Wonkbook: The early benefits of embracing Obamacare

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(Photo by Jessica Rinaldi/Reuters)

Wonkbook’s Number of the Day: 43 percent. That's the percentage by which the administration has decreased deportation cases in the nation's immigration courts since 2009. The steepest drop came after 2011.

Wonkbook’s Chart of the Day: States that have embraced Obamacare saw their uninsured rate drop this year three times faster than the states that didn’t.

Wonkbook's Top 5 Stories: (1) The red-blue divide on Obamacare uninsureds; (2) Yellen's dovish speech; (3) Obama's Russia sanctions bind; (4) bringing context to Obama's "deporter-in-chief" status; and (5) can Bloomberg turn the gun-control tide?

1. Top story: Survey day for Obamacare shows a red-blue divide on uninsured rates

States that embrace Obamacare are doing much better at insuring people than non-embracing states are. "Gallup reports that states which fully embraced the law by setting up their own exchanges and expanding their Medicaid programs saw their uninsured rate drop this year three times faster than the states that didn’t....Meanwhile, the Urban Institute...finds that states that expanded their Medicaid programs saw their uninsured rate drop 4 percent, while states that didn't expand saw a much slower drop at 1.5 percent." Jason Millman in The Washington Post.

Gallup: 12 million previously uninsured have gained coverage since fall. "That is millions more than Gallup found in March and suggests that as many as 4 million people have signed up for some kind of insurance in the last several weeks as the first enrollment period for the Affordable Care Act drew to a close. Just 12.9% of adults nationally lacked coverage in the first half of April, initial data from the Gallup-Healthways Well-Being Index indicate. That's the lowest rate since the survey began in 2008. Eighteen percent were uninsured in the third quarter of 2013, just before Americans could start shopping for coverage on the new online marketplaces created by the law. Gallup pollsters cautioned that the data are preliminary but said it is increasingly clear the health law is responsible for the gains. Noam Levey in the Los Angeles Times.

Primary sources:

Poll: Uninsured rate drops more in states that embraced health care law. Gallup.

Rapid increase in health insurance coverage under the ACA. Urban Institute.

Poll: Newly insured represent 4 percent of all U.S. adults. Gallup.

Poll: The individual-mandate penalties are working. Gallup.

How good is Gallup at measuring the impacts of Obamacare? "Survey research in health policy is having its moment, assuming abstruse methodology is ever vogue enough to have a 'moment': yesterday’s news about the Census revising its widely-used Current Population Survey sparked one of the nerdier rounds of Obamacare controversy we’ve seen yet....Gallup puts out periodic reports on the uninsured (among other things), but their data is also available for researchers to purchase....All in all, it’s a mixed bag: There are serious limitations for empirical research, but Gallup data seems adequate for the rough cuts of information that our impatient news cycle seems to demand:" Adrianna McIntyre in The Incidental Economist.

Primary source: The new research paper.

@JeffYoung: Just in: Actually trying to cover the uninsured is more effective than trying not to. http://bit.ly/1qIRn9m

Youth enrollments: More evidence that we won't have a 'death spiral.' "In the list of ominous predictions about Obamacare, a main fear has been that only sick people will sign up. This would prompt insurers to raise prices, making healthy people even less likely to enroll (the dreaded death spiral). However, Gallup reported that the newly insured are not more or less sickly than the general population. Furthermore, new enrollees are disproportionately young: those aged 18-29 comprise 30% of the newly insured, compared with 21% of the broader adult population. There is no magic number of young, healthy enrollees that will make Obamacare succeed. But a death spiral seems unlikely." The Economist.

Explainer: Obamacare’s special enrollment period could help youth signups. Jason Millman.

Why bondholders love Obamacare. "Regardless of what Americans think about Obamacare, reining in health-care costs is winning the support of investors in U.S. Treasuries. After doubling in the past two decades, medical expenses rose less last year than at any time since Harry S. Truman was president in 1949, helped by Medicare reimbursement cuts. The rollout of President Barack Obama’s signature 2010 law will hold down consumer prices for years to come as millions of Americans obtain coverage....Less inflation, which boosts the purchasing power of fixed-rate payments, may help attract buyers to Treasuries as the economy strengthens and the Federal Reserve pares its own bond buying." Daniel Kruger in Bloomberg.

