Albano’s Orange County football Top 35 rankings for Week 10

• October 25, 2023

Support our high school sports coverage by becoming a digital subscriber. Subscribe now

OCVarsity’s Dan Albano votes each week in the Orange County football Top 25 poll.

Here are his rankings for Oct. 23, plus the other schools he views as his “Next 10”:

ALBANO’S TOP 35

1. Mater Dei 8-1

2. Orange Lutheran 5-4

3. San Clemente 8-1

4. Servite 5-4

5. Los Alamitos 7-2

6. Santa Margarita 5-4

7. JSerra 4-5

8. Mission Viejo 6-3

9. Edison 6-3

10. Tustin 9-0

11. San Juan Hills 8-1

12. Villa Park 8-1

13. Newport Harbor 4-5

14. Tesoro 5-4

15. Corona del Mar 4-5

16. Trabuco Hills 6-3

17. Yorba Linda 6-3

18. Capistrano Valley 7-2

19. Cypress 6-3

20. Foothill 6-3

21. Western 8-1

22. El Modena 5-4

23. El Dorado 4-5

24. Laguna Beach 8-1

25. Crean Lutheran 6-3

Albano’s Next 10

26. Huntington Beach 4-5

27. Laguna Hills 8-1

28. Santa Ana 7-2

29. La Habra 5-4

30. Dana Hills 7-2

31. Aliso Niguel 6-3

32. Irvine 6-3

33. St. Margaret’s 5-4

34. Orange 5-4

35. Sonora 8-1

Also considered: Esperanza (5-4), Troy (5-4)

Please send football news to Dan Albano at dalbano@scng.com or @ocvarsityguy on Twitter

Related Articles

​ Orange County Register 

What is TSA PreCheck? Everything you need to know

• October 25, 2023

Raychelle Heath | Bankrate (TNS)

Many travelers are looking forward to a much-awaited vacation this year. According to the Transportation Security Administration (TSA), daily traveler numbers for 2023 are approaching pre-pandemic (2019) levels.

If you’ve been considering applying for TSA PreCheck to streamline the process of airport security, here’s your guide to how it works, the interview process and more, along with some tips for using your membership for the first time.

What is TSA PreCheck?

TSA PreCheck is a Trusted Traveler Program (TTP) designed to expedite the process of getting through airport security. The program is managed by the TSA and gives passengers access to special security lines at participating airports in the United States. TSA PreCheck membership costs $78 (previously $85) and is good for five years.

TSA PreCheck is available in more than 200 airports and with 85 airlines across the United States. When you get to the security line after check-in, an agent will direct you to the PreCheck line after confirming your membership via your boarding pass.

This membership allows you to keep your light jacket, shoes and belt on, and liquids and electronics (like laptops) can stay inside your luggage, too. Then, it’s as simple as walking through a security scanner and you’re good to go to your gate.

How to participate in TSA PreCheck

Becoming a member of the TSA PreCheck program will require a few steps, starting with your application. To apply for TSA PreCheck, you must be a U.S. citizen, U.S. national or lawful permanent resident. There is no age restriction for applicants, and children of age 12 and under can use their parents’ or guardians’ memberships and need not officially apply.

Once you’ve applied with an enrollment provider, you’ll need to schedule an appointment at an enrollment center to complete a background check and fingerprinting. At this appointment, you’ll pay your membership fee and find out if you’ve been approved. Once you’ve been approved, you’ll receive a known traveler number (KTN) that you can use whenever you book a flight. It can take up to 60 days to receive your KTN, but most applicants receive their KTN within three to five days.

Complete the online application

The application for TSA PreCheck can be found on the TSA website under “Apply Now.” When completing your application, it’s very important that your name appears exactly as it does on your government identification. Some of the information you’ll need includes:

—Full name

—Date of birth

—Gender

—Preferred language

—A preferred method of contact (email or phone)

When you complete your application, you’ll be directed to set your appointment for your background check and fingerprinting, and you’ll be given a list of enrollment centers to choose from in your area. You’ll also have the opportunity to set a time and date for your appointment.

Complete the in-person interview at an enrollment center

TSA PreCheck allows walk-ins for interviews, but applicants with appointments are prioritized. Appointments are scheduled to last about 10 minutes (if the enrollment center is busy, it may take a bit longer). It’s best to schedule a TSA PreCheck appointment while completing your application, and the earlier you can schedule it, the better. You’ll be given the option to choose from a variety of enrollment centers in your area, along with different days and times.

