text:
1980 - Iasos - The Paradise Bird of Endless Melodies
anonymous asked:
Could you give some examples of the sweet nothings QN and STARISH would say to their s/o?
1980 - Iasos - The Paradise Bird of Endless Melodies
You are the best thing that has ever happened to me. And if the universe tells me otherwise, I will defy all laws of gravity that tries to pull me away from you, because without you, I don't know what the taste of life is anymore.
➤ pairing: jimin | reader ; royalty!au pauper!jimin
➤ words: 4.9k
➤ genre: angst with potential fluff
(okay this is just gonna make you relieved) ➤ summary: royalty was no adventure to you. but when you find yourself in depths of the kingdom for the first time, you didn't expect to find your favourite adventure in the heart of a pauper florist.
➤ a/n: i'm so fucking sorry for this oNE MONTH LATE UPDATE i drafted this 81273021847 too many times but thank you @yoongsigh for actually being an actual angel and support my late nights to commit to this. so here it is, the…..nOT FINAL CHAPTER.
The house felt quieter, a little more grueling with the silent self-abhorrence reeking the atmosphere and a little less hopeful with shattering dreams scattering at the foot of the door of the bedroom down the hall of the cottage.
It used to hold sonorous symphonies of endless laughter and melodies with mellifluous singing that bounced off the walls, the sweet giggles and contagious laughter that spread life to this flower cottage. It was the very voice that Jimin fell in love with, the one that he learns in hushed whispers as they spoke arbitrary declarations and confessions together under the night blue sky. The very one that he listens to lovingly as you ramble on and on about your hopes and dreams. It's the very one he heard in all sorts of pitches and timbres, echoing in the back of his head like an unforgettable memory he couldn't ignore.
It's the very thing he heard broke in utter devastation as he watches you whisper goodbye, faint and weak, your figure disappearing in the nefarious mischief of the night.
Jimin doesn't remember what heartbreak feels like. He recalls the first flowers he plants in the garden, as he sobs quietly at the dying roses in his hands because he didn't take care of it enough. It was difficult to forget - the numbing feeling, the regret and unbearable thought of loss. Jimin particularly doesn't remember what the side effect was but now he does feel it, right to the bones, piercing and spreading in him like a toxic poison, injecting his heart and soul in all the right and wrong places. Its like something in him withered because he just didn't take care of it enough.
The hall was alive with high-spirited festivities and the enjoyment of company. Golden lights adorned the deep red beams of the Tsutsujigasaki palace and music flowed through the crisp, autumn air somewhere between the conversation and laughter. The clatter of dishes being carried to and from the main hall as well as the clinking of sake bottles seemed to punctuate the music in its own creative way.
You had been busy at work, your long hair tied back in order to keep it out of the meals that you had been preparing. To your relief, there were fewer dishes going out at this point in time, which meant that soon you would be finished with your work and able to get some air. Despite the chill of the late autumn air, it tended to get hot in the kitchens. The other maids had already joined the party in the main hall, but you didn't mind, afterall they had promised that they would take care of the clean-up afterwards. You put away the rest of the unused ingredients before stopping in front of the wide window above the stoves.
You gazed out the window longingly, even though you would have some time to yourself, you wouldn't be able to spend it with who you wished to the most. Your thoughts ghosted to the memories of him. Standing in the snow, his long scarf fluttering in the wind elegantly like butterfly wings, his breath small clouds as he gazed at you, a look of adoration clear in his bright eyes. Your heart longed to see him so badly that it made your chest tighten with the weight of your yearning heart.
Something shifted in the darkness beyond the window, just outside of the lantern's gentle glow. Your eyes flitted to the mysterious movement.
That's impossible, you half-mocked yourself for the hope even alighting in your mind.Your hands gripped your kimono as silent tears welled in your eyes, blurring your vision. What am I thinking? He told me he wanted me to be happy, so why am I-
Hastily you wiped away the tears, before taking a deep breath and turning to resume your work.
As you turned away from the window, out of the corner of your eye you could have sworn you saw a tall figure looming in the doorway. You whirled back around, gazing wide-eyed at where it had been just a moment ago. It was gone. The tears seemed to flow anew, staining your kimono and falling down your cheeks as painful sobs began to wrack your body.
"Why are you crying?" A low, familiar voice spoke as you felt warm arms pull you into an embrace, your bodies fitting together perfectly.
You gazed up in disbelief, there was no way-
But there he stood, sending all your disbelieving thoughts into the void.
"Hotaru?" Your tears increased, but the bitterness was gone, all that remained was their sweetness. He kiss them away, warming your cheeks and sending ripples of warmth through you like drops of water on the surface of a calm lake.
"Shh… It's okay, I'm here, so please don't cry." Hotaru smiled sadly, that smile that held a thousand emotions.
You wrapped your arms tightly around his neck as he leaned down to press his forehead gently against yours. You wished this moment would last forever, that time would stand still, the rest of the world be damned, just let the two of you hold each other within the embrace of tranquility.
"I- I missed you so much." Your voice was barely a hoarse whisper as your eyes met his gentle ones. They were so deep you felt you could get lost in them.
"I missed you too." He murmured as his hand gently caressed your face, the pads of his fingers tickling your cheeks affectionately while his other hand let your hair down," I thought I would die if I didn't see you again."
"Hotaru-" your voice broke, tears threatening to return, but his lips chased away all of your thoughts, gently, lovingly, passionately. Your eyelids fluttered shut as his warmth enveloped you and you became lost in his familiar scent. The smell of the hearth, of fire, ash, and the heat that seemed to linger like burning coals within his amber eyes. He was your universe, your timelines intertwining in this moment to become the braided strands of fate that united the two of you over and over again.
He broke the kiss gently,"I want to show you something."
You simply nodded in reply, the flushed color of your cheeks gilding your affectionate smile.
The two of you ran down the halls, hand in hand, like two young deer bounding after one-another in the meadows. His footsteps were soundless, like snow falling, your footfalls eagerly rushing after him with childlike glee. As the two of you neared the edge of the engawa he suddenly stopped, you practically collided with him laughing, your hair cascading around the two of you. His eyes narrowed mischievously as he swept you up into his arms effortlessly and swung the two of you up onto the rooftop with expert skill. You clung to him tightly as your heart leapt into your throat, the two of you were so high up, you could see all of the Tsutsujigasaki's palace grounds from here.
"It's alright, I've got you, and I don't plan on letting go." He gazed at you warmly as you did your best to relax in his arms, the hammering of your heart was not entirely from the excitement. You could hear his heartbeat hammering as your head moved with the rise and fall of his chest.
"Look." He whispered, his breath tickling the shell of your ear.
You raised your chin skywards. The sky was simply breathtaking. So vast, the stars more numerous than grains of sand on a seashore, shining brighter than beacons on the mountain peaks. The clouds shifted so that the moon shone on the two of you as you basked in its ethereal radiance.
"Hotaru, it's beautiful-" Your words caught in your mouth as you saw the stars reflected in his keen eyes, millions of galaxies all contained within his amber irises.
He smiled again, and you felt as if your heart would take flight from your very chest.
"That's not all-" He squeezed your thigh affectionately before leaping from the rooftop. You held on tight, trusting him with your very life as the two of you plummeted towards the earth. Hotaru's arm left your legs to grasp you firmly with his other arm. You squeezed your eyes shut, the wind roaring in your ears. But the impact never came, you slowly opened your eyes to see Hotaru smiling down at you as the two of you swung from a silver chain that gleamed with metallic vibrance in the moonlight.
