Report Finds Efficiency Could Replace Power from Indian Point Nuclear Plant in New York

Last month, when New York Gov. Andrew Cuomo announced a deal to close the Indian Point Nuclear Power plant by 2021, some experts questioned whether the plant’s output could be replaced without relying on large quantities of natural gas. Indian Point supplies one quarter of the electricity consumed by New York City and Westchester County.

Under Gov. Cuomo, New York has established aggressive renewable energy and carbon-reduction goals, and the governor said the state had identified zero-emitting sources to replace the plant’s generation, including  investing in offshore wind, and adding new transmission lines to deliver large quantities of hydropower from Québec.

A new report from Synapse Energy Economics, Inc., estimates that more efficient energy use alone could replace all of Indian Point’s annual energy production of roughly 16 terawatt-hours (TWh) by 2023, and lead to efficiency gains that are more than double the plant’s output, by 2030.  In addition, through deployment of energy efficiency and renewable energy, the state can “easily” exceed its goal of cutting electric-sector greenhouse gas emissions 40% below 1990 levels by 2030, said the report, which was prepared for two environmental groups, Riverkeeper and the Natural Resources Defense Council.

Under New York’s Clean Energy Standard, energy efficiency measures must yield energy savings equivalent to 1.5% of annual retail sales, or 2.2 TWh of electricity, by 2025. The researchers found that by ramping up the energy-efficiency requirement to 3% of retail sales by 2021 — an energy savings of 4.6 TWh a year — all of the consumption that would otherwise be met with power from Indian Point could be met through more efficient energy use, within eight years from now. The report stresses that the more aggressive energy savings are achievable, and points out that in recent years, utilities in multiple New England states, including Massachusetts and Rhode Island, have achieved annual efficiency savings of roughly 3% of retail sales.

The researchers also modeled various other scenarios, including the completion of a transmission line to carry hydroelectric power from Québec to New York State, known as the Champlain Hudson Power Express. The project has reportedly received most of the state and federal approvals it needs to begin construction.

The analysis showed that hydropower supplied by the transmission line would make up around 43% of Indian Point’s power. If there were no changes to the state’s energy-efficiency requirements, in order to bridge the supply shortfall – and avoid importing non-Québec energy or boosting in-state fossil fuel generation — the state would need to increase power production from renewables beyond the requirements in its current Clean Energy Standard, a situation that would cost more than the aggressive energy efficiency scenario, the report said. (Québec hydropower cannot be used to achieve compliance with the state’s Clean Energy Standard.)

Ultimately, the overall costs to the electricity system to replace the generation supplied by Indian Point are estimated to range from 0.2% to 2.1%, and will hinge on the technologies that are used, as well as total demand in the state, said the report.

New report finds adults in Medicaid expansion states have better access to care, fewer financial barriers

A new report from the CDC provides the first analysis of the population-based impact of the Affordable Care Act. The analysis used data from the 2014 Behavioral Risk Factor Surveillance System, a state-based ongoing survey of adult Americans about health risk behaviors, chronic conditions, health care access and use of preventive care. As for previous studies, this study found that challenges to accessing care are highest for adults with less than a high school education, are unmarried, unemployed, racial/ethnic minorities and people living in poverty. Adjusting for age differences, the study found a sizeable difference between states that chose to expand Medicaid and those that did not for health coverage (85.3% vs. 79.1%, respectively), having a usual source of care (73.8% vs. 69.7%), and experiencing a cost barrier to receiving needed care (15.3% vs. 18.5%). Interestingly there was almost no difference in the age-adjusted rate of having had a routine check up in the last year (65.0% vs. 64.9%). The report also compares rates of preventive care, cancer screenings and specific cost barriers by income level, region of the country, and type of coverage. For example, 27.8% of uninsured American adults reported that they had to pay off medical bills over time in 2014 while only 21.9% of people with public coverage and 22.1% of privately insured Americans faced that barrier. About half as many uninsured American adults received flu vaccines in 2014 (18.0%) than those with public (37.4%) or private (36.7%) coverage. The ERC region compares well in most categories with the rest of the nation.