At your appointment, you’ll be required to present approved identification documents. This includes an unexpired U.S. passport or else a valid photo ID and a document that meets citizenship requirements (such as a U.S. birth certificate). You’ll also be fingerprinted and pay your membership fee. Membership fees are nonrefundable and can be paid with a credit card, debit card, money order, company check or certified/cashier’s check.

The interview itself is pretty low-key. You’ll be asked to verify the information on your application and may also be asked about your employment history and travel habits. If you have any criminal history, you should be prepared to give more information about that.

How to get TSA Precheck for free

Getting the most out of TSA PreCheck actually starts before you use the service. In fact, many travel credit cards provide a statement credit to cover the cost of TSA PreCheck or Global Entry membership. So, if you have an eligible credit card — like the Chase Sapphire Reserve®, for example — you’ll get reimbursed up to $100 for TSA PreCheck or Global Entry.

To receive the credit, you’ll simply pay the fee with your eligible credit card. Also check out Bankrate’s travel toolkit for tips and tricks on how to maximize travel with a credit card.

Using TSA PreCheck for the first time

Once you have your TSA PreCheck membership, here are some tips that can help you make the most of it:

—Make sure you use your KTN whenever you book a flight to ensure TSA PreCheck shows up on your boarding pass.

—If you’re a frequent flyer, add your KTN to your profile.

—Do online check-in for your flight 24 hours ahead of time to make sure your PreCheck status is there. If it isn’t, contact the airline.

—Arrive at the airport at least two hours ahead of your flight to make sure your PreCheck status is confirmed (if you aren’t able to do so online or by phone).

—Be sure you are traveling through an airport with TSA PreCheck services.

Does one TSA PreCheck membership work for families?

The short answer to this question is no. TSA PreCheck membership doesn’t automatically transfer to your family members. The one exception is children of age 12 and under. Children in this age category can go through the TSA PreCheck line with a parent or guardian who has membership in the program.

Children of ages 13 to 17 may also be able to use the TSA PreCheck lane if they’re traveling with a parent or guardian who has TSA PreCheck and if they have the TSA PreCheck indicator on their boarding pass. However, their use of the lane is not guaranteed, and they may be required to go through standard security screening.

How to update personal information for TSA PreCheck

Your TSA PreCheck membership is good for five years. If during that time your personal information changes, you’ll need to update it as soon as you can with the provider that enrolled with. The most direct way to do so is to call it at 855-347-8371 (for IDEMIA) or 833-777-1811 (for Telos), Monday through Friday, 8 a.m. to 10 p.m. ET. You can also send an inquiry online to get information about how to change your personal information. This may take a little longer, however, because you will have to wait for a response.

The bottom line

If you do any domestic travel, having TSA PreCheck can be a real perk. Participating in this Trusted Traveler Program will enable you to breeze through security lines. While there is a membership fee of $78 to participate in this program, several credit cards offer members credits that cover this application fee. There are other Trusted Traveler Programs from the government that offer different benefits. If you’re looking to have a quicker re-entry into the U.S. after international travel, Global Entry is the program to look at — and it includes TSA PreCheck membership, too.

________

Key takeaways

—TSA PreCheck membership can help you get through airport security faster.

—With TSA PreCheck, you can keep a light jacket, shoes and belt on, and you won’t have to remove your laptop or liquids from your bag.

—To apply for TSA PreCheck, you’ll need to fill out a short online form and complete an in-person appointment at an enrollment center.

—Many travel credit cards offer a statement credit to cover the entire cost of TSA PreCheck membership (currently $78).

©2023 Bankrate online. Visit Bankrate online at bankrate.com. Distributed by Tribune Content Agency, LLC.

​ Orange County Register 

Online reviews of the Crocs cowboys boots are in — and they’re hilarious

• October 25, 2023

Oct. 23 was Croc Day, and this year, the Broomfield, Colorado-based company celebrated with the release of its first cowboy boots design.

The Crocs Classic Cowboy Boots debut on Oct. 23. Better boot, scoot and boogie to buy them as they’re only available for a limited time. (Provided by Crocs, Inc.)