When your bare feet finally touched the ground again, the two of you were in a secluded forest glen within the castle grounds. The only presence watching the two of you was the moon itself as it traced its course across the endless, starry sky. The melodious music from the castle seemed to float on the wind down to where the two of you stood.
Wordlessly he knelt down on one knee, grasping both of your hands gently in his own larger ones.
"May I have this dance?" He bowed his head to place a soft kiss on your hand.
Your heart fluttered at the gentle caress of his lips,"Yes…"
He grinned broadly, an expression he rarely wore due to his more reserved expressions. You returned his smile, glowing with happiness as he rose and began to guide you through the steps.
The two of you moved as one, with the grace of butterflies fluttering to meet each other over and over again in the sky. He twirled you around, letting your hair alight on the wind freely as you laughed with joyous mirth. He tugged you back to him and you once more met his chest, your free hand coming to rest on his broad shoulder. As the music increased in momentum, the two of you danced in synchronization with the rising and falling of the notes. Your breaths mingled together in little warm clouds as the dance continued to sway your forms back and forth as if you two were under a spell. Hotaru picked you up by your waist and raised you up to the night sky as you spread your arms laughing. He brought you back down to earth and ran one of his hands through your hair as you continued to dance around him. A great wind came through the trees, circling through the clearing where the two of you were dancing. And then it happened. As if they fell from the trees like fall leaves, hundreds of swallowtail butterflies soared through the air around the two of you, alighting on Hotaru's scarf and your hair as the two of you danced in the clearing. They circled around the two of you, their vibrant, sapphire wings reflecting the moonlight causing an azure glow to hang in the air.
As they flew off into the night, Hotaru closed the space between the two of you, his lips melding with yours passionately, stealing your breath away. He lightly tugged at your lower lip with his teeth, asking, begging for entrance. You opened your mouth and his tongue explored your mouth with a hunger unlike any you had ever experienced before.
When you both finally came up for air, he was now nose-to-nose with you as he gazed into your eyes panting heavily," I love you."
You felt the color blossom in your cheeks as you smiled,"I love you too. I can't live without you." Your shoulders began to shake as you realized that you didn't know when he was leaving, or how much time you would have together. He seemed to understand, leaning in to place a slow, gentle kiss on your forehead.
"I'm not going anywhere, I'm staying here for a good long time." His voice reassured you gently as his lean body drew closer to yours, his voice rumbling gently in his chest as he nuzzled into the crook of your neck.
~ ~ ~ ~ ~ ~ ~ ~ ~ ~
That night the two of you slept snuggled up together in your futon, his scarf wrapped around you and your arms around each-other.
Endless Shore
Made by idealsofthefallen, ArgusDreamer
Melody's Echo Chamber - Endless Shore
anonymous asked:
Could you give some examples of the sweet nothings QN and STARISH would say to their s/o?
Natsuki: You're easily the most wonderful thing in my life
Tokiya: I treasure you, every bit of you
Cecil: You are my endless melody
Ren: I think that dress should come off
Otoya: You're the best thing that ever happened to me
Syo: Thank you for being so good to me
Masato: If you were cheese, I'd want to be your macaroni #StopMasato2K15
Reiji: My favorite place to be is inside one of your hugs
Camus: You're the one - the only one - that I want.
Ranmaru: You drive me crazy
Ai: I miss you when you're not around, cant you stay longer?
Endless Shore / Melody's Echo Chamber
Some thoughts:
One of the things that intrigues me most about this chapter (and about the Silm in general) is that it is meant to be told by an in-universe narrator, with all of the bias and inaccuracy that implies. In terms of the rest of the Silm, you wouldn't know that unless you had read through the HoME, but here it is stated right here at the end of the chapter that "what has here been declared is come from the Valar themselves, with whom the Eldalie spoke in the land of Valinor".
and so given that the Valar are like, these huge elemental forces of nature trying to narrate the story of creation to the elves, who are naturally not going to be able to understand it as the Valar do and will come to the story with preconceived ideas and values which shape how they retell it, what was it really like? How much of the story is accurate?
I feel like this kind of thing leaves people a lot of opportunity to play around with canon and reinterpret things from different perspectives, which is a kind of engagement with the text that I really enjoy.
Other things:
anonymous asked:
When you pray to a god or goddess do you just think it or say it out loud or what? I guess I'm asking how you pray, in general?
I am going to try to answer your question, sweet Anon, but I need to talk about the difference between prayers and hymns first. Probably the best definition of 'prayer' I have ever happened upon was by William D. Fuley, who says: "prayers (and hymns) are attempts by men and women to communicate with gods by means of the voice". It is simple, elegant, and accurate. Especially in the ancient Hellenic religion, it was important to raise one's voice when hymns were sung, and especially so when prayers were made.
I am going to generalize here and say that a hymn was sung to the Theoi, with the aim to please the God in question. They have a beginning, middle, and end. The beginning contains two things: a note that the hymn is about to begin, and an announcement of whom the speaker/singer is addressing. In the Orphic hymn to Pan, this is beautifully done:"I Call strong Pan, the substance of the whole, etherial, marine, earthly, general soul, Immortal fire; for all the world is thine, and all are parts of thee, O pow'r divine. Come, blessed Pan, whom rural haunts delight, come, leaping, agile, wand'ring, starry light;"
The middle part tends to focus on why the God or Goddess in question is not only the best in solving the problem that will be posed to Them later on in prayer, but why they are the best, period. The middle section contains all the wonderful things the deity in question has done, His or Her greatest accomplishments, and above all, it contains a description of the deity. For Pan:"The Hours and Seasons [Horai], wait thy high command, and round thy throne in graceful order stand. Goat-footed, horned, Bacchanalian Pan, fanatic pow'r, from whom the world began, Whose various parts by thee inspir'd, combine in endless dance and melody divine. In thee a refuge from our fears we find, those fears peculiar to the human kind. Thee shepherds, streams of water, goats rejoice, thou lov'st the chace, and Echo's secret voice: The sportive nymphs, thy ev'ry step attend, and all thy works fulfill their destin'd end.O all-producing pow'r, much-fam'd, divine, the world's great ruler, rich increase is thine. All-fertile Pæan, heav'nly splendor pure, in fruits rejoicing, and in caves obscure. True serpent-horned Jove [Zeus], whose dreadful rage when rous'd, 'tis hard for mortals to asswage. By thee the earth wide-bosom'd deep and long, stands on a basis permanent and strong. Th' unwearied waters of the rolling sea, profoundly spreading, yield to thy decree. Old Ocean too reveres thy high command, whose liquid arms begirt the solid land.The spacious air, whose nutrimental fire, and vivid blasts, the heat of life inspire the lighter frame of fire, whose sparkling eye shines on the summit of the azure sky, Submit alike to thee, whole general sway all parts of matter, various form'd obey. All nature's change thro' thy protecting care, and all mankind thy lib'ral bounties share: For these where'er dispers'd thro' boundless space, still find thy providence support their race."
The end is a prayer onto itself. The surviving hymns often conclude with a call to the deity in question to listen to the request that follows, and to grant it, should They be so inclined. The hymn to Pan concludes:"Come, Bacchanalian, blessed power draw near, fanatic Pan, thy humble suppliant hear, Propitious to these holy rites attend, and grant my life may meet a prosp'rous end; Drive panic Fury too, wherever found, from human kind, to earth's remotest bound."
Hymns were sung to please, to bring forth. It was a way to celebrate the Deity in question, but also to make Him or Her more inclined to grant the following request. Hymns were accompanied with music and dancing; they were true celebrations in that regard. They were performed to establish existing kharis and built upon it: when the Orphic Hymns ask for 'a hymn' instead of incense, they request a show that entertains the Gods.
