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May 15th, 2021:

You can lose the mask if you’re fully vaxxed

Do your part, reap the reward.

Federal health officials reversed course Thursday and advised that people who are fully vaccinated can stop wearing masks and observing social distancing in most indoor and outdoor settings.

It’s welcome news for many who have grown weary of the safety precautions more than 14 months into the global public health crisis and is a significant milestone in returning to pre-pandemic life. But the announcement will likely give new life to the debate about requiring vaccinations that has been playing out in Texas and across the nation — and it comes as less than a third of Texans are fully vaccinated.

“We have all longed for this moment,” Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said from the White House on Thursday. “If you are fully vaccinated, you can start doing the things that you had stopped doing because of the pandemic.”

But Walensky cautioned that the CDC’s guidance comes with exceptions. Vaccinated people should continue to wear masks and distance themselves from others in medical settings and around high-risk populations, such as doctor’s offices, hospitals and long-term care facilities, and while traveling aboard airplanes, busses and trains. Incarcerated people and people in homeless shelters should also continue to observe safety precautions.

[…]

More than 11 million Texans had received at least one dose of the COVID-19 vaccine as of Tuesday, according to state data. Nearly 31% of the state’s residents are fully vaccinated. But the rate at which Texas is vaccinating its residents has slowed despite ample supply. An April poll by the University of Texas at Austin and The Texas Tribune found that 36% of Texans said they were either reluctant to receive the vaccine or would refuse to get it, including nearly half of the state’s Republicans.

Peter Hotez, a preeminent infectious disease expert and dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, said on Twitter that he supported the announcement, but that it carries a risk in places like Texas.

“COVID19 immunization rates in my part of the country, TX + South, are still lagging the rest of the nation, so I worry about a 5th wave this summer in the South like last summer,” he said.

As noted in the story, this comes on the heels of the approval of the vaccine for 12 to 15 year olds. I’ve already seen pictures of a bunch of my friends’ kids getting their first shot; ours will do so later today. Our vaccination numbers in Texas can certainly be better, but that’s one part helping people overcome the obstacles in their path to getting a shot, and one part giving whatever answers or reassurances the hesitant folks have. Not much you can do about the flat-out resisters, but if we can limit the damage to just them we’ll be all right. I also suspect that over time we’ll see higher vax numbers in the urban areas than elsewhere, or at least we will if we do the job of making it as accessible as possible. In the meantime, those of us who have gotten our shots can show our faces again, and just in time for summer. That’s gonna feel good.

(To be sure, some number of unmasked people are the same chuckleheads who refuse to be vaccinated, and they’ve been walking around unmasked for a long time now. There is an argument that the CDC’s new guidance isn’t a good idea. And of course, individual retailers and restaurants and what have you may continue to require masks in their establishments for the time being, since there’s no way to tell who is and isn’t vaccinated. You can take your mask off where you can if you’re vaxxed, just as always be thoughtful and considerate about it.)

Paxton sues over revocation of Medicaid 1115 waiver

Someone please explain to me if this has any merit.

Best mugshot ever

Texas Attorney General Ken Paxton sued the Biden administration Friday to reinstate an eight-year extension to a federal health care funding agreement, worth billions of dollars annually and set to expire next year, that the state uses to help pay for health care for uninsured Texans.

Last month, federal health officials rescinded the Trump-era extension to the 1115 waiver agreement — which Texas has had with the U.S. Centers for Medicare and Medicaid Services since 2011 and is up for review every few years — and ordered Texas to collect public input, as the agreement requires, while it renegotiates a new extension beyond its current October 2022 expiration date.

The decision did not stop the funding in the current waiver, which will continue to provide $3.87 billion in annual funding for 2021 and 2022 to partly offset free care provided by Texas hospitals to the uninsured, and to pay for innovative health care projects that serve low-income Texans, often for mental health services.

The extension, granted in the waning days of Donald Trump’s presidency, would have continued hospital reimbursements until September 2030 but allowed the innovation fund to expire.

In his lawsuit filed Friday, Paxton said the decision was a political move by President Joe Biden that was meant to force Texas to expand its Medicaid program under the Affordable Care Act of 2010.

Forcing Texas back to the drawing board on negotiations over the extension, which Paxton said would have amounted to $30 billion in federal funding through 2030, threatens to “destabilize” the programs the state funds through the waiver, he said.

