Wednesday, May 12, 2021

INSURANCE 5/12/2021


Cyber Insurance A Likely Bet For TxDOT, A Year After Ransomware Attack

Gas pumps are seen out of service at a station in Annapolis, Maryland, on May 12, 2021. Fears the shutdown of the Colonial Pipeline because of a cyberattack would cause a gasoline shortage led to some panic buying and prompted U.S. Regulators on May 11, 2021 to temporarily suspend clean fuel requirements in three eastern states and the nation's capital.

Pending final approval from the legislature, the Texas Department of Transportation plans to spend about $100,000 annually on cybersecurity insurance aimed at repaying the state should it incur expenses related to loss of business or recouping costs related to correcting a cyber attack. To buy the insurance, TxDOT needs some minor language changes to state law. HB 3390 by State Rep. Ed Thompson, R-Pearland, would make those adjustments, clearing the way for the transportation agency to buy a policy.

Thompson’s bill is awaiting Senate approval before going to Gov. Greg Abbott for his signature.

State Sen. Cesar Blanco, D-El Paso, who sponsored an identical bill in the senate, said the premium on the insurance would cost TxDOT about $100,000 annually.

The insurance comes about a year after the department was the victim of a ransomware attack on its systems that cost about $10 million to correct and prevent future invaders.

“It was pretty bad,” said State Sen. Robert Nichols, chairman of the Senate Transportation Committee.

A number of state agencies, smaller public entities and major businesses in Texas have faced internet assaults, including school districts, the Houston Rockets, Texas’ court system and Texas Children’s Hospital.

TxDOT did not pay a ransom, officials at the time said, but spent weeks working with consultants and companies, such as AT&T, to identify the issue and install new hardware related to stopping infiltrations. James Bass, TxDOT’s executive director, said analysts believe the breach happened when a contract employee clicked a link disguised as coming from an internal source.

“Unlike in the movies, it does not come up with a skull and crossbones on the laptop,” Bass told lawmakers on May 5 during a discussion of Thompson’s bill.

Officials reported the attack to the FBI, but it was determined the perpetrators likely were not in the United States, making prosecution unlikely.

Bass said the need for the insurance at this time is somewhat confusing, since last year’s attack was covered by insurance. To satisfy bond holders, who lent money for the state to build toll roads, TxDOT purchased cyberattack insurance on its tolling systems about a decade ago. At that time, the insurer allowed TxDOT to add all of its operations free of charge.

Now that the state has been attacked, however, Bass said it likely will need separate insurance, which requires the change in law so TxDOT can use state money — not toll revenue — to pay the premium.

State email accounts and systems remain under constant attack, Bass said, in the flurry of emails coming in because state addresses are so publicly accessible.

“The amazing thing to me … 70 percent of those never make it to our inbox because they are spam,” Bass said. “The attempts are just astounding to try and penetrate.”


No More 'Grateful Patient' Bonuses; Med School Cheating Saga; Junk Insurance Fallout

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Docs Won't Get Bonuses for Fundraiser Referrals

Jefferson Health has changed course when it comes to a policy that linked some doctors' bonuses to their referrals of patients to the health system's fundraising office, The Philadelphia Inquirer reported.

Grateful patient fundraising, steering patients who have expressed gratitude for care to a health system's fundraising office in the hope they'll give money, isn't new, The Inquirer noted. However, earlier this year several Jefferson Health doctors called attention to their concern when the health system linked those referrals to incentive pay, the outlet reported.

"After receiving internal feedback, Jefferson has gone back to the original grateful patient referral program, which does not have an incentive component," John Brand, Jefferson's chief communications officer, told The Inquirer.

The outlet reported that Jefferson Health's reversal comes on the heels of The Inquirer's February report that some of the health system's doctors were "being asked to refer at least one 'grateful' patient each month," and that efforts could affect their annual bonus.

Patients had also expressed their alarm over the policy.

After reading The Inquirer's initial reporting on the issue, Steven Cohen, PhD, a Southampton psychologist and Jefferson Health patient, sent a letter to the hospital's CEO, the outlet reported.

"All patients should have the assurance that when they receive care the health-care provider is focused on the diagnosis and treatment and is not burdened by any conflicts of interest imposed by the employer," Cohen told The Inquirer after Jefferson Health walked back its policy.

Questionable Cheating Allegations Rile Medical Students

At Dartmouth's Geisel School of Medicine, 17 students have been accused of cheating on remote exams while in-person tests were shut down due to COVID-19, according to a New York Times report. But the finger-pointing hasn't been without backlash.

"The allegations have prompted an on-campus protest, letters of concern to school administrators from more than two dozen faculty members, and complaints of unfair treatment from the student government," The Times reported, "turning the pastoral Ivy League campus into a national battleground over escalating school surveillance during the pandemic."

Dartmouth's use of a technology system called Canvas to retroactively track students' activity during remote exams without their knowledge is at the center of the debate. The process may have led to erroneous allegations, The Times wrote, citing technology experts, a review of the software code, and school documents it obtained.

"If other schools follow the precedent that Dartmouth is setting here, any student can be accused based on the flimsiest technical evidence," Cooper Quintin, senior staff technologist at the digital rights organization Electronic Frontier Foundation, told The Times.

Though seven of the accused students have had their cases dismissed, the other 10 have been expelled, suspended, or received course failures and unprofessional conduct marks on their records, according to the report. Such consequences "could curtail their medical careers," the outlet wrote.

'Junk Insurance' Stuck Patient with $33,000 Bill

When Cory Dowd was diagnosed with appendicitis last summer and had an appendectomy, he never imagined his final hospital statement would show his insurance paid just $1,682 for the procedure, leaving him on the hook for $33,600. But that's exactly what happened, ProPublica reported.

In 2019, Dowd -- a self-employed event planner in between a Peace Corps stint and graduate school -- turned to the internet to shop for insurance, ProPublica reported. "But the individual insurance market he was about to enter was one dramatically changed under President Donald Trump's push to dismantle Obamacare, offering more choices at cheaper prices," the outlet wrote.

The short-term plans that Dowd signed up for aren't beholden to the Affordable Care Act's (ACA) strict coverage rules and have been called "'junk insurance'" by both consumer advocates and health policy experts. "The plans can deny coverage for people with preexisting conditions, exclude payments for common treatments and impose limits on how much is paid for care," ProPublica wrote.

