Killer Storm brings freezing rain and snow to U.S. Northeast

(Reuters) – A winter storm packing freezing rain and heavy snow was expected to sweep across much of the U.S. Northeast on Wednesday, snarling transportation, closing dozens of schools and threatening power outages.

The same storm system has killed several people in accidents in the Midwest since Monday, including six in Iowa, two in Missouri and one in Montana, local media in those states reported.

Much of the region from southern Indiana northeast through Maine was under either a winter storm watch or warning. Some 6 to 12 inches (15 to 30 cm) of snow and a 1/4 inch (.5 cm) of ice accumulation were in the forecast, the National Weather Service said.

“Travel will be dangerous and nearly impossible,” the service said, warning that ice may cause widespread power outages.

Dozens of school districts in the East Coast, including in Pittsburgh and Albany, New York canceled classes on Wednesday while Baltimore schools delayed the start of school for two hours. Federal agencies in Washington D.C. were also opening two hours later than normal.

About 800 flights within, into or out of the United States were canceled on Wednesday nationwide, according to the FlightAware tracking service.

(Reporting by Brendan O’Brien in Milwaukee; Editing by Frances Kerry)

Deadly winter storm delays travel in U.S. Midwest, Northeast

Weather conditions for winter storm 2-6-18 National Weather Service

(Reuters) – A winter storm will dump snow and freezing rain on the U.S. Midwest and the Northeast beginning on Tuesday after it caused several deaths as it snarled highways and spurred the cancellation of hundreds of flights at Chicago’s main airport.

The National Weather Service warned commuters in northern Texas, east through southern Illinois and Indiana, and New York and Massachusetts, to watch for icy road conditions, wind gusts and reduced visibility throughout the day and into Wednesday.

“The ice and snow will result in difficult travel conditions,” the NWS said in an advisory. “Motorists are strongly urged to slow down and allow plenty of time to reach their destinations.”

Winds of 40-miles an hour(65 kph) and as much as 4 inches (10 cm) of snow are expected across the affected regions, with parts of New York and Vermont getting as much as a foot of snow, the NWS said.

The storm was responsible for the death of six people on Monday in crashes throughout Iowa, the Des Moines Register reported.

Two people also died in southwest Missouri and more than 70 others were injured after icy roads caused a high number of crashes, the Springfield News-Leader reported.

At Chicago’s busy O’Hare International Airport, the storm caused the cancellation of more than 460 flights, according to the flight tracking website FlightAware.

(Reporting by Brendan O’Brien in Milwaukee; Editing by Bernadette Baum)

Deep freeze keeps grip on eastern United States; four die

Elena Barduniotis from Colorado waits in Times Square ahead of New Year's celebrations in Manhattan.

By Brendan O’Brien

MILWAUKEE (Reuters) – A record-shattering Arctic freeze kept its grip on much of the United States east of the Rocky Mountains on Tuesday but temperatures everywhere except the Northeast were expected to warm within 24 hours.

Many school districts shut their classrooms due to the cold snap, which claimed four lives over the long New Year’s weekend.

The National Weather Service issued wind chill warnings for Tuesday as dangerously low temperatures were due from eastern Montana across the Midwest into the Atlantic coast and the Northeast and down through the deep South.

School districts in Iowa, Massachusetts, Indiana, Ohio and North Carolina canceled or delayed the start of classes as bitterly cold temperatures, 20 degrees to 30 degrees Fahrenheit (11 to 17 degrees Celsius) below normal, were expected across the eastern half of the United States.

“Just the bitter cold which is just too dangerous to put kids out on the street waiting for a bus that may not come,” Herb Levine, superintendent of the Peabody Public Schools, north of Boston, told a local CBS affiliate television station.

The cold was blamed for the deaths of two men in separate incidents in Milwaukee, according to the Milwaukee Journal Sentinel. A homeless man was found dead on a porch in Charleston, West Virginia, while another man was found dead outside a church in Detroit and police said he may have froze to death, local news outlets reported.

