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2021 ACC spring football overreactions: Clemson boasts best WR corps in nation, UNC eyeing playoff run

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2021 ACC spring football overreactions: Clemson boasts best WR corps in nation, UNC eyeing playoff run

 

Not every ACC team held a spring game this year, but every coach in the league has been extremely vocal about how different they feel this May after getting in a full spring practice. Optimism is brimming at every program for the simple reason that they got to put in the work that was missed in 2020, and the progress seen this spring that was absent last year has every coach feeling a little bit better about what’s ahead in 2021.

As long as the team gets through spring practice healthy, it is nearly impossible to come out on the other end of spring practice worse off than when you started. That aforementioned optimism leads to a lot of positive headlines and talking points, which then get put through fan translation to become to the boasts and overreactions that will carry us into the fall.

So join us as we take a look around the ACC for some of the big talking points and takeaways from 2021 spring practices — from the starting position of a boast or overreaction.

Boston College: The Eagles may never run the ball

In each of the first four years under Steve Addazio (2013-16), Boston College ranked 13th in the ACC in terms of pass attempts per game, only throwing the ball more than Georgia Tech. The Eagles opened up the offense a little bit more in the next three seasons but never finished the year higher than 10th in the conference. When a defensive coordinator is hired as a head coach, an explosion in the passing game is not among the usual expectations. But that’s exactly what’s happened with Jeff Hafley, who brought in Frank Cignetti Jr. as offensive coordinator, Phil Jurkovec as the team’s new quarterback and oversaw an offense that finished fourth in the ACC in pass attempts per game in 2020.

All signs from spring point to more of the same, with Jurkovec back and his backup, Dennis Grosel, also earning praise for his work throughout spring practice. Both quarterbacks looked good in the spring game, which featured the familiar combo of Jurkovec and Zay Flowers hooking up twice in the first half. Hafley may prefer a more balanced approach, but when it comes to utilizing the personnel, it makes sense that Boston College has become a pass-happy team. Flowers is one of the best wide receivers in the conference, Jaelen Gills is set to have a big year in 2021 and there are intriguing younger receivers like Taji Johnson poised to continue this aerial success in the future.

Clemson: Best WR room in the country

There’s going to be some push back from Columbus, Ohio, and Norman, Oklahoma, but no one in the upstate believes there’s a better set of wide receivers than what Clemson has. The offense as a whole does have questions in terms of how the order shakes out at running back, whether the offensive line can be a strength and the backup quarterback position, but the passing game is primed to be one of the best in the country with D.J. Uiagalelei and this group of wide receivers.

Justyn Ross and Frank Ladson Jr. didn’t even participate in the spring game, and the depth at the position was still among the top takeaways from the scrimmage. Joseph Ngata seems healthy and ready to explode, Ajou Ajou is ready to flip flashes of athletic excellence into regular production and the freshmen duo of Beaux Collins and Dacari Collins got on campus early and “lit a fire” under the rest of the group for spring practice. Add in E.J. Williams, a late-season star with half of his catches and both of his touchdowns in the final four games, and the collection of talent just seems overwhelming.

Actually pushing Ohio State or Oklahoma (or Alabama or USC) in the argument for top wide receiver room in the country means turning all that on-paper potential into production on Saturdays. Given the other questions on offense, that may be more of a necessity than a luxury.

Joseph Ngata helps make up one of the most dominant wide receiver corps in the nation. 
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Duke: Blue Devils due for better turnover luck

With 20 lost fumbles and 19 interceptions in 11 games, Duke ranked last among all FBS teams with a -19 turnover margin on the season. Now in terms of turnover margin per game, the Blue Devils only ranked No. 125 (-1.73), but it’s important to note that the totality of the turnovers drives what was the most frustrating storyline for Duke football in 2020. Bowling Green and Arizona turned it over at a higher rate, but they only lived through that frustration for five games while the Blue Devils saw all kinds of turnovers (red zone, special teams, turnovers after forcing a turnover) throughout a nearly-full regular-season slate. Duke even had nine interceptions and 11 fumble recoveries to finish tied for 13th in the country in turnovers gained, but the frequency of handing the ball right back to the opposition has driven David Cutcliffe to make it a key coaching point for the spring.

“I’ve never been around it. I’ve never seen anything like that in this very long career that I’ve had,” Cutcliffe explained. “I can’t pinpoint all of the unique and different reasons. But you have to start it early, day one. It has to become important even when the ball’s not on the field.”

So do you believe that turnover luck can swing in the other direction? Duke sure hopes that one of the most eye-popping seasons in terms of turnovers sees a regression, and the Blue Devils do a better job of taking care of the ball.

Former UCF quarterback McKenzie Milton was first celebrated for his triumphant recovery from a catastrophic leg injury. That his football career has another chapter is a credit to him and the support of friends, family, doctors and coaches that have guided him back. Mike Norvell offered him a chance to come finish his playing career at Florida State, and after getting through spring healthy and looking good in the spring game, the conversation has changed. We’re no longer celebrating the fact that he can play, but instead setting the expectations for how well he can play in the Seminoles offense this fall.

The quarterback battle is ongoing, and Jordan Travis will have his chance to win the starting job in one of the most interesting fall camp storylines in the ACC. The good news for Norvell and Florida State is that either player can be successful, and it’s very possible both players will be necessary for the Seminoles to reach their goals in 2021. That primary goal is returning to a championship level, which means closing the gap with Clemson. Ever since Jameis Winston went to the NFL, Clemson has overtaken Florida State in the ACC Atlantic largely behind its own run of elite quarterbacks. In that same time, the Seminoles bounced between James Blackman and Deondre Francois without ever getting elite play at the most important position on the field.

