How Would State-Based Individual Mandates Affect Health Insurance Coverage and Premium Costs?

Issue: The Tax Cuts and Jobs Act of 2017 eliminated the financial penalty of the Affordable Care Act's individual mandate. States could reinstate a similar penalty to encourage health insurance enrollment, ensuring broad sharing of health care costs across healthy and sick populations to stabilize the marketplaces.Goal: To provide state-by-state estimates of the impact on insurance coverage, premiums, and mandate penalty revenues if the state were to adopt an individual mandate.Methods: Urban Institute's Health Insurance Policy Simulation Model (HIPSM) is used to estimate the coverage and cost impacts of state-specific individual mandates. We assume each state adopts an individual mandate similar to the ACA's.Findings and Conclusion: If all states implemented individual mandates, the number of uninsured would be lower by 3.9 million in 2019 and 7.5 million in 2022. On average, marketplace premiums would be 11.8 percent lower in 2019. State mandate penalty revenues would amount to $7.4 billion and demand for uncompensated care would be$11.4 billion lower. The impact on coverage and on premiums varies in significant ways across states. For example, in 2019, the number of people uninsured would be 19 percent lower in Colorado and 10 percent lower in California if they implemented their own mandates. With mandates in place, average premiums would be 4 percent lower in Alaska and 15 percent lower in Washington

high temperature cavity receiver integrated with a short term storage system for solar mgts heat transfer enhancement

Abstract Dish-Micro Gas Turbines (MGTs) can be promising systems for power production at small-scale by concentrated solar radiation. Several high-temperature solar receivers have been already designed for such plants, however, nowadays, none of them can assure the proper thermal inertia to level the effects of solar radiation fluctuations on engine performance and safety. In this paper, a solar receiver integrated with a short-term storage system based on high-temperature Phase-Change Materials (PCMs), is proposed. On the basis of a previous preliminary component design and analysis, the receiver geometry has been modified to improve storage capability and heat transfer to the working fluid, reducing temperatures on the irradiated surface making them compatible with material properties and reducing also temperature gradients inside the PCM. Six different geometries, varying length, opening and shape of a front cavity have been analyzed by means of CFD methods. All the configurations have shown a satisfactory behavior in terms of working fluid outlet temperature, storage capabilities and maximum temperatures reached on the surface and inside the receiver. In particular, among them, three geometries can be considered the most promising ones

Development of turbomachines for renewable energy systems and energy-saving applications

Abstract Turbomachines play a significant role in some key sectors as aircraft and marine propulsion, power production, heat ventilation and air conditioning and chemical processing. The success of dynamic machines is connected to the wide variety of demands that they can cover, together with their compactness, reliability and availability. In this respect, such machines are the favourite candidate to support an efficient exploitation of some renewable energy sources and the development of energy-saving systems. Innovative plants require machines which can work with new fluids (e.g. Organic Rankine Cycle systems) or in new operating conditions (e.g. high-flexibility or new pressure ratios) and it poses new challenging aspects in the preliminary machinery design. Moreover, another challenging aspect is how innovative techniques (e.g. high-integrated design systems, 3D printing) can be integrated in the design process and how much they can affect the machine development and final performance. Two case studies are presented to focus the attention on such aspects, discussing preliminary design and prototyping of "unconventional" turbomachines

Techno-economic analysis of a sCO2 power plant for waste heat recovery in steel industry

Abstract Industrial facilities release a large amount of heat as a by-product of their processes. To improve environmental performance and increase process profitability, a portion of the waste heat can be recovered and employed for power generation by recovery systems. Supercritical carbon dioxide (sCO2) plants are emerging as potential alternatives to the well-established technologies for waste heat recovery (WHR) power generation in heavy industry. This paper offers a preliminary techno-economic analysis of a waste heat-to-power system based on a sCO2 closed-loop for a heavy-industrial process. By conducting a parametric investigation on the WHR sCO2 system's key design parameters, a number of preferable configurations from a thermodynamic perspective were initially identified; they were subsequently analyzed from the economic point of view in terms of net present value (NPV) and pay-back period (PBP). The privileged WHR system configuration achieved an overall efficiency of 30.4% and a power output of 21.6 kWe, providing an NPV of almost US k$ 376 with a PBP of approximately 4.5 years

