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Health Insurance

Gov. Wolf Urges Congress to Preserve Affordable Care Act Subsidies to Ensure Health Care Remains Affordable for Tens of Thousands of Pennsylvanians

Billie S. Dickenson July 2, 2022

Healthcare, Press Release

Governor Tom Wolf is urging Congress to take action to preserve Affordable Care Act (ACA) subsidies to ensure that individuals and families who were eligible for this important subsidy may continue to obtain health care.

In a joint letter, Gov. Wolf and 13 other governors urged Congress to take action and ensure funding is in place to preserve ACA subsidies known as advanced premium tax credits
(APTCs), which were expanded through the American Rescue Plan Act of 2021. The ARPA-expanded subsidy eligibility is set to expire at the end of the current plan year, leaving consumers exposed to dramatic premium increases.

“Tens of thousands of Pennsylvanians will be impacted if this subsidy expansion expires in December, which will mean their insurance premiums will increase, putting individuals in a health and financial risk. It’s critical that we continue to make affordable coverage as accessible as possible to as many as possible, and I applaud President Joe Biden for his leadership to not only expand coverage as part of ARPA, but also to make it permanent,” Gov. Wolf said. “I urge Congress to make these subsidies permanent so that Pennsylvanians can continue to have a better quality of life through affordable comprehensive ACA coverage.”

Governor Wolf has made access to affordable health coverage a priority throughout his administration.

In July 2019, Governor Wolf signed legislation establishing Pennie, the state-based ACA marketplace. Pennie replaces healthcare.gov as Pennsylvania’s official destination for shopping for quality health insurance plans and the only source of financial assistance to help with the cost of coverage and care. Currently there are nearly 360,000 Pennie customers throughout the commonwealth.

In addition to Pennie, Governor Wolf expanded Medicaid in 2015 — one of his first acts as governor — ensuring more Pennsylvanians have access to Medical Assistance in Pennsylvania. Today, more than 3.3 million Pennsylvanians are covered by Medical Assistance including almost 1 million people through the expansion. By expanding access to health care, the commonwealth realized the lowest uninsured rate in Pennsylvania history during the Wolf Administration and insurance rates are now the most stable year over year than they’ve ever been.

View a copy of the letter:

As governors, we are working to expand access to quality, affordable healthcare for the people of our states. Since the beginning of the pandemic, we have seen the tragic impact of disease and illness among the uninsured and underinsured, particularly in communities of color and other underserved populations. As we have experienced during the COVID-19 pandemic, access to affordable health insurance can sometimes mean the difference between life or death. At a time when governments at all levels are struggling to find ways to reduce costs for the American people, we cannot allow the looming specter of rising health costs to cause more uncertainty and stress for American families. Therefore, we urge you to take action and ensure funding is in place to preserve Affordable Care Act (ACA) subsidies known as advanced premium tax credits (APTCs).

We applaud Congress for the passage of the American Rescue Plan Act of 2021 (ARP), which expanded and enhanced ACA APTCs. The ARP’s expansion of subsidies, along with the Biden Administration’s investment in marketing and enrollment support, led to a record high 14.5 million people signing up for ACA coverage during the most recent open enrollment period, a 21 percent increase from the prior year.

Health insurance coverage is critical to ensure consumers have access to healthcare and the best way to increase enrollment is to make coverage more affordable. The ARP has lowered costs for consumers: families saved an average of $200 a month in premiums, with four out of five consumers eligible to obtain a plan for $10 or less. The ARP expanded access to financial assistance and increased the number of consumers eligible for subsidies by 2.8 million in 2022 compared to the prior year.3 With the Biden Administration’s reinvestment in the ACA and the proposed rulemaking to fix the “Family Glitch,” we have a historic opportunity to build upon these enrollment gains and affordability improvements next year and in years to come.

Unfortunately, the ARP-expanded subsidy eligibility is set to expire at the end of the current plan year, leaving consumers exposed to dramatic premium increases, and threatening the progress we have made. As inflation continues to put a strain on consumers’ budgets, we are concerned that many people will choose to reduce health insurance coverage or even go without coverage if Congress fails to act. The Biden Administration estimates that approximately 3.4 million consumers currently enrolled could lose coverage if the ARP subsidy expansions expire at the end of 2022. The expiration of the enhanced subsidies would also lead to a decrease in enrollment and an increase in premiums, destabilizing health insurance markets, and impacting affordability for the broader population. Additionally, as the Public Health Emergency is expected to end in the coming months, some consumers will no longer be eligible for Medicaid but may become eligible for ACA subsidies. Without the enhanced subsidies to ensure there are affordable marketplace options, those consumers are likely to become uninsured.

Healthcare is a right—not a privilege. The ARP greatly improved health insurance affordability to ensure lifesaving healthcare is accessible to all Americans. We urge you to take action immediately to make the ARP expanded subsidies permanent to prevent a disastrous erosion of health insurance coverage.

Nutrition

Wilbur-Ellis Nutrition extends reach in pet food as it acquires Ohio based firm

Billie S. Dickenson July 2, 2022

Emmert is a 140-year-old, family-owned company with manufacturing operations in Cincinnati, Ohio, and 35-plus employees.

The company has a proven track record in animal nutrition, delivering “the right balance of brewer’s yeast, protein, vitamins, and essential amino acids” to support companion animal and livestock health, said Wilbur-Ellis.

“The acquisition will expand our product and customer base in pet food with value-added products. We also see great potential for Emmert’s research and development capabilities – which complement our own and can be leveraged in the future across the division, including the livestock and aquaculture businesses,” Matt Fanta, president of Wilbur-Ellis Nutrition.

Wilbur-Ellis CEO, John Buckley, noted: “Emmert’s capabilities are a great fit for the nutrition business, bringing greater balance and diversification to the division’s portfolio. The acquisition also supports the company’s broader strategy to continue building on our position as a leading agriculture and food company in North America.”

