, if Congress passes the tax bill and does not waive the PAYGO law, federal officials “would be required to issue a sequestration order within 15 days of the end of the session of Congress to reduce spending in fiscal year 2018 by the resultant total of $136 billion.”

Cuts to Medicare are limited under the PAYGO law, so the Medicare reduction would be limited to 4 percent of program spending, which is roughly $25 billion of that total. Cuts of a similar size would be required in future years. Most of that would likely come from payments to providers.

4. Change tax treatment for graduate students and those paying back student loans.

The House bill, though not the Senate’s, would for the first time require graduate students to pay tax on the value of tuition that universities do not require them to pay.

Currently, graduate students in many fields, including science, often are paid a small stipend for teaching while they pursue advanced degrees. Many are technically charged tuition, but it is “waived” as long as they are working for the university.

The House tax bill would eliminate that waiver and require them to pay taxes on the full value of the tuition they don’t have to pay, which would result in many students with fairly low incomes seeing very large tax bills.

At the same time, the House tax bill would eliminate the deduction for interest paid on student loans. This would disproportionately affect young doctors.

According to the Association of American Medical Colleges, 75 percent of the medical school class of 2017 graduated with student loan debt, with nearly half owing $200,000 or more.

5. Change or eliminate the tax credit that encourages pharmaceutical companies to develop drugs for rare diseases.

Congress created the so-called Orphan Drug Credit in 1983, as part of a package of incentives intended to entice drugmakers to study and develop drugs to treat rare diseases, defined as those affecting fewer than 200,000 people. With such a small potential market, it does not otherwise make financial sense for the companies to spend the millions of dollars necessary to develop treatments for such ailments.
To date, about 500 drugs have come to market using the incentives, although in some cases drugmakers have manipulated the credit for extra financial gain.

The House tax bill would eliminate the tax credit; the Senate bill would scale it back. Sen. Orrin Hatch (R-Utah), chairman of the tax-writing Finance Committee, is one of the original sponsors of the orphan drug law.

The drug industry has been relatively quiet about the potential loss of the credit, but the National Organization for Rare Disorders called the change “wholly unacceptable” and said it “would directly result in 33 percent fewer orphan drugs coming to market.”

This story was originally published by Kaiser Health News on December 1, 2017. Read the original story here.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

Bills proposed to address underfunded pension, health plans

  • Underfunded systems could be forced to make changes
  • Republican-backed bills designed to address underfunded pension, health care liabilities
  • Bills could face stiff resistance

 Bills proposed to address underfunded pension, health plans

 Bills proposed to address underfunded pension, health plans

LANSING — Legislation proposed Thursday would require municipal pension and retiree health plans to annually report their finances to the state, and severely underfunded systems could ultimately be forced to make changes by state appointees.

The bills, introduced in both the Republican-controlled House and Senate and backed by Gov. Rick Snyder, are designed to ensure that local governments adequately address billions in unfunded pension and health care liabilities, according to GOP legislators. Democrats and police and firefighter unions, which had been concerned about potential benefit cuts, were studying the package and had no immediate reaction.

The legislation does not go as far as more sweeping bills — which died a year ago — that would have prohibited new municipal workers from qualifying for health insurance in retirement, made retiree health benefits a prohibited subject of collective bargaining and forced current retirees to pay more for health care. But the bills could still face resistance given their interplay with Michigan’s law that allows state emergency managers to run financially distressed cities.

Under a five-stage process, communities with significantly underfunded retirement plans would have to submit planned “corrective actions” to a new Local Government Retirement Stability Board comprised of three gubernatorial appointees. If the board rejected the plan or a local government could not agree on a proposal, the state treasurer would declare a financial emergency and appoint a three-person team to act as an emergency manager — with “broad powers” to rectify the underfunded status. The team, however, could choose not to impose measures if it decided they would “directly endanger the health, safety, or welfare” of residents.

Initially, a retiree health plan would be deemed inadequately funded if it is not at least 30 percent funded and costs the municipalities more than 10 percent of general fund spending. A pension plan would have to be at least 60 percent funded. The minimum thresholds would rise over time. The treasurer would issue a waiver from an underfunding status if the debt is being adequately addressed. Otherwise, the state board would become involved.

“If we don’t fix this problem now, communities with dangerously underfunded retirement systems could go bankrupt and fail to keep promises made to retirees,” said Republican Rep. Jim Lower of Cedar Lake. “This plan heads off that problem and gives local governments a warning system to prioritize and safeguard the benefits retirees and current employees expect.”