A prayer was carefully formulated to convey a message as persuasively as possible to the God, and was thus often spoken. The idea was not to please, but to request. They made use of the established and just now strengthened kharis to petition the Gods for aid. Where the hymn is an offering to go along with material sacrifice, the prayer is not an offering at all.
Hellenic prayer and hymn-singing is not a private thing; unlike the Christian type of praying we are used to today—a praying that is intimate, calm, and very much private—the Hellenic form of praying did and does everything it can to draw attention to itself as a public display. It is a form of heightened expression which claims the attention of a God. Hymns are a means to get a divine spotlight upon you, because without it, your prayer will fall upon deaf ears. This is why hymns and prayers always go together in the typical structure of (ancient) Hellenic ritual: one is useless without the other.
Ancient Hellenic prayers were made standing up, with arms raised. If you were the one pouring libations, the arms needn't be raised as high, but the libation-bowl was poised. For the Ouranic deities, the palms faced upwards, to the sky. For the Khthonic deities, the palms faced downwards, to the earth. To both, the voice is raised, so as to draw as much attention as possible. In general, that is how you pray in Hellenismos.
meowstic-seer-of-the-future asked:
When I closed my eyes and felt with my hand, I heard the beats in the depths of my chest. I'm sending this endless melody to the nameless you.
The rusted instruments were an illusion in the depths of the ocean.
1. I'm 5' built of the remains of the universe. Galaxies run through my veins. My bones are sculpted of gold. I shimmer. I shine. Tiny but mighty. I was always born from better things it just took me awhile to break the porcelain concealing it all away and find the sun resting right at my core.
2. Ever since I was small as soon as I hit the ground I'd pick myself back up and keep on running. It's just my way of being. I never stop going, even when the rest of the see through world constructed of glass and fragile things around me begins to shatter. I pick up every single piece and try to turn it into something new.
3. Every single person I've come across says differently about what color my eyes are. Blue, green, gray, hazel. All of the above. Multiple choice. They change. The first person who loved me told me I had oceans in my eyes. My family always said it switched depending on the lighting or the weather or what I was wearing like some sort of mood ring. I still haven't settled on an actual share and I quite like that.
4. My lips have met with 19 (ish) other pairs. Yet I've only ever spilled confessions of love to 1 out of the 19. I think I've forgotten what it feels like to want to breathe another human in until they've replaced all the oxygen with them. Til my rib cages break, so everything I feel for them and everything they feel for me consumes us both. Leaving us with heavy hearts and light heads.
5. I carry the entire world on my shoulders. I offer to lighten others loads only to increase my own. I've always been like this. Until my back begins to bend and I crumble for everyone else. I'm atlas. I keep the sky above everyone's heads because If I let go it call comes crashing down.
6. Music has always kept my soul going. It's my fire. It's my fuel. Rough finger tips and worn down strings. Secretly lyrics and endless melodies. I'm sorry for the stories I've confessed. I'm sorry for the things I've not spoken but sang. To the world. I'm also not sorry because they were mine to tell. If you don't want the last word then I'll snatch it up without hesitation.
7. I used to pour my heart out to anyone who would listen. I would throw it into shaking hands because it was just too heavy for me. I couldn't take it along with the sky on my shoulders. But that's not how you handle a heart. You don't toss it to the first person who smiles at you on the street or offers an umbrella in the storm. You have someone lock their fingers into your own and carry theirs along side you.
8. I'm a patchwork person. I have so many different sides to me. I don't think any one of them is the 'REAL' one. Every single stitch makes up who I am. Sometimes I show one side more then the others. Sometimes I hide certain parts that I don't think people are ready to see yet or understand. It doesn't make me fake. It makes me cautious.
9. I've always hated being stuck in one place for too long. I'm a wanderer. Even if I can't get that far I will run and run and run until my legs give out and my lungs burn just to feel alive again. If I stay dormant for too long I bubble up and I burst. I'm a volcano. I'm a mountain. I've got to stay on my toes or else everything becomes too blurry to understand.
10. I've always felt like I had a clear idea of who I am. A strong sense of self. Now I realize that I'm constantly in a state of flux. I will never ever be my 'TRUE' self because whoever I am right now is who I am. Tomorrow I may be a completely different person. I may have my ideas or views changed. Growths is a part of life. It's okay not to be 100% sure of myself every step of the way. I've never been much for street signs or maps. I'm much more a landmarks person. But I will get there, I just got to do it my way.
so I was listening to the track tolkienreadalong used for the readalong trailer
and I suddenly got hit with all these feels. and i don't know whether it was intentional or not, but there are three main themes in the final pitch
there are three main themes in ainulindale.
"Then the voices of the Ainur […] began to fashion the theme of Iluvatar to a great music; and a sound arose of endless interchanging melodies woven in harmony. […] Iluvatar sat and hearkened, and for a great while it seemed good to him, for in the music there were no flaws."
the first in the final pitch is very melodic, like the theme is discovering itself, almost exploring? SO I'M GETTING ALL THESE FEELS. BECAUSE THE BEGINNING IS JUST REALLY SOFT AND THE MELODIES KINDA WIND AROUND OTHER LIKE THEY'RE HESITANT AND DISCOVERING THEIR POTENTIALwith the piano and the strings and that one little triangle and everything else and justjkglfjd
But as the theme progressed, it came into the heart of Melkor to interweave matters of his own imagining that were not in accord with the theme of Iluvatar […] and straightaway discord arose around him […] but Iluvatar sat and hearkened until it seemed that about his throne there was a raging storm, as of dark waters thaat made war upon one another in an endless wrath that would not be assuaged. The Iluvatar arose […] and he lifted up his hand, and a new theme began amid the storm, like and yet unlike to the former theme, and it gathered power and had new beauty.
and then the third movement starts and there's a break of … stunned silence, kinda? and then it's just "everything has gone to hell" but there's still the counter-melodies that you heard in the beginning and the vocals get more intense and chant-like? and there's new ideas that are introduced and built on but everything new eventually gets woven back into the main theme that's going on originally but it's mostly in the background at this point? except it slowly grows again and comes back to the forefront
Then again Iluvatar arose {…} and behold! a third theme grew amid the confusion, and it was unlike the others.[…] The other had now achieved a unity of its own […] and it essayed to drown out the other music by the violence of its voice, but it seemed that its most triumphant notes were taken by the other and woven into its own solemn pattern.
I DUNNO MAN IT JUST KINDA STRUCK ME AND NOW I CAN'T STOP THINKING ABOUT IT I dunno if it was intentionally chosen for that reason (AND I MEAN IT'S A FANTASTIC TRAILER IT REALLY IS OMG 'cause perf use of scenes and images and it gives me so many feels plus it's an awesome track) but yeah. any thoughts?
"In the midst of this strife, wheat the halls of Iluvatar shook and a tremor ran out into the silences yet unmoved, Iluvatar arose a third time, and his face was terrible to behold. The he raised up both his hands, and in one chord, deeper than the Abyss, higher than the Firmament, piercing as the eye of Iluvatar, the Music ceased."
Cause I don't feel anything, that is what scares me.
Lily was at Lana's Del Rey concert.