Along with a strong business fit, Buckley and Fanta highlighted the similar values and culture of both firms.

“Wilbur-Ellis has a long history of growth through acquisition,” Fanta noted. “And in every case, having similar values has been an important consideration.”

The deal is subject to the customary closing conditions.

Forage focus

July 2021 saw Wilbur-Ellis Nutrition acquire the forage pellet unit of Ametza, based in Holtville, California, with it saying then the acquired business complemented its existing forage manufacturing operations, located nearby. “Going forward, we expect to leverage our respective capabilities as we continue to invest in this business and grow our presence both domestically and internationally.”

Body Builder

What is the Best Workout Schedule?

Billie S. Dickenson July 2, 2022

With so many different exercise routines and types of workouts, it can be overwhelming to figure out how to get started. You may wonder what the best workout schedule is, what types of exercise you should include and how often you should be doing them.

I will start by saying, some exercise is better than nothing! I never want people to feel discouraged to even start because they feel like they can’t commit to a certain number of days per week or a certain length workout each day. Even a 10-minute walk around the block is making steps in the right direction — so do what you can, when you can!

For those people with a general goal of improving their health and fitness, incorporating different types of exercise on a consistent basis, and reaching a moderate-intensity during those workouts, will provide the best results. Being regularly active boasts a wide variety of health benefits that include managing weight, reducing the risk of disease, strengthening bones, improving brain health, and improving a person’s ability to perform daily activities.

As a personal trainer, many of my clients enlist me to create the best workout schedule for their lifestyle and their goals. While this is customized to each person, there are a few basic guidelines that I follow.

How often should I exercise?

The CDC recommends 4-5 days of exercise a week to improve overall health and fitness. The recommend length is at least 30 minutes daily, though some exercise is better than none.

Depending on your personal goals, gym accessibility and what kind of exercise you enjoy doing (i.e. running, weight lifting, Pilates), your workout schedule may look different from someone else’s. But this is the workout schedule I generally recommend to improve overall health and fitness.

As a certified personal trainer, yoga and Pilates instructor, I recommend that my clients exercise five days a week, dividing the workouts as follows:

How many cardio days should I do each week?

How much cardio you should be doing depends on your goals. If your goal is to lose weight, participating in at least two days of high-intensity interval training (HIIT) or another aerobic activity (like spinning, swimming or fast walking) is what I recommend for my weight-loss clients.

These vigorous activities increase calorie burn. Though most lower-intensity cardio sessions will only increase calorie burn during the activity itself and maybe a little afterward, HIIT workouts lead to the “after-burn effect.” This means that not only are you burning calories during the workout, but for hours after your workout session.

How many strength-training days should I do each week?

I recommend that my clients strength train three days a week. Not only does research show that strength training help reduce overall body mass and fat, but research also shows it can improve your body image. Many of my clients report feeling stronger and more confident after a single strength-training session because they have find a sense of accomplishment in strengthening their bodies. Other clients have found that after adding in strength training, their bodies begin to release weight and they finally see the number on the scale start to go down.

A sample weekly workout plan

I usually recommend adding Pilates core work to strength-training days and yoga and/or stretching to the cardio days.

However, if you are crunched for time, you can perform cardio and strength training in the same day. Just keep in mind that it’s best for your muscles to not do the same strength-training workout two days in a row because the muscles need time to rest and repair. You can do cardio, core work and stretching every day!

This sample workout plan gives you an idea of what a week of well-balanced workouts may look like, including strength training, cardio, yoga and rest days.

Monday: Strength training (full body) with Pilates abs and yoga stretching
Tuesday: Cardio HIIT Session (20-30 minutes) or long walk/swim
Wednesday: Strength training (full body) & with Pilates abs and yoga stretching
Thursday: Rest day
Friday: Strength training (full body) with Pilates abs and yoga stretching
Saturday: Cardio HIIT session (20-30 minutes) or long walk/swim
Sunday: Rest day

Stephanie Mansour is a contributing health and fitness writer for TODAY. She is a certified personal trainer, yoga and Pilates instructor and weight-loss coach for women. She hosts “Step It Up with Steph” on PBS. Join her complimentary health and weight-loss challenge and follow her for daily inspiration on Instagram and in her new app.

Health Insurance

Health insurance premiums through marketplace poised to jump in 2023

Billie S. Dickenson July 1, 2022

The Good Brigade | Digitalvision | Getty Images

If you get your health insurance through the government Health Insurance Marketplace, you may want to brace for higher premiums next year.

Unless Congress takes action, enhanced premium subsidies — technically, tax credits — that have been in place for 2021 and 2022 will disappear after this year. The change would affect 13 million of the 14.5 million people who get their health insurance through the federal exchange or their state's marketplace.

"The default is that the expanded subsidies will expire at the end of this year," said Cynthia Cox, a vice president at the Kaiser Family Foundation and director of its Affordable Care Act program. "On average, premiums would go up more than 50%, but for some it will be more."

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Most enrollees — which includes the self-employed and workers with no job-based health insurance — receive subsidies, which reduce what they pay in premiums. Some people also may qualify for help with cost-sharing such as deductibles and copays on certain plans, depending on their income.

Before the temporary changes to the calculation for subsidy eligibility, the aid was generally only available to households with income from 100% to 400% of the poverty level.

The American Rescue Plan Act, which was signed into law in March 2021, removed — for two years — that income cap, and the amount that anyone pays for premiums during the reprieve is limited to 8.5% of their income as calculated by the exchange.

Assuming Congress does not extend the expanded tax credits, only people with household income from 100% to 400% of the federal poverty level will once again qualify for subsidies.

Exactly how much of a premium increase a person would see depends on income, age, the premium cost where they live and how the premiums charged by insurers change for next year, according to Kaiser.

Here's a hypothetical example, based on a report from the Congressional Budget Office: Say a 64-year-old with $58,000 in income — about 430% of the 2022 poverty level of $13,590 — has insurance through the exchange. The 8.5% limit currently in place means they would pay no more than $4,950 for premiums this year. However, if faced with a 400% cap on eligibility in 2023, that same person would pay $12,900 for premiums because they'd no longer qualify for subsidies.