Washington Mayor Muriel Bowser urged residents to call the city if they saw people outside.

“We want every resident to have shelter and warmth,” she said in a tweet.

Many places across the United States experienced record low temperatures over the last few days. Omaha, Nebraska, posted a low of minus 20F (minus 29C), breaking a 130-year-old record, and Aberdeen, South Dakota, shattered a record set in 1919 with a temperature of minus 32F (minus 36C).

The cold should ease across most of the country after Tuesday, but the northeastern section of the country will see a repeat of the frigid weather on Thursday or Friday as another arctic blast hits the area.

Private AccuWeather forecaster said the cold snap could combine with a storm brewing off the Bahamas to bring snow and high winds to much of the Eastern Seaboard as it heads north on Wednesday and Thursday.

(Reporting by Brendan O’Brien in Milwaukee; Editing by Raissa Kasolowsky and Jeffrey Benkoe)

Iowa pulls request to opt out of Obamacare requirements

Iowa pulls request to opt out of Obamacare requirements

By Susan Cornwell

(Reuters) – Iowa on Monday withdrew a request to waive some Obamacare rules to help shore up its struggling healthcare insurance market, marking a setback in efforts by Republican-governed states to sidestep requirements of the Obama-era law.

With open enrollment for the Affordable Care Act – better known as Obamacare – set to start in just over a week, the state announced it would no longer wait to hear if federal officials would approve its request aimed at cutting individual healthcare insurance premiums and widening coverage.

The withdrawal prompted a leading U.S. Senate Republican to urge Congress to approve a bipartisan fix to Obamacare, which President Donald Trump has vowed to scrap.

Iowa was viewed as a test case by some for other states that submitted similar, if far less-reaching, waivers and of how the Trump administration would respond to such requests.

Iowa Governor Kim Reynolds said the law had not been flexible enough to accommodate the state’s request.

“Ultimately, Obamacare is an inflexible law that Congress must repeal and replace,” the governor said in a statement, adding that premiums under Obamacare had increased by 110 percent for Iowans since 2013.

Iowa sought the waiver after its individual healthcare marketplace shrank to only one insurer for next year, Minnesota-based Medica.

Some of the state’s requests were similar to provisions included in Republican repeal and replace bills this year. For instance, the waiver sought to replace Obamacare’s income-based tax credits with flat age-based credits and eliminate insurer payments that Trump cut off earlier this month.

Senator Lamar Alexander, Republican of Tennessee, said the move by Iowa demonstrated the need for repairs to Obamacare that he and Democratic Senator Patty Murray have proposed aimed at stabilizing insurance markets. It would also provide states more flexibility in reshaping some parts of Obamacare.

Trump has sent mixed signals over whether he would support the bipartisan fix. Senate Majority Leader Mitch McConnell said on Sunday that he was willing to bring up the proposal for a vote but needed to know where Trump stood.

Alexander said the bipartisan repair proposal would allow the federal government to approve Iowa’s waiver.

Alexander told reporters that the Congressional Budget Office, a nonpartisan scorekeeper, would soon announce its analysis of the bipartisan repair legislation, possibly on Tuesday.

(Reporting by Susan Cornwell,; additional reporting by Yasmeen Abutaleb and Amanda Becker in Washington; Editing by Andrew Hay)

Planned Parenthood to close four Iowa clinics after cuts

FILE PHOTO - Iowa Governor Terry Branstad arrives to testify before a Senate Foreign Relations Committee confirmation hearing on his nomination to be U.S. ambassador to China at Capitol Hill in Washington D.C., U.S. on May 2, 2017. REUTERS/Carlos Barria/File Photo

By Chris Kenning

(Reuters) – Planned Parenthood said on Thursday it would shutter four of its 12 clinics in Iowa as a result of a measure backed by Republican Governor Terry Branstad that blocks public money for family planning services to abortion providers.

