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Heart Attack Prevention Tips

Posted by Memorial Planning Svcs on July 30, 2011 at 8:35 PM Comments comments (0)

It's never too late to take steps to prevent a heart attack - even if you've already had one. Taking medications can reduce your risk of a second heart attack and help your damaged heart function better. Lifestyle factors also play a critical role in heart attack prevention and recovery.


 

Medications

Doctors typically prescribe drug therapy for people who've had a heart attack or who are at high risk of having one. Medications that help the heart function more effectively or reduce heart attack risk may include:

 

    Blood-thinning medications. Aspirin makes your blood less "sticky" and likely to clot. Doctors recommend a daily aspirin for most people who've had a heart attack. Your doctor may, in some cases, prescribe a stronger blood thinner than aspirin.

 

    Doctors may prescribe aspirin and an anti-clotting drug, such as clopidogrel (Plavix), for people undergoing an angioplasty or stent procedure to open narrowed coronary arteries, both before and after the procedure.

 

    If you're taking aspirin to help prevent a heart attack, be aware that taking the painkiller ibuprofen (Advil, Motrin, others) at the same time may increase the risk of gastrointestinal problems and may interfere with the heart benefits of aspirin. If you need to take a pain-relieving medication for certain conditions, such as arthritis, discuss with your doctor which is best for you.

    Beta blockers. These drugs lower your heart rate and blood pressure, reducing demand on your heart and helping to prevent further heart attacks. Many people will need to take beta blockers for the rest of their lives following a heart attack.

    Angiotensin-converting enzyme (ACE) inhibitors. Doctors prescribe ACE inhibitors for most people after heart attacks, especially for those who have had a moderate to severe heart attack that has reduced the heart's pumping capacity. These drugs allow blood to flow from your heart more easily, prevent some of the complications of heart attacks and make a second heart attack less likely.

    Cholesterol-lowering medications. A variety of medications, including statins, niacin, fibrates and bile acid sequestrants, can help lower your levels of unwanted blood cholesterol. The majority of people who've had a heart attack take cholesterol-lowering medications — drugs that help lower the risk of a second heart attack. These medications can help prevent future heart attacks even if your cholesterol was not very high at the time of the heart attack.

 

Lifestyle changes

In addition to medications, the same lifestyle changes that can help you recover from a heart attack can also help prevent future heart attacks. These include:

 

    Not smoking

    Controlling certain conditions, such as high blood pressure, high cholesterol and diabetes

    Staying physically active

    Eating healthy foods

    Maintaining a healthy weight

    Reducing and managing stress


Courtesy of Mayo Clinic

 

 

Heart Attack Signs for Men and Women

Posted by Memorial Planning Svcs on July 30, 2011 at 8:25 AM Comments comments (0)

 Be Heart Healthy

 "If you think you're having a heart attack, that's not the time to try and figure out whether you're right," says Gordon Tomaselli, M.D., president-elect of the American Heart Association, who adds he has patients who have done exactly that.

          (One of the symptoms for a heart attack in women is pain in the shoulder blades.)

 And yet, among the most commonly searched subjects online is "heart attack signs," according to the search engine Google. In fact, the number of searches for that term has increased by a whopping 90 percent in the last five years or so, according a company spokesperson. Searches for "Am I having a heart attack?" alone have risen by more than 35 percent since 2008, the company says.

 One reason people are searching online for emergency information is that it's not always easy to tell whether you're having a heart attack — even doctors have a tough time knowing without tests. If you suspect you're having a heart attack, call for an ambulance immediately. And don't be embarrassed if it turns out you're not.

 "It's not always straightforward," says Tomaselli. "If you develop the classic symptoms — pressing chest pain, sweating, nausea — then you're pretty clear that there's a big problem that needs to be dealt with quickly." But, he says, many people, especially women, may develop completely different symptoms when experiencing a heart attack.

Common symptoms in men and women

 You should pay particular attention to the following signs if — like more than half of all Americans — you are over 50, have high blood pressure, have high cholesterol, are a smoker or have a family history of heart disease. A heart attack occurs when the blood supply to the heart is blocked, damaging the muscle. Chewing aspirin (either one regular or two baby) helps the heart by thinning the blood.