The shoemaker announced its release earlier this month – which it deems Croctober – attributing the boots’ development to demand from fans. Based on the number of people complaining online about the Crocs website going down Monday morning, it seems they’re poised to be a fan favorite.

A Crocs spokesperson declined to say how many pairs of the limited edition style are available, saying only that they are expected to sell out. By midday Monday, several sizes listed “only a few left” while larger sizes were listed as “coming soon.” By late afternoon, several sizes appeared to be sold out.

Despite that, reviews began pouring in several weeks ago on Crocs’ website. While it’s unclear how they were tried so soon (we’ve asked), the reviews are endlessly entertaining, with at least one citing the Crocs cowboy boots as the impetus for a divorce.

Here are the funniest reviews of the Crocs cowboy boots from the website.

Crocs? Boots? Croots

“Nothing says ‘yeehaw’ like having a pair of spiky wheels attached to your feet,” wrote reviewer sniktak from Atlanta. “Forget about subtlety – with these boots, you can jingle your way through life like a walking wind chime, ensuring that everyone within a ten-mile radius is well aware of your presence.”

Soon, soon

“Automatic Texan purchase,” said Texas-based reviewer They’ll Be Mine.

I would buy these again even though I was divorced

“When I first laid eyes on this I felt an immediate spark and pleasure staring at them. When I showed my boring old ass wife she side-eyed and told me she would divorce me if I bought a pair. Well guess what? She was not kidding. I bought a pair on a Sunday after church and my wife instantly handed me the house key and left,” reviewer Tucker Wilson of Montana wrote, in part. “The price is worth it but expensive if it causes a divorce. Attorneys are a pretty penny. When I walked into court everyone’s eyes fell upon my shoes. I graced that crowd with godly shoes. The Judge was deeply impressed and I knew I won the case.”

Related Articles

Fire drop

“These boots are like the love child of John Wayne and the marshmallow man from Ghostbusters. They’re so confused about their identity that they’ve become the fashion equivalent of an existential crisis,” said reviewer StylishGambino of Los Angeles. “They’re the fashion equivalent of a plot twist in a telenovela – utterly unexpected, yet strangely captivating. But here’s the kicker: They’ll hug your feet like a country love song.”

Yee Haw Croc Cowboys

“These are great to rustle up some cattle and gather my horses for a train robbery. Feel fancy, and they are 4-wheel drive so I can run fast,” wrote reviewer Cowboy Rick of The Pasture.

​ Orange County Register 

Will Ozempic temper consumer hunger for Olive Garden breadsticks, groceries?

• October 25, 2023

Darden Restaurants CEO Rick Cardenas got a question on a recent earnings call that even the industry analyst asking it thought was odd.

The analyst wanted to know about what effect diabetes and appetite suppressant drugs such as Ozempic would have on restaurant demand. Cardenas heads the company that owns Olive Garden, home to “never-ending” soup, salad and breadsticks.

“Full-service dining occasions are driven by a desire to connect with family and friends,” Cardenas answered on the earnings call last month, noting he did not expect a “meaningful impact” for his Orlando-based company.

Despite all those breadsticks at Olive Garden, Cardenas said Darden has spent a lot of time over the years developing menus to give guests a wide range of choices.

“If it suppresses appetite a little bit, they’re still going to eat,” Cardenas said. “So we’re going to be there for them when they do.”

Darden has 1,998 restaurants including Olive Garden, LongHorn Steakhouse, Cheddar’s Scratch Kitchen and Ruth’s Chris Steak House.

But it’s not just at Darden where these kinds of questions are coming up. Walmart U.S. CEO John Furner told Bloomberg that the company has seen a “slight pullback” from shoppers taking those medications.

GLP-1 drugs such as Ozempic are Type 2 diabetes medicines that help with blood sugar and might also help with weight loss. According to the Mayo Clinic, the drugs appear to assist in subduing hunger.

Still, restaurant and retail experts say it’s too soon to know for sure what will happen.

“It’s more of a Wall Street story as opposed to a consumer story because if it becomes a big consumer story it would take so long to work its way through all the different consumers,” San Diego-based restaurant analyst John Gordon told the Orlando Sentinel. “I think it would take years to reach mainstream coverage and adaptation.”