A proposal to extend the extra subsidies through 2025 was included in the Democrats' Build Back Better bill, which cleared the House last year but fell apart in the Senate.

It's uncertain whether the provision will be revived in some form via other legislation that Democrats may try to get through the Senate before a new Congress starts in January — the makeup of which could look very different due to the midterm elections Nov. 8.

Body Builder

7 Best Bodyweight Workouts to Build Muscle

Billie S. Dickenson July 1, 2022

Most people write off bodyweight training as a way to achieve conditioning, fat loss, and not much more. While bodyweight moves are good for conditioning and burning fat, you can use bodyweight workouts to build muscle as well. To do that, you need to mix the right movements with the right amount of volume.

The seven bodyweight workouts below will help you do it. Each of these workouts focuses on building muscle in a specific part of the body, and they can be completed in 30 minutes. For these workouts, all you’ll need is a TRX system or gymnastic rings, a pullup bar, benches and blocks, resistance bands (and a stable object, like a squat cage, to anchor them to), floor space, and some good old fashioned gusto. These are the best bodyweight workouts to build muscle—grab your gear and get to it.

The 7 Best Bodyweight Workouts to Build Muscle

Directions: These workouts contain a mix of straight sets, supersets, and compound sets. Straight sets are listed as A, B, or C. Perform the set and immediately take the prescribed rest. Supersets and compound sets involve pairing two movements back to back. They’re listed as A1 and A2, B1 and B2, etc. For these, perform one set of each movement and then take the prescribed rest.

Workout 1: Arms

A1. TRX/Ring Dip x Max reps: Use a pair of gymnastic rings or TRX straps hung at waist level. Place a hand in each ring/strap and get into a dip position. Be sure to keep the straps close against your body—any gaps between your arms and the straps will cause instability. Perform the dips by leaning forward slightly and lowering yourself while keeping the straps close as described above.
A2. TRX Rocker x 12: Hold a gymnastic ring or TRX strap in each hand and lean back into a supine position, with your chest facing up. Keeping your knees bent and feet flat on the floor, pull yourself upward into a sitting up position, bending at the waist. Let your butt swing under your torso as this happens. That’s one rep. Return to your starting position and repeat. Perform A1 and A2 as a superset for 4 rounds. Rest 60 seconds between rounds.

B1. Close-grip Pushup x 20
B2. Flexed Arm Hang x 30 sec.: This one is simple. Use an aid like a box or a step to assist you up to the top position of a chinup (chin over the bar). Then hold that position, focusing on good form and engaging your back, for the allotted time. Perform B1 and B2 as a superset for 4 rounds. Rest 60 seconds between rounds.

Workout 2: Legs

A1. Band-assisted Nordic Curl x 8: Start on a mat or pad in an upright kneeling position (chest perpendicular to the floor) with your heels secured under something immovable. Attach a resistance band to something immovable above you (like a pullup bar or squat cage) and position the band around your chest or ribs. Next, keep your hands by your sides and slowly “fall” forward, without losing your tall body position; bend at the knees and try not to “take a bow” by leading from the hip joint. Aim for the chest to make it all the way to the ground, and use your hamstrings and the band assistance to pull you up to the top position.
A2. Band-assisted Reverse Nordic Curl x 12: Using the same resistance band setup as above, start on a mat or pad in an upright kneeling position, this time facing the band (keep the tops of your feet facing the floor). Hold the free end of the resistance band in both hands and keep your arms held straight out in front of you. Perform the same Nordic curl action in reverse: Stay tall and lean backward. Focus on lengthening the quads while keeping them contracted. Go as far as you comfortably can before using your quads to return to the top position. Perform A1 and A2 as a superset for 4 rounds. Rest 60 seconds between rounds.

B1. Foot-Over x 10 (each leg): Sit on your butt with outstretched legs and place a kettlebell or a similarly sized object near one foot. Pointing your big toe and keeping your leg straight, lift the leg nearest the kettlebell slowly over the kettlebell and touch down on the other side of it. Return to the start position in the same fashion. As you move your leg, remain tall and keep the knee as straight as possible. Make sure your hip and quads in the working leg are engaged the entire time.
B2. Copenhagen Plank x 10 (each side): Find a bench and lay sideways on the floor perpendicular to it: Place the shin of the top leg on the bench and rest on your opposite forearm. Assume a side plank by raising the hips off the ground while staying anchored to the bench by your top leg. The bottom leg should “sandwich” the bench from below—it’s okay if the knee bends to do so. Repeat this motion for 10 reps per side. Perform as a superset for 4 rounds. Rest 60 seconds between rounds.

Workout 3: Back

A. Band-assisted Chinup 8 x 8: Rest 60 seconds between rounds.
B. Inverted Row 5 x 12: At a squat rack, securely place a bar at waist level. Then place both hands on the bar and hang under it, maintaining a straight body from head to heels. Pull your chest to the bar while engaging the upper back and squeezing the shoulder blades together. Rest 60 seconds between rounds.

C1. Bear Dog x 6 (each side): Start in a quadruped position (on all fours facing the floor). Keep your knees off the ground by a couple of inches—only your hands and feet should touch the ground. Slowly raise one arm and the opposite leg off the ground simultaneously while maintaining stability. Aim for a full extension of each limb, and repeat on the opposing sides.
C2. Blackburn x 10 (slow reps): Start out lying on your stomach with your hands beside your shoulders, elbows bent, and arms parallel to your body. Pull your shoulder blades together and slowly move your arms straight above your head to full extension (creating a flying Superman pose). Make sure not to let any part of your arms or hands touch the floor through the entire range of motion. Perform C1 and C2 as a superset for 4 rounds. Rest 60 seconds between rounds.