Some Republicans are quietly shifting away from repeal. "The repeal-or-nothing approach is getting trickier now that millions of potential voters have enrolled in health plans and started receiving medical care as a result. That means members of Congress running for reelection in November will have to face real people for whom repeal would likely mean losing coverage. On the other hand, hard-line Obamacare opponents within the GOP’s base are ready to pounce on any comment that suggests any goal short of repeal....But away from reality, in the bizarro world where political campaigns exist, Republican candidates are trying to appease those voters dedicated to repeal without alienating more moderate constituents." John Tozzi in Bloomberg Businessweek.

Census officials says those survey question changes actually make it easier to assess health law. "The director of the Census Bureau said he is confident that new changes in the wording of survey questions on health insurance will not diminish its ability to measure the impact of the Affordable Care Act. John H. Thompson, responding to critics, said the survey questions were rephrased specifically to establish a benchmark for how many people were uninsured in 2013, the year before the health insurance mandate took effect, so comparisons can be made in future years. Concerns, first reported in the New York Times, have arisen that changes in the phrasing of one survey’s questions may make future comparisons more difficult." Carol Morello in The Washington Post.

Other health care reads:

Long read: Even after doctors are sanctioned or arrested, Medicare keeps paying. Charles Ornstein in ProPublica.

Are the CBO's new cost estimates the Obamacare win that wasn't? Olivia Nuzzi in The Daily Beast.

COHN: The tragic red-blue divide on the Medicaid expansion. "The Gallup results are very imprecise, enough that nobody should take specific figures too seriously. And these aggregate totals surely mask all sorts of variation among the states. But the overall pattern -- a sharp divergence between the two groups of states -- is almost certainly real. It’s also very tragic. As as you can see plainly in the above graph of Gallup’s results, the states rejecting part or all of Obamacare are the ones with the most uninsured residents. They are, in other words, the states that need the most help." Jonathan Cohn in The New Republic.

BRENNAN: Additional caution on Gallup's new numbers. "Gallup’s data point is interesting, but because the sample wasn’t focused on the newly insured, their numbers actually could be way off. Indeed, there has to be something amiss: By their reckoning, 12 million American adults gained insurance this year, which isn’t out of the realm of possibility. But 6 million Americans became newly insured via the exchanges, which doesn’t seem possibly, since there were only about 7.5 million enrollees, and indications are that many enrollees were previously insured....The problem with Gallup’s survey isn’t that it isn’t huge -- it’s big enough to have a margin of error of just 1 percentage point -- but that we’re looking at a very small subset of it." Patrick Brennan in National Review.

STRAIN: Census Bureau and Obamacare: Dumb decision? Yes. Conspiracy? No. "None of this is to say that the Census Bureau’s decision to change to a new methodology in the midst of Obamacare’s rollout isn’t a dumb decision. It is. And Census should have known better. Either the new methodology should be delayed, or the old and the new methodologies should be employed concurrently to ensure comparability across years. But it’s a long walk from bad decision to conspiracy. The process of crafting sound public policy requires excellent data. Economists, analysts, and government officials need the best information they can get, and that means the highest quality government statistics. It is crucial that the public trusts the federal statistical agencies, if for no other reason than to ensure the quality of the data being collected....So this decision is evidence of very poor judgment. But until there’s any evidence of a conspiracy, we should not make accusations of conspiracy." Michael R. Strain in American Enterprise Institute.

Top opinion

KRISTOF: In Ukraine, seeking U.S. aid. "For decades, Ukrainians have been starved, oppressed and bullied by Russians, and, with Russia now inciting instability that could lead to an invasion and dismemberment of eastern Ukraine, plenty of brave Ukrainians here say they’ve had it and are ready to go bear-hunting. If they could just equip themselves....Ukrainians mounted their revolution because they wanted to be more like the West, so it frustrates them that the West hasn’t returned the love. Europe fears that sanctioning Russia would hurt business, and even the Obama administration has been cautious and has resisted providing military assistance (except for military meals). The Ukrainians have a point. A bear is charging them, and we offer spaghetti?" Nicholas Kristof in The New York Times.