Health centers in Burlington, Keokuk and Sioux City will close on June 30 and one in Quad Cities soon after as a result of losing $2 million in funds under the new measure, said Susan Allen, a spokeswoman for Planned Parenthood of the Heartland. The four clinics served 14,676 patients in the last three years, she said, including many rural and poor women.

“It will be devastating,” Allen said.

The closures marked the latest fallout from a continuing push by Republicans, including President Donald Trump, to yank funding from Planned Parenthood. Many have long opposed the organization, some on religious grounds, because its healthcare services include abortions, although it receives no federal funding for abortions, as stipulated by federal law.

The Republican-controlled U.S. House of Representatives included such a defunding measure as part of the American Health Care Act, the bill aimed at replacing Obamacare.

Iowa’s Republican-led legislature agreed in its recent budget to discontinue a federal Medicaid family planning program and replace it with a state program that bars funding to organizations that provide abortions or maintain facilities where abortions are carried out. The move cost the state about $3 million.

Texas in 2011 made a similar move that has reduced funding. A state report in 2015 found that nearly 30,000 fewer women received birth control, cancer screenings and other care as a result.

A coalition of 35 Iowa groups that oppose abortion have previously argued that funding for family planning indirectly subsidizes abortions.

“The pro-life movement is making tremendous strides in changing the hearts and minds, to return to a culture that once again respects human life,” said Ben Hammes, a spokesman for Branstad, who said there were 2,400 doctors, nurses and clinics around the state for family planning that do not provide abortions.

Planned Parenthood of the Heartland said it will continue to operate eight clinics in Iowa. They provide services including cancer screenings, birth control, STD testing and annual checkups.

The group said in a tweet on Thursday that politicians driven more by personal beliefs than facts were hurting access to women’s health care.

“The devastation in Iowa is a sign of what could be next for the rest of the nation,” Danielle Wells, an official at Planned Parenthood Federation of America, said in an email.

(Reporting by Chris Kenning; Editing by Jonathan Oatis)

Iowa Supreme Court blocks portion of 20-week abortion ban

Iowa Governor Terry Branstad testifies before a Senate Foreign Relations Committee confirmation hearing on his nomination to be U.S. ambassador to China at Capitol Hill in Washington D.C., U.S. on May 2, 2017. REUTERS/Carlos Barria/File Photo

By Timothy Mclaughlin

(Reuters) – The Iowa Supreme Court on Friday granted an emergency temporary injunction halting a portion of a 20-week abortion ban that was signed into law by Republican Governor Terry Branstad just hours earlier.

The law, passed by Iowa’s Republican-controlled House and Senate last month, bans abortions once a pregnancy reaches 20 weeks and stipulates a three-day waiting period before women can undergo any abortion.

The law does not make exceptions for instances of rape or incest but does allow for abortions if the mother’s life or health is at risk.

The American Civil Liberties Union (ACLU) and Planned Parenthood, a group that provides family planning services, including abortions, challenged the waiting-period part of the legislation in court as well as the requirement for an additional clinical visit women must make before an abortion.

The state Supreme Court on Friday issued the injunction after it was denied Thursday by a district judge.

“We are pleased that the court granted the temporary injunction, ruling on the side of Iowa women who need access to, and have a constitutional right, to safe, legal abortion,” Suzanna de Baca, chief executive of Planned Parenthood of the Heartland said in a statement.

The state will have an opportunity to respond to the court’s decision on Monday.

“This is all part of the process and we’re confident that the stay will be lifted very shortly,” said Ben Hammes, a spokesman for the Republican governor.

Women in the United States have the right under the Constitution to end a pregnancy, but abortion opponents have pushed for tougher regulations, particularly in conservative states.

There are 24 states that impose prohibitions on abortions after a certain number of weeks, according to the Guttmacher Institute, which tracks reproductive policy.

Seventeen of these states ban abortion at about 20 weeks and after.

