Other Proposals for Structural Change. Proposals completed by the Local Government Commission since the beginning of , but not including. Other Proposals. Recognizing Infrastructure's Role as a Local Economic Anchor, Ausick, 24/7 WallSt 8/ Do We Need a Universal Basic Income? A Debate. Other proposals. Find the retreat that satisfies your expectations and needs. Each year, the Foyers de Charité organise sessions and retreats that are different in.
The code points of the characters or sequences to be affected must be listed in a new item 1. Images must be supplied in a 'flat' zip file without internal folders. Images must be in PNG format with dimensions of 72x72 pixels. The image should extend to the sides of the cell ie, no extra padding.
Outside of the main image it should be transparent. Grayscale is not acceptable. The images supplied for deployed or in-development emoji should represent how the system works in practice. For example, if a system uses the same glyph for multiple emoji, then the image should be supplied once for each emoji. This currently occurs on some systems with:. If you have the rights to the image, state that it meets those conditions, otherwise include a link to a page indicating that the license for the image does meet those conditions.
Image Search or equivalent can be useful for finding suitable images for proposed characters. You can try filtering for usage rights or license. There are two kinds of selection factors. Some weigh in favor of encoding the emoji, and some against. These are listed in the sections below. Initially, the Unicode emoji characters were selected primarily on the basis of compatibility.
The selection factors have been broadened to include other factors; here are the factors that the Emoji subcommittee now considers when assessing possible new emoji. None of these factors alone determine eligibility or priority: The most important factors for inclusion are compatibility and expected usage level. Before approving as candidates or adding to a release of Unicode, other considerations are taken into account.
The goal of this section of your proposal is to gather information that can be used to assess the expected usage level for the new emoji. There is no perfect way to do this, but you are expected to supply the following data to help the committee assess your proposal. The reference emoji in the table below are chosen to be about median popularity among existing emoji, and to be reasonably distinct.
As with the rest of this section, this list may be updated over time. All proposals are required to use at least one of the emoji in this table for comparison data. Just pick the closest one.
The type is not as important as the emoji being of median popularity. Proposed smiley faces need to be assessed differently, since comparison are quite difficult. Generally the best terms capture the particular emoji or reaction, but proposals must be careful to provide evidence that such emotions or reactions cannot be coveyed by the existing smileys. Remember, each category must have at least two items: For this case, the category term is chosen when item is selected: In your screenshot, include enough of the header to see the category.
Please contact us if you have other suggestions for other ways to get pertinent frequency data about expected emoji usage.
The following describes the process and approximate timeline for new emoji characters. Normally proposals need to be submitted to the Emoji subcommittee at least a year before they can appear in a Unicode release. The process is simpler for emoji sequences and other proposals that don't require new characters.
Suggested short name and keywords for the emoji, as in the Emoji List. Adjectives or other narrowing terminology should be avoided except where necessary to distinguish from an existing character. Some existing emoji names deviate from this for historical reasons.
These are to illustrate how each character might be displayed. The format and license must be as specified in Images. The proposer must certify that the images have appropriate licenses for use by the Unicode Consortium, and list the type of license. The images must be included in the document at the top in two sizes: The 18x18 image is to provide immediate feedback to you and the committee as to whether the image is distinctive enough. All of the emoji being used for 5.
Do not use any emoji except those listed in Reference Emoji. Selection factors — Inclusion. A section that addresses all Selection Factors for Inclusion, and for each one provides evidence as to what degree each of the proposed characters would satisfy that factor. Compatibility Expected usage level Frequency must have separate evidence for each proposed emoji Multiple usages Use in sequences Breaking new ground Image distinctiveness Completeness Frequently requested Selection factors — Exclusion.
Any other information that would be helpful, such as design considerations for images. Type Representative face drooling face hand handshake body nose role construction worker fantasy goblin activity massage animal elephant bird penguin plant rice food melon food hamburger drink tumbler glass transport ambulance sport tennis clothing necktie computer laptop computer office scissors office notebook tool wrench symbol warning.