Endless Melody - Clarensau
I really like this band… their music is slow, but it's touching. And their vocals… man :)
'cause i don't feel anything
and that is what scares me
Literally Tay is like this master lyricist who doesn't get enough credit for her metaphors and endless stream of perfect melodies


text:
Increased literacy means that more people is reading than ever before, but the majority read dull newspapers, trivial magazines, gossip news, popular fiction or facebook and twitter posts, not the work of committed and obscure authors. I always viewed the public and its tastes with the greatest suspicion and I have never sought a vast success. As a result I will finish into that great majority of minority writers, or the great unread, just as my modernist predecessors. I am not a spokesman of my age, but I consider myself a traditional revolutionary and anarchist writer, I believe in old and new values and I struggle against stupidity in all its forms, but as a member of the most secret avant-garde I can't be read by a wide public and personally I am almost proud and glad of it.
Carl William Brown
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- Police & fire scanners
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Posted Feb 15, 2012, 5:14 pm
Counterfeits of Avastin, Swiss drug maker Roche's multi-billion dollar cancer drug, are circulating in the United States, the company warned on Tuesday.
Reuters reported that Roche was contacted about the fake Avastin by a health authority outside the United States, but it does not yet know how much of the counterfeit drug is out in the market.
"We are working with the FDA and law enforcement to aid their evaluations, determine the source of the counterfeit drug, and prevent its further distribution," Roche and Genentech said in a statement. "The counterfeit product is not safe or effective and should not be used."
Roche's U.S. biotech wing Genentech said that the fake products do not contain the key ingredient in Avastin, which is given intravenously and used to treat colon, lung, kidney and brain cancers, the Associated Press reported. The drug generates about $6 billion a year for Roche.
"We're still analyzing what it is, but we know it doesn't contain the active ingredient in Avastin," Genentech spokeswoman Charlotte Arnold told the AP. "It's an infused medicine and not something a patient would have in their hands, so it's really health care providers who should be on the lookout."
The unapproved cancer medications were purchased from a foreign supplier known as Quality Specialty Products, which may also be known as Montana Health Care Solutions, according to the FDA, CNN reported. The Food and Drug Administration has contacted 19 medical practices that may have purchased unapproved drugs, including counterfeit Avastin, from the company, the AP reported.
Patients and doctors can tell the counterfeit drugs from the real ones by their labels: real Avastin has Genentech on the label, which is all in English, and the counterfeit labels say "Roche" and are in French, according to Reuters. As well, lot numbers of actual Avastin have six digits with no letters, while the counterfeit lot numbers begin with a letter.
Avastin is administered in doctor's offices and hospitals, and works by choking off the blood supply that feeds tumors, according to the AP. It was the first drug of its kind approved by the FDA.
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Sangeeta Bijlani, Designer Anita Dongre, Urmila Matondkar at Anita Dongre Show at lakme fashion show
Dazzling Bollywood divas Urmila Matondkar, Sangeeta Bijlani, Neetu Chandra, and Sushma Reddy graced designer Anita Dongre's show on the third day of Lakme Fashion Week 2012 in Mumbai today. The designer showcased her exquisite collection titled 'Waves of joy'. For the first time Anita Dongre showcased her men's wear line. She had put her collection for the man who appreciates refined fabrics, clean cuts and impeccable fits. Neetu Chandra, Krishika Lulla, Sangeeta Bijlani, Anita Dongre, Urmila Matondkar, Sushma Reddy, Sanjay Suri, Purab Kohli, Sucheta Sharma, Dipannita Sharma, Shraddha Nigam, Mayank Anand, Karan Mehra, Nisha Jamwal, Pooja Misra, Maria Goretti, Shweta Kawatra, Manav Gohil at Anita Dongre Show at lakme fashion week 2012 Day 3 in Grand Hyatt, Mumbai on 4th March 2012. Watch more Bollywood news, events, and videos. Kindly subscribe to www.youtube.com/page3life
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- Misha spotted outside gym, comes to pick up parents Shahid-Mira


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Explore Lol and more!
That one I haven't seen yet!
Lemons are ones of the most beneficial fruits on the planet, and due to their countless health benefits and unique flavor and scent, they are added to various recipes Lemons are excellent for detoxification of the body, but when juiced, the lemon loses many of its nutrients and a great part of the medicinal potential …
IT'S THE MOST BEAUTIFUL THING I'VE EVER SEEN IN MY LIFE IT'S A JAR OF DIRT IN A JAR OF DIRT In A JaR Of DiRt!!!!!
his different characters always crack me up
This cracked me up. Hundreds of years of people losing it over the "bigger on the inside" concept and he's always wanted to do it himself. Lol.
something like this was said in maths by a new teacher to a BOY, Russel Howard FTW
Yook a moment fot me to find out that one
Men's equivalent to bras.<---make it so that it has a wire on each side like the wire bras we buy, lol. This cracked me up
Thankshahahaha... I need to start doing stuff like this. Think of all the things you could get away with saying. awesome pin
Husband Comes Home From Work Thinking His Wife is in Danger so funny
What's up wit that?
I dunno why this is cracking me up but it is
How to ruin hipster photos--the last 4 are great, especially the Oceanlol
Soft looking tattoos - watercolor (no black lines) technique is amazing! It is better than the traditional tattoo "look", but all this tattoo action still falls under my board "Stuff That Cracks Me Up!" (This woman's back will look like melted crayons by the time she hits 70! LOL!)
Parents Texting - I laughed way to hard....


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Browse through the calendar to see concert listings for all 68 concerts featured in the 2014 Brandenburg Choral Festival.
The Brandenburg Sinfonia return as resident orchestra to open Thaxted Festival with a wonderful concert of Mendelssohn, Rodrigo, Beethoven and ... The Beatles!
Venue: Thaxted Parish ChurchClick on the image for further details and booking information----------------------------------------------
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The Senate Health Care Bill is Just as Bad as the House Version
The Senate Health Care bill, released on Thursday, jeopardizes Montanans' health and well-being by deeply cutting Medicaid, raising premiums for many Montanans, and causing tens of thousands of hard-working Montanans to lose their insurance. The Senate took the deeply flawed House-passed American Health Care Act (AHCA) and "tweaked it." In some ways, the Senate bill is even worse than the House AHCA.
While details are still emerging about the Senate bill, let's take a look at the most important provisions, and how they affect everyday Montanans:
First, the Senate bill would end Montana's bipartisan Medicaid Expansion program, causing nearly 80,000 people to lose access to care.
Montana's bipartisan Medicaid expansion program is the first of its kind in the country by utilizing a third-party administrator to provide health care coverage to nearly 80,000 Montanans. The Senate bill will effectively end Montana's Medicaid expansion program in 2021, by ratcheting down federal matching funds well below what ACA provided. Most of those newly enrolled are working at low wages and will be left with little or no options for affordable health insurance.
Second, the Senate Bill drastically cuts and caps the traditional Medicaid program.
Over 216,000 Montanans rely on Medicaid for health care including people with disabilities, seniors, and families with children. Eight in ten Montanans on Medicaid live in working households. Many of these hard-working Montanans, however, work at jobs that do not provide insurance. Despite the outcry over the House's deep cuts to Medicaid (over $800 billion by 2026), the Senate bill's cuts are even harsher over the long run than the House bill. Under the House version, Montana is expected to lose $4.8 billion in federal Medicaid funding – 35 percent of its current law funding – between 2020 and 2026. We have yet to see a full analysis of the Senate proposal by Congressional Budget Office, but the bill appears to cut an even greater amount of federal Medicaid funds over time.
Third, the Senate bill would raise premiums and deductibles for thousands of Montanans who buy insurance on the marketplace.
