The Environment Agency is preparing for more heavy rain and potential flooding problems in West Sussex.
The Met Office issued a yellow warning for heavy rain for today with up to 20mm expected in the area from midday Friday.
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More rain is forecast in West Sussex over the weekend
Crews are using pumps to lower river water levels to provide capacity for even more rain that is expected over the next 48 hours.
A flood warning remains in force in various locations in Bersted. Eight flood alerts were in place earlier in the week and though this has been reduced, the Environment Agency said that more could be issued if there is further significant rain.
West Sussex saw major flooding problems earlier in the week, in particular at Littlehampton and Bognor and the surrounding areas. 250 homes in the village of Elmer were flooded by around six foot of water and residents had to be rescued by boat and taken to temporary accommodation.
Other areas that saw floods were Worthing Hospital, Havens' Church Farm holiday camp, near Chichester and access to Butlins in Bognor Regis was prohibited. Several schools and colleges in the area were also shut.
Peter Quarmby, South East flood and coastal risk manager, said: "We are focusing all efforts in working in areas that have been affected by flooding over the past few days to lower river levels and will continue to work alongside our emergency partners to assist flooded communities with immediate response and recovery.
"Latest forecasts indicate that heavy rainfall is again expected to cross the South East on Friday and into the weekend. We urge everyone to remain vigilant."
Frank Saunders, chief forecaster at the Met Office, said: "We are working closely with colleagues in the Environment Agency and other agencies to ensure that we are all aware of the latest weather forecast."
Arun District Council is holding information days for communities in areas that have experienced the worst of the flooding. They are being held at Felpham, Elmer, Littlehampton, Barnham, Wick and South Bersted, from Friday until Wednesday, visiting one location each day.
Source: www.thisissussex.co.uk
Russell Brand criticises Graham Norton for divorce questions - Digital Spy
Source: www.digitalspy.co.uk
Challenges give health care law four possible outcomes - Detroit Free Press
WASHINGTON (USA TODAY) — The Supreme Court's decision this month on President Obama's health care law is likely to take one of four basic forms. No matter what the court rules, however, it won't be the last word.
The court can uphold the entire law, strike down the "individual mandate" requiring most Americans to buy insurance, strike down the mandate and related health insurance changes, or kill the entire law.
Still to come: State actions. More lawsuits. The verdict from voters on Nov. 6. And more battles in Congress next year.
"The bottom line here is the Affordable Care Act is moving through a gantlet," says Robert Laszewski, a private health policy consultant. "The first stop in the gantlet was the Supreme Court. The second stop in the gantlet is the election."
The court has some additional issues to decide, including whether the law's Medicaid expansion is unduly "coercive" and whether the law can't be challenged at all until someone pays a penalty to the Internal Revenue Service for not buying insurance.
The major battle, however, is over the constitutionality of the mandate and its relationship to the rest of the law.
Here are four scenarios:
Option 1: Law upheld
A decision upholding the law would unleash a series of political, legislative and legal forces.
As states decide whether to implement the law, such as setting up health care exchanges for millions of Americans to pick insurance plans, "there's going to be political action, there's going to be legislative action, there's going to be lawsuits," says Michael Cannon, health policy director at the Cato Institute, a libertarian think tank. "Opponents will not go away."
Republicans in Congress plan to resume legislative attacks. The House of Representatives has voted to weaken or wipe out the law more than a dozen times, including this month's vote to repeal a tax on medical devices.
Opponents would be galvanized for the fall elections. For Obama, that could mean a more difficult path to re-election, despite his victory in court.
Lawsuits pending at lower courts will move forward, and new ones could be filed to test other aspects of the law, ranging from its Independent Payment Advisory Board charged with finding savings in Medicare to its requirement that most insurance plans pay for contraception coverage.
The pace of litigation could increase as more regulations are issued, because "there's going to be winners and losers all over the place," says Bradley Joondeph, a law professor at Santa Clara University who tracks health care litigation.
Given that upheaval, state governments would face a choice: How fast should they move to implement the law?
"I think most of us are going to wait," Wisconsin Gov. Scott Walker, a Republican, said Thursday.
Bill McCollum, the former Florida attorney general who filed the first lawsuit against the Affordable Care Act on March 23, 2010, agrees. "I don't think it would be an immediate rush to enact the exchanges or conform to the law," he says.
Nevertheless, the Department of Health and Human Services says 34 states have accepted grants to pay for exchanges. They have until November to meet deadlines for exchanges to go into effect in January 2014.