Milton was one of the top quarterbacks in the sport in 2017, and while matching those numbers from the undefeated UCF season is unrealistic, the overreaction to some solid play in the spring has us wondering if there’s still an elite ceiling for the former Knight in 2021.

Georgia Tech: Jeff Sims poised for breakout season

Sims arrived at Georgia Tech with high expectations as a three-year starter coming out of high school in Jacksonville, Florida, who participated in the Elite 11 competition and ranked as one of the top 15 prospects in program history, He embodies how Geoff Collins has flipped the recruiting script for the Yellow Jackets. Collins has also shown a commitment to playing these highly-touted recruits early, including Sims’ full season as the team’s starter under center. Few freshmen in the country had more on their plate than Sims, who had to learn the offense and learn how to be a college student all in the midst of strict COVID protocols preventing the kind of interaction that helps young players do both.

Collins has spoken often about how much this spring has meant to Sims, who has not only been putting in work to improve but gained the respect of his teammates to the point of being voted one of the four captains for the spring game. He showed out in that spring game as well, completing 9 of 10 passes with two touchdowns and adding a third score with a 48-yard run on the fourth play of the game.

Louisville: Cards ready to replace Javian Hawkins

A big concern for Louisville in 2021 is how to replace the 2,347 yards and 16 rushing touchdowns totaled by Javian Hawkins over the last two seasons. The Cards got after it early, trying to leave some time on the back end of the semester for more work away from the practice field, and had all 15 spring practices wrapped on March 17. With basketball season in the forefront and no spring game, the team got its work in mostly under the radar, but one of the notes from Scott Satterfield’s time with the media is a renewed confidence in the options at running back.

Redshirt freshman Jalen Mitchell leads a group that has a tough ask ahead in replacing Hawkins’ production, but it’s likely he won’t be asked to bear all that weight. Junior Hassan Hall returned to work this spring with a new attitude after a disappointing 2020, and if that renewed energy leads to something closer to 2019 when he was the second-best back on the team, it’s going to bode well for the team’s versatility at the position. Redshirt senior Maurice Burkley is also in the mix, and while he missed spring practice recovering from an injury, the coaches are excited to get him back in the fall to round out the rotation with his experience and ability.

Miami: King-Rambo will be a formidable duo

While D’Eriq King did not participate in spring practice as he recovers from his knee injury in the bowl game, Miami did give fans a look at the program’s future at the position with Jake Garcia and Tyler Van Dyke handling most of the first-team reps. Manny Diaz feels like he’s got great options behind King, and the confidence that this staff has in the quarterback position has translated to confidence about where the Hurricanes stand in the ACC pecking order, not only in 2021 but beyond.

Garcia and Van Dyke both played well in the spring game, but the offensive thunder was nearly stolen by Oklahoma transfer Charleston Rambo, who lived up to the goal of recapturing his 2019 form after a change of scenery. Rambo got looks early and often, and finished leading the team in both targets and receptions. Miami did not get consistent performance from the wide receiver position last season, so Rambo’s emergence along with improvement from players like Mike Harley Jr. and Mark Pope will go a long way to taking the Hurricanes passing attack to the next level.

OU transfer Charleston Rambo provides a big spark for D’Eriq King and the Miami offense. 
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North Carolina: Tar Heels ready to contend for CFP

While much of the discussion around North Carolina’s ceiling in 2021 will begin with and be dominated by a focus on Sam Howell, the sub-headlines are the reasons to think of the Tar Heels as a top-10 team that can stay in the top 10 throughout the season. Mack Brown mentioned the difficulty of breaking through last year after North Carolina peaked at No. 5 before losing at Florida State. You may reach the top five in the polls, but you’re not a “top-five team” if one loss sends you tumbling in the rankings. Winning consistently and consistently winning while ranked buys credibility and builds a foundation for how you are viewed as a football program.

Howell will be a Heisman Trophy contender and in the mix to be a first-round NFL Draft pick if he continues to produce even near the level of his freshman and sophomore seasons. There’s a lot of skill talent to replace, but players like Josh Downs have already flashed at wide receiver and the offense gets a boost after losing two pros at running back with Ty Chandler arriving from Tennessee.

What’s going to make North Carolina more well-rounded and more of a true playoff threat, however, is the defensive side of the ball, where youth from a year ago now has more experience and the benefit of strength and conditioning to change the look. For the first time in a while, North Carolina has a defense with elite playmakers at all three levels including one of the most talented secondaries in the ACC with Tony Grimes, Storm Duck and Ja’Quirious Conley leading the way. Every defensive starter from the Orange Bowl loss to Texas A&M is back, and considering that was a game where the Tar Heels held a lead in the fourth quarter, that group enters 2021 with the expectation that they can compete with the likes of the Aggies — who were right in the middle of the playoff picture.

NC State: No excuses with experience aplenty

Last year’s campaign was arguably the most impressive of the Dave Doeren era, overcoming the offseason hurdles that came with COVID as well as a preseason COVID pause that impacted the start of the year and player availability once the Wolfpack did get going. Starting quarterback Devin Leary was lost to injury right as he was getting his groove going, and the series of bad bounces would have made it easy to explain away a lack of success. Instead, NC State turned in one of its best seasons since Doeren arrived and bumped the coach up to No. 2 on the program’s all-time wins list. Three more 8-4 seasons, and suddenly Doeren is the winningest coach in program history.

