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Lawyer Behind West Virginia County Lawsuit Against Opioid Distributors

Pharmaceutical distributors — the middle men in the opioid epidemic — have already been paying out millions to federal and state law enforcement officials for the companies’ role in the crisis. But a new front in the legal battle against opioids has opened. One personal injury lawyer in small-town West Virginia has come up with a creative legal theory to go after these distributors so that small, ravaged communities can collect too.

ROBERT SIEGEL, HOST:

A lawyer in a small West Virginia town is taking on the wealthy middleman in the opioid crisis, the pharmaceutical distribution industry. It’s a $400 billion business that’s built on moving drugs from manufacturers to pharmacies, and these distributors are supposed to flag any unusually large orders of opioids.

Ailsa Chang of NPR’s PLANET MONEY podcast reports on a new spate of lawsuits in West Virginia that uses a creative legal theory against the distributors.

AILSA CHANG, BYLINE: In Cabell County, W.Va., a personal injury lawyer is going after Fortune 500 drug distribution companies like they were dilapidated buildings. Paul Farrell has declared these companies a public nuisance, and he’s hoping to make them pay billions of dollars to several counties. As he recalls it, the battle plan was hatched months ago at his dad’s house in Huntington at breakfast.

PAUL FARRELL: He’s a judge in town. But he puts on this apron, and he stands at the grill. And he cooks bacon and eggs, and it’s kind of a Sunday morning tradition for my family.

CHANG: And on this particular Sunday morning, the family’s just sitting around, talking about a news story about how drug distributors dumped truckloads of opioid pills into their small county for years without ever reporting suspicious orders as they’re supposed to. At one point, Farrell’s mom speaks up.

FARRELL: She made some offhand comment to the rest of the family that somebody in our community should do something about it. And that’s when my – one of my brothers looked at me and said, isn’t that what you do for a living? And everybody kind of looked at me. And I said, well, what am I supposed to do?

CHANG: What was he supposed to do? The Drug Enforcement Administration was already fining these distributors millions of dollars. The state attorney general extracted millions more, but very little of that money was filtering down to the counties most devastated by the opioid epidemic, counties still struggling to pay for jails, hospitals, police and recovery programs. So Farrell wanted to figure out a way his county could sue these companies directly. That’s when he started flipping through some books he keeps mostly for display behind the reception desk at his law office. It’s the West Virginia Code.

FARRELL: Then I get to one particular statue, and it has a simple heading and one sentence.

CHANG: What was the sentence?

FARRELL: And the sentence was, the West Virginia Legislature hereby gives authority to the county commission to eliminate hazards to public health and safety and to abate or cause to be abated public nuisances. It was pow. It hit me right in the nose. This is exactly what I need.

CHANG: Pow.

FARRELL: Pow.

CHANG: Public nuisance. Farrell starts pitching this idea around, and one night he’s explaining to Kent Carper, a county commissioner in Kanawha County, how he’s going to use the public nuisance law in the opioid fight.

KENT CARPER: The interesting thing about that is, I helped write this statute.

CHANG: Oh.

Kent Carper helped write the state public nuisance law about 20 years ago to go after what he calls illegal dumps.

CARPER: Where people would have a dump in their backyard and just have it piled up with trash 12 feet high, tires, refrigerators.

CHANG: After illegal dumps, he used the statute to close down unsightly strip clubs and then meth houses. So when Farrell suggested using the statute against opioids, Carper said it was like a bell went off in his head.

CARPER: They had no idea that I had been involved in this statute so intensely. So when he started talking about the statute, he starts talking about it, and I’m going like, yeah. I love it when people tell me I’m right.

CHANG: (Laughter).

CARPER: So I was very receptive to that. I’m thinking, how clever that is.

CHANG: Farrell has now filed these public nuisance suits for seven counties along the coal belt, the areas hardest hit by opioids. Right now the distributors are trying to get these suits dismissed. They say they’re just scapegoats, that a lot of other people are in the supply chain, and they are not the ones who actually put the pills into the hands of addicts. John Parker’s the spokesman at the trade association for drug distributors.