But Dowd and millions of others have only seen what they believe to be a good deal, according to the ProPublica report. And the Biden administration now faces a challenge when it comes to the proliferation of short-term plans.

The American Rescue Plan includes an extension of the special enrollment period to sign up for ACA-compliant plans, subsidizes COBRA payments, and expands federal assistance to lower ACA plan premiums, ProPublica reported. But some experts worry that may not be enough, especially for people who haven't yet realized the limits of non-ACA-compliant plans.

"It will take the same level of intentionality that got people on these plans to get them off of them," Dorianne Mason, director of health equity for the National Women's Law Center, told ProPublica.

After an appeal, Dowd's insurer ultimately paid $32,772 for his procedure, with the hospital waiving the remaining amount.

  • Jennifer Henderson joined MedPage Today as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.

  • Best Cheap Car Insurance In Connecticut

    MarketWatch has highlighted these products and services because we think readers will find them useful. This content is independent of the MarketWatch newsroom and we may receive a commission if you buy products through links in this article.

    Looking for low-cost car insurance in Connecticut? The best way to find cheap car insurance in any state is to compare rates and discounts from a number of providers. Of course, cost isn’t the only important factor when choosing an insurer — you’ll also want to look for quality customer service.

    In this article, we’ll outline which providers offer the best car insurance in Connecticut. Our review team has chosen these providers based on their reputation and availability in the state, as well as the types of coverage they offer, average pricing and customer service.

    To start comparing free, personalized car insurance quotes right away, enter your zip code below.

    In this article:

  • 5 best car insurance companies in Connecticut
  • Cost of Connecticut insurance
  • Connecticut car insurance requirements
  • How to get car insurance in Connecticut
  • Our methodology
  • 5 best car insurance companies in Connecticut

    The chart below outlines what we’ve identified to be the five of the best options for car insurance in Connecticut. In making this list, we considered factors such as cost, coverage, reputation and customer experience in Connecticut.

    Top Car Insurance Companies in Connecticut Overall Rating Coverage Rating Cost Rating 1. Amica Mutual 8.5 8.5 8.0 2. State Farm 8.6 8.5 8.0 3. Geico 9.1 8.5 8.5 4. USAA 9.1 8.5 9.5 5. Progressive 9.0 9.0 8.5

    *Our research team considers nationwide factors when scoring providers. However, the order of providers in this table is specific to car insurance in Connecticut.

    1. Amica Mutual

    In the J.D. Power 2020 U.S. Auto Insurance Satisfaction StudySM for the New England region — which includes Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont — Amica Mutual ranked in first place. The company received a satisfaction score of 863 out of 1,000. The regional average was 821.

    Amica Mutual has been in business for more than 100 years and it currently has an A+ rating and accreditation from the Better Business Bureau (BBB). The company also has an A+ financial strength rating from AM Best, indicating a superior ability to meet customer claims.

    In addition to the standard types of auto insurance — liability insurance, collision insurance, comprehensive insurance, medical payments, personal injury protection and underinsured/uninsured motorist coverage — Amica offers the following add-on coverage options:

  • Gap coverage: Pays the difference between the actual cash value (ACV) of your vehicle and the amount you still owe on your loan or lease if your car is totaled
  • Glass coverage: Covers repairs or replacements for windshield glass without a deductible
  • Roadside assistance: Includes towing, flat tire changes, battery jump-starts, fuel deliveries, winching and lockout services
  • Rental reimbursement: Helps pay for the cost of alternative transportation while your vehicle is in the shop for covered repairs
  • 2. State Farm

    State Farm placed second in the J.D. Power Satisfaction Study for the New England region. The insurer scored 855 out of a possible 1,000 points. State Farm insurance is offered through local agents, so customer service quality can vary by region. When it comes to car insurance in Connecticut, the insurer has a positive customer service reputation.

    State Farm has an A++ financial strength rating from AM Best, but it is not rated by the BBB. In addition to standard coverage, State Farm offers the following auto insurance add-ons:

  • Rental insurance: Pays for the cost of a rental car while your vehicle is in the shop for covered repairs
  • Travel expense coverage: Helps pay for meals, lodging and transportation if you are in an accident more than 50 miles from your home
  • Rideshare insurance: Extends your existing coverage to include accidents that happen while you use your car for a rideshare service like Uber or Lyft
  • Emergency road service: Covers up to one hour of roadside labor, towing, fuel delivery, battery jump-starts, tire changes and locksmith services
  • 3. Geico

    Geico ranked first in our review of the best auto insurance companies nationwide. It is a good option for any state, including car insurance in Connecticut. Geico offers competitive rates across the U.S. And has a positive customer reputation in the Constitution State. It scored above average with 841 points in the J.D. Power Satisfaction Study for the region.

    Geico has an A+ rating from the BBB and an A++ rating from AM Best. The insurer offers standard auto insurance policies as well as the following coverage:

  • Emergency roadside service: Provides access to roadside services through the Geico app
  • Rental reimbursement: Helps pay for car rental costs while your vehicle undergoes covered repairs
  • Mechanical breakdown insurance: Pays for the cost of repairs after an unexpected breakdown
  • Rideshare insurance: Required if you plan to use your vehicle to drive for a rideshare service such as Uber or Lyft
  • 4. USAA

    USAA is typically one of the best-regarded insurers in every state. In the J.D. Power Satisfaction Study for the New England region, the insurer scored the most points of any company (895). However, USAA is not eligible for formal ranking with J.D. Power because it is not available to all drivers. Only those who are members of the U.S. Armed services or who have a parent, grandparent or spouse with a USAA account are eligible for a USAA auto insurance policy.

    USAA has an A rating from the BBB and an A++ rating from AM Best. In addition to standard coverage options, USAA policyholders can also purchase the following add-ons:

  • Roadside assistance: Provides access to roadside help such as towing, lockout services, fuel deliveries and battery jump-starts
  • Rental reimbursement: Pays for a rental car while your vehicle is being repaired due to a covered incident
  • Accident forgiveness: A promise that your rates won’t rise after you file a claim, provided for free after five years without filing a claim
  • Car replacement assistance: Pays an additional 20% above your car’s estimated value if it is declared a total loss and you need a new vehicle
  • 5. Progressive

    Progressive insurance is a good option for high-risk drivers. If you have a recent accident or DUI on your record, a policy with Progressive may be your cheapest option for car insurance in Connecticut. Progressive is rated A+ in financial strength by AM Best and has an A- rating from the BBB.