Validation of the new technology sensor fusion K-50 based on data integration detected by GPS 50 Hz and inertial sensors

Advanced technology systems applied to sports are increasingly valid support for operators and technicians in the sector. Useful to improve the correct planning of training and therefore of the athlete as well as to the correct management of workloads developed during it and of the season. Studies carried out on the use of new dedicated technologies have shown how supportive they are for improving the performance and preparedness of the individual and the athlete in our case, mathematically developing real parameters for the sessions of the sport practiced (Barbero et a., 2010, Boyd et al., 2011, Brodie et al., 2016, Izzo et al., 2018). The attempt is to further reduce the error coefficient, of the same, the GPS in this case, the objective of this validation study is the validity and reliability of the advanced GPS device K-50 (K-Sport Universal, Ita). The test protocol was administered to 50 junior soccer students-players aged 17 ± 3 years by amateur sports clubs in Italy. The athletes were subjected to different types of stresses considered in the literature, significant in surveys with GPS (Izzo et al., 2018). The GPS device K-50 in our case is a tool, also equipped with inertial sensors (IMU) such as accelerometer, magnetometer, gyroscope, and it is the only one on the market that has the features to be able to use the technologies integrated into a calculation method integrated within the K-50 device, thanks to the use of a Sensor Fusion which allows more performing and sharper data quality. The results of the research protocol were compared using different methodologies for the calculation of some investigated parameters or using the GPS device with the Doppler effect, using the Sensor Fusion, and using the position calculation with different interpolations such as Lat-Lon 0.2 and Lat-Lon 0.05 (Latitude - longitude). In the end, the decidedly positive test results verify the validity of the device (GPS K-50). With the use of inertial systems enriched with the Sensor Fusion the error of the device in measuring the distances traveled is very close to zero with a standard deviation within the percentage limits

Design of an Expander for Internal Power Recovery in Cryogenic Cooling Plants

Abstract The electrical power consumption of refrigeration plants is evaluated to be in the order of 15% of the total electricity consumption worldwide. For this reason, many efforts are spent in the development of energy saving techniques to be applied to refrigeration and air conditioning systems. This paper deals with the development of a device which allows an internal recovery in cryogenic plants, reducing their power consumption. Such a device consists in a Compressor-Expander Group (CEG) developed on the basis of automotive turbocharging technology. According to the rules of the similarity theory, a preliminary CEG design has been realized modifying commercially available components. The critical CEG component is the expander. In order to address the new requirements, a turbocharger expander wheel has been strongly modified and equipped with supersonic variable nozzles, designed to have a radially inflow full admission. To verify the performance of such a machine and suggest improvements, a numerical fluid dynamic model has been set up. The commercial Ansys-CFX software has been used to perform steady-state 3D CFD simulations. In this paper all the numerical results are presented, compared with available experimental data and discussed

[Editorial] Habitability Beyond Earth

The question of whether Earth is a unique location for life remains one of the most enduring questions of our time. Geochemical data suggests that habitable environments may exist, or may have existed, elsewhere in the Solar System with promising targets including Mars and icy bodies where liquid water is believed to exist (Kargel, 2000; Grotzinger et al., 2014; Glein et al., 2015). Furthermore, potential habitable Exoplanets have been discovered where potentially there is sufficient atmospheric pressure to maintain liquid water (Jenkins et al., 2015; Gillon et al., 2017; Orosei et al., 2018). Yet, for life to exist it is not solely dependent on liquid water as it also needs bio-essential elements, an energy source, and the environmental conditions, that are conducive to life (Nixon et al., 2013). To investigate the feasibility of life elsewhere in the Solar System a combination of field and laboratory based studies, in-situ space experiments, and theoretical modeling is required. Here, we present 14 original research papers, one mini review, and two hypothesis and theory papers highlighting the novel and diverse methods that are employed to investigate potential life beyond the Earth. The overall focus of this collection of work is to understand if terrestrial life could exist elsewhere in the Solar System, and if so, what evidence (bio-signatures) could be used to support or negate the hypothesis of life

La mossa del cavallo. Israele e la strategia delle alleanze periferiche.