JOHN PARKER: Distributors don’t write prescriptions. We don’t dispense medicines to patients, and we don’t regulate the practice of medicine or pharmacy in any way.

CHANG: The next three months will determine whether Farrell’s strategy will live or die.

FARRELL: So what’s happened now is I’ve penetrated the lines. And they’ve circled the wagons, and they’re going to do their best to try to eliminate me.

CHANG: And if they don’t, Farrell says he is ready to replicate his battle plan in other counties across the country. Ailsa Chang, NPR News.

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Young Women Make Economic Strides As Young Men Fall Behind In U.S.

Here’s the good news about young adults in the U.S. over the past four decades: More of them are working full time and year-round.

In 1975, close to 67 percent of adults from ages 25 to 34 were employed full time, and that share increased to 77 percent by 2016, according to a new report on young adults by the U.S. Census Bureau.

A closer look at the numbers, though, reveals a gender divide — with young women making economic strides and young men falling behind.

The percentage of young men in the U.S. workforce has not shifted much from just under 85 percent in 1975. But the share of young women working full time has jumped from just shy of one-half (49 percent) to more than two-thirds (70 percent) over the past four decades. And more of them are moving into higher income brackets: The share of young women earning $60,000 or more (in 2015 dollars) increased from around 2 percent to 13 percent.

In fact, young female workers have been driving the growth of the young workforce in the U.S. since 1975.

Their male counterparts, on the other hand, appear to be on the economic decline.

“They are falling to the bottom of the income ladder,” says Jonathan Vespa, a demographer at the Census Bureau who wrote the report.

The share of young men making less than $30,000 a year, he writes in the report, has “swelled” from 25 percent in 1975 to around 41 percent in 2016. There have also been a drop in the share of young men making $30,000 to $59,999 — from almost half (49 percent) to more than a third (35 percent).

“It is little surprise then that those still living with parents are disproportionately young men,” writes Vespa, adding that today young men are more likely to be idle — not in school and not working — than 40 years ago.

Despite these shifts, a gender gap in young men’s favor remains. While young women have seen a $6,000 jump in their median income (from $23,000 to $29,000), it is still $11,000 lower than the median income of young men.

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Episode 765: The Holiday Industrial Complex

#NationalCaramelDay

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AJ Mast/Invision for Werther’s Original via AP

Today, we want to wish you a happy Pet Owners Independence Day! And, a static-free International Amateur Radio Day! Also, a calming National Stress Awareness Day. Today is all of that and more. There are too many holidays to count.

It seems like there are legions of people inventing holidays to get people to buy more things. But even more of them are just… weird. So we figured if we could follow the events that got one of these questionable holidays on TV, then maybe there was a way to find out who is running the holiday machine.

We picked National Splurge Day. It was easy enough to find coverage about it. But few people wanted to talk about how it wound up on their television shows.

Today on the show, we journey to the center of the holiday industrial complex. And we go on a trip that takes us from harried TV news bookers to the halls of Congress to a storage locker in Chicago.

Music: “Baiser Fatal” and “Big Black Boots.” Find us: Twitter / Facebook.

Subscribe to our show on iTunes or PocketCast.

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New Trump Order Extends 'Buy American' And 'Hire American' Rules

Wipro Ltd. employees walk inside the company’s compound in January during a break at their headquarters in Bangalore, India. Top Indian IT companies are in the crosshairs of proposed changes to U.S. H-1B visas, including an executive order President Trump is expected to sign Tuesday.

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President Trump is trying to put more muscle into his campaign slogan of “Buy American and Hire American” and is preparing to sign an executive order Tuesday aimed at strengthening existing government policies to support domestic products and workers.

Trump is expected to sign the order during a visit to the Snap-on tool company in Kenosha, Wis.

“The capability of the American middle class to make things and keep them running has been at the base of our nation’s strength since its founding,” Snap-on CEO Nicholas T. Pinchuk said in a statement. “We believe the President’s visit emphasizes the need to nurture such manufacturing strength.”

The “Buy American” portion of the executive order calls for stricter enforcement of laws requiring the federal government to buy American-made products when possible. Administration officials complain that those laws have been watered down over the years and often are sidestepped with government waivers.