    In addition to standard auto insurance coverage, Progressive offers:

  • Loan/lease payoff: Helps pay off the amount you still owe on your car payments after a total loss accident
  • Rental car reimbursement: Helps cover the cost of a rental vehicle while your car is in the shop for covered repairs
  • Custom parts and equipment value: Pays to repair or replace items added to your car, like your stereo, navigation system or custom paint job
  • Rideshare coverage: Required if you use your vehicle for a rideshare service like Uber or Lyft
  • Roadside assistance: Pays for towing services, lockout services, flat tire changes, fluid deliveries and related issues
  • Cost of Connecticut insurance

    Every state sets its own minimum insurance coverage limits and regulations. Different states also have different weather, road conditions and driving cultures. This means differing crash and theft rates. For these reasons, the cost of car insurance in Connecticut can vary dramatically from that of another state.

    The following table outlines the average cost for car insurance in Connecticut compared to the national average. Data comes from the 2021 National Association of Insurance Commissioners (NAIC) Auto Insurance Database Report. Data represents average premiums paid in 2018. This report found that Connecticut was the 10th most expensive state for car insurance that year.

    Connecticut Car Insurance Average National Average Liability Premium $784.70 $644.11 Collision Premium $407.54 $377.62 Comprehensive Premium $133.86 $167.91 Average Expenditure* $1,216.55 $1,056.55

    *Average expenditure represents what drivers actually spent on their insurance policies. It takes into account all levels of coverage purchased by Connecticut drivers.

    Your own rates may vary. Not only can average rates change from city to city, but your personal driver profile is also used when insurers calculate your premium. The following factors may be taken into account when calculating premiums:

  • Age
  • Gender
  • Marital status
  • Vehicle
  • Driving record
  • City
  • Credit score
  • Overall, Connecticut car insurance rates are a little higher than the national average. The good news is that auto fatality rates in Connecticut are lower than the national average. Here are a few statistics about Connecticut drivers versus the national average, according to the U.S. Department of Transportation’s Fatality Analysis Reporting System (FARS):

    Connecticut National Average Number of Miles Driven 31,601 63,956 Number of Deaths Resulting from Auto Accidents 249 707 Deaths Per 100,000 People 7 11 Deaths Per 100 Million Vehicle Miles Traveled 0.79 1.11 Connecticut car insurance requirements

    Car insurance coverage is required in Connecticut. All drivers must maintain the following state minimum insurance limits:

    Type of Insurance Required Car Insurance in Connecticut Liability coverage $25,000 per person bodily injury liability $50,000 per accident bodily injury liability $25,000 per accident property damage liability Uninsured/underinsured motorist coverage (UM/UIM) $25,000 per person  $50,000 per accident 

    If you are caught driving without the minimum required car insurance in Connecticut, you could face the following penalties:

  • Suspension of registration
  • Vehicle impoundment
  • Fine between $100 and $1,000
  • Suspension of license for one month on first conviction
  • Suspension of license for six months on second and subsequent convictions
  • Imprisonment up to three months
  • Connecticut is an at-fault insurance state. This means that if you are found at fault for a car accident, your own liability car insurance pays for the cost of damages and medical bills for the other driver. If your insurance does not cover the full cost of damages, you can be sued in civil court to make up the difference.

    If you want your own vehicle to be covered after an accident you cause, you must purchase collision insurance. Many drivers opt for full coverage auto insurance, which adds comprehensive coverage along with liability and collision.

    How to get car insurance in Connecticut

    Car insurance can be easily purchased online or over the phone in any state, including Connecticut. If you are unsure about your coverage needs, you may want to call one of the providers listed above.

    The easiest way to get car insurance in Connecticut is to start by requesting a quote. You can get free auto insurance quotes from many top insurers by using the tool below.

    Our methodology

    Because consumers rely on us to provide objective and accurate information, we created a comprehensive rating system to formulate our rankings of the best car insurance companies. We collected data on dozens of auto insurance providers to grade the companies on a wide range of ranking factors. The end result was an overall rating for each provider, with the insurers that scored the most points topping the list.

    Here are the factors our ratings take into account:

  • Reputation: Our research team considered market share, ratings from industry experts and years in business when giving this score.
  • Availability: Auto insurance companies with greater state availability and few eligibility requirements scored highest in this category.
  • Coverage: Companies that offer a variety of choices for insurance coverage are more likely to meet consumer needs.
  • Cost: Average auto insurance rates and discount opportunities were both taken into consideration.
  • Customer Experience: This score is based on volume of complaints reported by the NAIC and customer satisfaction ratings reported by J.D. Power. We also considered the responsiveness, friendliness and helpfulness of each insurance company’s customer service team based on our own shopper analysis.
  • *Data accurate at time of publication.

    Tuesday, May 11, 2021

    Biden on Health Insurance 5/11/21


    Biden: 1M Sign Up For Health Insurance During Obamacare Special Enrollment Period

    Joe Biden wearing a suit and tie: The Associated Press © The Associated Press The Associated Press

    A million people signed up for health insurance through the Affordable Care Act in less than three months since the Biden administration reopened enrollment, the White House said Tuesday, adding that the numbers reinforce the need to further expand the health care law.

    "That's one million more Americans who now have the peace of mind that comes from having health insurance. One million more Americans who don't have to lie awake at night worrying about what happens if they or one of their family members gets sick," President Joe Biden said in a statement.

    Biden in January signed an executive order opening a special enrollment period for the federal insurance marketplace. The order allowed people to sign up or change their health insurance plan outside of the annual open enrollment period or a qualifying life change in the 36 states that use the marketplace.

    The enrollment period remains open until Aug. 15. In his statement, Biden praised the latest COVID-19 relief package signed earlier this year that also subsidized health insurance premiums for low-income people through the marketplace for two years. Biden further called on Congress to take up his American Families Plan, a sweeping economic plan that would make the premium reduction permanent.

    "Today's milestone demonstrates that there is a need and a demand for high quality, affordable health insurance across this country. It is up to Congress to hear them, and act quickly to pass the American Families Plan," Biden said.

