Fifth Edition. Exchange Rates and. International Finance. Prentice Hall. FINANCIAL TIMES. An imprint of Pearson Education. For foreign currency. 1.3 The balance of payments. 1.4 The DIY model. 1.5 Exchange rates since World War I. 1.6 Overview of the book. Reading guide. (2014), International Corporate Finance: Value Creation with. Currency Derivatives in Global Capital Markets, Wiley and Sons, Ltd, West. And DeMarzo, P. (2013), Corporate Finance, 3rd Edition, Pearson, Harlow. Secondary Reading. (2014), Exchange Rates and International.

• • • The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act ( ACA) or nicknamed Obamacare, is a United States enacted by the and signed into law by on March 23, 2010. The term 'Obamacare' was first used by opponents, then by supporters, and eventually used by President Obama himself. Together with the amendment, it represents the 's most significant regulatory overhaul and expansion of coverage since the passage of and in 1965. The ACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20–24 million additional people covered during 2016.

The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and to major changes to markets. Both involved new spending, funded through a combination of new taxes and cuts to Medicare provider rates and. Several reports said that overall these provisions reduced the, and that repealing the ACA would increase the deficit. The law also enacted a host of reforms intended to constrain healthcare costs and improve quality. After the law went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans.

The act largely retains the existing structure of Medicare, Medicaid, and the, but individual markets were radically overhauled around a three-legged scheme. Insurers in these markets are made to and regardless of or sex. To combat resultant, the act that individuals buy insurance and insurers cover a list of '. To help households between 100–400% of the afford these compulsory policies, the law provides. Other individual market changes include and programs.

The act has also faced challenges and opposition. In 2009, Senator died, and the resultant cost the their 60-seat filibuster-proof majority before the ACA had been fully passed. The ruled 5 to 4 that states could choose not to participate in the ACA's Medicaid expansion, although it upheld the law as a whole.

The federal,, initially faced major technical problems during its rollout in 2013. In 2017, a unified government failed to pass partial repeals of the ACA. The law spent several years opposed by a slim of Americans polled, although its provisions were generally more popular than the law as a whole, and the law gained majority support by 2017.

And Nancy Pelosi celebrating after the House passes the amended bill on March 21 The ACA includes provisions to take effect between 2010 and 2020, although most took effect on January 1, 2014. It amended the and inserted new provisions on affordable care into. [ ] Few areas of the US health care system were left untouched, making it the most sweeping health care reform since the of and in 1965. However, some areas were more affected than others. The individual insurance market was radically overhauled, and many of the law's regulations applied specifically to this market, while the structure of Medicare, Medicaid, and the were largely retained. Most of the coverage gains were made through the expansion of Medicaid, and the biggest cost savings were made in Medicare.

Some regulations applied to the employer market, and the law also made delivery system changes that affected most of the health care system. Not all provisions took full effect. Some were made discretionary, some were deferred, and others were repealed before implementation. Individual insurance markets Among the groups who are not subject to the individual mandate are: •, estimated at around 8 million—or roughly a third of the 23 million projection—are ineligible for insurance and Medicaid. They remain eligible for emergency services. • Eligible citizens not enrolled in Medicaid.

• Citizens who pay the annual penalty instead of purchasing insurance, mostly younger and single. • Citizens whose insurance coverage would cost more than 8% of household income and are exempt from the penalty. • Citizens who live in and who qualify for neither existing Medicaid coverage nor subsidized coverage through the states' new insurance exchanges.

Regulations prohibits insurers from denying coverage to individuals due to. States were required to ensure the availability of insurance for individual children who did not have coverage via their families. Premiums must be the same for everyone of a given age, regardless of preexisting conditions. Premiums are allowed to vary by enrollee age, but those for the oldest enrollees (age 45–64 average expenses $5,542) can only be three times as large as those for adults (18–24 $1,836).

The defines the law's ' as 'ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care' and others rated by the. In determining what would qualify as an essential benefit, the law required that standard benefits should offer at least that of a 'typical employer plan'. States may require additional services. One provision in the law mandates that health insurance cover 'additional preventive care and screenings' for women. The guidelines issued by the to implement this provision mandate '[a]ll Food and Drug Administration approved methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity'. This mandate applies to all employers and educational institutions except for religious organizations. These regulations were included on the recommendations of the.

In 2012 Senator created this summary to explain his view on the act. The individual market has several other regulations: • Annual and lifetime coverage caps on essential benefits were banned. • Prohibits insurers from dropping when they get sick. • All health policies sold in the United States must provide an annual maximum out of pocket (MOOP) payment cap for an individual's or family's medical expenses (excluding premiums). After the MOOP payment cap is reached, all remaining costs must be paid by the insurer. • A partial requires insurers to offer the same premium to all applicants of the same age and location without regard to gender or most pre-existing conditions (excluding use). Premiums for older applicants can be no more than three times those for the youngest.

• Preventive care, vaccinations and medical screenings cannot be subject to,. Specific examples of covered services include: and, wellness visits, screening, testing, counseling, screening and counseling, contraceptive methods, breastfeeding support/supplies and screening and counseling. • The law established four tiers of coverage: bronze, silver, gold and platinum. All categories offer the essential health benefits. The categories vary in their division of premiums and out-of-pocket costs: bronze plans have the lowest monthly premiums and highest out-of-pocket costs, while platinum plans are the reverse. The percentages of that plans are expected to cover through premiums (as opposed to out-of-pocket costs) are, on average: 60% (bronze), 70% (silver), 80% (gold), and 90% (platinum). • Insurers are required to implement an process for coverage determination and claims on all new plans.

• Insurers must on health costs; rebates must be issued to if this is violated. Individual mandate The is the requirement to buy insurance or for everyone not covered by an,, or other public insurance programs (such as ). Also exempt were those facing a financial hardship or who were members in a recognized religious sect exempted by the. The mandate and the limits on open enrollment were designed to avoid the in which healthy people. In such a situation, insurers would have to raise their premiums to cover the relatively sicker and thus more expensive policies, which could create a in which more and more people drop their coverage. The purpose of the mandate was to prevent the healthcare system from succumbing to, which would result in high premiums for the insured and little coverage (and thus more illness and medical bankruptcy) for the uninsured. Studies by the, and Rand Health concluded that a mandate was required.

The mandate increased the size and diversity of the insured population, including more young and healthy participants to broaden the, spreading costs. Experience in New Jersey and Massachusetts offered divergent outcomes. Subsidies Households with incomes between 100% and 400% of the were eligible to receive for policies purchased via an exchange.

Subsidies are provided as an advanceable,. Additionally, small businesses are eligible for a tax credit provided that they enroll in the Marketplace. Under the law, workers whose employers offer affordable coverage will not be eligible for subsidies via the exchanges. To be eligible the cost of employer-based health insurance must exceed 9.5% of the worker's household income. Subsidies (2014) for Family of 4 Income% of Premium Cap as a Share of Income Income Max Annual Out-of-Pocket Premium Premium Savings Additional Cost-Sharing Subsidy 133% 3% of income $31,900 $992 $10,345 $5,040 150% 4% of income $33,075 $1,323 $9,918 $5,040 200% 6.3% of income $44,100 $2,778 $8,366 $4,000 250% 8.05% of income $55,125 $4,438 $6,597 $1,930 300% 9.5% of income $66,150 $6,284 $4,628 $1,480 350% 9.5% of income $77,175 $7,332 $3,512 $1,480 400% 9.5% of income $88,200 $8,379 $2,395 $1,480 a. Note: In 2014, the was $11,800 for a single person and $24,000 for family of four.

See Subsidy Calculator for specific dollar amount. And estimate the average annual premium cost in 2014 would have been $11,328 for a family of 4 without the reform. Exchanges Established the creation of in all fifty states. The exchanges are regulated, largely online marketplaces, administered by either federal or state government, where individuals and small business can purchase private insurance plans. Setting up an exchange gives a state partial discretion on standards and prices of insurance. For example, states approve plans for sale, and influence (through limits on and negotiations with private insurers) the prices on offer.

They can impose higher or state-specific coverage requirements—including whether plans offered in the state can cover abortion. States without an exchange do not have that discretion.

The responsibility for operating their exchanges moves to the federal government. Risk corridor program. This section contains for an encyclopedic entry. Please by presenting facts as a summary with.

Consider transferring direct quotations to. (July 2017) The risk-corridor program was a temporary risk management device defined under the PPACA section 1342: 1 to encourage reluctant insurers into the 'new and untested' [ ] ACA insurance market during the first three years that ACA was implemented (2014–2016). For those years the (HHS) 'would cover some of the losses for insurers whose plans performed worse than they expected. Insurers that were especially profitable, for their part, would have to return to HHS some of the money they earned on the exchanges' [ ] According to an article in, risk corridors 'had been a successful part of the Medicare prescription drug benefit, and the ACA's risk corridors were modeled after Medicare's Plan D.' They operated on the principle that 'more participation would mean more competition, which would drive down premiums and make health insurance more affordable' [ ] and '[w]hen insurers signed up to sell health plans on the exchanges, they did so with the expectation that the risk-corridor program would limit their downside losses.'

[ ] The risk corridors succeeded in attracting ACA insurers. The program did not pay for itself as planned with 'accumulated losses' [ ] up to $8.3 billion for 2014 and 2015 alone. Authorization had to be given so that HHS could pay insurers from 'general government revenues'. [ ] Congressional Republicans 'railed against' [ ] the program as a 'bailout' for insurers. (R-Ga.), on the that funds the and the Labor Department '[slipped] in a sentence'—Section 227—in the 'massive' (H.R. 3547) that said that no funds in the discretionary spending bill 'could be used for risk-corridor payments.'

[ ] This effectively 'blocked the administration from obtaining the necessary funds from other programs' [ ] and placed Congress in a potential breach of contract with insurers who offered qualified health plans, under the as it did not pay the insurers. On February 10, 2017, in the v the US Government, Moda, one of the insurers that struggled financially because of the elimination of the risk corridor program, won a '$214-million judgment against the federal government'. [ ] On appeal, judge stated, 'the Government made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise.

After all, to say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government.' Temporary reinsurance Temporary reinsurance for insurance for insurers against unexpectedly high claims was a program that ran from 2014 through 2016. It was intended to limit insurer losses. [ ] Risk adjustment Of the three risk management programs, only risk adjustment was permanent. Risk adjustment attempts to spread risk among insurers to prevent purchasers with good knowledge of their medical needs from using insurance to cover their costs ().

Plans with low actuarial risk compensate plans with high actuarial risk. [ ] Medicaid expansion ACA revised and expanded eligibility starting in 2014. Under the law as written, all U.S.

Citizens and legal residents with income up to 133% of the, including adults without dependent children, would qualify for coverage in any state that participated in the Medicaid program. The federal government paid 100% of the cost of Medicaid eligibility expansion in participating states in 2014, 2015, and 2016; and will pay 95% in 2017, 94% in 2018, 93% in 2019, and 90% in 2020 and all subsequent years. The law provides a 5% 'income disregard', making the effective income eligibility limit for Medicaid 138% of the poverty level.

However, the ruled in that this provision of the ACA was coercive, and that the federal government must allow states to continue at pre-ACA levels of funding and eligibility if they chose. Medicare savings Spending reductions included a reduction in Medicare reimbursements to insurers and drug companies for private policies that the and found to be excessively costly relative to government Medicare; and reductions in Medicare reimbursements to hospitals that failed standards of efficiency and care. Taxes Medicare taxes Income from self-employment and wages of single individuals in excess of $200,000 annually are subject to an additional tax of 0.9%.

The threshold amount is $250,000 for a married couple filing jointly (threshold applies to joint compensation of the two spouses), or $125,000 for a married person filing separately. In ACA's sister act, the, an additional Medicare tax of 3.8% was applied to unearned income, specifically the lesser of net investment income or the amount by which adjusted gross income exceeds $200,000 ($250,000 for a married couple filing jointly; $125,000 for a married person filing separately.) Excise taxes for the raised $16.3 billion in 2015 (17% of all excise taxes collected by the Federal Government).

$11.3 billion was raised by an excise tax placed directly on health insurers based on their market share. The ACA also includes an excise tax of 40% (') on total employer premium spending in excess of specified dollar amounts ($10,200 for single coverage and $27,500 for family coverage) indexed to inflation, originally scheduled to take effect in 2018, but delayed until 2020 by the. Annual excise taxes totaling $3 billion were levied on importers and manufacturers of prescription drugs. An excise tax of 2.3% on medical devices and a 10% excise tax on indoor tanning services were applied as well. SCHIP The (CHIP) enrollment process was simplified. Dependent's Health Insurance Dependents were permitted to remain on their parents' insurance plan until their 26th birthday, including dependents who no longer live with their parents, are not a dependent on a parent's tax return, are no longer a student, or are married. Employer mandate Businesses that employ 50 or more people but do not offer health insurance to their full-time employees pay a tax penalty if the government has subsidized a full-time employee's healthcare through tax deductions or other means.

This is commonly known as the. This provision was included to encourage employers to continue providing insurance once the exchanges began operating. Approximately 44% of the population was covered directly or indirectly through an employer. Delivery system reforms The act includes a host of reforms intended to constrain healthcare costs and improve quality. These include Medicare payment changes to discourage and, initiatives, the, the, and the creation of. Hospital quality Health care cost/quality initiatives including incentives to, to adopt, and to coordinate care and prioritize quality over quantity.

The (HRPP) was established as an addition to the, in an effort to reduce. This program penalizes hospitals with higher than expected readmission rates by decreasing their Medicare reimbursement rate.

Bundled Payments The payment system switched from to. A single payment was to be paid to a hospital and a physician group for a defined episode of care (such as a ) rather than individual payments to individual service providers. In addition, the (commonly called the 'donut hole') was to shrink incrementally, closing completely by January 1, 2020. Accountable Care Organizations The Act allowed the creation of Accountable Care Organizations (ACOs), which are groups of doctors, hospitals and other providers that commit to give coordinated, high quality care to Medicare patients. ACOs were allowed to continue using a fee for service billing approach.

They receive bonus payments from the government for minimizing costs while achieving quality benchmarks that emphasize prevention and mitigation of chronic disease. If they fail to do so, they are subject to penalties. Unlike, ACO patients are not required to obtain all care from the ACO. Also, unlike HMOs, ACOs must achieve quality of care goals.

Medicare donut hole Medicare Part D participants received a 50% discount on brand name drugs purchased after exhausting their. The began mailing rebate checks in 2010. By the year 2020, the donut hole will be completely phased out. State waivers From 2017 onwards, states can apply for a 'waiver for state innovation' that allows them to conduct experiments that meet certain criteria. To obtain a waiver, a state must pass legislation setting up an alternative health system that provides insurance at least as comprehensive and as affordable as ACA, covers at least as many residents and does not increase the federal deficit.

These states can be exempt from some of ACA's central requirements, including the individual and employer mandates and the provision of an insurance exchange. The state would receive compensation equal to the aggregate amount of any federal subsidies and tax credits for which its residents and employers would have been eligible under ACA plan, if they cannot be paid under the state plan. In May 2011, Vermont enacted, a state-based for which they intended to pursue a waiver to implement. In December 2014, Vermont decided not to continue due to high expected costs. Other • The (or CLASS Act) established a voluntary and public option for employees, • Consumer Operated and Oriented Plans (CO-OP), member-governed non-profit insurers, could start providing health care coverage, based on a 5-year federal loan.

Legislative history. Main articles: and An coupled with subsidies for private insurance as a means for was considered the best way to win the support of the Senate because it had been included in prior bipartisan reform proposals. The concept goes back to at least 1989, when the proposed an individual mandate as an alternative to. It was championed for a time by conservative economists and senators as a market-based approach to healthcare reform on the basis of individual responsibility and avoidance of. Specifically, because the 1986 (EMTALA) requires any hospital participating in Medicare (nearly all do) to provide emergency care to anyone who needs it, the government often indirectly bore the cost of those without the ability to pay.

President in 1993 that included a mandate for employers to provide health insurance to all employees through a regulated marketplace of. Republican Senators proposed an alternative that would have required individuals, but not employers, to buy insurance. Ultimately the Clinton plan failed amid an unprecedented barrage of negative advertising funded by politically conservative groups and the health insurance industry and due to concerns that it was overly complex. Clinton negotiated a compromise with the to instead enact the in 1997. John Chafee The 1993 Republican alternative, introduced by Senator as the, contained a 'universal coverage' requirement with a penalty for noncompliance—an individual mandate—as well as subsidies to be used in state-based 'purchasing groups'.

Advocates for the 1993 bill included prominent Republicans such as Senators,, and. Of 1993's 43 Republican Senators, 20 supported the HEART Act. Another Republican proposal, introduced in 1994 by Senator (R-OK), the Consumer Choice Health Security Act, contained an individual mandate with a penalty provision; however, Nickles subsequently removed the mandate from the bill, stating he had decided 'that government should not compel people to buy health insurance'.

At the time of these proposals, Republicans did not raise constitutional issues with the mandate; Mark Pauly, who helped develop a proposal that included an individual mandate for, remarked, 'I don't remember that being raised at all. The way it was viewed by the Congressional Budget Office in 1994 was, effectively, as a tax.' Mitt Romney's went from 90% of its residents insured to 98%, the highest rate in the nation. In 2006, was enacted at the state level in Massachusetts. The bill contained both an individual mandate and an.