“Buy American” provisions also may run afoul of free trade agreements, though the White House wants to conduct a full review before seeking adjustments to those trade agreements.

The “Hire American” part of the order aims to crack down on what the administration calls “abuses” of government guest-worker programs. The biggest target is the H-1B visa program, which is designed to help technology firms fill jobs requiring special skills but which critics say often is used to replace American workers with lower-paid foreign competitors.

“The H-1B visa program is commonly discussed as being for when employers have a labor shortage,” said Daniel Costa, director of immigration law and policy research at the Economic Policy Institute. “The reality of it is that employers are not required to recruit and try to hire U.S. workers before they hire an H-1B worker.”

The government issues 85,000 H-1B visas annually. In recent years, many of those visas have been snapped up by outsourcing firms that offer low-cost IT support to American corporations.

“A very big share of the visas are actually going to IT outsourcing companies,” Costa said. “We do know that many of the companies that have this business model are the ones that are paying the lowest wages to H-1Bs.”

The executive order calls on the departments of Commerce, Labor, Homeland Security and State to more strictly police the visa program. It also proposes changes, such as awarding H-1B visas to guest workers with the best skills and highest potential wages, rather than through a random lottery as is done now.

“The latest data that I’ve seen showed that 80 percent of the H-1Bs who were coming in came in below the local average wage,” Costa said.

Some of the changes the White House wants would require cooperation from lawmakers.

“There’s some things that the Trump administration could do at the margins that might help clean up some of the worst abuses in the program,” Costa said, but “legislation is going to be required to really fix the program.”

Although H-1Bs are the main focus of the order, other guest worker programs could also come under scrutiny.

The president himself has relied on guest workers with a different kind of visa — H-2B — to help staff his Mar-a-Lago resort, according to the Palm Beach Post. During the campaign Trump defended his use of foreign workers, saying it’s difficult to find Americans willing to accept seasonal employment.

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'Brave New Workers': Ex-Construction Worker Builds A New Life Grooming Cats

Cat groomer Alex Perry shaves a cat.
  • Cat groomer Alex Perry shaves a cat.

    Courtesy Alex Perry

  • Former construction worker Alex Perry finds his calling as a cat groomer.

    Former construction worker Alex Perry finds his calling as a cat groomer.

    Courtesy Alex Perry

  • Cat groomer Alex Perry with a cat after he bathed it.

    Cat groomer Alex Perry with a cat after he bathed it. “I like to wrap them in a little microfiber cloth and then we roll them in the beach towel and we make a little purr-ritto,” Perry says.

    Courtesy Alex Perry

  • Cat groomer Alex Perry clips the nails of one of his cats.

    Cat groomer Alex Perry clips the nails of one of his cats.

    Rachel Valadez/Artis Photography

  • Cat groomer Alex Perry was a fan of cats since childhood.

    Cat groomer Alex Perry was a fan of cats since childhood.

    Courtesy Alex Perry

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During his first day on the job, Alex Perry learned one of the pitfalls of cat grooming when he was bitten by a Maine Coon.

“This one decided to bite me right in the gut. I made the mistake of pulling away. And I got a big tear right in my belly,” Perry recalls of that day back in 2012.

If you’re a cat lover, chances are you know what a Maine Coon is. Commonly referred to as “the gentle giant,” the Maine Coon is one of the largest and most social domesticated cats.

So not only was the cat’s action a surprise, but it was enough for Perry’s boss to wonder if he might quit.

But Perry reasoned, “It certainly wasn’t the worst thing that had happened to me. It wasn’t enough to scare me away.”

Perry stuck with it for a full week, at the end of which, his boss asked, “Well, what do you think?”

“I said, ‘I love it,’ “Perry recounts.

Groomed thousands ofcats

Since then, Perry says he has groomed more than 30,000 cats — a job he never would have imagined himself doing just a few short years ago when he was making a thriving livelihood in the construction industry.

Back in the early 2000s in Seattle, Wash., where Perry still lives, he was a housing contractor and business was booming. He says that the work could be grueling, but he was young, and the money was good.