    Health and Human Services Secretary Xavier Becerra echoed that sentiment.

    "Now, it's time for Congress to build on this progress with the American Families Plan, which would lower health care costs for families and make premium relief permanent. In addition, four million uninsured Americans could gain health coverage," Becerra said in a statement.

    Copyright 2021 U.S. News & World Report

    Liz Weston: Here Is Who’s Eligible For Free Or Lower Cost Health Insurance Through COVID-19 Relief

    The latest coronavirus relief package did more than dole out $1,400 checks. The law also made health insurance free for millions more people and reduced costs for others, at least for now.

    The American Rescue Plan , which President Joe Biden signed in March, expanded subsidies for people buying their own insurance on Affordable Care Act exchanges. In addition, anyone who receives unemployment benefits this year can qualify for zero-premium health insurance through the exchanges, regardless of income.

    In fact, many people who are currently uninsured will qualify for free or low-cost coverage through the exchanges or Medicaid, says Daniel McDermott, a policy analyst with KFF, the nonpartisan health care think tank formerly known as the Kaiser Family Foundation.

    People who lost their jobs but want to keep their former employer’s health insurance also may get help. If you don’t qualify for group health insurance elsewhere, the federal government will pay your COBRA premiums for up to six months.


    Since 2013, ACA exchanges have allowed people to buy individual and family health insurance policies, usually with tax credits that reduced their premiums and other costs. ACA has four levels: bronze, silver, gold and platinum. Bronze plans typically have the lowest monthly premiums and the highest deductibles; platinum plans have the highest premiums and the lowest deductibles.

    Before the new relief package, people with incomes greater than 400% of the federal poverty level typically didn’t qualify for subsidies to reduce their premiums. Now people with incomes up to 600% of the poverty level — up to $76,560 for a single person or $157,200 for a family of four — can qualify, according to KFF. (KFF’s calculator can show you how much you’d likely pay for ACA coverage.)

    The relief package reduced premiums for the vast majority of people who buy their own insurance, McDermott says. In addition, nearly half of the 29 million currently uninsured now qualify for a free plan, he says.

    Those with incomes below 250% of the poverty line also will benefit from reduced cost-sharing, which means lower deductibles and other out-of-pocket costs. At 150% of the poverty line — income of about $19,000 for a single person and just under $40,000 for a family of four — people qualify for zero-premium silver plans with annual deductibles of just $177 .

    Millions of unemployed people will be eligible for similar coverage. Anyone who receives unemployment benefits for any part of 2021 can qualify for a zero-premium silver plan with the maximum cost-sharing reductions, McDermott says. “For all intents and purposes, the health insurance exchanges are going to look at you as if your income was under 150%” of poverty level, he says.


    The expansion of Affordable Care Act subsidies is retroactive to Jan. 1 and will continue through Dec. 31, 2022. People must purchase their insurance from Healthcare.Gov or their state’s ACA exchange to qualify for subsidies. The act also created a new special enrollment period that extends through Aug . 15, 2021.

    Some people still don’t qualify for subsidies, including most people with incomes above 600% of the poverty line; undocumented immigrants; people who have offers of employer-provided health insurance that’s considered affordable; and certain low-income people in states that haven’t expanded Medicaid coverage.


    Many people prefer to keep their employer’s health insurance coverage when they lose their jobs, although the cost is often prohibitive. Most employers pay a large portion of the cost to cover workers, but former employees who opt to extend their coverage using the federal COBRA law typically must pay the full premium plus a 2% administrative fee.

    Thanks to the new law, employers are required to provide free COBRA coverage from April 1 through Sept. 30 to eligible former employees who lost their health care coverage because of involuntary termination or a reduction in hours, says financial planner and certified public accountant Kelley Long , consumer financial education advocate for the American Institute of CPAs. The employers’ cost will be offset by federal tax credits.

    If you’re eligible for other group health coverage — through a spouse, new employer or Medicare, for example — you won’t qualify for free COBRA.

    “The intention is to help people who have no other options and would otherwise be uninsured because they can’t afford COBRA,” Long says.

    Normally you have 60 days after you lose your job to opt for COBRA coverage, which typically lasts a total of 18 months. If you missed that 60-day window, or signed up but then dropped coverage, you may have another opportunity to enroll. The new law extends the sign-up period so that people who lost their jobs during the pandemic can get the free coverage. Employers are required to reach out to eligible former employees by May 31 . If you think you’re eligible but you haven’t heard from your employer, McDermott recommends contacting your former employer’s human resources department.

    There will be a special enrollment window at the end of September to allow people with COBRA to switch to an ACA plan, McDermott says.


    This column was provided to The Associated Press by the personal finance website NerdWallet. Liz Weston is a columnist at NerdWallet, a certified financial planner and author of “Your Credit Score.” Email: lweston@nerdwallet.Com. Twitter: @lizweston.


    KFF: Health Insurance Marketplace Calculator https://www.Kff.Org/interactive/subsidy-calculator/

    NerdWallet: A Guide to Coronavirus Unemployment Benefits http://bit.Ly/nerdwallet-unemployment-covid

    Note to readers: if you purchase something through one of our affiliate links we may earn a commission.

    1 Million People Sign Up For Health Care During Special Enrollment

    Biden reopened the HealthCare.Gov insurance markets in February for the special sign-up opportunity amid the coronavirus pandemic.

    WASHINGTON — President Joe Biden said Tuesday that 1 million Americans had signed up for health insurance under “Obamacare” during a special enrollment period for those needing coverage during the coronavirus pandemic.

    Biden reopened the HealthCare.Gov insurance markets in February for a special six-month sign-up opportunity that will go through Aug. 15. His coronavirus relief package also boosted taxpayer subsidies, making the coverage a much better deal for new and current customers.

    “Health care is a right, not a privilege — and ensuring that every single American has access to the quality, affordable health care they need is a national imperative,” he said in a statement.

    Biden has promised to build on President Barack Obama's Affordable Health Care Act to push the U.S. Toward coverage for all. He said the law known as “Obamacare” has been “a lifeline for millions of Americans” since it became law more than a decade ago.

    Biden said the U.S. Had made “enormous progress" in expanding access to health insurance through this special enrollment period.