Workout 4: Chest and Core

A. TRX/Ring Pushup 5 x 12: Rest 60 seconds between sets.
B1. Pushup with Single-arm Deficit x 7 (each arm): Set up a low platform and then get into a pushup position with one hand on the floor and the other on the edge of the platform. Lower yourself to the bottom of your range of motion and then push up until the arm on the platform is completely straightened. (The other hand will leave the ground.)
B2. Hanging Leg Raise x 10: Hang from a pullup bar with both arms straight. Raise both legs together, keeping them straight, until they are parallel to the floor. Repeat. Perform B1 and B2 as a superset for 4 rounds. Rest 60 seconds between rounds.

C1. Hand Walkout x 6: Start in a standing position. Then, bending at the waist, place both hands on the ground right in front of your feet and “walk” with your hands outward, past a pushup position. Keeping your body off the ground, hold that position for 3 seconds before “walking” your hands backward to your start position. It’s OK to stand up between reps.
C2. Band-assisted Plyo Pushup x 12 (max effort): Place a resistance band around your chest or ribcage and attach the other end to a high, sturdy fixture like a pullup bar. Keeping the band around your chest, lower yourself into a pushup position. Perform explosive pushups with the assistance of the band; your hands should leave the ground on each rep. Perform C1 and C2 as a superset for 4 rounds. Rest 90 seconds between rounds.

Workout 5: Shoulders

A1. Suicide Pushup x 10: Place both feet on a bench, and set up two more benches or other sturdy platforms for your hands to rest on. You want to position your hands a bit closer to your feet than normal—the pushup will be performed from a pike position. Lower the body headfirst to “dive” between the two hand platforms for an inverted shoulder press.
A2. Isometric Shoulder Extension x 30 sec. (max effort): Start in a squat position in front of a wall. Reach back with straight arms so your fists make contact with the wall while in the squat position. Push as hard as you can against the wall with your arms. Keep your upper back contracted while doing so. Perform A1 and A2 as a superset for 4 rounds. Rest 90 seconds between rounds.

B1. Bodyweight Bridge x 30 sec.: Lay flat on your back with your feet flat on the floor and your knees bent. Place your hands behind your shoulders, palms down. Press into the floor with your hands and feet and raise your body off the ground. Aim for a full extension of your arms, and squeeze your glutes to open your hips up. Hold that position.
B2. Single-arm Burpee x 8 (each arm): Start in a standing position. Then reach down and place one hand on the floor, and quickly extend your legs back so you’re in a single-arm pushup position. Then quickly bring your legs back underneath your body and return to a standing position. That’s one rep. Perform B1 and B2 as a superset for 4 rounds. Rest 90 seconds between rounds.

Workout 6: Legs Part II

A1. Glute L-bridge x 10 (each leg): Lay on your back with your feet on the floor and legs bent, then raise your hips up into a bridge position. While holding that position, lift one foot off the ground, and bring your knee back toward your chest, keeping that knee at a 90-degree angle. Next, slowly rotate the raised leg out to the side, keeping your knee in the same position. Go as far as you can without tilting your body, and slowly return to the start position. Repeat for 10 reps.
A2. Hip Thrust With Added Range of Motion x 10 (each leg): Start with your upper back on a bench (body extending sideways off the bench) and one foot resting on another bench or other sturdy platform. Perform a single-leg hip thrust with the opposite leg. Allow your butt to travel all the way to the floor, not just the level of the platform. Perform A1 and A2 as a compound set for 4 rounds. Rest 60 seconds between rounds.

B1. Band-assisted Pistol Squat x 8 (each leg): Set up a band across the pins of a squat cage, or between two other sturdy anchor points, and perform single-leg squats into the band (your butt should contact and stretch the band downward as you move). The band will act as a sling to assist you through the difficult bottom end of the movement and back up to the top position.
B2. Rear Foot Elevated Split Squat x 8 (each leg): Stand in front of a bench. Extend one leg backward and place the top of your foot on the bench behind you. Then slowly lower your body into a squat, flexing the opposite knee. Return to the start position and repeat. Perform B1 and B2 as a compound set for 4 rounds. Rest 60 seconds between rounds.

C. Bench Leg Extensions 4 x 12: Place both feet on a bench (rest on your toes) and both hands on the floor. Keep the hips high (similar to a pike position), and then lower your knees toward the floor. Aim for as much knee flexion as possible. Next, drive the knees back up to the original position, aiming for straight legs at the top. Flex your quads hard as you return to the starting position.

Workout 7 – Core Part II

A1. TRX Bear Stance Shoulder Taps x 10 (each arm): Set up a gymnastics ring or TRX strap so the handle is about a foot off the ground. Start in a quadruped position with your knees hovering off the ground by a few inches and your feet spread apart behind you (a bit wider than shoulder width). Grab the handle with one hand and push up so your arm has just a slight bend at the elbow. Hold that position. Carefully lift your other hand off the ground and touch the opposite shoulder. Avoid shifting or twisting the body as you do this, and repeat on the other side.
A2. Banded L-sit x Max Time: Sit on the ground with legs extended. Place two blocks or other short, sturdy objects on either side of you, at your hips. Wrap a resistance band around your torso, just below your arms, and wrap the other end of the band around your feet. Keeping your legs straight out in front of you, push down on the blocks with your hands and lift your entire body off the ground. Hold that position. Perform A1 and A2 as a superset for 4 rounds. Rest 60 seconds between rounds.

B1. Pushup to Long Lever Plank x 10: Perform a standard pushup, and at the top of your motion, explosively “jump” with the hands out to a long lever plank—that means finishing with outstretched arms—before “jumping” back into your next pushup rep.
B2. EZ Dragon Flag x 10: Lay flat on your back in front of a sturdy structure or post. Make sure it’s something you can get a good grip on. Hold the post tightly with both hands and raise your legs and lower- to mid-back off the ground, so your legs point straight up. Then slowly lower your back and legs to the floor. Keep your legs as straight as possible throughout. Perform B1 and B2 as a superset for 4 rounds. Rest 60 seconds between rounds.