One unknown for restaurants, Gordon said, is if the prescription could mean different things for different kinds of eateries, such as Denny’s versus Darden’s The Capital Grille, a fine dining chain.

“It’s an issue that those that follow stocks day in and day out … might find to be a catalyst, and a catalyst is something that is new news that might drive stocks either up or down,” Gordon said.

But traditional grocers such as Lakeland-based Publix could be more exposed than retailers such as Walmart or Target that offer more than food, said Amanda Lai, a director at Chicago-based retail consulting firm McMillanDoolittle.

“Retailers like grocers that are more food-centric would likely be more impacted if the trend of pulling back on shopping for food as a result of appetite suppressant drugs continues to grow,” Lai said.

Lai also noted shoppers have been tightening their wallets for an entirely different reason: high inflation in recent years.

“Since we’re just hearing some of the preliminary findings from retailers, it’s still fairly early to draw definitive conclusions,” Lai said.

When asked about the comments from Walmart and what, if any, effects Publix had seen or expects to see from shoppers who might be on these medications, spokeswoman Maria Brous said in an email the company did not have “direct data that would correlate or support this theory.”

Publix has more than 1,350 stores in the Southeast and 859 stores in Florida.

Lai said the issue could put “the onus on food companies to continue to innovate their offerings.”

​ Orange County Register 

H-1B: Government’s proposed visa changes are murky but could mean big changes

• October 25, 2023

The federal government is proposing major changes to the H-1B visa program intended to allow U.S. companies to hire foreign citizens with specialized skills, including expanding the types of work not subject to an annual cap.

While the plan runs to 227 pages, it leaves unanswered some questions about how the new rules might change the number of H-1B visas and who could receive them.

Silicon Valley technology giants rely heavily on the H-1B to secure top foreign talent. Those companies, and many others in the Bay Area, also employ large numbers of H-1B workers at below-market wages, using staffing and outsourcing companies to secure such employees. Critics cite reported abuses and say companies, including major tech firms and staffing and outsourcing companies, use the H-1B to supplant U.S. workers, drive down wages and facilitate outsourcing.

The Department of Homeland Security on Friday released the proposal, saying it would “modernize and improve the efficiency of the H-1B program, add benefits and flexibilities, and improve integrity measures.” The new proposal was published Monday in the Federal Register, triggering a 60-day period for public comments the agency will review before publishing a final rule.

The visa, which employers obtain through a lottery on behalf of specific workers, has become a flashpoint in debates over immigration. Replacement of U.S. workers by visa holders has spawned lawsuits, and efforts to shorten the lengthy path to a green card and citizenship for Indian workers — by far the largest group of H-1B recipients — have been ensnared in political gridlock.

Among the most consequential of the planned changes is expanding the types of jobs not subject to the 85,000 annual visa cap, said Ron Hira, a Howard University professor who studies the H-1B.

Many universities, and nonprofit and government research organizations, are exempt from the visa cap. Under current rules, H-1B visas can be awarded to foreign citizens for work that “directly and predominately” advances “the essential purpose, mission, objectives or functions” of such employers. Under the new rules, visas could be awarded for work that would “directly further an activity that supports or advances one of the fundamental purposes, missions, objectives, or functions” of the employer.

“A qualifying organization may have more than one fundamental purpose, mission, objective, or function, and this fact should not preclude an H-1B beneficiary from being exempt from the H-1B cap,” the proposed rule said.

Hira said the vagueness of the proposal raises concerns that companies, including staffing companies who seek to game the H-1B system, could exploit their partnerships with cap-exempt entities. “A lot of companies that are subject to the cap work with government organizations, are vendors to nonprofit research organizations,” Hira said.

“It potentially opens up a huge avenue for virtually any company to magically become cap exempt,” Hira added. “The reason we have a cap in the first place is to protect the labor market so that employers don’t flood the labor market with H-1B workers.”

Hira noted that UC San Francisco in 2017 laid off dozens of U.S. workers as it outsourced IT work to an Indian company that assigned H-1B workers to the contract.

The agency did not provide in its proposal an estimate of how many additional H-1B workers could be brought in by expanding cap-exempt work, Hira said.

The agency also proposed tightening the definition of a “specialty occupation” that qualifies for the visa. Job duties must be directly related to required degrees, and although there may be more than one acceptable degree field for an occupation, “a general degree is insufficient,” according to the proposal.