Home Site Map Search. Making Existing Characters be Emoji. Selection Factors for Inclusion. Selection Factors for Exclusion. Process for Proposed Emoji Sequences. UTR 51, Unicode Emoji. Unicode Emoji Data Files. The Merkley bill also would require employers that do not offer health benefits to refer their employees to navigators.
All three proposals would require hospitals, physicians and other health care providers participating in Medicare to participate in the new public plan; this would result in a broad network of providers because the vast majority of all hospitals and physicians participate in the current Medicare program. The Schakowsky and Bennet bills would also require Medicaid providers to participate in the public plan which would include pediatricians and others who may be less likely to treat the current Medicare population.
Providers would have the ability to opt out of participating in the public plan without penalty under the Schakowsky bill. The three proposals would also require the Secretary to allow other providers to participate in the public plan — an important consideration in providing health coverage for children, and for meeting the needs of individuals with special needs.
All three bills would extend Medicare payment rates, or some variation on those rates, to providers participating in the public plan to help lower the overall cost of the program, which in turn would reduce premiums and out-of-pocket cost sharing for patients.
The Schakowsky proposal would have the Secretary negotiate rates with providers, using Medicare payment rates as a back-up, if negotiations are not successful. The Merkley proposal directs the Secretary to negotiate payment rates for Medicare Part E, between Medicare and private insurance plan rates. None of the public plan option bills specifically prohibits balance billing by physicians and other providers who treat patients enrolled in the public plan; however to the extent that they adopt Medicare payment rates and rules, these bills would appear to apply Medicare limits on balanced billing to the public plan.
Under current rules, participating providers agree to accept assignment for all of their Medicare patients, and are prohibited from balance billing; non-participating providers do not agree to accept assignment for all patients or all services, and may choose to charge patients higher fees, up to a certain limit.
All three bills acknowledge ongoing public concern about prescription drug costs by authorizing the Secretary to negotiate drug prices for the new public plan; two of the three proposals Bennet and Merkley would extend this policy to the current Medicare program.
Under current law, the Secretary is prohibited from negotiating payments with drug manufacturers on behalf of Medicare Part D enrollees. The Merkley proposals is the only one of the three bills to include a failsafe to leverage lower drug prices under Medicare Part E and the current Medicare program.
If negotiations are not successful in obtaining an appropriate price as determined by the Secretary, prices would be paid based on the lesser of those paid by the Veterans Administration or the federal supply schedule. Two proposals focus specifically on creating a new Medicare buy-in option for older adults — ages in the Stabenow bill and in the Higgins bill.
These proposals would give eligible individuals the option to buy into Medicare. This differs from an alternative approach that would simply lower the age of Medicare eligibility from age 65 to age 50 or The Higgins bill would also allow adults ages who are eligible for job-based coverage to elect the Medicare buy-in option, and allow employers to pay Medicare premiums on their behalf — a feature that could expand the number of older working individuals who select the buy-in option.
Under the Stabenow bill, enrollment in the buy-in plan would be managed by Medicare, while under the Higgins bill enrollment in the buy-in plan would be conducted through the marketplace. Both bills would allow marketplace subsidies to apply to the buy-in plan for individuals otherwise eligible for subsidies, so the marketplace would continue to be the place where people apply for financial assistance.
Under both bills, Medicare cost-sharing standards would apply, with no annual out-of-pocket limit on cost sharing for individuals who enroll in Medicare unless they enroll in private Medicare Advantage plans assuming current rules apply or qualify for cost-sharing subsidies through the marketplace.
Both proposals would give buy-in enrollees the option to buy Medicare Advantage plans instead of fee-for-service coverage, and both would require private Medigap policies to be offered on a guaranteed-issue basis to buy-in enrollees. In other words, older adults not yet eligible for the current Medicare program would potentially have access to private marketplace plans, private Medicare Advantage plans, and traditional Medicare Parts A, B and D with an option to purchase Medigap — each with different guaranteed benefits, rating rules, premium and cost-sharing subsidies and provider networks.
