Independent Women's Forum RSS feedhttp://www.iwf.orgThe RSS feed for the IWF. News, Commentary and Blog posts from the Independent Women's Foundation.(...)IWF RSS individual mandate belongs in the trash heap<p> The individual mandate &ndash; the requirement that virtually all Americans obtain government-approved health insurance or pay a penalty &mdash; has long been the least popular part of the Affordable Care Act. Narrowly surviving a Supreme Court challenge in 2012, the mandate&rsquo;s associated penalty has since technically been a &ldquo;tax,&rdquo; as it was only by the&nbsp;<a href="" target="_blank">taxing power</a>&nbsp;that the provision was found constitutional.</p> <p> It would only be appropriate now for congressional leaders to repeal this mandate, or at least reduce the &quot;tax&quot; amount to $0, via tax reform legislation.</p> <p> This would have several positive effects. First, the obvious: the approximately&nbsp;<a href="" target="_blank">6.5 million people</a>&nbsp;who paid the penalty last year would not have to pay it this year.</p> <p> Second, repeal of the individual mandate would save the government money. The Congressional Budget Office estimates that in the absence of the mandate, fewer people would enroll in subsidized Obamacare plans and in Medicaid, which means the government would spend fewer dollars on their health coverage. The&nbsp;<a href="" target="_blank">latest score</a>&nbsp;shows savings of $338 billion over 10 years, and 13 million people going uninsured.</p> <p> Finally, and perhaps most important from the long-run perspective: repealing the individual mandate gets it off the books and out of the way for future health reform plans. Undoubtedly, one of the most harmful talking points used against efforts to repeal and replace Obamacare was the charge that these plans would leave 22 million Americans without coverage. But a closer look at the CBO score reveals that&nbsp;<a href="" target="_blank">73 percent of the coverage change</a>&nbsp;(then 16 million out of 22 million) was a result of repealing the individual mandate. If Congress repeals the individual mandate now, as part of tax reform, this will pave the way for a more politically friendly battlefield over future health reforms.</p> <p> The debate over the individual mandate puts Democrats in a difficult position. They have to defend the least popular part of an already very divisive law. Yet most Democrats believe the individual mandate to be a critical piece of Obamacare that holds the rest of the law together. This is how: Obamacare takes away the ability of insurance companies to offer different prices to different customers based on risk. This creates an incentive for people to go without coverage until they have a need for it (at which point they can enroll at the same price as a healthy person). This would ultimately cause a &ldquo;death spiral,&rdquo; a phenomenon where only the unhealthy seek coverage.</p> <p> To stop this, the law includes the mandate, which is supposed to force people to enroll in coverage even if they don&rsquo;t see it as a beneficial financial arrangement.</p> <p> In theory, all of this is true: the ACA model needs the individual mandate. But in practice, the mandate has been far less effective and is therefore far less critical to Obamacare&rsquo;s success or failure than many first thought. The Obamacare mandate simply doesn&rsquo;t have enough &ldquo;teeth&rdquo; to be truly effective. First, there are many different types of exemptions, taken by about&nbsp;<a href="" target="_blank">12.7 million</a>&nbsp;people last year. Then consider that average penalty that taxpayers paid for going without insurance in 2016 was&nbsp;<a href="" target="_blank">about $470</a>&hellip; compared to Obamacare premiums, which cost, on average&nbsp;<a href="" target="_blank">$411 monthly.</a></p> <p> The sad truth is that, even with the mandate in place, many Americans are opting out of Obamacare, and the feared &ldquo;death spiral&rdquo; is happening anyway, mainly because its plans are so expensive. By comparison, the mandate isn&rsquo;t that bad for most.</p> <p> We should keep in mind the wisdom of&nbsp;<a href="" target="_blank">former President Barack Obama</a>, who, before changing his tune, once said, &ldquo;If a mandate was a solution, we could try that to solve homelessness by mandating everybody buy a house. The reason they don&rsquo;t have a house is that they don&rsquo;t have the money.&rdquo; The same is true of health coverage.</p> <p> To really help hardworking Americans get the insurance coverage they need, our approach to healthcare should be very different from the Obamacare approach. We should focus on bringing down costs and offering consumers more options through more vibrant market competition. In the meantime, we can offer Americans tax relief through repeal of Obamacare&rsquo;s misguided and unproductive individual mandate.</p> HeathWed, 15 Nov 2017 14:11:00 CSTen-usIndependent Women's ForumA very rare opportunity to reform our outdated tax code & help Americans • Intelligence Report HeathMon, 13 Nov 2017 14:11:00 CSTen-usIndependent Women's ForumOur Debt to Military Spouses<p> November is Military Family Appreciation Month.&nbsp; Of course, our nation owes military families a debt of gratitude: Their sacrifices and stressors should not go unnoticed. We do try to honor them, with thanks and praise, but during this month set aside to appreciate military families, we should consider practical ways we can do more to address the challenges they face. Fortunately, such efforts are underway.</p> <p> In August, the White House hosted a&nbsp;<a href="">listening session</a>&nbsp;of military spouses, and the common themes were disruptions in career development and employment.</p> <p> Ninety-two percent of military spouses are female, but the unemployment rate for military spouses (16 percent) is&nbsp;<a href="">four times higher</a>&nbsp;than the rate for all adult women in the U.S. (4 percent). About half of military spouses who are now working part-time report that they are underemployed; they would prefer full-time work.&nbsp;</p> <p> Both the private sector and the public sector are making efforts to address the needs of military families.</p> <p> First, because military life often requires moving from state to state, varying occupational licensing and a continuing education programs can keep military spouses from working, or slow them down and impose additional costs after a move. Unbelievably, today in the U.S., nearly&nbsp;<a href="">one in three workers</a>&nbsp;need a license to work. Scaling back these requirements, or offering state-to-state reciprocity, is one way governments can help. &nbsp;A trio of bills (the Restoring Board Immunity Act, the New HOPE Act, and the ALLOW Act) are currently under Congressional consideration. Each would encourage states to dial back oppressive licensing laws.