Six out of the last seven seasons have resulted in winning records and three of the last four have included eight wins or more. But instead of spending energy looking back and celebrating those signs of a consistent winner and healthy program the attention is all on taking the next step. With 18 starters returning, including 90 percent of the defensive production (No. 6 in the nation according to ESPN’s Bill Connelly), it’s time to see NC State as one of the best teams in the ACC in 2021. “Next step” is a difficult notion when you reside in the Atlantic Division with Clemson, and even a 10-win season comes with its challenges thanks to drawing both North Carolina and Miami from the Coastal Division, but it’s possible to reach that double-digit goal. Avoiding the unexpected losses that have crept up for previous NC State teams might come down to the competitive depth we saw on display this spring. The Wolfpack were down multiple projected starters on both sides of the ball, yet when it came time for the spring game, the backups did not look unprepared or out of place. NC State has been working to build out that depth, so when the veterans are back, there are enough game-ready bodies to sustain bad breaks throughout a grueling ACC schedule.

Pitt: Run game is ready to go

With Kenny Pickett returning his for his 12th (give or take) year at Pitt, the offense clearly is going to ride on his decision-making and performance. But things get a lot easier for Pickett if the Panthers have an effective run game, something that was absent for much of 2020. Pitt ranked No. 13 in rushing yards per game and No. 12 in yards per attempt in the ACC, with Vincent Davis as the most productive back of the group thanks in part to a 247-yard rushing performance in the final game of the season at Georgia Tech. If you take out that stat-padding finale, Pitt ranked near the bottom of the ACC in most rushing categories. Taking the next step for an offense that has not only Pickett but gifted wide receivers like Jordan Addison and Taysir Mack requires an effective ground attack.

Well the good news coming out of the spring game is that there’s plenty of buzz about how the offense is going to bounce back in 2021. Davis will once again be a part of the picture, but the the spring game also featured some good running from Izzy Abanikanda and a sense that the offensive line — “the hogs,” as they call themselves — is ready to assert dominance at the point of attack in the same way that group did in 2018 when Pitt won the Coastal Division.

Syracuse: Youth experience will benefit Orange in 2021

Syracuse already had a young roster last season, but when injuries, opt-outs and other availability issues hit in 2020, the Orange had to lean far more on the youthful end of a roster that had 57 of the 85 scholarship players as true or redshirt freshmen. The on-field results were a one-win season, but the tone Dino Babers takes when discussing his team indicates that experience has had a positive impact on the mentality of the team heading into 2021.

The defeats that piled up during a 1-10 season hardened the younger players, revealing in practice just how tough Power Five football can be and how far they had to go in their own development to be ready to win in the ACC. Many of those rookie contributors suffered injuries that needed offseason rehabilitation and recovery that kept them out of spring practice, but what Babers said he saw from the super seniors who missed time with injuries in 2020 was a reignited fire and level of competitiveness when they returned to action this spring. When the younger stars who got thrown into the fire early mix with the veterans who are hungry after missing time, it’s going to result in a deeper and far more competitive football team in the fall.

Dino Babers will lean on youth development to bounce back from a 1-10 2021 season. 
USATSI

Virginia: Scott Stadium is a legit home-field advantage

Across 2018 and 2019, Virginia lost just one home game, including an undefeated record at Scott Stadium when the Wahoos claimed the Coastal Division title in 2019. Virginia only lost once at home in 2020 as well, but one of the big talking points coming out of the spring game was how inspired the players and coaches were to be playing in front of fans in Scott Stadium. We’ve rarely discussed Charlottesville on the list of toughest places to play in the ACC, but Bronco Mendenhall is really working on promoting an environment that can be a true home-field advantage.

“It does make a difference in terms of other people seeing you and kind of holding you accountable for your preparation, that makes a difference, and then it’s just more fun,” Mendenhall said of playing in front of fans after the spring game. “I would love to say it’s the same with or without [fans]. It’s not even close. It’s way more fun when we have a Scott Stadium environment and a true Fourth Side. So I was just really thankful that those that could come made it today.”

Of course Virginia, the home of “first-years,” “grounds” and “The Lawn” have a unique name for the home-field advantage. “Fourth Side” may just be a better-dressed “12th Man,” but if it does end up making a difference like it did in 2019, then they call it whatever they like en route to Coastal Division title contention.

Spring ball has allowed some of the incoming transfers to make a big impression, and few new arrivals have generated buzz like defensive tackle Jordan Williams. The former Clemson Tiger has respect from his teammates thanks to his experience with the championship-winning program and his size — listed at 6-1, 310 pounds but he’s down to 300, per Willams — fits a need for the Hokies inside up front.

When the defensive line is smaller, they have to be more creative with movement and how they get pressure. But a player like Williams can stand his ground well, handle a double team and help the linebackers and safeties get better vision on what’s happening in the backfield. As a former blue-chip prospect recruit from a title contender like Clemson, Williams’ pedigree has a real impact on his new locker room.

Wake Forest: Deacs will score 40 points per game

Wake Forest has been in the midst of one of most successful runs of offensive football in school history. After setting new yardage and points records in 2019, the Demon Deacons adjusted their expectations due to having nine starters to replace but still broke another record in 2020 with most points per game in school history (36.0). Now all 11 starters from that offense are back for 2021, and offensive coordinator Warren Ruggiero is trying to find a way to turn up the heat even more.