     Chest pain: Most people do call 911 or get to the hospital if they feel like they've got an elephant sitting on their chest, but even this most common heart attack symptom may be hard to recognize. It may just feel like a squeezing that lasts more than a few minutes or goes away and comes back. "It may be a chest fullness that they don't recognize as pain," says Tomaselli, who is also chief of cardiology at the Johns Hopkins School of Medicine. "Sometimes it doesn't particularly hurt. It's an uncomfortable sensation." If chest pain lasts more than five minutes, go to the emergency room.

   Shortness of breath: You may feel you can't catch your breath, even when resting. This breathlessness often occurs before the chest pain.

   Dizziness or lightheadedness: You may feel as if you will pass out.

   Cold sweat: Sweating when you are cold or have a chill. Symptoms more likely in womenWomen have a higher risk of dying from a heart attack than men do, partly because they often don't realize they're having a heart attack and partly because they delay getting help.

  Chest pain was not the main symptom in about 46 percent of women who had a heart attack. Women are less likely than men to have the typical "Hollywood heart attack," says Sharonne Hayes, M.D., cardiologist and director of the Mayo Clinic's Women's Heart Clinic in Rochester, Minn.

  Pain in the arm (especially left arm), back, neck, abdomen or shoulder blades: When the nerves of the heart are irritated because the heart isn't getting enough blood, discomfort or pain can radiate out to many places in the body. The pain often is described as an uncomfortable pressure, tightness or ache. "If you can put a finger on it and say, 'It hurts right here,' that's much less likely to be a heart attack," says Pamela Ouyang, a cardiologist with the Johns Hopkins Bayview Medical Center.

  Jaw pain: Jaw and throat pain are quite common, says Ouyang. She says the feeling can start in the chest and move to the throat — as if someone is choking you — and then to the jaw. But again, it's not always obvious. Sometimes people "go to the dentist, because they think it's a toothache," when they actually had a heart attack.

 Nausea and vomiting: Women are more likely than men to have this symptom, and they may think they have a stomach flu rather than a heart attack.

 Overwhelming and unusual fatigue: Fatigue is generally a symptom of 21st-century life, so it's often overlooked as a heart attack sign, but it's extremely common, so beware if you're unusually exhausted.


Courtesy of AARP



How To reduce Hot Flashes and Night Sweats

Posted by Memorial Planning Svcs on September 18, 2010 at 8:03 PM Comments comments (1)

Considered by many to be the hallmark of menopause, hot flashes are the most common menopausal symptom in Western societies. According to NIH -- The National Institute of Health -- a hot flash is a sudden temporary onset of body warmth, flushing and sweating.



The intensity and frequency of hot flashes varies greatly from woman to woman. Hot flashes are considerably less common in non-Western countries such as Japan, Hong Kong, Pakistan, and Mexico, where studies show that 10% or less of menopausal women experience hot flashes. It has been postulated that the low incidence in Japanese women is due to their high-fiber, low-fat diets and high dietary intake of soy products.


Diets high in phytoestrogens have been shown to help reduce menopausal symptoms. Soy products, such as Revival Soy Protein tofu, tempeh, soymilk, and miso contain large amounts of phytoestrogens, which are plant hormones with weak estrogen-like effects. Conversely, high-fat, low-fiber diets are associated with higher estrogen activity. Since Asian women tend to have lower levels of estrogen before (and after) menopause, the drop in estrogen levels that occurs in menopause may be less dramatic, resulting in milder symptoms at menopause, or none at all. Fiber increases fecal excretion of excess estrogen, which may account for the protective effect of a high fiber diet against a variety of hormone sensitive conditions, including breast cancer.

Other foods specifically indicated for hot flashes include flaxseed, (1) high-lignan flaxseed oil, fennel, celery, and parsley. Both flaxseed and high-lignan flaxseed oil are rich in lignans, which can function to help normalize estrogen levels. Fennel, celery, parsley, and all legumes are excellent sources of phytoestrogens.


While most authors state that hot flashes, also known as vasomotor flushes, are experienced by 80% to 90% of American women, others report that only 50% of women experience hot flashes. The Mayo Clinic reports that 75% of menopausal and post menopausal women experience hot flashes.

Our incomplete understanding of hot flashes is reflected not only by the lack of consensus over how common they are, but also by the multitude of theories to explain what causes them. The most widely accepted theory is that hot flashes are caused by a deficiency in circulating estrogen as a result of declining ovarian function. We know that fluctuating estrogen levels are at least part of the picture, because many women experience relief from hot flashes while taking estrogen.