</p> <p> Second, private companies can work to foster more workplace flexibility. In industries where this is possible, employers should allow flexible hours, telecommuting and work-from-home options. These flexible workplace practices are helpful to any spouse (or single parent) who has to juggle the lion&rsquo;s share of childcare duties. This particularly applies to military spouses.</p> <p> The government can&nbsp;<a href="">help to foster more workplace flexibility as well</a>, simply by staying out of employment contracts and reducing regulations promulgated under the Fair Labor Standards Act that actually restrict employer&rsquo;s ability to offer flexible arrangements. In May, the House passed the Working Families Flexibility Act, which would allow workers to elect to take comp time instead of overtime pay. This would be one good step toward greater flexibility. The bill is now with the Senate.</p> <p> Finally, thirdly, many military spouses have found that the best way to become and stay employed is simply to work for oneself. Many run Etsy shops or otherwise operate their own small businesses. Pursuing a pro-growth economic policy, including tax reforms that make it easier to comply with the tax code and reducing the tax burden that small businesses face, would greatly help these military families. Congress is hard at work trying to pass such tax reforms now.&nbsp;</p> <p> To their credit, there are already many entities &ndash; both public and private &ndash; who are working hard to provide opportunities for military spouses. The&nbsp;<a href="">Small Business Administration</a>&nbsp;has partnered with the Department of Defense to focus on economic opportunity for military spouses. The&nbsp;<a href="">National Military Family Association</a>&nbsp;and&nbsp;<a href="">Military Spouse Employment Partnership</a>&nbsp;also work toward this end, and the U.S. Chamber of Commerce heads a project called&nbsp;<a href="">Hiring Our Heroes</a>, which is dedicated not just to helping veterans, but also military spouses, find jobs.</p> <p> More good news: New technologies&mdash;and the growth of tech-related industries&mdash;are making more flexible, work-from-home positions available, and some companies, like&nbsp;<a href=";loc_query=&amp;job_count=10&amp;result_limit=10&amp;sort=relevant&amp;optional_search_labels%5B%5D=work-from-home&amp;job_id_icims%5B%5D=SF170009156&amp;job_id_icims%5B%5D=508047&amp;job_id_icims%5B%5D=528340&amp;job_id_icims%5B%5D=521233&amp;job_id_icims%5B%5D=535958&amp;job_id_icims%5B%5D=532271&amp;job_id_icims%5B%5D=520531&amp;job_id_icims%5B%5D=518388&amp;job_id_icims%5B%5D=513194&amp;job_id_icims%5B%5D=543297&amp;cache">Amazon</a><strong>,&nbsp;</strong>are committed to hiring military spouses in these jobs. These efforts are welcome and help combat the bias that some other employers may exhibit toward military spouses, whom they may see as a &ldquo;flight risk&rdquo; due to the frequent moving associated with military life.</p> <p> Our economy is changing rapidly. Thanks to cultural and technological changes, the workplace can be more flexible than ever. By reducing barriers like occupational licenses and outdated labor and tax laws, we can do more to provide better economic opportunities for military families. Our debt to them can never be repaid &ndash; but fostering better employment options would be a good start.&nbsp;&nbsp;</p> HeathMon, 6 Nov 2017 08:11:00 CSTen-usIndependent Women's ForumThere’s still time to repeal, replace ObamaCare’s Medicare board<p> Did you resolve to do something ambitious in 2017? GOP lawmakers did: They resolved (even promised) to repeal and replace the Affordable Care Act &hellip; and failed.</p> <p> But there&rsquo;s still time left in 2017 to make good on this year&rsquo;s resolutions. And lawmakers have a good chance &mdash; with an upcoming vote on Thursday &mdash; to undo one of the ACA&rsquo;s most egregious harms: the Independent Payment Advisory Board, a cost-cutting board for Medicare.</p> <p> IPAB epitomizes the ACA&rsquo;s approach to health care: great power concentrated in the hands of a few. The unelected 15-member board would ultimately have the power to cut Medicare spending without Congressional review, impacting the health access of more than 55 million seniors.</p> <p> The board has never been appointed, and it has never been triggered. If (when) Medicare&rsquo;s actuaries predict that the program will not meet a certain budget target, the Affordable Care Act empowers the board to make budget recommendations that will bear the weight of law. In the absence of a board, these powers fall to the Secretary of Health and Human Services.</p> <p> It&rsquo;s hard to argue about the harm of something that hasn&rsquo;t happened yet (which is why all reforms to Medicare are so difficult), but IPAB represents a loaded gun that threatens the program in the most undemocratic way. Statutorily, IPAB exists. It&rsquo;s only a matter of time until it is triggered by budget realities (actuaries now predict&nbsp;<a href="" target="_blank">in 2021</a>) and begins setting policy. &nbsp;</p> <p> But there&rsquo;s strong, bipartisan opposition to IPAB. Liberals don&rsquo;t like it because they typically oppose any potential cut to social programs. Conservatives don&rsquo;t like it because it represents the big-government approach to cutting healthcare dollars, which will inevitably result in the backdoor rationing of services and treatments.</p> <p> Senior advocacy groups like the AARP don&rsquo;t like it (because of the obvious effect on seniors), and constitutional watchdogs disdain its end-run around the normal budget- and law-making process. Myriad doctors&rsquo; groups don&rsquo;t want anything to come between them and patients, so they oppose IPAB as well.</p> <p> Now all of these stakeholders have the opportunity to get what they&rsquo;ve been hoping for: A vote to repeal IPAB is scheduled for Thursday in the U.S. House. This won&rsquo;t be the first time the House has voted on the controversial board; they actually voted to repeal it as far back at 2012, but the effort failed in the Senate (and of course then-President Obama would not have signed such legislation anyway).</p> <p> But now the game has changed, along with control of the Senate and the White House. Opponents of the ACA, having failed to comprehensively address the law, now have the chance to target its harmful pieces one by one, and also now with some help from across the aisle.</p> <p> Supporters of IPAB argue that the board is needed to address Medicare&rsquo;s runaway spending and keep the program fiscally solvent for future enrollees. They are right to be concerned with Medicare&rsquo;s unsustainable funding model, where today seniors use $3 of Medicare benefits for every $1 they paid in to the program (<a href="" target="_blank">on average</a>).</p> <p> But IPAB is simply the wrong way to reform Medicare. A better approach respects the individual choices of patients, rather than using one-size-fits-all, top-down cuts from an unaccountable government board. Instead of blunt cuts, Medicare needs structural reform that offers seniors more private-sector options for insurance coverage, allowing competition &mdash; instead of price controls &mdash; to hold down costs.