The Senate bill pulls the rug out from under Montanans who rely on the marketplace for reasonable health care coverage. Because Montana is a rural state, health care costs are higher here than in other parts of the country. While the Senate version does take into account income and regional costs of insurance (similar to what ACA does), the level of tax credits and assistance is below that in the ACA for many middle-income Montanans. Insurance costs, especially for older Montanans, would rise sharply under the Senate bill. Montanans would also likely face higher deductibles and out-of-pocket costs under the Senate bill. Approximately 117,000 Montanans rely on the Marketplace for affordable coverage, and many are in danger of seeing their insurance costs rise to unaffordable levels.
Fourth, the Senate bill allows states to strip away important consumer protections for people with pre-existing conditions and others most in need of care.
While the Senate version does not include the House proposal to allow states to waive protections for preexisting conditions, there are a number of other provisions that could have a devastating impact on the over 420,000 Montanans that live with a pre-existing condition. The Senate bill would allow states to waive certain protections, such as the ACA's requirement that insurance plans limit people's total out-of-pocket costs, which will disproportionately hurt those with pre-existing conditions. The Senate bill also allows states to waive certain health benefits, including access to, to maternity care, mental health care, or substance abuse treatment. With the opioid crisis spreading across Montana, a bill that reduces access to health care will only make the problem worse.
Because we are still waiting on a CBO score, it's unclear exactly how many Montanans will lose insurance coverage under the Senate Bill. But make no mistake – this bill, like the one in the House, reduces coverage, increases health costs for many, strips consumer protections, and endangers Medicaid as well as the state's own finances.
Montana's senators should not support this bill due to the devastation it would cause for tens of thousands of Montanans. Anything less would break their promise to the people of this state.
Wonky Word: Substance Use Disorders (SUDs)
The debate continues around the House-passed American Health Care Act (AHCA) and now the Senate's effort to craft a similar bill that will effectively end Medicaid expansion, dramatically cut Medicaid funding, and result in loss of coverage for millions of Americans. In our effort to continue to provide information on AHCA, we provided details earlier this week on what Essential Health Benefits (EHBs) are. One of these ten EHBs is mental health and substance use disorder (SUD) services, which includes behavioral health treatment. Substance use disorder, also known as drug use disorder, is a condition in which the use of one or more psychoactive substances leads to a clinically significant impairment or distress.
Substance use disorders are a nationwide problem, and Montana is all too familiar with alcohol and drug abuse. Montana residents have a higher rate of alcohol dependence or abuse than the national average, as well as a higher rate of untreated illicit drug dependence or abuse.
At the end of May, the Montana Department of Justice announced a new effort through the office's Aid Montana initiative to gather input from Montanans regarding how best to address substance abuse. Over the summer, the Montana Department of Justice will partner with the Montana Healthcare Foundation to hold six listening sessions across the state to hear real life experiences of individuals affected by substance abuse.
These listening sessions should provide great feedback; however, there is one thing we already know: the Affordable Care Act and Medicaid Expansion funding provide the foundation to effectively addressing substance use disorders. The ACA and the state's Medicaid expansion provide critical resources and services to those Montana residents battling addiction personally and the family members impacted by drug and alcohol abuse.
While we do not know what will be included in the Senate's version, press reports indicate the Senate is sticking fairly close the House-passed bill, which would land a devastating blow to mental health and opioid addiction treatment due to the following components of the bill:
- Dramatic cuts to Medicaid will cut billions in federal funds provided for substance use disorder treatment. Since 2015, Medicaid has become our state's primary payer for SUD treatment services and Montana's most potent tool in combatting alcoholism, methamphetamine use, opioid abuse and overdose, and the myriad social consequences of addiction. In fact, since the passage of Medicaid expansion, Montana has seen a XX% increase in federal dollars going toward SUD treatment. A radical restructure of Medicaid, by converting it to a per capita cap will result in the loss of nearly $5 billion in federal Medicaid funds. To compensate, Montana would have little choice but to cut eligibility, cut payments to hospitals and doctors, and/or cut benefits — including behavioral health services.
- A return to pre-ACA coverage could result in the elimination of mental health and substance use treatment in private insurance plans. The AHCA allows states to waive certain essential health benefits, and this includes mental health and substance use treatment. Prior to ACA, almost no state required insurance companies to cover these services, and it is likely states will again start waiving these benefits.
As in most states, substance use disorder is a serious and growing public health problem in Montana. We can face this problem head on by maintaining the crucial federal Medicaid funds to pay for substance use disorder treatment. We can't afford to lose this lifeline to recovery in Montana.
Wonky Word: Essential Health Benefits
During recent weeks, you have probably heard the term Essential Health Benefits repeatedly as Congress continue efforts to repeal and replace the Affordable Care Act (ACA). Right now, the Senate GOP leadership is cooking up their version of a health care bill behind closed doors and could take a vote before the July 4th recess.
The House-passed GOP plan eliminates Medicaid expansion and dramatically cuts Medicaid funding. Congress is also considering measures to allow states to waive the essential health benefit rules within the ACA. What are "Essential Health Benefits" and why have they become so central in the debate around health insurance coverage in America?
Essential Health Benefits (EHBs), also called federal minimum benefit standards, are at heart of the ACA. EHBs outline a set of ten categories of services that health insurance plans must cover at minimum. States must also provide EHB to beneficiaries eligible under the ACA's Medicaid expansion, and plans may offer additional benefits such as dental and vision coverage.
Prior to the ACA, it was up to each respective state to determine what benefits (called insurance mandates) had to be included in insurance plans. Not surprisingly, states differed widely in terms comprehensiveness required, and no specific benefit was deemed essential in all 50 states and Washington, D.C.
EHBs provide coverage that offers viable protection against some of the most basic health care costs Americans experience and were designed to provide marketplace consumers with insurance coverage similar to the coverage of employer-sponsored insurance and Medicaid.
So, every health plan must cover the following services1:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren't essential health benefits)
- And these two additional benefits:
- Birth control coverage (contraceptive methods and counseling for all women)
- Breastfeeding coverage (breastfeeding equipment and counseling for pregnant and nursing women)
Before the ACA, most health insurance frequently did not cover these basic services. For example, in 2011, among people in the individual market:
- 62 percent had plans that didn't cover maternity care;
- 34 percent had plans that didn't cover substance use treatment;
- 18 percent had plans that didn't cover mental health; and
- 9 percent had plans that didn't cover prescription drugs.
Under the GOP's replacement plan, comprehensive insurance, with benefits like maternity or mental-health coverage, could become unaffordable—if not unavailable.
If the Essential Health Benefit standards were eliminated, individual and small-group market plans would quickly revert to the pre-ACA status quo and would likely:
- Leave people who have pre-existing conditions without the coverage they need. People with pre-existing conditions — who need services like substance abuse treatment,mental health services, or comprehensive prescription drug coverage — often wouldn't be able to find the coverage they need at any price, much less an affordable one.
- Charge women more than men for coverage. In practice, eliminating Essential Health Benefit requirements means that women would once again be charged more than men, since they'd have to pay more for plans with maternity coverage — if they could even find a plan.
- Burden even insured people with unaffordable bills and medical bankruptcies. Before the ACA, millions of people had health insurance that wouldn't actually cover them if they got sick. Plans often had annual and lifetime limits on coverage and no limits on individuals' out-of-pocket costs, and they omitted key services.The ACA fixed this by prohibiting annual and lifetime limits and setting an annual limit on what enrollees can be required to pay out-of-pocket for deductibles and other cost-sharing. Eliminating the Essential Health Benefit standards would make these rules meaningless.
Myth Busting: What is really at stake with Medicaid and AHCA
Last week there were two articles quoting Senator Daines on health care and the continued effort in the Senate to repeal and replace the Affordable Care Act: Senator Daines Urged To Protect Medicaid and Daines and Tester weigh in on status of 'Obamacare' repeal in U.S. Senate. Some of the statements made about Medicaid were inaccurate, and we want to provide additional context on how Medicaid works and its importance to accessing health services in Montana.