  Age-standardized rates  
Insured at the time of the interview Routine checkup in the last year Cost barrier to needed health care in the last year
US Medicaid expansion states 85.3% 65.0% 15.3%
US Medicaid non-expansion states 79.1% 64.9% 18.5%
CT 88.8% 67.0% 13.4%
DE 88.6% 68.2% 12.6%
ME 85.5% 65.2% 13.8%
MD 88.2% 71.2% 12.1%
MA 94.5% 74.2% 9.7%
NH 85.0% 62.1% 13.5%
NJ 84.2% 71.3% 16.2%
NY 84.7% 70.6% 16.3%
PA 86.9% 66.5% 14.7%
RI 89.7% 75.5% 14.1%
VT 91.2% 61.6% 10.6%

Employer sponsored coverage stable but states vary

Between 2014 and 2015, overall US rates of private employers offering health coverage did not change, but rates decreased among small firms and rose among large firms, according to a new analysis by SHADAC. States continued to vary considerably in private sector offer rates. Nationally 47.5% of all private sector workers are enrolled in employer-sponsored insurance (ESI) in 2015, but ERC states varied from 41.9% (VT) to 51.7% (DE). That rate is a combination of the percent of private establishments that offer health coverage, the percent of workers who are eligible, and the percent who accept, or “take up”, the offer. The number of private sector workers in high-deductible health plans continued its climb reaching 39.4% across the country in 2015. Again states varied significantly from New Hampshire with the highest rate of private sector workers with high-deductible plans to Hawaii with the lowest rate. The analysis also includes premium costs as well as employee and employer shares. SHADAC includes state-specific fact sheets in their report.

% all workers in ESI rank among states in % workers in high deductible health plans
US 47.5% 39.40%
CT 48.7% 8th
DE 51.7% 39th
ME 44.2% 3rd
MD 47.1% 41st
MA 48.8% 45th
NH 45.6% 1st- highest
NJ 46.9% 24th
NY 45.9% 42nd
PA 50.6% 48th
RI 43.3% 28th
VT 41.9% 31st

Meet the Legislator – PA Senator Judy Schwank

This month’s featured CSG-ERC Agriculture and Rural Affairs legislator is Senator Judy Schwank of Pennsylvania.

Senator Schwank was first elected to the senate in 2011. The long-serving and well-loved senator from Judy’s district unexpectedly passed away, and the seat needed to be filled. Judy was on vacation with her husband when she got the call from the Party asking her to run. Judy says her husband often reminds her “You never said ‘no’.” He, of course, was concerned about the amount of time and energy this job would require. She would also be required to resign from the job that she loved – that of Dean of Agriculture and Environmental Sciences at Delaware Valley College.

So, knowing she would be out of a job if she lost the election, she signed up anyway. “I was very nervous,” she admitted, “but I had an incredible amount of help. Volunteers stepped forward to help.” And she gave her normal 110% to the campaign, doing everything she could, and then more. It paid off in the end, and she has been filling the large shoes of her predecessor ever since.

We asked Senator Schwank what the biggest issues are facing Pennsylvania agriculture today. “Pennsylvania is primarily a dairy state, and the biggest issue right now is that of dairy profitability.” She added, “Following that is the trade issue, especially with the uncertainty of the new administration, and the renegotiation of NAFTA, which is a big concern. Food processing is big business in my state, and the cost of food may rise as a result of the trade deals.”

When asked what the big non-agricultural issues are in the state, she immediately said, “The huge budget deficit. Our state has a $3.1 billion budget, and our deficit is $3 billion. The governor is committed to resolving this problem but it will mean some very difficult decisions of what to cut and who will suffer.” She added, “The Affordable Care Act is a big issue as well. In Pennsylvania, 700,000 people are on expanded Medicaid. This is an important resource for the treatment of opioid addiction, which is a public health epidemic in our state. Overdose deaths have more than doubled. If ACA funding is taken away, we will lose the ability to treat so many people in need.”

When we asked about the state of the Dairy industry in her state, Judy noted that it is very precarious because of the low prices the farmers are receiving. Some are selling off their herds. However, she understands there is going to be an uptick in the prices, which will help. It is a problem that needs attention at the federal government level as well. On the plus side, they’re seeing a lot of automation come online on dairy farms, and more and more young and beginner farmers are interested in getting into the business.

We asked Judy how she first got interested in agriculture. She said she has always been interested in horticulture, even from a very early age. “When most kids at 8 or 9 are reading comic books, I loved reading horticultural magazines. I would look at the pictures of the flowers and plants, and just dream of one day being a horticulturist.” So it was poppy seed packets, not paper dolls, for Judy! She added, “I even studied Latin starting at age 11, not because I wanted to speak it, but because I thought it would help me with the botanical names of the plants and flowers I loved.”