Related Articles

Again, Hira said, the agency did not provide estimates on how changing the definition could affect visa numbers and patterns of allocation.

Homeland Security, through U.S. Citizenship and Immigration Services, did not answer detailed questions about the proposal, but said in a statement that it “remains committed to preventing misuse and fraud in the H-1B registration process, meeting the ever-changing needs of the U.S. labor market, and breaking down administrative barriers for eligible U.S. employers seeking to use the H-1B program.”

In the most recent application period, the agency received 750,000 applications, with hundreds of thousands of duplicates, Hira said. The proposed rule to ban what the agency described as “multiple registrations by related entities,” and ensure each applicant has only one shot at selection, could “maybe clean up this problem,” Hira said.

David Bier, associate director of immigration studies at the libertarian Cato Institute, who supports increasing the H-1B cap, applauded the proposed expansion of exceptions for research jobs. Bier also lauded the rule’s proposal to codify entrepreneurs’ ability to obtain an H-1B visa, which could lead to new jobs and industries. Bier noted that the agency proposed an 18-month limit on the visa for entrepreneurs based on possible fraud, but failed to specify what fraudulent behavior it believed might occur.

The new rules’ “biggest value add” may be resolving issues in a way that makes it harder to undo progress later, Bier said.

​ Orange County Register 

Disneyland sets reopening date for Adventureland Treehouse

• October 25, 2023

Work is finally finished on the transformation of Tarzan’s Treehouse into the what’s-old-is-new-again Adventureland Treehouse that has taken twice as long to complete as the original creation of Disneyland.

Disneyland will reopen the Adventureland Treehouse inspired by Walt Disney’s “Swiss Family Robinson” on Nov. 10 after a refurbishment project that has stretched for more than two years.

SEE ALSO: Disneyland sets opening date for Pixar Place Hotel makeover

The new Adventureland Treehouse pays tribute to Disneyland’s original Swiss Family Treehouse while also serving as a tie-in to a new Swiss Family Robinson television show in the works for the Disney+ streaming service.

A family of five who possess magical and unique gifts that help them survive life in the jungle will soon be moving into the Adventureland Treehouse once work is complete on their new home, according to the backstory created for the rethemed Disneyland attraction.

The family uses objects found in the jungle to collaborate together while also pursuing their own individual passions and interests, according to the backstory created by Walt Disney Imagineering.

SEE ALSO: ‘Drones are the next thing’ for Disney nighttime spectaculars

The treetop home’s iconic water wheel pulley system with bamboo buckets powered by a small nearby brook generates the energy needed to run the family’s gadgets and inventions.

The chef father has built a ground floor kitchen and dining room where meals cook themselves and “magical water” cools an ice box. The father’s studio displays hand-made gadgets and inventions for exploring the jungle along with sketches and paintings of each of the treehouse rooms.

Concept art of the Adventureland Treehouse coming to Disneyland. (Disney)

The musical mother has a player organ in her room that plays “Swisskapolka” in an homage to Disneyland’s original Swiss Family Treehouse. The music den is filled with a harp, lute, guitar and other musical instruments she uses to entertain the family.

The teenage daughter is an astronomer and astrologer whose room near the top of the treehouse is filled with diagrams of the solar system and models of the universe. She tracks the stars, planets and comets with her telescope and charts her discoveries in her notebooks and sketchbooks.

An abstract illustration of the astronomers loft in the Adventureland Treehouse at Disneyland. (Disneyland)

The naturalist twin sons — one an animal lover and the other a plant lover — share a room filled with monkeys, toucans and man-eating plants.

SEE ALSO: Disney reveals secrets behind Indiana Jones Adventure boulder scene

The Disneyland treehouse in the boughs of an 80-foot-tall manmade tree has changed ownership a few times over the past six decades.

The original Swiss Family Treehouse based on the 1960 Disney film opened at Disneyland in 1962. The Adventureland attraction was rethemed in 1999 as Tarzan’s Treehouse based on the Disney animated film from the same year about a boy raised by apes.

Related Articles

Tarzan’s Treehouse closed in September 2021 — meaning the two-year refurbishment project has taken twice as long as the yearlong construction of Disneyland that was completed in 1955.

Disneyland announced plans in 2022 for a rethemed version of the attraction that would be once again inspired by the “Swiss Family Robinson” novel written by Johann David Wyss in 1812.