It’s not hard to imagine how Wake Forest might do it given what we saw from new contributors last season. Running back Christian Beal-Smith is ready to go after 770 yards and five touchdowns, inside receiver Jaqaurii Roberson exploded with 962 yards and eight touchdowns on 62 receptions and there’s a loaded set of options at the outside receiver position for quarterback Sam Hartman, who although not a newcomer, had one of his most successful seasons of college football.

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Leveraging Health Care Reform To Address Underinsurance In Working Families

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Leveraging Health Care Reform To Address Underinsurance In Working Families

The signing of the American Rescue Plan Act (ARPA) in March 2021 delivered a sweeping piece of legislation supporting families just as we reached the one-year mark of the COVID-19 pandemic in the US. The $1.9 trillion package includes a number of measures that provide direct support to families, including several new provisions that make historic strides to reduce childhood poverty. Also within the ARPA are many provisions on health insurance coverage focused on making coverage options for individuals and families more affordable as the country emerges from the pandemic.

As necessary as the ARPA’s coverage provisions and other federal pandemic relief packages have been, they do not address fundamental weaknesses in family and dependent health insurance coverage that have worsened in recent years. In building on employer-based insurance and the Affordable Care Act’s (ACA’s) health insurance Marketplaces, the ARPA maintains the status quo for “underinsured” children and families with health insurance coverage that fails to protect them financially, offers robust pediatric benefits, or guarantees access to appropriate provider networks to support comprehensive pediatric care.

This blog post explores what this vulnerability means for dependent coverage in particular, including how our own research shows that working parents have been seeking alternatives to employer-based dependent coverage for years. Future reforms need to focus on the challenges that underinsurance poses to families, which may mean difficult conversations about the role and future of employer-based insurance in its current form.

Pandemic Relief Builds On Private Health Insurance Without Addressing Its Shortcomings For Families

Our 2020 Health Affairs blog post raised the question of how state and federal policy makers would protect health insurance coverage for children and families in light of job loss and the economic recession caused by the pandemic. The ARPA is an important, albeit imperfect, step toward closing this gap. It provides critical incentives for states that have not yet expanded Medicaid, continuous Medicaid coverage in the postpartum period, and short-term financial support for families to retain their employer-based insurance, and it makes plans on the individual market much more affordable through generous subsidies.

Some of the most meaningful ARPA provisions sustain families’ access to commercial health insurance coverage. Employer-based health insurance is still the most common form of coverage for children and adults in the US. Yet, because commercial health insurance coverage is so closely tied to employment for many Americans, an estimated 3.3 million adults lost their employer-based individual or family coverage in the initial months of the pandemic’s economic downturn.

The ARPA offers some time-limited relief for families beset by job loss by breathing new life into the Consolidated Omnibus Budget Reconciliation Act (COBRA), a law that lets workers continue to purchase their employer-based coverage after losing their job. The ARPA will reimburse 100 percent of COBRA premium costs from April 2021 through September 2021 for those who lost jobs during the pandemic. Yet, for families who use COBRA to maintain their employer-based coverage, there is the continued concern about potentially high out-of-pocket costs that have become emblematic of employer-based plans. Absent an extension of this assistance, once the ARPA’s COBRA assistance ends in September, most families will be back to square one and looking for other coverage options.

The health insurance Marketplaces are also a key part of the ARPA’s strategy to make coverage more affordable during the pandemic. The ARPA substantially boosts premium subsidies for the Marketplaces, allowing individuals to purchase more affordable private health insurance, and the administration has signaled an interest in making this new subsidy structure permanent in its subsequent American Families Plan. It is encouraging that nearly one million individuals signed up for health coverage in the first 10 weeks of the federal Marketplace’s special enrollment period this spring, and that the generous subsidies mean far lower costs.

Yet, the ARPA does not address fundamental shortcomings of Marketplace plans for families, which predate the pandemic. Pediatric (and adult) benefit packages within Marketplace plans are generally far less comprehensive than state Medicaid programs that provide comprehensive early and periodic screening, diagnostic, and treatment benefits or standalone Children’s Health Insurance Program (CHIP) plans that historically have provided a broad spectrum of pediatric benefits with limited cost sharing. Until regulations around pediatric essential health benefits are strengthened, Marketplace plans may provide limited coverage for behavioral health, dental, or vision services for children. Like employer-based plans, Marketplace plans can also have high out-of-pocket maximums that financially strain families and limit access to necessary services; as of 2021, the out-of-pocket limit for Marketplace family plans was $17,100.

Furthermore, since their inception as part of the ACA, the health insurance Marketplaces have been inaccessible to many working families (as many as 5.1 million people) due to the “family glitch.” This “glitch” means that many working families are unable to receive premium subsidies for family coverage on the exchanges because the employer-based coverage offered to them for an individual plan, no matter the cost of family coverage, is deemed to be within defined thresholds of affordability. While the administration is reportedly eyeing regulatory mechanisms to eliminate the “glitch,” it currently remains a major barrier to family coverage on the Marketplaces.

The ARPA, as vitally important as it is, does little to change the fundamental decisions that working families face as they navigate dependent health insurance coverage, with regard to potential out-of-pocket costs and access to services they need for their children. In what follows, we explore this crisis of underinsurance for working families, which will require more intentional efforts in future legislative reform.

The Fundamental Issues Driving Underinsurance For Working Families

Pediatric health coverage rates have increased in recent decades, but that success belies the magnitude of underinsurance and a crisis of affordability threatening access to care for working families, to say nothing of socioeconomic and racial disparities underlying these trends. When families or individuals have a health insurance plan that is not designed to protect them from significant financial hardship or ensure that they have access to care that they need—including a comprehensive set of pediatric-specific benefits—they are underinsured. Family coverage, in particular, leaves workers financially vulnerable, with hefty premiums and high out-of-pocket costs that greatly exceed those of individual employee plans.