C. Rear Support March 3 x 10 (each leg): Start in a reverse plank position, with both hands on the floor, your body facing upward (supine) and both heels in contact with the ground. There should be a straight line between your head, shoulders, and heels. Maintaining that position, carefully raise one knee into the chest, and slowly return it to the start position. Repeat on the opposite side. Rest 60 seconds between sets.

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Health Insurance

New Study: Employer-Sponsored Health Insurance Produces +47% Return on Investment for American Businesses

Billie S. Dickenson June 30, 2022

Washington, D.C. — Employers in the United States this year will earn an average return on investment (ROI) of 47% from their employer-sponsored health insurance (ESI) programs, according to a new study from Avalere Health. This means for every dollar spent on ESI, employers get back $1.47 in financial benefits. The analysis from the health data firm finds that the average ROI is projected to grow to 52% in 2026, and that businesses that invest more in their ESI programs tend have a higher ROI.

While providing employees high quality health insurance is the right thing to do for workers, the report shows how it makes business sense. Avalere attributes the direct financial return for employers to lower direct medical costs, increased productivity, lower recruitment costs, stronger retention, lower short- and long-term disability costs, as well as tax benefits. More than 155 million Americans currently get their health insurance through ESI.

The study was commissioned by the U.S. Chamber of Commerce on behalf of the Protecting Americans’ Coverage Together (PACT) campaign. PACT members, including the U.S. Chamber of Commerce, Business Roundtable, The National Association of Manufacturers, Council for Affordable Health Coverage, and Vermeer Corporation, represent leading employer voices focused on strengthening the employer-sponsored insurance (ESI) system and protecting the coverage and benefits that American families depend on for their health.

The report from Avalere looks across industries at trends that drive ROI higher and lower. Avalere highlights the manufacturing industry as an example, finding American manufacturers see an ROI of 42% on their ESI programs.

“Employee-sponsored health insurance is a win-win for employers and employees,” said Katie Mahoney, Vice President of Health Policy at the U.S. Chamber of Commerce. “We know employees place a high value on quality health insurance in the workplace, and now we have more evidence that employers benefit significantly from investing in these programs as well. Employer-provided coverage is the backbone of the American health care system, and this report reinforces that any reforms should build off this model that is good for workers and companies alike.”

“Improving productivity and wellness make America more competitive and prosperous,” said Joel White, President of the Council for Affordable Health Coverage. “While employers offer health coverage to improve the health and welfare of their employees, employees and their families benefit significantly. This study shows that Congress and the Administration must work to expand job-based coverage, not weaken it.

“Manufacturers are in the business of innovating and delivering best-in-class products to their customers,” said Robyn Boerstling, Vice President, Infrastructure, Innovation and Human Resources Policy at the National Association of Manufacturers. “That philosophy extends to the benefits provided to their employees, and this report further validates that offering comprehensive and innovative health benefits is not only the right thing to do but also critical to attracting and retaining the best talent. We are proud that approximately 99% of NAM member companies offer health benefits to employees, and working Americans understand the value and competitiveness of employer-sponsored health care.” 

“As an employer, knowing who we are caring for and the communities they come from gives us the advantage of providing access to quality, affordable care to our team and their families,” said Vermeer Corporation. “It is an incredibly important part of how we care for our people.”

The study, which examined employers with 100 or more employees, defined ROI as “the monetary value of benefit for each dollar employers invest in healthcare coverage. Investment in ESI may include health insurance premiums, wellness programs, direct medical expenses, administrative costs associated with processing medical claims, and other costs associated with providing health insurance. Avalere calculated the ROI derived from ESI by dividing the total employer benefits by the total costs of providing ESI.”

The full report including methodology can be found here.

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Nutrition

If You’re Not Counting Your Macros Yet, Read This

Billie S. Dickenson June 30, 2022

For some people, tracking your daily diet can be a helpful way to make sure you're getting the right amount of fuel each day. Trying to track every single calorie might not be your best bet, though. Instead, consider tracking your macronutrients -- that's basically a fancier word for the major nutrient groups that your body needs, which are carbohydrates, fats and protein.

There are many benefits to tracking macros instead of calories. First, you'll have a more balanced diet by focusing on eating a variety of nutrients that give your body energy and help your digestive system work. Not only can this practice help you reach your health goals faster than focusing on calories alone, this method of food logging can also help you understand which types of food make you feel good or bad, which foods improve your athletic performance and which foods help you focus or make you drag. Counting macros can also help you shift your current eating habits to healthier patterns for the long-term.

You'll need to learn how to read a nutrition facts label for this approach, but the benefits far outweigh the time you'll spend grasping the concept of a macro diet.

What are macronutrients?

Macronutrients are molecules we need in large amounts, also known as the main nutrients we need to simply survive. Micronutrients, in contrast, are substances required in much smaller amounts, such as vitamins, minerals and electrolytes.

The three macronutrients are carbohydrates, proteins and fats. Despite fad diets, you do need all three: Cutting out any one macronutrient puts you at risk for nutrient deficiencies and illness.

A man's hands opening a loaf of homemade bread. — Hudzilla/Getty Images

Carbohydrates

Carbohydrates give you quick energy. When you eat carbs, your body converts them to glucose (sugar) and either uses that sugar immediately or stores it as glycogen for later use, often during exercise and in between meals. Complex carbohydrates — like starchy vegetables and whole grains — also promote digestive health because they're high in dietary fiber.

Protein

Protein helps you grow, repair injuries, build muscle and fend off infections, to name a few functions. Proteins are made of amino acids, which are the building blocks of many structures in your body. You need 20 different amino acids, nine of which are essential amino acids, meaning your body can't produce them on its own and you must obtain them from food.

High-protein foods include poultry, beef, fish, soy, yogurt, cheese and other dairy products. If you stick with a plant-based diet, some starches, vegetables and beans are also good sources of protein.