    However, the 1 million figure announced Tuesday by the White House also includes people who would have otherwise qualified for a sign-up opportunity, even without Biden's special enrollment period.

    A life change such as losing workplace coverage or getting married is considered a “qualifying life event” that allows people to sign up any time during the year. Last year about 390,000 people signed up because of life changes from Feb. 15-Apr. 30, the government said, and in 2019 it was more than 260,000.

    So the net number of new customers who could not have enrolled this year but for Biden's action is likely lower than 1 million.

    The number of uninsured Americans has risen because of job losses due to the economic hit of the coronavirus, but last year President Donald Trump's administration resisted calls to authorize a special enrollment period for people uninsured in the pandemic.

    Failure to repeal and replace the Affordable Care Act as Trump, a Republican, repeatedly vowed to do, was one of the former president's most bitter disappointments. His administration continued trying to find ways to limit the program or unravel it.

    A Supreme Court decision on Trump’s final legal challenge to the Affordable Care Act is expected this year.

    Monday, May 10, 2021

    5/10/21 Accidents


    Helmut Jahn, Architect Who Redefined Chicago's Skyline, Dies In A Road Accident Age 81

    Helmut Jahn wearing glasses and smiling at the camera: Architect Helmut Jahn died aged 81 years old in a cycling accident Saturday. © Andreas Müller/VISUM/Redux Architect Helmut Jahn died aged 81 years old in a cycling accident Saturday.

    Helmut Jahn, the architect behind some of America's best-known buildings, has died in a bicycle accident aged 81.

    The German-American designer, whose high-profile projects include Liberty Place in Philadelphia and Terminal 1 at Chicago's O'Hare International Airport, was involved in a collision with two vehicles Saturday, according to Cameron Hills Police Department in Illinois. He was pronounced dead at the scene.

    Born in Germany in 1940, Jahn arrived in the US in the mid-1960s to study under the modernist master Ludwig Mies van der Rohe at the Illinois Institute of Technology (IIT). In 1967, he joined architecture firm C. F. Murphy Associates, which he would later take full ownership of, before renaming it Murphy/Jahn and then simply Jahn.

    Jahn's buildings often celebrated their frames and structural elements, rather than hiding them away behind tidy facades. But while his often-complex amalgamations of glass of steel marked a notable departure from the modernism of his early teacher, Mies, he was similarly deferential to history and context in his embrace of high-tech engineering.

    Jahn's early career saw him working on various large-scale public and civic buildings, from the imposing Kemper Arena in Kansas City to the Michigan City Public Library in Indiana. But it was his work in Chicago, his adopted home city, that established his reputation as one of America's great contemporary architects.

    In particular, his State of Illinois Center, completed in 1985 and better known as the James R. Thompson Center, became one of his most enduring designs. With its sloped glass facade and towering open atrium, the 17-story structure not only became one of downtown Chicago's most recognizable buildings, but a bold architectural expression of transparency and open government.

    However, Jahn's best-known -- or certainly his most widely-used -- creation, was his 500,000-square-foot Terminal 1 building at Chicago's O'Hare International Airport. Most memorably, he masterminded an iconic pedestrian tunnel linking two concourses and photogenically illuminated in neon by Canadian artist Michael Hayden.

    Also renowned for high-rises, Jahn redefined Philadelphia's skyline with his "Neo-Deco" One Liberty Place towers, which put a bold contemporary spin on the Chrysler building. Jahn also worked internationally, completing major projects on four different continents, from the Sony Center in Berlin to Bangkok's Suvarnabhumi Airport.

    Though regarded as a key figure in the postmodernism movement, he opted for simpler, cleaner forms in his later career. Buildings such as the Cosmopolitan Twarda in Warsaw, completed in 2013, and 50 West Street building in Lower Manhattan both demonstrated a more understated approach to skyscraper design.

    In 1991, Jahn was named alongside the late César Pelli as one of the "Ten Most Influential Living American Architects" by the American Institute of Architects. He also held various teaching posts through his career, including at the University of Illinois Chicago, Harvard University, Yale University and IIT, according to a profile on his firm's website.

    As news of Jahn's death emerged on the weekend, tributes began flowing in from Chicago residents and the architecture world. A number of social media users posted images of themselves inside the rainbow-colored tunnel at O'Hare International in remembrance of its late creator.

    Chicago's mayor, Lori Lightfoot, praised Jahn as one of the city's "most inventive" architects, adding that "his impact on the city -- from the skyline to the O'Hare tunnel -- will never be forgotten."

    The University of Chicago, where Jahn completed a striking glass-domed library in 2011, meanwhile tweeted that the architect had left "an enduring impact" on its campus.

    Top image: Helmut Jahn picture in Munich, Germany, in 2012.

    a clock tower in the background: One Liberty Place in Philadelphia, Pennsylvania, pictured in 2015. © Bill McCay/Getty Images One Liberty Place in Philadelphia, Pennsylvania, pictured in 2015. Helmut Jahn's striking Sony Center in Berlin, Germany. © Zeitort/ullstein bild/Getty Images Helmut Jahn's striking Sony Center in Berlin, Germany.

    Lehigh Valley Trucking Legend, 79, Drives 4 Million Miles Without A Single Accident: ‘I’m Not Retiring’

    a man standing in front of a building: Don Cook sporting the leather jacket he received after entering the YRC Freight Hall of Fame for his 4 million miles of safe driving. © April Gamiz/The Morning Call Don Cook sporting the leather jacket he received after entering the YRC Freight Hall of Fame for his 4 million miles of safe driving.

    The last time we saw trucker Don Cook, his career odometer had just rolled over to 3 million miles. He hadn’t had an accident in all that time, and his company, YRC Freight, gave him a truck cab with his name on it and a leather jacket with a patch reading “Three Million Miles Safe Driving.”

    That was nine years ago. Cook was 70 then, and it stood to reason he would retire before long. But here he was at the YRC terminal in Bethlehem Township on Friday, about nine months shy of 80, wearing a new leather jacket with a patch reading “Hall of Fame.” He has been enshrined among the trucking legends there because he has, since 2012, racked up an additional million flawless miles.

    a man sitting in a car: Don Cook, has driven over 4 million accident free miles and is in the YRC Freight Hall of Fame. He said when he sits behind the wheel and gets going he is 30 years old again. © April Gamiz/The Morning Call Don Cook, has driven over 4 million accident free miles and is in the YRC Freight Hall of Fame. He said when he sits behind the wheel and gets going he is 30 years old again.

