Mid week update

Following up on Monday’s post, here is a link to the OPM website referenced in the Federal Times article which discusses the legal difficulties in accelerating the increase in the dependent child age limit from 22 to 26. It’s worth noting that effective January 1, 2011, the health care reform act (PPACA) not only increases the limiting age but overrides the FEHB Act’s provision that terminates coverage for a child under age 22 who marries.

Yesterday, the Internal Revenue Service issued Notice 2010-38 which discusses the PPACA provision that modifies the federal tax code (Internal Revenue Code Sections 105, 106) to ensure that the expanded dependent coverage will not create adverse income tax consequences for employees / parents.  Under current law, if employer coverage is extended to, for example, a domestic partner of an employee, the employer must impute the value of that coverage to the employee’s taxable income. Absent this tax law change, employers also would have found it necessary to impute the value of the adult dependent children coverage to the employee. The IRS confirms that “As a result of changes made by the recently enacted Affordable Care Act [or PPACA], health coverage provided for an employee’s children under 27 years of age is now generally tax-free to the employee, effective March 30, 2010.”  The IRS has a website dedicated to health care reform changes. We now await Health and Human Services guidance on PPACA’s dependent child coverage provision (Sec. 2714).

Enough PPACA for now, as you may know, I am enthralled with the long term prospects for personalized medicine. I therefore found interesting this San Francisco Chronicle article about an experiment which examined the genomes to twins — one who had contracted multiple sclerosis and the other who had not.
The study led by a UCSF neurologist took nine months to complete using some of the most advanced analysis equipment in the world, at a laboratory in Santa Fe, N.M. The results are published in Thursday’s issue of Nature.

Researcher Sergio Baranzini and his team couldn’t find a genetic trigger in the twin with multiple sclerosis, but that doesn’t mean it isn’t there, he said. Geneticists may just need to dig deeper, with even more advanced technology, or they may need to narrow their search.

Or, it’s possible that at least with this one pair of twins, genes weren’t what separated them – environmental factors may have caused one sibling to develop MS, Baranzini said.

“We did not find any genetic evidence that could explain why one individual developed a disease and not the other. In that regard, it’s a significant finding because no one has looked at this level of resolution before,” he said. “But I’m not surprised we didn’t find it. We may be looking for one cell in a million.”

The study isn’t just the first to fully analyze the genomes of a pair of twins, one of whom has MS, but it’s the first detailed genomic analysis of any pair of twins – period. It is also the first to analyze someone with an autoimmune disease.

That’s hope for the future.