Fats

Dietary fat is required for your body to do its many jobs. You need fat to absorb the fat-soluble vitamins (A, D, E and K), to insulate your body during cold weather and to go long periods of time without eating. Dietary fat also protects your organs, supports cell growth and induces hormone production.

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How many calories does each macronutrient have?

Each macronutrient corresponds to a specific calorie amount per gram:

Carbohydrates have 4 calories per gram
Proteins have 4 calories per gram
Fats have 9 calories per gram

How many macros should I eat?

There's really no answer to this question: Every person is different, and as such, every person's preferable macronutrient intake will be different. However, the federal dietary recommendations suggest this macronutrient ratio:

45 to 60% carbohydrate
20 to 35% fats
Remainder from protein

The federal suggestion is based on the fact that carbs serve as the body's main fuel source, and are the easiest macronutrient for the body to convert from food into energy. The metabolic processes for fat and protein are much more complex and take longer, which wouldn't serve you well when you need quick energy.

Your macro ratio depends on your health and fitness goals, as well as how your body responds to particular foods. For example, many people thrive on a low-carb diet, but the thought of a low-carb diet for myself makes me shudder. I perform at my best when I eat about 50% carbohydrates.

Similarly, you may do well on a high-protein diet, while someone else might experience digestive discomfort from consuming too much protein.

Note that some people, especially those on the keto diet, count net carbs instead of total carbs. To get net carbs, subtract the grams of fiber from the total grams of carbs. Why count net carbs? Our bodies don't digest fiber, so it doesn't get absorbed by the small intestine and doesn't provide your body with any energy. In that sense, calories from fiber don't really count.

How to calculate macronutrients

Now you know what macros are and how many calories they have. Next, you'll need to do some math. That's because your intake ratio is written in percentages but nutrition information is provided in grams. I'll use my macro intake as an example.

1. First, you need to know how many calories you eat (or want to eat) each day. I eat roughly 2,300 calories per day.

2. Next, determine your ideal ratio. I like to eat about 50% carbs, 25% fat and 25% protein.

3. Then, multiply your total daily calories by your percentages.

4. Finally, divide your calorie amounts by its calorie-per-gram number.

Here's how I would calculate my calories for each macronutrient:

Carbs: 2,300 x 0.50 equals 1,150. I eat 1,150 calories worth of carbs each day (hello, extra slice of toast).
Protein: 2,300 x 0.25 equals 575, so I get 575 calories worth of protein.
Fats: 2,300 x 0.25 equals 575. I also get 575 calories comprised of dietary fat.

To calculate the actual gram amounts:

Carbs (four calories per gram): 1,150 divided by 4 equals 287.5 grams of carbs.
Protein (four calories per gram): 575 divided by 4 equals 143.75 grams of protein
Fat (nine calories per gram): 575 divided by 9 equals 63.8 grams of fat.

If you don't like math, don't fret. The internet is home to a range of macronutrient calculators that will do the math for you.

The best macro calculators

IIFYM

Price: Free, but you must provide your email address to get your results.

IIFYM stands for "If It Fits Your Macros" -- a phrase and popular hashtag used by the macro-tracking community to refer to their flexible dieting approach.

This calculator is one of the most comprehensive available. It collects lifestyle and health information that many calculators don't, such as how active you are at work, what kind of cravings you have and whether you have any medical conditions.

Screenshot of the IIFYM calculator. — The IIFYM calculator takes into account your daily routine and other important factors.

Healthy Eater

Price: Free

Healthy Eater's macro calculator calculates your macronutrient ratio based on your age, gender, height, weight and activity level. You can customize your ratio based on whether you want to reduce your weight, lose 10% body fat, maintain or gain weight.

I like this macro calculator because you can see your ratio in terms of all day, three meals, four meals or five meals.

Legion Athletics

The Muscle for Life macro calculator dashboard. — This macro calculator uses your lean body mass (LBM), basal metabolic rate (BMR) and total daily energy expenditure (TDEE) to calculate an accurate ratio.

Legion Athletics

Price: Free

The Legion Athletics macro calculator is another very detailed calculator. It takes into account your weight, your body fat percentage, and your activity level. From there, this calculator determines your lean body mass, basal metabolic rate and total daily energy expenditure.

The upside to this calculator is that you get a more accurate ratio because it considers more factors. The downside is that you need to know your body composition before using it.

You choose whether you want to gain, lose or maintain your current weight, and you can use the sliders at the bottom to adjust your ratio if the automatic recommendation isn't ideal for you.

How to track your macros

Your macro numbers aren't very helpful if you don't put them to use.

"Tracking macros" refers to the process of logging all your meals throughout the day and breaking down your macro ratio to ensure you're eating according to your goals. It sounds scary, but again, the web comes to the rescue with a slew of digital macro-tracking programs.

The best macro trackers

MyFitnessPal

Price: Free or $20 per month

The free version of MyFitnessPal doesn't allow you to enter gram amounts for macros, only percentages. If you're comfortable with percentages only, then MFP is a great free option because of its barcode scanning feature and massive database of foods and drinks.

Screenshot of MyFitnessPal dashboard. — The MyFitnessPal dashboard breaks down your macronutrient intake with a helpful pie chart.

MyFitnessPal

With a premium subscription, you can track by gram amounts and percentages, and you can see macro breakdowns for each meal and snack. A premium subscription also gets you extra features like food analyses (quality of what you're eating), food timestamps (when you eat what) and weekly reports.

MyMacros Plus

MyMacros Plus is another great app with a large food database and barcode scanning feature.

You can also track your body weight and enter custom foods for homemade recipes so you don't have to log the individual ingredients. My favorite thing about MyMacros Plus is that it's usable without the internet, so you can track macros even when you're offline.

Tip: Food databases are helpful, but they often include multiple entries with different information for the same item, which can get confusing. It might be easier to manually log the macronutrients in your meals instead of relying on the food database.