The introduction of the legislation came a day after hundreds of law enforcement officers and firefighters protested at the Capitol in support of their retirement benefits.

Senate Majority Leader Arlan Meekhof, a West Olive Republican, said the bills would give local governments and their unionized employees an incentive to live up to their retirement obligations.

“Why would a local community want somebody to have to come in and tell them what else they need to do to solve their retirement problem? They don’t want that,” Meekhof said.

Bills Today: How Zay Jones made the internet buzz

1 – How Zay Jones made the internet buzz
Rookie receiver, Zay Jones, has gone viral with his Jedi-like move from Sunday’s game. Though he scored a decisive touchdown in the game, his slick maneuver after a play along the sidelines seems to be overshadowing that.

Jones after hitting the turf following an incomplete pass against the Chiefs, pushed himself up off his stomach, initially with his hands, then seemingly floated back up to his feet backwards.

On Tuesday, Good Morning Football did a segment on Jones. They tried to make sense of his seemingly impossible move that he made look so nonchalant.

45dd5_eaton-bills-banner-300-250 Bills Today: How Zay Jones made the internet buzz

GMFB Co-host, Nate Burleson, tried to replicate Jones’ sorcery during their segment. Jones went to Twitter and gave him the thumbs up, saying, “The force is with you!”

Jones’ past three games have been the best of his rookie year. He’s totaled 13 receptions, 154 yards, and two touchdowns in those games. The rookie is turning heads, with or without the ball.

2 – Week 12 power rankings round-up

The Bills skyrocketed in the Week 12 power rankings after their conference win over the Chiefs. After a tough three-game skid, Buffalo’s back to trending in the right direction.

Chris Simms, of Bleacher Report, ranked the Bills 17th this week. It was a considerable jump from the 26th spot he had them in last week’s rankings. Simms showed Buffalo some love after their sound performance.

When the Bills take care of the football, play sound defense and run the ball, they can be a challenge for even the best teams. Buffalo forced some turnovers against the Chiefs, and even though they didn’t run well, the Bills stuck with the run and avoided becoming one-dimensional. This was the kind of game we saw from Buffalo early in the year. The Bills ran, played well on defense and got a few big plays from Tyrod Taylor. This was a key win for them and a game that gets the Bills back on track.

Elliot Harrison, of NFL.com, was a little more generous with his ranking. He had the Bills at 16th this week, compared to 20th from the following week.

What a statement win for the Bills… Buffalo’s performance Sunday was a statement about this group’s pride… Football fans around the country should start noticing Tre’Davious White, who has been an impact player in his first year and saved the day for the Bills on Sunday. Especially after the horrific personal-foul call extended the Chiefs’ make-or-break drive.

Middle of the road isn’t exactly where Buffalo wants to be in the power rankings. Considering they cracked the top-ten earlier in the season. A home win against the Patriots in Week 13 would increase their ranking, but more importantly their playoff chances. 

Charles Clay is fully back from his knee injury.

On Sunday, Clay was quietly the Bills leading receiver. He hauled in four catches on four targets for 60 yards. His biggest play of the game went for 33 yards and in the process drew a critical face mask call. The penalty pushed Buffalo to Kansas City’s 27-yard line and resulted in a field goal to pad the Bills lead. The Week 12 contest was Clay’s most productive game since Oct. 1, prior to his injury.

“I think he did a good job with the matchup,” offensive coordinator Rick Dennison said. “That’s where we’re trying to get him isolated in a couple of things with the route that he did.”

Clay’s injury occurred in Week Five against the Cincinnati Bengals. The following week was Buffalo’s bye. He would go on to miss Weeks Seven, Eight, and Nine. The TE returned in Week 10, but it was evident his elusiveness wasn’t quite there. He reeled in a season-low two receptions for 13 yards in his first game back. The following week (Week 11), it appeared he still wasn’t 100-percent healthy. He tallied three receptions for 27 yards against the Chargers.

Despite missing three games and battling through injury, Clay still leads the team in receiving yards (358). He has also reeled in the second-most receptions (29) and has two touchdowns. Week 12 was a good indication that Buffalo has their top target back.

“He played fast. I think he’s getting close but, you know, I’m no expert,” Dennison said. “I just know he was open and he made some plays.”