MYTH #1: The original Medicaid program focused on those in deep poverty and seniors below the age of 65.
FACT: In fact, before passage of ACA, Medicaid left out many low-income individuals, including most seniors living in poverty. Montana's bipartisan Medicaid expansion provides health coverage to those exact populations.
Before the Affordable Care Act and Montana passed Medicaid expansion, Medicaid did not cover the very poor unless they were disabled or had children under the age of 18-years-old. This left tens of thousands of Montanans below the poverty line uninsured. Additionally, Medicaid did not take care of older adults who were under 65 unless they qualified due to a disability, meaning that low-income seniors between 50-64 often did not qualify for Medicaid.
Montana's bipartisan Medicaid Expansion plan has provided access to health care coverage to nearly 80,000 low-income Montanans, including seniors, adults, and others.
MYTH #2: Congress should give states more flexibility to administer their Medicaid programs.
FACT: States already have significant flexibility in how they run their Medicaid program, and cuts to federal Medicaid funding will only make it harder for states to provide access to coverage and benefits.
In exchange for the federal funds, states must meet federal standards that reflect the program's role covering a low-income population with limited resources and often complex health needs. The federal standards largely focus on requiring states to cover certain groups, such as poor children and pregnant women, as well as certain core benefits.
However, states can choose to cover additional groups, offer enhanced benefits, and already have wide latitude over many aspects of the program, particularly how they pay providers and structure their delivery systems. States can use Section 1115 waiver authority to vary from the federal standards and state options to address different priorities and emerging issues.
The programs across states vary widely in terms of who is eligible, what benefits are covered, what premiums and cost sharing are charged, and how providers are paid and care is delivered.
MYTH #3: Medicaid expansion can be protected if the phase out of the higher federal match occurs over several years.
FACT: Any phase-out of the higher federal match for Medicaid expansion will end Medicaid expansion in Montana.
The House-passed AHCA eliminates the higher match of federal funds for those who would be newly enrolled after 2019. The Senate is considering a longer phase-out, but to be clear: this has the same effect. CBO estimates that more than two-thirds of those enrolled in the Medicaid expansion would fall off the program within two years and that fewer than 5 percent would remain on Medicaid after six years. For those who see their income drop after phase out, the state would not receive the higher match and would most likely no longer be able to afford to continue to provide Medicaid to this population.
MYTH #4: Medicaid creates a disincentive to individuals to seek employment or employment opportunities with higher wages.
FACT: Among adults with Medicaid coverage—those most likely to be in the workforce—nearly 8 in 10 live in working families, and a majority are working themselves.
Nearly half of working Medicaid enrollees are employed by small businesses, and many work in low-wage industries that do not offer employer-paid insurance. Since the majority of Medicaid expansion enrollees are low-wage workers, Medicaid expansion prevents them from falling into the coverage gap; it helps them cope with high turnover in the low-wage labor market.
Medicaid expansion and the tax credits and subsidies under ACA provide a smoother transition to private Marketplace coverage. This has been particularly important for Montanans living in rural communities, accessing Medicaid and insurance on the marketplace at a greater rate. When their earnings rise or they get a new job, they can transition to employer coverage or the ACA marketplaces. Under ACA, the tax credits and subsidies provide significant support to lower costs for marketplace coverage. And families have the security of knowing that Medicaid will be there for them again if they lose their job, see their hours cut, or face financial crisis. Additionally, when they no longer qualify for Medicaid but live at 139% of the poverty rate, individuals can currently qualify for a tax subsidy to help pay the health insurance premium.
By eliminating Medicaid expansion and cutting tax credits for low-income families, the AHCA (and likely any iteration from the Senate) will create a situation where many families may have to choose between employment and keeping health insurance. For example, a family who earns $20,000 in Montana will see their premium paid after tax credit rise by 295% for a total of $3,690. That is the equivalent of 15% of that family's income.
Mother's Day: What Moms need is health care
We hope moms and moms-to-be around the state had a wonderful Mother's Day.
Because we love our moms and we are a female-led organization, our team spent time looking into how the House GOP bill to repeal and replace the Affordable Care Act (ACA) might affect women, and moms specifically.
The ACA changed the landscape for women's health insurance coverage. As we await the Senate's version of a bill, it is crucial to understand the particular damage that ACA repeal poses for women's health and economic security.
We know that much attention has been given to the provision of the AHCA that allows states to waive the "essential health benefits" coverage for individual market plans. Which basically means that pregnancy, c-sections, or injuries from domestic violence are included as pre-existing conditions and subject moms and women to significantly higher premiums.
However the issue of fundamentally changing Medicaid is equally as detrimental to moms in our state and country. As it stands, the House health bill would have devastating consequences for the nearly 40 million women across the country who rely on Medicaid. In Montana, 129,200 women are enrolled in Medicaid and 35% of births are financed by Medicaid.
The House-passed bill would slash Medicaid by more than $800 billion over ten years by effectively eliminating Medicaid expansion to low-income adults and imposing a "per capita cap" on the program.
Women would bear a disproportionate impact of these cuts because they are not only the majority of Medicaid beneficiaries, but are also the primary utilizers of family planning and maternity care, benefits that could be eliminated with devastating federal cuts to Medicaid.
In addition, Medicaid expansion gave many women not raising children access to coverage and offered continuous coverage to new mothers who had qualified while pregnant but would not have qualified after their pregnancy. Ending the expansion would take these benefits away.
There are a few other benefits the ACA gave women that could be lost with repeal. One is breastfeeding. The ACA covers lactation support and counseling, equipment and supplies, such as pumps, and infrastructure, such as pump rooms and break time. The other is access to birth control which provides health benefits for women and children, improves women's ability to control whether and when they have a child, and fosters women's ability to participate in education and the workforce on an equal footing with men. The ACA was a total game-changer when it comes to access to birth control for women because it removed the cost barriers. Women no longer have to pay out-of-pocket costs or choose between paying for birth control and paying for other necessities, like groceries and utilities.
The ACA and Medicaid have been hugely beneficial for women's health. With the potential repeal hanging above us, women – and mom's – have a lot to lose. While the future is uncertain, we want to make sure that women and moms continue to have access to affordable health care. We encourage all moms, women, and the men in their lives to contact our Montana Senators and tell them to reject any health bill that causes people to lose coverage, caps or cuts Medicaid, ends the Medicaid expansion, or takes away critical protections.
The New House Health Care Plan Makes a Bad Bill Even Worse
While Montana still is without a congressional representative, the House is poised to vote on a bill tomorrow, which could result in 259,000 Montanans either losing their coverage or facing increased out-of-pocket costs for health insurance.
Press reports have indicated House leadership continues to try to cobble together votes to repeal ACA, and we could see a vote on a newer version of the GOP plan as early as tomorrow or Saturday. The revised version does nothing to address the 24 million Americans who will lose coverage or the cut of over $800 billion in federal Medicaid dollars. Instead, the amended GOP plan makes a bad bill even worse, in three ways:
- Gutting protections for Montanans with pre-existing conditions: The new proposal would allow states to eliminate protections for those with pre-existing condition. Insurance companies would now have the power to deny coverage based on pre-existing conditions except in states that choose to prohibit it. 426,400 Montanans have pre-existing conditions and risk losing the coverage they desperately need.
