Roundup: Pre-existing ZIP Codes

Some rural residents see increases in insurance premiums under Obamacare • Climate change hits poor, rural areas harder • Another look at the rural/urban ‘divide’ • Is Canada softening stance on Keystone XL? 

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Health insurers can’t use pre-existing conditions to raise the cost of premiums any more, but they can still base rates on geography.

“We’ve gone from letting the insurance companies use a pre-existing medical condition to jack up rates to having a pre-existing zip code being the reason health insurance is unaffordable,” said Bill Fales, a western Colorado rancher whose insurance premium went up 50% recently. “It’s just wrong.”

Fales is quoted in an AP report on the impact of Obamacare on rural health-care costs.

Geography is one of only three determinants insurance companies are allowed to use to set premiums under the federal health care law, along with age and tobacco use. Insurance officials say they need such controls to remain viable. …

The nonpartisan Kaiser Family Foundation recently rated the Colorado region where Fales lives as the nation’s priciest … 

Other insurance price zones on the most-expensive list include rural areas in Georgia, Nevada, Wisconsin and Wyoming. But the cost differences between densely and sparsely populated areas shouldn’t come as a shock, said [one insurance industry spokesman], because it’s simply more expensive to deliver care in such communities. …

States have only one option to reduce the premium divide between their urban and rural areas. They can set a single statewide rating zone, an option that would reduce premiums for those in rural areas by shifting costs onto more-populated regions.

It’s something officials in all but the smallest states are reluctant to do. Only five states — Delaware, Hawaii, New Hampshire, New Jersey, Rhode Island and Vermont — chose a single rating zone, in addition to Washington, D.C., according to the Kaiser Family Foundation.

“There’s always been geographic variance in insurance,” said Craig Garthwaite, an economist at Northwestern University’s Kellogg School of Management who has studied the economic consequences of the new health care law.

The difference now, he said, is insurers have fewer levers to adjust premium pricing. Garthwaite also said the health care law makes it easier for rural health insurance shoppers to see what city residents are paying.

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International rural communities are some of the hardest hit by the effects of climate change, according to a new report from Intergovernmental Panel on Climate Change, a development agency based in the United Kingdom.

“They’re not really visible to us, particularly in the wealthy countries,” report author Alison Doig said. “There are so many millions of people that are affected by climate change in different ways, and that’s what we wanted to show in the report.”

The report found that indigenous and agricultural communities in developing nations are some of the hardest hit groups. Climate change has affected water supplies, creating both shortages and flooding. Sea level changes affect coastal and island communities.

“In the Western countries, we have insurance, enough financial resources; we can move from place to place; and we have recovery mechanisms,” she said. “But, unfortunately, for the farming communities we work with across the world, they have no backup, no insurance, and nowhere else to go.”

The report has stories from communities in El Salvador, Bangladesh, Brazil, Kenya, Malawi, Bolivia and the Philippines.

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Governing, a website the covers state and local political and government news, is the latest national outlet to take a look at a perceived divide between rural and urban America. (Last week, the Wall Street Journal looked at that trend.)

Four stories look at population changes, divisiveness in politics, hospital closings and declining tax revenue in rural areas, even as some rural sectors prosper.

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USDA is trying to help identify new breeds of livestock protection dogs that are better suited to deter large predators. “Finding suitable dog breeds for use as livestock protection dogs against wolves and bears not only helps us safeguard livestock and the livelihoods of ranchers, but also enhances and encourages coexistence between people and large predators” says William Clay, deputy administrator of USDA Wildlife Services, which is directing the research. The program started in 2013 and recently expanded.

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Japan has stepped up the use of coal in electricity production as a result of the nuclear power failures created by the 2011 tsunami, the Wall Street Journal reports. (Required subscription.)

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Is the Canadian government softening its previously strident stand on the necessity of building the Keystone XL oil pipeline through the U.S. Midwest? Paul Koring with the Globe and Mail reports on comments from Canada’s transport minister.

“The reality is this,” Ms. Raitt said, taking a long view rarely previously evident in the fevered Keystone debate. “There’s an increase in [oil] production in this continent and we want to make sure we are moving it as efficiently and as safely as we possibly can.”

She added: “All modes can be safe; all modes can mitigate the risks associated with them.”

Should Ms. Raitt’s understated tone focusing on the broader issue of getting North American oil – Canadian and American – safely to markets signal an end to years of strident, insistent Canadian demands that President Barack Obama approve the project, it will mark the third shift in Ottawa’s stance in barely half a year.

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U.S. smoking rates are in decline across the boards, except in poor and rural areas, reports the New York Times. The report looks at attitudes in rural Clay County, Kentucky, and is based on new research published in Population Health Metrics.

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Consumer Reports says the average American spends $1,848 a year on telecommunications services. But we don’t like what we are getting for the money, the report says.

 

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