Iowa’s law, Hammes said after the signing, marked a “return to a culture that once again respects human life.”

In Tennessee, a bill similar to the Iowa measure was sent to the desk of that state’s Republican governor on Wednesday to possibly be signed into law.

(Reporting by Timothy Mclaughlin in Chicago; Editing by Jonathan Oatis)

Tennessee, Iowa close to banning abortions after 20 weeks

ultrasound machine

By Tim Ghianni

NASHVILLE, Tenn (Reuters) – Two U.S. states drew closer on Wednesday to legislating tougher restrictions on abortion with both Iowa and Tennessee seeking governors’ signatures that would ban the procedure after 20 weeks.

Women in the United States have the right under the Constitution to end a pregnancy, but abortion opponents have pushed for tougher regulations, particularly in conservative states.

A Tennessee bill banning abortions after 20 weeks was sent to the desk of Governor Bill Haslam after it was passed by the state’s Republican-controlled House on Wednesday.

Haslam, a Republican, has not made a decision on whether he will sign the measure into law and will discuss the bill with the state’s attorney general, his spokeswoman Jennifer Donnals said.

Attorney General Herbert Slatery could not be reached for comment.

Iowa Governor Terry Branstad, also a Republican, said he would sign on Friday a 20-week abortion ban. The bill was passed by the Republican-controlled House and Senate last month.

There are 24 states that impose prohibitions on abortions after a certain number of weeks, according to the Guttmacher Institute, which tracks reproductive policy.

Seventeen of these states ban abortion at about 20 weeks.

The Tennessee bill would require women to undergo a test of viability and gestational age before a doctor performed an abortion. Doctors who violate the law could face felony charges. The bill does not make exceptions for rape or incest. It does allow for abortions if the mother’s life or health is at risk.

“We’ve made significant progress as a legislative body in recent years to give a voice to the unborn,” Republican representative Matthew Hill said in a statement.

Iowa’s bill bans abortions once a pregnancy reaches 20 weeks and stipulates a three-day waiting period before a woman can undergo any abortion. It does not make exceptions for instances of rape or incest. It does allow for abortions if the mother’s life or health is at risk.

The American Civil Liberties Union and Planned Parenthood, a group that provides family planning services, including abortions, filed a lawsuit challenging Iowa’s waiting period.

“The governor, lieutenant governor and Iowa legislators have waged an outright war on women’s access to safe and legal abortions,” said Suzanna de Baca, president and chief executive of Planned Parenthood of the Heartland.

(Additional reporting and writing by Timothy Mclaughlin in Chicago; editing by Grant McCool)

Insight: Ballooning bills – More U.S. hospitals pushing patients to pay before care

FILE PHOTO: An emergency sign points to the entrance to Scripps Memorial Hospital in La Jolla, California, U.S. March 23, 2017. REUTERS/Mike Blake/File Photo

By Jilian Mincer

(Reuters) – Last year, the Henry County Health Center in Iowa started providing patients with a cost estimate along with pre-surgery medical advice.

The 25-bed rural hospital in the southwest corner of the state implemented the protocol because of mounting unpaid bills from insured patients, a group that had previously not raised red flags.

Henry County is one of hundreds of U.S. hospitals trying to cope with an unexpected consequence of the Affordable Care Act of 2010, known as Obamacare: millions more Americans have health insurance, but it requires them to spend thousands of dollars before their insurer kicks in a dime.

Since U.S. hospitals do not want to end up footing the bill, they are now experimenting with pre-payment strategies for patients, with a growing number requiring payment before scheduled care and offering no interest loans, according to interviews with more than two dozen hospitals, doctors, patients, lenders and healthcare experts.

“Most patients are appreciative that we’re telling them up front,” said David Muhs, chief financial officer for the Henry County hospital, which provides a discount for early payment. The discussion leads some patients to skip care, others to delay it or use a no interest loans available through the hospital, he said.