[…]

The 1115 waiver was originally granted to Texas as a temporary funding bridge while the state developed its plan to expand its Medicaid program, but the U.S. Supreme Court ruled in 2012 that the ACA could not require states to do so — and Texas has since leaned on the 1115 waiver to help pay for care for the uninsured.

Supporters of Medicaid expansion have said that the state should utilize both 1115 waiver funding and expanded Medicaid eligibility, and have expressed confidence that the state would be able to negotiate the extension — with the required public input — before it expires.

“We have an attorney general and other state leaders who have made crystal clear the last few months and last few years that they have little interest in health care for working Texans — although they do have an obsession with filing lawsuits against the White House,” said Patrick Bresette, executive director of Children’s Defense Fund-Texas. “This misguided lawsuit is the cherry on top of a legislative session in which state leaders shot down all attempts to give an affordable health insurance option to janitors, cooks, grocery store clerks, and other Texans.”

“This would be a disaster for our state, and yet President Biden seems intent on thrusting his bloated model of government on everyone — including Texas,” he said in a statement Friday.

See here and here for some background, and here for a reminder that the Republicans have once again passed on the opportunity to fully expand Medicaid and make this issue moot. Let’s put aside the irony of a guy who is the lead attorney on a still-active case that would entirely kill the Affordable Care Act if he wins suing to keep federal funds flowing into Texas and ask the key question: This is a federal program, which requires federal approval. Doesn’t that mean that the federal government has some discretion here? If one accepts the premise that this move by the feds was purely capricious and driven by partisan motives, then sure, a lawsuit would be an appropriate remedy. On the other hand, if the feds reasonably believe that the extension, granted in the waning days of a President that gave little care to details and openly favored Republican states, was done in error, well, don’t they have the authority to correct that? I’m asking because I have no idea what the fine points of the law are here, and I have no reason to believe anything Ken Paxton says. That by itself doesn’t mean that the law couldn’t be on his side, though. I welcome any informed feedback on this. The Chron has more.

How hot will summer be?

Depends on how dependable the electricity providers are.

ERCOT sought to reassure worried Texans that the state’s electricity grid will have enough power to meet record-breaking demand this summer, less than three months after a catastrophic power failure left millions in freezing darkness.

The Electric Reliability Council of Texas on Thursday released its final seasonal forecast for this summer, predicting record peak power demand of 77,144 megawatts. The summer record as set on August 12, 2019, when demand hit 74,820 megawatts.

The grid manager said it expects to have enough generation to meet the record demand, forecasting generation capacity of 86,862 megawatts. ERCOT, however, didn’t rule out the possibility for “tight grid conditions” on the hottest summer days when demand for air conditioning is at its highest. Electricity supply is often stretched during Texas’ blazing summers.

“If we get into a combination of (high demand) and low wind or low solar output or a high number of generators that have been unavailable because they’ve been running so hard, then we may need to go into emergency operations,” said Woody Rickerson, ERCOT’s vice president of planning and operations.

Emergency operations allow ERCOT to tap into additional power resources, including 2,300 additional megawatts of generation, enough to power nearly half a million homes on a hot summer day.

[…]

In light of the catastrophic power failure in the winter, ERCOT on Thursday said it took into account three additional extreme weather scenarios to create its summer electricity forecast, considering scenarios of high heat and low wind or forced power plant outages that have less than a 1 percent chance of occurring. For comparison, ERCOT said the February winter storm was a 1 in 100 event.

“I think the consumers in Texas can be very confident that these are extremely unlikely scenarios,” said Warren Lasher, ERCOT’s senior director of system planning. “We recognize that we failed to appropriately communicate what the potential risks were going into the winter season. These additional extreme scenarios are our initial attempt to proactively try to not only communicate what those extreme risks are, but try to restore the trust of the consumers in Texas.”

For the first time, ERCOT said, it will visit a select group of power plants to evaluate their summer weatherization plans, reviewing plans for cooling critical equipment and stocking fuel supplies. The grid manager also said it will coordinate with power utilities, such as CenterPoint Energy, to limit planned outages to maintain transmission and power lines during the summer months and request power plants to contact natural gas suppliers to ensure availability of the fuel through pipelines.

If power demand exceeds supply, ERCOT said it is prepared to call for emergency operations, including ordering power utilities to turn off power to customers to preserve the integrity of the grid.

I think I speak for all of us when I say “Do better than you did in February”. No one has any faith in the concept of “rolling blackouts” at this point.