Republican Governor vetoed the mandate, but after Democrats overrode his veto, he signed it into law. Romney's implementation of the and individual mandate in Massachusetts was at first lauded by Republicans. During, Senator praised Romney's ability to 'take some good conservative ideas, like private health insurance, and apply them to the need to have everyone insured'. Romney said of the individual mandate: 'I'm proud of what we've done. If Massachusetts succeeds in implementing it, then that will be the model for the nation.' In 2007, a year after the Massachusetts reform, Republican Senator and Democratic Senator introduced the, which featured an individual mandate and state-based, called 'State Health Help Agencies'. The bill initially attracted bipartisan support, but died in committee.

Many of the remained in Congress during the 2008 healthcare debate. By 2008 many Democrats were considering this approach as the basis for healthcare reform. Experts said that the legislation that eventually emerged from Congress in 2009 and 2010 bore similarities to the 2007 bill and that it was deliberately patterned after Romney's state healthcare plan.

Healthcare debate, 2008–10. See also: Healthcare reform was a major topic during the. As the race narrowed, attention focused on the plans presented by the two leading candidates, and the eventual nominee,. Each candidate proposed a plan to cover the approximately 45 million Americans estimated to not have health insurance at some point each year. Clinton's proposal would have required all Americans to obtain coverage (in effect, an individual mandate), while Obama's proposal provided a but rejected the use of an individual mandate. During the, Obama said that fixing healthcare would be one of his top four priorities as president.

Obama and his opponent, Sen., proposed health insurance reforms though they differed greatly. Senator John McCain proposed tax credits for health insurance purchased in the individual market, which was estimated to reduce the number of uninsured people by about 2 million by 2018.

Obama proposed private and public group insurance, income-based subsidies, consumer protections, and expansions of Medicaid and SCHIP, which was estimated at the time to reduce the number of uninsured people by 33.9 million by 2018. President Obama, September 9, 2009 After his inauguration, Obama announced to a joint session of Congress in February 2009 his intent to work with Congress to construct a plan for healthcare reform. By July, a series of bills were approved by committees within the. On the Senate side, from June to September, the held a series of 31 meetings to develop a healthcare reform bill. This group—in particular, Democrats, and, along with Republicans, and —met for more than 60 hours, and the principles that they discussed, in conjunction with the other committees, became the foundation of the Senate healthcare reform bill.

Congressional Democrats and health policy experts like economics professor and argued that would require both and an individual mandate to ensure that and/or would not result in an. This approach was taken because the president and congressional leaders had concluded that more progressive plans, such as the, could not obtain in the Senate. By deliberately drawing on bipartisan ideas—the same basic outline was supported by former Senate majority leaders,, and —the bill's drafters hoped to garner the votes necessary for passage. However, following the adoption of an individual mandate, Republicans came to oppose the mandate and threatened to any bills that contained it. Senate minority leader, who led the Republican congressional strategy in responding to the bill, calculated that Republicans should not support the bill, and worked to prevent defections: It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out. Republican Senators, including those who had supported previous bills with a similar mandate, began to describe the mandate as 'unconstitutional'. Journalist wrote in that 'a policy that once enjoyed broad support within the Republican Party suddenly faced unified opposition.'

Reporter Michael Cooper of wrote that: 'the provision. Requiring all Americans to buy health insurance has its roots in conservative thinking.' Tea Party protesters at the, September 12, 2009 The reform negotiations also attracted attention from, including deals between certain lobby groups and the advocates of the law to win the support of groups that had opposed past reforms, as in 1993. The documented many of the reported ties between 'the healthcare lobbyist complex' and politicians in both parties. During the August 2009 summer congressional recess, many members went back to their districts and held town hall meetings on the proposals. The nascent organized protests and many groups and individuals attended the meetings to oppose the proposed reforms.

Many threats were made against members of Congress over the course of the debate. When Congress returned from recess, in September 2009 supporting the ongoing Congressional negotiations.

He acknowledged the polarization of the debate, and quoted a letter from the late Senator Edward 'Ted' Kennedy urging on reform: 'what we face is above all a moral issue; that at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.' On November 7, the House of Representatives passed the on a 220–215 vote and forwarded it to the Senate for passage. Senate The Senate began work on its own proposals while the House was still working. The requires all revenue-related bills to originate in the House. To formally comply with this requirement, the Senate used H.R. 3590, a bill regarding housing tax changes for service members. It had been passed by the House as a revenue-related modification to the.

The bill became the Senate's vehicle for its healthcare reform proposal, discarding the bill's original content. The bill ultimately incorporated elements of proposals that were reported favorably by the Senate and committees. With the Republican Senate minority vowing to, 60 votes would be necessary to pass the Senate.

At the start of the, Democrats had only 58 votes; ultimately won by was still undergoing a recount, while was still a Republican (he became a Democrat in April, 2009). Negotiations were undertaken attempting to satisfy moderate Democrats and to bring Republican senators aboard; particular attention was given to Republicans Bennett, Enzi, Grassley and Snowe. On July 7 Franken was sworn into office, providing a potential 60th vote. On August 25 —a longtime healthcare reform advocate—died. Was appointed as Senator Kennedy's temporary replacement on September 24.

After the Finance Committee vote on October 15, negotiations turned to moderate Democrats. Majority leader focused on satisfying centrists. The holdouts came down to of Connecticut, an independent who caucused with Democrats, and conservative Nebraska Democrat. Lieberman's demand that the bill not include a was met, although supporters won various concessions, including allowing state-based public options such as Vermont's. Republican not voting (1) The White House and Reid addressed Nelson's concerns during a 13-hour negotiation with two concessions: a compromise on, modifying the language of the bill 'to give states the right to prohibit coverage of abortion within their own insurance exchanges', which would require consumers to pay for the procedure out of pocket if the state so decided; and an amendment to offer a higher rate of reimbursement for Nebraska. The latter half of the compromise was derisively termed the 'Cornhusker Kickback' and was repealed in the subsequent reconciliation amendment bill. On December 23, the Senate voted 60–39 to end debate on the bill: a to end the.

The bill then passed, also 60–39, on December 24, 2009, with all Democrats and two independents voting for it, and all Republicans against (except, who did not vote). The bill was endorsed by the and. On January 19, 2010, Republican was elected to the Senate in, having campaigned on giving the Republican minority the 41st vote needed to sustain Republican filibusters. His victory had become significant because of its effects on the legislative process. The first was psychological: the symbolic importance of losing Kennedy's made many Congressional Democrats concerned about the political cost of passing a bill.

No representative seated (4) Brown's election meant Democrats could no longer in the Senate. In response, argued that Democrats should scale back to a less ambitious bill; pushed back, dismissing Emanuel's scaled-down approach as 'Kiddie Care'. Obama remained insistent on comprehensive reform. The news that in intended to raise premium rates for its patients by as much as 39% gave him new evidence of the need for reform.

On February 22, he laid out a 'Senate-leaning' proposal to consolidate the bills. He held a meeting with both parties' leaders on February 25.

The Democrats decided that the House would pass the Senate's bill, to avoid another Senate vote. House Democrats had expected to be able to negotiate changes before passing a final bill. Since any bill that emerged from conference that differed from the Senate bill would have to pass the Senate over another Republican filibuster, most House Democrats agreed to pass the Senate bill on condition that it be amended by a subsequent bill. They drafted the, which could be passed by the. Per the, reconciliation cannot be subject to a. But reconciliation is, which is why the procedure was not used to pass ACA in the first place; the bill had inherently non-budgetary regulations.

Although the already-passed Senate bill could not have been passed by reconciliation, most of House Democrats' demands were budgetary: 'these changes—higher subsidy levels, different kinds of taxes to pay for them, nixing the Nebraska Medicaid deal—mainly involve taxes and spending. In other words, they're exactly the kinds of policies that are well-suited for reconciliation.'

The remaining obstacle was a pivotal group of Democrats led by who were initially reluctant to support the bill. The group found the possibility of federal funding for abortion significant enough to warrant opposition. The Senate bill had not included language that satisfied their concerns, but they could not address abortion in the reconciliation bill as it would be non-budgetary. Instead, Obama issued, reaffirming the principles in the.

This won the support of Stupak and members of his group and assured the bill's passage. The House passed the Senate bill with a 219–212 vote on March 21, 2010, with 34 Democrats and all 178 Republicans voting against it. The next day, Republicans introduced legislation to repeal the bill.

Obama signed ACA into law on March 23, 2010. Since passage, Republicans have voted to repeal all or parts of the Affordable Care Act over sixty times; no such attempt by Republicans has been successful. The amendment bill, The Health Care and Education Reconciliation Act, cleared the House on March 21; the Senate passed it by reconciliation on March 25, and Obama signed it on March 30. See also: The law has caused a significant reduction in the number and percentage of people without health insurance.

The CDC reported that the percentage of people without health insurance fell from 16.0% in 2010 to 8.9% during the January–June 2016 period. The uninsured rate dropped in every congressional district in the U.S. Between 2013 and 2015. The reported in March 2016 that there were approximately 12 million people covered by the exchanges (10 million of whom received subsidies to help pay for insurance) and 11 million made eligible for Medicaid by the law, a subtotal of 23 million people.

An additional 1 million were covered by the ACA's 'Basic Health Program,' for a total of 24 million. CBO also estimated that the ACA would reduce the net number of uninsured by 22 million in 2016, using a slightly different computation for the above figures totaling ACA coverage of 26 million, less 4 million for reductions in 'employment-based coverage' and 'non-group and other coverage.' The (HHS) estimated that 20.0 million adults (aged 18–64) gained healthcare coverage via ACA as of February 2016, a 2.4 million increase over September 2015.

HHS estimated that this 20.0 million included: a) 17.7 million from the start of open enrollment in 2013–2016; and b) 2.3 million young adults aged 19–25 who initially gained insurance from 2010–2013, as they were allowed to remain on their parent's plans until age 26. Of the 20.0 million, an estimated 6.1 million were aged 19–25. Similarly, the issued a report in December 2016 that said that about 19.2 million non-elderly Americans had gained health insurance coverage from 2010 to 2015.

In March 2016, the CBO reported that there were approximately 27 million people without insurance in 2016, a figure they expected would range from 26–28 million through 2026. CBO also estimated the percentage of insured among all U.S. Residents would remain at 90% through that period, 92–93% excluding unauthorized immigrants. Those states that expanded Medicaid had a 7.3% uninsured rate on average in the first quarter of 2016, while those that did not expand Medicaid had a 14.1% uninsured rate, among adults aged 18 to 64. As of December 2016 there were 32 states (including Washington DC) that had adopted the Medicaid extension, while 19 states had not. By 2017, nearly 70% of those on the exchanges could purchase insurance for less than $75/month after subsidies, which rose to offset significant pre-subsidy price increases in the exchange markets. Healthcare premium cost increases in the employer market continued to moderate.

For example, healthcare premiums for those covered by employers rose by 69% from 2000–2005, but only 27% from 2010 to 2015, with only a 3% increase from 2015 to 2016. The ACA also helps reduce income inequality measured after taxes, due to higher taxes on the top 5% of income earners and both subsidies and Medicaid expansion for lower-income persons. CBO estimated that subsidies paid under the law in 2016 averaged $4,240 per person for 10 million individuals receiving them, roughly $42 billion. For scale, the subsidy for the employer market, in the form of exempting from taxation those health insurance premiums paid on behalf of employees by employers, was approximately $1,700 per person in 2016, or $266 billion total in the employer market. The employer market subsidy was not changed by the law.

Insurance exchanges As of August 2016, 15 states operated their own exchanges. Other states either used the federal exchange, or operated in partnership with or supported by the federal government. Medicaid expansion. Not adopting Medicaid expansion As of December 2016 there were 32 states (including Washington DC) that had adopted the Medicaid extension, while 19 states had not. Those states that expanded Medicaid had a 7.3% uninsured rate on average in the first quarter of 2016, while those that did not expand Medicaid had a 14.1% uninsured rate, among adults aged 18 to 64.

Following the Supreme Court ruling in 2012, which held that states would not lose Medicaid funding if they didn't expand Medicaid under the ACA, several states rejected expanded Medicaid coverage. Over half of the national uninsured population lived in those states.

In a report to Congress, the (CMS) estimated that the cost of expansion was $6,366 per person for 2015, about 49 percent above previous estimates. An estimated 9 million to 10 million people had gained Medicaid coverage, mostly low-income adults. The estimated in October 2015 that 3.1 million additional people were not covered because of states that rejected the Medicaid expansion.

States that rejected the Medicaid expansion could maintain their Medicaid eligibility thresholds, which in many states were significantly below 133% of the poverty line. Many states did not make Medicaid available to childless adults at any income level. Because subsidies on exchange insurance plans were not available to those below the poverty line, such individuals had no new options.

For example, in Kansas, where only able-bodied adults with children and with an income below 32% of the poverty line were eligible for Medicaid, those with incomes from 32% to 100% of the poverty level ($6,250 to $19,530 for a family of three) were ineligible for both Medicaid and federal subsidies to buy insurance. Absent children, able-bodied adults were not eligible for Medicaid in Kansas. Studies of the impact of state decisions to reject the Medicaid expansion calculated that up to 6.4 million people could fall into this status. The federal government initially paid for 100% of the expansion (through 2016).

The subsidy tapered to 90% by 2020 and continued to shrink thereafter. Several states argued that they could not afford their 10% contribution. Studies suggested that rejecting the expansion would cost more than expanding Medicaid due to increased spending on uncompensated emergency care that otherwise would have been partially paid for by Medicaid coverage, A 2016 study led by health economics professor found that residents of Kentucky and Arkansas, which both accepted the Medicaid expansion, were more likely to receive health care services and less likely to incur emergency room costs or have trouble paying their medical bills than before the expansion. Residents of Texas, which did not accept the Medicaid expansion, did not see a similar improvement during the same period.

Kentucky opted for increased managed care, while Arkansas subsidized private insurance. The new Arkansas and Kentucky governors have proposed reducing or modifying their programs.

Between 2013 and 2015, the uninsured rate dropped from 42% to 14% in Arkansas and from 40% to 9% in Kentucky, compared with 39% to 32% in Texas. Specific improvements included additional primary and preventive care, fewer emergency departments visits, reported higher quality care, improved health, improved drug affordability, reduced out-of-pocket spending and increased outpatient visits, increased diabetes screening, glucose testing among diabetes patients and regular care for chronic conditions.

A 2016 study found that states that expanded Medicaid had lower premiums on exchange policies, because they had fewer low-income enrollees, whose health on average is worse than that of those with higher income. Healthcare insurance costs. Healthcare cost information, including rate of change, per-capita, and percent of GDP. (Data source: ) The law is designed to pay in the form of tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies. While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer.

For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in Alabama and 60 percent in Texas. However, some or all of these costs are offset by subsidies, paid as tax credits. For example, the reported that for the second-lowest cost 'Silver plan' (a plan often selected and used as the benchmark for determining financial assistance), a 40-year old non-smoker making $30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $208/month) after the subsidy/tax credit, despite large increases in the pre-subsidy price. This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases. Healthcare premium cost increases in the employer market continued to moderate after the implementation of the law. For example, healthcare premiums for those covered by employers rose by 69% from 2000–2005, but only 27% from 2010 to 2015, with only a 3% increase from 2015 to 2016.

From 2008–2010 (before passage of the ACA) health insurance premiums rose by an average of 10% per year. Several studies found that the and accompanying recession could not account for the entirety of the slowdown and that structural changes likely share at least partial credit. A 2013 study estimated that changes to the health system had been responsible for about a quarter of the recent reduction in inflation. Richard Harvey Concerto Antico Pdf on this page. Paul Krawzak claimed that even if cost controls succeed in reducing the amount spent on healthcare, such efforts on their own may be insufficient to outweigh the long-term burden placed by demographic changes, particularly. In a 2016 review of the ACA published in, Barack Obama himself wrote that from 2010 through 2014 mean annual growth in real per-enrollee Medicare spending was negative, down from a mean of 4.7% per year from 2000 through 2005 and 2.4% per year from 2006 to 2010; similarly, mean real per-enrollee growth in private insurance spending was 1.1% per year over the period, compared with a mean of 6.5% from 2000 through 2005 and 3.4% from 2005 to 2010.

Effect on deductibles and co-payments While health insurance premium costs have moderated, some of this is because of insurance policies that have a higher, and out-of-pocket maximums that shift costs from insurers to patients. In addition, many employees are choosing to combine a with higher deductible plans, making the impact of the ACA difficult to determine precisely. For those who obtain their insurance through their employer ('group market'), a 2016 survey found that: • Deductibles grew by 63% from 2011 to 2016, while premiums increased 19% and worker earnings grew by 11%. • In 2016, 4 in 5 workers had an insurance deductible, which averaged $1,478.

For firms with less than 200 employees, the deductible averaged $2,069. • The percentage of workers with a deductible of at least $1,000 grew from 10% in 2006 to 51% in 2016. The 2016 figure drops to 38% after taking employer contributions into account.

For the 'non-group' market, of which two-thirds are covered by the ACA exchanges, a survey of 2015 data found that: • 49% had individual deductibles of at least $1,500 ($3,000 for family), up from 36% in 2014. • Many marketplace enrollees qualify for cost-sharing subsidies that reduce their net deductible. • While about 75% of enrollees were 'very satisfied' or 'somewhat satisfied' with their choice of doctors and hospitals, only 50% had such satisfaction with their annual deductible. • While 52% of those covered by the ACA exchanges felt 'well protected' by their insurance, in the group market 63% felt that way.