Ezekiel Emanuel, a former White House health policy adviser now at the University of Pennsylvania, says the health exchanges should be up and running roughly a year from now. "We certainly can't do that at the last minute," he says.
Option 2: No mandate
The verdict that would present the biggest complications is also one of the most likely, if the justices' questions in March prove prophetic: striking down the individual mandate requiring most Americans to buy health insurance.
That's because the law's expansive provisions would remain, including requirements that insurance companies guarantee coverage for people with pre-existing conditions and limit premiums for those with expensive ailments.
The mandate is intended to bring young, healthy people into the market, providing premiums for insurers and patients for health care providers. Without it, the Congressional Budget Office estimates, about half of the law's projected 32 million newly insured people would remain uninsured, and premiums in the individual health insurance market would rise by an additional 15% to 20%.
"It becomes an impossible thing for the insurance companies. It becomes unworkable," McCollum says. "I think both sides would realize that there has to be some change."
Insurers wouldn't be the only ones seeking a change. Doctors, hospitals, drugmakers and medical device manufacturers accepted new taxes and cuts in Medicare reimbursements under the law because they expected more patients.
Proponents of the law say not much would be lost. They say the mandate was a small portion of the law, dwarfed by the promise of covering 32 million Americans and improving coverage for millions of others.
"The notion that the mandate is the heart of the statute is way off base," says Ron Pollack, executive director of Families USA, a leading health care consumers group. He says Congress could replace it with incentives designed to get young adults to buy insurance, such as late enrollment penalties or automatic enrollment provisions.
States most likely those controlled by Democrats also could create their own mandates. That's what then-governor Mitt Romney signed in Massachusetts in 2006, without legal challenge.
In Congress, Democrats could seek alternatives to the mandate, but such efforts might prove unpopular before the November elections. Republicans, prodded by the insurance industry, could try to scuttle the insurance changes for people with preexisting conditions, but those are among the law's most popular provisions.
"Whether Congress can agree on any of those alternatives is a very different story," says Larry Levitt, vice president of special projects at the non-partisan Kaiser Family Foundation. "It's entirely possible that stalemate is the result."
Option 3: More provisions invalidated
Lawmakers would be under far less pressure to fix what the court hands them if insurance protections for people with pre-existing conditions and related changes are eliminated along with the mandate.
The insurance market would be similar to today's, with the same advantages and drawbacks. Premiums could go down, particularly for young and healthy people. But so would the quality of coverage, particularly for the old and sick.
Even a high-risk insurance pool created under the law to help people with pre-existing conditions who were without insurance at least six months will expire in January 2014, when the broader changes were to take effect. About 60,000 people have joined that plan, the Health and Human Services Department says.
Under this scenario, states could seek to fill the gap with their own mandates and insurance market changes. That's most likely in states with Democratic governors and legislatures.
Democrats in Congress also could try to replace the mandate and insurance market overhaul with lesser changes.
Among opponents, however, "there's going to be blood in the water," Cannon says. Opponents "are going to be energized to get rid of the rest of it."
House Republicans say they will try to repeal the rest of the law its insurance expansions, taxes, Medicare savings and more and then vote on lesser fixes as part of their "repeal and replace" strategy.
"Our goal would be to have the end result be all of it gone," says Brendan Buck, a spokesman for House Speaker John Boehner. "Clear out whatever is left from what they strike, and then move step by step on our replacement provisions."
Option 4: Law killed
The justices may decide to strike down all the taxes, subsidies, mandates, coverage expansions, insurance market changes and other provisions in the law. But some may find their way back.
Several insurance companies plan to keep some changes already enacted. "Consumers and employers will continue to have the option of purchasing coverage that includes many of the benefits they have today, such as allowing dependent children to stay on their parents' policies until age 26," says Karen Ignagni, president of America's Health Insurance Plans.
Some 6.6 million young adults joined their parents' plans in the first year of eligibility, according to the Commonwealth Fund, a liberal health research group.
One program at risk would be discounts from drug companies for more than 5 million seniors and people with disabilities. The Medicare discounts have saved consumers $3.5 billion since the law was passed.
The bigger question: Would the effect of the court's ruling be prospective or retroactive? It would be difficult to retract benefits already on the books.
"You would have a mess on your hands," says Levitt, of the Kaiser Family Foundation. "The general sense is anything that's already happened kind of is water under the bridge."