The ACA extended insurance to 20 million Americans, which initially helped hospitals begin to shrink debt from uninsured patients who could not pay their medical bills. But more and more, people in Obamacare plans or in employer-based health plans are choosing insurance that features low monthly payments. The trade-off is high out of pocket costs when they need care. (For a graphic, click http://tmsnrt.rs/2oCzePS)

If President Donald Trump dismantles Obamacare as promised, these plans won’t disappear. Republicans also believe high-deductible plans curb spending, and Americans faced with medical costs that rise faster than inflation and wages will look for premiums they can afford.

The trend is expected to accelerate this year because unpaid bills are creating massive bad debt for even the most prestigious medical centers. U.S. hospitals had nearly $36 billion in uncompensated care costs in 2015, according to the industry’s largest trade group, a figure that is largely made up of unpaid patient bills.

The largest publicly-traded hospital chain, HCA Holdings Inc, reported in the fourth quarter of 2016 that its ratio of bad debt to gross revenues of more than $11 billion was 7.5 percent.

One of the first to test this new payment strategy was Novant Health, headquartered in North Carolina with 14 medical centers and hundreds of outpatient and physician facilities. It saw patient debt increase when more local employers started adopting high deductible plans, including one that made its executives pay $10,000 in out-of-pocket expenses.

“To remain financially stable, we had to do something,” said April York, senior director of patient finance at Novant, whose patient default rate dropped to 12 percent from 32 percent after it started offering no interest loans through ClearBalance.

“Patients needed longer to pay. They needed a variety of options,” she said.

IMPACT ON PATIENTS

These prepayment strategies are being rolled out by hospitals across the country because the financial equation has changed so much for patients – even the insured ones.

Almost half of Americans – 45 percent – polled by the Kaiser Family Foundation said they would have difficulty paying an unexpected $500 medical bill. The average deductible this year for the least expensive of the widely used Obamacare health plans is $6,000 for an individual – an 18 percent spike since 2014 – and more than double that for a family, according to government data.

Jessica Curtis, a senior advisor at Community Catalyst, a consumer advocacy group in Boston, said the impact on patients stretches beyond personal finance.

“They delay procedures, they don’t follow advice on prescription drugs, and when they see care, they usually are for more expensive procedures because they’ve waited,” she said

Brian Sanderson, managing principal of Crowe Horwath’s healthcare services group, said communicating with patients and providing longer repayment options is a good strategy since hospital margins have shrunk, thanks to growing unpaid medical bills from consumers.

“A well informed patient is more likely to meet their obligations,” he said. “It’s just good patient relations and it helps to minimize bad debt.”

Hospitals are doing what they can to retain patients while helping them pay medical bills that could run thousands of dollars. Many are expanding charity eligibility, and hiring companies like ClearBalance, AccessOne and Commerce Bank to provide loans to patients no matter what their credit. Most carry no interest rate for the patient, and could be extended far longer than the few months that hospitals once required before sending a bill to collections.

“People are more likely to pay a bank than a hospital,” said Mark Huebner, director of Health Services Financing at Commerce Bank, which offers its line of credit at more than 200 hospitals.

“People are aware that banks will come after them. Banks do collect on debt, and hospitals generally have been more relaxed,” he said.

Wake Forest Baptist Medical Center in North Carolina had seen its bad debt creep up in recent years as more patients saw out of pocket expenses soar, with some deductibles reaching $15,000.

“We’ve seen that many patients are unaware of the increases in their deductibles,” said CFO Chad Eckes. Wake Forest now asks for payment before non-emergency services are provided but also offers zero interest, longer repayment options.

“It’s a challenging position,” he said. “It’s a discussion no one wants to be in, and none of us enjoy.”

(Editing by Caroline Humer and Edward Tobin)

Iowa poised for major overhaul to gun regulations

By Timothy Mclaughlin

(Reuters) – Iowa lawmakers approved on Thursday amended legislation that would enact sweeping changes to the state’s gun regulations, including a “stand your ground” provision, and sent it to the governor for final approval.

