March 25, 2014
Host: Ted Simons
- The March 31 deadline to enroll for insurance under the Affordable Care Act is fast approaching. Cheryl O'Donnell of Enroll America will bring us up to date on the latest in efforts to enroll Arizonans for health insurance.
- Cheryl O'Donnell - Director, Arizona Enroll America
| Keywords: medical
Ted Simons: Good evening. Welcome to "Arizona Horizon." I'm Ted Simons. Next Monday is the deadline to apply for health care coverage under the affordable care act. Here to give us an update on efforts to enroll Arizonans in the ACA is Cheryl O'Donnell, state director for enroll America. Thanks for joining us.
Cheryl O’Donnell: Thanks for having me.
Ted Simons: This March 31sy deadline, what kind of deadline?
Cheryl O’Donnell: March 31st is the deadline for individuals to purchase health insurance plans. This will be the last day of the year individuals can purchase health coverage for the rest of the year on healthcare.gov.
Ted Simons: So if you miss this deadline, what's the next deadline?
Cheryl O’Donnell: The next open enrollment period begins November 15th. You will have to wait until then to apply for coverage that will start January 1st of 2015.
Ted Simons: What happens if you miss that deadline and still want coverage? What happens if you miss the deadline, period?
Cheryl O’Donnell: Unfortunately, individuals not eligible for AHCCCS their options are limited. If you miss the Monday deadline you won't be able to buy insurance through individual companies or through the health insurance marketplace. You'll be able to get other types of plans but not federally qualified that meet the requirements for an essential benefit. If you don't get coverage by March 31st you may have to pay a fine.
Ted Simons: That penalty exists? I keep thinking I'm hearing the penalty will be delayed -- the penalty is there.
Cheryl O’Donnell: The penalty is there, yes. Individuals have to get their health coverage by March 31st or else pay a fine. That fine will actually be prorated. Let's say that someone is uninsured but they have a job starting in April, that job will provide them with health coverage. Then they would only have to pay a portion of that fine for the month that they are not covered.
Ted Simons: What kind of fine?
Cheryl O’Donnell: The fine is about $95 per adult in the household. $47.50 for each child, or 1% of the household income. What I like to tell individuals is that really, the biggest penalty of all is not having health coverage in case of an emergency.
Ted Simons: I'm guessing you're starting to see a last-minute crunch here.
Cheryl O’Donnell: Absolutely seeing a real surge in the number of people enrolling. There are over 150,000 people in the stayed of Arizona who have enrolled in health coverage and those numbers are increasing every day.
Ted Simons: Are those more or less than expected?
Cheryl O’Donnell: I actually don't know. From our perspective at enroll America we're trying to reach as many as possible to help them get enrolled. We know there were some challenges in October so the numbers are fantastic numbers. We're actually seeing more people enrolling every day.
Ted Simons: You’re saying you're trying to get more people enrolled. What's being done?
Cheryl O’Donnell: We have different organizations throughout the state, doing a variety of different outreach. This weekend this Saturday we're going to be at south mountain community center with a number of organizations providing information about health insurance as well as assistance in enrollment. At enroll America we're literally calling different households reminding them of the deadline and where they can go for assistance.
Ted Simons: When people actually show up to try to sign up, what are the most common questions?
Cheryl O’Donnell: A lot of individuals wonder how much is this going to cost me? At get covered America.org we have a calculator on our website that individuals can put in basic information about their household, get an estimate of premiums and any financial assistance that they will get.
Ted Simons: I was going to ask about financial assistance. Is it easy to figure out whether or not you will get that financial aid or is it the kind of thing you have to jump through hoops and then figure it out?
Cheryl O’Donnell: You could always use the calculator but also when you go to healthcare.gov and complete an application it will almost instantaneously tell you how much you're eligible for for financial assistance.
Ted Simons: You fill out that information, let's say I go there, I fill it out, I'm done, I press exit or whatever the case may be, am I immediately enrolled? Do I have to wait a day, a week, a month?
Cheryl O’Donnell: When you fill out the application that's just to tell you how much financial assistance you get. You have to go through the plans available on the website and select a plan and enroll in that plan for you to have coverage. Once you've enrolled and paid your first month's premium, then you'll be enrolled in coverage. Let's pretend that someone applied today., completed their application and paid their first month's premium. They would have coverage starting April 1.
Ted Simons: Okay, so it's not exactly immediate but it's the next start of the month?
Cheryl O’Donnell: Yes.
Ted Simons: Who -- we talked about this so many times, but who is eligible?
Cheryl O’Donnell: So individuals basically U.S. citizens, U.S. nationals, residents. Anyone that is in the country legally is eligible for services through the Affordable Care Act as well as financial assistance available.