</p> <p> Although Republicans didn&rsquo;t make good on their promise to repeal &ldquo;<a href="" target="_blank">every word of ObamaCare</a>&rdquo; this summer, they can take an important step and repeal at least the IPAB. This would be a welcome step toward protecting seniors, and would pave the way for better, patient-centered, market-driven reforms.</p> HeathThu, 2 Nov 2017 08:11:00 CSTen-usIndependent Women's ForumTax bill will ultimately make millions of Americans more financially secure • After The Bell HeathWed, 1 Nov 2017 12:11:00 CSTen-usIndependent Women's ForumStatement: IWF applauds President Trump for declaring opioid crisis a public health emergency<p> <strong>FOR IMMEDIATE RELEASE:</strong><br /> October 26, 2017</p> <h1 align="center"> <a href=",-Long-Overdue:-U.S.-Announces-It-Will-Withdraw-From-UNESCO-(Again)"><img alt="" height="157" src="" width="550" /></a></h1> <h1 align="center"> STATEMENT</h1> <h1 align="center"> <strong>Independent Women&#39;s Forum applauds President Trump for declaring opioid crisis a public health emergency</strong></h1> <p> <em>Washington, D.C.</em>&nbsp;&ndash; Independent Women&rsquo;s Forum (IWF) applauds Donald Trump for declaring a public health emergency on the opioid crisis. IWF urges the federal government to address how the crisis impacts women and children and consider the many factors, including government policies, have contributed to this epidemic.&nbsp;</p> <p> &ldquo;The opioid crisis is truly an issue worth addressing as it is devastating women, children, and families around the country at record societal levels. This public health emergency has wrecked havoc on women&#39;s health, families, and dignity,&quot; said IWF&#39;s Director of Policy Hadley Heath Manning.</p> <p> Earlier this week Independent Women&rsquo;s Forum <a href="'s-Forum-Letter-to-Commission-on-Combating-Drug-Addition-and-the-Opioid-Crisis-to-Draw-Attention-to-Impact-on-Women">sent a letter</a> to the Commission to address the epidemic and how it affects women and families. Unlike other substance abuse disorders, opioid addiction strikes women as often as it does men. But women and men experience the path to and the consequences of addiction differently.</p> <p> &quot;It is our sincere hope that this latest move by the White House can turn the tide of the opioid crisis and offer the support that women and families need.&quot;</p> <p> Independent Women&#39;s Forum has done extensive work on the opioid crisis in our latest <a href="">Policy Focus</a> and <a href="">Takeaways</a> documents.&nbsp;IWF stands ready to help the Opioid Commission and other policymakers find the best solutions to help rescue more women and families from the devastation of drug addiction.&nbsp;</p> <p style="text-align: center;"> ###</p> <p align="center"> <a href="" target="_blank"></a><br /> &nbsp;</p> <p> <em>Independent Women&#39;s Forum works to improve the lives of Americans by increasing the number of women who value free-markets and personal liberty.&nbsp;</em></p> <p> &nbsp;</p> <table> <colgroup> <col /> <col /> </colgroup> <tbody> <tr> <td> <p dir="ltr"> &nbsp;</p> <p dir="ltr"> <a href="" target="_blank"><img alt="IWF_Stacked.png" height="29" src="" width="92" /></a></p> </td> <td> <p dir="ltr"> Celia Meyer<br /> Communications Strategist<br /> <a href="" target="_blank">Independent Women&rsquo;s Forum</a><br /> <a href=""></a></p> </td> </tr> </tbody> </table> <p> &nbsp;</p> HeathThu, 26 Oct 2017 12:10:00 CSTen-usIndependent Women's ForumPerhaps the Dems doth protest too much<p> Enrollment for 2018&nbsp;<a href="" target="_blank">begins</a>&nbsp;next week (on November 1) and ends December 15. This means people who want or need health insurance for next year can sign up at or partnering websites such as Regardless, Democrats have been vocal about the enrollment period, saying it&#39;s a shorter time frame than consumers had during the Obama administration.</p> <p> &quot;They&#39;re trying to sabotage the markets,&quot; Sen. Claire McCaskill (D-Missouri)&nbsp;<a href="" target="_blank">said</a>&nbsp;earlier this month. &quot;It&#39;s now all them, it is all them &ndash; one hundred percent.&quot;</p> <p> In September, Rep. Elijah Cummings (D-Maryland) questioned reported plans by the Trump administration to do maintenance on five out of six Sundays during the 2018 enrollment period.</p> <p> &quot;It is unclear why the Trump administration needs so many more outages to maintain the site this year &ndash; after the enrollment period was shortened &ndash; and why the administration designated the first day of open enrollment season to conduct purportedly regular, non-urgent maintenance,&quot; Mr. Cummings&nbsp;<a href="" target="_blank">wrote</a>&nbsp;to then HHS Secretary Tom Price.</p> <p> The &quot;s&quot; word (<a href=";rlz=1C1GGRV_enUS751US751&amp;oq=democrats%2Benrollment%2Bsabotage&amp;aqs=chrome..69i57.7568j0j7&amp;sourceid=chrome&amp;ie=UTF-8" target="_blank">sabotage</a>) has also been used in remarks about the Trump administration&#39;s budget cuts to &quot;navigators&quot; (people who helped enrollees find insurance plans and financial assistance). For the 2018 enrollment period, agents and brokers will be made available by</p> <p style="margin-left: 40px;"> <span style="font-size:14px;"><strong><span style="color:#ffffff;"><span style="background-color:#ea425b;">&quot;I think Democrats are really making a mistake politically because&nbsp;</span></span><a href="" target="_blank"><span style="color:#ffffff;"><span style="background-color:#ea425b;">when you cry &#39;sabotage&#39;</span></span></a><span style="color:#ffffff;"><span style="background-color:#ea425b;">&nbsp;you&#39;re sort of making a tacit admission that things aren&#39;t going well, and of course Democrats still deserve most of the credit for the Affordable Care Act being the law, becoming the law, and of course they stand against any changes to the law,&quot; says Hadley Heath Manning, director of policy at the&nbsp;</span></span><a href="" target="_blank"><span style="color:#ffffff;"><span style="background-color:#ea425b;">Independent Women&#39;s Forum</span></span></a><span style="color:#ffffff;"><span style="background-color:#ea425b;">. &quot;So I think they&#39;re making a mistake in sort of ceding the debate to Republicans that the Affordable Care Act isn&#39;t working well.&quot;</span></span></strong></span></p> <p> Meanwhile, Ed Haislmaier, senior research fellow at&nbsp;<a href="" target="_blank">The Heritage Foundation</a>&nbsp;doesn&#39;t think the Trump administration is trying to sabotage enrollment.</p> <p> &quot;What the Trump administration is really doing is recognizing a reality that maybe some of the supporters of the ACA don&#39;t want to recognize,&quot; he explains. &quot;The reality is that even under President Obama, the enrollment had kind of plateaued; the program had reached about as far as it was going to go. This was not some kind of big solution to healthcare &ndash; rather it&#39;s really just another niche program for lower-income, sicker people.