The politics could be a wash, as in the case of the law being upheld. While Obama and Democrats would lose their most prized achievement from his term in office, their liberal base would be energized. A recent United Technologies/National Journal poll found striking down the law would have little impact on the president's re-election
The Supreme Court, favored by just 44% of Americans in a recent New York Times/CBS Poll, could become more unpopular after such a perceived power grab.
"You could well imagine an argument being made around the politicization of the court," says Sheila Burke, a health policy lecturer at Harvard University who served as the top aide to former Senate Republican leader Bob Dole.
What would happen next?
Democrats might seek to replace at least portions of the law, such as smaller federal subsidies for the uninsured. But they would face the "Obamacare" moniker that has made the law relatively unpopular, Cannon says.
Republicans likely would follow through on their "repeal and replace" agenda by proposing lesser changes. Romney, for instance, wants to give states more flexibility, let consumers buy insurance across state lines, and limit awards in medical malpractice lawsuits.
"It puts the ball back in the political arena," says Randy Barnett, a Georgetown University law professor who represents the business groups challenging the law. "We'll have a national debate about health care reform, and then we'll have an election, and whoever wins the election will have a mandate."
Copyright 2012 USA TODAY
Source: www.freep.com
Possible outcomes in pivotal health care law case - The Guardian
RICARDO ALONSO-ZALDIVAR
Associated Press= WASHINGTON (AP) — Some are already anticipating the Supreme Court's ruling on President Barack Obama's health care law as the "decision of the century." But the justices are unlikely to have the last word on America's tangled efforts to address health care woes. The problems of high medical costs, widespread waste, and tens of millions of people without insurance will require Congress and the president to keep looking for answers, whether or not the Affordable Care Act passes the test of constitutionality.
With a decision by the court expected this month, here is a look at potential outcomes:
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Q: What if the Supreme Court upholds the law and finds Congress was within its authority to require most people to have health insurance or pay a penalty?
A: That would settle the legal argument, but not the political battle.
The clear winners if the law is upheld and allowed to take full effect would be uninsured people in the United States, estimated at more than 50 million.
Starting in 2014, most could get coverage through a mix of private insurance and Medicaid, a safety-net program. Republican-led states that have resisted creating health insurance markets under the law would face a scramble to comply, but the U.S. would get closer to other economically advanced countries that guarantee medical care for their citizens.
Republicans would keep trying to block the law. They will try to elect presidential candidate Mitt Romney, backed by a GOP House and Senate, and repeal the law, although their chances of repeal would seem to be diminished by the court's endorsement.
Obama would feel the glow of vindication for his hard-fought health overhaul, but it might not last long even if he's re-elected.
The nation still faces huge problems with health care costs, requiring major changes to Medicare that neither party has explained squarely to voters. Some backers of Obama's law acknowledge it was only a first installment: get most people covered, then deal with the harder problem of costs.
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Q: On the other hand, what if the court strikes down the entire law?
A: Many people would applaud, polls suggest.
Taking down the law would kill a costly new federal entitlement before it has a chance to take root and develop a clamoring constituency, but that still would leave the problems of high costs, waste, and millions uninsured.
Some Republicans in Congress already are talking about passing anew the more popular pieces of the health law.
But the major GOP alternatives to Obama's law would not cover nearly as many uninsured, and it's unclear how much of a dent they would make in costs. Some liberals say Medicare-for-all, or government-run health insurance, will emerge as the only viable answer if Obama's public-private approach fails.
People with health insurance could lose some ground as well. Employers and insurance companies would have no obligation to keep providing popular new benefits such as preventive care with no copayments and coverage for young adults until age 26 on a parent's plan. Medicare recipients with high prescription drug costs could lose discounts averaging about $600.
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Q: What happens if the court strikes down the individual insurance requirement, but leaves the rest of the Affordable Care Act in place?
A: Individuals would have no obligation to carry insurance, but insurers would remain bound by the law to accept applicants regardless of medical condition and limit what they charge their oldest and sickest customers.
Studies suggest premiums in the individual health insurance market would jump by 10 percent to 30 percent.
Experts debate whether or not that would trigger the collapse of the market for individuals and small businesses, or just make coverage even harder to afford than it is now. In any event, there would be risks to the health care system. Fewer people would sign up for coverage.
The insurance mandate was primarily a means to an end, a way to create a big pool of customers and allow premiums to remain affordable. Other forms of arm-twisting could be found, including limited enrollment periods and penalties for late sign-up, but such fixes would likely require congressional cooperation.
Unless there's a political deal to fix it, the complicated legislation would get harder to carry out. Congressional Republicans say they will keep pushing for repeal.