Ted Simons: And again, these are folks -- when you speak to people and when they speak to you do they know, are they even sure they are eligible?
Cheryl O’Donnell: Well, what they are not sure about is whether or not they are eligible for the financial assistance piece. What we're seeing is that about 75% of individuals who are filling out their applications and enrolling in the process are eligible for financial assistance.
Ted Simons: What is the biggest challenge from where you sit and how you deal with people? What is your biggest challenge getting folks covered?
Cheryl O’Donnell: Our biggest challenge is letting them know that costs shouldn't be a barrier. There is financial assistance available there also is expansion of the AHCCCS program. A lot of individuals don't realize that if you're a single adult without children that if your income qualifies you, you could get coverage through AHCCCS.
Ted Simons: Just the expansion of AHCCCS can be confusing to many. How do you get through the clutter there?
Cheryl O’Donnell: That's just getting the word out. Through the various organizations we work with, through the volunteers we have in the state we have gone door to door, stood outside libraries and grocery stores. We're literally calling households to let them know these services are available to them.
Ted Simons: One more time, this last minute crunch, last minute effort, where will you be?
Cheryl O’Donnell: There are events all over the state. Individuals can go to GetCoveredAmerica.org to find events. We will be at south mountain community center this weekend from to helping people fill out their applications.
Ted Simons: If you're just not computer literate and you can't get to healthcare.gov, what do you do?
Cheryl O’Donnell: Call the hotline. You can complete your application over the phone with one of the operators. If you can't get to an event to get someone to help you I would call the hotline number.
Ted Simons: Do you have the number handy?
Cheryl O’Donnell: Unfortunately, I do not.
Ted Simons: Go to healthcare.gov and find out where to call.
Cheryl O’Donnell: Exactly.
Ted Simons: Thanks for joining us.
Modern Governance Research
- Congress has some of its lowest approval ratings ever. Arizona State University researchers will join an elite group of international experts to study ways to improve governance. Erik Johnston, director of the Center for Policy Informatics at Arizona State University, and Justin Longo, also of the Center for Policy Informatics, will help study new uses of technologies, data, and public engagement to design innovative government programs. Johnston and Longo will talk about their efforts.
- Erik Johnston - Director, Center for Policy Informatics at Arizona State University
- Justin Longo - Center for Policy Informatics at Arizona State University
| Keywords: technology
Ted Simons: ASU researchers are set to join an elite group of international experts on a study that looks to improve modern governance. Joining us now for more on this formidable task is Erik Johnston, director for center for policy informatics at ASU, and Justin Longo, also from ASU's center for policy informatics. Obviously the goal is to get better government but a research network on opening governance, what does that mean?
Erik Johnston: It means technology is changing the way that we work in terms of what Google can do, but also how we can work in terms of what government can do. As these possibilities come, you can either embrace them or try to resist them. What we're trying to do is figure out what are the best uses of technology within government so we can take advantage of this amazing democratic surplus of the people.
Ted Simons: Is there a particular issue, you crunch some numbers and get a result or an idea?
Justin Longo: There's particular ways to get people involved. I saw your show on Friday, your political panel was talking about the budgeting process. To have a state of six plus million people and a budget of 9 billion people decided by three people is odd. Participatory budgeting is one mechanism of getting a number of people around the issues of how to decide a budget for a particular location, getting them together around discussion of what the priorities are and how to spend and budget for a location.
Ted Simons: As far as the research on something like this goes, is it similar to mathematicians in baseball? Are you looking at numbers to move ideas or vice versa?
Erik Johnston: There's elements of that. So the MacArthur grant we just got is a $5 million grant to study it over three years. There are three key dimensions of it. First, how do we open up government to get expertise in? We have experts around the public that have something to say about government that can contribute to their communities. You have new programs like code for America or Teach for America or Habitat for Humanity, but how do we apply those skills to improving the community? The second aspect is how do we get data out? The government collects a tremendous amount of information. It's very valuable. You can see that because if you look at the biggest companies, the biggest success stories, the key element between them all is they were data focused. Google, EBay, Facebook, twitter. All have a data emphasis on to it, but government can also take advantage of that aspect. The third was what Justin was just referencing, this co-production of governance, getting people involved because they care.
Ted Simons: Yes, and to that point, you can give some lawmakers absolutely all the evidence they need to choose A, but because A is not within their policy mind set they are going to choose B. How do you get around that?