“I think my favorite part of the whole thing was just kind of hanging out with the guys,” Perry says. “You made a lot of friends. We were going out to dinner a lot, getting together, going dirt bike riding, everybody had toys. It was a good time to be in construction.”

But then the housing bubble burst.

“I started getting a feeling about 2008. I was saying that this whole housing bubble couldn’t last forever. … This was the beginnings of things starting to take a turn.”

Soon, it was hard for Perry to get jobs.

“I felt like I was working to make about $12 an hour for work that I used to get $50-60 an hour to do. It was very demoralizing,” Perry says.

In 2011, Perry said he and his business partnerdecided it was no longer worth the effort scrounging to find work and only landing low-paying jobs. He said they decided to sell off their assets and get out of the industry.

“I just kind of quit everything and for the first two weeks it was absolutely wonderful; no more headaches, no more phone calls,” Perry says. “But sitting home and watching TV in your underwear is only fun for so long. I would say week three and week four, I really started to feel like a loser and then I really started thinking hard about what I was going to do next.”

Cat grooming as difficult as construction

The inspiration for Perry’s next career move came from an unexpected place—his own cat, a silver Himalayan named Gizmo.

“She was beautiful. She was one of those cats that got by on her looks,” Perry says. “One day, my neighbor was changing his motor oil and she decided to take a nap in the used motor oil pan. She was a mess, so I quickly had to find myself a cat groomer. So, I found one, took her in there. They got her all scrubbed up I watched the process and I was fascinated by it.”

Perry said he’d never even heard of cat grooming until that day Gizmo had that strange accident.

When Gizmo died, Perry went in search of a new cat at Seattle Persian and Himalayan Rescue. But instead of a new pet, Perry stumbled across a new hobby. Finding himself unemployed and job hunting with no prospects, Perry volunteered at the Seattle Persian and Himalayan Rescue and started getting some practical experience in cat grooming.

And that’s when he said, “I started to think, ‘Hey, maybe I could do this for a living.'”

By the following year, Perry had started his new life as an entry level cat groomer, and he quickly got plenty of experience, helping to groom 12 to 18 cats a day, five days a week.

Former construction worker Alex Perry has found his calling as a cat groomer.

Courtesy Alex Perry

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Courtesy Alex Perry

It was quite a grueling [pace].I would say in the time I worked there, I saw 12 people come and go. Out of those 12, I would say eight of them quit either the first day or within the first week.”

But Perry says he was hooked. By 2015 was a co-owner at Cozy Cat Boarding and Grooming in Seattle.

“I’ve probably groomed over 40,000 cats now. … It’s a lot,” Perry says. “You know, a lot of them are the same cats. I wouldn’t say that’s 40,000 individual cats. That’s cats that come in every few months or quarterly so I groom a lot of cats over and over again.”

Perry, 43, believes that most people have a misconception about what cat grooming is all about.

“A lot of people get into it thinking you get to play with kitty cats all day, which in a sense you do, but it’s hard work. I would put it right up there with construction as far as the difficulty of the work,” he says.

Cats feed off of your energy

Perry insists that one must have a special touch to be successful in the cat grooming business.

“Some people have a gentle touch and some people don’t,” he says. “I just feel very relaxed around cats, you know. I’m not a hippy-dippy type person, but I definitely believe cats feed off of your energy and if you have a positive, quiet energy, I think the cat senses that and it will just make everybody’s life much easier.”

One of Perry’s favorite things about the job is bathing the cats, and he offers a special tip.

“I like to wrap them in a little microfiber cloth and then we roll them in the beach towel and we make a little purr-ritto,” he says.

Perry believes he’s found his calling in cat grooming.

“I feel lucky because I am now finally one of those people that — I do what I enjoy for a living and I am able to maintain a decent lifestyle doing it.”

As for that age old question some may be asking, “Well, how do you bathe a cat?”

The short answer Perry says, “Quickly.”

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Tax Day And Health Insurance Under Trump

People who lacked health insurance for more than three consecutive months in 2016, or who bought individual insurance and got federal help paying the premiums, will need to do a little work to figure out what, if anything, they owe the IRS.