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45dd5_eaton-bills-banner-300-250 Bills Today: How Zay Jones made the internet buzz

US House, Senate Committee Tax Bills Threatens the Health and Well Being of Americans and Undercuts Investments …


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Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

  • Treasury Secretary Steven Mnuchin and his wife, Louise Linton, unveiled the first dollar bills bearing his signature.
  • The internet is having a field day.

Treasury Secretary Steven Mnuchin and his wife, Louise Linton, caused a stir on the internet Wednesday as they unveiled the first $1 bills bearing the signatures of both Mnuchin and US Treasurer Jovita Carranza.

The signature will go on the bottom right of all newly minted bills, replacing former Treasury Secretary Jack Lew’s name.

Previously, Mnuchin told CNBC’s Becky Quick he changed his signature to make it more legible for the currency.

Here’s what people are saying on Twitter:

1add6_d499c480edc1e2f172be7685b54167ee91520f0a Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

1add6_d499c480edc1e2f172be7685b54167ee91520f0a Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

1add6_d499c480edc1e2f172be7685b54167ee91520f0a Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

1add6_d499c480edc1e2f172be7685b54167ee91520f0a Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

1add6_d499c480edc1e2f172be7685b54167ee91520f0a Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

1add6_d499c480edc1e2f172be7685b54167ee91520f0a Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

Here’s a look (The top signature is Mnuchin’s old one; the bottom signature is the new one):

1add6_d499c480edc1e2f172be7685b54167ee91520f0a Steven Mnuchin just showed off the first dollar bills with his signature — and the internet is having a field day

Lawmakers to consider school finance, computer science bills at Tuesday meeting – Casper Star

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State to pay down employee health insurance, Medicaid bills – The State Journal

Billions of dollars in old state employee health insurance bills and Medicaid bills will be paid off in the next few days with money from bonds issued to cut into the state’s nearly $17 billion bill backlog, Comptroller Susana Mendoza said Wednesday.

Combined with federal matching funds available for some of the bills, a total of nearly $9 billion can be used to pay down medical-related bills, many of which are subject to late payment penalties.

“Important to all of the providers, many of them, who have been waiting far too long to get paid, will begin to see immediate relief,” Mendoza said at a Statehouse news conference. “Tonight, the first round of major payments on paying down the bill backlog will be taking effect.”

As part of the budget deal in July, lawmakers authorized the state to issue up to $6 billion in bonds to pay down old bills accumulated before July 1. Mendoza said that because the state got a very good interest rate on the bonds, there effectively is $6.4 billion to apply to old bills.

Mendoza said $2 billion was going out Wednesday toward old state employee group health insurance bills. Another $2.5 billion was being applied to Medicaid bills.

On Monday, another $1.9 billion will be used to pay down group health insurance bills.

By the time it’s done, Mendoza said, about two-thirds of the backlogged group health insurance bills will be paid. Her office said between $1.3 and $1.5 billion will remain in the hopper.

“We’re still going to owe group health,” Mendoza said. “It’s not enough money to cover, even remotely, all of our bills, even when we’re done paying this $6.4 billion total.”

Medicaid bills, which are mostly subject to late payment penalties and also qualify for federal matching funds, that were accumulated prior to July 1 will be paid off.

None of the bond money is being earmarked to pay bills owed to human service agencies and other vendors owed money by the state. Mendoza said she is sympathetic to those entities, but said bills owed to human services agencies generally don’t qualify for late payment penalties. She said the fiscally prudent thing to do is pay off old bills that qualify for late payment penalties. The state owes about $900 million in late payment penalties.

Mendoza also said that her office has given priority to human services payments as much as possible during the state’s budget crisis.

Mendoza said it is difficult to say exactly what the bill backlog will look like in another week after the payments are made because bills continue to arrive in her office, some of them that the office didn’t know existed. That could change under legislation approved in the Senate Wednesday.

The Senate voted 52-3 to override Gov. Bruce Rauner’s veto of the Debt Transparency Act, legislation pushed by Mendoza to give her a clearer picture of state finances. The bill requires state agencies to report monthly on bills being held in the agencies awaiting payment. Currently, those bills only have to be reported once a year. Mendoza noted that the Rauner administration disclosed $2.8 billion in spending no one knew existed when the state marketed the bill payment bonds.

She said a clear picture of state bills is vital to deal with the state’s financial issues.

