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"As the pinnacle of motorsports, F1 demands boundary-pushing innovation and excellence. It's an honor for General Motors and Cadillac to join the world's premier racing series, and we're committed to competing with passion and integrity to elevate the sport for race fans around the world," GM President Mark Reuss said. "This is a global stage for us to demonstrate GM's engineering expertise and technology leadership at an entirely new level." The approval ends years of wrangling that launched a U.S. Justice Department investigation into why Colorado-based Liberty Media, the commercial rights holder of F1, would not approve the team initially started by Michael Andretti. Andretti in September stepped aside from leading his namesake organization, so the 11th team will be called Cadillac F1 and be run by new Andretti Global majority owners Dan Towriss and Mark Walter. The team will use Ferrari engines its first two years until GM has a Cadillac engine built for competition in time for the 2028 season. Towriss is the the CEO and president of Group 1001 and entered motorsports via Andretti's IndyCar team when he signed on financial savings platform Gainbridge as a sponsor. Towriss is now a major part of the motorsports scene with ownership stakes in both Spire Motorsports' NASCAR team and Wayne Taylor Racing's sports car team. Walter is the chief executive of financial services firm Guggenheim Partners and the controlling owner of both the World Series champion Los Angeles Dodgers and Premier League club Chelsea. "We're excited to partner with General Motors in bringing a dynamic presence to Formula 1," Towriss said. "Together, we're assembling a world-class team that will embody American innovation and deliver unforgettable moments to race fans around the world." Mario Andretti, the 1978 F1 world champion, will have an ambassador role with Cadillac F1. But his son, Michael, will have no official position with the organization now that he has scaled back his involvement with Andretti Global. "The Cadillac F1 Team is made up of a strong group of people that have worked tirelessly to build an American works team," Michael Andretti posted on social media. "I'm very proud of the hard work they have put in and congratulate all involved on this momentous next step. I will be cheering for you!" The approval has been in works for weeks but was held until after last weekend's Las Vegas Grand Prix to not overshadow the showcase event of the Liberty Media portfolio. Max Verstappen won his fourth consecutive championship in Saturday night's race, the third and final stop in the United States for the top motorsports series in the world. Grid expansion in F1 is both infrequent and often unsuccessful. Four teams were granted entries in 2010 that should have pushed the grid to 13 teams and 26 cars for the first time since 1995. One team never made it to the grid and the other three had vanished by 2017. There is only one American team on the current F1 grid — owned by California businessman Gene Haas — but it is not particularly competitive and does not field American drivers. Andretti's dream was to field a truly American team with American drivers. The fight to add this team has been going on for three-plus years, and F1 initially denied the application despite approval from F1 sanctioning body FIA. The existing 10 teams, who have no voice in the matter, also largely opposed expansion because of the dilution in prize money and the billions of dollars they've already invested in the series. Andretti in 2020 tried and failed to buy the existing Sauber team. From there, he applied for grid expansion and partnered with GM, the top-selling manufacturer in the United States. The inclusion of GM was championed by the FIA and president Mohammed Ben Sulayem, who said Michael Andretti's application was the only one of seven applicants to meet all required criteria to expand F1's current grid. "General Motors is a huge global brand and powerhouse in the OEM world and is working with impressive partners," Ben Sulayem said Monday. "I am fully supportive of the efforts made by the FIA, Formula 1, GM and the team to maintain dialogue and work towards this outcome of an agreement in principle to progress this application." Despite the FIA's acceptance of Andretti and General Motors from the start, F1 wasn't interested in Andretti — but did want GM. At one point, F1 asked GM to find another team to partner with besides Andretti. GM refused and F1 said it would revisit the Andretti application if and when Cadillac had an engine ready to compete. "Formula 1 has maintained a dialogue with General Motors, and its partners at TWG Global, regarding the viability of an entry following the commercial assessment and decision made by Formula 1 in January 2024," F1 said in a statement. "Over the course of this year, they have achieved operational milestones and made clear their commitment to brand the 11th team GM/Cadillac, and that GM will enter as an engine supplier at a later time. Formula 1 is therefore pleased to move forward with this application process." Yet another major shift in the debate over grid expansion occurred earlier this month with the announced resignation of Liberty Media CEO Greg Maffei, who was largely believed to be one of the biggest opponents of the Andretti entry. "With Formula 1's continued growth plans in the US, we have always believed that welcoming an impressive US brand like GM/Cadillac to the grid and GM as a future power unit supplier could bring additional value and interest to the sport," Maffei said. "We credit the leadership of General Motors and their partners with significant progress in their readiness to enter Formula 1."None