It was only natural, then, that she study at Pennsylvania State University, where she received her BS in Agricultural Education, and a Masters in Agricultural Education with a Horticulture minor. She went on to become an agriculture extension agent with the Cooperative Extension, where she worked on community development projects, including a developing a wholesale produce auction with Mennonite farmers to supply farmers markets in the state. Because of her work with the county commissioners as an extension agent, when a Commissioner’s seat opened up, she decided to run, and won.

We asked her, of the many jobs she has had in her career, which one was her favorite. “This one,” she said without hesitation. “I love being a state senator. I love being in a position where I don’t have to run for my life or run to support my family, but I run to do the best job I can for my constituents.” She adds, ‘I have found my voice as a senator, speaking out on issues.’ She said, ‘That is what I love the most, the public service aspect of the position. When someone pulls me aside and says, ‘Your staff just did an amazing job and helped me or my family members’, that makes me feel terrific.”

When we asked what Senator Schwank dislikes most, she answered, “I dislike it when people disparage politicians so often. I wish they knew how hard my colleagues work, and how serious they take the work that they do. I may not agree with them politically, but to a person my colleagues are very sincere and want to do the best job possible for their constituents.”

Judy is an active member of CSG-ERC, and we asked her why. ‘I am just so thankful that CSG-ERC exists. I come from academia, where we have in-service education and continuing education opportunities where our colleagues convene and meet to discuss common issues. CSG-ERC makes sure we legislators have the same kind of high educational opportunities. Networking is valuable. A number of the bills I have sponsored have come from the discussions at our annual meetings.”

Senator Judy Schwank is just one of the many great members of our Agricultural & Rural Affairs Policy Committee. Come and meet her, and all of us, this summer at the Annual Meeting in Uncasville, Connecticut, August 13 through 16



Bob, Tara and Elsie


ERC region remains among best-insured states in new CDC survey

As in past years, CSG-ERC states enjoyed lower than average uninsured rates in the first nine months of 2016, according to the CDC’s latest estimates. While not all states are individually reflected in the early survey, the seven reported ERC states varied between 3.1% (MA) to 8.2% (NJ) of residents uninsured compared to 8.8% of all Americans. Northeastern states had the lowest uninsured rate in the US (among four regions), the second highest rate of public coverage (behind the West) and the second highest rate of private coverage (behind the Midwest). 400,000 fewer Americans were without coverage last year, the percentage of Americans with high deductible plans jumped significantly but the percent with coverage in the ACA health insurance exchanges did not change much in the 2016 survey compared to the year before. US trends over the last twenty years show a steady increase in public coverage starting in 1999, a sharp drop in the uninsured rate, and an oscillating private coverage rate. Not surprisingly, since 2010, gains in coverage have been greatest among low income and minority Americans, but they still remain at far higher risk of uninsurance. Also not surprisingly, from 2013 through 2016 uninsured rates in states that elected to expand Medicaid have fallen 9.1% compared with a drop of 5.2% in non-expansion states.


It’s important to note that these are very early numbers and the final state-specific uninsured rates sometimes vary considerably from the final numbers released later in the year.

Understanding the Margin Protection Program (MPP)

You may have heard complaints from our dairy farmers about the Margin Protection Program (MPP), who say that the insurance program for dairy has been a failure. Let’s take a look at the program, what it was meant to do, and what the problems are.

To be sure, our dairy farmers have had their share of low milk prices, the up and down cyclical nature of prices that the farmers receive for their product, and the high cost of producing milk in the northeast. We covered this part of the story in our January blog ( And this year many in our region have been hit with unprecedented drought that has stunted the crops needed to feed the herds. On top of this, we have the highly touted new insurance program fail the farmers, which is adding salt to the wounds.

When we were preparing to tackle this blog, we both thought we understood the MPP. However, as we went to put pencil to paper (or fingers to keyboard), we found ourselves having a hard time explaining the program. So we did what we are good at – we set off to research the issue.   There were many explanations being bandied about, all of which were long, obtuse and leaving one scratching one’s head and saying, “Huh?” We need to thank a friend, Jay Phinizy, former USDA–FSA director in NH and Chair of the House Ag Committee, for his patience in making sure we understood the issue. We hope we are able to explain it more simply than most of the attempts we have read.