WEISSMANN: The big secret about Washington's student-loan profits. "This week, the Congressional Budget Office projected that the federal government would earn roughly $127 billion from student lending during the next 10 years....I noticed something intriguing about those fat-sounding profits: Most of them don’t come from undergraduate lending. The Department of Education is really making its killing by loaning money to grad students....As the feds don’t charge utterly usurious interest rates -- and if they were, the private sector would likely step in and siphon off more customers -- then making a profit on lending to MBA students and their ilk doesn’t strike me as fundamentally wrong....There is a question, however, about what to do with these profits." Jordan Weissmann in Slate.

SAMUELSON: Give us back our statistical data. "In this age of Big Data, the Obama administration seems determined to make it hard for average Americans to get little data. Recall that in 2011, the Census Bureau decided to eliminate 'The Statistical Abstract of the United States,' first published in 1878. This was the nation’s best compilation of figures on hundreds of topics, ranging from birth rates to forest fires to wage rates to voting patterns. The Census Bureau said that it couldn’t afford the Stat Abstract (the savings were trivial, about $3 million) and that most figures were online. True. But this doesn’t mean that people can get them easily. You have to know where online to go....Overcoming these problems often requires a large investment of time and much frustration." Robert J. Samuelson in The Washington Post.

JOHNSON: The end of our financial illusions. "Before September 2008 -- or at least before 2007, when some of the underlying problems first became more clearly manifest -- the prevailing consensus among officials and specialists was that financial innovation was a good thing. In isolated instances, a particular new product might not work out as planned, as happens, for example, with medical innovation. But over all, the consensus went, financial innovation led by the private sector was making the system safer and more efficient. This view was wrong. In its day, this line of thinking justified the legal and regulatory changes that allowed some banks to become very large and to build up a much more complex range of activities in the 1990s and early 2000s, including through various kinds of opaque derivatives transactions." Simon Johnson in The New York Times.

VINIK: Signs that Yellen has sights set on long-term unemployed. "On one side are conservative economists who worry that inflation is lurking in the near future....Once wages start to pick up even a little bit, they’ll lobby for tighter monetary policy. If that happened, the best-case scenario would be to choke off wage growth, something American workers very much need. The worst case would be to cut off employment opportunities for the long-term unemployed. If Yellen’s speeches are indicative of the Fed’s policy strategy, she’s not about to let that happen." Danny Vinik in The New Republic.

MULLIGAN: Stealth taxes in health law are still income taxes. "Is it possible that, in writing the health care reform bill, America discovered a radical new way of financing public health coverage expansions without significantly burdening its labor market with taxes? Have the decades of high Western European payroll tax rates been unnecessary for governments to provide medical coverage for their nonelderly citizens? The answers are no. The health overhaul contains a variety of hidden taxes -- provisions that politicians and journalists do not call taxes, but nonetheless are the economic equivalent of taxes -- that in combination have a lot in common with the payroll taxes that Europeans use to pay for their public medical programs." Casey B. Mulligan in The New York Times.

TOMASKY: How to win the war on inequality. "So Republicans are going populist, or at least two of them are, reports The Daily Beast’s Patricia Murphy. And perhaps it’s only in the sense that unlike Mitt Romney and many in the House GOP, they’re not speaking of working people with contempt. Well, it’s a start. But I wish they’d pick up copies of Thomas Piketty’s Capital in the Twenty-First Century....If you’ve not heard of Piketty or Capital, it’s certainly the economic book of the year, and probably of the decade so far....What Piketty has done, my economist friends tell me, is nothing short of revolutionary and deserves to change the way we think about wealth and inequality. Much more important, it also deserves to alter what we do about them." Michael Tomasky in The Daily Beast.

Daredevil interlude: Gutsy downhill biking caught on camera.

2. Don't look for the Fed to let up the gas just yet

The economic recovery could be nearly complete in two years, Yellen says. "In her first monetary policy speech as Federal Reserve chair, Janet Yellen said Wednesday that the nation’s economic recovery will be nearly complete within two years, but cautioned that the economy still needs the central bank’s support. The Fed’s own forecasts project that the unemployment rate will bottom out and inflation will pick up by the end of 2016, marking the first time in nearly a decade that the economy is running close to full steam. Still, Yellen noted those predictions are far from certain and argued that the Fed should remain flexible if conditions change." Ylan Q. Mui in The Washington Post.

Primary source: Yellen's prepared remarks.

Explainer: Yellen's handy dashboard for tracking the economy. Ylan Q. Mui in The Washington Post.

