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Test Code : LOT-828
Test title : Administering IBM Workplace Services Express 2.6
Vendor title : IBM
: 86 true Questions
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IBM Administering IBM Workplace Services
FILE picture: The IBM logo is seen on the SIBOS banking and fiscal convention in Toronto, Ontario, Canada October 19, 2017. REUTERS/Chris Helgren/File picture
SAN FRANCISCO (Reuters) - IBM Corp introduced on Tuesday that a few of its Watson synthetic intelligence features will now toil on compete cloud computing providers as it seeks to win over valued clientele that wish better flexibility in how they hold and analyze statistics.
The announcement builds on IBM’s strikes to position its services as compatible with nearly any variety of laptop infrastructure a consumer desires to operate. other efforts include a pending acquisition of open-supply utility company crimson Hat for $34 billion.
With the trade, corporations could live in a position to consume Watson AI rig corresponding to Watson Assistant, which may benefit them extend conversational services comparable to a digital consumer carrier agent, in cellular apps hosted on Amazon.com Inc and Microsoft Corp in addition to IBM servers.
“With most immense agencies storing data across hybrid cloud environments, they want the freedom and selection to commemorate AI to their information at any position it is saved,” Rob Thomas, accustomed manager of IBM records and AI, said in a information liberate on Tuesday because it opened “suppose,” its annual convention in San Francisco to flaunt off fresh expertise.
IBM will import on an open-supply software rig called Kubernetes to do the links to compete clouds.
IBM in recent years has sought to bolster its sooner-turning out to live cloud and analytics organizations whereas relocating faraway from slumping hardware items and traditional utility choices.
Charles King, president at know-how consulting company Pund-IT, described extending Watson to different clouds as “a significant step forward in making Watson AI greater consumer-friendly.”
Nick persistence, co-founder and analysis vice chairman at 451 analysis, mentioned IBM’s strategy is an “acknowledgement that they live – and should continue to are vital - in a hybrid cloud ambiance where organizations don’t want to live locked into a unique cloud supplier for every bit of kinds of service, live it for AI or anything.”
Reporting by Paresh Dave; enhancing through Sonya Hepinstall
Two of IBM’s Watson-branded collection of laptop-intelligence capabilities can live accessible to evade as standalone purposes in the public or deepest cloud of your choice. IBM is providing these native Watson capabilities atop IBM Cloud inner most for data, a mixed analytics and records governance platform that will furthermore live deployed on Kubernetes.
Ruchir Puri, CTO and chief architect for IBM Watson, pointed out this changed into driven by customer require for computer studying options that may well live evade the position client facts already resides, usually a multicloud or hybrid cloud ambiance (see linked interview).
“rather than making an attempt to rush the information to a unique cloud, and create a lockin in this open compute-ambiance-pushed world, we're making attainable AI and relocating it to the data,” Puri referred to. The concept follows how Hadoop and other mass records-processing techniques operate toil on records in area, instead of affecting the records to the processing.
at present, handiest two features—Watson coadjutant and Watson OpenScale, which Puri described as “flagship products”—should live offered to shoppers as standalone applications. Watson coadjutant is used to construct “conversational interfaces” reminiscent of chatbots; Watson OpenScale provides “computerized neural community design and deployment,” or a way to teach, installation, and oversee laptop getting to know models and neural networks in an industry surroundings.
IBM Cloud private for facts is composed of preconfigured microservices that evade on a multinode, Kubernetes-based mostly IBM Cloud private cluster. Puri observed the consumer is expected to operate their personal integration between IBM Cloud deepest for statistics and its local statistics outlets; such integration isn’t handled through IBM without delay.
Puri made it transparent these local Watson incarnations effect not simply ahead API calls from a local proxy into IBM-hosted Watson. The client runs its personal native incarnation of the provider, delivered atop IBM Cloud private and working in the environment of option. Supported environments include Amazon internet features, Google Cloud, Microsoft Azure, and crimson Hat OpenShift. native Watson features are API-suitable with Watson features operating in IBM Cloud.
What’s likely to trade is the results delivered from native Watson incarnations versus the grasp edition of Watson, because the local models needs to live periodically up-to-date. Puri couldn't provide a selected timeline for a way regularly fresh versions of local Watson functions will approach down the pike (quarterly, yearly, and so forth.), but he did verify that it should live updated “on a comparatively common groundwork.”
The volume of rig materials vital to dedicate to a Watson service instance varies counting on the workload. Some SLAs for the provided products consist of a prescription for the computing environment (memory, cores, GPUs) required for the desired performance, Puri stated. both virtualized and naked-metal deployments are supported.
different Watson services will live made available locally atop IBM Cloud private later. IBM plans later in 2019 to bring Watson talents Studio, which “discovers meaningful insights from unstructured text with out writing any code,” and Watson herbal Language figuring out, an automatic metadata extraction tool. The latter, Puri stated, is already used in Watson coadjutant as an internal microservice, so many of the toil to port it to a local incarnation has already been achieved.
This fresh incarnation of Watson capabilities provides a glimpse into probably the most motives round IBM’s acquisition of pink Hat. IBM Cloud inner most can consume the Kubernetes-powered OpenShift as its base, and Watson’s services were reworked over a three-yr duration round Kubernetes and containers, Puri stated. as soon as purple Hat is absolutely below IBM’s umbrella, it looks doubtless that purple Hat’s infrastructure talents will unlock cloud portability for future IBM records-centric functions, Watson and otherwise.