Justin Longo: Between the process of argumentation and persuasion. People look at the internet and think, really, we're going to use the internet to facilitate public discussions? It’s given us more arguing but not necessarily better arguing. One objective is how do we get better of a arguing in the sense of persuading each other of what we think is the right thing to do. I believe we can work towards better persuasive arguing and get better outcomes.
Ted Simons: I think anyone who has read the comments section of anything online right now would say the less of that the better. When you research something like this what do you study? What data do you look at?
Erik Johnston: If you're studying the comments section of a discussion, technology can allow for the noise to be suppressed so it can study because people in general understand what a good comment is. Even if they don't agree with a comment they can understand something that's informative, valuable, that contributes to the conversation even if it's politically or ideologically opposite of them. They can identify when someone is just trying to provoke them. We studied, especially after something we called crowd sourcing civility which allows a lot of people to study the comments section and allow for the good conversations to filter to the top but noise to be suppressed. That's a technology solution to a very basic challenge.
Ted Simons: When you do these kinds of studies can you see the raw numbers panning out in a certain direction?
Erik Johnston: That's what's new now. Governance is taking place in a lot of forms that never were before. So, online communities. What we studied was what works, what doesn't to make them sustainable to give people a sense that they have a voice that they can change what's happening. Unlike our governance you can just switch to another online community. You can opt out. It gives you this wonderful natural experiment. You can test this worked here but not over here.
Ted Simons: Are we talking about moving a battleship here? Or can it move relatively quickly?
Justin Longo: I think it's a long-term process. Getting the technology right as well as we establishing the parameters of what good argue mentation looks like. You're right about the current internet, that language and the interaction is a lot to be desired. That's part of a process of relearning but also a process of getting the technology right to facilitate that, which is more effective than we see today.
Ted Simons: What do we do to get the technology right?
Erik Johnston: You scientifically study it instead of stumble toward it. That's one of the key aspects of this grant. There's a couple people involved. Including Beth Novak, Obama's original CTO, who was responsible for the open governance laws and data laws. The other person is the heavy hitter is Sir Tim Barnard Lee, credited for creating the internet. How do we architect these spaces in which we already participate in ways that allow good governance? People are frustrated with government. You probably hear that a lot. We take that as a positive because it means they still care.
Erik Johnston: What we are demonstrating is two things. One, academics is not going to wait for government to change itself. We're going to provide evidence for in this case or locality here's a wonderful example. Why can't Mesa use it? Mesa and Phoenix are relatively on the forefront of using technology and participatory methods to improve their government.
Ted Simons: There’s a core group of 12 experts in all these diverse disciplines. You mentioned a couple of them.
Justin Longo: There's an advisory panel, another 50 or 60 who's who in terms of technology, economics, et cetera.
Ted Simons: You getting them all agreeing that this shows improvement or this A plus B equals C?
Justin Longo: Maybe not agreement, but movement towards agreement. I think we can move towards a consensus position that there are certain avenues that would be more effective than others. Everyone will always have their own opinion, but in this group we are going to see a lot of persuasive argumentation.
Ted Simons: This is a three-year study?
Justin Longo: It is a three-year study that just kicked off.
Ted Simons: After three years how will the results be presented?
Justin Longo: They will be presented continuously. The key is that a lot of people are doing this on their own right now. One of the big goals is to coordinate the efforts so that we have a systematic way of approaching government instead of a lot of individuals poking at it. It's not going to stop after three years. In fact it's just going to galvanize what's currently happening.
Ted Simons: The center for policy informatics at ASU. Tell us about this.
Erik Johnston: I would love to.
Ted Simons: You got about a minute so make it quick.
Justin Longo: We do three basic aspects. One, how can we organize now that we're in an information rich environment? You asked Mayor Stanton last night, what does that economy look like? We're trying to figure that out and give you examples. The second is how does technology change how we make decisions? Each of us carries around a supercomputer in your pocket. About an hour ago most people watching the show got a notification that a dust storm was coming. So, how does it change how they navigate the world? The third aspect of it is we can make better decisions. If Google is analyzing everything, if we have access to that we can make more informed decisions, be aware of what other people are doing. This technique is only possible in the last 10 or 15 years.
Ted Simons: Good luck. We're all rooting for you. Good to have you here.
Justin Longo: Thank you.
Ted Simons: Tomorrow it's our weekly look at state politics with the Arizona Capitol Times and efforts to improve development along the light-rail line in Phoenix.
Ted Simons: That is it for now. I'm Ted Simons. Thank you so much for joining us. You have a great evening.