Health outcomes. The map illustrates the frequency of premature deaths (those under age 75) adjusted for the age of persons in the county. Insurance coverage helps save lives, by encouraging early detection and prevention of dangerous medical conditions. According to a 2014 study, the ACA likely prevented an estimated 50,000 preventable patient deaths from 2010 to 2013. Public health professors David Himmelstein and Steffie Woolhandler wrote in January 2017 that a rollback of the ACA's Medicaid expansion alone would cause an estimated 43,956 deaths annually. The Federal Reserve publishes data on premature death rates by county, defined as those dying below age 74. According to the Kaiser Foundation, expanding Medicaid in the remaining 19 states would cover up to 4.5 million persons.

Since expanding Medicaid expands coverage and expanding coverage reduces mortality, therefore expanding Medicaid reduces mortality. Texas, Oklahoma, Mississippi, Alabama, Georgia, Tennessee, Missouri and South Carolina, indicated on the map at right as having many counties with high premature mortality rates could therefore reduce mortality by expanding Medicaid, other things equal. Federal deficit CBO estimates of revenue and impact on deficit.

See also: and The CBO reported in several studies that the ACA would reduce the deficit, and that repealing it would increase the deficit. The 2011 comprehensive CBO estimate projected a net deficit reduction of more than $200 billion during the 2012–2021 period: it calculated the law would result in $604 billion in offset by $813 billion in, resulting in a $210 billion net deficit reduction. The CBO separately predicted that while most of the spending provisions do not begin until 2014, revenue would exceed spending in those subsequent years.

The CBO claimed that the bill would 'substantially reduce the growth of Medicare's payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs' —ultimately extending the solvency of the by 8 years. This estimate was made prior to the that enabled states to, thereby forgoing the related federal funding. The and subsequently updated the budget projection, estimating the impact of the ruling would reduce the cost estimate of the insurance coverage provisions by $84 billion. The CBO in June 2015 forecasted that repeal of ACA would increase the deficit between $137 billion and $353 billion over the 2016–2025 period, depending on the impact of macroeconomic effects. The CBO also forecasted that repeal of ACA would likely cause an increase in GDP by an average of 0.7% in the period from 2021 to 2015, mainly by boosting the supply of labor. Although the CBO generally does not provide cost estimates beyond the 10-year budget projection period because of the degree of uncertainty involved in the projection, it decided to do so in this case at the request of lawmakers, and estimated a second decade deficit reduction of $1.2 trillion. CBO predicted deficit reduction around a broad range of one-half percent of GDP over the 2020s while cautioning that 'a wide range of changes could occur'.

Opinions on CBO projections The CBO cost estimates were criticized because they excluded the effects of potential legislation that would increase Medicare payments by more than $200 billion from 2010 to 2019. However, the so-called 'doc fix' is a separate issue that would have existed whether or not ACA became law – omitting its cost from ACA was no different from omitting the cost of other tax., a Princeton, wrote. 'The rigid, artificial rules under which the Congressional Budget Office must score proposed legislation unfortunately cannot produce the best unbiased forecasts of the likely fiscal impact of any legislation', but went on to say 'But even if the budget office errs significantly in its conclusion that the bill would actually help reduce the future federal deficit, I doubt that the financing of this bill will be anywhere near as fiscally irresponsible as was the financing of the.' , CBO director during the George W.

Bush administration, who later served as the chief economic policy adviser to U.S. Senator 's 2008 presidential campaign, alleged that the bill would increase the deficit by $562 billion because, he argued, it front-loaded revenue and back-loaded benefits. Scheiber and Cohn rejected critical assessments of the law's deficit impact, arguing that predictions were biased towards underestimating deficit reduction. They noted that for example, it is easier to account for the cost of definite levels of subsidies to specified numbers of people than account for savings from, and that the CBO had a track record of overestimating costs and underestimating savings of health legislation; stating, 'innovations in the delivery of medical care, like greater use of and financial incentives for more coordination of care among doctors, would produce substantial savings while also slowing the relentless climb of medical expenses. But the CBO would not consider such savings in its calculations, because the innovations hadn't really been tried on such large scale or in concert with one another—and that meant there wasn't much hard data to prove the savings would materialize.' In 2010,, former then working for, stated that the CBO estimates are not likely to be accurate, because they were based on the assumption that the law would not change. The objected that Congress had a good record of implementing Medicare savings.

According to their study, Congress followed through on the implementation of the vast majority of provisions enacted in the past 20 years to produce Medicare savings, although not the payment reductions addressed by the annual 'doc fix'. Economic consequences CBO estimated in June 2015 that repealing the ACA would: • Decrease aggregate demand (GDP) in the short-term, as low-income persons who tend to spend a large fraction of their additional resources would have fewer resources (e.g., ACA subsidies would be eliminated). This effect would be offset in the long-run by the labor supply factors below.

• Increase the supply of labor and aggregate compensation by about 0.8 and 0.9 percent over the 2021–2025 period. CBO cited the ACA's expanded eligibility for Medicaid and subsidies and tax credits that rise with income as disincentives to work, so repealing the ACA would remove those disincentives, encouraging workers to supply more hours of labor. • Increase the total number of hours worked by about 1.5% over the 2021–2025 period. • Remove the higher tax rates on capital income, thereby encouraging additional investment, raising the capital stock and output in the long-run. In 2015 the found no evidence that companies were reducing worker hours to avoid ACA requirements for employees working over 30 hours per week. The CBO estimated that the ACA would slightly reduce the size of the labor force and number of hours worked, as some would no longer be tethered to employers for their insurance.

Cohn, citing CBO's projections, claimed that ACA's primary employment effect was to alleviate: 'People who are only working because they desperately need employer-sponsored health insurance will no longer do so.' He concluded that the 'reform's only significant employment impact was a reduction in the labor force, primarily because people holding onto jobs just to keep insurance could finally retire', because they have health insurance outside of their jobs. Employer mandate and part-time work. For more details on health insurance mandates, see. The employer mandate requires employers meeting certain criteria to provide health insurance to their workers.

The mandate applies to employers with more than 50 employees that do not offer health insurance to their full-time workers. Critics claimed that the mandate created a for business to keep their full-time headcount below 50 and to hire part-time workers instead. Between March 2010 and 2014 the number of part-time jobs declined by 230,000, while the number of full-time jobs increased by 2 million. In the public sector full-time jobs turned into part-time jobs much more than in the private sector. A 2016 study found only limited evidence that ACA had increased part-time employment.

Several businesses and the state of Virginia added a 29-hour-a-week cap for their part-time employees, [ ] [ ] to reflect the 30-hour-or-more definition for full-time worker. As of yet, however, only a small percent of companies have shifted their workforce towards more part-time hours (4% in a survey from the Federal Reserve Bank of Minneapolis). Trends in working hours and the effects of the correlate with part-time working hour patterns. The impact of this provision may have been offset by other factors, including that health insurance helps attract and retain employees, increases productivity and reduces absenteeism; and the lower training and administration costs of a smaller full-time workforce over a larger part-time work force. Relatively few firms employ over 50 employees and more than 90% of them offered insurance.

Workers without employer insurance could purchase insurance on the exchanges. Most policy analysts (on both right and left) were critical of the employer mandate provision. They argued that the perverse incentives regarding part-time hours, even if they did not change existing plans, were real and harmful; that the raised of the 50th worker for businesses could limit companies' growth; that the costs of reporting and administration were not worth the costs of maintaining employer plans; and noted that the employer mandate was not essential to maintain adequate risk pools.

The effects of the provision generated vocal opposition from business interests and some unions not granted exemptions. A 2013/4 survey by the found that about 75 percent of those surveyed said ACA hadn’t influenced their planning or expectations for 2014, and 85 percent said the law wouldn’t prompt a change in their hiring practices. Some 21 percent of 64 businesses surveyed said that the act would have a harmful effect and 5 percent said it would be beneficial.

Hospitals From the start of 2010 to November 2014, 43 hospitals in closed. Critics claimed that the new law caused these hospitals to close.

Many of these rural hospitals were built using funds from the 1946, to increase access to. Some of these hospitals reopened as other medical facilities, but only a small number operated (ER) or centers. Between January 2010 and 2015, a quarter of emergency room doctors said they had seen a major surge in patients, while nearly half had seen a smaller increase. Seven in ten ER doctors claimed that they lacked the resources to deal with large increases in the number of patients. The biggest factor in the increased number of ER patients was insufficient primary care providers to handle the larger number of insured patients. Insurers claimed that because they have access to and collect patient data that allow evaluations of interventions, they are essential to ACO success. Large insurers formed their own ACOs.

Many hospitals merged and purchased physician practices. The increased market share gave them more leverage in negotiations with insurers over costs and reduced patient care options. Public opinion Prior to the law's passage, polling indicated the public's views became increasingly negative in reaction to specific plans discussed during the legislative debate over 2009 and 2010. Polling statistics showed a general negative opinion of the law; with those in favor at approximately 40% and those against at 51%, as of October 2013.

About 29% of approve of the law, compared with 61% of and 91% of. Opinions were divided by age of the person at the law's inception, with a solid majority of seniors opposing the bill and a solid majority of those younger than forty years old in favor. Congressional Democrats celebrating the 6th anniversary of the Affordable Care Act in March 2016 on the steps of the U.S. Specific elements were popular across the political spectrum, while others, such as the mandate to purchase insurance, were widely disliked. In a 2012 poll 44% supported the law, with 56% against.

By party affiliation, 75% of Democrats, 27% of Independents and 14% of Republicans favored the law overall. 82% favored banning insurance companies from denying coverage to people with pre-existing conditions, 61% favored allowing children to stay on their parents' insurance until age 26, 72% supported requiring companies with more than 50 employees to provide insurance for their employees, and 39% supported the individual mandate to own insurance or pay a penalty. By party affiliation, 19% of Republicans, 27% of Independents, and 59% of Democrats favored the mandate.

Other polls showed additional provisions receiving majority support, including the creation of insurance exchanges, pooling small businesses and the uninsured with other consumers so that more people can take advantage of large group pricing benefits and providing subsidies to individuals and families to make health insurance more affordable. In a 2010, 62% of respondents said they thought ACA would 'increase the amount of money they personally spend on health care', 56% said the bill 'gives the government too much involvement in health care', and 19% said they thought they and their families would be better off with the legislation. Other polls found that people were concerned that the law would cost more than projected and would not do enough to control costs.

Some opponents believed that the reform did not go far enough: a 2012 poll indicated that 71% of Republican opponents rejected it overall, while 29% believed it did not go far enough; independent opponents were divided 67% to 33%; and among the much smaller group of Democratic opponents, 49% rejected it overall and 51% wanted more. In June 2013, a majority of the public (52–34%) indicated a desire for 'Congress to implement or tinker with the law rather than repeal it'. After the Supreme Court upheld the individual mandate, a 2012 poll held that 'most Americans (56%) want to see critics of President Obama's health care law drop efforts to block it and move on to other national issues'. A 2014 poll reported that 48.9% of respondents had an unfavorable view of ACA vs. 38.3% who had a favorable view (of more than 5,500 individuals).

A 2014 poll reported that 26% of Americans support ACA. Another held that 8% of respondents say that the Affordable Care Act 'is working well the way it is'. In late 2014, a poll reported Repeal: 30%, Leave as is: 13%, Improve: 52%. In 2015, a / poll reported that 47% of Americans approved the health care law.

This was the first time that a major poll indicated that more respondents approved ACA than disapproved of it. The recurring from December 2016 reported that: a) 30% wanted to expand what the law does; b) 26% wanted to repeal the entire law; c) 19% wanted to move forward with implementing the law as it is; and d) 17% wanted to scale back what the law does, with the remainder undecided. Separate polls from Fox News and NBC/WSJ both taken during January 2017 indicated more people viewed the law favorably than did not for the first time. One of the reasons for the improving popularity of the law is that Democrats who opposed it in the past (many prefer a 'Medicare for All' approach) have shifted their positions since the ACA is under threat of repeal. A January 2017 Morning Consult poll showed that 35% of respondents either believed that 'Obamacare' and the 'Affordable Care Act' were different or did not know. Approximately 45% were unsure whether the 'repeal of Obamacare' also meant the 'repeal of the Affordable Care Act.'

39% did not know that 'many people would lose coverage through Medicaid or subsidies for private health insurance if the A.C.A. Were repealed and no replacement enacted,' with Democrats far more likely (79%) to know that fact than Republicans (47%). A 2017 study found that personal experience with public health insurance programs leads to greater support for the Affordable Care Act, and the effects appear to be most pronounced among Republicans and low-information voters. Political aspects 'Obamacare' The term 'Obamacare' was originally coined by opponents as a.

The term emerged in March 2007 when healthcare lobbyist Jeanne Schulte Scott used it in a health industry journal, writing 'We will soon see a '-care' and 'Obama-care' to go along with '-care', '-care', and a totally revamped and remodeled ' from the 1990s'. According to research by Elspeth Reeve, the expression was used in early 2007, generally by writers describing the candidate's proposal for expanding coverage for the uninsured. It first appeared in a political campaign by in May 2007 in. Romney said, ' We had half a million people without insurance, and I said, 'How can we get those people insured without raising taxes and without having government take over healthcare?' And let me tell you, if we don't do it, the Democrats will.

If the Democrats do it, it will be socialized medicine; it'll be government-managed care. It'll be what's known as Hillarycare or Barack Obamacare, or whatever you want to call it.' By mid-2012, Obamacare had become the colloquial term used by both supporters and opponents. In contrast, the use of 'Patient Protection and Affordable Care Act' or 'Affordable Care Act' became limited to more formal and official use. Use of the term in a positive sense was suggested by Democrat.

Obama endorsed the nickname, saying, 'I have no problem with people saying Obama cares. In March 2012, the Obama reelection campaign embraced the term 'Obamacare', urging Obama's supporters to post messages that begin, 'I like #Obamacare because.' In October 2013, the and began cutting back on use of the term.

Stuart Seidel, NPR's managing editor, said that the term 'seems to be straddling somewhere between being a politically-charged term and an accepted part of the vernacular'. Common misconceptions 'Death panels'. Main article: On August 7, 2009, pioneered the term ' to describe groups that would decide whether sick patients were 'worthy' of medical care. 'Death panel' referred to two claims about early drafts.

One was that under the law, seniors could be denied care due to their age and the other that the government would advise seniors to end their lives instead of receiving care. The ostensible basis of these claims was the provision for an (IPAB).

IPAB was given the authority to recommend cost-saving changes to Medicare by facilitating the adoption of cost-effective treatments and cost-recovering measures when the statutory levels set for Medicare were exceeded within any given 3-year period. In fact, the Board was prohibited from recommending changes that would reduce payments to certain providers before 2020, and was prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing. The other related issue concerned consultation: would have reimbursed physicians for providing patient-requested consultations for Medicare recipients on end-of-life health planning (which is covered by many private plans), enabling patients to specify, on request, the kind of care they wished to receive. The provision was not included in ACA. In 2010, the reported that 85% of Americans were familiar with the claim, and 30% believed it was true, backed by three contemporaneous polls. A poll in August 2012 found that 39% of Americans believed the claim.

The allegation was named 's 'Lie of the Year', one of 's 'whoppers' and the most outrageous term by the. Described such rumors as 'rife with gross—and even cruel—distortions'. Members of Congress ACA requires members of Congress and their staffs to obtain health insurance either through an exchange or some other program approved by the law (such as Medicare), instead of using the insurance offered to federal employees (the ). Illegal immigrants ACA does not provide benefits to illegal immigrants. Anime Studio Pro 7 Keygen Download more. It explicitly denies insurance subsidies to 'unauthorized (illegal) aliens'. Exchange 'death spiral' One argument against the ACA is that the insurers are leaving the marketplaces, as they cannot profitably cover the available pool of customers, which contains too many unhealthy participants relative to healthy participants.

A scenario where prices rise, due to an unfavorable mix of customers from the insurer's perspective, resulting in fewer customers and fewer insurers in the marketplace, further raising prices, has been called a 'death spiral.' During 2017, the median number of insurers offering plans on the ACA exchanges in each state was 3.0, meaning half the states had more and half had fewer insurers. There were five states with one insurer in 2017; 13 states with two; 11 states with three; and the remainder had four insurers or more. Wisconsin had the most, with 15 insurers in the marketplace. The median number of insurers was 4.0 in 2016, 5.0 in 2015, and 4.0 in 2014. Further, the CBO reported in January 2017 that it expected enrollment in the exchanges to rise from 10 million during 2017 to 13 million by 2027, assuming laws in place at the end of the Obama administration were continued.

Following a 2015 CBO report that reached a similar conclusion, wrote: 'But the truth is that this report is much, much closer to what supporters of reform have said than it is to the scare stories of the critics—no death spirals, no job-killing, major gains in coverage at relatively low cost.' Opposition Opposition and efforts to repeal the legislation have drawn support from sources that include labor unions, advocacy groups, Republicans, small business organizations and the. These groups claimed that the law would disrupt existing health plans, increase costs from new insurance standards, and increase the deficit. Some opposed the idea of, viewing insurance as similar to other unsubsidized goods. President has repeatedly promised to 'repeal and replace' it.