IBM (NYSE: IBM)’s rush to do its Watson AI expertise purchasable on competing cloud functions is a good, analysts referred to following the computing enterprise’s annual IBM reckon gathering.
IBM said on the annual adventure this week in San Francisco that, in preference to require clients to convey their statistics to Watson AI on IBM cloud functions, the company will Take Watson AI to them in the event that they consume another cloud service.
during the past, IBM has handiest made its Watson application available on IBM’s cloud computing service. but it surely introduced at IBM feel which will now permit Watson for consume via valued clientele with data that can live kept in competing cloud information facilities, akin to Microsoft organisation (NASDAQ: MSFT)’s Azure and Amazon.com Inc. (NASDAQ: AMZN)’s Amazon internet features.
IBM's new dedication to toil across every bit of platforms, together with competing ones, to benefit access to an even bigger market probability turned into the most high-quality exchange in approach at IBM and a favorable one, bank of the united states Merrill Lynch's Wamsi Mohan talked about in a Thursday observe.
IBM didn’t update its 2019 information, however spoke of the company is confident in its capacity to meet Q1 earnings per participate estimates, the analyst noted.
BofA has a purchase rating on IBM with a cost target of $165.
Morgan Stanley’s Katy Huberty additionally focused on IBM’s fresh openness with Watson, as well as noting IBM’s announcement of fresh capabilities to aid consumers migrate toil to the cloud and control hybrid cloud or multicloud environments.
those capabilities, Huberty referred to, will leverage IBM’s world company capabilities application functions and consulting arm and its world expertise capabilities infrastructure and hardware arm to supply conclusion-to-conclusion functions, which the company talked about has favorable margins.
IBM administration mentioned there are not any signals of a slowdown in consulting, which traditionally is a leading indicator of economic cycles, the analyst mentioned.
Morgan Stanley has no ranking accessible on IBM. The sell-facet firm is advising pink Hat Inc (NYSE: RHT) in the case of IBM’s stream to acquire the company.
IBM stock turned into up 0.78 p.c at $137.55 on the time of booklet Friday.
How IBM Watson performs in the Fintech space
IBM Nails profits, but may live Overbought in the nigh term
latest scores for IBM
View greater Analyst ratings for IBMView the latest Analyst scores
See more from Benzinga
© 2019 Benzinga.com. Benzinga doesn't give investment advice. every bit of rights reserved.
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Administering IBM Workplace Services Express 2.6
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WASHINGTON, Feb. 6 -- The Education and Labor Committee issued the following testimony by Sabrina Corlette, research professor at Georgetown University's seat on Health Insurance Reforms, at a hearing entitled "Examining Threats to Workers with Preexisting Conditions":
"Good morning, Mr. Chairman, Ranking Member Foxx, members of this committee. I am Sabrina Corlette, a Research Professor at Georgetown University's seat on Health Insurance Reforms (CHIR). I am amenable for directing research and analysis on health insurance, health insurance markets, and implementation of the Patient Protection and Affordable freight Act (ACA). The views I express today are my own and effect not reflect those of Georgetown University.
"I thank you for the chance to testify, and for the leadership of this Committee in addressing the exigency for affordable job-based coverage, particularly for those with pre-existing conditions. In my testimony I will argue many of the challenges that people with pre-existing conditions faced in obtaining affordable, adequate insurance before the ACA was enacted, how the ACA was designed to address those challenges, and how current threats to the ACA could possess disproportionately harmful effects on individuals and workers with health freight needs.
The ACA Corrected Many Problems in a Dysfunctional Insurance Market
"The Affordable freight Act was enacted in fraction to rectify solemn deficiencies in health insurance markets that left millions uninsured and millions more with inadequate coverage that failed to protect them from solemn financial harm if and when they got sick. In order to assess the impact the ACA has had, it is distinguished to understand the problems that Congress was seeking to solve when it enacted the law in 2010.
"Prior to implementation of the Affordable freight Act's market reforms, approximately 48 million Americans lacked health insurance.1 Those without health insurance possess a lower life expectancy than those with coverage. Before the ACA was enacted, an estimated 22,000 people per year died prematurely because they lacked insurance.2 This is likely because the uninsured are more than six times as likely as the insured to detain or forego needed freight due to costs. For example, uninsured cancer patients are more than five times more likely than their insured counterparts to forego cancer treatment due to cost.3
"Being uninsured furthermore results in financial insecurity. In 2010, when the ACA was enacted, sixty percent of the uninsured reported having problems with medical bills or medical debt.4 Additionally, prior to the ACA, the lofty and rising uninsured rate led to lofty and rising uncompensated freight costs for providers, in 2009 estimated at $1000 worth of services per uninsured person.5 Providers ultimately pass those costs onto insured consumers and taxpayers.
"Prior to the ACA, for most workers with job-based coverage, leaving their job - to freight for a loved one, start their own business, or pursue other toil that better suitable their skills and talents - meant leaving the guarantee of subsidized health insurance coverage sponsored by the employer for the skepticism of the individual health insurance marketplace. Economists call this "job lock." Until 2014, the individual health insurance market was an inhospitable place, particularly for anyone in less than perfect health. That's a lot of us - an estimated 133 million Americans possess at least one pre-existing condition.6
"Additionally, although most large employer plans were relatively comprehensive and affordable before the ACA, some plans offered only skimpy coverage or had other barriers to accessing care, leaving individuals--particularly those with costly, inveterate health conditions--with vast bills and uncovered medical care. For that reason, in addition to reforms for the individual and small-employer insurance markets, the ACA extended several meaningful protections to employees of large businesses.