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Brennan Linsley/AP

Your federal income taxes are due April 18 this year, and — for perhaps several million people — a fine for failing to get health insurance is due that day, too.

Despite a lengthy debate, Congress has not yet acted on a bill to repeal portions of the Affordable Care Act. That means the law and almost all of its regulations remain in force, at least for now.

For the majority of tax filers, who had health insurance through an employer for 2016 or through a government program, all they have to do is check the box on the 1040 form that says they were covered for a full year. That’s it.

The Obama administration had called for the IRS to begin rejecting tax returns for 2016 that left that box blank. But the IRS under the Trump administration has canceled that policy, citing a Trump executive order that calls on federal agencies to “minimize the burden” of the health law.

Still, those who lacked insurance for more than three consecutive months, or who bought individual insurance and got federal help paying the premiums, need to do a little more work to figure out what, if anything, they owe.

Those with no insurance, and those who have had a lengthy gap in coverage, may be required to pay what the federal government calls a “shared responsibility payment.” It’s a fine for not having coverage, on the theory that even those without insurance will eventually use the health care system at a cost they can’t afford, which means that someone else other patients, hospitals, health care providers and taxpayers — will have to pay that bill.

Many people who don’t have insurance, however, qualify for one of the several dozen “exemptions” from the fine. Nearly 13 million tax filers claimed an exemption for 2015 taxes, according to the IRS. Most often those exemptions came from people whose income was so low (less than $10,350 for an individual) that they are not required to file a tax return, or from Americans who lived abroad for most of the year, or from people for whom the cheapest available insurance was still unaffordable (costing more than 8 percent of their household income).

The fine for 2016 taxes is the greater of $695 per adult or 2.5 percent of household income. Fines for children who lack insurance coverage are half the amount for uninsured adults. Fines are pro-rated by the number of months each person was uninsured.

The maximum fine is $2,676; that is the national average cost of a “bronze” level insurance plan available on the health exchanges. But most people do not pay anywhere near that much. Last year, said the IRS, an estimated 6.5 million tax filers paid a fine that averaged $470.

If you bought your own insurance from the federal marketplace or a state health insurance exchange and you got a federal tax credit to help pay for that coverage, you have to take another step before you can file your taxes.

People who got those tax credits must fill out a form that “reconciles” the amount of subsidies they received based on their income estimates with the amount they were entitled to according to their actual income reported to the IRS.

In tax filings for 2015, about 5.3 million taxpayers had to pay the government because they got too much in tax credits, compared to 2.4 million who got additional money back. But among those who underestimated their incomes and had to pay back some of those tax credits, 62 percent still received a net refund on their taxes.

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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United Airlines Changes Its Policy On Displacing Customers

Two United Airlines planes taking off at George Bush Intercontinental Airport in Houston. After a man was dragged off a United flight, the company changed its policy on overbooked flights.

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David J. Phillip/AP

United Airlines crew members will no longer be able to bump a passenger who is already seated in one of the airline’s planes.

The policy change was first reported by TMZ. A spokesperson for the airline confirms that United has updated its policy “to make sure crews traveling on our aircraft are booked at least 60 minutes prior to departure. This ensures situations like Flight 3411 never happen again.”

If the crew member is not booked an hour before the flight, then he or she will have to wait for the next available flight.

The policy change effectively means that if there is a need to displace a passenger from a flight, the decision is made before boarding begins.

“This is one of our initial steps in a review of our policies in order to deliver the best customer experience,” said the spokesperson.

TMZ quoted an internal email that states, “No must ride crew member can displace a customer who has boarded an aircraft.”

The policy change comes as the beleaguered airline is still in recovery mode in the aftermath of the viral video of a passenger being dragged off a Chicago-to-Louisville flight Sunday night.

David Dao, the 69-year old Kentucky physician yanked off the fully booked flight after refusing to give up his seat for a crew member, sustained injuries and may need surgery, according to his attorney.

At least one other airline is rethinking its policy too.

Delta is authorizing its supervisors to offer a displaced passenger almost $10,000 in compensation. The previous incentive had been $1,350. Gate agents can offer $2,000.