Under both bills, rating rules for the buy-in plan would be somewhat different from those for marketplace plans. The bills would set the buy-in premium to cover the full cost of benefits provided under Medicare Parts A, B and D for enrollees, plus administrative expenses. The Stabenow bill would establish a single, national premium while the Higgins bill would apply a geographic adjustment. Neither proposal would adjust buy-in premiums for age, in contrast to current marketplace rules.
Buy-in enrollees would be eligible for ACA-based premium and cost-sharing subsidies. When buy-in enrollees become eligible for the current Medicare program, at age 65, premium and cost-sharing subsidies , and other coverage features, would revert to those applicable to Medicare beneficiaries under current law.
Marketplace premium subsidy amounts would be calculated somewhat differently for buy-in enrollees. Both proposals would require all Medicare participating providers and facilities to participate in the buy-in plan for older adults; and, to help constrain costs, reimburse hospitals , physicians and other participating providers using Medicare payment rates, which typically are lower and less variable than the rates paid by commercial insurers.
Using Medicare payment rates would tend to make the buy-in plan more cost competitive relative to private plan options. Though the bills do not address balance billing specifically, by adopting Medicare provider payment rules, it appears that Medicare limits on balance billing would also apply to enrollees in the buy-in plan.
The Higgins proposal would also authorize the Secretary to negotiate lower drug prices for the buy-in population and for the current Medicare program — the only change in the bill that would directly affect the current Medicare program. The Higgins bill would make other changes aimed at stabilizing the private individual insurance market. It would establish a federal reinsurance program to help cover high-cost medical claims, and reauthorize the temporary ACA risk corridor program through the year Both bills specify that the buy-in program would be financially separate from the current Medicare program, and that benefits under the current program, and the Medicare trust funds would not be affected.
The Higgins proposal establishes a separate trust fund for the purpose of collecting premiums and making payments for services provided to individuals enrolled in the Medicare buy-in plan. The public plan option envisioned under the Schatz bill would build on the Medicaid program rather than Medicare. Under this approach, states would have the option of creating a Medicaid buy-in program that would be offered through the marketplace alongside other private plans.
For states that elect this option, the bill would allow individuals at all income levels to buy into Medicaid, as long as they are not enrolled in other coverage. The Medicaid buy-in option would be offered as a Silver-level plan through the marketplace. Medicaid buy-in enrollees would receive an alternative benefit package ABP , which includes the ACA essential health benefits, and could be defined by states to include the full Medicaid benefit package.
The bill does not require that premiums and cost-sharing payments cover the full costs of the buy-in program. Instead, states would receive federal matching payments for any costs for the Medicaid buy-in program that are not covered by premiums and cost-sharing payments.
With this flexibility, states could promote enrollment in the public plan by setting premiums lower than commercial plans, and count on the federal government to make up some of the cost; though as under the current Medicaid program, they would be required to finance the state share of these costs. This proposal would extend current law ACA premium and cost-sharing subsidies to people purchasing Medicaid buy-in coverage. In addition, it would cap premiums for the public plan at 9. The Medicaid buy-in would rely on Medicaid participating providers, including Medicaid managed care organizations MCOs to deliver services.
The grants would be available to all states, not just those establishing a buy-in program. The eight bills introduced during the th Congress are similar in that they would each establish a public program, yet they differ in ways that could have significant implications for consumers, payers, health care professionals, and the federal budget. As of yet, CBO has not formally estimated the effects of these bills on costs or coverage.
Below are key questions regarding the policy implications and tradeoffs involved in these various proposals. These eight proposals span a broad spectrum in terms of eligibility rules that are likely to affect the number of people who would gain coverage and the size of the public program.