- Eliminating coverage for services, like maternity care, mental and substance use treatment, and prescription drugs: The new version of the GOP plan would also allow states to waive Essential Health Benefits standards that require plans to cover services such as mental health and substance use treatment. It would also do away with guaranteed maternity care coverage, effectively allowing plans to charge women more for insurance than men.
- Reinstate annual and lifetime limits on health care: The ACA prohibits plans from limits on coverage that are Essential Health Benefits. If states are allowed to eliminate the Essential Health Benefit standards, plans could likely place caps on coverage for those services, such as emergency services, impatient care, and prescription drugs. Before ACA, over 330,000 Montanans – most with employer coverage – faced lifetime limits on health services. The new, worse GOP plan could put in place these same practices, which means even those Montanans who can afford coverage could be one major illness away from bankruptcy.
This new bill is in no way a compromise or an improvement. Instead, it only further exacerbates the problems it would create for millions of Americans. This flawed proposal would: shift of over $3 billion in Medicaid costs to the state, end Montana's bipartisan plan to expand Medicaid covering over 71,000 Montanans, and raise premiums and health care costs on tens of thousands of Montana families. D.C. politicians must take note – the GOP plan is a dangerous move that is wrong for Montana.
Indian Country Suicide Prevention Receives Attention and Investment
Maybe it's our relative isolation and inability to easily access sufficient mental and behavior healthcare. Or maybe it's the elevation or the sigma we often associate with depression. Whatever the reason, Montana has had one of the highest suicide rates in the country for almost forty years.
According to a report by the Montana Department of Health and Human Services, Montana ranked first in the nation for suicides in 2014. Nationally, whites have the highest rate of suicide, followed by American Indians. In Montana, this trend is reversed. Between 2014 and 2015, the American Indian suicide rate was 35.5 (per 100,000 people) compared to 28.1 for whites.
The same report notes that American Indian youth ages 11-17 are especially at risk. In fact, they are almost four times more likely to die by suicide than their white counterparts in Montana. Further, youth suicidal risk assessments for 2015 also show that American Indian youth living in urban areas are more likely than reservation-residing American Indian youth to seriously consider, plan, and attempt suicide.
We know that suicide has been a major public health concern in Montana for years, and particularly in Indian Country. This is why we applaud the legislature's recent passage of House Bill 118, which invests $1 million in statewide suicide prevention efforts. Of this, $250,000 goes expressly to implement the action steps outlined in the Montana Native Youth Suicide Reduction Plan (MNYSRP). The Indian-owned consulting firm, Kauffman & Associates, in collaboration with both reservation and urban-based tribal communities in Montana, as well as the five urban Indian Health organizations created MNYSRP. MNYSRP came about as a result of an initiative developed by Governor Bullock in 2015, which was funded through the 64th Montana Legislative session.
An official bill signing has been scheduled for Tuesday, April 25, 2017 at 3pm.
Blog Series: Who Has the Most to Lose With a Capped System
Who has the most to lose from capping Medicaid spending?
In yesterday's blog, we talked about some of the recent proposals by Congress to impose a block grant or per capita cap on federal Medicaid spending. We also wrote about the disastrous impact it would have on state budgets and ability to provide affordable health coverage for families. Today, we are going to take a deeper look at who has the most to lose under a capped system.
As a quick refresher, if Congress votes to cap the federal government's contribution to states' Medicaid programs through either a block grant or per capita cap, states will then have to take up a greater share of their Medicaid costs as health care costs increase, to the tune of over $560 billion over the next decade. In turn, states would likely face significant budgetary pressure to begin cutting Medicaid services, critical to millions of families across the country.
Impact on the State Budget
As Montana sees diminishing contributions from the federal government, our state will have to pick up an increasingly larger share of costs. This could put a significant strain on the state's budget, making it likely that at some point the state will have to reduce benefits. As the state's share of Medicaid costs grows, Montana would be faced with difficult decisions to limit Medicaid costs moving forward, including: (i) cuts to the level of benefits under Medicaid; (ii) cuts to the number of Montanans enrolled in Medicaid; and/or (iii) cuts to Medicaid payments made to doctors, hospitals and other providers. All of these options will hurt Montana families trying to access Medicaid coverage.
Cuts to benefits
Medicaid currently provides more benefits than private insurance, and does so at a significantly lower cost for beneficiaries. While proponents of block grants tout the "flexibility" that states will have, the flexibility essentially means that states will be able to cut important services. For example, to save costs, states may cut a pediatric benefit known as Early Periodic Screening, Diagnostic, and Treatment (EPSDT) that assesses the health and development of children and covers the services they need. Covering fewer services is a shortsighted move that would reduce the overall health and well being of thousands of Montanans and potentially lead to much larger statewide health care costs down the road.
Cuts to enrollees
Montana would most likely have to cut the number of people it enrolls through Medicaid, including some of the most vulnerable recipients.
Those most at risk of losing coverage would be the over 70,000 Montanans who have gained affordable coverage through the Montana HELP Act, the state's Medicaid expansion program. Congressional House legislation could effectively end Medicaid expansion, by eliminating the current 90% federal match after 2019. The Health and Economic Livelihood Partnership (HELP) Act, designed with bipartisan support, has expanded health care to over 70,000 Montanans, who now risk losing that coverage.
Montana currently provides Medicaid to pregnant women with incomes up to 150 percent of the federal poverty level (FPL), even though federal law only requires coverage up to 138 percent. As costs rise, Montana may be forced to drop coverage for pregnant women with incomes above the federal minimum.
Cuts to payments for doctors, nurses, health care clinics, and hospitals
Spending caps could also mean that Montana would have to reduce the payments it sends to providers. The Urban Institute has estimated that block grants could cause states to reduce reimbursements, which are already lower than what private insurance pays, to providers by more than 30 percent. In turn, this could cause a decrease in the number of providers willing to accept Medicaid payment for services. For rural Montanans, fewer providers could drastically reduce their ability to access affordable health care.
Block granting Medicaid or implementing per capita spending caps would wreak havoc in Montana and reduce our ability to provide comprehensive, affordable health care coverage to people in need. Capping Medicaid spending does nothing to improve health care, but rather only limits Montana's options and flexibility.
Blog Series: Medicaid Block Grants and Per Capita Caps
This week, House Republicans are aiming to begin marking up the repeal of ACA. House leaders have announced a plan that would drastically alter states' Medicaid programs by putting a cap on the federal contribution for Medicaid. This change could significantly reduce access to health care for tens of thousands of Montanans. Nationally, these changes could result in cutting federal Medicaid support by over $560 billion over the next decade.
There are two ways that the federal government can cap spending – Medicaid block grants and per capita caps. Both of these measures would limit the amount of money the federal government sends to states for Medicaid, while increasing cost for state governments.
These two options are structured differently, but have similar long-term results.
How does Medicaid spending work now? Currently, Montana receives a fixed share of its Medicaid costs from the federal government. On average, a state receives about 64 percent of this cost. (Under Medicaid expansion, which has helped over 70,000 Montanans get access to health coverage, the federal share is even higher, a minimum of 90%.) In the past, if a state spends more on Medicaid one year, say due to a bad flu season, the federal government would send more money, keeping the percentage the same.
Under a block grant, states would receive a fixed amount of federal funds for Medicaid. Anything above that amount, the state would be responsible for paying. Under a block grant, Congress eliminates the set federal matching rates, and instead, the states will receive a total fixed amount of funds to run their Medicaid programs.
Per Capita Cap
A per capita cap is similar, but instead of setting a dollar limit for the entire Medicaid program, it would cap the amount of spending per beneficiary. If a beneficiary's health needs exceeds that capped amount, the state would be responsible for the entire amount of those costs. The per capita cap would likely be set using current per-beneficiary spending and grow only slightly over time using an inflationary adjustment (but highly unlikely to keep pace with rising health care costs).