Problems with Access
"Prior to the ACA, in most states, applicants for health insurance could live denied a policy because of their health status, or charged more in premiums based on their health and gender, along with a number of other factors.7 For many, coverage was often simply not available at any price. One of the many ways insurers maximized revenue was through aggressive underwriting practices resulting in a denial of coverage to individuals posing a potential health risk.8 A Georgetown University study found that even people with minor health freight conditions, such as hay fever, could live turned down for coverage.9
"A U.S. Government Accountability (GAO) study in 2011 found that unprejudiced insurer denial rates were 19 percent, but they varied dramatically market-to-market and insurer-to-insurer. For example, across six insurers in one state, denial rates ranged from 6 percent to 40 percent.10 These underwriting practices were banned by the ACA in 2014.
"Additionally, it was not uncommon for insurers to rescind coverage after they had accepted an applicant. If an enrollee had any health freight claims within their first year of coverage, the insurer would investigate that person's health history. If they found evidence that their condition was a pre-existing one and not fully disclosed during the initial underwriting process, even if unintentional, the company would deny the relevant claims and rescind or cancel the coverage.11 The ACA has prohibited this rehearse except in transparent cases of fraud by the policyholder.
Problems with Affordability
"Prior to the Affordable freight Act, individual insurance was often unaffordable. Unlike those with employer sponsored coverage or in public programs dote Medicare or Medicaid, people with individual insurance had to pay the plenary cost of their premium. According to one national survey prior to the ACA, 31 percent of individual market respondents spent 10 percent or more of their income on premium costs.12 And, although those leaving job-based coverage were guaranteed access to an individual policy so long as they maintained continuous coverage, federal rules did not circumscribe how much insurers could freight in premiums based on their age, gender, or health status.
"As a result, the cost of premiums caused many individuals to forego coverage completely. A national survey found that nearly three-quarters (73 percent) of people seeking coverage in the individual market did not suspension up buying a plan, most often because the premium was too high. The coverage was least affordable for those individuals who needed it the most - people with pre-existing conditions.
"Prior to the ACA, older and less vigorous individuals had to pay more for coverage because health insurers would segment their enrollees into different groups and freight them different prices based on their health or other risk factors. In practice, this meant that people would live charged more because of a pre-existing condition (even if they had been symptom-free for years), because of their age, gender (insurers assume women consume more health freight services than men), family size, geographic location, the toil they do, and even their lifestyle.13 A Georgetown University study of insurers' rating practices before the Affordable freight Act found rate variation of more than nine-fold for the very policy based on age and health status.14
"Under the Affordable freight Act, using health status and gender to set premium rates is prohibited. In addition, the Affordable freight Act provides low- and moderate-income people between 100 and 400 percent of the federal poverty line with subsidies to benefit defray their premium costs. In 2018, the unprejudiced monthly premium tax credit was $550, resulting in an unprejudiced monthly premium for consumers receiving a premium tax credit of $89.15
Problems with Coverage Adequacy
"Prior to the Affordable freight Act, coverage in the individual market was often inadequate to meet people's health freight needs. In addition to paying more in premiums, people in the individual market furthermore spent a larger participate of their income on cost-sharing than those with employer-sponsored coverage. A primary intuition people buying individual insurance coverage had lofty out-of-pocket costs was that many individual plans - over half according to one study - did not meet minimum standards for coverage.16 Coverage in the individual market was inadequate for a number of reasons, including:
* Pre-existing condition exclusions: in many states, insurers in both the individual and employer group markets were permitted to permanently or for a epoch of time exclude from covered benefits treatments for any health problem that a consumer disclosed on their application. This rehearse was banned under the Affordable freight Act.
* benefit exclusions: Insurers in the individual market often sold policies that did not cover basic benefits such as maternity care, prescription drugs, mental health, and core consume treatment services. For example, 20 percent of adults with individual insurance lacked coverage for prescription medicines before the Affordable freight Act.17 The Affordable freight Act requires insurers in the individual and miniature employer markets to cover a minimum set of essential health benefits that includes maternity services, prescription drugs, and mental health and core consume treatment. The ACA furthermore requires plans, including employer plans, to cover recommended preventive services without consumer cost-sharing.
* lofty out-of-pocket costs: Prior to the Affordable freight Act, individual insurance policies often came with lofty deductibles - $10,000 or more was not uncommon - and lofty cost-sharing.18 In fact, deductibles were often three times what they were in employer-sponsored plans. As a result, many individual insurance plans were extremely low-value. The ACA requires plans to cover, at minimum, 60 percent of an unprejudiced enrollee's covered health freight costs. The law furthermore helps protect consumers in both individual and employer plans from catastrophic medical costs by capping their annual out-of-pocket spending (for 2019, the annual cap is $7900 per individual).