As of 2013 unions that expressed concerns about ACA included the, which called ACA 'highly disruptive' to union health care plans, claiming it would drive up costs of union-sponsored plans; the,, and, whose leaders sent a letter to Reid and Pelosi arguing, ' ACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40-hour work week that is the backbone of the American middle class.' In January 2014, Terry O'Sullivan, president of the (LIUNA) and D. Taylor, president of sent a letter to Reid and Pelosi stating, 'ACA, as implemented, undermines fair marketplace competition in the health care industry.' In October 2016,, the governor of Minnesota and a member of the, said that the ACA had 'many good features' but that it was 'no longer affordable for increasing numbers of people' and called on the Minnesota legislature to provide emergency relief to policyholders. Dayton later said he regretted his remarks after they were seized on by Republicans seeking to repeal the law.

Legal challenges. See also: National Federation of Independent Business v. Sebelius Opponents challenged ACA's constitutionality in multiple lawsuits on multiple grounds. [ ] In, the Supreme Court ruled on a 5–4 vote that the individual mandate was constitutional when viewed as a tax, although under the.

The Court further determined that states could not be forced to participate in the Medicaid expansion. ACA withheld all Medicaid funding from states declining to participate in the expansion.

The Court ruled that this withdrawal of funding was unconstitutionally coercive and that individual states had the right to opt out without losing preexisting Medicaid funding. Contraception mandate In March 2012, the, while supportive of ACA's objectives, voiced concern through the that aspects of the mandate covering contraception and sterilization and 's narrow definition of a religious organization violated the right to and conscience.

Various lawsuits addressed these concerns. On June 25, 2015, the U.S. Supreme Court ruled 6–3 that federal subsidies for health insurance premiums could be used in the 34 states that did not set up their own insurance exchanges. Price In (previously United States House of Representatives v.

Burwell) the House sued the administration alleging that the money for premium subsidy payments to insurers had not been appropriated, as required for any federal government spending. The ACA subsidy that helps customers pay premiums was not part of the suit. Without the cost-sharing subsidies, the government estimated that premiums would increase by 20 percent to 30 percent for silver plans. In 2017, the uncertainty about whether the payments would continue caused Blue Cross Blue Shield of North Carolina to try to raise premiums by 22.9 percent the next year, as opposed to an increase of only 8.8 percent that it would have sought if the payments were assured. Non-cooperation Officials in Texas, Florida, Alabama, Wyoming, Arizona, Oklahoma and Missouri opposed those elements of ACA over which they had discretion. For example, Missouri declined to expand Medicaid or engaging in active, enacting a statute forbidding any state or local official to render any aid not specifically required by federal law.

Other Republican politicians discouraged efforts to advertise the benefits of the law. Some conservative political groups launched ad campaigns to discourage enrollment. Repeal efforts.

Main article: ACA was the subject of unsuccessful repeal efforts by in the,, and Congresses: Representatives (R-IA) and (R-MN) introduced bills in the House to repeal ACA the day after it was signed, as did Senator (R-SC) in the Senate. In 2011, after Republicans gained control of the House of Representatives, one of the first votes held was on a bill titled 'Repealing the Job-Killing Health Care Law Act' (H.R. 2), which the House passed 245–189. All Republicans and 3 Democrats voted for repeal. House Democrats proposed an amendment that repeal not take effect until a majority of the Senators and Representatives had opted out of the; Republicans voted down the measure.

In the Senate, the bill was offered as an amendment to an unrelated bill, but was voted down. President Obama had stated that he would have the bill even if it had passed both chambers of Congress. 2017 House Budget Following the upholding ACA as constitutional, Republicans held another vote to repeal the law on July 11; the House of Representatives voted with all 244 Republicans and 5 Democrats in favor of repeal, which marked the 33rd, partial or whole, repeal attempt. On February 3, 2015, the House of Representatives added its 67th repeal vote to the record (239 to 186). This attempt also failed. 2013 federal government shutdown Strong partisan disagreement in Congress prevented adjustments to the Act's provisions.

However, at least one change, a proposed repeal of a tax on medical devices, has received bipartisan support. Some Congressional Republicans argued against improvements to the law on the grounds they would weaken the arguments for repeal.

Republicans attempted to defund its implementation, and in October 2013, House Republicans refused to fund the federal government unless accompanied with a delay in ACA implementation, after the President unilaterally deferred the employer mandate by one year, which critics claimed he had no power to do. The House passed three versions of a bill funding the government while submitting various versions that would repeal or delay ACA, with the last version delaying enforcement of the individual mandate. The Democratic Senate leadership stated the Senate would only pass a 'clean' funding bill without any restrictions on ACA. The began on October 1. Senate Republicans threatened to block appointments to relevant agencies, such as the Independent Payment Advisory Board and.

2017 repeal effort. Main article: During a midnight congressional session starting January 11, 2017, the Senate of the voted to approve a 'budget blueprint' which would allow to repeal parts of the law 'without threat of a.' The plan, which passed 51–48, is a budget blueprint named by Senate Republicans the 'Obamacare 'repeal resolution. ' Democrats opposing the resolution staged a protest during the vote. Announced their replacement for the ACA, the, on March 6, 2017. On March 24, 2017 the effort, led by and, to repeal and replace the ACA failed amid a revolt among Republican representatives.

May 4, 2017, the United States House of Representatives voted to pass the American Health Care Act (and thereby repeal most of the Affordable Care Act) by a narrow margin of 217 to 213, sending the bill to the Senate for deliberation. The Senate Republican leadership announced that Senate Republicans would write their own version of the bill, instead of voting on the House version.

The Senate process began with an unprecedented level of secrecy; named a group of 13 Republican Senators to draft the Senate's substitute version in private, raising bipartisan concerns about a lack of transparency. On June 22, 2017, Republicans released the first discussion draft for an amendment to the bill, which would rename it to the 'Better Care Reconciliation Act of 2017' (BCRA).

On July 25, 2017, although no amendment proposal had yet garnered majority support, Senate Republicans voted to advance the bill to the floor and begin formal consideration of amendments. Senators and were the only two dissenting Republicans making the vote a 50–50 tie. Vice President then cast the tiebreaking vote in the affirmative.

All specific bills were defeated, however. The revised BCRA failed on a vote of 43–57.

A subsequent 'Obamacare Repeal and Reconciliation Act' abandoned the 'repeal and replace' approach in favor of a straight repeal, but failed on a vote of 45–55. Finally, the 'Health Care Freedom Act', nicknamed 'skinny repeal' because it would have made the least change to the ACA, failed by 49–51, with Collins, Murkowski, and Senator joining all the Democrats and independents in voting against it. Actions to hinder implementation Under both the ACA (current law) and the AHCA, CBO reported that the health exchange marketplaces would remain stable (i.e., no 'death spiral'). However, Republican politicians have taken a variety of steps to undermine it, creating uncertainty that has adversely impacted enrollment and insurer participation while increasing premiums. Insisting the exchanges are in difficulty was also used as an argument for passing reforms such as AHCA or BCRA. Past and ongoing Republican attempts to weaken the law have included, among others: • Lawsuits such as, which resulted in a decision by the Supreme Court that limited Medicaid expansion but upheld the mandates and insurance subsidies.

According to the, not expanding Medicaid in 19 states has increased the number uninsured by an estimated 4.5 million persons. • Lawsuits pending ( ) such as whether cost-sharing subsidies must be paid. President Trump threatened not to pay these subsidies in early 2017 and later decided to stop paying them.

CBO estimated in September 2017 that discontinuing the payments would add an average of 15–20 percentage points to health insurance costs on the exchanges in 2018 while increasing the budget deficit nearly $200 billion over a decade. • Prevention of appropriations for transitional financing ('risk corridors') to steady insurance markets, resulting the bankruptcy of many co-ops offering insurance. This action was attributed to Senator Marco Rubio. • Weakening of the individual mandate through his first executive order, which resulted in limiting enforcement of mandate penalties by the IRS. For example, tax returns without indications of health insurance ('silent returns') will still be processed, overriding instructions from the Obama administration to the IRS to reject them.

• Reduction to funding for advertising for the 2017 and 2018 exchange enrollment periods by up to 90%, with other reductions to support resources used to answer questions and help people sign-up for coverage. CBO said in September 2017 that the reductions would lead to reduced ACA enrollment. • The Trump administration reduced the enrollment period for 2018 by half, to 45 days. The NYT editorial board referred to this as part of a concerted 'sabotage' effort.

• Public statements by Trump that the exchanges are unstable or in a. • Trump's October 12, 2017 and a related action the same day ending federal subsidies of questionable legality used to help those buying insurance through exchanges with their co-payments and deductibles. About 6 million people were helped at a cost of $7 billion a year but that amount was expected to double in 10 years. State officials claimed the action caused insurance premiums to go up dramatically. Many states sued in federal court on the grounds that Trump was not legally allowed to take the action. • Several insurers and actuary groups cited uncertainty created by President Trump, specifically non-enforcement of the individual mandate and not funding cost sharing reduction subsidies, as contributing 20–30 percentage points to premium increases for the 2018 plan year on the ACA exchanges. In other words, absent Trump's actions against the ACA, premium increases would have averaged 10% or less, rather than the estimated 28–40% under the uncertainty his actions created.

• The (CBPP) maintains a timeline of many 'sabotage' efforts by the Trump Administration. Ending cost-sharing reduction (CSR) payments. Main article: President Trump announced on October 12, 2017 he would end the smaller of the two types of subsidies under the ACA, the cost sharing reduction (CSR) subsidies. This controversial decision significantly raised premiums on the ACA exchanges along with the premium tax credit subsidies that rise with them, with the CBO estimating a $200 billion increase in the budget deficit over a decade. The reasons for this are complex and require discussion of how the two major subsidies work. The CSR subsidies are paid to insurance companies to reduce copayments and deductibles for a smaller group of ACA enrollees, those earning less than 250% of the federal poverty line (FPL).

The second and larger type of subsidy, the premium tax credits designed to reduce the post-subsidy cost of monthly premiums, apply to all enrollees earning less than 400% of the FPL. For scale, during 2017, approximately $7 billion in CSR subsidies will be paid, versus $34 billion for the premium tax credits. A court decision meant that CSR subsidies were treated as discretionary spending, meaning Congress must decide to appropriate funds for them each year. This effectively gave the President the power to end them, as Democrats with a minority in Congress could not appropriate the funds, let alone override his veto of an appropriations bill. However, the premium tax credits are mandatory spending, meaning all those eligible under the ACA receive them without Congressional appropriation. These adjust with premium increases to limit after-subsidy premium payments by ACA enrollees to a fixed percentage of income.

Based on President Trump's threats to end the CSR payments during early 2017, several insurers and actuarial groups estimated this resulted in a 20 percentage point or more increase in premiums for the 2018 plan year. In other words, premium increases expected to be 10% or less in 2018 became 28–40% instead. The CBO reported in August 2017 (prior to President Trump's decision) that ending the CSR payments might increase ACA premiums by 20 percentage points or more, with a resulting increase of nearly $200 billion in the budget deficit over a decade, as the premium tax credit subsidies would rise along with premium prices. CBO also estimated that initially up to one million fewer would have health insurance coverage, although more might have it in the long-run as the subsidies expand.

CBO expected the exchanges to remain stable (i.e., no 'death spiral' before or after Trump's action) as the premiums would increase and prices would stabilize at the higher (non-CSR) level. CBO estimated that of the 12 million with private insurance via the ACA exchanges in 2017, about 10 million receive premium tax credit subsidies and will be shielded from premium increases, as their after-subsidy premiums are limited as a percentage of income under the ACA. However, those 2 million who do not receive subsidies face the brunt of the 20%+ premium increases, without subsidy assistance. This may adversely impact enrollment in 2018 and beyond. Another 13 million who are covered under the ACA's Medicaid expansion (in the 31 states that chose to expand coverage) should not be directly affected by Trump's action.

President Trump's argument that the CSR payments were a 'bailout' for insurance companies and therefore should be stopped, actually results in the government paying more to insurance companies ($200B over a decade) due to increases in the premium tax credit subsidies. Implementation history Once the law was signed, provisions began taking effect, in a process that continued for years. Some provisions never took effect, while others were deferred for various periods. [ ] Existing individual health plans Plans purchased after the date of enactment, March 23, 2010, or old plans that changed in specified ways would eventually have to be replaced by ACA-compliant plans. [ ] At various times during and after the ACA debate, Obama stated that 'if you like your health care plan, you'll be able to keep your health care plan'.

However, in fall 2013 millions of Americans with individual policies received notices that their insurance plans were terminated, and several million more risked seeing their current plans cancelled. Obama's previous unambiguous assurance that consumers' could keep their own plans became a focal point for critics, who challenged his truthfulness. On November 7, 2013, President Obama stated: 'I am sorry that [people losing their plans] are finding themselves in this situation based on assurances they got from me.' Various bills were introduced in Congress to allow people to keep their plans. In late 2013, the Obama Administration announced a transitional relief program that would let states and carriers allow non-compliant individual and small group policies to renew at the end of 2013.

In March 2014, HHS allowed renewals as late as October 1, 2016. In February 2016, these plans were allowed to renew up until October 1, 2017, but with a termination date no later than December 31, 2017.

[ ] 2010 In June small business tax credits took effect. For certain small businesses, the credits reached up to 35% of premiums. At the same time uninsured people with pre-existing conditions could access the federal high-risk pool. Also, participating employment-based plans could obtain reimbursement for a portion of the cost of providing health insurance to early retirees. In July the Pre-Existing Condition Insurance Plan (PCIP) took effect to offer insurance to those that had been denied coverage by private insurance companies because of a pre-existing condition. Despite estimates of up to 700,000 enrollees, at a cost of approximately $13,000/enrollee, only 56,257 enrolled at a $28,994 cost per enrollee. 2011 As of September 23, 2010, pre-existing conditions could no longer be denied coverage for children's policies.

HHS interpreted this rule as a mandate for ', requiring insurers to issue policies to such children. [ ] By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement. The average beneficiary in the prior coverage gap would have spent $1,504 in 2011 on prescriptions. Such recipients saved an average $603. The 50 percent discount on brand name drugs provided $581 and the increased Medicare share of generic drug costs provided the balance.

Beneficiaries numbered 2 million 2012 In decided on June 28, 2012, the Supreme Court ruled that the individual mandate was constitutional when the associated penalties were construed as a tax. The decision allowed states to opt out of the Medicaid expansion.

Did so, although some later accepted the expansion. 2013 In January 2013, the ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold. This was estimated to leave 2–4 million Americans unable to afford family coverage under their employers’ plans and ineligible for subsidies. A June 2013, study found that the provision had saved individual insurance consumers $1.2 billion in 2011 and $2.1 billion in 2012, reducing their 2012 costs by 7.5%. The bulk of the savings were in reduced premiums, but some came from rebates.

On July 2, 2013, the announced that it would until 2015. The (or CLASS Act) was enacted as Title VIII of the ACA.

It would have created a voluntary and public option for employees. In October 2011 the administration announced it was unworkable and would be dropped. The CLASS Act was repealed January 1, 2013. The launch for both the state and federal exchanges was troubled due to management and technical failings., the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered endless problems. Operations stabilized in 2014, although not all planned features were complete. CMS reported in 2013 that, while costs per capita continued to rise, the rate of increase in annual healthcare costs had fallen since 2002. Per capita cost increases averaged 5.4% annually between 2000 and 2013.

Costs relative to GDP, which had been rising, had stagnated since 2009. Several studies attempted to explain the reductions. Reasons included: • Higher unemployment due to the, which limited the ability of consumers to purchase healthcare; • Out-of-pocket costs rose, reducing demand for healthcare services. The proportion of workers with employer-sponsored health insurance requiring a deductible climbed to about three-quarters in 2012 from about half in 2006. • ACA changes that aim to shift the healthcare system from paying-for-quantity to paying-for-quality. Some changes occurred due to healthcare providers acting in anticipation of future implementation of reforms.

2014 On July 30, 2014, the released a non-partisan study that concluded that the administration did not provide 'effective planning or oversight practices' in developing the ACA website. In the Supreme Court exempted closely held corporations with religious convictions from the contraception rule.

In vs Burwell the Court issued an injunction allowing the evangelical college and other religiously affiliated nonprofit groups to completely ignore the contraceptive mandate. A study found that average premiums for the second-cheapest ( silver) plan were 10–21% less than average individual market premiums in 2013, while covering many more conditions. Credit for the reduced premiums was attributed to increased competition stimulated by the larger market, greater authority to review premium increases, the and risk corridors. [ ] Many of the initial plans featured narrow networks of doctors and hospitals. [ ] A 2016 analysis found that health care spending by the middle class was 8.9% of household spending in 2014. 2015 By the beginning of the year, 11.7 million had signed up (ex-Medicaid). On December 31, 2015, about 8.8 million consumers had stayed in the program.

Some 84 percent, or about 7.4 million, were subsidized. Bronze plans were the second most popular in 2015, making up 22% of marketplace plan selections. Silver plans were the most popular, accounting for 67% of marketplace selections. Gold plans were 7%.

Platinum plans accounted for 3%. On average across the four metal tiers, premiums were up 20% for HMOs and 18% for EPOs. Premiums for POS plans were up 15% from 2015 to 2016, while PPO premiums were up just 8%. [ ] A 2015 study found 14% of privately insured consumers received a medical bill in the past two years from an out-of-network provider in the context of an overall in-network treatment event. Such out-of-network care is not subject to the lower negotiated rates of in-network care, increasing out-of-pocket costs. Another 2015 study found that the average out-of-network charges for the majority of 97 medical procedures examined 'were 300% or higher compared to the corresponding Medicare fees' for those services.