&quot;</p> <p> Haislmaier adds that the Obama administration wasn&#39;t able to persuade young, healthy people to sign up. He doubts the Trump administration is going to suddenly get them to sign up down the road.</p> <p> &quot;So it&#39;s not that the program is being sabotaged &ndash; it&#39;s just the reality is the program doesn&#39;t get much better than this, even if you&#39;re trying.&quot;</p> HeathThu, 26 Oct 2017 11:10:00 CSTen-usIndependent Women's ForumTrump Executive Order on Health Care Gives Relief to Consumers<p> There&rsquo;s a fundamental disagreement in healthcare policy: One side believes that the government must plan and control the behavior of all actors, including consumers, insurers, even providers. The other side believes that individuals know better than regulators what choices in care and coverage are best.&nbsp;</p> <p> With President Trump&#39;s executive order, President Trump signals that he agrees with the latter, and seeks to offer relief to American small businesses, workers, and families from the unfair high costs, and lack of choice in insurance plans created by the Affordable Care Act.</p> <p> The purpose of this EO is to give people and business new coverage options and ways to obtain insurance, and by making insurance more affordable, helping more people get covered.&nbsp;</p> <p> Defenders of the current government-controlled system predictably warn that any change that offers an escape hatch from the ACA will &ldquo;destabilize markets.&rdquo; Freedom is dangerous, folks.</p> <p> What does it say about the ACA that so many are anxious to escape in the first place?&nbsp;</p> <p> A look at the sobering reality of the ACA exchanges, where consumers are supposed to go and seek insurance policies, can answer that: Today about 30 percent of exchange consumers have only&nbsp;<em>one</em>&nbsp;insurance carrier available, now that the ACA has decimated the market.&nbsp;</p> <p> It would be hard to destabilize things further, given how many millions are already opting out entirely only to go uninsured and pay a penalty. They&rsquo;d rather do that than pay premiums for ACA plans (which have increased 105 percent in just three years) because ACA plans hardly offer protection: narrow networks and high deductibles mean little value.</p> <p> The Trump executive order aims to correct many of these harms: Instead of no choice, more competition. Instead of high costs for little value, lower costs for solid coverage. Instead of a choice between ACA plans and no plan, some new options.</p> <p> For small businesses, the executive order can allow them to bind together as associations (so long as the companies are in the same business), to purchase health plans. This will help create a fairer playing field with larger businesses, who for a long time have had a competitive advantage as insurance consumers due to their large and varied pools of employees.&nbsp;</p> <p> This idea is not new: In fact the House passed legislation to the same effect in March of this year. The bill received four votes from Democrats. And Senator Rand Paul pushed the idea in the Senate over the summer, without success.</p> <p> For consumers in the individual market &ndash; the sector most devastated by the ACA &ndash; the most important change in the executive order is the expansion of short-term insurance plans. Typically meant for people between jobs or otherwise in transition, these plans became more popular under the ACA, because consumers were attracted to their lower premiums (about one-third the premiums of ACA plans).&nbsp;</p> <p> They are not compliant with government rules, containing all the bells and whistles that Washington D.C. has determined a must. But clearly, this type of insurance is attractive to consumers looking for a way out of the ACA&rsquo;s oppressive and costly regulations. The Obama Administration took steps to squash short-term plans by limiting them to 90 days, a move that ironically hurts consumers with pre-existing conditions the most (consumers would have to undergo underwriting every 90 days). Trump&rsquo;s executive order can reverse this.&nbsp;</p> <p> Why did the Obama Administration seek to destroy these short-term plans? Possibly, it was a political effort to save the ACA, putting politics ahead of people. Or, more charitably, it was out of concern that consumers just can&rsquo;t be trusted to buy the right kind of plan.</p> <p> And this is where the Trump Administration is fundamentally different. President Trump is putting people ahead of politics in this executive order and trusting Americans to determine what health insurance plan is best for them. That&rsquo;s a big step in the right direction.&nbsp;</p> HeathWed, 25 Oct 2017 12:10:00 CSTen-usIndependent Women's ForumRelease: Independent Women's Forum Letter to Commission on Combating Drug Addition and the Opioid Crisis to Draw Attention to Impact on Women<p> WASHINGTON, D.C. - Independent Women&#39;s Forum today sent the Presidential Commission on Combating Drug Addiction and the Opioid Crisis a letter drawing attention to IW&#39;s work on the issue and urging them to pay close attention to the impact of the crisis on women.</p> <p> <span style="font-size:14px;"><strong><a href="">VIEW PDF OF LETTER</a></strong></span></p> <p style=" margin: 12px auto 6px auto; font-family: Helvetica,Arial,Sans-serif; font-style: normal; font-variant: normal; font-weight: normal; font-size: 14px; line-height: normal; font-size-adjust: none; font-stretch: normal; -x-system-font: none; display: block;"> <a href="" style="text-decoration: underline;" title="View Opioid Epidemic Letter to the Presidential Commission on Combating Drug Addiction and the Opioid Crisis on Scribd">Opioid Epidemic Letter to the Presidential Commission on Combating Drug Addiction and the Opioid Crisis</a> by <a href="" style="text-decoration: underline;" title="View Independent Women's Forum's profile on Scribd">Independent Women&#39;s Forum</a></p> <p> <iframe class="scribd_iframe_embed" data-aspect-ratio="0.7729220222793488" data-auto-height="false" frameborder="0" height="600" id="doc_56336" scrolling="no" src=";view_mode=scroll&amp;access_key=key-Eyi2sIx83Hc1aiGbBRju&amp;show_recommendations=true" title="Opioid Epidemic Letter to the Presidential Commission on Combating Drug Addiction and the Opioid Crisis" width="100%"></iframe></p> <p> &nbsp;</p> <p> &nbsp;</p> <p> <em>Dear Members of the Presidential Commission on Combating Drug Addiction and the Opioid Crisis,</em></p> <p> &nbsp;</p> <p> <em>On behalf of Independent Women&rsquo;s Forum, I write to urge you to give special attention to the ways the opioid crisis especially impacts women and children and consider the many factors, including government policies, have contributed to this epidemic.</em></p> <p> <em>Women and men are inherently and biologically different and therefore experience both the path to and the consequences of addiction in distinct ways. Your proposed solutions to the opioid crisis should take this into account.