* Lifetime or annual dollar limits on coverage: Prior to enactment of the ACA, an estimated 102 million people were in plans with a lifetime circumscribe on benefits and about 20,000 people hit those limits every year. An estimated 18 million people were in plans with annual dollar limits on their benefits. For people with solemn lofty cost medical conditions, such as hemophilia, solemn cancers, or end-stage renal disease, this can literally live a life or death issue. The ACA ushered in bans on lifetime and annual dollar limits for both individual and employer group plans.
The ACA: Expanding Coverage, Protecting People with Health freight Needs
"One of Congress' goals for the ACA was to extend affordable, adequate health insurance coverage to more people and to protect people with pre-existing conditions from common insurance industry practices, described above. Congress tried to achieve these goals through a three-pronged strategy:
* Insurance reforms for the individual and employer group markets to benefit people with health freight needs;
* An individual mandate to hearten vigorous people to enroll in the insurance pool and hold premiums stable; and
* Subsidies to benefit people afford the insurance coverage (with Medicaid expansion available for people under 138 percent of the federal poverty line). The Affordable freight Act furthermore created state-based insurance marketplaces where people can apply for the subsidies and shop for plans.
"To a significant degree, the ACA has achieved its goals. It has expanded access to insurance coverage, improved health outcomes, and improved families' financial security. Under the ACA, the percentage of people uninsured declined from 14.5 percent in 2013 to 9.1 percent in 2017. An estimated 20 million people gained insurance coverage because of the ACA, although some recent survey data intimate those gains are now being reversed.19,20
"The goal of expanding coverage is ultimately to help people's health outcomes and their financial security in the event of an unexpected illness or injury. Although the law is only a few years old, data are nascence to emerge that intimate it is having a significant positive impact.
"Since enactment of the ACA, the percentage of Americans reporting that they didn't notice a doctor or fill a prescription because they couldn't afford it has declined by more than one-third.21 Further, more people are reporting that they possess a primary freight doctor or possess had a check-up in the final 12 months.22
"Research furthermore strongly suggests that expanding access to coverage leads to better health outcomes. For example, studies of the health reforms in Massachusetts, upon which the ACA was modeled, possess found that coverage expansion in that situation led to reported improvements in physical and mental health, as well as reductions in mortality.23 A Harvard study found that expanded coverage under the ACA was linked to major improvements in the diagnosis and treatment of inveterate diseases such as hypertension, diabetes, and lofty cholesterol.24
"In addition to improving access to care, health insurance furthermore provides financial security, particularly in the event of a large, unanticipated medical expense. Survey data flaunt that the number of families who thunder they are having problems paying medical bills has fallen dramatically since 2013, particularly among low- and moderate-income families.25
"The ACA has furthermore helped reduce uncompensated freight costs borne by providers. For example, hospital-based uncompensated freight fell by over 25 percent between 2013 and 2015, and in Medicaid expansion states it has fallen by closer to 50 percent.26
"Unfortunately, much of the progress under the ACA is at risk due to litigation that threatens to overturn the law, as well as recent federal policy decisions designed to roll back key provisions of the law and bypass consumer protections. Ultimately, some of these decisions are likely to result in consumers in the individual market facing higher premiums and fewer contrivance choices, while putting protections for workers with job-based coverage at risk.
Health System Upheaval and Workers attach at Risk: Consequences of Overturning and Undermining the ACA
Texas v. Azar: ACA "Repeal" without "Replace"
"The attorney common of Texas leads a coalition of states seeking to possess the ACA enjoined, arguing that the individual mandate is unconstitutional, and the rest of the law is non-severable from the mandate provision. A district court referee has agreed with that view, although he has stayed enjoining the law while his decision is being appealed.27 Granting Texas' request to enjoin the ACA amounts to an application to repeal the law without any transparent public policy to supplant it. Congress explicitly rejected repealing the ACA without a replacement in 2017. This is because uprooting a knotty law that has been in position for almost 10 years, touches almost every facet of their health freight system, and includes many provisions with widespread bipartisan uphold (such as allowing green adults to stay on their parents' plans until age 26, closing the Medicare drug benefit "donut hole," and expanding Medicaid) will inevitably result in theatrical negative consequences:
"First, an estimated 32 million people will lose their insurance coverage.28 Second, those remaining in the individual market would notice their premiums roughly double.29
"Third, even a partial repeal of the provisions of the ACA would primarily harm working middle class Americans. The majority of people losing coverage - as many as 82 percent - would live in working families.30 Fourth, repealing the ACA will possess significant negative consequences for public health and safety. For example, researchers from Harvard and fresh York University found that repealing the ACA would result in 1.25 million Americans with solemn mental conditions losing coverage. They further evaluate that 2.8 million Americans with a core consume disorder, including roughly 222,000 with an opioid-related disorder, would lose coverage.31
"Fifth, repealing the ACA will drive insurance companies out of the market. The CBO estimated that legislation repealing the ACA would leave an estimated three-fourths of the nation's population in areas where no insurers are willing to proffer nongroup coverage by 2026.32 These estimates align with my own research at Georgetown, in which colleagues and I conducted interviews with 13 health insurance company executives participating in the individual markets in 28 states. In those interviews, executives told us they would "seriously consider" a market withdrawal if the ACA were repealed.33
"Sixth, an extend in the uninsured will impose significant financial harm on hospitals and other health freight providers. For example, repealing the ACA without a replacement was estimated to cost the nation's public hospitals $54.2 billion in uncompensated freight charges between 2018 and 2026.34
"Seventh, repeal of the ACA would lead to significant negative economic consequences. For example, repealing just the Medicaid expansion and Affordable freight Act tax credits would result in an estimated loss of 2.6 million jobs across the country.35
"Eighth, and importantly for this committee, overturning the ACA would furthermore harm the estimated 156 million Americans with job-based insurance who will lose faultfinding protections, including:36
Preventive Services Without Cost-Sharing
"The ACA requires every bit of fresh health plans, including those sponsored by employers, to cover recommended preventive services without cost-sharing, bringing fresh benefits to 71 million Americans.37 That means individuals can pick up the screenings, immunizations, and annual check-ups that can enmesh illness early or prevent it altogether without worrying about meeting a costly deductible or co-payment. Women employees can furthermore access affordable contraception, making available a wider variety of contraceptive choices and increasing consume of long-term contraceptive methods.