This theory, however, does not fully explain the phenomenon of hot flashes, as many menopausal and post-menopausal women with low estrogen levels never experience hot flashes, while other women simultaneously experience hot flashes and symptoms of a relative estrogen excess. Signs of estrogen excess or estrogen dominance include weight gain, breast tenderness, heavy menstrual flow, and erratic mood swings. Furthermore, studies consistently show a 30% improvement in hot flashes in women who are treated only with placebos. We can infer from the response to placebo that hot flashes are a complex neuroendrocrine phenomenon affected by a variety of factors including our thoughts, expectations, and emotions. The wide range of stimuli that trigger flushing further attests to the multi-factorial nature of hot flashes. Common triggers include: spicy food, hot drinks, alcohol, sugar, caffeine, stress, hot weather, hot tubs and saunas, tobacco, and "heated" emotions. Be sure to read Power Surge's Menopause Survival Tips.

Another explanation for hot flashes is that they are triggered by a brief but sudden downward adjustment in the body's internal temperature setting. We know that both estrogen and progesterone play a role in temperature regulation, but we do not fully understand specifically how these two hormones, or a multitude of others, may trigger a shift in the body's thermoregulatory center. Some research indicates that hot flashes may be triggered when declining levels of estrogen and progesterone cause a withdrawal of naturally occurring opiates, chemicals in the brain that have a significant impact on mood, pain control, and hormone modulation.

Studies indicate that stabilization of either estrogen or progesterone can minimize hot flashes. Natural progesterone cream has been shown to afford significant relief from hot flashes. A recent double blind, placebo-controlled study conducted at St. Luke's Hospital in Bethlehem, Pennsylvania found that 83% of women had a decrease in the frequency and/or severity of their hot flashes while using transdermal progesterone. These results are comparable to the effectiveness of prescription estrogens, as several studies showed that prescription estrogens relieved hot flashes in approximately 85% of women. Studies demonstrate that regular exercise for as little as 3.5 hours per week also lowers the frequency and severity of hot flashes. Exercise is clearly a key element of any program to minimize menopausal symptoms, given its additional benefits for bone and cardiovascular health.

A number of medicinal plants used for centuries by indigenous cultures have gained reputations as female tonics. The tonifying effects of these herbs are most likely due to the presence of phytoestrogens, as well as the plants' abilities to nourish the endocrine glands and increase blood flow to the pelvic organs. Herbs commonly used to alleviate hot flashes include black cohosh, motherwort, chaste tree berry, blue cohosh, ginseng, dong quai, licorice, sarsaparilla, and false unicorn. A variety of nutritional supplements have demonstrated a beneficial effect on hot flashes as well. Bioflavonoids have been shown to decrease the incidence of hot flashes, particularly when they are taken with vitamin C. Their effect on hot flashes may be due to the structural similarity between certain bioflavonoids and our body's own estrogens. Studies have shown that menopausal women tend to have lower levels of vitamin C than pre-menopausal women do. Extensive research indicates that vitamin C strengthens the blood vessel membranes and acts as a potent antioxidant. Vitamin C is considered an essential nutrient for optimal functioning of the adrenal glands, an important source of post-menopausal hormone production. During perimenopause and menopause, the body begins producing more estrogen at sites other than the ovaries. The adrenal glands, as well as adipose and muscle tissue, assume an increasingly important role in hormone synthesis as ovarian function begins to slow down.

Pantothenic acid (vitamin B-5) also plays an important role in the maintenance of normal adrenal gland function. Providing the adrenal glands with optimum nutrition may help ease the body's transition to alternate sites of hormone synthesis. Para-aminobenzoic acid (PABA), another B-complex vitamin, has been shown to promote circulating levels of the body's own estrogens. It is considered a pro-estrogenic compound, capable of modifying the body's estrogen metabolism. PABA appears to be an innocuous substance even when consumed in large amounts. Several studies report significant reductions in hot flashes with vitamin E supplementation. A number of clinical trials, from as early as the 1940's, reported that vitamin E controlled flushing in more than 50% of the cases. It is thought that vitamin E may act as an estrogen substitute, thereby regulating hot flashes. Vitamin E also has additional beneficial effects for the cardiovascular system as well as being an antioxidant.

Glandular products are not hormones, but are considered by some to be a potential source of hormone precursors. Supplementing with adrenal tissue concentrate has therapeutic value as a food substance, and is thought to support the female endocrine system.