</em></p> <p> <em>Typically, substance use disorders affect men more than women. But this is not true for opioid use disorder. Perhaps this is because women:</em></p> <p style="margin-left:1.25in;"> <em>o&nbsp;&nbsp; Have a greater inflammatory response to pain than men.</em></p> <p style="margin-left:1.25in;"> <em>o&nbsp;&nbsp; Are more likely to have chronic pain.</em></p> <p style="margin-left:1.25in;"> <em>o&nbsp;&nbsp; Are more likely to get opioid prescriptions.</em></p> <p style="margin-left:1.25in;"> <em>o&nbsp;&nbsp; More frequently take these drugs for longer periods of time.</em></p> <p> <em>Men are still more likely to die from addiction, but women are closing the gap. During the years 1999 and 2010, women saw a five-fold increase in opioid-related deaths while men&rsquo;s deaths multiplied at a factor of 3.6, according to the CDC.</em></p> <p> <em>As I&rsquo;ve outlined in an enclosed policy focus for Independent Women&rsquo;s Forum, government policies, including survey questions asked by the Centers for Medicare and Medicaid Services, as well as guidance from the Joint Commission, may have contributed to the increase in opioid prescribing and addiction.&nbsp;</em></p> <p> <em>While today women are just as likely as men to become addicted, it&rsquo;s important to understand that the consequences of addiction affect women and men differently.</em></p> <p> <em>The opioid crisis has particularly dire consequences for women.</em></p> <p> <em><strong>Neonatal Opioid Withdrawal</strong></em></p> <p> <em>Sadly, incidence of neonatal abstinence syndrome (NAS)&mdash;opioid withdrawal in newborn babies&mdash;has seen a five-fold increase since the year 2000. According to the National Institute on Drug Abuse, a baby with NAS is born every 25 minutes. These infants typically have to stay in hospitals for about 17 days, compared to the 2 days for healthy newborns.</em></p> <p> <em>In addition to the suffering that this causes these innocent victims, <strong>this problem also comes at an enormous cost to our healthcare system, particularly the Medicaid program, which covers about 81 percent of babies born with NAS. </strong></em></p> <p> <em>To put numbers on it, the cost of the average hospital stay for a baby with NAS is $66,700 compared to $3,500 for a healthy baby.&nbsp; It&rsquo;s clear in this instance that preventive measures, such as strengthening Medicaid&rsquo;s response to drug addiction in pregnancy, would pay off in reduced cost when babies are born.</em></p> <p> <em>Importantly, drug abuse during pregnancy can also lead to a host of other health problems and complications. In some areas, tragically, NAS has contributed to an increase in infant mortality.</em></p> <p> <em>Among pregnant women, 17-19 percent are prescribed opioids, according to Dr. Nora Volkow, director of the National Institute on Drug Abuse. This number is too high. <strong>Every effort should be made to treat women&rsquo;s pain using alternative methods, especially during and after pregnancy</strong>. Dr. Randy Tobler, a board-certified OB-GYN and health policy expert, explained in an IWF podcast that pregnancy and the post-partum period can be especially difficult times for women to taper or stop opioid use because the time can be marked by physical pain and emotional stress.</em></p> <p> <em>Importantly, steps can be taken to ensure that women who do struggle with opioid addiction have access to contraception if it is their choice to use it. <strong>The federal Title X family planning program can be reviewed for opportunities to cooperate with drug addiction treatment programs, clinics, and centers.</strong></em></p> <p> <em><strong>Impact on Parenting</strong></em></p> <p> <em>The impact on maternal health isn&rsquo;t the only way the opioid crisis affects women and families. <strong>Opioid addiction is most likely to affect women (and men) in their prime parenting years, ages 25-54.</strong> This tragically means that the crisis is contributing to an increase in home removals by Departments of Child Services. This also makes it difficult for addicted women, who more often than men are primary (or sole) caregivers for children to commit to residential treatment programs.</em></p> <p> <em>Of course, we cannot allow children to continue to live in unsafe environments where addicted parents may neglect them or where children may even misuse opioid drugs themselves.</em></p> <p> <em>But <strong>we commend states that have experimented with holistic programs to reach out to families with young children through interagency collaboration and keep children with their parents when possible.</strong> &nbsp;These programs can be costly, and they often draw upon Medicaid funds. This underscores the importance of Medicaid reforms that will focus and strengthen the safety net for those who truly need it, rather than expanding Medicaid to pay for health care for the middle class.</em></p> <p> <em><strong>We also encourage states to explore working with private-sector partners and charitable organizations</strong> that already work to combat drug addiction in children or foster strong families.</em></p> <p> <em><strong>Women in Illicit Drug Markets</strong></em></p> <p> <em>Although opioid prescriptions decreased from 2010 to 2015 by 18 percent, <strong>opioid-related deaths remain high because addicted people often turn to illicit opioids, like synthetically produced fentanyl or heroin.</strong> It is estimated that 4-6 percent of people with opioid prescriptions turn to heroin use, and 80 percent of heroin users first misused a prescription opioid drug.</em></p> <p> <em>Because of the link to illicit drugs, the opioid crisis is also associated with an increase in HIV and Hepatitis C infections from injections for both women and men.</em></p> <p> <em><strong>Women who resort to illicit drug markets can also be drawn into sex work or face violence and exploitation.</strong> Human traffickers take advantage of addiction in women by hovering near areas of drug activity in efforts to lure desperate women in with the promise of drugs, shelter, or even food.&nbsp;</em></p> <p> <em>Traffickers sell women for sex, sometimes using online advertisements. We hope that law enforcement will be empowered with every resource necessary to fight this abuse of women and crack down on the exchange of drugs and sex.</em></p> <p> <em>Sometimes, the abuse of women isn&rsquo;t as extreme as forced sex slavery, but could take the shape of pressuring women to exchange nude photographs for drugs for small amounts of cash so that they can buy their next dose. For obvious reasons, women involved with illicit drugs will be reluctant to report any type of abuse, but <strong>providing tip lines or other anonymous reporting mechanisms could help.</strong></em></p> <p> <em><strong>Conclusion</strong></em></p> <p> <em>Obviously, the impact of addiction on women&rsquo;s lives, health, and dignity is devastating. &nbsp;The Commission should seek every avenue for helping reverse this tide of addiction and consider how policy change&mdash;including government direction to the medical community on how to respond to patient&rsquo;s reports of pain&mdash;ought to be reformed moving forward.