Pre-Existing Condition Exclusions
"Under the ACA, employers cannot impose a waiting epoch for coverage of a pre-existing condition. Prior to the ACA, individuals who became eligible for an employer plan--for example, once hired for a fresh job--might possess to wait up to 12 months for the contrivance to cover pre-existing health conditions. You could "buy down" that waiting epoch with months of coverage under another plan, so long as it was the perquisite benign of contrivance and you didn't travel without coverage for 63 days or more. But if you lost your job, couldn't afford COBRA, went a few months without coverage and then were lucky enough to pick up another job with benefits, you might find the freight you needed wasn't covered under your contrivance for an entire year.
Dependent Coverage to Age 26
"The ACA requires every bit of health plans, including those sponsored by large employers, to cover dependents up to age 26. Prior to the ACA, one of the fastest growing groups of uninsured was green adults - not because they turned down coverage offered to them, but because they were less likely to possess access to employer-based plans or other coverage. The result has been a theatrical extend in the number of insured green adults, particularly among those with employer-sponsored coverage.
Annual Out-Of-Pocket Limit
"The ACA requires every bit of fresh health plans, including those sponsored by employers, to cap the amount individuals can live expected to pay out-of-pocket each year. Prior to the ACA, even those with the security of coverage on the job couldn't import on protection from crippling out-of-pocket costs.
Prohibition On Annual and Lifetime Limits
"The ACA prohibits employer plans from having an annual or lifetime dollar circumscribe on benefits. Prior to the ACA, employer plans often included a cap on benefits; when employees hit the cap, the coverage slit off. For individuals who needed costly care, dote a baby born prematurely or those with hemophilia or multiple sclerosis, that often meant a desperate scramble to find fresh coverage options as one after another benefit circumscribe was reached.
"The ACA guarantees individuals the perquisite to an independent review of a health plan's decision to deny benefits or payment for services, regardless of whether the employer contrivance is insured or self-funded. Prior to the ACA, only workers in insured plans had the perquisite to an independent review of a denied claim. But more than 60 percent of workers are in self-funded plans, and before the ACA, the only option for those workers to hold their contrivance accountable was to sue, an expensive and lengthy process.38
Administrative Actions to Roll Back ACA Result in Higher Prices for Older, Sicker Americans
"In 2016, financial data from insurers demonstrate that the ACA markets were nascence to stabilize and insurers were gaining their footing after a rocky start.39 Indeed, in 2017 the CBO concluded that the ACA's insurance markets would likely live stable in most places if left unchanged.40 Consistent with this projection, 2017 appears to possess been a profitable year for most individual market insurers.41
"Unfortunately, my own review of insurers premium rate justifications (referred to as actuarial memoranda) for contrivance years 2018 and 2019 found that recent policy changes are putting the stability of the individual market at risk.42 Specifically:
"The Trump administration's decision in October of 2017 to slit off reimbursement to insurers for low cost-sharing plans (called cost-sharing reduction or CSR plans) resulted in significant premium increases in 2018. Additionally, the skepticism about that decision, which the President had been threatening for months, was a contributing factor for some insurers to either exit the marketplaces or reduce their service areas.
"Additionally, although Congress did not zero out the individual mandate penalty until 2019, many insurers increased premiums for 2018 coverage on the expectation that the Trump administration would not invoke the individual mandate.
"Similarly, insurers increased premiums due to the Trump administration's decision to dwindle spending on marketplace advertising and consumer assistance, which are faultfinding for educating and enrolling the vigorous uninsured. For example, a Cigna filing for 2018 celebrated that they expected a smaller and sicker population in their risk pool due to the lower "overall awareness of individual health insurance products."
"Going into 2019, insurers predicted that their risk pools would live smaller and sicker due to "potential movement into other markets." These markets include association health plans and short-term health plans, both of which are exempt from many of the Affordable freight Act's consumer protections and are being promoted by the Trump administration as cheaper alternative coverage.
"Individuals who are eligible for the ACA's premium tax credits are largely insulated from these premium increases because the tax credit rises, dollar for dollar, with the extend in premiums for silver flush health plans. The people who suffer the most from these premium increases are the working middle class: entrepreneurs who evade their own businesses, freelancers and consultants, independent contractors, farmers and ranchers, and early retirees who rate too much to qualify for the ACA's premium subsidies.
"For people with job-based coverage, the higher prices and skepticism roiling the individual market inevitably leads to more "job lock," as people stay in jobs that guarantee health benefits, even if their skills and talents are not optimally deployed.