Other airlines have not said whether they will increase their compensation limits to displaced passengers.

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Get Set For Trump Revisions To Your Affordable Care Act Insurance

The Trump administration is proposing changes to Obamacare that the White House says should stabilize the insurance marketplace. But critics of the proposal see big bumps ahead for consumers.

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Gary Waters/Ikon Images/Getty Images

Repeal and replace is on-again, off-again, but that doesn’t mean the rules affecting your insurance will stay the same in the meantime.

The Trump administration late Thursday issued a final rule aimed at stabilizing the existinghealth law’s insurance marketplace that could have rapid, dramatic effects — perhaps as soon as early summer — on people who do not get insurance through work, and buy it on the Affordable Care Act’s exchanges instead.

The final rule upholds much of what was proposed by the administration in February, including a shorter enrollment window, tighter vetting of people who sign up outside of those open periods and efforts to require some consumers to show proof of prior insurance coverage.

The controversial proposal by the Department of Health and Human Services drew letters from nearly 4,000 organizations and individuals during an unusually short, 20-day public comment period that ended in early March. In their comments, consumer advocacy groups decried the proposal, saying it would wreak havoc by making it harder to get coverage. Insurers were generally supportive.

But some specialists in the health law, including Christopher Condeluci of CC Law & Policy in Washington, D.C., saw the initial proposal released in February by HHS as helpful for insurers, though he also thought more adjustments were necessary.

“Does it meet all the carriers’ asks when it comes to what changes are needed? No, I don’t think it goes far enough,” said Condeluci, a former staffer to the Senate Finance Committee who specialized in insurance issues.

Sabrina Corlette, an attorney who studies the individual marketplace for the Center on Health Insurance Reforms at Georgetown University, said the directive could result in fewer healthy enrollees — which insurers also would not like — and doesn’t address some of the biggest concerns for the insurance industry, such as the fate of federal subsidies that help low-income consumers pay deductibles and other out-of-pocket costs.

The Trump administration’s proposal, Corlette said, is “nibbling away at the margins.”

She could not be reached late Thursday for comment on the final version.

Here are four ways the stabilization rule might change the individual health insurance market:

If you owe, you pay first

The final rule, to be published in the Federal Register next week, saysconsumers who want to sign up for an ACA plan with their same insurer for 2018 would have to repay past-due premiums from the previous 12 months before being granted new coverage. Because Obamacare has allowed a three-month grace period before people who haven’t paid premiums are kicked out of coverage, a consumer’s overdue premiums could tally hundreds of dollars — even more than $1,000.

The proposed change aims to discourage people from gaming the system. Insurers say a person with a bad knee, for example, might enroll and pay just long enough to get an expensive knee replacement, then stop paying premiums.

But wait, consumer groups and the National Association of Insurance Commissioners warned in their comment letters: There might be legitimate reasons people stop paying premiums — billing errors that are not the fault of the consumer, for example, or the loss of a job. By making such a change, the groups argue, the Trump administration violates a key part of the health law that requires insurers to offer coverage to just about everyone who applies.

“Only those who can rapidly come up with a possibly significant sum of money by a given deadline can be guaranteed access to coverage,” wrote Families USA.

Better act quickly

Open enrollment this fall (for 2018 health insurance coverage) would shorten to six weeks, down from three months. While opening day would remain the same — Nov. 1 — the final rule closes the marketplace on Dec. 15 instead of at the end of January. That period “provides sufficient time for consumers to enroll,” the administration has said, and would mean all who sign up would have a full year of coverage starting Jan. 1.

The shorter time period, the administration said, could also reduce the number of people who wait to enroll until after they find out they have a health problem. These late joiners are likely to use more health care than a healthy person their age, insurers and the Trump administration say, and can drive up the cost of insurance to everyone.

Consumer groups argue the Trump plan could backfire, because those who tend to wait until the last minute to sign up are actually often the youngest and healthiest — and they may miss the enrollment window if it is shorter. Additionally, the deadline falls around the holidays, when money and time are often tight, which could have a chilling effect on insurance sign-ups.