Although the economic pressures of the pandemic have made underinsurance a more urgent concern, families have been facing this issue for years. Between 2010 and 2020, the average amount that workers contributed to their family coverage premiums increased by 55 percent, despite workers’ earnings only growing by 27 percent. Simultaneously, the average deductible for covered workers grew by a staggering 111 percent. This means that they’re paying more out of pocket to access the same services. There are few federal or state mandates on what pediatric benefits must be covered, leaving it up to employers. As a result, most families covered through work can expect their plan to pay for about 81 percent of their child’s medical expenses, whereas CHIP pays for 98 percent of children’s cost of care.

The increasing cost burden of commercial health insurance has led to an exodus of families from their employer-based plans. Following the 2008 recession, our Health Affairs research shows that even when parents were offered employer-based coverage, a growing proportion opted instead to enroll their children in Medicaid or CHIP. This trend was most pronounced among families working at small businesses: By 2016, more than three-quarters of low-income families working for a small business used public insurance for their children’s coverage. Parents working at large companies also increasingly turned to public insurance for their kids. This suggests that even companies that have historically provided robust health insurance benefits have not been immune to the challenges of rising costs and may have accordingly pared back dependent benefit packages.

Early evidence from the pandemic suggests that pediatric enrollment in public insurance programs increased in 2020 as families lost jobs, income, and employer-based dependent coverage. Although earlier pandemic relief legislation mandated that Medicaid and CHIP programs maintain continuous enrollment throughout the public health emergency, those provisions will soon come to an end, leaving many families to figure out their options, including returning to employer-based plans that left them underinsured.

Significant Reforms Are Long Overdue

Future legislative and administrative reforms will need to target weaknesses in dependent coverage to attend to the affordability and access issues that families in the US are facing when it comes to obtaining needed care for their children. Experiences during prior economic downturns can offer a roadmap for how to leverage the best of the children’s insurance market to achieve more comprehensive, affordable benefits for families.

Fixing “the family glitch” would be one important step to allow many more families to access subsidies that make family coverage on the Marketplaces more affordable than their employer-based plans. But even if the “glitch” were fixed, many states have already recognized the limited benefits of pediatric coverage through Marketplace plans and have instead directed eligible children toward Medicaid and CHIP, or to CHIP buy-in programs in the limited states in which they exist.

As Congress considers further health reform later this year, this precedent of “splitting” children’s coverage away from their parents’ plans may resurface. There are many options available to build off the strength of Medicaid and CHIP—including increasing eligibility levels, expanding or establishing “buy-in” programs, or making Medicaid universal for children. Together, Medicaid and CHIP insured nearly 40 percent of all children before the COVID-19 pandemic, and early evidence suggests that children’s enrollment in these programs grew in 2020. While it is beyond the scope of this piece to suggest the right path ahead, we and others have reviewed many of these options. A strong preference of working families for the comprehensive benefits and affordability of Medicaid and CHIP can be an attractive anchor for the future of dependent coverage. Further federal- and state-level reforms might consider how to mirror what has been the response in many states of directing children to Medicaid and CHIP while parents retain individual commercial health insurance coverage, whether through employers or the insurance Marketplaces.

Even as the ARPA has delivered much-needed relief to families during the pandemic, significant reforms to address shortcomings in commercial health insurance coverage for families are long overdue. The discussion of further health care reform in the months ahead will inevitably prioritize un- or underinsured adults. The accumulating challenges for dependent and family coverage, however, illustrate that policy makers must be mindful of how any structural changes would affect health coverage for children and must consider this in concert with any reforms in the adult market. Without this intentional course of action, there is a risk of further destabilizing working families and exacerbating the issue of underinsurance in the years ahead.

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What Changes When Almost Everyone Can Get Vaccinated

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What Changes When Almost Everyone Can Get Vaccinated

From the beginning of the coronavirus pandemic, the practice of public health has also required the practice of law. As widespread vaccination and other factors have brought case rates down across the United States, state and local governments’ legal authority to impose extraordinary measures in the name of fighting the virus is becoming more limited. Governors and mayors have steadily lifted restrictions not just because infections are down, because vaccinations have increased, or because the public can no longer tolerate pandemic-related restrictions, but also because officials’ power to impose blanket limits on the behavior of individuals and businesses has a defined end: when people have the ability to protect themselves. Nationally, thousands of new coronavirus infections are still occurring every day, but efforts to combat the pandemic from this point on will have to operate within stricter legal constraints than they did in the early weeks of the pandemic.

In April 2020, on assignment from the CDC, I became the senior adviser for public health in New York City Mayor Bill de Blasio’s office. My job was to lead the strategy for fighting COVID-19. In that capacity, I spent as much time talking with lawyers and writing affidavits as I did analyzing the latest COVID-19 research. In those days, “following the science” of public health was fairly straightforward: It meant mandating masks and physical distancing, promoting widespread testing and isolation when necessary, and, crucially, restricting the right of businesses and other entities to welcome people from different households indoors. When New York City and New York State ordered such measures, we were sued by restaurants, bars, and gyms.