“We, the legislature and my office, can’t do the job we’ve been elected to do without this full transparency,” Mendoza said.

Rauner vetoed the bill because he said it was an attempt by Mendoza to micromanage his agencies and he said the agencies themselves didn’t have the capability to report bills on a monthly basis.

Mendoza didn’t buy it.

“The numbers are available, they know what they are and they should report them,” Mendoza said. There’s no excuse for it.”

Contact Doug Finke: doug.finke@sj-r.com, 788-1527, twitter.com/dougfinkesjr

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cox bills grow for internet-only customers in Hampton Roads – Virginian

Did your Cox internet bill just get a little pricier?

In its last billing cycle, the company raised its rates by $3 to $5 for customers subscribing to only one service versus bundled packages.

It now costs $88.46 a month to get Cox’s mid-level “preferred” internet, which offers download speeds of up to 100 megabits per second. That’s up from $83.46 following an initial promotion priced at $62.40 for the first 12 months.

Cox spokeswoman Emma Inman said the price hike is “a necessary part of doing business and allows us to continue to invest in our network to enable future growth and to continue to provide leading broadband services.”

For many customers, primarily in Norfolk, Cox remains the only option for high-speed internet service. The arrival of ultra-fast undersea broadband fibers to the shore of Virginia Beach has lawmakers there hopeful it may attract more internet service providers to Hampton Roads, leading customer bills to shrink from competition.

Inman said Cox is investing $10 billion in the next five years “with a focus on enhancing the customers’ experience inside and outside the home.”

Finding savings on cell, internet, cable bills

PHOENIX – Are you happy with your TV and internet bill? Likely, you want to save money.

Brian Keaney with billshark.com says there are some easy ways to do that. Billshark.com tries saving money on your provider bills and you only pay if they do.

First, Keaney says, start with your bill.

Are there things you pay for that you no longer need?

He says it could be that $10 monthly insurance you have on an old phone worth about $100.

Keaney says he’s found some people with multiple insurance policies that are unnecessary now.

Also, check your phone provider data usage and your internet speed.

Can you switch to a less expensive plan?

And when you call your provider to get a better deal, don’t waste too much time with customer service.

Keaney says they can’t offer the best deals.

He says it’s the retention department that is able to cut costs in order to keep you as a customer.

BT: We’ll speed up internet for higher bills

BT Openreach on Tuesday said it could turn Britain into an ultra-fast broadband economy by the mid 2020s — if consumers are willing to pay higher bills and put up with massive disruption to roads.

The infrastructure arm of the telecom giant, spun out of BT as part of a regulatory move to increase competition, says it has the “ambition” to build a Fibre-to-the-Premises (FTTP) broadband network that would “safeguard the UK’s position as a leading digital economy”.

At the moment, internet is typically delivered via boxes on street corners, with the last bit of the journey made on a slower, copper line. 

An overhaul of that would cost perhaps £6 billion per 10 million homes — or around £30 billion for the entire country. It would involve a massive shake-up of the UK’s digital infrastructure and mean roads would be dug-up to install the fibre wires.

BT has in the past argued that copper broadband meets the needs of nearly all consumers.

Openreach says Sky, TalkTalk, Vodafone and others think there is enough demand for an ultra-fast broadband network. It needs government and customer approval for what would be a gigantic engineering project.

Openreach chief executive Clive Selley, said: “We believe that under the right conditions, we could build FTTP connections to ten million homes and businesses by the mid-2020s. We want to do it, we think it’s the right thing to do for the UK, but it’s clear that we can’t do it alone, so I’m encouraged to hear that our wholesale customers support our vision.”

Openreach says it would need “a regulatory environment that encourages investment, and we need to agree how the costs of such a huge engineering project can be recovered fairly from all those that stand to benefit”.

In order to persuade shareholders to back the investment, they would need reassurance that they can recoup the costs, says Openreach, which will be its own limited company by the end of the year.

While Sky and the others think consumers will be willing to pay a premium for ultra-fast internet, they wouldn’t pay enough to make back the costs of the investment.

Openreach now says it wants to consult with the government and Ofcom watchdog over how such a giant scheme would work in practice. Openreach says it will come back before Christmas with a specific pricing plan for the ambitious idea.

Parent company BT reports quarterly results later this week, with chief executive Gavin Patterson under some pressure, not least due to customer service issues at Openreach.

BT has seen arch rival Virgin Media win some custom with its own telecom network.