Women react to hot flashes in many ways. Some women feel cleansed and energized after a flash, while others dread them. Many women are looking for natural ways to ease the transition through menopause. For some women, a diet rich in phytoestrogens is all that is needed. Others find more success using a combination of natural products along with exercise and a healthy diet.


1.-Flaxseed is the richest source of alpha-linolenic acid (ALA), a plant source of omega-3 fatty acids. As mentioned in the fish oils chapter, the omega-3?s are one of two families of essential fatty acids, which are necessary for growth and development and cannot be made by the body. Omega-3?s are the building blocks of eicosanoids, hormonelike compounds that regulate blood pressure, clotting, and other body functions.


 

By Power-Surge contributor:

Dr. Holly Zapf

 


Is Cannabis a Cure for Cancer?

Posted by Memorial Planning Svcs on August 13, 2010 at 4:57 AM Comments comments (3)

Cannabinoids possess … anticancer activity [and may] possibly represent a new class of anti-cancer drugs that retard cancer growth, inhibit angiogenesis (the formation of new blood vessels) and the metastatic spreading of cancer cells." So concludes a comprehensive review published in the October 2005 issue of the scientific journal Mini-Reviews in Medicinal Chemistry.

Not familiar with the emerging body of research touting cannabis' ability to stave the spread of certain types of cancers? You're not alone.


For over 30 years, US politicians and bureaucrats have systematically turned a blind eye to scientific research indicating that marijuana may play a role in cancer prevention -- a finding that was first documented in 1974. That year, a research team at the Medical College of Virginia (acting at the behest of the federal government) discovered that cannabis inhibited malignant tumor cell growth in culture and in mice. According to the study's results, reported nationally in an Aug. 18, 1974, Washington Post newspaper feature, administration of marijuana's primary cannabinoid THC, "slowed the growth of lung cancers, breast cancers and a virus-induced leukemia in laboratory mice, and prolonged their lives by as much as 36 percent."

Despite these favorable preclinical findings, US government officials dismissed the study (which was eventually published in the Journal of the National Cancer Institute in 1975), and refused to fund any follow-up research until conducting a similar –- though secret –- clinical trial in the mid-1990s. That study, conducted by the US National Toxicology Program to the tune of $2 million concluded that mice and rats administered high doses of THC over long periods experienced greater protection against malignant tumors than untreated controls.

Rather than publicize their findings, government researchers once again shelved the results, which only came to light after a draft copy of its findings were leaked in 1997 to a medical journal, which in turn forwarded the story to the national media.

Nevertheless, in the decade since the completion of the National Toxicology trial, the U.S. government has yet to encourage or fund additional, follow up studies examining the cannabinoids' potential to protect against the spread cancerous tumors.

Fortunately, scientists overseas have generously picked up where US researchers so abruptly left off. In 1998, a research team at Madrid's Complutense University discovered that THC can selectively induce apoptosis (program cell death) in brain tumor cells without negatively impacting the surrounding healthy cells. Then in 2000, they reported in the journal Nature Medicine that injections of synthetic THC eradicated malignant gliomas (brain tumors) in one-third of treated rats, and prolonged life in another third by six weeks.

In 2003, researchers at the University of Milan in Naples, Italy, reported that non-psychoactive compounds in marijuana inhibited the growth of glioma cells in a dose dependent manner and selectively targeted and killed malignant cancer cells.

The following year, researchers reported in the journal of the American Association for Cancer Research that marijuana's constituents inhibited the spread of brain cancer in human tumor biopsies. In a related development, a research team from the University of South Florida further noted that THC can also selectively inhibit the activation and replication of gamma herpes viruses. The viruses, which can lie dormant for years within white blood cells before becoming active and spreading to other cells, are thought to increase one's chances of developing cancers such as Karposis Sarcoma, Burkitts lymphoma, and Hodgkins disease.

More recently, investigators published pre-clinical findings demonstrating that cannabinoids may play a role in inhibiting cell growth of colectoral cancer, skin carcinoma, breast cancer, and prostate cancer, among other conditions. When investigators compared the efficacy of natural cannabinoids to that of a synthetic agonist, THC proved far more beneficial – selectively decreasing the proliferation of malignant cells and inducing apoptosis more rapidly than its synthetic alternative while simultaneously leaving healthy cells unscathed.