Analysis: Eagles WRs DeVonta Smith, A.J. Brown complain about offense entering Steelers game
GENEVA (AP) — Netflix has secured the U.S. broadcasting rights to the Women’s World Cup in 2027 and 2031 as the streaming giant continues its push into live sports. The deal announced Friday is the most significant FIFA has signed with a streaming service for a major tournament. The value was not given, though international competitions in women’s soccer have struggled to draw high-value offers. “Bringing this iconic tournament to Netflix isn’t just about streaming matches,” its chief content officer Bela Bajaria said in a statement. “It’s also about celebrating the players, the culture and the passion driving the global rise of women’s sport.” Netflix dipped into live sports last month with more than 60 million households watching a heavily hyped boxing match between retired heavyweight legend Mike Tyson and social media personality Jake Paul. Some viewers reported streaming problems , however. Netflix also will broadcast two NFL games on Christmas Day: the Kansas City Chiefs at the Pittsburgh Steelers and Baltimore Ravens at the Houston Texans. That’s part of a three-year deal announced in May. World Cups are typically broadcast on free-to-air public networks to reach the biggest audiences, and the last women's edition in 2023 earned FIFA less than 10% of the men's 2022 World Cup. FIFA president Gianni Infantino had publicly criticized public broadcasters , especially in Europe, for undervaluing offers to broadcast the 2023 tournament that was played in Australia and New Zealand. That tournament was broadcast by Fox in the U.S. “This agreement sends a strong message about the real value of the FIFA Women’s World Cup and the global women’s game,” Infantino said. The World Cup rights mark another major step in Netflix’s push into live programming. It’s recipe that Netflix has cooked up to help sell more advertising, a top priority for the company since it introduced a low-priced version of its streaming service that includes commercials two years ago. The ad-supported version is now the fastest growing part of Netflix’s service, although most of its 283 million worldwide subscribers till pay for higher-priced options without commercial. But Netflix is still trying to sell more ads to boost its revenue, which is expected to be about $30 billion. Netflix executives have predicted it might take two or three years before its ad sales become a major part of its revenue. Netflix expects to spend about $17 billion on programming this year — a budget that the Los Gatos, California, company once funneled almost entirely into scripted TV series and movies. But Netflix is now allocating a significant chunk of that money to sports and live events, a shift that has made it a formidable competitor to traditional media bidding for the same rights. FIFA will likely use the Netflix deal to drive talks with European broadcasters that likely will be hardball negotiations. Soccer finance expert Kieran Maguire, a co-host of The Price of Football podcast, suggested the deal was “a bit of a gamble" for FIFA and “saber-rattling” by Infantino. “(Netflix) get experience of football broadcasting, FIFA can say, ‘we are now partnering with a blue chip organization, so watch out you nasty Europeans,’” Maguire, an academic at the University of Liverpool, said in a telephone interview. FIFA and Infantino also want to raise the price of broadcast deals to help fund increased prize money and close the gender pay gap on the men’s World Cup. At the men’s 2022 World Cup in Qatar, the 32 team federations shared $440 million in prize money. For the women’s 2023 tournament , FIFA had a $152 million total fund for prize money, contributions to teams’ preparation costs and payments to players’ clubs. In FIFA’s financial accounts for 2023 , the soccer body reported total broadcasting revenue of $244 million. In the year of the men’s 2022 World Cup it was almost $2.9 billion. The next Women's World Cup will be a 32-team, 64-game tournament in 2027, played in Brazil from June 24-July 25. The U.S. originally bid jointly with Mexico. The 2031 host has not been decided, though the U.S. likely will bid for a tournament which FIFA is expected to try to expand to 48 teams. That would match the size of the 104-game format of the men's World Cup that debuts in 2026 in the U.S., Canada and Mexico. Spain won the 2023 Women's World Cup after the U.S. won the two previous titles — in France in 2019 and Canada in 2015. More than 25 million viewers in the U.S. watched the 2015 World Cup final, a 5-2 win over Japan, played in Vancouver, Canada, in a time zone similarly favorable to Brazil. FIFA tried to sign Apple+ to an exclusive global deal to broadcast the inaugural 32-team Club World Cup which is being played in 11 U.S. cities next June and July. Broadcast networks showed little interest in the FIFA club event that will now be broadcast for free on streaming service DAZN, which is building closer business ties to Saudi Arabia. Ahead of the next Women's World Cup, Netflix will "produce exclusive documentary series in the lead-up to both tournaments, spotlighting the world’s top players, their journeys and the global growth of women’s football,” FIFA said. AP Technology Writer Michael Liedtke in San Francisco contributed to this report. AP soccer: https://apnews.com/hub/soccerWalmart's Black Friday Sale Is Now Live, Here Are The Best Discounts