</em></p> <p> <em>At Independent Women&rsquo;s Forum, we have studied this issue and will continue to do so. We stand ready to help the Opioid Commission in any capacity, and we commend your efforts. We respectfully request an opportunity to share our findings regarding opioid addiction and its unique impact on women, children, and families with members of the Commission. We would be honored to work with the Commission in the coming months, to ensure these issues are addressed.</em></p> <p> &nbsp;</p> <p> <em>Sincerely,</em></p> <p> <em>Hadley Heath Manning</em><br /> <em>Director of Policy</em><br /> <em>Independent Women&rsquo;s Forum</em></p> <p> &nbsp;</p> <p> <em>Enclosed:<a href=""> IWF Policy Focus: The Opioid Crisis</a></em></p> HeathTue, 24 Oct 2017 14:10:00 CSTen-usIndependent Women's ForumTakeaways: The Opioid Epidemic Effects on Women<p> Do you know anyone who has died from drug overdose? Chances are you do. It&#39;s now the #1 cause of death for Americans under age 50. Drug overdose deaths have tripled since 2000.&nbsp;Here&#39;s a quick recap of how the opioid epidemic impacts women:</p> <p> <strong style="font-size: 20px;"><a href="">GET THE FACTS (PDF/DOWNLOAD) &gt;&gt;&gt;</a></strong></p> <p style=" margin: 12px auto 6px auto; font-family: Helvetica,Arial,Sans-serif; font-style: normal; font-variant: normal; font-weight: normal; font-size: 14px; line-height: normal; font-size-adjust: none; font-stretch: normal; -x-system-font: none; display: block;"> <a href="" title="View Top Takeaways | The Opioid Epidemic Effects on Women on Scribd">Top Takeaways | The Opioid Epidemic Effects on Women</a> by <a href="" title="View Independent Women's Forum's profile on Scribd">Independent Women&#39;s Forum</a></p> <p> <iframe class="scribd_iframe_embed" data-aspect-ratio="0.23944783647464826" data-auto-height="false" frameborder="0" height="600" id="doc_49479" scrolling="no" src=";view_mode=scroll&amp;access_key=key-5IU41P3Rr5Y1BG7ax81Q&amp;show_recommendations=true" title="Top Takeaways | The Opioid Epidemic Effects on Women" width="100%"></iframe></p> <p> &nbsp;</p> HeathTue, 24 Oct 2017 14:10:00 CSTen-usIndependent Women's ForumMassachusetts shows rationing is inevitable when government is in charge of healthcare<p> Americans tend to look overseas to see how government-run health systems lead to long wait times, poor quality, and rationing of care. But sadly, there&#39;s a clear example at home in the commonwealth of Massachusetts of where socialized medicine inevitably leads.</p> <p> Because Massachusetts chose to expand Medicaid, the joint federal-state program created to pay for health services for the sick and vulnerable poor, the program now faces significant budget challenges. To cut those costs, the state is proposing, among other changes, to significantly limit benefits for all Medicaid beneficiaries, including vulnerable groups such as pregnant women and the disabled.</p> <p> Although enrollment in Massachusetts Medicaid, also known as MassHealth, was high before the expansion, approximately&nbsp;<a href=";sortModel=%7B%22colId%22:%22Total%20Medicaid%20Enrollment%22,%22sort%22:%22desc%22%7D" target="_blank">400,000 more beneficiaries</a>have been added since 2014, bringing total enrollment to 1.85 million people. MassHealth now covers more than one in four commonwealth residents and has expanded well beyond being a safety net to being a major insurer in the state.</p> <p> Spending on the program has ballooned as a result, increasing&nbsp;<a href="" target="_blank">by more than $1 billion</a>&nbsp;in the initial year of the expansion. Massachusetts now spends&nbsp;<a href="" target="_blank">40 cents</a>&nbsp;of every state tax dollar on the Medicaid program and budget pressures are driving a proposal to amend the agreement, technically a waiver, between the federal and state government about how the program operates.</p> <p> Massachusetts&#39; proposal includes many changes, but among them is a &quot;closed formulary&quot; for Medicaid beneficiaries. This means the program may offer only one drug per class (a class is something like antidepressants or anticonvulsants used to prevent seizures). For patients, this means the government will essentially dictate to physicians how to treat patients, interfering between patients and doctors.</p> <p> Of course, we can all respect the impulse to be frugal with taxpayer dollars. Yet, some research&nbsp;<a href="" target="_blank">suggests</a>&nbsp;that restricting drug access can sometimes increase overall health costs due to increased hospitalizations.</p> <p> There are better ways for Massachusetts to reform Medicaid to protect both taxpayers&#39; interests and ensure that vulnerable populations have access to the healthcare and insurance they need.</p> <p> The most compassionate policy would put the needs of the most vulnerable first. Rather than ration care, Massachusetts and other states should focus on moving as many able-bodied adults as possible off of the Medicaid rolls into private insurance plans, in order to preserve and strengthen the program for those who truly have no other option.</p> <p> Notably, Massachusetts&#39; latest proposal does take steps in this direction, by moving current nondisabled Medicaid beneficiaries with incomes over the poverty level to CommonwealthCare, where they can find subsidized private insurance plans. This would benefit both those who leave and those who stay in MassHealth: Private plans typically offer greater provider networks and better access to care and the Medicaid program would be relieved of a significant budget burden because of this shift. This idea &mdash; moving beneficiaries out of MassHealth into competitive private plans &mdash; should be the focus, rather than restricting benefits.</p> <p> Of course, competition will only work if our insurance markets are free to compete. The Affordable Care Act significantly limits competition by dictating what all insurance plans must cover and regulating how plans are priced and sold. This has caused premiums to increase dramatically, making it harder for consumers at all income levels to find coverage they can afford.</p> <p> The real lesson from Massachusetts is that a safety net stretched too wide will also wear thin, putting at risk those for whom the safety net is truly intended.</p> <p> This should serve as a cautionary tale about the Medicaid expansion in particular and about government-run healthcare in general. We all want to help low- and middle-income Americans who now face skyrocketing private insurance premiums. But the best way to do that is to reform the private market and foster greater competition so that more affordable plans are available.</p> <p> The answer is not to throw millions into a program that should be only for the most vulnerable people, and then serving everyone poorly. To strengthen the safety net, make it smaller.