RNA Research in Brain Injuries
- Phoenix Children’s Hospital, Barrow Neurological Institute and the Translational Genomics Research Institute are going to study the role of extracellular RNA, or RNA located outside our body’s cells, as biomarkers in brain injuries that include hemorrhaging in the brain. Researchers will be working to develop a prognostic tool that will lead them to more effective treatments for a form of bleeding in the brain that affects approximately 12,000 premature babies. They are also going to look into the role of extracellular RNA in the development of blood vessel spasms following a stroke caused by bleeding in the brain. Dr. Jorge Arango, a research scientist at the Neuroscience Research for Barrow Neurological Institute at Phoenix Children's Hospital, will explain the research.
- Dr. Jorge Arango - Research Scientist, Neuroscience Research for Barrow Neurological Institute at Phoenix Children's Hospital
| Keywords: phoenix
Ted Simons: Phoenix Children's Hospital, Barrow Neurological Institute and the Translational Genomics Research Institute are teaming up for a major study on the role of RNA in brain injuries that cause hemorrhaging in premature babies and adult stroke patients. Here to explain this is Dr. Jorge Arango, research and scientist with Barrow Neuorological Institute at Phoenix Children’s Hopsital. Thanks for joining us. We appreciate it. This study now to look at brain injuries in babies, looking at extra cellular RNA. What is that?
Dr. Jorge Arango: That's correct. The basic molecular theory is that we have DNA and pretty much DNA determines who we are. Well, RNA is the entity or like the transport in charge of translating that information that DNA has. That's what we all believed for a very long time. Now during the last decade, there were RNA molecules found outside of the cell, which there's no real reason for these molecules to be outside because all the translation process of DNA occurs inside the cell. Well, with time we have been learning that these molecules have different action and act actually like sort of hormones just going to our cells and making replication dictated by the different cells, right, so pretty much telling information from you, some information from you, come to me and tell me to now change my hair to lighter.
Ted Simons: That’s basically the extra cellular RNA doing that? Wandering out there action looking for something to get involved with?
Dr. Jorge Arango: Something like that. We're trying to find out what actually the mechanism is that produce RNA and which are translated and why.
Ted Simons: We move from that definition, which I think I tortured a little bit, to the idea of hemorrhagic brain injuries, bleeding on the brain of premature babies. How does that work?
Dr. Jorge Arango: This is premature babies are very sensitive because their lungs are not completely developed. Several components of their bodies are basically immature. There are very sensitive to hypoxia. That's lack of oxygen in tissues. Blood is in charge of the liver. Due to the lack of oxygen in the tissue in specific cells that are in the middle of your brain close to these areas that are the ventricles that hold cerebral spinal fluid, that's a completely different story, but around these areas these cells had extremely sensitive to the lack of oxygen. So when this lack of oxygen happens they bleed. They bleed inside the ventricles. When this bleed happens there are several outcomes that come and follow this insult. Some of the outcomes are the development of hydrocephalus. Hydrocephalus is accumulation of cerebral spinal fluid, so the babies have big heads. That is pretty much what ended up happening. Or there is actually these cells when they die they produce an insult to the cells next to them and so on, and these act like everything on our bodies as a chain reaction, so you produce a death around this area. Why is this area important, a lot of information from your brain pass through this area. So if these cells or areas are injured, then your body doesn't respond to what is happening in your head and you develop cerebral palsy.
Ted Simons: The study looks at the extra, the extra cellular RNA and how it applies in these situations and if you find out how it applies maybe you can find some treatment?
Dr. Jorge Arango: We're looking specifically into that. It was clear on the first question it was we don't know what is the role of it on this condition, however these hemorrhagic conditions in association with we're doing the part of -- these all are called intracranial bleeds, right?
Ted Simons: Right.
Dr. Jorge Arango: So we're working on hemorrhage that are common in children or counterpart in St. Joseph hospital are looking at what happens on this when an adult has an aneurysm that breaks and releases the same substances. So what we're trying to identify is what changes are particular in how they change over time on these extra cellular RNA molecules to understand somehow the events that happen during the hemorrhage and why these things happen later.
Ted Simons: Does this mean better treatment or does it mean a better way to identify the possibility of these activities happening?
Dr. Jorge Arango: Both. What we will try to identify first is what happened and with what happened that means better diagnosis so we can be able to tell what's going to happen with you from the basis of how much substance are you releasing or what type of substance are you releasing. In the future, what we want to learn is, okay, if this substance is causing this, how can we block or stimulate this to make you better?
Ted Simons: How far along is the study?
Dr. Jorge Arango: We started late last year, tise first year has been pretty much identifying the best mechanism to test for the substance?
Ted Simons: Promising?
Dr. Jorge Arango: I hope so.
Ted Simons: Congratulations on great work. Good to have you here. Thanks for joining us.
Dr. Jorge Arango: Thank you so much.