    Four million miles and not so much as a fender-bender. He attributes this to skill and patience — “You have to have your wits about you,” he said — but also to luck. Drowsy drivers, drunk drivers, distracted drivers — all have kept out of his way over the years, and nature has spared him its worst.

    Cook plans to keep rolling, too. His eyes and reflexes are sharp, and his love of the road burns as bright now as it did when he started trucking professionally 47 years ago.

    “I’m not retiring,” he said. “I’m still a young pup. And my wife would drive me crazy.”

    This was a joke, of course. The Cook marriage is in its 58th year. Dolores Cook has been her husband’s rock all that time. It’s not easy being married to a trucker, after all, because they can be gone for long stretches. Don, for example, used to run routes to Texas and California.

    “If it wasn’t for her supporting me, I wouldn’t be here,” he said.

    He stays closer to home these days, with an overnight route that takes him 400 miles to Akron, Ohio. He makes one stop along the way, at a truck stop on Interstate 80 in Barkeysville, Venango County. He uses the facilities and has a cup of strong black coffee. Next stop, Akron.

    When Cook returns to Pennsylvania and drops his truck at the terminal, he has to drive another 30 miles home to Snydersville, in Monroe County. Some people might consider that a few miles too many, but Cook seems to have a sort of Zen approach to driving. It doesn’t bore him or make him grind his teeth. He puts country and western music or oldies on the radio and hums placidly along the asphalt.

    “You get bopping down the road and pretty soon, you’re where you’re supposed to be,” he said.

    Which is not to say the beauty of the country is lost on him. He spoke warmly of his days passing through New Mexico and Arizona on cross-country runs, stopping at roadside stands to buy dreamcatchers and trinkets from Native American craftspeople.

    Cook grew up in Belleville, New Jersey, where his father drove a tour bus, hauling Vaughn Monroe and other stars of the 1940s from show to show.

    He could be gone for ages at a time. Sometimes, Cook would wake in the morning and see the bus outside. Father and son would enjoy a brief reunion.

    “He’d give me a ride to school on the bus and I wouldn’t see him again for six months,” he said.

    Cook drove a factory truck for a while after high school. His first job as a tractor-trailer driver was with Roadway Corp. Yellow Transportation acquired Roadway and the merged companies became YRC Freight in 2009.

    YRC in the process of reverting to Yellow Transportation again. Whatever the name, its star employee has driven surely and steadily into the record books.

    His colleagues admire him. One, Danny Brown, a 37-year driving veteran, pulled in to the terminal as Cook was having his picture taken and paused to watch.

    “He deserves it,” Brown said, noting how rarely drivers reach multimillion-mile thresholds without an accident.

    “I got a million miles a while back,” he said. “I got a nice watch for that. I don’t think I’ll make another million.”

    Cook probably won’t either, though it might not be wise to bet against him.

    “I’m an old guy,” he said, “but when I sit behind that wheel, I’m 30 years old again.”

    Morning Call reporter Daniel Patrick Sheehan can be reached at 610-820-6598 or dsheehan@mcall.Com.

    State Police Investigating Fatal Accident In Frederick County

    POINT OF ROCKS, Md. (WJZ)– State police are investigating a fatal accident in Frederick County.

    It happened on Route 15 around 3:30 p.M. On Sunday near Point of Rocks.

    Police say a Nissan Altima driven by Dwayne Teal of Manassas, VA was driving southbound, when he crossed into the northbound lanes and hit a Toyota Camry.

    The driver of the Camry, Agustin Arellano-Ayon of Chantilly, VA, was declared dead at the scene.

    Two others were flown to Shock Trauma.

    Investigators believe alcohol played a factor in the crash.

    Anyone with information is asked to call State Police.

    Monday, May 3, 2021

    DENTAL HEALTH 5/3/2021


    South Africa: Oral Health - Dire Shortage Of Dental Practitioners In Public Sector

    Oral health is critical to people's overall health, but a dire shortage of oral health practitioners in the public health sector means that many people are not getting the oral healthcare services they need.

    Some dental practitioners such as Dr Bulela Vava says these chronic shortages, especially in provinces like the Eastern Cape, force dentists in the public health system to operate as "dental butcheries as opposed to oral healthcare centres".

    Vava is the founder and national chairperson of the Public Oral Health Forum.

    Oral healthcare is integrated into the primary health care package provided in the public health sector.

    As the rural and poor province that it is, the focus of the Eastern Cape should be on prevention, but it does not have more than 50 oral hygienists, says Vava. The Eastern Cape health sector is under immense pressure when it comes to oral and dental healthcare. Owing to the lack of qualified staff, the provinces' dentists have no time for restoration services or sophisticated processes other than pulling teeth, according to Vava.

    But this situation is not limited to the Eastern Cape.

    Vava tells Spotlight that oral health patients across the country do not have access to the requisite services.

    "With more than 6 000 registered dentists in the country, [fewer] than 2 000 of these practice in the public service, though the public healthcare system has the majority of the population. Even the 2 000 is not evenly distributed across the provinces. As usual, urban areas have the better share of dentists," says Vava.

    "The poor population in rural and peri-urban areas depend on a strained and under-resourced public health service for most of their oral healthcare needs. It becomes worse in the rural areas, as patients do not have access to the oral health services that they should have. The government is pushing for the National Health Insurance programme that will focus on providing primary healthcare to the citizens, but the current service delivery model focuses on curative as opposed to preventative and educational efforts."

    According to Vava, the challenges to access oral healthcare highlights the need for the successful implementation of primary oral healthcare, but with the shortage of oral hygienists and dental therapists, this becomes a challenge.

    The shortage of qualified personnel can easily be felt both in rural and urban areas, as patients are struggling to access the most basic services such as preventative support. Without the required oral and dental health education, many people find themselves dealing with unpleasant consequences like tooth decay and gum diseases.

    The numbers

    According to the Health Professions Council of South Africa's (HPCSA) 2018/19 annual report, there are 6 374 dentists in South Africa serving a population of 59.6 million people. This translates into 9 350 people per dentist. The report states that the country has 4 325 dental assistants and 1 257 dental therapists. According to the report the country has only 740 oral hygienists.