"The ACA is by no means perfect, and there remain many people who struggle to find affordable health freight coverage. Even the law's most ardent supporters own that more could live done to hearten states to expand Medicaid, benefit families who rate too much to qualify for subsidies, reduce extreme deductibles, and help access for those who are otherwise ineligible for coverage. There are a compass of policy options that would strengthen the law's foundation while furthermore building on its remarkable achievements. I root this committee for providing a forum for constructive debate on these issues. Thank you, and I stare forward to your questions."
* * *
1 DeNavas-Walt C, Proctor BD, Smith J. Income, Poverty, and Health Insurance Coverage in the United States: 2012, U.S. Census Bureau, Sept. 2013. Available at https://www.census.gov/prod/2013pubs/p60-245.pdf.
2 Dorn S. Uninsured and Dying Because of It, The Urban Institute, Jan. 2008. Available at https://www.urban.org/sites/default/files/publication/31386/411588-Uninsured-and-Dying-Because-of-It.PDF.
3 Lives on the Line: The Deadly Consequences of Delaying Health Reform, Families USA, Feb. 2010. Available at http://familiesusa.org/sites/default/files/product_documents/delaying-reform.pdf.
4 Cunningham, P. and Sommers, A. Medical Bill Problems uniform for U.S. Families 2007-2010, seat for Studying Health System Change, Dec. 2011. Available at http://www.hschange.org/CONTENT/1268/?words=tracking%20report%2028.
5 Hu, L. et al. The effect of the Patient Protection and Affordable freight Act Medicaid Expansions on financial Wellbeing, National Bureau of Economic Research, Feb. 2018. Available at http://www.nber.org/papers/w22170.
6 Office of the coadjutant Secretary for Planning and Evaluation, Health Insurance Coverage for Americans with Pre-Existing Conditions: The impact of the Affordable freight Act, Issue Brief, Jan. 2017. Available at https://aspe.hhs.gov/system/files/pdf/255396/Pre-ExistingConditions.pdf.
7 Corlette S, Volk J, Lucia K. true Stories, true Reforms. Robert Wood Johnson Foundation, Sept. 2013. Available at https://georgetown.app.box.com/file/124506387872.
8 U.S. Government Printing Office, Senate Hearing 113-663. A New, Open Marketplace: The effect of Guaranteed Issue and fresh Rating Rules, U.S. Senate Health, Education, Labor & Pension Committee, Apr. 11, 2013. Available at https://www.gpo.gov/fdsys/pkg/CHRG-113shrg95186/html/CHRG-113shrg95186.htm.
9 Pollitz K, Sorian R. How Accessible is Individual Health Insurance for Consumers in Less-than-perfect Health? Georgetown University and Kaiser Family Foundation, Jun. 2001. Available at https://kaiserfamilyfoundation.files.wordpress.com/2013/01/how-accessible-is-individual-health-insurance-for-consumers-in-less-than-perfect-health-executive-summary-june-2001.pdf.
10 U.S. Government Accountability Office. Private Health Insurance: Data on Application and Coverage Denials, Mar. 2011. Available at https://www.gao.gov/assets/320/316699.pdf.
11 Girion L. Health Insurer Tied Bonuses to Dropping Sick Policyholders, Los Angeles Times, Nov. 9, 2007. Available at http://articles.latimes.com/2007/nov/09/business/fi-insure9.
12 Collins SR, Robertson R, Garber T, Doty MM. Insuring the Future: Current Trends in Health Coverage and the Effects of Implementing the Affordable freight Act, The Commonwealth Fund, Apr. 2013. Available at http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2013/Apr/1681_Collins_insuring_future_biennial_survey_2012_FINAL.pdf.
13 Buntin MB, Marquis MS, Yegian JM. The Role Of The Individual Health Insurance Market And Prospects For Change, Health Affairs, Nov./Dec. 2004. Available at https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.23.6.79.
14 Pollitz K, Sorian R. How Accessible is Individual Health Insurance for Consumers in Less-than-perfect Health?
15 Kaiser Family Foundation. Marketplace unprejudiced Premiums and unprejudiced Advanced Premium Tax Credit (APTC), Open Enrollment 2018. Available at https://www.kff.org/health-reform/state-indicator/marketplace-average-premiums-and-average-advanced-premium-tax-credit-aptc/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
16 Gabel JR et al. More Than Half Of Individual Health Plans proffer Coverage That Falls Short Of What Can live Sold Through Exchanges As Of 2014, Health Affairs, Jun. 2012. Available at https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2011.1082.
17 Doty MM, Collins SR, Nicholson JL, Rustgi SG. Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families
18 McDevitt R et al. Group Insurance: A Better Deal For Most People Than Individual Plans, Health Affairs, Jan. 2010. Available at https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.0060.
19 Cohen RA, Zammitti EP, Martinez ME. Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2017, Centers for Disease Control and Prevention, National seat for Health Statistics, May 2018. Available at https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201805.pdf.
20 Gallup News, U.S. Uninsured Rate Rises to Four-Year High, January 23, 2019. Available at https://news.gallup.com/poll/246134/uninsured-rate-rises-four-year-high.aspx.
21 McCarthy, J. U.S. Women More Likely Than Men to attach Off Medical Treatment, Gallup, Dec. 2017. Available at http://news.gallup.com/poll/223277/women-likely-men-put-off-medical-treatment.aspx.