Nevertheless, US politicians have been little swayed by these results, and remain steadfastly opposed to the notion of sponsoring – or even acknowledging – this growing body clinical research, preferring instead to promote the unfounded notion that cannabis use causes cancer. Until this bias changes, expect the bulk of research investigating the use of cannabinoids as anticancer agents to remain overseas and, regrettably, overlooked in the public discourse.

 


Can Asparagus fight Cancer?

Posted by Memorial Planning Svcs on August 5, 2010 at 3:49 PM Comments comments (2)

ASPARAGUS FIGHTS CANCER

"Asparagus is one of nature's most perfect foods. Asparagus are poor in calories and loaded with vitamins and minerals. Asparagus also contains the phyto-chemical glutathione, which has antioxidant and anticarcinogenic properties.

According to the National Cancer Institute,asparagus is the highest tested food containing glutathione, one of the body's most potent cancer fighters. Additionally, asparagus is high in rutin, which is valuable in strengthening the blood vessels. Avocado and walnuts are also particularly rich in dietary sources of glutathione.

Glutathione is a small protein composed of three amino acids; cysteine, glutamic acid, and glycine. Glutathione is involved in detoxification. It binds to fat-soluble toxins, such as heavy metals, solvents, and pesticides, and transforms them into a water-soluble form that can be excreted in urine."



 


I personally like asparagus and can't see how this could hurt. 

  

My Mom had been taking the full-stalk canned style asparagus that she pureed and she took 4 tablespoons in the morning and 4 tablespoons later in the day. She did this for over a month. She is on chemo pills for Stage 3 lung cancer in the pleural area and her cancer cell count went from 386 down to 125 as of this past week. Her oncologist said she does not need to see him for 3 months.

 

 

THE ARTICLE: Several years ago, I had a man seeking asparagus for a friend who had cancer. He gave me a photocopied copy of an article, entitled, Asparagus for cancer 'printed in Cancer News Journal, December 1979. I will share it here, just as it was shared with me: I am a biochemist, and have specialized in the relation of diet to health or over 50 years. Several years ago, I learned of the discovery of Richard R. Vensal, D.D.S. That asparagus might cure cancer. Since then, I have worked with him on his project We have accumulated a number of favorable case histories. Here are a few examples:

  

Case No. 1, A man with an almost hopeless case of Hodgkin's disease (cancer of the lymph glands) who was completely incapacitated. Within 1 year of starting the asparagus therapy, his doctors were unable to detect any signs of cancer, and he was back on a schedule of strenuous exercise.

 

 

Case No. 2, a successful businessman 68 years old who suffered from cancer of the bladder for 16 years. After years of medical treatments, including radiation without improvement, he went on asparagus. Within 3 months, examinations revealed that his bladder tumor had disappeared and that his kidneys were normal.

 

 

Case No. 3, a man who had lung cancer. On March 5th

1971, he was put on the operating table where they found lung cancer so widely spread that it was inoperable. The surgeon sewed him up and declared his case hopeless. On April 5th he heard about the Asparagus therapy and immediately started taking it By August, x-ray pictures revealed that all signs of the cancer had disappeared.. He is back at his regular business routine.

 

 

Case No. 4, a woman who was troubled for a number of years with skin cancer. She finally developed different skin cancers which were diagnosed by the acting specialist as advanced. Within 3 months after starting on asparagus, her skin specialist said that her skin looked fine and no more skin lesions. This woman reported that the asparagus therapy also cured her kidney disease, which started in 1949. She had over 10 operations for kidney stones, and was receiving government disability payments for an inoperable, terminal, kidney condition. She attributes the cure of this kidney trouble entirely to the asparagus.

 

 

I was not surprised at this result, as `The elements of materia medica', edited in1854 by a Professor at the University of Pennsylvania , stated that asparagus was used as a popular remedy for kidney stones. He even referred to experiments, in 1739, on the power of asparagus in dissolving stones. Note the dates! We would have other case histories but the medical establishment has interfered with our obtaining some of the records. I am therefore appealing to readers to spread this good news and help us to gather a large number of case histories that will overwhelm the medical skeptics about this unbelievably simple and natural remedy.

 

 

For the treatment, asparagus should be cooked before using, and therefore canned asparagus is just as good as fresh. I have corresponded with the two leading canners of asparagus, Giant and Stokely, and I am satisfied that these brands contain no pesticides or preservatives. Place the cooked asparagus in a blender and liquefy to make a puree, and store in the refrigerator. Give the patient 4 full tablespoons twice daily, morning and evening.