Without the mandate, millions of uninsured low-income people still would get coverage through the law's Medicaid expansion. The problem would be the 10 million to 15 million middle-class people expected to gain private insurance under the law. They would be eligible for federal subsidies, but premiums would get more expensive.
Taxes, Medicare cuts and penalties on employers not offering coverage would stay in place.
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Q: What if the court strikes down the mandate and also invalidates the parts of the law that require insurance companies to cover people regardless of medical problems and that limit what they can charge older people?
A: Many fewer people would get covered, but the health insurance industry would avoid a dire financial hit.
Insurers could continue screening out people with a history of medical problems; diabetes patients or cancer survivors, for example.
That would prevent a sudden jump in premiums. But it would leave consumers with no assurance that they can get health insurance when they need it, which is a major problem that the law was intended to fix.
Obama administration lawyers say the insurance requirement goes hand in hand with the coverage guarantee and cap on premiums, and have asked the court to get rid of both if it finds the mandate to be unconstitutional.
One scenario sends shivers through the health care industry: The Supreme Court strikes down the mandate only, and delegates other courts to determine what else stays or goes.
---
Q: What happens if the court throws out only the expansion of the Medicaid program?
A: That severely would limit the law's impact because roughly half of the more than 30 million people expected to gain insurance under the law would get it through the expansion of Medicaid, the federal-state health insurance program for low-income people.
But a potentially sizable number of those low-income people still might be eligible for government-subsidized private insurance under other provisions. Private coverage is more expensive to subsidize than Medicaid.
States suing to overturn the federal law argue that the Medicaid expansion comes with so many strings attached it amounts to an unconstitutional power grab by Washington. The administration says the federal government will pay virtually all the cost and that the expansion is no different from ones that states have accepted in the past.
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Q: What happens if the court decides that the constitutional challenge is premature?
A: The wild card, and least conclusive outcome in the case, probably also is the most unlikely, based on what justices said during the arguments.
No justice seemed inclined to take this path, which involves the court's consideration of a technical issue.
The federal appeals court in Richmond, Va., held that the challenge to the insurance requirement has to wait until people start paying the penalty for not purchasing insurance. The appeals court said it was bound by the federal Anti-Injunction Act, which says that federal courts may not hear challenges to taxes, or anything that looks like a tax, until after the taxes are paid.
So if the justices have trouble coming together on any of the other options they could simply punt.
The administration says it doesn't want this result. Yet such a decision would allow it to continue putting the law in place, postponing any challenge until more of the benefits are being received. On the other hand, it might give Republicans more ammunition to press for repeal in the meantime.
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Online:
Supreme Court: http://tinyurl.com/3zukoc4
Source: www.guardian.co.uk
Bogus traders warning to West Sussex flood victims - BBC News
People affected by severe flooding in West Sussex are being warned against falling victim to rogue traders.
West Sussex County Council said trading standards had received reports of cold callers offering to carry out repairs to damaged properties in Littlehampton.
"Whenever an emergency of this nature occurs, it seems to bring unscrupulous traders out of the woodwork," said Councillor Christine Field.
The council said it had a list of approved and reputable builders.
"If you do need emergency work done to your property, ignore the claims of bogus callers if they turn up at your door," said Ms Field.
On Saturday, only two flood alerts remained across the whole of South East England, with six flood warnings and alerts lifted by the Environment Agency (EA) in the last 24 hours.
However, it said further rain could lead to more flooding in areas already vulnerable.
Butlins blockedThe EA set up an incident command centre at Bracklesham Lane car park in Bracklesham Bay to co-ordinate its response after many hundreds of people were affected by flooding.
About 250 homes in Elmer were flooded, with residents rescued by boat and taken to rest centres and temporary accommodation.
More than 20 people, including several children, were rescued from flooded caravans at two holiday parks in Bracklesham Bay and flood waters also reached the Manorfield care home in Earnley.
Havens' Church Farm holiday camp, near Chichester, was also flooded and access roads to Butlins in Bognor Regis were closed.
Worthing Hospital's basement and lift shaft was flooded, several schools and one college were shut and many roads were impassable.
An emergency channel had to be dug through sea defences to release flood waters and firefighters used pumps to lower river levels.
Arun District Council officers are continuing to staff a flood recovery vehicle to give advice to residents.
It is stationed in Elmer's shopping area on Saturday until 21:00 BST.
It will be in South Terrace, Littlehampton on Sunday, in Barnham near the railway station on Monday, Wick on Tuesday and South Bersted on Wednesday.
Source: www.bbc.co.uk
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