[ ] Some 47% of the 2015 ACA plans sold on the Healthcare.gov exchange lacked standard out-of-network coverage. Enrollees in such plans, typically received no coverage for out-of-network costs (except for emergencies or with prior authorization). A 2016 study on Healthcare.gov health plans found a 24 percent increase in the percentage of ACA plans that lacked standard out-of-network coverage.

[ ] The December spending bill delayed the onset of the ' on expensive insurance plans by two years, until 2020. The average price of non-generic drugs rose 16.2% in 2015 and 98.2% since 2011. 2016 As of March 2016 11.1 million people had purchased exchange plans, [ ] while an estimated 9 million to 10 million people had gained Medicaid coverage, mostly low-income adults. 11.1 million were still covered, a decline of nearly 13 percent. 6.1 million uninsured 19–25 year olds gained coverage. Employers A survey of New York businesses found an increase of 8.5 percent in health care costs, less than the prior year's survey had expected.

A 10 percent increase was expected for 2017. Factors included increased premiums, higher drug costs, ACA and aging workers. Some firms lowered costs by increasing cost-sharing (for higher employee contributions, deductibles and co-payments). 60% planned to further increase cost-sharing.

Coverage and benefits were not expected to change. Approximately one fifth said ACA had pushed them to reduce their workforce. A larger number said they were raising prices. Insurers The five major national insurers expected to lose money on ACA policies in 2016.

UnitedHealth withdrew from the Georgia and Arkansas exchanges for 2017, citing heavy losses. Humana exited other markets, leaving it operating in 156 counties in 11 states for 2017. 225 counties across the country had access to only a single ACA insurer. A study released in May estimated that 664 counties would have one insurer in 2017. [ ] Aetna cancelled planned expansion of its offerings and following an expected $300 million loss in 2016 and then withdrew from 11 of its 15 states. In August 2016 Anthem said that its offerings were losing money, but also that it would expand its participation if a pending merger with Cigna was approved. Aetna and Humana's exit for 2017 left 8 rural Arizona counties with only Blue Cross/Blue Shield.

Blue Cross/Blue Shield Minnesota announced that it would exit individual and family markets in Minnesota in 2017, due to financial losses of $500 million over three years. Another analysis found that 17 percent of eligibles may have a single insurer option in 2017. North Carolina, Oklahoma, Alaska, Alabama, South Carolina and Wyoming were expected to have a single insurer, while only 2 percent of 2016 eligibles had only one choice. Aetna, Humana, UnitedHealth Group also exited various individual markets. Many local Blue Cross plans sharply narrowed their networks. In 2016 two thirds of individual plans were narrow-network HMO plans. One of the causes of insurer losses is the lower income, older and sicker enrollee population.

One 2016 analysis reported that while 81% of the population with incomes from 100–150% of the federal poverty level signed up, only 45% of those from 150–200% did so. The percentage continued to decline as income rose: 2% of those above 400% enrolled. Costs The law is designed to pay in the form of tax credits to the individuals or families purchasing the insurance, based on income levels. Higher income consumers receive lower subsidies.

While pre-subsidy prices rose considerably from 2016 to 2017, so did the subsidies, to reduce the after-subsidy cost to the consumer. For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in Alabama and 60 percent in Texas. However, some or all of these costs are offset by subsidies, paid as tax credits. For example, the reported that for the second-lowest cost 'Silver plan' (a plan often selected and used as the benchmark for determining financial assistance), a 40-year old non-smoker making $30,000 per year would pay effectively the same amount in 2017 as they did in 2016 (about $208/month) after the subsidy/tax credit, despite large increases in the pre-subsidy price.

This was consistent nationally. In other words, the subsidies increased along with the pre-subsidy price, fully offsetting the price increases. Cooperatives The number of ACA nonprofit insurance cooperatives for 2017 fell from 23 originally to 7 for 2017. The remaining 7 posted annual losses in 2015.

A General Accountability Report found that co-ops’ 2015 premiums were generally below average. At the end of 2014, money co-ops and other ACA insurers had counted on risk corridor payments that didn't materialize.

Maryland's Evergreen Health claims that ACA's risk-adjustment system does not adequately measure risk. [ ] Medicaid Newly elected Louisiana Governor issued an executive order to accept the expansion, becoming the 32nd state to do so. The program was expected to enroll an additional 300,000 Louisianans. 2017 More than 9.2 million people signed up for care on the national exchange (healthcare.gov) for 2017, down some 400,000 from 2016. This decline was due primarily to the election of President Trump, who pulled advertising encouraging people to sign up for coverage, issued an executive order that attempts to eliminate the mandate, and has created significant uncertainty about the future of the ACA. Enrollments had been running ahead of 2016 prior to President Obama leaving office, with 9.8 million expected to sign-up, so President Trump's actions potentially cost about 600,000 national enrollments (i.e., 9.8 million expected − 9.2 million actual = 0.6 million impact).

Of the 9.2 million, 3.0 million were new customers and 6.2 million were returning. The 9.2 million excludes the 11 states that run their own exchanges, which have signed up around 3 million additional people. These figures also exclude the additional coverage due to the Medicaid expansion, which covers another approximately 10 million persons, as described in the impact section above. In February, Humana announced that it would withdraw from the individual insurance market in 2018, citing 'further signs of an unbalanced risk pool.' That month the IRS announced that it would not require that tax returns indicate that a person has health insurance, reducing the effectiveness of the individual mandate, in response to an executive order from President Donald Trump. Aetna CEO Mark Bertolini stated that ACA was in a 'death spiral' of escalating premiums and shrinking, skewed enrollment. However, a U.S.

Judge found that the Aetna CEO misrepresented why his company was leaving the exchanges; an important part of the reason was the Justice Department's opposition to the intended merger between Aetna and Humana. Aetna announced that it would exit the exchange market in all remaining states. It stated that its losses had grown from $100M in 2014 to $450M in 2016.

Withdrew from Iowa in April. As of May, no insurer had indicated its intention to offer ACA insurance in Nebraska. Also in May Blue Cross and Blue Shield of Kansas City announced it would withdraw from Missouri and Kansas's individual markets in 2018, potentially leaving nearly 19,000 residents in Western Missouri without a coverage option.

Anthem announced plans to withdraw from Ohio and later Wisconsin and Indiana, describing the market as 'volatile' and referring to the difficulty in pricing its plans 'due to the shrinking individual market as well as continual changes in federal operations, rules and guidance.' The CBO reported in March 2017 that the healthcare exchanges were expected to be stable; i.e., they were not in a 'death spiral.' In June, announced that it intended to initiate coverage in Nevada, Kansas and Missouri and expand coverage in Ohio and Florida., a major Medicaid provider, said that it was considering exiting some markets in 2018, citing 'too many unknowns with the marketplace program.' Molina lost $110 million in 2016 due to having to contribute $325 million more than expected to the ACA 'risk transfer' fund that compensated insurers with unprofitable risk pools. These pools were established to help prevent insurers from artificially selecting lower-risk pools. In May the voted to repeal the ACA using the.

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The Effects Of Sawdust Addition On The Insulating Characteristics Of Clays From The Federal Capital Territory Of Abuja Abstract: l Capital of Abuja like linear shrinkage, solid density, apparent porosity and thermal conductivity were characterized with a view of studying the effect of sawdust on them. The results showed that the linear shrinkage improved from an average of 8.57% for the three samples for 0% sawdust to an average of 8.32% with 40% addition of saw dust, bringing them closer to the lower range of the international standard of 7-10%. Solid density averaged 3.18g/cm3 with 0% saw dust and 2.91g/cm 3 with 40% saw dust, still bringing them closer to the international range of 2.3-3.5g/cm3. Apparent porosity averaged 13% with 0% saw dust and 17% with 40% addition of saw dust bringing them closer to the acceptable range of 20-80%. While thermal conductivity averaged 0.493W/mo k with 0% saw dust and 0.134W/mo k with 40% saw dust thereby improving their insulating properties.

This 40% sawdust addition was discovered to be the maximum under which mechanical strength and other refractory properties of clay will remain stable. Agha O A (1998) Testing of local refractory clay for producing furnace lining bricks. Thesis: Mech.

Akinbode F O. An investigation on the properties of termite hill as refractory material for furnace lining: Indian Foundry Journal. (1999) Investigation on local refractory materials for high temperature applications, PhD Thesis mech. Federal University Of Technology, Minna 4. The Nature properties of soil, 20th Edition and Pub Prentice-Hall Inc. New Jersey 5. (1994) Industrial Minerals and rocks, 6th Edition, Pergamon Press, Oxford.

IEE (1992) Wiring regulation requirement for electrical installation BS7671, 15th Edition, A Mclay and co. Ltd Cardiff 7. Ijagbemi C.O.(2002) Development and performance evaluation of a biomass clay lined cookstove. Meng thesis, Department of mechanical Federal University of Technology Akure, Nigeria. Li Zaigeng and Zhou Ningsheng (2001) Technological advancement in the preparation and application of monolithic refractories.

China's refractories Volume 10 number 1 9. And Agbajelola D. (2011) Characterization of some selected clay deposits in Benue State.

A paper presented at the 2nd Biennial Engineering Conference. School of Engineering and Engineering technology, Federal University of Technology, Minna 10. Mahmoud S., Ayman H and Mousa A (2003) Pretreatment effects on the catalytic activity of Jordanian bentonite.

Journal of the clay mineral society Volume 51 number 1 Manukaji John U. A Review On Historical And Present Developments In Ejector Systems Abstract: Ejectors are simple pieces of equipment. Nevertheless, many of their possible services are overlooked. They often are used to pump gases and vapours from a system to create a vacuum. However, they can be used for a great number of other pumping situations. This paperprovides reviewon the development in ejectors, applications of ejector systems and system performance enhancement.

Several topics are categorized provides useful guidelines regarding background and operating principles of ejector including mathematical modelling, numerical simulation of ejector system, geometric optimizations. Research works carried out recently are still limited to computer modelling, forthe real industrial applications more experimental and large-scale work are needed in order to provide better understanding. Reference [1] Riffat SB, Jiang L, Gan G.

Recent Development in Ejector Technology: A Review. International Journal of Ambient Energy1995; 26:13–26. [2] Chunnanond K, Aphornratana S. Ejectors: Applications in Refrigeration Technology. Renewable and Sustainable Energy Reviews 2004; 8:129–55.

[3] Abdulateef JM, Sopian K, Alghoul MA, Sulaiman MY. 'Review on Solar-Driven Ejector Refrigeration Technologies. Renewable and Sustainable Energy Reviews 2009; 13:1338–49. [4] El-Dessouky H, Ettouney H, Alatiqi I, AlNuwaibit G. 'Evaluation of Steam Jet Ejectors' Chemical Engineering and Processing: Process Intensification' 2002; 41:551–61. [5] Pianthong K, Seehanam W, Behnia M, Sriveerakul T, Aphornratana S. 'Investigation and Improvement of Ejector Refrigeration System Using Computational Fluid Dynamics Technique' Energy Conversion and Management 2007; 48:2556–64.

[6] Ma X, Zhang W, Omer SA, Riffat SB. Experimental investigation of a novel steam ejector refrigerator suitable for solar energy applications. Applied Thermal Engineering 2010; 30:1320-5. [7] Chunnanond K, Aphornratana S. 'AnExperimental Investigation of a Steam Ejector Refrigerator: The Analysis of the Pressure Profile along the Ejector'.

Applied Thermal Engineering 2004; 24:311–22. [8] Selvaraju A, Mani A. Experimental investigation on R134a vapour ejector refrigeration system.

International Journal of Refrigeration 2006; 29: 1160–6. [9] Sankarlal T, Mani A. Experimental Investigations on Ejector Refrigeration System with Ammonia. Renewable Energy 2007; 32:1403–13. [10] Chaiwongsa P, Wong wises S. Experimental study on R-134a refrigeration system using a two-phase ejector as an expansion device.

Applied Thermal Engineering 2008; 28:467–77 Mohammed Raffe Rahamathullah, Karthick Palani, Thiagarajan Aridass, Prabakaran Venkatakrishnan, Sathiamourthy, Sarangapani Palani 010-034 5. Synthesis of Silver Nanoparticles from Microbial Source-A Green Synthesis Approach, and Evaluation of its Antimicrobial Activity against Escherichia coli Abstract: Nanoparticles synthesis by biological methods using various microorganisms, plants, and plant extracts and enzymes have attracted a great attention as these are cost effective, nontoxic, eco-friendly and an alternative to physical and chemical methods. In this research, Silver nanoparticles (Ag-NPs) were synthesized from AgNO3 solution by green synthesis process with the assistance of microbial source only.

The detailed characterization of the Ag NPs were carried out using UV-visible spectroscopy, Scanning electron microscopy (SEM), Energy dispersive X-ray Spectroscopy (EDS), Dynamic light scattering (DLS) analysis, and their antimicrobial evaluation was done against Escherichia coli. The UV-visible spectroscopy analysis showed the surface plasmon resonance property of nanoparticles. The DLS analysis showed the particle distribution of synthesized silver nanoparticles in solution, and SEM analysis showed the morphology of nanoparticles. The elemental composition of synthesized sample was confirmed by EDS analysis. Antibacterial assay of synthesized Ag NP was carried out in solid (Nutrient Agar) growth medium against E.coli. The presence of zone of inhibition clearly indicated the antibacterial activity of silver nanoparticles. Key words: MAntibacterial assay, eco-friendly, nanoparticles, silver nanoparticles, zone of inhibition Reference [1] Kim, S.W., Nam, S.H.

And An, Y.J., Interaction of silver nanoparticles with biological surfaces of Caenorhabditis elegans. Ecotoxicol Environ Saf, 77, 2011, 64-70. [2] Hussain, S.M., Hess, K.L., Gearhart, J.M., Geiss, K.T. And Schlager, J.J., In vitro toxicity of nanoparticles in BRL 3A rat liver cells. Toxicol In Vitro, 19 (7), 2005, 975-983(2005) [3] Premanathan, M., Karthikeyan, K., Jeyasubramanian, K. And Manivannan, G., Selective toxicity of ZnO nanoparticles toward Gram-positive bacteria and cancer cells by apoptosis through lipid peroxidation.

Nanomedicine, 7 (2), 2011, 184-192. [4] Srivastava, M., Singh, S. And Self, W.T., Exposure to silver nanoparticles inhibits selenoprotein synthesis and the activity of thioredoxin reductase.

Environ Health Perspect, 120 (1), 2012, 56-61. [5] Nagy, A., Harrison, A., Sabbani, S., Munson, R.S., Jr., Dutta, P.K. And Waldman, W.J., Silver nanoparticles embedded in zeolite membranes: release of silver ions and mechanism of antibacterial action.

Int J Nanomedicine, 6, 2011, 1833- 1852. [6] Bhumkar, D.R., Joshi, H.M., Sastry, M. And Pokharkar, V.B., Chitosan reduced gold nanoparticles as novel carriers for transmucosal delivery of insulin. Pharm Res, 24 (8), 2007, 1415-1426(2007). [7] Arunachalam, R., Dhanasingh, S., Kalimuthu, B., Uthirappan, M., Rose, C. And Mandal, A.B., Phytosynthesis of silver nanoparticles using Coccinia grandis leaf extract and its application in the photocatalytic degradation.

Colloids Surf B Biointerfaces, 94, 2012, 226-230. [8] Patil, R.S., Kokate, M.R. And Kolekar, S.S., Bioinspired synthesis of highly stabilized silver nanoparticles using Ocimum tenuiflorum leaf extract and their antibacterial activity. Spectrochim Acta A Mol Biomol Spectrosc, 91C, 2011, 234- 238.

[9] Kumar, R., Roopan, S.M., Prabhakarn, A., Khanna, V.G. And Chakroborty, S., 'Agricultural waste Annona squamosa peel extract: Biosynthesis of silver nanoparticles'. Spectrochim Acta A Mol Biomol Spectrosc, 90,173-176. [10] Natrajan, Kannan, Subbalaxmi Selvaraj, and V. Microbial production of silver nanoparticles. Digest Journal of Nanomaterials and Biostructures 5(1), 2010: 135-140.

Behera S.S., Jha S., Arakha M., Panigrahi T.K. Recognition of Similar Shaped Handwritten Marathi Characters Using Artificial Neural Network Abstract: The growing need have handwritten Marathi character recognition in Indian offices such as passport, railways etc has made it vital area of a research.

Similar shape characters are more prone to misclassification. In this paper a novel method is provided to recognize handwritten Marathi characters based on their features extraction and adaptive smoothing technique. Feature selections methods avoid unnecessary patterns in an image whereas adaptive smoothing technique form smooth shape of charecters.Combination of both these approaches leads to the better results.

Previous study shows that, no one technique achieves 100% accuracy in handwritten character recognition area. This approach of combining both adaptive smoothing & feature extraction gives better results (approximately 75-100) and expected outcomes. Key words: character recognition, features Extraction, adaptive Smoothing, Image segmentation, pattern matching, Image Pixel Rating Reference [1] T.M. Mitchell, 'Machine Learning', McGraw-Hill Education (ISE Editions), December 1997. Mohamad, M.M.

Anwar, 'Recognition of Online Isolated Handwritten Characters by Back propagation Neural Nets Using SubCharacter Primitive Features', IEEE Multitopic Conference( INMIC), 2006, pp. 157 - 162 [3] G. Stamatopoulos, 'An EfficientFeature Extraction and Dimensionality Reduction Scheme for Isolated Greek Handwritten Character Recognition', IEEE Ninth International Conference on Document Analysis and Recognition(ICDAR ), 2007, vol. 1073 – 1077 Figure 2. Misclassification Rate of Bayesian Network and C4.5 with FULL,CFS and CON Features Sets 34 Computer Science & Information Technology (CS & IT) [4] J.R. Kulkarni, R.S.