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FORT LAUDERDALE, Fla. (AP) — Republican senators pushed back on Sunday against criticism from Democrats that Tulsi Gabbard , Donald Trump's pick to lead U.S. intelligence services , is “compromised” by her comments supportive of Russia and secret meetings , as a congresswoman, with Syria’s president, a close ally of the Kremlin and Iran. Sen. Tammy Duckworth, D-Illinois, a veteran of combat missions in Iraq, said she had concerns about Tulsi Gabbard, Trump's choice to be director of national intelligence . “I think she’s compromised," Duckworth said on CNN’s “State of the Union," citing Gabbard's 2017 trip to Syria, where she held talks with Syrian President Bashar Assad. Gabbard was a Democratic House member from Hawaii at the time. “The U.S. intelligence community has identified her as having troubling relationships with America’s foes. And so my worry is that she couldn’t pass a background check,” Duckworth said. Gabbard, who said last month she is joining the Republican party, has served in the Army National Guard for more than two decades. She was deployed to Iraq and Kuwait and, according to the Hawaii National Guard, received a Combat Medical Badge in 2005 for “participation in combat operations under enemy hostile fire in support of Operation Iraqi Freedom III." Duckworth's comments drew immediate backlash from Republicans. “For her to say ridiculous and outright dangerous words like that is wrong," Sen. Markwayne Mullin, R-Oklahoma, said on CNN, challenging Duckworth to retract her words. “That’s the most dangerous thing she could say — is that a United States lieutenant colonel in the United States Army is compromised and is an asset of Russia.” In recent days, other Democrats have accused Gabbard without evidence of being a “Russian asset.” Sen. Elizabeth Warren, a Massachusetts Democrat, has claimed, without offering details, that Gabbard is in Russian President Vladimir “Putin’s pocket.” Mullin and others say the criticism from Democrats is rooted in the fact that Gabbard left their party and has become a Trump ally. Democrats say they worry that Gabbard's selection as national intelligence chief endangers ties with allies and gives Russia a win. Rep. Adam Schiff, a California Democrat just elected to the Senate, said he would not describe Gabbard as a Russian asset, but said she had “very questionable judgment.” “The problem is if our foreign allies don’t trust the head of our intelligence agencies, they’ll stop sharing information with us,” Schiff said on NBC's “Meet the Press.” Gabbard in 2022 endorsed one of Russia’s justifications for invading Ukraine : the existence of dozens of U.S.-funded biolabs working on some of the world’s nastiest pathogens. The labs are part of an international effort to control outbreaks and stop bioweapons, but Moscow claimed Ukraine was using them to create deadly bioweapons. Gabbard said she just voiced concerns about protecting the labs. Sen. Eric Schmitt, R-Missouri, said he thought it was “totally ridiculous” that Gabbard was being cast as a Russian asset for having different political views. “It’s insulting. It’s a slur, quite frankly. There’s no evidence that she’s a asset of another country,” he said on NBC. Sen. James Lankford, another Oklahoma Republican, acknowledged having “lots of questions” for Gabbard as the Senate considers her nomination to lead the intelligence services. Lankford said on NBC that he wants to ask Gabbard about her meeting with Assad and some of her past comments about Russia. “We want to know what the purpose was and what the direction for that was. As a member of Congress, we want to get a chance to talk about past comments that she’s made and get them into full context,” Lankford said. Adriana Gomez Licon, The Associated Press