22 Karpman, M. et al. Time for a Checkup: Changes in Health Insurance Coverage, Health freight Access and Affordability, and contrivance Satisfaction among Parents and Children between 2013 and 2015, Urban Institute, Jan. 2016. Available at http://hrms.urban.org/briefs/changes_coverage_access_affordability_parents_children.pdf.
23 Van Der Wees, PJ, et al. Improvements In Health Status After Massachusetts Health freight Reform, National seat for Biotechnology Information, Dec. 2013. Available at https://www.ncbi.nlm.nih.gov/pubmed/24320165.
24 Hogan DR et al. Estimating The Potential impact Of Insurance Expansion On Undiagnosed And Uncontrolled inveterate Conditions, Health Affairs, Sept. 2015. Available at https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2014.1435.
25 Karpman, M and Long, S. 9.4 Million Fewer Families Are Having Problems Paying Medical Bills, Urban Institute, May 2015. Available at http://hrms.urban.org/briefs/9-4-Million-Fewer-Families-Are-Having-Problems-Paying-Medical-Bills.pdf.
26 Schubel, J and Broaddus, M. Medicaid Waivers That Create Barriers to Coverage Jeopardize Gains, May 2018. Available at https://www.cbpp.org/research/health/uncompensated-care-costs-fell-in-nearly-every-state-as-acas-major-coverage.
27 Texas v. Azar... https://affordablecareactlitigation.files.wordpress.com/2018/12/Texas-v.-US-partial-summary-judgment-decision.pdf
28 Congressional Budget Office. Cost Estimate: H.R. 1628, Obamacare Repeal Reconciliation Act of 2017, Jul. 2017. Available at https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/52939-hr1628amendment.pdf.
30 Blumberg L, Buettgens M, Holahan J. Implications of Partial Repeal of the ACA Through Reconciliation, Urban Institute, Dec. 2016. Available at https://www.urban.org/sites/default/files/publication/86236/2001013-the-implications-of-partial-repeal-of-the-aca-through-reconciliation_1.pdf.
31 outspoken RG, Glied SA. hold Obamacare to hold Progress on Treating Opioid Disorders and Mental Illnesses, The Hill, Jan. 2017. Available at http://thehill.com/blogs/pundits-blog/healthcare/313672-keep-obamacare-to-keep-progress-on-treating-opioid-disorders.
32 Congressional Budget Office. Cost Estimate: H.R. 1628, Obamacare Repeal Reconciliation Act of 2017, Jul. 2017.
33 Corlette S, Lucia K, Giovannelli J, Palanker D. Uncertain Future for Affordable freight Act Leads Insurers to Rethink Participation, Prices, Georgetown University and Robert Wood Johnson Foundation, Jan. 2017. Available at https://georgetown.app.box.com/file/127781433019.
34 America's Essential Hospitals. ACA Replacement Must Protect Vulnerable People, Communities, Feb. 2017. Available at https://essentialhospitals.org/wp-content/uploads/2017/02/UCC-policy-brief-February-2017-FINAL.pdf.
35 Ku L, Steinmetz E, Brantley E, Bruen B. Repealing Federal Health Reform: Economic and Employment Consequences for States, The Commonwealth Fund, Jan. 2017. Available at http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2017/jan/ku-aca-repeal-job-loss/1924_ku_repealing_federal_hlt_reform_ib.pdf.
36 Rae M., Claxton G., Levitt L., McDermott D., Long-Term Trends in Employer-Based Coverage, Kaiser Family Foundation, January 30, 2019. Available at https://www.healthsystemtracker.org/brief/long-term-trends-in-employer-based-coverage/.
37 U.S. Department of Health & Human Services, coadjutant Secretary for Planning and Evaluation, Seventy-one Million Additional Americans are Receiving Preventive Services Coverage without Cost-sharing Under the Affordable freight Act, March 18, 2013. Available at https://aspe.hhs.gov/pdf-report/seventy-one-million-additional-americans-are-receiving-preventive-services-coverage-without-cost-sharing-under-affordable-care-act.
38 Kaiser Family Foundation, 2018 Employee benefit Survey, October 3, 2018. Available at https://www.kff.org/report-section/2018-employer-health-benefits-survey-section-10-plan-funding/.
39 Banerjee D. The ACA Individual Market: 2016 Will live Better Than 2015, But Achieving Target Profitability Will Take Longer, S&P Global Ratings, Dec. 2016. notice furthermore Herman B. How some Blues made the ACA toil while others failed. Modern Healthcare. October 15, 2016. Available at www.modernhealthcare.com/article/20161015/MAGAZINE/310159989.
40 H.R. 1628 American Health freight Act of 2017, Congressional Budget Office, May 2017. Available at https://www.cbo.gov/system/files/115th-congress-2017-2018/costestimate/hr1628aspassed.pdf.
41 Cox C, Semanskee A, Levitt L. Individual Insurance Market Performance in
2017, Kaiser Family Foundation, May 2018. Available at http://files.kff.org/attachment/Issue-Brief-Individual-Insurance-Market-Performance-in-2017.