Prasad, 'Offline handwritten character recognition of Gujrati script using pattern matching', IEEE 3rd International Conference on Anticounterfeiting, Security,and Identification in Communication, 2009, pp. Lee, 'An HMMRFBased Statistical Approach for Off-line Handwritten Character Recognition', IEEE Proceedings of the 13th International Conference on Pattern Recognition, 1996, vol.

Fujisawa, 'Performance evaluation of pattern classifiers for handwritten character recognition', International Journal on Document Analysis and Recognition (IJDAR), 2002, vol. Ishigaki, 'A Statistical Approach for Handwritten Character Recognition Using Bayesian Filter', IEEE 3rd International Conference on Innovative ComputingInformation and Control, 2008, pp.

Yarman-Vural, 'An Overview Of Character Recognition Focused On Off-line Handwriting', IEEE Transactions on Systems, Man, and Cybernetics, 2001, vol. Gokmen, 'Comparison of SVM and ANN performance for handwritten character classification', Proceedings of the IEEE12th Signal Processing and Communications Applications Conference, 2004, pp.

Verma, 'Handwritten Hindi Character recognition Using Multilayer Perceptron and Radial Basis Function Neural Networks,' Proceedings of IEEE International conference on Neural Networks, 1995, vol. Ramaraj, 'Neural Network Based Offline Tamil Handwritten Character Recognition System', IEEE International Conference on Computational Intelligence and Multimedia Applications, 2007, vol.

Mrs.Archana P.Jane, Prof.Mukesh.A.Pund 063-067 8. An Overview Of Pavement Management System For Industrial Areas Abstract: With the current surge in national economy the industrial traffic has increased many folds in terms of quantity of load and traffic volume. This results in early deterioration of the roads. Also the serviceability reduces hampering the industry's supply of raw material and transport of finished goods. An efficient road transportation system is of vitally important for smooth operations of industrial units.

Construction of new roads needs an enormous investment. However, once constructed the road network system requires huge resources to maintain serviceability and to ensure safe passage at an appropriate speed and with low VOC (Vehicle Operating Cost). Road maintenance is therefore an essential function and should be carried out on a timely basis.

The cost of providing and maintaining the roads for the industrial areas at an acceptable serviceability level is quite high. It is therefore essential for a transportation engineer to attempt establishing an acceptable pavement condition level from economic, safety and environmental point of view. In today's economic environment of constrained budgets, as the existing road infrastructure has aged, a more systematic approach towards determining maintenance and rehabilitation needs is necessary. The efficient pavement management system shall provide objective information and useful analysis to ensure consistent and cost effective decisions related to preservation of existing industrial road network in healthy condition. Key words: Pavement, maintenance, management rehabilitation, transportation Reference 1. Allez, F., Dauzats,M., Joubert, P., Labat, G.P., and Pusselli, M.

'ERASME: An Expert System for Pavement Maintenance'. Transportation Research Record, 1205, pp 1-5. Al-Shawi, M.A.,Cabrera, J.G., Watson, A.S, 1989.

'Pavement Expert; An Expert to Assist in the Evaluation of Concrete Pavements'. Proceeding of Transportation and Planning Meeting, Leeds, England, P293. Ameri Mahmod, Eftehkarzadah Farhad. Pavement Management System forRoads. Iran Science and Technology University. Ayati Esmail. Optimum Method for Distribution Road Maintenance Budget in the Country Road and Transportation quarterly journal.

(In Persian). Basri, NEA, 1999.

'An Expert System for the Design of Composting Facilities in Developing Contries'. PhD Dissertation, University of Leeds. Bennett, C.R. And Paterson, W.D.O. Guidelines on Calibration and Adaptation. And Wang, H., 'Harmonizing Automated Rut Depth Measurement', Report to Transfund, New Zealand, 2002 8.

Broten, M., Corner, C., and Muntasir, A., 2004a. 'State Airport Pavement Management Practices and the Impact on Pavement Condition'.

Presented at 6th International Conference on Managing Pavements, Queenland, Australia. Chang Albitres, C., P.

Krugler, and R. 'A Knowledge Approach Oriented to Improved Strategic Decisions in Pavement Management Practices'.

1st Annual Inter-university Symposium of Infrastructure Management. Waterloo, Ontario, Canada. URMS; A Graphical Ban Road Way Management System of Network Level Transportation Research Record, Trr1337. Landge 068-075 9.

Effects Of Different Fragmentation Thresholds On Data Dropped And Retransmission Attempts In A Wireless Local Area Network Abstract: act This paper discusses the effects of different fragmentation thresholds on data dropped and retransmission attempts in a wireless local area network. A wireless local area network (LAN) is a network that connects computer systems and devices within the same geographical area but without the use of wire. Fragmentation threshold is one of the parameters used in a wireless local area network which specifies the values to decide if the Media Access Control (MAC) Service Data Unit (MSDU) received from the higher layer network needs fragmentation before transmission. The number of fragments to be transmitted is calculated based on the size of the MSDU and the fragmentation threshold. OPNET IT guru 9.1 software was used for the analysis. Based on the graphical results obtained, it can be said that fragmentation increases the size of queue and the number of data dropped in a transmission, and also the smaller the fragmentation, the more increase in the retransmission attempts. Key words: Data dropped, fragmentation threshold, LAN, packet drop probability, retransmission attempts.

Reference [1] Ralph M. Stair and George W. Renolds, Fundamentals of information systems (3 rd Edition,Thomson Course Technology, Massachusetts, USA, 2006) [2] Holtzman, J.M., Wireless technology (John Wiley and Sons, USA, 2007) [3] Chetoui Y. And Bouabdallah N., Adjustment mechanism for the IEEE 802.11 contention window: An efficient bandwidth sharing scheme, Computer Communications Journal, Vol. 13 [4] Okeshi P.N., Fundamentals of wireless communication (Global Publishers Co., Lagos, Nigeria, 2009) [5] Andree Tanenbaum, Berry Ker cheval, LAN computer networks and network topology (2 ndedition, McGraw Hill, New York, 2009) [6] Achinkole S. O., Computer networks (Orient Printers and Communications, Accra, Ghana, 2010) [7] Makta M. H., Basic computer mmunication (Educational Printing & Publishers, Accra, 2008) [8] Ede K.

I., A guide to wireless communication networks (Excellent Series Printers, Lagos, Nigeria, 2009) Isizoh A. N., Anazia A.E., Okide S.O., Okwaraoka C.A.P., Onyeyili T.I. Software-Based Visual Loan Calculator For Banking Industry Abstract: The use of Visual Loan calculator for banking industry is very necessary in modern day banking system using many design techniques for security reasons. This paper thus presents the software-based design and implementation of a Visual Loan calculator for banking industry using Visual Basic.Net (VB.Net). The fundamental approach to this is to develop a Graphical User Interface (GUI) using VB.Net operating tools, and then developing a working program which calculates the interest of any loan obtained. The VB.Net programming was done, implemented and the software proved satisfactory.

Key words: Principal, rate, simple interest, time, Visual Basic.Net Reference [1] Ochi-Okorie A.S., Computer fundamentals: Introduction and utilization (Solid Rock Computer Press, Lagos, 2008) [2] Hutson Michael, Introduction to visual basic.net (John Wesley and Sons, New York, 2008) [3] Wright Peter, Beginning visual basic.net (Wrox Press Ltd, Canada, 2009) [4] Stroo Eric and Stuart J. Stuple, Microsoft visual basic programmer's guide (Microsoft Press, USA, 2007) [5] Kratter M. C., Practical use of visual studio 2008 (Prentice Hall Ltd, India, 2008) [6] Afata Emmanuella, Applications of visual basic.net (Chriscord Publishers Ltd, Accra, 2006) Isizoh A.

N., Anazia A.E., Okide S.O., Onyeyili T.I., Okwaraoka C.A.P. Production of Household Paint using Clay Materials Abstract: The use of clay materials for the production of emulsion paints was investigated. Two types of clay: White tinged with Purple and Smooth clay (WSP) and Grey Brown and Coarse clay (GBC), were used for the production of Emulsion Clay Paints (ECP). Conventional Chemical pigmented Paint (CP) was also produced as a control.

Atomic Absorption Spectroscopy, (AAS) was used to determine the chemical composition of the clay and the concentration of heavy metals on the paints produced. Total organic content (TOC) and quality control tests were also carried out on the paints.

The results of the analysis on the two clay types showed that they contained (45.26 and 47.370)% of silicon oxide and (38.26 and 35.72)% of aluminum oxide respectively. ECP has TOC values of (0.34-0.52)% while CP has TOC value of (0.29-0.31). The cost per litre of CP was (N262.17) while that of ECP was (N111.64), which is about 50% lesser. Reference [1] J. Lowe, 'A three Dimensional Approach to Solubility', Journal of Paint Technology, Vol. 20 – 28, 2008.

Abidalla, 'Natural house paint', Retrieved March 3rd 2011, from 2008. Rangwala, 'Pigment History of Chemistry Artistic importance of Colouring agents', retrieved March 4th, 2011, from 2009.

Binsacca, 'VOC-free Paints and Natural Paints provide Eco-Friendly Options with comparable performance', retrieved April 25, 2011, from 2008. [5] Nigerian Industrial Standard, NIS 278: Part 6, Standard for paint and varnishes, Nigerian Industrial Standard, Lagos, 1990. [6] World Health Organisation, Bentonite, Kaolin and selected Clay Minerals, Environmental Health Criteria 231,World Health Organisation, 2005. [7] EPA, Regulation for the use of primers, EPA Rule 4C CFR Part 63 subpart HHHHHH (EPA 6H Rule), United State, 2011. Middleton, and R. Murray, 'Environmental Characteristics of Clays and Clay Minerals Deposits', retrieved May 3rd 2011, from: icsofclay/claymi neraldeposit.mht, 1987.

[9] Nigerian Industrial Standard, NIS 273, Specification for emulsion paint for decorative purpose, Nigerian Industrial Standard, Lagos, 1990. Olowu 085-093 12. Detecting Copy Move Forgery In Digital Images Abstract: In today's world several image manipulation software's are available. Manipulation of digital images has become a serious problem nowadays. There are many areas like medical imaging, digital forensics, journalism, scientific publications, etc, where image forgery can be done very easily.

To determine whether a digital image is original or doctored is a big challenge. To find the marks of tampering in a digital image is a challenging task. The detection methods can be very useful in image forensics which can be used as a proof for the authenticity of a digital image.

In this paper we propose the method to detect region duplication forgery by dividing the image into overlapping block and then perform searching to find out the duplicated region in the image. Key words: — Image forgery, Copy move forgery, Block matching, PCA, Region duplication detection.

Reference [1] Tao Jing Xinghua li, Feifei Zhang, Image Tamper Detection Algorithm Based on Radon and fourier-Mellin Transform',pp 212-215 IEEE 2010. Summers, Sarah C. Wahl'Multimedia Security and Forensic Authentication of Digital images, '52006/sasummer/doc/cs525projsummersW ahl.doc'. Soukal, and J. Lukas, 'Detection of Copy-Move Forgery in Digital Images', in Proceedings of Digital Forensic Research Workshop, August 2003. Popescu and H.

Farid, 'Exposing Digital Forgeries by Detecting Duplicated Image Regions,' Technical Report, TR2004-515, Department of Computer Science, Dartmouth College, pp. 758-767, 2006. [5] Guoqiang Shen, Lanchi Jiang, Guoxuan Zhang, 'An Image Retrieval Algorithm Based on Color Segment and Shape Moment Invariants,' Second International Symposium.

Computational Intelligence and Design vol. 10, no.2, pp. [6] M.Sridevi, C.Mala and S.Sandeep 'Copy – move image forgery detection', Computer Science & Information Technology (CS & IT), Vol. [7] Hieu Cuong Nguyen and Stefan Katzenbeisser'Detection of copy-move forgery in digital images using Radon transformation and phase correlation',Eighth International Conference on Intelligent Information Hiding and Multimedia Signal Processing, IEEE, pp.

Wei, 'Identifying Tampered Regions Using Singular Value Decomposition in Digital Image Forensics,' International Conference on Computer Science and Software Engineering, pp. 926-930, 2008. Mahdian and S.

Saic, 'Detection of copy-move forgery using a method based on blur moment invariants.,' Elsevier Forensic Science International, vol. [10] S.-jin Ryu, M.-jeong Lee, and H.-kyu Lee, 'Detection of Copy-Rotate- Move Forgery Using Zernike Moments,' IH, LNCS 6387, vol. Huang, and G. Qiu, 'Robust Detection of Region-Duplication Forgery in Digital Image,' 18th International Conference on Pattern Recognition (ICPR'06), pp. 746-749, 2006. Ashima Gupta, Nisheeth Saxena, S.K.

Vasistha 094-097 13. Measuring Performance Degradation in Multi-core Processors due to Shared resources Abstract: The effect of resource sharing in multicore processors can lead to many more effects most of which are undesirable.

This effect of Cross-core interference is a major performance bottleneck. It is important that Chip multiprocessors (CMPs) incorporate methods that minimise this interference. To do so, some accurate measure of Cross Core Interference needs to be devised. This paper studies the relation between Instructions per cycle (IPC) of a core and the cache miss rate across various workloads of the SPECCPU 2006 benchmark suite by conducting experimentation on a Full System simulator and makes some important observations that need to be taken into account while allocating resources to a core in multi-core processors.

Key words:: Chip Multiprocessors (CMPs), CrossCore Interference, Pre-fetching, Instructions Per Cycle (IPC), LLC ( Last Level cache)Miss rate Reference 1. Alexandra Fedorova, Margo Seltzer, Michael D.

Smith, Improving Performance Isolation on Chip Multiprocessors via an Operating System Scheduler, Proceedings of the 16th International Conference on Parallel Architecture and Compilation Techniques( PACT'07), Page(s): 25-36. Alex Settle, Dan Connors, Enric Gilbert, Antonio Gonzalez, A dynamically reconfigurable cache for multithreaded processors, Journal of Embedded Computing, Volume 2 Issue 2, April 2006, Page(s):221-233.

Lingjia Tang, Jason Mars, Mary Lou Soffa, Contentiousness vs Sensitivity: improving contention aware runtime systems on multicar architectures, Proceedings of 1st International Workshop on Adaptive Selftuning Computing Systems for the Exaflop Era ( EXADAPT'11), Pgs. Qureshi and Yale N. Patt, Utility-Based Cache Partitioning: A LowOverhead, High-Performance, Runtime Mechanism to Partition Shared Caches, in Proceedings of the 39th Annual IEEE/ACM International Symposium on Microarchitecture (MICRO 39). IEEE Computer Society: Orlando, Florida, USA, 2006, Pgs. Nikrouz Faroughi, Profiling of parallel processing programs on shared memory multiprocessors using Simics, ACM SIGARCH, Pgs.51-56. Sergey Zhuravlev, Sergey Blagodurov, Alexandra Fedorova, Addressing Shared Resource Contention in Multi-core Processors via Scheduling, Proceedings of the fifteenth edition of ASPLOS on Architectural support for programming languages and operating systems,ASPLOS'10, Pgs.129-142.

Xiaomin Jia,Jiang Jiang, Tianlei Jhao,Shubo Qi,Minxuan Zhang, Towards Online Application Cache Behaviors Identification in CMPs, Proceedings of the High Performance Computing and Communications (HPCC), 2010, Pgs. Y Xie, G H Loh. Dynamic classification of program behaviors in CMPs. Proc Workshop on Chip Multiprocessor Memory Systems and Interconnects. Beijing, China, 2008., Pgs.28–36. Rafael Rico, SPEC CPUint2006 characterization, Technical Report TRHPC -01-2009 10.

Simics Programming Guide, Version 3.0. Simics User Guide for Unix, Version 3.0. Www.spec.org 13. Www.software.intel.com Sapna Prabhu, Dr.

Daruwala 098-102 14. Ajax Architecture Implementation Techniques Abstract: Today's rich Web applications use a mix of Java Script and asynchronous communication with the application server. This mechanism is also known as Ajax: Asynchronous JavaScript and XML.

The intent of Ajax is to exchange small pieces of data between the browser and the application server, and in doing so, use partial page refresh instead of reloading the entire Web page. AJAX (Asynchronous JavaScript and XML) is a powerful Web development model for browser-based Web applications. Technologies that form the AJAX model, such as XML, JavaScript, HTTP, and XHTML, are individually widely used and well known. However, AJAX combines these technologies to let Web pages retrieve small amounts of data from the server without having to reload the entire page.

This capability makes Web pages more interactive and lets them behave like local applications. Web 2.0 enabled by the Ajax architecture has given rise to a new level of user interactivity through web browsers. Many new and extremely popular Web applications have been introduced such as Google Maps, Google Docs, Flickr, and so on. Ajax Toolkits such as Dojo allow web developers to build Web 2.0 applications quickly and with little effort.

Key words: Web applications, Java Script, Web application 2.0, Ajax architecture technology Reference 1. Jesse James Garrett (18 February 2005). 'Ajax: A New Approach to Web Applications'. Retrieved 19 June 2008. Ullman, Chris (March 2007). Beginning Ajax.