</p> HeathFri, 20 Oct 2017 14:10:00 CSTen-usIndependent Women's ForumOpioid epidemic exposé simplifies America's real path to addiction<p> In a joint&nbsp;<a href="" target="_blank">investigation</a>&nbsp;with the Washington Post, CBS 60 Minutes correspondent Bill Whitaker recently explored the&nbsp;<a href="" target="_blank">opioid crisis and its causes</a>, concluding that a 2016 law&nbsp;<a href="" target="_blank">contributed</a>&nbsp;to the epidemic by diminishing the power of the nation&rsquo;s biggest drug busters, the Drug Enforcement Agency (DEA).</p> <p> The segment cast characters in a rather simplistic story about good guys (DEA officers) versus bad guys (the pharmaceutical industry and politicians who were in their pocket). Given present cynicism toward &ldquo;the political swamp,&rdquo; it would be easy to believe.</p> <p> But this over-simplified narrative misses some of the roots of the opioid problem, which took hold long before 2016. Between 1999 and 2015, opioid-related deaths&nbsp;<a href="" target="_blank">quadrupled</a>. Only in recent years have there been efforts to stem the epidemic, and on a positive note, opioid prescriptions have&nbsp;<a href="" target="_blank">decreased</a>about 18 percent between 2010 and 2015. Much of the challenge now lies in combatting illicit opioids, including heroin and synthetically-produced fentanyl.</p> <p> Certainly our public policies played a role in fostering the initial wave of legal opioid prescriptions, but perhaps surprisingly, these were nice-sounding policies pushed with very good intentions, not evil efforts to gut enforcement agencies or enrich big business.</p> <p> For example, the Centers for Medicare and Medicaid Services use, among other inputs, customer satisfaction surveys to determine payments to providers. Most people may agree that customer satisfaction is important and worthy of measuring and maximizing, but for years &ndash; until a very recent change in January of this year &ndash; these surveys included questions about pain management. &nbsp;</p> <p> If patients weren&rsquo;t satisfied with how their doctors treated their pain, doctors were dinged. This represents one of the challenges of medicine: doing what pleases patients in the short run isn&rsquo;t always what&rsquo;s best for their long-run health. Sadly, these survey questions encouraged a bad culture in hospitals of over-prescribing opioids for pain management.</p> <p> Here&rsquo;s another example: The Joint Commission (JC, formerly known as the Joint Commission on the Accreditation of Healthcare Organizations)&nbsp;<a href="" target="_blank">encouraged</a>&nbsp;very aggressive pain assessment guidelines. This may not sound like an influential factor, but it&rsquo;s important to understand the JC&rsquo;s role: It operates under a unique statutory mandate to accredit hospitals to work with Medicare and Medicaid, giving it enormous power to dictate hospital policy. &nbsp;Medicare and Medicaid are the biggest payers in our health system. Hospitals badly need this accreditation.</p> <p> Last year, dozens of health providers and groups sent a&nbsp;<a href="" target="_blank">letter</a>&nbsp;to the JC, saying that its standards &ldquo;encourage unnecessary, unhelpful, and unsafe pain treatments that interfere with primary disease management.&rdquo; The letter asked that JC change its standards to allow individual clinicians to use their judgment for pain assessment rather than mandating routine pain assessment.</p> <p> Advocacy organizations played a role in all of this as well: The American Pain Society began a campaign as early as the 1990&rsquo;s to elevate pain to be the &ldquo;<a href="" target="_blank">fifth vital sign.</a>&rdquo; This was obviously an effort to ensure that providers took their patients&rsquo; pain seriously, but pain, unlike other vital signs like temperature and heart rate, cannot be measured objectively. Asking patients to report their own pain sadly opens the door to addicts who want to abuse the system.</p> <p> It would be comforting if we could reduce the opioid crisis to a simple narrative about bad actors and their innocent victims. But reality is more complex than that. Even policies crafted with the best of intentions in wanting to help and comfort patients can end up causing harm. And in this case, our government&rsquo;s central planning and over-standardization contributed to the opioid crisis.</p> <p> This should be warning for the future: Instead of heavy-handed guidelines and rules, the best patient protection is to empower individual physicians to use their own clinical judgment, without any pressure to prescribe pain pills or meet certain government-imposed metrics. Policies have to be judged by their outcomes, not just their intentions.</p> HeathThu, 19 Oct 2017 14:10:00 CSTen-usIndependent Women's ForumParties reach health care deal, but no real winners?<p> Senators are talking up a bipartisan deal to continue subsidies that President Donald Trump said he would cut off.</p> <p> Sen. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) maintain that their plan would stabilize health insurance markets by funding the Cost-Sharing Reduction (CSR) payments for two years. The payments are meant to go to insurers and help lower co-pays, deductibles and other out-of-pocket expenses.</p> <p> However, House Republicans argue that they never appropriated the money and sued the Obama administration for improperly funding the CSRs. A federal judge ruled against the administration in 2016.</p> <p> <a href="" target="_blank">Heritage Foundation</a>&nbsp;Senior Research Fellow Ed Haislmaier insists that the CSRs set up by former President Barack Obama misled the American public.</p> <p> &quot;Basically, the Cost-Sharing Reduction subsidies &ndash; paying those is really about stabilizing federal funding of subsidies,&rdquo; Haislmaier asserted. &ldquo;It&#39;s not about stabilizing the market. The market consists of those people who are getting subsidized coverage, but it&#39;s also people who are not subsidized, and they are the ones who are really hurting.&rdquo;</p> <p> In fact, the so-called CSRs actually stuck it to the very people they were supposed to help out.</p> <p> &ldquo;They are the ones who have been paying higher premiums, higher deductibles, [seeing] fewer choices and getting nothing &ndash; no subsidies or anything else in return,&rdquo; Haislmaier pointed out. &ldquo;So, to stabilize the unsubsidized market, you have to remove the things in Obamacare that are increasing their costs &ndash; the insurance mandates and regulations. So, &hellip; the question is whether the deal will have enough of that in it to be worthwhile.&quot;</p> <p> He also contends that these are different subsidies than those helping people offset the cost of their health insurance premiums.</p> <p> &quot;Contrary to all the hollering, none of these people are going to lose their coverage,&quot; Haislmaier contended. &quot;They&#39;re not even going to lose their subsidies.&quot;</p> <p> Too early to tell?