The two Medicare-for-All proposals would build a single, national public program, replacing all other forms of coverage, to cover all individuals residing in the U. The Medicare-for-All bills would adopt a broader definition of eligibility than is used for Medicare, Medicaid or marketplace plans, which limit eligibility based on citizenship and immigration status, potentially benefiting millions of lawfully present and undocumented immigrants.
The three federal public plan proposals would offer a public option to augment the current mix of public and private sources of coverage. Among these three plans, the Merkley proposal would extend eligibility to all U. The two Medicare buy-in proposals for older adults who are not yet eligible for the current Medicare program would likely lead to a smaller public plan than the aforementioned proposals due to age restrictions.
Of these two proposals, the Higgins bill could reach a larger number of older adults because it defines eligibility somewhat more broadly ages , rather than age , allows employers to pay premiums for their older employees if they opt in, and enhances premiums and cost-sharing subsidies. The Medicaid buy-in proposal would make the public plan an option for states.
This approach would limit its availability to residents of states that elect to establish a Medicaid buy-in. While the ACA has made significant inroads in reducing the number of people without health insurance , affordability challenges have continued, particularly among people with significant health needs.
In , more than one-in-four insured non-elderly adults skipped or delayed care due to costs or had problems paying out-of-pocket medical bills; among the insured in fair to poor health, nearly one-in-three faced such affordability problems. The Medicare-for-All bills take the most comprehensive approach to improving affordability by eliminating premiums and cost-sharing requirements, and adding benefits, such as dental and vision.
However, these costs would ultimately be shifted back to some individuals in the form of higher taxes, meaning some people would end up paying more while others would pay less. Several of the other bills would address affordability issues in the marketplace by enhancing premium and cost-sharing subsidies for currently eligible individuals, by capping premiums for individuals not eligible for premium tax credits, and, in some cases, by making more people eligible for subsidies.
Limits on provider payments Medicare payment rates would be expected to put downward pressure on premiums and other costs. Two of the bills would enhance financial protections for individuals by prohibiting balance billing by providers. The others are silent on balance billing, although to the extent those proposals use Medicare or Medicaid provider payment rates, they would appear to incorporate into the public plan limits and prohibitions on balance billing that apply under those programs today.
In addition, one of the bills would address the financial burden of health care for people covered under the current Medicare program by adding an annual out-of-pocket limit. Virtually all of the proposals aim to make prescription drugs more affordable for people in both the current Medicare program and the new buy-in proposal by giving the Secretary the authority to negotiate lower drug prices.
As of early , more than 14 million people obtained non-group coverage through ACA marketplaces or outside in the individual market. The introduction of a new public plan could change marketplace dynamics and premiums. Premiums for the public plan could be higher or lower than private marketplace plans depending on a number of factors, including the level of fees paid to providers, rating rules, the comparability of benefits, and other features.
For example, as noted above, the use of Medicare provider payments in the public plan would put downward pressure on costs, which would likely lead to lower premiums for coverage under the public plan compared to marketplace plans. At the same time, the methodology used to set premiums could potentially mitigate the cost advantage of the public plan.
Premiums for a Medicare buy-in for older adults could conceivably be higher than premiums for marketplace plans for people of a similar age because the risk pool is restricted to older, higher-cost adults.
Further, if the public plan uses a uniform, national premium and private insurers set premiums based on local costs, the public plan could be more competitive in high cost areas, and less competitive in low cost areas.
To the extent that the rules for setting premiums are not aligned for private plans and the public program, individuals may be more attracted to one over the other, potentially destabilizing the marketplaces.
Currently, a majority of the non-elderly U. The Medicare-for-All bills would replace employment-based and virtually all other forms of coverage with the new plan.
The other six public plan proposals would retain a role for employer-sponsored coverage, while giving employers access to the public plan to varying degrees. Under one proposal, all employers, including large employer-sponsored plans, could opt to obtain coverage under the public plan on behalf of their employees. Others would allow small but not large employers to offer the public plan to their employees by purchasing public plan coverage through the small group market or the SHOP marketplace.