Prove you have a reason — and maybe prior coverage

The ACA allows people to sign up outside the open enrollment period for a variety of special reasons, such as moving, losing coverage, getting married or having a child. This provision has always been a sticking point with insurers, who have maintained that too many customers who made a change during the special enrollment period were sicker and costlier than average. In response, the Obama administration tightened some of these requirements last year and announced it would run a pilot program starting this summer to randomly select half of all special enrollment applicants for verification review, holding up the applicant’s insurance coverage until they provide the proper documentation.

Under the new rule, 100 percent of those applications would be required to undergo preapproval verification — beginning in June 2017. Consumers will have to provide documentation proving they qualify for special enrollment before getting coverage. The rule also says that for marriage, at least one member of the couple would have to prove they had health coverage for at least one day in the two months before their nuptials.

Consumer groups are unhappy with the pre-verification idea — and the extra requirement of prior coverage for people who have gotten married. Particularly hard-hit would be couples who were uninsured previously because they could not afford health insurance as singles or could not get it under their state’s Medicaid rules. Additionally, consumer advocates and some regulators say requiring newlyweds to prove prior coverage violates the health law.

Flexibility — or higher deductibles?

The health law uses a complex formula to divide plans into metallic tiers — bronze, silver, gold and platinum — based on an average percentage of a typical year’s health care bills that each level of plan covers. Bronze plans, for example, currently must cover an average of 60 percent of costs, while a silver one is 70 percent. Insurers are allowed wiggle room of plus or minus 2 percent around those averages.

The Trump rule tweaks the formula, allowing insurers to create plans with larger variations around the average. (It exempts certain silver plans for low-income consumers from the change.) So, for example, a bronze plan might cover only 56 percent of costs and silver 66 percent. Insurers say this would allow them to create plans that appeal to more customers, particularly those looking for lower premiums. But critics say the move would increase the size of deductibles.

One big problem in boosting enrollment has been that many potential consumers — particularly younger, healthier ones — say premiums are too high. But adjusting the law in this way could raise deductibles and other cost-sharing requirements, which consumers may dislike even more. While the health law sets a maximum cap per year on such payments, for many people those deductibles are already thousands of dollars annually. Under the proposal, deductibles could increase by more than $1,000 a year, according to an analysis by the consumer advocacy group Families USA.

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

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United Scrambles To Recover From Ousted Passenger Fiasco

United Airlines CEO Oscar Munoz in June 2016. Wednesday, he apologized to a passenger who was dragged off a flight and said “this will never happen again.”

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Richard Drew/AP

United Airlines announced that it will compensate all passengers who were on board United Express Flight 3411 Sunday night. That’s the Chicago-to-Louisville flight in which a 69-year-old man was dragged off the plane by airport police officers because he didn’t want to give up his seat.

United spokeswoman Megan McCarthy says the compensation will equal the cost of passengers’ tickets and will come in the form of cash, travel credits or miles.

Earlier in the day, United Airlines CEO Oscar Munoz told ABC’s Good Morning America that the company would never again use law enforcement officers when it decides to to remove passengers from a flight.

United personnel had asked for volunteers to give up their seats for four airline employees who were needed in other cities. Three passengers left. Kentucky physician David Dao refused.

Munoz said he felt “ashamed” of the incident which was video-recorded and went viral. “This will never happen again on a United flight. That’s my premise and that’s my promise,” he said.

Munoz offered an apology to Dao, his family and other passengers on the flight. The United CEO had previously referred to Dao as a “disruptive and belligerent passenger” in an internal company communication. That reaction was widely panned as exacerbating United’s PR nightmare.

But when asked by ABC whether the passenger was at fault in any way, Munoz replied, “No, he can’t be. He was a paying passenger sitting on our seat, in our aircraft and no one should be treated that way. Period.”

In a statement issued on the airline’s website yesterday, Munoz said “It’s never too late to do the right thing.”

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Maryland Lawmakers Vote To Allow Beekeepers To Shoot Black Bears That Threaten Hives

Honeybees are seen inside a colony at the U.S. Department of Agriculture’s Bee Research Laboratory in Beltsville, Md., in 2007. Maryland lawmakers approved a bill this week permitting beekeepers to shoot black bears that threaten their hives.