The 150-ton evergreen with 6,000 vinyl leaves even has its own tree species name — Disneydendron semperflorens grandis.

​ Orange County Register 

Ike’s Love and Sandwiches opens Huntington Beach location

• October 25, 2023

Soon after Ike’s Love and Sandwiches opened its first store in San Francisco in 2007 (formerly known as Ike’s Place), the then-nascent sandwich shop, founded by eponymous owner-founder Ike Shehadeh, had long lines stretching from its storefront daily. So much so that the regular queue of devotees and persistent smell of fried bacon stoked the ire of neighbors. Their loss. Since then, Shehadeh’s shop has grown to nearly 100 locations nationwide.

Ike’s latest spot, which will officially open in Huntington Beach in early November, has softly opened for business this week.

Shehadeh’s menu honors his hometown of San Francisco with sandwiches like the Robin Williams (which comes with halal chicken, Italian dressing, mushrooms and pepper jack). He even pays tribute to — avert your eyes, Dodgers fans — the San Francisco Giants with such meaty concoctions as the Barry Bonds (turkey, bacon, Swiss), Matt Cain (roast beef, salami, turkey and provolone) or the Hunter Pence (turkey, bacon, avocado, barbecue sauce, honey mustard, Swiss, cheddar, and pepper jack).

Ike’s has revealed two new sandwiches exclusive to the Huntington Beach shop: the Safari Surfin’, which comes with chicken-fried steak, Ike’s Double H Sauce, honey, and gouda cheese, and the Pacific City, featuring breaded eggplant, Ike’s Double H Sauce, avocado and pepper jack. All sandwiches are served hot with hot dirty sauce, a garlic aioli with a blend of hush-hush seasonings and spices (vegan sauce is also available).

Related links

The Ecology Center throwing public party to celebrate 15 years in San Juan Capistrano
In-N-Out Burger rocks fans at its 75th anniversary festival
The Orange County train-station dining guide: Santa Ana
Some of O.C.’s best Texas-style barbecue can be found inside this liquor store
Where to find the fluffiest souffle pancakes in O.C.

Customers are also allowed to build their own sandwich if the vast menu isn’t to their liking. Sandwich buns come in Dutch crunch (another tip of the hat to San Francisco), sourdough, white, gluten-free or whole wheat varieties.

For the official grand opening, Ike’s will host an event on Friday, Nov. 10 where the first 50 people in line will get a free T-shirt, a free sandwich, and a chance to win free sandwiches for a year. Ike’s will also have special $7.97 sandwiches available all day, as well as a special appearance by Shehadeh.

Ike’s Love and Sandwiches has six other Orange County shops in Lake Forest, Newport Beach, Costa Mesa, Tustin, Fountain Valley and Westminster. CEO Michael Goldberg said in a written statement, “Southern California loves Ike’s. We’re almost to 100 locations and we’ll be adding even more very soon.”

Find it: 18685-2 Main St. (at Delaware Street), Five Points Plaza, Huntington Beach

​ Orange County Register 

Quick genetic test offers hope for sick, undiagnosed kids. But few insurers offer to pay

• October 25, 2023

Phil Galewitz | (TNS) KFF Health News

Just 48 hours after her birth in a Seattle-area hospital in 2021, Layla Babayev was undergoing surgery for a bowel obstruction.

Two weeks later, she had another emergency surgery, and then developed meningitis. Layla spent more than a month in neonatal intensive care in three hospitals as doctors searched for the cause of her illness.

Her parents enrolled her in a clinical trial to check for a genetic condition. Unlike genetic tests focused on a few disease-causing variants that can take months to produce results, the study at Seattle Children’s Hospital would sequence Layla’s entire genome, looking for a broad range of abnormalities — and potentially offer answers in under a week.

The test found Layla had a rare genetic disorder that caused gastrointestinal defects and compromised her immune system. The findings led doctors to isolate her, give her weekly infusions of antibiotics, and contact other hospitals that had treated the same condition, said her father, Dmitry Babayev.

Today, Babayev credits the test, known as rapid whole-genome sequencing, for saving his daughter’s life. “It is why we believe Layla is still with us today,” he said.

Like her disorder, Layla’s experience is rare.