One plan would allow employers to pay premiums on behalf of their enrollees who choose to opt into the public plan, a departure from current law.
If employers are able to reduce health costs by offering coverage under the public plan, the public plan could take on a relatively large role as a source of coverage. Employers could realize savings by gaining access to the lower provider payment rates in the public plan. In addition, although none of the bills allow employers to selectively enroll high-cost enrollees in the public plan, employers with higher than average medical costs might realize savings by shifting their employees to the public plan, which in turn could lead to adverse selection and higher costs in the public plan.
Yet, the proposed public plans differ from the current Medicare program in several ways, including covered benefits, the methodology used to calculate premiums, and the availability of premium and cost-sharing subsidies.
The two Medicare buy-in bills for older adults would adopt current Medicare benefits and cost sharing for the public plan; the two Medicare-for-All bills would cover far more expansive benefits; and the other proposals align either with ACA-required essential health benefits or with a combination of ACA and Medicare benefits.
None of the bills would set premiums for the public plan using the same methodology used in the current Medicare program. In contrast, premiums for the current Medicare program are not set to cover full program costs. Further, the buy-in bills tend to use premium and cost-sharing subsidies, and eligibility levels, established for the ACA marketplace, rather than those that apply to people covered under the current Medicare program such as those used for the Medicare Savings Programs or the Part D low-income subsidy program.
The Medicare-for-All and public plan proposals tend to track the current Medicare program when it comes to provider participation and in using Medicare provider payment rates to leverage overall savings in health spending with some variation, as noted below. Six of the eight public plan proposals leave the current Medicare program generally intact, with the notable exception of the Medicare-for-All bills that would replace the current Medicare program with a new and more comprehensive Medicare program.
Four of the public plan bills would modify rules pertaining to the Medicare Part D benefit, by allowing the Secretary to negotiate drug prices. One proposal would enhance the current Medicare program by adding an out-of-pocket limit to Medicare Parts A, B and D, which would help align financial protections under the new and existing Medicare programs, but would also lead to higher Medicare spending and higher premiums.
The Sanders bill would enhance the current Medicare program during an interim implementation phase, by adding an out-of-pocket limit, covering vision and dental, and by expediting eligibility for people with disabilities. Several of the public plan buy-in bills include explicit language to protect the Medicare trust funds and Medicare benefits from changes made under the proposal. The Ellison proposal would eliminate Medicaid entirely while the Sanders bill would retain Medicaid for purposes of providing long-term services and supports.
The Sanders bill would impose requirements on states to maintain eligibility standards and expenditures on long-term services and supports at levels. Both proposals would eliminate the CHIP program. The Schatz proposal would address Medicaid provider payment rates and access-to-care issues by requiring states to increase payments to primary care providers and by providing funding for states to increase payments to other providers.
However, the one-time allocation of federal grant funds to finance the state share of the payment increase would not likely compensate states for the increased costs associated with the payment rate increase over the long term. While the bills intend to improve the affordability, and in some cases, the comprehensiveness, of health coverage, in general they vary in how they would address the specific needs of special populations, such as children, women of reproductive age, and people with disabilities and high health care needs,.
Children, in particular, have special needs and special providers that serve them. Except for the two Medicare-for-All proposals, the other bills would retain the Medicaid and CHIP programs and their important role in covering low-income children. However, the special EPSDT protections provided to children through the comprehensive coverage requirements in Medicaid are not extended to children who would gain coverage under Medicare-for-all, the federal public plans, or the Medicaid buy-in plan.
For people with disabilities and high health care needs, the adequacy of health plan provider networks matters can be especially important.
Other proposals and amendments on the ballot
Nov 6, There are several amendments and proposals on the ballots in Michigan and Indiana. Here's a breakdown of some of the initiatives and the. Feb 5, Proposals are likely to be declined unless they are complete and adhere to the submission instructions. Other proposals may be returned to the. Other proposed changes. A comprehensive overhaul and simplification of parking regulations are proposed. Some new buildings will be required to meet green.