Background reading: Yellen on what the Fed is doing to support the economy.

Well, so much for six months. "Six months may be history. Federal Reserve Chair Janet Yellen, in her speech today, emphasized that the central bank is maintaining maximum flexibility on monetary policy and moving away from schedules for raising the benchmark interest rate....To economist Ward McCarthy, the comments represent another effort to walk back comments Yellen made in her debut press conference as Fed chair on March 19, when she said the central bank’s benchmark interest rate may rise about six months after it stops buying bonds." Chris Wellisz and Jeanna Smialek in Bloomberg.

Inflation could lag the recovery, Yellen says. "Even a recovering US economy may not pull inflation back up towards the Federal Reserve’s 2 per cent target, Janet Yellen has said, in remarks that raise the possibility of easy monetary policy for longer than currently expected. In a speech to the Economic Club of New York on Wednesday, the chairwoman of the Fed said that high levels of unemployment had put less downward pressure on inflation than expected, so higher employment might not pull prices up again." Robin Harding in The Financial Times.

But maybe the labor market is close to recovering in some cities? "Companies across the U.S. from Texas to Virginia and Nebraska are struggling to fill positions with metropolitan jobless rates below the 5.2 percent to 5.6 percent level the Federal Reserve regards as full employment nationally. Competition for workers is prompting businesses to raise wages, increase hours for current employees, add benefits and recruit from other regions....Forty-nine, or 13 percent, of the 372 metro areas reported jobless rates below 5 percent that month, the most for February since 2008, two months after the start of the recession." Steve Matthews in Bloomberg.

And wage gains are outpacing inflation. "While rising inflation is a sign that the economy is improving, it does eat into those wage gains people are expecting. That lowers consumer spending, which accounts for around 70 percent of U.S. economic activity. Still, as long as wages are increasing faster than inflation, those gains are real -- and it means more money will flow into consumers’ pockets." Matthew Philips in Bloomberg Businessweek.

Clearly, Yellen isn't on Team Krueger when it comes to inflation, unemployed. "Mr. Krueger has argued that the long-term unemployed -- those out of work for more than six months -- are on the margins of the labor force, and that the short-term unemployment rate is a better way to predict wage growth and inflation. Ms. Yellen, on the other hand, has pointed to the large number of Americans out of work for more than six months as a sign of slack in the labor market. She said in a March 31 speech that as the economy improves, more of the long-term unemployed should be able to find jobs." Ben Leubsdorf in The Wall Street Journal.

What Yellen didn't discuss may be just as interesting as what she did discuss. "Clearly the FOMC has increasingly worried about financial stability repercussions of asset purchases and low rates. Yellen herself has referred to the potential problems associated with a low term premium, but she has also long held a view that macroprudential measures were more appropriate than monetary policy for mitigating bubbles. In this speech, financial stability concerns weren’t raised at all." Cardiff Garcia in The Financial Times. 

Another thing Yellen didn't mention: The effects of the Fed's actions on other countries. Jamila Trindle in Foreign Policy.

Meanwhile, the Fed saw growth continue as the nation's winter freeze subsided. "Eight of 12 Fed districts characterized growth as 'modest or moderate,' the Fed said today in its Beige Book business survey, based on reports gathered before April 7. Economic growth in Chicago 'picked up' while New York and Philadelphia saw a rebound from weather-related slowdowns, the report said. The Cleveland and St. Louis districts reported declines. The Beige Book gives the Federal Open Market Committee anecdotal information about the state of the economy before it meets April 29-30 to discuss monetary policy." Aki Ito in Bloomberg.

Primary source: The new Beige Book survey.

Other economic reads:

Yellen pegs Europe's struggles to weak banks. Victoria McGrane in The Wall Street Journal.

Some exempted from minimum wage, increased or not. Alan Fram in the Associated Press.

Explainer: Obama's new jobs-training initiative represents a drop in the bucket. Matthew Yglesias in Vox.

Recession's lingering scars could include lower labor-force participation rate. Ben Leubsdorf in The Wall Street Journal.

Golf interlude: If mini-golf were broadcast like the Masters.