Tennessee is the new No. 1 in men’s college basketball after a massive shakeup in the AP Top 25 . The Vols received 58 first-place votes from a 62-person media panel Monday to reach No. 1 for the first time since the 2018-19 season. Tennessee climbed two spots from last week after Kansas lost twice and Auburn fell to No. 4 Duke. The Tigers remained No. 2 and received three first-place votes. No. 3 Iowa State had one first-place vote and climbed three places from last week for its highest ranking since 1956-57. Kentucky rounded out the top five. In all, 14 ranked teams lost last week, including six teams in the top 10; Kansas and then-No. 11 Wisconsin lost twice. Only two teams — Auburn and No. 12 Oregon — remained in the same poll spots they were a week ago, and the volatility saw five teams jump into the rankings. Tennessee (8-0) is off to its best start since opening the 2000-01 season 9-0 and is No. 1 in the NET rankings. The Vols also are second in the KenPom ratings, ranking second in defensive efficiency and ninth in offensive efficiency despite losing four starters from last year’s SEC championship team. Tennessee beat Syracuse 96-70 in its only game last week. Kansas had been No. 1 since the preseason poll before losing to 76-63 to Creighton and 76-67 to rival Missouri . The losses dropped the Jayhawks to No. 10. Auburn was poised to move into the No. 1 spot for the first time since 2021-22 but lost 84-78 at Duke before beating Richmond. Iowa State had its highest preseason ranking at No. 5 after reaching the NCAA Tournament’s Sweet 16 a year ago. The Cyclones lost by two to Auburn in the Maui Invitational but have reeled off four straight wins since. Iowa State blew out Jackson State 100-58 in its only game last week before facing rival Iowa this week. Two-time reigning national champion UConn nearly dropped out of the poll last week following a 0-for-3 run in Maui. The Huskies bounced back nicely last week, picking up impressive wins over Baylor and Texas to move up seven spots in this week’s poll to No. 18. “Maybe the people with the shovels and the dirt, maybe they were too quick to grab the shovel and throw the dirt on us,” UConn coach Dan Hurley said. Oklahoma had the biggest jump within this week’s poll, climbing eight spots to No. 13 after beating Georgia Tech and Alcorn State . Duke and No. 17 Texas A&M each moved up five spots. Kansas had the biggest drop, followed by No. 20 Wisconsin, which fell nine spots. No. 22 Cincinnati dropped eight places. Multiple teams moved in and out of this week’s poll. No. 14 Michigan is ranked for the first time in nearly three years after tight wins over Wisconsin and Iowa . The Wolverines have won seven straight under first-year coach Dusty May. No. 16 Clemson is ranked for the first time this season following wins over Kentucky and Miami . No. 21 Michigan State also is ranked for the first time after wins over Nebraska and Minnesota . No. 24 UCLA is ranked for the first time since the preseason poll following wins over Washington and Oregon. No. 25 Mississippi State is back in the poll after blowing out Pittsburgh 90-57 and beating Prairie View A&M . Baylor, Memphis, Pittsburgh, Illinois and North Carolina all dropped out of the rankings. The SEC led all conferences with nine ranked teams, followed by the Big Ten with six and the Big 12 with four. The Atlantic Coast Conference and Big East each had two ranked teams, while the West Coast and Mountain West conferences each had one.Brainy, 'normal guy': the suspect in US insurance CEO's slaying
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French designer Louis Le Joly Senoville has introduced Ha Mat, a wearable chess set that turns a centuries-old game into a playful, portable accessory. Born from his passion for chess and a desire to play anytime, anywhere, the design combines functionality and style, challenging traditional notions of both games and fashion. Designer: The Ha Mat set consists of three key elements: 32 bold metal rings represent the chess pieces. Each piece is crafted from rectangular brass blocks, laser-cut to feature graphic reliefs that symbolize their identity. A cross for the king, a zigzag for the queen’s crown, and a simplified horse head for the knight exemplify the blend of utility and artistry. The silk scarf serves as the chessboard, seamlessly blending form and function. Its design incorporates patterns derived from the ring pieces, creating an elegant accessory that can be worn daily. To complement the unconventional forms of the chess pieces, the scarf features a printed layout of their arrangement, making it intuitive for players to recognize and use the pieces during a game. A sleek aluminum and leather wristwatch serves as a dual chess timer when separated, enhancing its multifunctional appeal. Le Joly Senoville’s design draws from history, referencing concealed wearable objects like silk escape maps from WWII and 19th-century military scarves. This historical context blends with modern aesthetics to create a set steeped in tradition yet tailored for contemporary use. The pieces were precision-cut from brass and galvanized with silver, produced in collaboration with a French waterjet metal cutting company. The scarf was crafted from deadstock silk sourced from LVMH Group, emphasizing sustainability. Even the watch prototype was handmade with the help of watchmakers, demonstrating meticulous attention to detail. The designer’s decision to manufacture entirely in France challenges the mass-production norms of design industries, aligning with his commitment to local craftsmanship and sustainable practices. While Ha Mat’s concept may not cater to daily wear, its ingenuity and charm are undeniable. The wearable rings are visually striking, balancing functionality and artistic expression. The project was conceived as Le Joly Senoville’s final-year project at Central Saint Martins, reflecting his appreciation for chess as a “timeless and intergenerational” game. The name Ha Mat pays homage to the Breton