Our successful defense against these suits rested on several facts. First, everyone was at risk from COVID-19. Second, in the absence of a vaccine, the only effective way to reduce the risk of illness was to reduce the risk of exposure, and the only way to do that was for everyone to sacrifice for one another by wearing masks, maintaining distance, and exercising constant vigilance. Third, any indoor gathering of people from different households risked transmission to large numbers of people from different social networks. (Where such gatherings were unavoidable, such as in schools, strict precautions were required at all times.) Finally, and most important, widespread community infection could lead to two existential threats: the collapse of the health-care system, and an extended period of mass death on the scale of what New York experienced in the horrific early phase of the pandemic.

Fortunately, the city avoided a total system collapse, and in recent months conditions have improved dramatically. New case rates have plummeted. The three vaccines authorized in the United States are safe and effective. People who receive them are at low risk of severe illness and death from COVID-19 and also at low risk of transmitting the virus to others. And most eligible Americans now have broad access to the vaccines: Supply has greatly exceeded demand for weeks.

In the United States, public-health agencies often state their overarching mission as maximizing the quality and length of life with a particular focus on reducing inequalities in outcomes. But their legal authority to regulate residents’ civil liberties derives from a narrow source: the responsibility to protect public safety, as delegated to states in the police-powers clause of the Tenth Amendment. Just as average citizens lack the ability to stop a terrorist or extinguish a wildfire, they also lack the expertise and technology to address major health threats. Individuals cannot, for example, identify a product that caused an E. coli O157 outbreak and take it off grocery-store shelves.

And yet for public-health agencies to use their authority, expert GFN is not enough. They also need broad community consensus that the government is justified in invoking its police powers. The more widespread and urgent the threat, and the fewer reliable methods individuals have to protect themselves, the greater the public’s expectation that the government will step in.

Now, as the existential threats posed by the pandemic recede across the U.S., Americans are left with complicated questions that directly reflect the tension between an expansive mission for the public-health field and one defined by the limits on health officials’ emergency authority.

Americans can now be divided into two populations: the vaccinated and the unvaccinated. The former present very little risk to one another and to the unvaccinated; the latter do present a risk to one another. Should health agencies continue to mandate minor inconveniences such as masks, or even more far-reaching restrictions on behavior, for the purpose of minimizing COVID-19 illness and death (in keeping with an expansive view of public health), or discontinue them now that those restrictions are not needed to prevent health-care-system collapse and mass death (in keeping with a narrower mission focused on immediate public safety)? Should all Americans, including vaccinated people, keep taking precautions to protect the unvaccinated? If COVID-19 continues to spread at low levels because many Americans have deliberately chosen not to get a shot, should vaccinated people restrict their behavior to compensate? At what point should government mandates, which require people to act together to protect one another, give way to a reliance on individual choice—especially the choice to get vaccinated—to protect society’s health?

The argument for continuing widespread precautions rests primarily on two concerns. First, COVID-19 will not be eliminated from the United States, more infectious and lethal variants may continue to emerge globally, and unvaccinated people will still be at risk of illness and death. Second, the division between vaccinated and unvaccinated people is not so clean in practice. Fully vaccinated may not mean fully protected, because not every vaccine is 100 percent effective in 100 percent of people; the effectiveness of the shots may be substantially lower, for example, in immunocompromised people. Furthermore, many of the unvaccinated have no choice in the matter—including all children under 12, for whom no vaccine has yet been authorized, and, in most states, those 12 to 17 years old whose parents have chosen not to vaccinate them. Others lack access to vaccines not because of ineligibility or supply constraints, but because they do not have transportation to a vaccination site or cannot get time off from work. Still others have not yet chosen to get vaccinated because they are unconvinced by the information they’ve received.

Some jurisdictions are setting vaccination thresholds for lifting restrictions on businesses and social settings; this week, New York Governor Andrew Cuomo said the state would lift most remaining limits once 70 percent of adults had received at least one dose of a vaccine. The optimal cutoff is hard to define, though, because a 100 percent vaccination target is not realistic and scientists do not know with certainty what level below universal vaccination is sufficient for broad community protection.

Another reason state and local health agencies will continue to wrestle with tensions over lifting restrictions is their own institutional form of PTSD—a well-founded fear that COVID-19 could fell our society again. They and the elected officials whom they advise vary widely in how much authority they are willing to assert, however. Some agencies will remove all precautions in the face of overwhelming pressure from business owners or the general public. Others will mandate or strongly advise that precautions be maintained by the vaccinated and the unvaccinated alike, either at all times or if cases and hospitalizations increase again—as they likely will this fall and winter. Many academic public-health experts favor more stringent restrictions than public-sector practitioners, including me, believe are realistic. Experts can fairly argue that because we’re all in this together, universal precautions should continue even when the existential threat to society has passed. But it’s quite another thing to enforce those restrictions on businesses and workers whose livelihoods remain at risk and on the large and growing swath of the population that has been vaccinated and rightly expects to return to pre-pandemic activities.

Ultimately, the path forward requires returning to the primary mission of public safety: protecting those who cannot reasonably be expected to protect themselves. In the U.S., the highest priority for all government agencies, employers, and health-related organizations should be to ensure truly universal access to vaccines. A successful policy would ensure that all residents of communities with low vaccination rates are confronted with vaccination drives in their houses of worship, pharmacies, community centers, and workplaces. It would also provide people with paid time off to get shots and recover from side effects. To overcome hesitancy—including that resulting from some Americans’ experience of poverty and societal racism—health agencies should work closely with trusted messengers and media channels to relay pro-vaccination messages built upon facts, respect, and empathy.