    A dental assistant is registered with the Professional Board for Dental Therapy and Oral Hygiene of the HPCSA and often works in dental practices, clinics, or hospitals where they help prepare patients and "assist in dentistry with regard to infection control, practice management and the education of patients, the public and the community regarding basic oral health".

    The Regulations relating to the scope of practice of the profession of oral hygiene gazetted in 2017, refers to an oral hygienist as a practitioner who can develop and implement oral health promotion programmes; assess and clinically examine patients' oral health, take x-rays and make diagnoses on oral hygiene and advise and educate patients about oral self-care.

    The Regulations defining the scope of the profession of dentistry gazetted in 2009, defines a dentist as a practitioner who, among others, can physically examine, make diagnoses of oral diseases and injuries, perform dental procedures, and prescribing medicine to manage the oral health of a patient.

    Health Department spokesperson Popo Maja tells Spotlight that there is indeed a shortage of dental practitioners for the entire public health sector, and the challenge is worse in rural areas.

    "The shortage [resulted from] 80% of oral and dental health practitioners who prefer the private sector, making it difficult for the majority of citizens who are not on medical aid to access services," he says.

    "While there is a dire shortage of dental practitioners in the public sector, all oral and dental health services and specialties are offered at different primary healthcare facilities throughout the country. But the waiting list for none emergency services may be long depending on the provinces. It's best for patients to check with their nearest clinic or hospital if oral health services are offered by the facility, or if you need to be referred to a facility that does. In some provinces there are mobile services to accommodate some communities," he says.

    Maja could not confirm exactly how many registered dentists, dental assistants, dental therapists, and oral hygienists are available in the country. He referred Spotlight to the HPCSA.

    Saving teeth

    Vava is convinced that patients do not have access to even 50% of the oral health services they are supposed to have access to because government opts for cheaper services.

    "At a clinic in a regional hospital where a patient is expected to receive restorative services, it is just extraction every day. Unused dental supplies are expiring on healthcare facilities' shelves because dentists are busy with extraction," he said.

    According to Vava, it is often cheaper to just extract teeth compared to restorative and preventative procedures. "Hence there are elderly people who have never visited a dentist in their lifetime. They are terrified of the dentist and don't see the need for dental care unless they feel excruciating pain that forces them to consult a dentist. Our oral health system needs more dental hygienists to travel to under-serviced [sections of the] population to perform preventative education," says Vava.

    'Incessant pain'

    When Spotlight visited the dental clinic in Motherwell, it was Sinazo April's (42) second visit to the clinic. Four years ago her tooth was extracted, and she developed an infection that made her wary of dental visits. She says pain forced her to return.

    "Incessant pain drove me to the clinic though I did not want anything to do with this clinic owing to my previous experience," she tells Spotlight. April says she was not informed about whether or not the tooth can be saved, it was just extracted.

    Gcobisa Magwala (31) also visited the clinic with her eight-year-old son Aphiwe, who was suffering a toothache. Magwala said the child's tooth was extracted, and she wanted to have her own teeth cleaned at the same time but was told to make an appointment, which meant a two to three-month waiting time. Magwala told Spotlight she doubts she will return to have that done. "But my boy was excited about consulting the dentist as it was his first time. Everything went well. We didn't experience anything untoward. The dentist was friendly."

    A nurse who spoke to Spotlight on condition of anonymity, says that there is a dire need for dentists in areas such as Motherwell in the Nelson Mandela Bay metro. She says these shortages have been a problem for several years.

    "Although the number of practising dentists at this clinic increased from two to three in recent years, it still doesn't meet the demand. Motherwell is one of the fastest-growing townships in Nelson Mandela Bay and services neighbouring townships such as Wells Estate and Ikamvelihle, [all using] the same dental clinic," she says.

    Bring dental care to schools

    "Oral health education is the integral component at all primary health care facilities," says Professor Yusuf Osman of the faculty of dentistry at the University of the Western Cape. "Employing an oral hygienist in all primary health care facilities will ensure that oral health becomes part of the general health system and that all patients visiting primary health care facilities will be screened for oral health conditions and are informed about how to practice good oral hygiene."

    Osman says the best approach to improve oral health is to bring dental care to schools to ensure that the burden of the disease does not continue into the future. "It is also important to seal the grooves of the first permanent molar soon after it erupts into the mouth. This prevents decay from setting in at the base of the groove in the tooth, but more importantly, it is the awareness of the tooth and its health in the mind of the child and the parent," he says.

    Dental Care Remains Neglected In State, Nation


    In this image released on Thursday, March 18, 2021, dentists are confronting the fallout from a year of disrupted dental care and treatment. Press release and media available to download at www.Apmultimedianewsroom.Com/newsaktuell. HANDOUT IMAGE - please refer to special instructions. (Shutterstock/FDI World Dental Federation/news aktuell via AP Images)

    COLUMBUS, Ohio — The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.Com under a content-sharing agreement.

    One of the leading health care needs in the state of Ohio is one that’s most neglected, especially when it comes to low-income communities.

    As dental director at the Cincinnati Health Department and as part of the CincySmiles dental clinic program, Dr. Larry Hill’s major task was making sure low-income and high risk populations had access to oral health services, something he says isn’t enough of a priority in the state.

    “It’s been a decades long battle to try to do something about this,” Hill said. “Oral health is…connected to everything else (in health), but it’s been forgotten in most state and national health policy.”

    Hill said it’s hard to understand how dental care has been overlooked by state legislation, federal measures and insurance companies alike, when the small area of the mouth makes so much of a difference in overall health.

    According to the Harvard Medical School, those with gum disease are more likely to have other medical issues, such as high blood pressure, rheumatoid arthritis and osteoporosis.

    Infections in the oral cavity can make diabetes worse, impact the cardiovascular system, and can even create adverse pregnancy outcomes, something Ohio already struggles with when it comes to people of color.

    Health disparities that impact low-income communities and people of color extend to dental care as well, Hill said.

    “The system hasn’t responded to the needs of these populations,” Hill said. “The system is there for people who have insurance and who can afford to take time off work.”

    An Ohio Department of Health screening of more than 3,000 third-grader’s oral health from 2017-18 showed nearly half of the children screened had a history of tooth decay.