42 notice Corlette S. The Effects of Federal Policy: What Early Premium Rate Filings Can disclose Us About the Future of the Affordable freight Act, CHIRblog, May 2018. Available at http://chirblog.org/what-early-rate-filings-tell-us-about-future-of-aca/; Corlette S. They Read Actuarial Memoranda so You Don't possess to: Trends from Early Health contrivance Rate Filings, CHIRblog, Jun. 2017. Available at http://chirblog.org/we-read-actuarial-memoranda-so-you-dont-have-to/; Corlette S. Proposed Premium Rates for 2018: What effect Early Insurance Company Filings disclose Us? CHIRblog, May 2017. Available at http://chirblog.org/proposed-premium-rates-for-2018-what-do-early-filings-tell-us/.
Hiring the best and brightest cybersecurity talent will always live difficult for situation and local governments. They possess to compete with private-sector firms that can proffer significantly greater compensation. Many government agencies furthermore must meet rigorous certification standards for fresh hires, including exceptional requirements that do them eligible for in-depth background investigations.
Making matters worse, there are not enough people in the cybertalent pipeline. Cybersecurity Ventures, a research firm, estimates there will live a global shortage of 3.5 million cybersecurity workers by 2021. Moreover, the Cisco 2018 Annual Cybersecurity Report found that these staff shortages contribute to organizations failing to design and build secure information systems as well as maintain basic security controls.
Some states are tackling the problem through training programs and possess built and staffed their own cybersecurity centers. Others possess offered grants to establish cybersecurity courses to train fresh talent. The SANS Institute, an information security and cybersecurity research and training company, has started the CyberStart program, a unique and innovative suite of tools and games designed to introduce children and green adults to the province of cybersecurity by completing various challenges. At a more strategic level, many situation and local governments are considering a collaborative, “community” approach to solving their cybersecurity challenges.
Collaboration: energy in Numbers
Security communities are groups of cybersecurity professionals who concluded that working together to solve their country’s security challenges better serves their organization and the broader community when compared to working in a silo alone. In general, the more people there are working on a problem, collaboratively, with a broader data set and context, the better the outcome for everyone.
From threat detection to incident response, the tactics that shameful actors consume — and methods to thwart and resolve them — are constantly evolving. Drawing from the lessons scholarly and best practices of more than just a unique organization enables security professionals to live more efficient with their time, gain maturity more quickly and to identify and leverage innovation earlier.
Efforts are underway. The situation of Ohio, under the direction of former Gov. John Kasich, has formed a committee to foster collaborative partnerships to strengthen cyberinfrastructure and resources. InfraGard is a partnership between the FBI and members of the private sector. The program provides a vehicle for public-private collaboration that expedites the timely exchange of information and promotes mutual learning opportunities relevant to the protection of faultfinding infrastructure. While one of the most difficult parts of communities is getting people to join, participate and ultimately share, the government sector provides the chance for top-down mandates around collaboration.
MITRE’s scholarship groundwork of Cybertactics
A collaborative community project that has had a huge impact on the practical side of cybersecurity is the MITRE ATT&CK™ framework. Founded in 1958, MITRE is a nonprofit organization that manages federally funded research. The organization works on projects for a variety of agencies, including the IRS, Department of Defense (DOD), Federal Aviation Administration (FAA) and National Institute of Standards and Technology (NIST).
Based on real-world observations, the ATT&CK (adversarial tactics and techniques and common knowledge) framework is a globally accessible scholarship groundwork of adversary tactics and techniques. It serves as a foundation for developing specific threat models and methodologies in the private sector, security vendor community and varying government organizations.
The ATT&CK scholarship groundwork has helped several projects, mappings and supplemental resources, allowing the supporting communities to continue growing. The platform and data sources sections are incredibly valuable because they disclose practitioners which systems they exigency to live monitoring and what they exigency to live collecting from them to mitigate and/or detect mistreat of the technique. The consume of scholarship provided by the framework can almost immediately extend the maturity of a government security organization.
By classifying attacks into discreet tactics, it’s easier for researchers to notice common patterns, determine the author of different campaigns and track how a threat has evolved over the years as the author adds fresh features and beset methods. The framework recognizes that real-world threats are constantly advancing, and maps events to give analysts the context needed to identify advanced persistent threats (APT). The term APT is commonly thrown around, but for the federal, state, and local government as well as organizations supporting them, APT is a genuine concern.
Simplifying the Cyberdefense Process
With the impending security skills shortage, government organizations will possess to find fresh ways to do better consume of the talent and resources they currently have. Security operations centers (SOCs) are overwhelmed by thousands of daily alerts, and manually responding to each one — legitimate or not — is a time-consuming and arduous task.
By combining comprehensive data gathering; standardization; workflow analysis and analytics; and security orchestration, automation and response (SOAR), technology companies are working to provide organizations the faculty to easily implement sophisticated defense-in-depth capabilities based on internal and external data sources dote the ATT&CK framework. As a result, government agencies are nascence to adopt SOAR, seeking to quickly and effectively resolve a significant portion of the thousands of alerts they receive each day while furthermore ensuring that processes and standards are enforced through automation. This will free up their security experts to expend more time on knotty investigations, creating innovative processes, and proactive threat hunting.
From optimal productivity and performance to the faculty to respond to incidents faster, collaboration delivers invaluable benefits to security operations in the public sector. Because the private sector controls the vast majority of the world’s faultfinding infrastructure systems, government security will depend on effective, global collaboration with industry security professionals using resources dote the MITRE ATT&CK framework.
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