3. Obama is in a bind on Russia sanctions

U.S. has low expectations ahead of its meetings with Russia, Ukraine. "The Obama administration signaled little optimism ahead of diplomatic meetings Thursday with Russia and Ukraine over the escalating conflict in Eastern Europe and prepared to enact new economic sanctions designed to punish Moscow. Secretary of State John F. Kerry arrived in Geneva on Wednesday for direct talks with his counterparts, kicking off another round of high-level engagement by U.S. officials aimed at pressuring Russian President Vladi­mir Putin to reduce tensions in the region." David Nakamura and Karen DeYoung in The Washington Post.

Why the administration is being cautious about stating its intentions publicly. "As pro-Russian protests spread through Ukrainian cities, reporters asked press secretary Jay Carney more than 30 questions related to Russia. On Tuesday, when Ukraine began mobilizing troops to quell unrest, Carney fielded 30 more....Unsurprisingly, Carney did not provide concrete answers to many of them. But the verbal maneuvering doesn't necessarily mean the White House is purposefully hiding its strategy. The lack of answers may signal that, right now, the Obama administration can't predict Putin's next move with any certainty. Carney did hint to reporters Wednesday that the White House has prepared new sanctions, but he didn't say when those might be imposed." Marina Koren in National Journal.

Explainers on why moving forward with sanctions is easier said than done:

5 reasons Obama isn't pushing additional Russia sanctions quicker. Matthew Philips in Bloomberg Businessweek.

Video: 3 reasons Obama is holding off on imposing more sanctions. Gerald Seib in The Wall Street Journal.

A key impediment: The EU is hesitant. "The European Union has intensified its planning for broad economic sanctions against Moscow, as pro-Russian militants occupied government buildings in the Russian-speaking eastern half of Ukraine, sparking clashes with Ukrainian security forces. Western officials blame Moscow for supporting the militants and destabilizing eastern Ukraine....But it is unclear whether the EU is ready to impose broader sanctions that could bruise the bloc's still-wobbly economy." Matthew Dalton and Laurence Norman in The Wall Street Journal.

Russia could sue the U.S. in the World Trade Organization over the sanctions. "Russia is looking at the possibility of filing a lawsuit against the United States in the World Trade Organisation over sanctions hitting Russian banks, Economy Minister Alexei Ulyukayev said on Wednesday, according to Russian news agencies." Reuters.

How the crisis is echoing through the U.S. Farm Belt. "America’s diplomats and generals aren’t alone in watching the unfolding conflict between Russia and neighboring Ukraine. The U.S. agriculture sector is following the faraway events closely for reasons of both opportunity and risk. From rising global commodity prices to potential supply disruptions, there’s a lot at stake in the conflict for American farmers and producers. Ukraine is the world’s third-largest corn exporter and sixth-largest wheat exporter. Russia is the world’s fifth-biggest wheat exporter -- and a large buyer of U.S. corn and poultry products." Kevin G. Hall in the Miami Herald.

Other foreign policy reads:

U.S. working on non-lethal aid for Ukraine. Julie Pace and Lara Jakes in the Associated Press.

Obama aims to reinvigorate Asia strategy. David Nakamura in The Washington Post.

Rapping interlude: Rapping to teach girl how to use a cast.

4. Is President Obama really the 'deporter in chief'?

Yes, and no: He's deported the most foreigners ever, but new cases declining. "New deportation cases brought by the Obama administration in the nation’s immigration courts have been declining steadily since 2009, and judges have increasingly ruled against deportations, leading to a 43 percent drop in the number of deportations through the courts in the last five years, according to Justice Department statistics released on Wednesday. The figures show that the administration opened 26 percent fewer deportation cases in the courts last year than in 2009. In 2013, immigration judges ordered deportations in 105,064 cases nationwide. The statistics present a different picture of President Obama’s enforcement policies than the one painted by many immigrant advocates, who have assailed the president as the 'deporter in chief' and accused him of rushing to reach a record of two million deportations." Julia Preston in The New York Times.

Immigration activists aren't happy. They want more action from the president. "Latinos and immigration activists are warning of political peril for President Barack Obama and Democrats in the fall election unless the president acts boldly and soon to curb deportations and allow more immigrants to remain legally in the U.S....With House Republicans unlikely to act on an overhaul, executive action by Obama is increasingly the activists' only hope....Activists credit their sit-ins and hunger strikes for Obama directing new Homeland Security Secretary Jeh Johnson to review the administration's deportations policy and suggest ways to make it more humane." Erica Werner in the Associated Press.