    According to the study, while 84% of the third-graders reported having a dental visit within the past year, 20% had at least one untreated cavity. Parents of children in the study cited several difficulties in getting dental care for their children.

    “The cost of dental care was the factor most often cited by parents as a barrier to care, followed by the lack of dental insurance,” the study stated.

    The study also found that lower-income families, those covered by Medicaid, and uninsured children “experience more tooth decay and have a more urgent need to see the dentist because of pain or infection.”

    “However, these children are also those who are less likely to see the dentist on a regular basis,” according to the study.

    Part of the problem, statewide and nationally, with getting access to dental care is a shortage in dental health professionals, and a shortage in those professionals who accept Medicaid. For that reason, David Maywhoor, executive director of the Ohio Public Health Association says the industry needs to be more open to a different way of caring for community dental care: dental therapists.

    Dental therapists are trained in oral health care, usually in specific procedures like root canals or cavity filling, but work under the supervision of dentists. Typically, dental therapists work in facilities or communities that understaffed or without the resources to have full-time dental care.

    “When it works best, young people from communities of need go into an education program, come back out and begin working in communities of need,” Maywhoor said. “When a child is sitting in a (dental) chair…they’re seeing a person that looks like them.”

    Maywhoor said it’s been a struggle having the nation embrace dental therapists because of “misinformation” claiming therapists have less training and less supervision than dentists, despite taking some of the same classes and dental students and being supervised by licensed dentists.

    “I don’t know if it’s a question of control, or fear of the unknown,” Maywhoor said.

    In 2017, Ohio state Sens. Peggy Lehner, and Cecil Thomas introduced a bill to establish the licensing of dental therapists in Ohio, but the Health, Human Services and Medicaid Committee only held two hearings on the bill, and it was never put up for a vote.

    But with legislation passed in Minnesota and Connecticut, and several other states reviewing legislation on dental therapy, Hill said it’s time for Ohio to move forward, especially with a pandemic spotlight on public health.

    “Every day that we don’t do this, people aren’t getting the care that they should be able to get,” Hill said.

    Copyright 2021 Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

    Happy Smiles: Good Oral Health Important To Overall Well-being | Mahoney

    Mark A. Mahoney, Guest columnist Published 3:07 p.M. ET April 27, 2021

    Buy Photo

    A dental hygienist cleans 11-year-old Deitra "DeeDee" Jackson’s teeth at Neighborhood Medical Center as her mom Kisha Simms, 38, looks on in this file photo. (Photo: Alicia Devine/Tallahassee Democrat)

    Oral health is essential to general health and well-being. Oral disease can cause pain and infections that may lead to problems with eating, speaking, and learning. It can also affect social interaction and employment potential.

    The three oral conditions that most affect overall health and quality of life are cavities, severe gum disease and severe tooth loss.

    Oral health refers to the health of the teeth, gums, and the entire oral-facial system that allows us to smile, speak, and chew. Some of the most common diseases that impact our oral health include cavities (tooth decay), gum (periodontal) disease, and oral cancer.

    Oral conditions are frequently considered separate from other chronic conditions, but these are actually inter-related. Poor oral health is associated with other chronic diseases such as diabetes and heart disease. Oral disease also is associated with risk behaviors such as using tobacco and consuming sugary foods and beverages.


    Cavities are caused by a breakdown of the tooth enamel by acids produced by bacteria located in plaque that collects on teeth, especially along the gumline and in the crevices on the chewing surfaces of the teeth.

    Eating and drinking foods high in carbohydrates cause this bacteria to produce the acids that can cause the outer coating of the tooth (enamel) or root surface to break down (demineralize).

    Buy Photo

    Deitra "DeeDee" Jackson, 11, has her teeth cleaned at the Neighborhood Medical Center located near Rickards High School. (Photo: Alicia Devine/Tallahassee Democrat)

    Although cavities are largely preventable, they are one of the most common chronic diseases throughout the lifespan. About one-fourth of young children, half of adolescents and more than 90% of adults experienced tooth decay.

    Untreated tooth decay affected 10% of young children to 26% of adults aged 20–64.2 Untreated tooth decay can lead to abscess (a severe infection) under the gums which can spread to other parts of the body and have serious, and in rare cases fatal, results.

    Gum (periodontal disease)

    About 4 in 10 adults aged 30 years or older had gum (periodontal) diseases in 2009–2014. Gum disease is mainly the result of infections and inflammation of the gums and bone that surround and support the teeth.

    Certain chronic conditions increase one’s risk for periodontal disease including diabetes, a weakened immune system, poor oral hygiene, and heredity. Tobacco use is also an important risk factor for gum disease.

    If early forms of periodontal diseases are not treated, the bone that supports the teeth can be lost, and the gums can become infected. Teeth with little bone support can become loose and may eventually have to be extracted.

    Details on periodontal disease can be found at cdc.Gov.

    Oral cancer

    In 2016, there were nearly 45,000 new cases of cancer of the oral cavity and pharynx diagnosed in the United States and more than 10,000 deaths.  

    Preventing high risk behaviors, that include cigarette, cigar or pipe smoking, use of smokeless tobacco, and excessive use of alcohol are critical in preventing oral cancers. Early detection is key to increasing the survival rate for these cancers.

    Disparities in access to oral health 

    Cavities (also called tooth decay) are one of the most common chronic conditions affecting millions of Americans. Non-Hispanic Blacks, Hispanics, and American Indians and Alaska Natives generally have the poorest oral health compared to other US racial and ethnic groups.

    This is often a result of the social determinants of health – conditions in the places where people are born, live, learn, work, and play. More details on disparities in oral health are available at cdc.Gov.

    Additional educational resources

    Two additional factors that play important roles in promoting oral health are nutrition and diabetes. Links to two beneficial resources to better understand their role(s) follow: 

    Nutrition and your dental health (American Dental Association) 


    Diabetes and your teeth (National Diabetes Education Program) – 2 page information sheet is at cdc.Gov/diabetes.

    To better understand the health and economic benefits of preventing chronic diseases (oral disease in this case) read the two page Power of Prevention fact sheet.

    INSURANCE 5/12/2021

      Cyber Insurance A Likely Bet For TxDOT, A Year After Ransomware Attack Gas pumps are seen out of service at a station in Annapolis, Maryla...