Wrox.ISBN 978-0-470-10675-4. Archived from the original on 5 July 2008. Retrieved 24 June 2008. 'Dynamic HTML and XML: The XMLHttpRequest Object'. Retrieved 25 June 2008.

Hopmann, Alex. 'Story of XMLHTTP'. Alex Hopmann's Blog. Retrieved 17 May 2010. 'A Brief History of Ajax'. Aaron Swartz.

22 December 2005. Retrieved 4 August 2009. 'JavaScript Object Notation'. Archived from the original on 16 June 2008. Retrieved 4 July 2008. 'Speed Up Your Ajax-based Apps with JSON'.

DevX.com.Archived from the original on 4 July 2008. Retrieved 4 July 2008.

'Why use Ajax?' 10 November 2005.Archived from the original on 29 May 2008. Retrieved 26 June 2008. 'Deep Linking for AJAX'. 'HTML5 specification'. Retrieved 21 October 2011. Syed.Asadullah Hussaini, S.Nasira Tabassum, M.Khader Baig 111-117 16.

A Review Of Failure Of Composite Materials Abstract: Composite materials are ideal for aerospace applications due to their high strength to weight ratio and their excellent fatigue resistance. Fiber reinforced Composite is widely used in light weight structures for different applications. The main properties that describe a composite material are the engineering constants and the strength properties of a single unidirectional lamina that make the laminated structure. The experimental evaluation of these properties is quite costly and time consuming because they are functions of several variables such as the individual constituents of the composite, fiber volume fraction, packing geometry and fabrication processes. Hence, analytical models to predict these properties were developed by researchers to aid the design of composites. In recent years numerous failure theories have been proposed and are available to the composite structural designer. Object of this review is to gather the available guide lines for theoretical models of failure analysis of fiber reinforced Composite.

Reference [1]. Daniel and O. Ishai, Engineering Mechanics of Composite Materials, Second Edition, Oxford University Press, 2005 [2]. Tao, Purdue University, D.W.

Oplinger, William J. Hughes Technical Center, 'Comparative evaluation of failure analysis methods for composite laminates', National Technical Information Service (NTIS), Springfield, Virginia 22161. C., 'Standard Failure Criteria Needed for Advanced Composites,' AIAA. Khelifa, Eng. Journal, Vol. 29, No.2, 2011 Rajanish M, Dr. Nanjundaradhya N V, Dr.

Ramesh S Sharma, Dr. Bhaskar pal 122-124 18. THREE-PHASE FAULT CURRENTS EVALUATION FOR NIGERIAN 28-BUS 330kv TRANSMISSION SYSTEM Abstract: Fault studies are important power system analysis for stable and economical operations of power systems. Faults are categorised as symmetrical and unsymmetrical. In this paper, three-phase symmetrical fault is simulated using the Nigerian 28-Bus, 330kV Transmission Grid. Two different MatLab based programmes were developed; one program was for Load Flow Studies which determines prefault conditions for the power system based on Newton-Raphson method.

The other program determines fault current magnitudes for threephase short-circuit on the power system. The information gained from the fault studies can be used for proper relay select Key words: Power System, Power Flow, ThreePhase Fault, Short-Circuit Current. Reference [1] Muhammad, Aree A. (2011), 'Simmulation of Different Types of Faults on Northern Iraq Power System', IGEC VI – 2011 – 028. [2] Ibe, A.O. And Uzonwa, N.K. (2005), 'Power System Simulation for Short Circuit Current in the Selection of Switchgears', Nigerian Journal of Industrial and Systems Studies, Vol.

3, pp 9 – 15. [3] Okelola, M.O., Yussuf, A.A., and Awosope, C.O.A. (2005), 'Fault Analysis: An Application of Venin's Method to 330kV Transmission Grid System in Nigeria', LAUTECH Journal of Engineering and Technology, Vol. 1, pp 30 – 43.

[4] Okemiri, O.N., (2008), 'Basic Protection Scheme on Power System', The Nigerian Tribune, Tuesday 12th February 2008, pp 24. [5] El-Hawary, M.E.

(2008), 'Introduction to Electrical Power System', Wiley, IEEE Press. [6] Ravi Kumar, S.V.

And Siva Nagaraju, S. (2007), 'Loss Minimisation by Incorporation of UPFC in Load Flow Analysis', International Journal of Electrical and Power Engineering, Vol. 3, pp 321 – 327. [7] Nagrath, I.J.

And Kothari, D.P. (1994), 'Power System Engineering', Tata McGraw-Hill Publishing Company Limited, New Delhi. [8] Wang Xi-Fan, Yonghua Song and Malcolm Irving, (2008), 'Modern Power System Analysis', Springer Science + Business Media LLC. [9] Gupta, B.R.

(2006), 'Power System Analysis and Design', S. Chand and Company Ltd. [10] Mehta, V.K and Mehta Rohit (2006), 'Principles of Power Systems', S. Chand & Company Ltd, New Delhi, India. Adepoju, Muhammed A. Tijani, Mufutau A.

Sanusi, Dauda O. Olatunji 125-132 19. JIT: A Strategic Tool of Inventory Management Abstract: Investment in inventory absorbs a large portion of the working capital of a company and often it represents a large portion of the total assets of a business. By improving return on investment by increasing the rate of inventory turnover, management often wants to ensure economic efficiency.

Effective inventory management enables a firm to provide lower costs, rapid response and flexibility for its customers. Just-in-time (JIT) philosophy is most widely adopted and practices in the recent years worldwide. It aims at reducing total production costs by producing only what is immediately needed and eliminates wastes. It is based on a radically different concept, deviating substantially from the existing manufacturing practices in many respects.

It is a very effective tool to reduce the wastage of inventory and manage it effectively. It has the potential to bring substantial changes in the existing setup of a company; can give it a new face, broaden its acceptability and ensure a longer life. It can strategically change the atmosphere needed for longer survival. JIT is radically different from MRP and goes beyond materials management.

The new outlook acquired by the company can meet global expectations of the customers. JIT happens to provide global markets. The present paper examines the strategic role of JIT in inventory management. Information technology helps JIT in managing inventory effectively, as it helps in integrating the components of supply chain network. Quality aspect of inventory management has also been discussed. Key words: Inventory, Inventory management, ABC Analysis, JIT, Information system, Quality, Supply chain network, SCM.

Tersine, R.H (1994). Principles of Inventory and Materials Management, Prentice Hall, Englewood Chiffs NJ. Karmarkar, U (Sept.-Oct 1989). Getting control of just-in-time, Harvard Business Review, pp. Ward, P (May 1994).

Logistics: a simple guide, Professional Manager, pp. Schonberger, R.J (1986). World Class Manufacturing: The Lessons of Simplicity Applied, Free Press, New York. Harmon, R.L and Peterson, L.D (1990).

Reinventing the Factory: Productivity Breakthroughs in Manufacturing Today, Free Press, New York. Kaihara, T (2003). Multi-agent based Supply Chain Modeling with Dynamic Environment, International Journal of Production Economics, Vol. Verwijmeren, M (2004). Software Component Architecture in Supply Chain Management, Computers in Industry, Vol.

O'Brien, James. Management Information Systems, Fourth Edition, Galgotia Publications, New Delhi. Oz Effy (1999). Management Information Systems, Galgotia Publications, New Delhi. Flowers, S (1996). Software Failure: Management failure, John Wiley, U.K.

Satyendra Singh 133-136 20. Effect of Wafer Dimension on the Dispersion and other Polarizing Abstract: In this paper we propose some index guided Photonic Crystal Fiber (PCF) with elliptical holes. The design has been proposed such that it shows a decrease in the value of ratio of the area of elliptical air holes to that of the wafer dimension. The effect of variation in wafer dimension of a constant lattice size is analyzed for observing the unique properties of PCF like dispersion, birefringence, confinement loss and other polarizing properties. The simulation of the proposed structures has been carried out using OptiFDTD simulator with Full vector mode solver using FDTD method. The dispersion reported is almost zero at a wavelength of 0.3m for some of the structures proposed. It is observed that all the structures proposed has shown the most negative dispersion in between the wavelength range of 0.35 0.4   m m .

The birefringence reported is of the order of 103. However the confinement loss reported is low and of the order of 105.

Besides zero confinement loss is observed at a wavelength of 0.25m and at 0.9m for the structure proposed in configuration V and configuration I. Key words: Photonic crystal fiber (PCF), Total international reflection (TIR), Birefringence, Finite Difference Time Domain (FDTD), Transparent Boundary Condition (TBC), Confinement Loss, Vnumber, Normalized Wavelength. Reference [1] J. Birks, and P. Russell, 'Photonic bandgap guidance in optical fibers,' Science, vol.

1476-1478, Nov. Russell, 'Photonic crystal fibers: new ways to guidelight,' Science, vol. 276-277, Apr.

[3] K Suzuki, H. Kawanishi, M. Tanaka and M. Fujita, 'Opticalproperties of a low-loss polarization-maintaining photonic crystal fiber', Opt. Express, vol.

670-676, July 2001. Knight, and P. Russell, 'Endless single-mode photonic crystal fiber,' Opt. 961- 963, July1997. [5] K.K.Sharma, Pranaw Kumar, 'Some novel photonic crystal fiber structures based on Pascal‟s triangle and their dispersion behaviour' ICECT 2012, Kanyakumari, India, april6-8,2012.

Nakajima, and I. Sankawa, 'Dispersion flattened photoniccrystal fiber with large effective area and low confinement loss,' J. Technol., vol. 4178–4183, Dec. [7] M Pourmahyabadi and Sh. Mohammad Nejad, ― Numerical analysis of IndexGuiding photonic crystal fibers with low confinement loss and ultra-flattened dispersion by FDFD method,‖ Journal of Electrical and Electronic Engineering Department of Electrical Engineering Iran University of Science & Technology, vol.

3, pp.170-179, Sep. [8] Ritu Sharma,Vijay jaynyani, Rahul gupta 'Effect of wafer dimension on the mode profile in PCF,' International Journal of Recent Trends in Engineering, vol2,no. 6,November 2009. Varshney, N.J. Fujisawa, Numerical investigation and optimization of a photonic crystal fiber for simultaneous dispersion compensation over S+C+L wavelength bands,‖ Optics Communications, vol 274, pp.74-79, 2007. [10] H.Ademgil, S.Haxha,'Highly birefringent PCF with ultralow chromatic dispersion and low confinement loss', Journal of light wave technology, Vol. [11] Razzak, S.M Abdur,Namihira, Yoshinori,'Simultaneous control of dispersion and confinement loss with octogonal PCF for communication system', The international conference on electrical engineering 2008, No.

Joannopoulos, Steven G. Ohnson, Josgua N. Winn, Robert D.

Mede, Photonic crystal fiber: Molding the flow of light, 2nd edition, Priceton University Press, 2008. Properties of PCF Pranaw Kumar, Abhijit Mishra, Shashi Bhushan Panda, Swagat Mohanty 137-142 21. Lean manufacturing: A better way for enhancement in productivity Abstract: Productivity is the impact of peoples working together.

Machines are merely an extended way of collective imagination and energy. Lean Manufacturing is the most used method for continues improvement of business. Organization management philosophy focusing on the reduction of wastage to improve overall customer value.

'Lean' operating principles began in manufacturing environments and are known by a variety of synonyms; Lean Manufacturing, Lean Production, Toyota Production System, etc. It is commonly believed that Lean started in Japan 'The notable activities in keeping the price of Ford products low is the steady restriction of the production cycle. The longer an article is in the process of manufacture and the more it is moved about, the greater is its ultimate cost.' 'A systematic approach to identifying and eliminating waste through continuous improvement, flowing the product at the pull of the customer in pursuit of perfection.' Keep in mind that Lean applies to the entire organization. Although individual components or building blocks of Lean may be tactical and narrowly focused, we can only achieve maximum effectiveness by using them together and applying them cross-functionally through the system. Reference [1].

McKenzie and J. Roberts, (2011a), 'Does managementmatter: Evidence from India', NBER Working Paper 16658. Van Reenen (2011b), 'Americans do I.T. US multinationals and the productivity miracle' Monden, Yasuhiro, Toyota Production System: An Integrated Approach to Just-in- [3]. Time (Third Edition), Engineering & Management Press, NorcrossJerry Kilpatrick, Lean Principles, Utah Manufacturing Extension Partnership, 2003 [4].

E., Schroeder, R. O., The impact of Total Productive Maintenance on manufacturing performance. Journal of Operations Management, 19 (1), 39-58. Achanga, P., Shehab, E., Roy, R., and Nelder, G., (2006), 'Critical success factors for Lean implementation within SMEs', Journal of Manufacturing Technology Management, vol.

Pankaj Kumar Ahir,Lalit Kumar Yadav, Saurabh Singh Chandrawat 143-146 22. Synthesis, Characterization and Alignment of Mn2+ and/or Eu3+ Doped Cadmium Telluride Nanowires Abstract: The foremost objective of the proposed research is to synthesize magnetically-active CdTe nanowires that can be manipulated by magnetic fields. The ability to do so will facilitate fabrication of molecular electronics and a whole host of other potential applications.

The research will employ doping of CdTe with either Mn2+ or Eu3+ or a mixture of both to create nanoparticles with net magnetic moments. The particles size and morphology will be probed by AFM and TEM while the extent of doping and distribution of dopant ions will be determined by bulk analysis by ICP, surface analysis by XPS, EPR and X-ray powder diffraction. The magnetic moment and magnetic ordering will be determined by use of a SQUID magnetometer. Doped CdTe particles with suitable magnetic moments will then be converted to CdTe wires using a technique originally developed for undoped CdTe.

The changes in morphology, size, composition, and structure will be monitored using the same analytical methods used for characterization of the precursor nanoparticles. Finally, nanowires that possess a sufficient magnetic moment will be aligned using a magnetic field to prove the viability of this approach for manufacturing nanoscale devices and electronics. Key words: dopant, morphology, nanowire, lithography, paramagnetism Reference 1.

J.; Razavi, B.; Smith, P. A.; Mbindyo, J. K.; Natan, M. J.; Mayer, T. S.; Mallouk, T.

A.; Keating, C. D.; Electrochemical synthesis of multi-material nanowires as building blocks for functional nanostructures, Mat. Symp., 2001, 636, D4.6.1-5 2. Fasol, G., Selective Electrodeposition of magnetic and metallic nanowires: A new approach to a fundamental technology, Eurotechnology Japan K.

Feltin, N.; Levy, L.; Ingert, D., Unusual static and dynamic magnetic properties of Cd1-xMnxS nanocrystals, J. Of Applied Physics, 2000, 87, 3, 1415-1423 4. A.; Wiacek, R.

J.; Saunders, A. E.; Korgel, B.

A.; Synthesis and characterization of dilute magnetic semiconductor manganese-doped indium arsenide nanocrystals, Nanoletters, 2003, 3, 10, 1441-1447 5. Jun, Y; Jung, Y.; Cheon, J., Architectireal control of magnetic semiconductor nanocrystals, J. Soc., 2002, 124, 4, 615-619 6. Tsujii, N.; Kitazawa, H.; Kido, G., Magnetic properties of Mn and Eu doped ZnS nanocrystals, J.

Of Applied Physics, 2003, 93, 10, 6957-6959 7. Schrier, J.; Whaley, K. B., A simple model for magnetization ratios in doped nanocrystals, Condensed Matter, 2003, 1-8 8. Viswanatha, R.; Sapra, S.; Gupta, S. S.; Satpati, B.; Satyam, P.

N.; Sarma, D. D., Synthesis and characterization of Mn-doped ZnO nanocrystals, J. B, 2004, 108, 6303-6310 9. A.; Norberg, N. S.; Nguyen, Q.

P.; Parker, J. M.; Gamelin, D. R.; Magnetic quantum dots: Synthesis, spectroscopy, and magnetism of Co2+ and Ni2+ doped ZnO nanocrystals, J. Soc., 2003, 125, 8 10. A.; Wiacek, R. J.; Saunders, A. E.; Korgel, B.

A., Synthesis and characterization of dilute magnetic semiconductor manganese-doped indium arsenide nanocrystals, Nanoletters, 2003, 3, 10, 1441-1447 Volkan Cicek, Mehmet Ozdemir 147-157 23. Use of Experimental Box-Behnken Design for the Estimation of Interactions Between Harmonic Currents Produced by Single Phase Loads Abstract: In this paper, it is aimed to deal with the interactions of harmonic currents produced by different single phase loads. For this purpose, compact fluorescent lamps, incandescent lamps, and electric heaters were chosen as single phase loads.

The study was performed by adopting a full range of response surface methodology using Box–Behnken experimental design to express the net harmonic current (3rd and 5th) as an empirical model. The model provided an excellent explanation of the relationship among the number of loads and the net harmonic currents. Contour graphs of some of the harmonic currents was plotted to show the interactions clearly and to discuss the results of model in the graphic detail. The results of experiments showed that the harmonic interaction between the loads can be defined as a regression model which is statistically significant. Key words: Box-Behnken Design, Harmonic Currents, Harmonic Distortion, Single Phase Loads Reference 1 Y.J. Wang, 'Summation of harmonic currents produced by AC/DC static power converters with randomly fluctuating loads', IEEE Transactions on Power Delivery, Vol. 1129-1135, 1994.

2 Task Force on Harmonics Modeling and Simulation, 'Modeling devices with nonlinear voltage-current characteristics for harmonic studies', IEEE Transactions on Power Delivery, Vol. 1802- 1811, 2004. Blaabjerg, 'Harmonic cancellation by mixing nonlinear single-phase and three-phase loads', IEEE Transactions on Industry Applications, Vol. 152-159, 2000. 4 Task Force on Harmonics Modeling and Simulation, 'Modeling and simulation of the propagation of harmonics in electric power networks, Part I: Concepts, models, and simulation techniques', IEEE Transactions on Power Delivery, Vol. 452-465, 1996.