phrase “eched ha mat” (checkmate), a nod to the designer’s heritage in Brittany. It underscores the designer’s effort to modernize the game while honoring its rich history. Le Joly Senoville joins a growing movement of designers reimagining chess, such as Stefan Gougherty’s Negative Space Chess Set and Florian Hauswirth’s stackable Democratic Chess Set. However, Ha Mat stands out for its wearable, multifunctional approach, blending the worlds of design, fashion, and gameplay in an innovative and striking way. This unique set invites players to rethink the boundaries of the game, offering a creative and stylish way to engage with chess in any setting.Opinion: 5 common misconceptions about women and entrepreneurship To make entrepreneurship more gender-inclusive, it's important to confront the underlying biases that create barriers for women. The Conversation Nov 24, 2024 12:00 PM Share by Email Share on Facebook Share on X Share on LinkedIn Print Share via Text Message Although women in Canada engage in entrepreneurship more than in other comparable countries, there is still a significant gender gap. CoWomen/Pexels Listen to this article 00:06:48 Women entrepreneurs are essential for the Canadian economy, a fact recognized by the government’s Women Entrepreneurship Strategy . This strategy was launched in 2018 and has seen nearly $7 billion be put toward supporting women-owned businesses in Canada. Although women in Canada engage in entrepreneurship more than in other comparable countries, there is still a significant gender gap . Only 15 per cent of women are engaged in startups and seven per cent are owner-managers of established businesses, compared to 24 per cent and nine per cent of men, respectively. If women participated in entrepreneurship as much as men, global GDP would rise by an estimated three to six per cent, adding $2.5 to $5 trillion to the global economy . This is not just about economic growth, but is a broader ethical and societal issue. By limiting women’s entrepreneurial participation, we are also limiting women’s opportunities for employment, empowerment and the promotion of gender equality more broadly. To make entrepreneurship more gender-inclusive, it’s important to confront the underlying biases that create barriers for women. As experts and researchers in entrepreneurship, we’ve identified five common misconceptions about women and entrepreneurship that need to be challenged. Misconception #1: Women don’t want to be entrepreneurs The first misconception is that women are not motivated to become entrepreneurs. This misconception partly arises from the gendered language that is often used to describe entrepreneurship. Entrepreneurial language tends to be masculine, using terms like “risk-takers,” “achievement-oriented” and “confident,” which are all characteristics more commonly associated with men . This perceived mismatch may contribute to the belief that women are less motivated to pursue entrepreneurship. While women are less likely than men to start a business, in reality, there is strong entrepreneurial motivation among women. Women make up 37 per cent of self-employment statistics in Canada. Misconception #2: Women are not successful entrepreneurs The second misconception is that women are not successful entrepreneurs. This has to do with traditional measures of success, which focus on business size, profitability and growth rate. Relative to men, women are more likely to run smaller businesses with lower profitability and growth , but this does not necessarily mean they underperform. First, small businesses — regardless of the owner’s gender — have limited profitability and growth in general. Second, women are more likely to be part-time entrepreneurs because they often have to balance business ownership with family and household responsibilities. And third, women are over-represented in lower-growth and lower-wage industries like retail and food services . These factors explain the lower performance levels for women entrepreneurs, which are influenced by socially constructed and historical factors, not an inability to be successful. Misconception #3: Women can’t secure business funding The third misconception is that women entrepreneurs are not capable of securing business funding. While women entrepreneurs are less likely to receive financial backing , this is not because of lack of capabilities. Instead, women are less likely to ask for financial funding, either because they don’t require it or because they’re discouraged from applying due to fear of rejection. When women do seek financial backing, they’re usually asked different questions than men are , which affects their outcomes. Finance providers tend to ask women questions that focus on potential failures, while they ask men about potential success. Since the framing of questions influences their responses, women’s answers — which are often focused on preventing failure — instil less confidence and lead to less funding. Misconception #4: Women are risk-averse The fourth misconception is that women are risk averse, preventing them from becoming entrepreneurs. There is some research that points to this misconception being true; one study , for instance, found that women exhibit higher levels of risk