Cronometer

Price: $50 per year. Free version available.

The Cronometer tracker tracks vitamins and minerals in addition to macros. It also allows you to track important biometrics, such as blood pressure, cholesterol, sleep, mood, pulse and more — but you first need this information on hand to use the features.

If you do have access to that information, Cronometer provides insight into long-term trends and a clear snapshot of your overall health. While Cronometer is impressive, it can be a bit overwhelming if you only want to track macros, and not the rest of the metrics it offers.

Why should I track macros?

Know that you don't need to track macros to be healthy, lose weight, build muscle or reach any other health goal. The only time you actually need to track macros is if your doctor told you so.

In fact, logging your every bite can be frustrating and time-consuming, but it's worth noting that you'll get pretty good at eyeballing portions if you make tracking a habit.

Tracking macros can definitely be useful for some things, such as preparing for a bodybuilding show or optimizing athletic performance. It can also be helpful if you want to implement "flexible dieting," or the practice of eating any foods you want, as long as they fit into your macronutrient ratio.

Counting your macros may also be the key to finally eating less processed foods, as processed and packaged foods tend to be high in fats and carbs (and not often high in protein), and adding in more superfoods. Many people who want to create a calorie deficit to lose weight prefer tracking macronutrients instead of counting calories, as it takes the emphasis off of weight loss and shifts the focus to nutrition. This is helpful for creating long-term healthy habits.

Additionally, many people enjoy tracking macros because it helps them understand what types of foods work best for their bodies. Give it a try to see if it works for your lifestyle, but don't feel like you ever need to track your macros.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

Body Builder

Watch Now: A Kettlebell Abs Workout That Targets Your Obliques

Billie S. Dickenson June 30, 2022

Core exercises don’t need to be bodyweight-only, and this quick kettlebell abs workout proves that adding resistance to the mix can be a great way to challenge those all-important muscles.

In this video, the fifth installment of Sweat With SELF’s new kettlebells series, you’ll complete a 20-minute core workout that’s focused on your rectus abdominis (the muscles that run vertically along the front of your abdomen) and your obliques (the muscles along the sides of your abdomen). Lee Jimenez, a certified kettlebell level one instructor and ACE-certified personal trainer, and ACE-certified personal trainer Tiffany Ragozzino will take you through the routine, which includes three rounds of four kettlebell exercises.

After a quick warm-up—where you’ll get the blood flowing throughout your body with exercises like the cat-cow, bird-dog, and plank walk-out—you’ll get into your abs workout. You’ll complete each exercise—the single-arm assisted sit-up, Russian twist, plank pull-through, and side-bend/windmill progression—for 45 seconds, resting for 15 before going right to the next move. After all 4 exercises are finished, you’ll rest for 60 seconds before starting again from the top.

These kettlebell core exercises help you build both strength and stability in your rectus abdominis and your obliques through motions like rotating or flexing (say, when you’re performing the Russian twist or sit-up) as well as through resisting movement (like when you’re keeping your body steady during the plank pull-through). Working all of the functions of your core is important in any strength-training routine, since it better mimics the actions of your core in everyday life—which is super important for injury prevention.

Throughout the course of this workout, you’ll be encouraged to progress at your own pace and build ownership over these moves. In the first round, for instance, try to familiarize yourself with the movement patterns and get more comfortable performing them. The second round builds on that—to do so, you’ll sub in a windmill progression in place of the side bend—and the third round really encourages you to give it all you’ve got.

Choose your kettlebell wisely for these moves—you don’t want to go too heavy, which can cause your form to falter and overstress related muscles, like your lower back. A light- to moderate-weight kettlebell will likely be your best bet. (For more information on how to choose the best kettlebell for you, check out our introduction to kettlebells video.)

Ready to light up your core? Grab a kettlebell, block off 20 minutes, and give this kettlebell abs workout a try.

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Nutrition

EXPLAINER: What we know about shuttered baby formula plant

Billie S. Dickenson June 29, 2022

WASHINGTON (AP) — At the center of the nationwide baby formula shortage is a single factory: Abbott Nutrition’s plant that has been closed for more than three months because of contamination problems.

On Monday, U.S. officials announced a deal with Abbott that paves the way to restart production at the Sturgis, Michigan, facility, the largest in the U.S. and source of leading brands like Similac.

But it’s not yet clear how soon the site will be up and running. And even bigger questions remain unanswered, including what caused the contamination and whether U.S. regulators could have alleviated the current formula shortage by stepping in sooner. The plant shutdown exacerbated ongoing supply chain problems among U.S. formula makers.

WHAT CAUSED THE SHUTDOWN?

In mid-February, Abbott announced it was recalling various lots of three powdered infant formulas from the plant, after federal officials began investigating rare bacterial infections in four babies who were fed formula. Two of the infants died. But it’s not certain the bacteria came from the plant; strains found at the plant didn’t match the two available samples from the babies.

The company halted production while Food and Drug Administration inspectors conducted a six-week investigation of the plant.

A preliminary report released in March found traces of a bacteria — cronobacter— on several surfaces throughout the plant, though not in areas used to make the powder. Plant records showed Abbott had detected the bacteria eight times in its products or facility since 2019.

Inspectors also flagged other problems, including standing water on the floor and employees who didn’t properly sanitize their hands.

WHAT IS CRONOBACTER?

The bacteria occurs naturally in soil, water and other parts of the environment. Infections with cronobacter are rare but can be fatal in babies. Almost all previous outbreaks in the U.S. have been linked to powdered baby formulas, which don’t undergo the same high temperatures used to kill germs in many other foods.

Sometimes the bacteria can get into powdered formula after its opened at home if a dirty scoop is used or it is mixed with water that’s contaminated with the germ, according to the Centers for Disease Control and Prevention.

Cronobacter typically causes fever in infants and can sometimes lead to dangerous blood infections or swelling of the brain.

The four reported illnesses were in Minnesota, Ohio and Texas between September and January.