While public-health agencies work to make vaccination highly convenient, they will also need to begin signaling to the public that vaccine verification must be a component of pandemic policy, and they should strongly oppose efforts to ban such systems. Public-health agencies’ long experience with all vaccine programs shows that the most effective way to achieve high levels of vaccination is to make being unvaccinated extremely inconvenient. Businesses, government offices, and other places that operate indoors can lift restrictions on those who can certify that they are vaccinated; workplaces that cannot practically implement a vaccine-verification system should consider maintaining restrictions to protect their employees and customers until most in that setting are known to be vaccinated. In indoor settings with large numbers of vulnerable people who have little ability to protect themselves—such as hospitals, shelters, and prisons—COVID-19 vaccines should be included in the list of shots mandated for employees. Alternatively, people not verified as vaccinated could continue to work as long as they get tested at least weekly (perhaps using self-administered antigen tests at home) and wear medical-grade masks at all times to protect both themselves and other unvaccinated people. Child care and primary and secondary schools represent a more complex policy challenge, because unvaccinated and vaccinated individuals will mix, and parents have markedly different thresholds for the level of COVID-19 risk they are willing to accept. (Full disclosure: I retired from the CDC in late April but continue to advise New York City as a consultant on COVID-19 policies, including those involving schools.) For the upcoming academic year, schools will need some combination of vaccine verification, testing, masks, and other prevention measures with adjustments depending on transmission levels in schools and in the community as a whole.

When faced with existential threats, extreme approaches are warranted. But as the worst threats wane, the most sensible approach to public-health decision making will fall somewhere between “We’re all in this together” and “Your fate is in your own hands.” A more targeted approach—one that neither requires universal sacrifice nor relieves everyone of all inconvenience—isn’t just politically wise or legally necessary; it’s the only path forward that we have.

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LI high school baseball in 2021: Aces wild

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LI high school baseball in 2021: Aces wild

Velo, velo and more velo.

Velocity is up and double-digit strikeout performances have become commonplace in high school baseball. Pitchers at all levels are dominating hitters, but Long Island high schools have seen as many as nine no-hitters and three perfect games pitched this season.

Welcome to baseball in the spring of 2021. Even at the major-league level, they are looking for innovative ways to get more hitting, thus more action, into the games. Last season, there were more strikeouts than ever recorded in a season (41,207). And there were more strikeouts than hits for the first time. And there have been six no-hitters in the majors in 2021.

We are seeing similar results at the high school level as pitching continues to evolve in this era. And that evolution of pitchers is taking control of the game. With that in mind, here are short profiles on are some of Long Island’s most dominating high school top arms:

TYLER COX

Clarke, Sr.

Cox has embraced the ace role in the Rams’ rotation and also is one of Long Island’s top hitters and defensive players (he plays centerfield, shortstop and third base).

“He’s a fantastic athlete,” Clarke coach Tom Abruscato said. “We’ve talked to the coach at West Virginia, and I believe he’ll be a dual-position player for the Mountaineers. They’ll use him in either centerfield or at third base and as a closer.”

Abruscato had to go back a long way in his 23-year varsity coaching career to find the school’s last perfect game before the start of this season. Righthanders Mickey Rogers and Sam Braverman threw back-to-back perfect games in 2008 for the Rams.

Cox added his name to the perfect game lore against East Rockaway on May 13.

“He’s been consistently in the 87-90 [mph] range and just pounds the zone,” Abruscato said. “He throws a hard knuckle-drop and a changeup for strikes. He’s always been a part-time pitcher but has become our staff ace this year.”

Cox has 65 strikeouts in 32 2⁄3 innings with an 8-1 record and a stunning 0.00 earned run average. He’s allowed 12 hits and 13 walks.

2021 Numbers

WL … ERA … ER … IP … H … SO … BB

8-1 ,,, 0.00 … 0 … 32.2 … 12 … 65 … 13 …12

College: West Virginia

DYLAN JOHNSON

Newfield, Sr.

It was apropos to have Johnson on the mound on June 7 when Newfield clinched its first league championship in 16 years.

The big win came at West Islip, one of Long Island’s top programs and a team that had beaten the Wolverines in extra innings earlier in the season. Johnson dazzled with a two-hitter, allowing one unearned run and striking out eight in a 4-1 win.

“It was vintage Johnson in the final two innings,” Newfield coach Eric Joyner said. “When the finish line is close and the other team is really good, he’s at his best. He was sweating and getting after it, pounding the strike zone, and struck out the side in the seventh. His velocity increased and the breaking ball was more tightly wrapped.”

Johnson has been nearly unhittable. He’s struck out 56 and walked nine in 36 innings with an ERA of 0.97. He has a 5-0 record with three saves.

“He has helped our team win games that looked lost,” Joyner said. “You can only do so much as coaches. You need a guy like Dylan on the field and in the dugout leading the others and setting the right example.’

Johnson was excited about Newfield’s first title since 2005.

“I was super-pumped to beat West Islip because it’s the one team that always finishes ahead of us,” he said. “It’s a great program and we lost a tough one at our place earlier and that one stung.”

Johnson is committed to St. John’s University.

2021 Numbers

WL … ERA … ER … IP … H … SO … BB

5-0 (3 sv) ,,, 0.97 … 4 … 36 … 12 … 56 … 9

College: St. John’s

RAFE SCHLESINGER

Sachem East, Sr.

Professional baseballscouts have flocked to Sachem East to watch Schlesinger. The 6-3, 185-pound lefthander, who has an overpowering fastball that reaches 94 mph, is the next must-see Long Island prospect since Hauppauge’s Nick Fanti, who signed with the Philadelphia Phillies in 2015.