Haraz N. Ghanbari/ASSOCIATED PRESS

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Haraz N. Ghanbari/ASSOCIATED PRESS

It’s a cliché that happens to be true: Bears love honey. And in Maryland, lawmakers have passed a bill making it legal to shoot a black bear if it threatens a beekeeper’s hive.

In February, state Del. Mike McKay testified before the Environment and Transportation Committee on behalf of the bill. He wore a vest festooned with the image of Winnie the Pooh.

Del. Herb McMillan noted McKay’s attire didn’t seem to square with his arguments. “I know you came in here talking about Winnie the Pooh, but the gist of the bill is that you can shoot him,” McMillan said, according to The Baltimore Sun.

Existing Maryland law requires a person to have a hunting license and a black bear hunting permit in order to hunt black bears in the state. Exempted is “a person who kills or wounds a black bear in defense of his/her own life, the lives of other individuals, or the lives of animals on the individual’s property.”

This week, Maryland’s General Assembly passed McKay’s bill. So, if the measure is signed by the governor, as of June, the exemption on hunting bears will extend to the owners of honeybee colonies, if the owner has contacted the state’s Department of Natural Resources and installed an electric fence to protect the hive. The measure also provides funds to provide electric fences to beekeepers.

The DNR says it receives about six reports of damage to bee colonies annually, although could be things other than bears. The state has a Black Bear Damage Reimbursement Fund, and it says it gets approximately two claim requests per year.

“We’re concerned about the beekeepers who raise bees for honey and other agricultural uses,” Del. McKay explained in a video interview with the Sun in February. “We know that black bears do attack them, and we just need to figure out a way we can protect the investment, because it is livestock. If a black bear is hurting a lamb or a calf, you have the right to shoot that because it is your investment and your livestock. We just want to extend the same to those who are in the beekeeping industry.”

Four counties in western Maryland have breeding populations of black bears; the state estimates its population of black bears to be more than 1,000. One thousand bears lusting for honey.

“The proverbial bull in the china shop is no comparison to a bear in the beeyard when it comes to damage and destruction,” warns the state’s Department of Natural Resources.

If you’ve got a bear in your beeyard, the Maryland DNR recommends a four-strand electrical fence, with a small piece of bacon coated with honey or molasses affixed to it.

But Allen Hayes, president of the Maryland State Beekeepers Association, says that electric fences aren’t always effective in deterring bears, especially if the ground is very dry. His organization backed McKay’s bill.

If bears really want the hive, says Hayes, “they have been known to take the shock to the get the reward on the other side.”

Eric Mussen is Emeritus Extension Apiculturist at the University of California, Davis. He says that bears have a pretty good sense of smell, and they can catch the scent of a beehive if they get downwind of a nearby colony. “If the colony is living in a tree, often the bear literally tears the tree apart to get to the bees,” he writes in an email to NPR.

Once a bear gets into a colony, Mussen says, it will eat a little honey, but it will devour the bee “brood”: bee eggs, larvae, and pupae — a source of protein and fat.

Bears bring that same appetite — for brood and destruction — to man-made beehives.

“They leave the covers scattered all over; the hive boxes scattered and often broken; the combs pulled out, broken, and strewn about in the apiary; and the combs that had brood in them will have the comb eaten out,” writes Mussen. “The colony will not survive and there may be very little undamaged equipment to salvage.”

“To a small-scale beekeeper, the financial loss is not too severe,” Mussen adds. “However, losing the colony, that requires so much effort to keep healthy these days, is quite a blow. For commercial operators, who may not revisit the apiary for a couple weeks, it can mean very substantial economic loss.”

The Maryland legislature has been squarely in the bee camp lately. Last year lawmakers passed the Pollinator Protection Act, which bans consumers from buying pesticides that contain neonicotinoids, which are believed to harm bees. The Associated Press reports that Maryland beekeepers lost nearly 61 percent of their hives in 2015, about twice the national average.

“A beekeeper has the right to protect his or her property in an extreme situation,” Hayes said. “The state legislature obviously agrees with us.”

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