The bill, backed by the National Rifle Association, says a law-abiding person does not have to retreat before using deadly force.

A similar measure in Florida was thrust into the national spotlight in 2012 after the shooting death of unarmed teenager Trayvon Martin by neighborhood watch member George Zimmerman, who was acquitted of murder after the law was included in jury instructions.

At least 24 other states have similar measures, according to the National Conference of State Legislatures.

The Iowa bill allows for children under the age of 14 to use handguns while under the supervision of an adult who is 21 or older. It also says gun owners with permits can bring concealed handguns into capitol buildings.

Republican state Representative Matt Windschitl said on the House floor on Thursday the bill was, “the most monumental piece of Second Amendment legislation this state has ever seen.”

The bill also would make gun permits valid for five years, with a background check required when the permit is issued. Under the current law, permits are valid for one year with an annual background check.

The bill passed the state Senate on Tuesday and the House last month. The House voted on it again on Thursday to approve changes made in the Senate before advancing it to the desk of Republican Governor Terry Branstad.

A spokesman for Branstad said in an email that the governor will review the bill.

The bill has been criticized by gun control advocates, who say it could increase gun violence.

“We have had very good gun laws,” the Reverend Cheryl Thomas of Iowans for Gun Safety said by telephone. “With the passage of this law, we are going to lose that status.”

Iowans for Gun Safety wants Branstad to veto the measure.

Previous attempts to change the state’s gun regulations have been blocked by Democrats, who held a majority in the Senate until November.

Following the election, Republican lawmakers control the Senate, House and governor’s office for the first time in nearly two decades.

Republicans have used their majority to push through a number of bills during this legislative session, including drastic changes to the state’s collective bargaining laws.

(Reporting by Timothy Mclaughlin in Chicago; Editing by Bill Trott and Muralikumar Anantharaman)

Iowa moves to cut Medicaid funding for Planned Parenthood

Planned Parenthood in Texas

By Timothy Mclaughlin

(Reuters) – The Republican-controlled Iowa state senate voted on Thursday to cut Medicaid funding for family planning services to abortion providers including Planned Parenthood.

State senators passed the bill 30-20, advancing it to the Republican-controlled House. The vote was along party lines, with one independent voting in favor of the measure.

Republican Governor Terry Branstad has said he supports the bill.

Planned Parenthood draws the ire of many Republicans because it provides abortions, and Republican President Donald Trump has pledged to defund the organization.

“This change will allow Iowa to restrict government funding to family planning services away from organizations that perform abortions that are not medically necessary,” Republican Senator Amy Sinclair, one of the bill’s sponsors, said on Thursday before the vote.

Planned Parenthood denounced the vote.

“The Republican lawmakers who continue to advance this bill should be ashamed of themselves. They are playing political games, with the lives of low-income Iowans at stake,” Planned Parenthood of the Heartland said in a statement.

“This bill does nothing to advance their extremist agenda to limit access to abortion. Instead, it blocks access to crucial family planning services for thousands of Iowans – the very services that most effectively prevent abortion. It’s a self-serving, misleading and dangerous political game.”

The bill directs the Iowa Department of Human Services to discontinue the Medicaid family planning network waiver on July 1 and replace it with a state family planning services program.

Eligibility requirements for the new network would remain the same, but no funding would be provided to organizations that provide abortions or maintain facilities where abortions are carried out.

Planned Parenthood is Iowa’s largest abortion provider with 12 clinics in the state, but no public money is used for abortions, according to the Des Moines Register.

Branstad has proposed paying for the new state-run program by shifting $2.8 million in funds from services for vulnerable adults, families and children, the newspaper reported.

Planned Parenthood is also facing a funding cut in Texas, where a judge is considering the move, which the organization has challenged in court.

(Reporting by Timothy Mclaughlin in Chicago; Editing by Cynthia Osterman)