This Obama-GOP spat won't help immigration reform's chances. "A day after meeting with immigration advocates, Mr. Obama released a statement critical of House Republicans, saying that they 'have repeatedly failed' to fix the immigration system. He urged them to pass a bipartisan Senate bill introduced a year ago....After releasing the statement, Mr. Obama called Representative Eric Cantor of Virginia, the House majority leader, to talk about immigration. The call evidently did not go well....'You do not attack the very people you hope to engage in a serious dialogue.' Mr. Cantor said the Senate bill 'will not be considered in the House' and urged Mr. Obama to move on to 'other issues where we can find common ground,' a reflection of the divisions within his own Republican caucus on immigration and the party leadership’s inability to forge a consensus." Emmarie Huetteman and Peter Baker in The New York Times.

Animals interlude: This cat is better than I am at skateboarding.

5. A year after failed background check vote, can Bloomberg be the anti-NRA?

Why Bloomberg shouldn't be the face of the new gun-control effort. "The problem with Bloomberg's active involvement -- beyond cutting the checks -- is that it gives conservatives a way to dismiss the effort as simply his latest attempt to regulate the lives of private citizens. (It also allows the NRA -- and other like-minded groups -- to use Bloomberg as a bogeyman in fundraising appeals to their members.) The more groups opposed to gun control are able to cast the effort to pass measures that would tighten said laws as the efforts of a New York City billionaire bent on telling you how to live your life, the less effective the effort will be....People don't like others telling them how to handle their business -- especially if that person is a billionaire New York City resident who wants to regulate things like sugar in soda." Chris Cillizza in The Washington Post.

What the former NYC mayor's effort entails. "The plans call for a restructuring of the gun control groups he funds, Mayors Against Illegal Guns and Moms Demand Action for Gun Sense in America. They will be brought under one new umbrella group called Everytown for Gun Safety. The strategy will focus not on sweeping federal restrictions to ban certain weapons, but instead will seek to expand the background check system for gun buyers both at the state and national levels. The $50 million could be significant: In recent years, the N.R.A. has spent only $20 million annually on political activities." Jeremy W. Peters in The New York Times.

But things aren't looking up for gun-control advocates, at least for now. "Senate Majority Leader Harry Reid, D-Nev., recently said he needs additional votes before revisiting a proposed expansion of gun sale background checks that the Senate derailed last April. That has left advocates of tighter gun curbs hoping Reid will allow votes on more modest proposals....But with Reid wary of exposing Democratic senators facing tight re-election contests in some conservative and Western states to politically risky votes -- and the Republican-run House showing no appetite to restrict guns anyway -- people aren't holding their breath waiting for proposed gun restrictions to reach the Senate floor before Election Day." Alan Fram in the Associated Press.

Explainer: Takeaways from the newly announced effort. Alec MacGillis in The New Republic.

World's toughest job interlude: Just watch all the way through and you'll see.

Wonkblog roundup

New York court guts a groundbreaking health-care fund that would have changed taxi drivers’ lives. Lydia DePillis.

Obamacare’s special enrollment period could help youth signups. Jason Millman.

Operation Choke Point: The battle over financial data between the government and banks. Danielle Douglas.

Can Michael Bloomberg really build a gun-control lobby bigger than the NRA? Emily Badger.

Yellen: The recovery could be nearly complete within two years. Ylan Q. Mui.

Your brain is over the hill by age 24. Christopher Ingraham.

States embracing Obamacare are doing a better job of covering the uninsured, surveys show. Jason Millman.

Price transparency stinks in health care. Here’s how the industry wants to change that. Jason Millman.

Et Cetera

FTC gains control of cybersecurity measures after Wyndham Hotels case. Paul Rosenzweig in The New Republic.

College Board releases preview of SAT exam questions. Nick Anderson in The Washington Post.

Has Social Security disability enrollment hit a plateau? Damian Paletta and Josh Zumbrun in The Wall Street Journal.

Clean energy investment up 9 pct. from a year ago. Alex Morales in Bloomberg.

Got tips, additions, or comments? E-mail us.

Wonkbook is produced with help from Michelle Williams and Ryan McCarthy.

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Lydia DePillis · April 16, 2014