 

Patients usually show some improvement in from 2-4 weeks.

 

It can be diluted with water and used as a cold or hot drink. This suggested dosage is based on present experience, but certainly larger amounts can do no harm and may be needed in some cases. As a biochemist I am convinced of the old saying that `what cures can prevent.' Based on this theory, my wife and I have been using asparagus puree as a beverage with our meals. We take 2 tablespoons diluted in water to suit our taste with breakfast and with dinner. I take mine hot and my wife prefers hers cold. For years we have made it a practice to have blood surveys taken as part of our regular checkups. The last blood survey, taken by a medical doctor who specializes in the nutritional approach to health, showed substantial improvements in all categories over the last one, and we can attribute these improvements to nothing but the asparagus drink. As a biochemist, I have made an extensive study of all aspects of cancer, and all of the proposed cures. As a result, I am convinced that asparagus fits in better with the latest theories about cancer.

 

 

 

 

Asparagus contains a good supply of protein called histones, which are believed to be active in controlling cell growth.. For that reason, I believe asparagus can be said to contain a substance that I call cell growth normalizer. That accounts for its action on cancer and in acting as a general body tonic. In any event, regardless of theory, asparagus used as we suggest, is a harmless substance. The FDA cannot prevent you from using it and it may do you much good. It has been reported by the US National Cancer Institute, that asparagus is the highest tested food containing glutathione, which is considered one of the body's most potent anticarcinogens and antioxidants.

 

 

 

 

Please send this article to everyone in your Address Book. The most unselfish act one can ever do is paying forward all the kindness one has received, even to the most undeserved person.


courtesy fo Faye Lawill( a Loyal Client

 


Health Care Bill has passed!

Posted by Memorial Planning Svcs on March 22, 2010 at 12:39 AM Comments comments (1)

Federal News:

House Passes Health Reform Legislation

 

After intense negotiations that included a budget reconciliation process, the House of Representatives passed health care reform legislation. The House passed both H.R. 3590, the Patient Protection and Affordable Care Act (the Affordable Care Act), and H.R. 4872, the Health Care and Education Reconciliation Act of 2010 (the Reconciliation Act).

 


The Affordable Care Act was approved by the Senate on December 24, 2009, and it can now go to President Barack Obama for his signature. The Health Care Reconciliation Act strikes out or modifies a number of tax and revenue provisions in the Senate’s Affordable Care Act to which the House objected. Under budget reconciliation rules, the House Health Care Reconciliation Act now goes to the Senate, which can pass the bill with a 51 majority that is not subject to the 60-vote filibuster rules for other legislation considered in the Senate.

 

The Senate is expected to take up the Health Care Reconciliation Act this week, and Senate Democrats have the goal of sending a final package to the White House before its scheduled April recess begins on March 29. However, if the Senate makes any changes, the House and the Senate versions will go to a conference of House and Senate negotiators. An agreement by negotiators then will go back to the House and the Senate for a simple majority final vote by the two chambers under strict rules that set a timetable for action and that prohibit any amendments. Assuming passage of this conference committee agreement, it will be sent to the President Obama for his signature.

 

The president’s signature to both H.R. 3590 and 4872 will put into effect the provisions of the Affordable Care Act as amended by the Health Care Reconciliation Act. These provisions include the following:

 

Employer Responsibilities. Effective in 2014, assess certain employers a fee of $2,000 per full-time employee, excluding the first 30 employees from the assessment: employers with more than 50 employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit. Employers with more than 50 employees that offer coverage but have at least one full-time employee receiving a premium tax credit, will pay the lesser of $3,000 for each employee receiving a premium credit or $750 for each fulltime employee. (Effective January 1, 2014).

 

Employers with 50 or fewer employees are exempt from penalties.

 

Effective in 2014, employers that offer coverage would be required to provide a free choice voucher to employees with incomes less than 400% FPL whose share of the premium exceeds 8% but is less than 9.8% of their income and who choose to enroll in a plan in the Exchange. The voucher amount is equal to what the employer would have paid to provide coverage to the employee under the employer’s plan and will be used to offset the premium costs for the plan in which the employee is enrolled. Employers providing free choice vouchers will not be subject to penalties for employees that receive premium credits in the Exchange.

 

Employers with more than 200 employees must automatically enroll employees coverage offered by the employer. Employees may opt out of coverage.

 

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