aversion when making financial decisions compared to men. However, most women are not inherently risk-averse. This perception is likely a result of how women are socialized according to cultural norms and expectations. Women are often expected to be more communal and caring , while men are expected to be more competitive and risk-taking. The way we define and understand “risk” may also contribute to this misconception. Success stories about entrepreneurs often focus on financial risk — something more commonly associated with men. Less attention is given to the risks women are more likely to take, such as standing up for their beliefs or choosing the ethical route when faced with a dilemma, even if it might result in lower financial success. Misconception #5: Women don’t establish the right networks The fifth misconception is that women fail to build the right networks as entrepreneurs. Research shows women tend to develop more formal mentoring and networking relationships , such as through professional associations, while men typically have a mix of both formal and informal connections. Formal mentoring often offers fewer career development benefits compared to informal connections. Women are less likely to engage in informal mentoring, not because they lack interest or ability, but because there are fewer women entrepreneurs to connect with. Despite this, women are actually more active than men in supporting others’ careers, both men and women. These misconceptions about women entrepreneurs are rooted in the historically masculine nature of entrepreneurship and can be barriers to women becoming successful entrepreneurs. By challenging these stereotypes and promoting gender inclusivity in entrepreneurship, we can help remove obstacles and create a more supportive environment for women entrepreneurs. Ingrid Chadwick received funding from the Fonds Québécois de la Recherche sur la Société et la Culture (FRQ-SC) for this project. Alexandra Dawson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment. See a typo/mistake? Have a story/tip? This has been shared 0 times 0 Shares Share by Email Share on Facebook Share on X Share on LinkedIn Print Share via Text Message Get your daily Victoria news briefing Email Sign Up More Economy, Law & Politics Explosion at B.C. oil waste facility injures two workers, leads to $42K penalty Nov 22, 2024 4:05 PM Opinion: Why taxpayers deserve a public inquiry into Elections BC Nov 22, 2024 3:30 PM S&P/TSX composite up Friday, U.S. stock markets also rise Nov 22, 2024 1:42 PMNone
Michigan aims to cap lost season by beating Ohio StateIn April, just 12 weeks into her pregnancy, Kathleen Clark was standing at the receptionist window of her OB-GYN’s office when she was asked to pay $960, the total the office estimated she would owe after she delivered. Clark, 39, was shocked that she was asked to pay that amount during this second prenatal visit. Normally, patients receive the bill after insurance has paid its part, and for pregnant women that’s usually only when the pregnancy ends. It would be months before the office filed the claim with her health insurer. Clark said she felt stuck. The Cleveland, Tennessee, obstetrics practice was affiliated with a birthing center where she wanted to deliver. Plus, she and her husband had been wanting to have a baby for a long time. And Clark was emotional, because just weeks earlier her mother had died. “You’re standing there at the window, and there’s people all around, and you’re trying to be really nice,” recalled Clark, through tears. “So, I paid it.” On online and other , pregnant women say they are being asked by their providers to pay out-of-pocket fees earlier than expected. The practice is legal, but patient advocacy groups call it unethical. Medical providers argue that asking for payment up front ensures they get compensated for their services. How frequently this happens is hard to track because it is considered a private transaction between the provider and the patient. Therefore, the payments are not recorded in insurance claims data and are not studied by researchers. Patients, medical billing experts, and patient advocates say the billing practice causes unexpected anxiety at a time of already heightened stress and financial pressure. Estimates can sometimes be higher than what a patient might ultimately owe and force people to fight for refunds if they miscarry or the amount paid was higher than the final bill. Up-front payments also create hurdles for women who may want to switch providers if they are unhappy with their care. In some cases, they may cause women to forgo prenatal care altogether, especially in places where few other maternity care options exist. It’s “holding their treatment hostage,” said Caitlin Donovan, a senior director at the . Medical billing and women’s health experts believe OB-GYN offices adopted the practice to manage the high cost of maternity care and the way it is billed for in the U.S. When a pregnancy ends, OB-GYNs typically file a single insurance claim for routine prenatal care, labor, delivery, and, often, postpartum care. That practice of bundling all maternity care into one billing code began three decades ago, said Lisa Satterfield, senior director of health and payment