Few hospitalized babies with an undiagnosed illness undergo whole-genome sequencing — a diagnostic tool that allows scientists to quickly identify genetic disorders and guide clinicians’ treatment decisions by analyzing a patient’s complete DNA makeup. That’s largely because many private and public health insurers won’t cover the $4,000-to-$8,000 expense.

But an alliance of genetic testing companies, drugmakers, children’s hospitals and doctors have lobbied states to increase coverage under Medicaid — and their efforts have begun to pay off.

Since 2021, eight state Medicaid programs have added rapid whole-genome sequencing to their coverage or will soon cover it, according to GeneDX, a provider of the test. That includes Florida, where the Republican-controlled legislature has resisted expanding Medicaid under the Affordable Care Act.

The test is also under consideration for coverage in Georgia, Massachusetts, New York and North Carolina, according to the nonprofit Rady Children’s Institute for Genomic Medicine, another major provider of the test.

Medicaid coverage of the test can significantly expand access for infants; the state-federal program that insures low-income families covers more than 40% of children in their first year of life.

“This is an extraordinary, powerful test that can change the trajectory of these children’s diseases and our own understanding,” said Jill Maron, chief of pediatrics at Women & Infants Hospital in Providence, Rhode Island, who has conducted research on the test.

“The only thing interfering with more widespread use is insurance payment,” she said.

Proponents of whole-genome sequencing, which has been commercially available for about six years, say it can help sick infants with potentially rare diseases avoid a months- or years-long odyssey of tests and hospitalizations without a clear diagnosis — and increase survival.

They also point to studies showing rapid whole-genome testing may lower overall health costs by reducing unnecessary hospitalizations, testing and care.

But the test may have its limits. While it is better at identifying rare disorders than older genetic tests, whole-genome sequencing detects a mutation only about half of the time — whether because the test misses something or the patient does not have a genetic disorder at all.

And the test raises ethical questions because it can also reveal that babies — and their parents — have genes that put them at increased risk for adult-onset conditions such as breast and ovarian cancer.

Even so, some doctors say sequencing offers the best chance to make a diagnosis when more routine testing doesn’t provide an answer. Pankaj Agrawal, chief of neonatology at the University of Miami Miller School of Medicine, said only about 10% of babies who could benefit from whole-genome sequencing are getting it.

“It is super frustrating to have sick babies and with no explanation what is causing their symptoms,” he said.

Some private insurers now cover the test with certain limitations, including UnitedHealthcare and Cigna, but others do not.

Even in states that have adopted the test, coverage varies. Florida will add the benefit to Medicaid later this year for patients up to age 20 who are in hospital intensive care units.

Florida state Rep. Adam Anderson, a Republican whose 4-year-old son died in 2019 after being diagnosed with Tay-Sachs disease, a rare genetic disorder, led the push for Medicaid to cover sequencing. The new state Medicaid benefit is named for his son, Andrew.

Anderson said persuading his GOP colleagues was challenging, given they typically oppose any increase in Medicaid spending.

“As soon as they heard the term ‘Medicaid mandate,’ they shut down,” he said. “As a state, we are fiscally conservative, and our Medicaid program is already a huge program as it is, and we want to see Medicaid smaller.”

Anderson said it took doctors more than a year to diagnose his son — an emotionally difficult time for the family as Andrew endured numerous tests and trips to specialists in several states.

“I know what it’s like to not get those answers as doctors try to figure out what is wrong, and without genetic testing it’s almost impossible,” he said.

A Florida House analysis estimated that if 5% of babies in the state’s neonatal intensive care units got the test each year, it would cost the Medicaid program about $3.3 million annually.

Florida’s legislative leaders were persuaded in part by a 2020 study called Project Baby Manatee, in which Nicklaus Children’s Hospital in Miami sequenced the genomes of 50 patients. As a result, 20 patients — about 40% — received a diagnosis, leading to changes in care for 19 of them.

The estimated savings exceeded $3.7 million — a nearly $2.9 million return on investment, after the cost of the tests, according to the final report.

“We have shown that we can justify this as a good investment,” said Parul Jayakar, director of the hospital’s Division of Clinical Genetics and Metabolism, who worked on the study.

___

(KFF Health News, formerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)

©2023 KFF Health News. Distributed by Tribune Content Agency, LLC.

​ Orange County Register