WHAT ROLE DID ABBOTT’S FORMULA PLAY IN THE ILLNESSES?

It’s still not yet clear. The FDA hasn’t released a final ruling on the problems at the plant and whether they are linked to the infections.

“There are many factors involved in this ongoing investigation and we’re just not in a position to make any definitive statement,” FDA Commissioner Robert Califf said Monday..

Food safety experts say the case underscores the challenges of tracing foodborne illnesses.

Because there were only two samples collected from the four cases, “Right from the get-go we were limited in our ability,” to link the baby formula to the illnesses, said the FDA’s food director Susan Mayne. “We simply don’t have the evidence to demonstrate that causality.”

Abbot says the lack of a strain match indicates “there is no evidence to link our formulas to these infant illnesses.”

SHOULD THE FDA HAVE STEPPED IN SOONER?

The FDA is facing intense scrutiny about what steps it took — and didn’t — in the months before the recall.

FDA inspectors visited the factory in late September for a routine inspection, around the time that the first bacterial infection was reported in Minnesota. Although inspectors uncovered several violations— including standing water and unsanitary conditions — they didn’t find any bacteria and let the plant stay open. It’s unclear if inspectors were even aware of the first reported illness.

After three more cases were reported, the FDA returned to the plant in January and detected the bacteria.

The FDA mainly focuses on assuring the safety of the food supply, with extra regulations and standards on foods for babies and children. But former FDA officials say the agency is supposed to consider potential shortages that result from shutting down plants.

In previous cases, the FDA has worked with companies to shift production to other facilities or find alternative supplies.

The FDA is doing that now under a new policy that eases imports of baby formula from foreign manufacturers. But both the agency and the White House are facing questions on why that step wasn’t taken sooner.

“We always believe we can do better in terms of the time frame,” Califf said.

Rep. Rosa DeLauro, D-Conn., reported last month that a whistleblower had contacted the FDA in October with allegations about unsafe conditions and practices at the plant, including falsifying plant records and failing to properly test formula for contamination. She said the FDA did not interview the whistleblower until late December. Califf is scheduled to answer questions from DeLauro and other lawmakers on Thursday.

WHEN WILL THE PLANT RESTART PRODUCTION?

Both the FDA and Abbott say they are working as quickly as possible to restart manufacturing at the plant. But FDA officials say the onus is on Abbott to demonstrate its Michigan plant meets rigorous safety standards.

Former FDA officials say fixing the type of problems uncovered at Abbott’s plant takes time, and infant formula facilities receive more scrutiny than other food types. Companies need to exhaustively clean the facility and equipment, retrain staff, repeatedly test and document that there is no contamination.

Even after the facility opens, Abbott says it will take eight-to-ten weeks before new products start shipping to stores. The company continues to produce baby formula at its other plants in the U.S. and overseas.

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Follow Matthew Perrone on Twitter: @AP_FDAwriter

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Health

Expert Offers Advice on Maintaining a Healthy Lifestyle Before, During and After Cancer Treatment

Billie S. Dickenson June 29, 2022

Kristie L. Kahl: Can you explain how maintaining a healthy lifestyle helps before a diagnosis, during treatment and beyond that?

Dr. Navya Nair: Absolutely. So maintaining a healthy lifestyle is just so important in all stages, cancer prevention, and even after a diagnosis and while someone's undergoing treatment. So a healthy diet. So well balanced diet with lots of fruits and vegetables, lean meats, getting regular cardiovascular exercise, avoiding toxins like tobacco, limiting alcohol use can reduce your risk of ever getting a cancer diagnosis. So for example, we know that tobacco use is directly linked to lung cancer risk. Having a healthy BMI reduces your risk of getting endometrial cancer. So these are how some of these healthy lifestyles can prevent you from getting a cancer.

Now, you also asked how this can help once someone has a diagnosis and they're in treatment. You know, having a healthy body allows you to get through some of these really tough treatments. And, you know, I often explained to my patients that a big cancer surgeries often is like running a marathon and having a really fit body before allows you to get through that better and have less complications. And much like surgery, chemotherapy, radiation, these are all things very tough on the body that having a strong body. And the other important part that I didn't talk about yet is having a healthy mind and having strong support systems outlets for stress and anxiety. In some kind of practice of reflection, whether you do yoga meditation, is mental health is just as important as physical health, especially when dealing with cancer.

Kahl: Absolutely. So from the exercise standpoint, we know exercise is good. But can you give some examples of how people can stay active because I think there's always a misperception that you know, we you need to run a mile or two miles but I think we can go simpler than that. So can you give us some examples for our patients?

Nair: Absolutely. Yes, so it's important to get a heart rate up. So however you like to do that. So for some people they like to run. Some people hate to run maybe you prefer to swim or both. Go for vigorous walks. Go for a bike ride. The goal is to get your heart rate up for 30 to 60 minutes about three to four times a week.

Kahl: Absolutely. And then similarly with diet, why is diet important when it comes to when you're in treatment, but also those long-term effects? And are there examples of the types of diets that our patients should be seeking?

Nair: So really, it's a well-balanced diet with, you know, balance of the different food groups. And certain things like if we're looking at patients, risks and outcomes related to surgery, having a healthy amount of protein in your diet improves your ability to recover from surgery. But the goal is really having a well-balanced diet and maintaining that as much as you can during and after treatment.

Kahl: Absolutely. And so to bring it all together, what is your biggest piece of advice for a patient with a gynecologic cancer who is maybe interested in making changes toward a healthier lifestyle, now that they've received a diagnosis?

Nair: I would say my biggest advice would be to pick one or two things that that you want to try to change. Don't try to change everything at once. Because it's too hard on any one person. So pick one or two things that you're interested in changing. Try to do that. It often works better when people make a change as a family unit. So if you are trying to eat healthier, or go for more regular exercise, try to make that a family activity, because it's more likely to stick if you do that together.

Transcription edited for clarity and conciseness.

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