“Rafe is the real deal,” Sachem East coach Kevin Schnupp said. “There are four or more scouts at every game to see him throw. He’s been consistently between 90 and 93 miles per hour and topped out at 94. He’s developed such late life on his pitches.”

Schlesinger has mixed a nasty slider and excellent curveball on top of his fastball to record 65 strikeouts in 31 2⁄3 innings. He’s walked 12 and allowed 16 hits and four earned runs for an ERA of 0.88. His record is 2-1.

“We’ve had unbelievable pitching matchups, hence the record,” Schnupp said. “We’ve faced five No. 1 pitchers this season. It’s been tough on our hitters, but Rafe loves it. He’s a big-time competitor.”

Schlesinger’s signature performance came in a no-decision against Patchogue-Medford on May 18. He fired a no-hitter for 6 1⁄3 innings and struck out 17.

Sachem East (14-3) is in second place in Suffolk League I.

“We wouldn’t be there without him,” Schnupp said. “He’s a game- changer.”

Schlesinger is committed to the University of Miami.

2021 Numbers

WL … ERA … ER … IP … H … SO … BB

2-1 ,,, 0.88 … 4 … 31.2 … 16 … 65 … 12

College: Miami

HAYDEN LEIDERMAN

Roslyn, Sr.

Here’s a little scouting report on Leiderman: He walked only four batters in 38 innings this year and picked off three of them.

“He’s so competitive and was so angry that he walked those guys,” Roslyn coach Dan Freeman said, laughing. “So he picked them off. He’s a huge piece of a once-in-a-lifetime team here at Roslyn. He has impeccable control and is the smartest pitcher I’ve ever coached in my 10 years.”

Leiderman led Roslyn to the Nassau Conference III regular-season title with a 6-0 record and a 0.00 ERA. He struck out 52 and allowed 11 hits.

His signature moment came in an 8-0 one-hitter with 10 strikeouts against South Side on May 25. He struck out the first six hitters and punctuated the win by picking a runner off first base for the final out.

“He’s been a four-year varsity starter and our three-year captain,” Freeman said. “He has an incredible baseball IQ. He studies hitters and pounds the zone. Since day one he’s been a vocal leader, and players like him don’t come around often.”

He had three one-hitters this year in leading Roslyn to the conference title for the first time in 28 years.

He’s committed to play at the University of Chicago.

2021 Numbers

WL … ERA … ER … IP … H … SO … BB

6-0 ,,, 0.00 … 0 … 38 … 11 … 52 … 4

College: University of Chicago

TOMMY VENTIMIGLIA

Longwood, Sr.

Ventimiglia has been a tough-luck pitcher this season. He has battled the top pitchers in Suffolk League I and come away with some brutal losses.

Ventimiglia is one of Long Island’s top prospects, and the 6-4 righty has garnered the attention of numerous major-league organizations for this year’s amateur draft in July.

Ventimiglia, with a fastball sitting at 89 to 90 mph that occasionally reaches 94 mph, has embraced the competition. He’s struck out 42 in 26 2⁄3 innings and has a 1.22 ERA with a 4-3 record.

“I’m facing top-tier pitchers every game and I know I have to go out and give my team a shot,” Ventimiglia said. “There is no room for mistakes every time I get out there. We’re playing small ball to try and win these games. It’s absolutely 100% preparing me for the next level.”

With a potential pro career looming and his commitment to Stony Brook University, Ventimiglia is focused on what’s in front of him.

“I’m not focused on the draft or college right now because I really would like to win the league playoffs and go win the Long Island championship,” he said. “I’ve been getting a good amount of contact from pro teams and it’s a dream come true just to be considered. It’s hard not to get excited. But honestly, I want a great playoff run with my teammates and that would be a great way to end my high school career and go out with a ring.”

2021 Numbers

WL … ERA … ER … IP … H … SO … BB

4-3 ,,, 1.22 … 5 … 28.2 … 19 … 42 … 17

College: Stony Brook

BEST OF THE REST

John Downing, Chaminade, Jr.

Struck out 39 in 38 2/3 innings with nine walks. He’s 5-0 with a 1.33 ERA. Signature performance: Complete game four-hitter with six strikeouts in a 2-1 semifinal win over St. John the Baptist.

Josh Knoth, Patchogue-Medford, Soph.

Struck out 65 in 36 2/3 innings with six walks. He’s 4-1 with one save and an ERA of 1.71. Signature performance: 16 strikeouts in eight innings vs. Sachem East on May 18.

Tyler O’Neill, Mepham, Sr.

Struck out 49 in 38 innings with four walks. He is 4-1 with an 0.23 ERA. Signature performance: No-hitter with nine strikeouts and one walk vs. New Hyde Park on May 25.

John Rizzo, East Islip, Sr.

Struck out 68 in 42 innings with six walks. He’s 5-1 with one save and an ERA of 0.51. Signature performance: One-hitter with 20 strikeouts vs. Hills West on May 8.

Colin Rhein, North Babylon, Sr.

Struck out 54 in 34 innings. He’s 4-1 with a 1.44 ERA. Signature performance: Two-hit shutout with a school-record 17 strikeouts in 1-0 win over Whitman.

Kyle Rosenberg, Wheatley, Jr.

Struck out 38 in 31 innings with eight walks. He’s 5-0 with one save and 1.35 ERA. Signature performance: Complete game with 10 strikeouts vs. Cold Spring Harbor on May 7.

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