BaSudan, Y.G. Hegazy, 'Probabilistic modeling of distribution system loads for harmonic studies', IEEE, Vol. 1778-1781, 2001. Mansoor, W.M. Thallam, M.T. Samotyj, 'Predicting the net harmonic currents produced by large numbers of distributed single-phase computer loads', IEEE Transactions on Power Delivery, Vol.

2001-2006, 1995. Mansoor, E.F. Doyle, 'Estimating the net harmonic currents produced by selected distributed single-phase loads: computers, televisions, and incandescent light dimmers', IEEE, Vol. 1090-1094, 2002. Prudenzi, 'The continuous harmonic monitoring of single-phase electronic appliances: desktop PC and printers', IEEE, Vol. 697-702, 2000.

Mohamed, 'Determining harmonic characteristics of typical single phase non-linear loads', Proc. Student Conference on Research andDevelopment (SCORED), Putrajaya, Malaysia, August 2003 10 U. Prudenzi, 'Time-varying harmonics of single-phase non-linear appliances', IEEE, Vol. 1066-1071, 2002.

Oguz Perincek, Metin Colak 158-165 24. AES-128 Bit Algorithm Using Fully Pipelined Architecture for Secret Communication Abstract: In this paper, an efficient method for high speed hardware implementation of AES algorithm is presented. So far, many implementations of AES have been proposed, for various goals that effect the Sub Byte transformation in various ways. These methods of implementation are based on combinational logic and are done in polynomial bases. In the proposed architecture, it is done by using composite field arithmetic in normal bases. In addition, efficient key expansion architecture suitable for 6 sub pipelined round units is also presented. These designs were described using VerilogHDL, simulated using Modelsim.

Key words: AES, VLSI Cryptosystems, Encryption, Decryption, Block Cipher, Encipher, Decipher Reference [1] National Institute of Standards and Technology (NIST), Information Technology Laboratory (ITL), Advanced Encryption Standard (AES), Federal Information Processing Standards (FIPS) Publication 197, November 2001 [2] X. Parhi, On the Optimum Constructions of Composite Field for the AES Algorithm, IEEE Transactions on Circuits and Systems-II: Express Briefs, VOL.

10, OCTOBER 2006. Fischer and M. Drutarovsky, Two methods of Rijndael mplementation in reconfigurable hardware, in Proc. CHES 2001, Paris, France, May 2001, pp. Verbauwhede, Architectural optimization for a 1.82 Gbits/sec VLSI implementation of the AES Rijndael algorithm, in Proc. CHES 2001, Paris, France, May 2001, pp.

McLoone and J. McCanny, Rijndael FPGA implementation utilizing look-up tables, in IEEEWorkshop on Signal Processing Systems,Sept. Rijmen, Efficient Implementation of the Rijndael S-box, 2000. Available online at www.iaik.tugraz.at/RESEARCH/krypto /AES/old / rijmen/ rijndael/sbox.pdf. Munetoh, A Compact Rijndael Hardware Architecture with S-Box Optimization, Proceedings of ASIACRYPT 2001, LNCS Vol.2248, pp. 239 - 254, Springer-Verlag, December 2001. Preneel, and I.

Verbauwhede, A Systematic Evaluation of Compact Hardware Implementations for the Rijndael SBox, In Alfred Menezes, editor, CT-RSA, volume 3376 of LNCS, pages323-333. Springer, 2005. Rohatgi, Efficient implementation of Rijndael encryption with composite field arithmetic, in Proc.

CHES, Paris, France, May 2001, pp. [10] J.Wolkerstorfer, E. Oswald, and M. Lamberger, An ASIC implementation of the AES S-boxes, in Proc. RSA Conf., San Jose, CA, Feb.2002, pp.

Parhi, High-speed VLSI architectures for the AES algorithm, IEEE Trans. VLSI Systems, Vol. 957 - 967, Sept. Mazocca, and A. Strollo,, An FPGA based performance analysis of the unrolling, tiling and pipelining of the AES algorithm, Proc. FPL 2003, Portugal, Sept. M.Gnanambika, S.Adilakshmi, Dr.Fazal Noorbasha 166-169 25.

Finger Vein &Texture Recognization Using Score Level Fusion And 2-D Gabor Filter For Human Identification Abstract: The paper presents a new approach to improve the performance of finger-vein identification systems presented in the literature. The proposed system simultaneously acquires the finger-vein and low-resolution fingerprint images and combines these two evidences using a novel score-level combination strategy. We examine the previously proposed finger-vein identification approaches and develop a new approach that illustrates it superiority over prior published efforts. We develop and investigate two new scorelevel combinations, i.e., holistic and nonlinear fusion, and comparatively evaluate them with more popular score-level fusion approaches to ascertain their effectiveness in the proposed system.

Key words: Fingerprint Recognization,FingerVein Recognization,Fusion,Hand Biometrics Reference [1] Encyclopedia of Biometrics, S. New York: Springer- Verlag, 2009. Park, 'Restoration method of skin scattering blurred vein image for finger vein recognition,' Electron. 1074–1076, Oct. [3] J.-D.Wu and S.-H. Ye, 'Driver identification using finger-vein patterns with Radon transform and neural network,' Expert Sys. And Appl., vol.

Method,' U.S. Patent 20 100 080 422 A1, Apr. 1, 2010 [4] Feature extraction of finger vein patterns based on repeated line tracking and its application to personal identification - N. Nagasaka, and T. Miyatake,2004 [5]. Extraction of finger-vein patterns using maximum curvature points in image profiles - N. Nagasaka, and T.

Human identification using knucklecodes - A. Personal recognition using hand-shape and texture - A. Pores and ridges: High resolution fingerprint matching using level 3 features - A.K.

Diptanu Bhowmik 170-177 26. Determining the atmospheric stability classes for Mazoe in Northern Zimbabwe Abstract: The paper presents the method that was used in determining the atmospheric stability classes for a place called Mazoe Citrus situated in Northern Zimbabwe for two consecutive years, 2011 and 2012. The stability classes are an important tool to be used in the environmental impact assessment for an area before an industrial power plant is set up. The study has shown that conditions favoring neutral stability are prevalent and that there is moderate to strong winds with slight insolation and a cloud cover of more than 50% for 60% of the time Key words: stability class, effluent, insolation, temperature Reference [1] Canepa. L, Ratto C.F, Plume rise description in the code SAFE AIR. International journal of environment and Pollution, 14 (6), 2000, 235-245.

[2] Essa, K, Mubarak S, Elsaid F, Effects of plume rise and wind speed on extreme values of air pollutants concentration. Meteorology and Atmospheric Physics; Sprigler 93(3), 2006, 247-253. Y, Lamb B leclers M.Y, Lovejoy S, Multifractional analysis of line source plume concentration in surface layer flows. Journal of applied Meteorology 40, 2001, 229-245. [4] Georgopoulos P.G, sanfield J.H, Instanteneous concentration fluctuations in point source plumes, AlChE journal 32(10), 1986, 1042-1654. [5] Gifford, F.A, Atmospheric transport and diffusion over cities; Nuclear safety 13, 1972, 391-402.

[6] Slade D.H, Meteorology and Atomic Energy,(National information services,1968) S. Magidi 178-181 27. A Generalized Approach for Kinematic Synthesis and Analysis of Alternate Mechanism for Stone Crusher Using Relative Velocity Method Abstract: In this paper alternate mechanism for design and analysis of small size stone crusher mechanism is discussed. The basic idea is to optimize the design of the crusher which would be best suited for stone which need crushing force of 3 Tons. Presently for reducing sizes of stones from 10cm x 10cm to 2.5cm x 2.5cm in quarries is laborious job and is done manually our approach is to design a best optimum mechanism for said conditions.

Key words: Dynamic, Kinematic synthesis and analysis, Sector gear, Static. Reference 1) Anjali J. Modak, Design and Development of a small capacity stone crusher mechanism, Indian Journal of Applied Research, Volume: 3,Issue: 2 February 2013,ISSN - 2249- 555X 2) Dr. Reifschneider, Teaching Kinematic Synthesis of Linkages without Complex Mathematics, journal of Industrial Technology, Volume 21, Number 4-October 2005 through December. Books: 3) Dr. Habib,MEG 373'Kinematic and Dynamics of Machinery', Chapter 5 Force Analysis. Collins, Henery Busby, George Stoab, 'Mechanical Design of Machine Elements & Machines' Chapter 18 Flywheel and High –Speed Rotors.

5) Shriniwas S. Bali, Satish Chand, Transmission Angle in Mechanism (Triangle in mech), Pergamon Mechanism and Machine Theory 37(2002)175-195. Waldron / Gary L. Kinzel, Kinematice, Dynamics,& Design of Machinery, edition 2007.

Khurmi and J.K. Gupta, Theory of Machines, edition 2002 8) Robert L.Norton,Machine Design,pearson Second edition. 9) Amitabha Ghosh and Ashok Kumar Mallik,Theory of Mechanisms and Machines,Third Edition Reprint 2008.

Theses: 10) James G. D Thesis in Minning and Mineral Engineering, 'Fracture toughness based models for the prediction of power consumption,product size, and capacity of jaw crushers' July 2003.

11) Robert L.Norton,Machine Design,pearson Second edition. Modak 189-194 29.

Sufficient Number of Diversity Antennas for 64 QAM over Wireless Fading Channel Abstract: This paper describes the calculation of the absolute diversity gain (ADG) and relative diversity gain (RDG) in SNR in order to determine the sufficient number of diversity antennas for 64 QAM for different Rician parameter K. The effect of increase in Rician parameter K is simulated for 64 QAM and the bit error rate for different Rician parameter K (0, 6 & 12) is simulated in MATLAB.

The sufficient number of diversity antennas for K=0 dB, 6 dB and 12 dB is found to be four, two and one respectively, for 64 QAM. The effect of increase in Rician parameter K is simulated for 64 QA M.

Key words: 64 QAM, Rician parameter, Absolute Diversity Gain, Relative Diversity Gain, Bit error rate, diversity antennas Reference [1] BER Performance of Reed-Solomon Code Using M-ary FSK Modulation in AWGN Channel, International Journal of Advances in Science and Technology, Vol. 3, No.1, 2011 [2] Difference Threshold Test forM-FSK SignalingWith Reed–Solomon Coding and Diversity Combining in Rayleigh Fading Channels, IEEE TRANSACTIONS ON VEHICULAR TECHNOLOGY, VOL.

3, MAY 2005 [3] Performance Analysis of Combined Transmit Selection Diversity and Receive Generalized Selection Combining in Rayleigh Fading Channels Xiaodong Cai, Member, IEEE, and Georgios B. Giannakis, Fellow, IEEE, IEEE TRANSACTIONS ON WIRELESS COMMUNICATIONS, VOL. 6, NOVEMBER 2004 [4] Bit-Error Probabilities of 2 and 4DPSK with Nonselective Rayleigh Fading, Diversity Reception, and Correlated Gaussian Interference,Pooi Yuen Kam, IEEE TRANSACTIONS ON COMMUNICATIONS, VOL. 4, APRIL 1997 [5] D. Brennan, 'Linear Diversity Combining Techniques,' Proc.

Alouini, Digital Communications over Fading Channels. John Wiley & Sons, Inc., New York, 2000. Reed, 'Linear diversity analyses for M-PSK in Rician fading channels,' IEEE Trans. Commun., vol.

1749-1753, Nov. Vinay Negi, Sanjeev Kumar Shah, Sandeep Singh, Arun Shekhar, Tanuja Sund 205-207 31. Comparison of Interestingness Measures: Support-Confidence Framework versus Lift-Irule Framework Abstract: Data Mining is considered to be a step of paramount importance in the process of Knowledge Discovery in Databases.

The term 'Interestingness Measure' unequivocally forms a very essential aspect of extraction of 'interesting' rules from databases. As there are a huge number of association rules or patterns that are generated by most Association Rule Mining Algorithms, there arises a need to prune away the unnecessary and unwanted rules. The rules that are crucial and indispensable can therefore be presented to the end user based on the application of these 'Interestingness Measures'. The reason this is done is so that the user gets a narrow focus on only those rules that will provide better business understanding and intelligence.

However, there are a plethora of measures available today, and selecting the best amongst them requires a thorough research on each of them. This paper therefore provides a comparative study of certain important measures, thereby highlighting which measure is apt for application in which situation. Key words: Association Rule Mining, Confidence, Interestingness Measures, Irule, Lift, Support Reference Journal Papers: [1] Zaid Makani, Sana Arora and Prashasti Kanikar. Article: A Parallel Approach to Combined Association Rule Mining. International Journal of Computer Applications 62(15), 2013, 7-13. Wets, Defining Interestingness for Association Rules, International Journal 'Information Theories & Applications', Vol.10, 370 – 375.

[3] Prashasti Kanikar, Dr. Ketan Shah, Extracting Actionable Association Rules from Multiple Datasets, International Journal of Engineering Research and Applications, Vol.

2, Issue 3, May-Jun 2012, pp.1295-1300 [4] Prashasti Kanikar and Ketan Shah, An Efficient Approach for Extraction of Actionable Association Rules. International Journal of Computer Applications 54(11), 2012, 5-10. [5] Yuejin Zhang, Lingling Zhang, Guangli Nie, Yong Shi, A Survey of Interestingness Measures for Association Rules, International Conference on Business Intelligence and Financial Engineering, 2009, 460 – 463. [6] Jianhua Liu, Xiaoping Fan, Zhihua Qu, A New Interestingness Measure of Association Rules, Second International Conference on Genetic and Evolutionary Computing, 2008, 393 – 397. [7] Philippe Lenca, Patrick Meyer, Benoit Vaillant, Stephane Lallich, On selecting interestingness measures for association rules: User oriented description and multiple criteria decision aid, European Journal of Operational Research, Volume 184, issue 2 (January 16, 2008), 610-626.

Thesis: [8] Xuan – Hiep Huynh, Interestingness Measure for Association Rules in a KDD process: Post processing of rules with ARQAT tool, doctoral diss., University of Nantes, Nantes, 2010. Proceedings Papers: [9] Paulo J. Azevedo, Al´ıpio M. Jorge, Comparing Rule Measure for Predictive Association Rules, Proceeding ECML of the 18th European conference on Machine Learning, Springer–Verlag Berlin, Heidelberg, 2007, 510- 517. [10] Pang– Ning Tan, Vipin Kumar, Jaideep Srivastava, Selecting the Right Interestingness Measure for Association Patterns, Proceeding of the eighth ACM SIGKDD international conference on Knowledge discovery and data mining, New York, USA, 2002, pp. [11] Merceron, A., and Yacef, K.

Interestingness Measures for Association Rules in Educational Data. Proceedings for the 1st International Conference on Educational Data Mining, Montreal, Canada, 2008, 57 – 66.

Chandraveer S.Deora, Sana Arora, Zaid Makani 208-215 32. Optimal Selectionof Binary Codes for Pulse Compression in Surveillance Radar Abstract: The papers aim to make a comparative study of binary phase codes in Radar pulse compression. Pulse compression allows radar to use long waveforms in order to obtain high energy and simultaneously achieve the resolution of a short pulse by internal modulation of the longpulse.

This technique increases signal bandwidth through frequency or phase coding. This paper does a comparative analysis of binary codes based on the simulation results of their autocorrelation function and identifies 13 bit Barker code as the most optimal binary code for surveillance radar. Key words: Pulse compression, Range resolution, Peak side lobe level (PSL), Barker Code, Golay Code Reference [1] Merrill I. Skolnik, Introduction to radar systems, McGraw Hill Book Company Inc.,1962. [2] Carpentier, Michel H., 'Evolution of Pulse Compression in the Radar Field,' Microwave Conference, 1979. 9th European, vol., no., pp.45-53, 17-20 Sept. 1979 [3] Prasad, N.N.S.S.R.K.; Shameem, V.; Desai, U.B.; Merchant, S.N.;, 'Improvement in target detection performance of pulse coded Doppler radar based on multicarrier modulation with fast Fourier transform (FFT),' Radar, Sonar and Navigation, IEEE Proceedings -, vol.151, no.1, pp.

11- 17, Feb 2004doi: 10.1049/ip-rsn:20040119 [4] Bassem R. Mahafza,'Radar Signal Analysis and processing using MATLAB',- CRC Press 2009 Sonia Sethi 216-223 33. Implementing NAND Flash Controller using Product Reed Solomon code on FPGA chip Abstract: Reed–Solomon (RS) codes are widely used to identify and correct errors in storage systems and transmission and.

When RS codes are used for so many memory system and reduces error in data. (255, 223) product ReedSolomon (RS) for non-volatile NAND flash memory systems. Reed-Solomon codes are the most used in digital data storage systems, but powerful for tool burst errors.

To correct multiple random errors and burst errors in order, The composing of product code in to column-wise RS codes and row-wise RS codes may allow to decode multiple errors beyond their error correction capability. The consists of proposed code is two shortened RS codes and a conventional Reed-Solomon code.The nonvolatile NAND flash Controller memory systems.

Reed-Solomon codes are the most Powerful used in data storage systems. The proposed coding scheme on a FPGA-based simulator with using an FPGA device. The proposed code can correct 16 symbol erro.