</p> <p> More uncertainty about the toll of the health care deal reached between Alexander and Murray was expressed by <span style="font-size:14px;"><strong><span style="color:#ffffff;"><span style="background-color:#ea425b;">Hadley Heath Manning of the&nbsp;</span></span><a href="" target="_blank"><span style="color:#ffffff;"><span style="background-color:#ea425b;">Independent Women&rsquo;s Forum</span></span></a><span style="color:#ffffff;"><span style="background-color:#ea425b;">, a take on what both parties can expect was given.</span></span></strong></span></p> <p style="margin-left: 40px;"> <span style="color:#ffffff;"><span style="font-size:14px;"><strong><span style="background-color:#ea425b;">&quot;[A] lot of the details remain yet to be seen [about the deal],&rdquo; Manning shared when asked about its impact. &ldquo;It&#39;s obvious what Democrats get out of this deal. They get an extension of the Cost-Sharing Reduction payments that the Obama administration was sending out without congressional appropriation.&rdquo;</span></strong></span></span></p> <p> And here&rsquo;s what conservatives in the nation&rsquo;s capital are expecting from the deal.</p> <p style="margin-left: 40px;"> <span style="color:#ffffff;"><span style="font-size:14px;"><strong><span style="background-color:#ea425b;">&ldquo;On the other hand, Republicans are saying that the deal will include increased flexibility for states, but we don&#39;t know what that will look like yet,&rdquo; Manning pointed out. &ldquo;In fact, we do know it&#39;s not going to include any flexibility on the so-called essential health benefits or the laundry list of services and features that insurance plans have to have. So, with that in mind, I understand it&#39;s a compromise. There&#39;s some give and take, but knowing so little about the details so far, it&#39;s hard to say if it&#39;s a good deal or not.&quot;</span></strong></span></span></p> <p> Q: These cost-sharing reduction payments or subsidies are different from the subsidies that help offset the cost of a person&#39;s premiums, correct?</p> <p> She was then agreed that the CSR payments or subsidies are not the same as the subsidies that helped to offset the cost of premiums paid out by individual with coverage.</p> <p style="margin-left: 40px;"> <span style="color:#ffffff;"><span style="font-size:14px;"><strong><span style="background-color:#ea425b;">&ldquo;The premium support subsidies were appropriated by Congress,&rdquo; Manning informed. &ldquo;They are legal. They apply to anyone who is earning 400 percent of the federal poverty level, down to 100 percent of the federal poverty level &ndash; and you can get them in any of the state-based exchanges, or [at] the federal exchange where people buy ACA plans.&rdquo;</span></strong></span></span></p> <p> It was then noted that the money from the program gets funneled to the insurance companies &ndash; not the poor who need it.</p> <p style="margin-left: 40px;"> <span style="color:#ffffff;"><span style="font-size:14px;"><strong><span style="background-color:#ea425b;">&ldquo;The Cost-Sharing Reduction payments are not made to low-income people,&rdquo; Manning emphasized. &ldquo;In fact, none of the subsidies are made to low-income people, but they&#39;re made to insurance companies with the idea that these payments help health insurance companies lower the out-of-pocket costs for people who earn 250 percent of the federal poverty level or below.&rdquo;</span></strong></span></span></p> <p> And the illegality of the program was also mentioned.</p> <p style="margin-left: 40px;"> <span style="color:#ffffff;"><span style="font-size:14px;"><strong><span style="background-color:#ea425b;">&ldquo;So, it&#39;s a different set of consumers who qualify for Cost-Sharing Reduction, and the cost-sharing reduction payments that were going out were going out illegally without congressional appropriation,&rdquo; Manning impressed. &ldquo;They were the subject of litigation in federal court. In fact, one federal court found them unconstitutional. They were operating under a stay until president trump said they would stop.&rdquo;</span></strong></span></span></p> HeathThu, 19 Oct 2017 12:10:00 CSTen-usIndependent Women's ForumWill the bipartisan healthcare bill survive the President's criticism? • Kennedy HeathThu, 19 Oct 2017 08:10:00 CSTen-usIndependent Women's ForumPolicy Focus: The Opioid Epidemic<p> America has an opioid overdose epidemic. Opioid overdose now claims 91 American lives each day, and more than 1,000 people visit emergency rooms daily due to the misuse of opioid drugs. In August 2017, President Trump declared a National State of Emergency regarding opioid abuse.</p> <p> Opioids are drugs that act on the nervous system to reduce pain, including legal prescription drugs like oxycodone, hydrocodone, codeine, and morphine, as well as the illegal drug heroin. While legal opioids are safe when used properly under doctor&rsquo;s orders, they can be harmful if misused. Overdose happens by depressing the body&rsquo;s respiratory system, and breathing stops.</p> <p> Opioid addiction does not discriminate: It can happen to people of all races, all incomes, both male and female. However, addiction can have unique consequences for women, especially expectant mothers whose babies may suffer from withdrawal.</p> <p> Many factors have contributed to the recent surge in opioid addiction: Advocacy groups pressured health providers to be more aggressive in treating pain. Government policies fostered incentives for prescribing pain medications. Insurance plans, including Medicaid and Medicare, often covered opioids but not other pain-management treatments. And other economic factors&mdash;like joblessness&mdash;led to spikes in drug addiction as well.</p> <p> However, we may be beginning to turn the tide in the fight against opioid abuse. Education&mdash;for policymakers, doctors and patients&mdash;is the first step. Positive policy changes can help empower health providers by relieving the pressure to prescribe drugs in response to pain.&nbsp;</p> <p> <a href=""><img alt="" src="" style="width: 550px; height: 91px;" /></a></p> <p style=" margin: 12px auto 6px auto; font-family: Helvetica,Arial,Sans-serif; font-style: normal; font-variant: normal; font-weight: normal; font-size: 14px; line-height: normal; font-size-adjust: none; font-stretch: normal; -x-system-font: none; display: block;"> <a href="" style="text-decoration: underline;" title="View The Opioid Epidemic | Policy Focus on Scribd">The Opioid Epidemic | Policy Focus</a> by <a href="" style="text-decoration: underline;" title="View Independent Women's Forum's profile on Scribd">Independent Women&#39;s Forum</a></p> <p> <iframe class="scribd_iframe_embed" data-aspect-ratio="0.7729220222793488" data-auto-height="false" frameborder="0" height="600" id="doc_49688" scrolling="no" src=";view_mode=scroll&amp;access_key=key-11RMjjb1b8gospolndTv&amp;show_recommendations=true" title="The Opioid Epidemic | Policy Focus" width="100%"></iframe></p> <p> &nbsp;</p> HeathTue, 17 Oct 2017 09:10:00 CSTen-usIndependent Women's Forum