So why are spending caps so dangerous?
On a federal level, block grants and per capita caps are designed to do the same thing: create savings for the federal government in the long run, primarily by passing the cost along to the states. They achieve this by setting a cap below what the federal government is projected to spend, and then increase that cost each year only slightly, at or less than the rate of inflation. As noted above, health care costs have grown faster than inflation. The cost of Montana's Medicaid program would increase over time, but the federal contribution would not. After a few years, the federal government would be contributing a much smaller percentage than it is now, leaving Montana holding the bag.
We have historical evidence of how disastrous block granting can be for social safety net programs critical to low-income families. The most direct example of block granting is the federal Temporary Assistance for Needy Families (TANF) program, which Congress implemented in 1996 to replace the Aid to Families with Dependent Children (AFDC). Because federal support was capped, the TANF program in Montana now serves about 13 of every 100 families experiencing poverty in the state. Before TANF, AFDC served 63 of 100 Montana families living in poverty.
Why would health care costs increase?
Historically, health care costs have increased faster than inflation. Although the rate at which they have increased has slowed down, lawmakers cannot be sure if this slowdown is permanent or temporary, especially while they make other changes to the Affordable Care Act.
Montana also has a rapidly aging population, and the health care costs for older adults is significantly more expensive than it is for younger adults. By 2030, Montana is expected to be the fifth oldest state in the nation, and many older Montanans are served through the Medicaid program.
Last, with new diseases and new treatments, per-beneficiary costs could increase. For example, if researchers discover a new treatment for cancer, people's lives could be saved but costs could increase. Similarly, if there is an outbreak of a new disease – such as Zika, or an epidemic similar to HIV/AIDS in the 1980s – per-person treatment costs could increase.
So what happens?
If the amount of money the federal government sends is capped, the state would have to either spend more of its own money, or reduce the amount of health care it provides. This could leave thousands of Montanans without access to affordable health care.
Tomorrow, we will talk about who has the most to lose from putting a cap on Medicaid spending.
Blog Series: What ACA Repeal Could Mean to Health Care Providers
In the coming weeks, Congressional House members could begin committee work on the effort to repeal the Affordable Care Act (ACA). MBPC released a report last month on the detrimental impact of repeal on those who risk losing insurance coverage, including the over 71,000 Montanans who have gained coverage through Medicaid expansion. Montana is experiencing record levels of Montanans with insurance, but that could change quickly as families lose access to Medicaid and adequate subsidies to pay for insurance through the exchanges. A more recent report from the Urban Institute describes the impact of repeal on Montana's hospitals and medical providers. This report assumes partial repeal similar to that passed by Congress in 2016 (and vetoed by President Obama), which included the elimination of Medicaid expansion, the individual and employer mandates, and Marketplace subsidies.
We don't yet have full details on what exactly the House will take up this week, but Urban report provides a glimpse at how repeal of ACA could impact hospitals and providers across the state. If Congress does choose to eliminate these aspects of the ACA, Montana providers could face nearly one billion dollars less of health care spending in 2019, putting additional pressure on uncompensated care costs and those with insurance.
|Estimated total Health Care Spending in Montana for 2019 (in millions)
|ACA Repealed through Reconciliation
|Total Health Care Spending
|Physician Practices
|Over Services
|Prescription drugs
When fewer people have health insurance, health care spending decreases because people either forego care or are unable to pay in full. Statewide, health care providers stand to lose $972 million in 2019 with the loss of Medicaid expansion, the individual mandate, and existing health care subsidies.
From 2019-2028, these costs would add up. If the ACA were kept in place, Montana insurers would spend an estimated $71.3 billion on health care over this time period. But if the ACA is repealed without an adequate replacement plan included, this spending could decrease by $13.6 billion.
If someone is unable to forego medical care without insurance, and are unable to pay out of pocket, hospitals and other providers are left to pick up the tab. In 2019, uncompensated care would rise by $481 million across the state. Between 2019-2028, this figure would rise to over $5 billion.
Someone must pay for uncompensated care, meaning hospitals and other providers shift the cost to private insurance companies. This "cost-shift" forces insurance companies to raise their premiums, passing the burden along to those with insurance.
Reduction in health care spending would also result in the loss of jobs across the state. In 2019, Montana could lose up to 8,000 jobs, according to the Commonwealth Fund. Three thousand of these jobs would be in the health care sector.
Repeal of the ACA could have dramatic effects for Montana's economy, from rising health care costs to lost jobs. For more information about the effects of repeal, be sure to read MBPC's latest report: 142,000 Montanans Face Uncertainty of Health Coverage with Threat of ACA Repeal.


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On Bank Holiday Monday Rhodes Arts Complex will be open...
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7:00 pm
Blanche McIntyre returns to the RSC to direct Shakespeare's brutal revenge tragedy after her debut directing The Two Noble Kinsmen (2016). The decay of Rome reaches violent depths in Shakespeare's most bloody play.
8th November 2017
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A full-throttle war play that revels in the sweat of the battlefield, Coriolanus transports us back to the emergence of the republic of Rome.
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Rhodes is a vibrant, successful venue in the heart of Bishop's Stortford which attracts more than 100,000 visitors per year. Sponsorship of the arts offers excellent value for money! Find out more


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Amin, Bintal and Ismail, Ahmad and Yap, Chee Kong (2008) Distribution and speciation of Zn and Pb in coastal sediments of Dumai Sumatera, Indonesia. Toxicological and Environmental Chemistry, 90 (3). pp. 609-623. ISSN 0277-2248; ESSN: 1029-0486


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Explore In The Heights, The Check and more!
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Recent News
CHTM invites applications for a postdoctoral research associate
June 13, 2017
UNM is 33rd among universities worldwide in U.S. Utility Patents issued in 2016
June 8, 2017
Osiński earns grant from Office of Naval Research to develop novel ultrafast laser transmitter technology
May 30, 2017
U.S. Patent issued to Plumley et al. for "Compact Biosensor"
May 26, 2017
News Archives
UNM Collaborates on NSF Nanoscale Manufacturing Research Center
September 10, 2012
UNM Collaborates on NSF Nanoscale Manufacturing Research Center: UNM will participate on a National Science Foundation grant to develop nanoscale manufacturing systems for mobile computing. CHTM director Distinguished Professor Steven R. J. Brueck will lead the UNM activities under the $18.5 million multi-year grant, and a testbed for nanomanufacturing metrology will be built at CHTM. Read the full NSF news release on this exciting research. The UNM news release is here.


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It is well known that Tamil super star Ilayathalapathy Vijay's upcoming action entertainer Theri is releasing in Telugu as Policeodu. Expectations are equally high for the Telugu version and Dil Raju, who is releasing the film in Telugu, is giving it a huge release across the Telugu states.
Policeodu was supposed to hit the screens on April 14th along with its Tamil version. However, latest update from the film's unit reveals that the film's release has been delayed by a day and April 15th is the new release date for Policeodu.
Samantha and Amy Jackson will be seen as the female leads in this Atlee directorial. Tamil version's producer Kalaipuli S Thanu is the co-presenter of the Telugu version.
- Young Telugu hero eyeing Kollywood?
- MOM's story moved me to tears : Sridevi
- Special Column : Big stars on Small Screen
- Solid amount expected from DJ's first day
- Fidaa gets its release date
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My First Story - The South East
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Young Writers an imprint of Bonacia Ltd
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31st December 2012
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