We will start with a little history. The MPP came about in the 2012 Farm Bill that was actually not finalized and signed into law until 2014. Many in the dairy industry had asked for an insurance program to replace the previous MILC safety net program. Congress wanted to eliminate Milk Income Loss Contract program (MILC), because it was viewed as a subsidy for dairy farmers. In fairness, many of the dairy producers also preferred to pay into a program meant to protect them from either low milk prices or high feed costs, rather than the MILC handout. The insurance program MPP became a reality in the last farm bill, and MILC was repealed. (There are other programs for dairy, but we will concentrate only on the MPP in this article)

So how does the insurance program work – or how should it work? The program on one side of the ledger takes the “all milk price” as the revenue for the program, and uses the Midwest feed price on the Chicago Mercantile Exchange as the expense side of the equation. The difference between the revenue and the expense is the ‘Margin’. As of this writing, those numbers are $17.05 per cwt (a cwt – or hundredweight – is 100 pounds of milk), $7.89 in feed costs to produce that 100 pounds of milk; resulting in a margin of $9.16. The margin is the important number.

The MPP provides insurance that protects the farmer against the Margin falling below a specific level. The farmer needs that Margin to be reasonably high, because they have plenty of other costs to cover, such as heat, electric, labor, taxes, and on and on. You can purchase MPP to protect that Margin from going below $8:00 (the top level) or from falling below $4.00 (the lowest level). You can buy protection in 50-cent increments anywhere between those numbers. The $4.00 is premium free, except for a $100 annual fee. Above that, premiums go up and are based on actuarial data.

Even if you bought the most coverage of protection at the of $8.00 Margin, you would receive no payments because the margin is $9.16. Should milk prices drop by more than a $1.16, feed prices rise by an equal amount, or some combination of the two, the coverage would kick in if you had bought in at the high margin level.

So what is the problem with MPP? There are several. The ‘all milk price’ is a national average price for milk, and the ‘feed price’ is the Midwest price on the Futures Market. Neither of those is reflective of our Northeast region. Milk prices vary in different regions of the country.   The feed cost vary from region to region. This government insurance program is a one-size-fits-all average, and does not vary by region. Therefore, it is not taking into consideration varying cost factors. The MPP also does not consider other cost issues, which also vary by region. We all know that it costs more to operate a dairy farm in New England than it does in Louisiana.

Another problem is that the margins are calculated in two-month increments. Let’s assume you bought in at the $8 margin level.   If the margin calculated for January is $7.50 and in February the margin went back up to $8.52, the two-month average is $8.01 and the farmer would receive nothing. However, if the margins were calculated one month at a time, the farmer would have had a payout for January but not February. Lastly the margins have been relatively steady (in the $9 to $10 range), so there have been very few payouts. Even though dairy prices are extremely low, the Midwest corn, soybean and other grain prices are low as well. As a result, the numbers we hear are that the program has collected $78 million in premiums and paid out $11.2 mil. (Using New Hampshire as an example, only nine of the 101 dairy farms in that state received an MPP payment).

It is clear that the system is not working for the dairy farmer in our region. Congress has just begun its negotiations on the next Farm Bill. We need to make sure the needs of our Northeastern Dairy Farmers are represented. We will be facilitating discussions for members of our region to develop specific wording for changes we seek to the existing MPP subchapter in the Farm Bill (Title 7-AGRICULTURE, CHAPTER \ 115-AGRICULTURAL COMMODITY POLICY AND PROGRAMS, SUBCHAPTER III-DAIRY Part A-Margin Protection).


Bob, Tara and Elsie

ICER revises value assessment methodology, public comments open

The non-profit Institute for Clinical and Economic Review has posted for comment their updated Value Assessment Framework. ICER is an independent research institute that analyzes evidence on the effectiveness and value of drugs and other treatments, including evidence-based calculations of prices for new drugs that accurately reflect their value in long-term patient outcomes and highlighting prices that may be unaffordable for the entire health system. ICER’s assessments have been essential to government and private payers in assessing the value of new drugs and other treatments and keeping health care affordable. The new improvements to the framework have earned positive feedback. It builds on ICER’s work over the last two years with stakeholders to improve transparency and reflects input from over 50 patient groups, life science companies, insurers and policymakers. Improvements include emphasis on patient-reported outcomes, expanded standards for cost-effectiveness ratios, and use of real, rather than list, prices that take account of rebates.