policy at the . But such bundled billing has become outdated, she said. Previously, pregnant patients had been subject to copayments for each prenatal visit, which might lead them to skip crucial appointments to save money. But the Affordable Care Act now requires all commercial insurers to fully cover certain prenatal services. Plus, it’s become more common for pregnant women to switch providers, or have different providers handle prenatal care, labor, and delivery — especially in rural areas where patient transfers are common. Some providers say prepayments allow them to over the course of the pregnancy to ensure that they are compensated for the care they do provide, even if they don’t ultimately deliver the baby. “You have people who, unfortunately, are not getting paid for the work that they do,” said Pamela Boatner, who works as a midwife in a Georgia hospital. While she believes women should receive pregnancy care regardless of their ability to pay, she also understands that some providers want to make sure their bill isn’t ignored after the baby is delivered. New parents might be overloaded with hospital bills and the costs of caring for a new child, and they may lack income if a parent isn’t working, Boatner said. In the U.S., having a baby can be expensive. People who obtain health insurance through large employers pay an average of nearly $3,000 out-of-pocket for pregnancy, childbirth, and postpartum care, according to the . In addition, many people are opting for high-deductible health insurance plans, leaving them to shoulder a larger share of the costs. Of the with health care debt, 12% attribute at least some of it to maternity care, according to . Families need time to save money for the high costs of pregnancy, childbirth, and child care, especially if they lack paid maternity leave, said , CEO of the Policy Center for Maternal Mental Health, a Los Angeles-based policy think tank. Asking them to prepay “is another gut punch,” she said. “What if you don’t have the money? Do you put it on credit cards and hope your credit card goes through?” Calculating the final costs of childbirth depends on multiple factors, such as the , plan benefits, and health complications, said , a health policy researcher at the University of Southern California’s Schaeffer Center for Health Policy and Economics. The final bill for the patient is unclear until a health plan decides how much of the claim it will cover, she said. But sometimes the option to wait for the insurer is taken away. During Jamie Daw’s first pregnancy in 2020, her OB-GYN accepted her refusal to pay in advance because Daw wanted to see the final bill. But in 2023, during her second pregnancy, a private midwifery practice in New York told her that since she had a high-deductible plan, it was mandatory to pay $2,000 spread out with monthly payments. Daw, a health policy researcher at Columbia University, delivered in September 2023 and got a refund check that November for $640 to cover the difference between the estimate and the final bill. “I study health insurance,” she said. “But, as most of us know, it’s so complicated when you’re really living it.” While the Affordable Care Act requires insurers to cover some prenatal services, it doesn’t prohibit providers from sending their final bill to patients early. It would be a challenge politically and practically for state and federal governments to attempt to regulate the timing of the payment request, said , a co-director of the Center on Health Insurance Reforms at Georgetown University. Medical lobbying groups are powerful and contracts between insurers and medical providers are proprietary. Because of the legal gray area, , an insurance broker at Rapha Health and Life in Texas, advises clients to ask their insurer if they can refuse to prepay their deductible. Some insurance plans prohibit providers in their network from requiring payment up front. If the insurer says they can refuse to pay up front, Marshall said, she tells clients to get established with a practice before declining to pay, so that the provider can’t refuse treatment. Clark said she met her insurance deductible after paying for genetic testing, extra ultrasounds, and other services out of her health care flexible spending account. Then she called her OB-GYN’s office and asked for a refund. “I got my spine back,” said Clark, who had previously worked at a health insurer and a medical office. She got an initial check for about half the $960 she originally paid. In August, Clark was sent to the hospital after her blood pressure spiked. A high-risk pregnancy specialist — not her original OB-GYN practice — delivered her son, Peter, prematurely via emergency cesarean section at 30 weeks. It was only after she resolved most of the bills from the delivery that she received the rest of her refund from the other OB-GYN practice. This final check came in October, just days after Clark brought Peter home from the hospital, and after multiple calls to the office. She said it all added stress to an already stressful period. “Why am I having to pay the price as a patient?” she said. “I’m just trying to have a baby.” ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.
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