La strategia delle alleanze periferiche, argomento del presente lavoro, è una delle grandi direttive strategiche che hanno plasmato la politica internazionale dello Stato di Israele fin dai suoi albori e, nella sua ideazione ed applicazione, essa richiama la mossa del cavallo nel gioco degli scacchi, essendo basata letteralmente sul salto e l'aggiramento della prima fascia di Stati arabi e il raggiungimento di una sponda sicura di alleati nella cosiddetta seconda fascia di Stati, principalmente non-arabi e/o non musulmani. La dottrina della periferia adottata da Israele prese le mosse dalla consapevolezza, maturata fin dalla Prima guerra arabo-israeliana del 1948, che i rapporti con gli Stati arabo-musulmani confinanti (in special modo Egitto, Siria, Iraq) sarebbero stati sempre difficili e che il rischio di nuovi attacchi si sarebbe mantenuto elevato, proprio perché di Israele si metteva in discussione non solo e non tanto l'estensione geografica, quanto il mero diritto di esistere. Fino al momento in cui fosse mancata la possibilità di imboccare un cammino di pace e mutuo riconoscimento con gli arabi, l'unica via di uscita diplomatico-militare, nonché l'unica forma possibile di compensazione e di bilanciamento della distribuzione del potere nell'area mediorientale, sarebbero stati la ricerca e il consolidamento di alleanze più o meno segrete con Stati e minoranze etniche appartenenti alla fascia “periferica”. Le alleanze periferiche hanno vissuto la loro stagione più fruttuosa nel ventennio compreso tra la fine degli anni '50 e quella degli anni '70, (fino alla rivoluzione islamica iraniana). Quell'arco di tempo fu segnato da collaborazione a livello di intelligence, militare, commerciale, proseguita sporadicamente anche durante gli anni '80. Negli anni '90, dopo la fine del mondo bipolare e in parallelo con il revival dei rapporti con la Turchia, Israele individuò nell'Iran il suo acerrimo nemico. Negli ultimi dieci anni anche le relazioni con la Turchia sembrano essersi guastate (complice la permanenza di Erdoğan al potere) ed Israele ha cominciato a creare e consolidare nuovi legami con Paesi appartenenti alla sua prossima periferia nel tentativo di trovare un sostituto di Ankara. I rapporti sviluppatisi recentemente con Grecia, Cipro, Azerbaigian e India rappresentano gli esempi più rilevanti di come la strategia delle alleanze periferiche abbia saputo resistere nel tempo e rinnovarsi. Molto è cambiato dagli anni '40 ad oggi, ma Israele si trova tuttora a dover fronteggiare un ecosistema politico mediorientale prevalentemente ostile, in cui Stati ed entità parastatali situati nella sua prossimità geografica rappresentano le vere minacce mentre invece gli Stati della prima e seconda periferia fungono ancora come un tempo da contrappeso politico e assicurano deterrenza e profondità strategica ad Israele. Nel presente lavoro si analizzerà quindi la strategia delle alleanze periferiche tramite il ricorso a dei case studies, ovvero esponendo l'evoluzione dei rapporti tra Israele e i suoi più importanti alleati della periferia. Si cercherà, al contempo, di dare credito all'idea che tale approccio strategico caratterizzi e dia forma tuttora alla condotta e alla politica di alleanze internazionali di Israele

Implementing the Affordable Care Act: State Regulation of Marketplace Plan Provider Networks

Health plans with relatively narrow provider networks have generated widespread debate, mainly concerning the level of regulatory oversight necessary to ensure plans provide consumers meaningful access to care. The Affordable Care Act creates the first federal standard for network adequacy in the commercial insurance market for plans offered through the law's insurance marketplaces. However, states continue to play a primary role in setting and enforcing network rules. This brief examines state network adequacy standards for marketplace plans in the 50 states and District of Columbia. We identify state requirements in effect at the outset of marketplace coverage, focusing on quantitative measures of network sufficiency and rules designed to ensure the delivery of accurate and timely provider directories. We then explore the extent to which those standards evolved for 2015. Though regulatory changes were limited in year one, states were most likely to act to promote network transparency and enhance oversight

Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements

The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as "essential health benefits." Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees' experiences with their coverage—information called for under the law's delayed transparency requirements—to determine whether states' differing strategies are producing the coverage improvements promised by reform