This Startup Brews Beer with Surplus Bread. Here’s Why.

Originally published by MACH on February 22, 2018. Written by Denise Chow. 

If you’re passionate about craft brews and green living, how about raising a glass of beer made from leftover bread?

Toast Ale launched in the U.K. in 2015 in part to help bakeries recycle bread that otherwise would have been wasted — and to help raise public awareness about wasted food.

Food waste is one of the most important environmental issues of our time,” says Joanna Ehrenreich, Toast Ale’s head of operations in New York City, where the company set up shop last July. “We want to win over the hearts and minds of people who might otherwise not really pay attention to food waste. I’m very motivated by that.”

 Toast uses surplus bread to brew their beers. (Chris Montgomery/Toast) Chris Montgomery

One-third of all food produced in the U.S. goes to waste, according to the U.S. Environmental Protection Agency. And the same proportion of bread baked in the U.S. goes uneaten, according to Ehrenreich. Wasted food typically winds up in landfills, where it rots and releases large amounts of methane—a potent greenhouse gas that contributes to global warming.

But can a small company like Toast Ale really make a difference? Emily Broad Leib, director of the Food Law and Policy Clinic at Harvard Law School in Cambridge, Massachusetts, certainly thinks so.

“Grain products such as bread are some of the most commonly wasted food products in both the U.S. and the U.K.,” Broad Leib told NBC News MACH in an email. “Business models that find new uses for surplus bread therefore have significant potential to help reduce the amount of food that is wasted.”


Darby Hoover, a senior resource specialist in the food and agriculture program at the Natural Resources Defense Council, a nonprofit environmental advocacy organization in New York City, echoed Broad Leib’s assessment. “We love to see companies actively repurposing what would have been wasted food and turning them into useful products,” she said, adding that Toast Ale is a good example of a viable food recovery initiative.

Such initiatives are increasingly popular. Many supermarkets now repurpose misshapen or otherwise imperfect produce that traditionally has been wasted, for example, and some restaurants build dishes around ingredients, such as beet greens, that are commonly cut off and thrown away.

Toast Ale partners with specific bakeries to get surplus bread. In New York City, the leftover bread comes from a family-owned organic bakery, Ehrenreich said. The company’s brewing process is similar to that used to brew conventional beer — only it substitutes bread for one-third of the barley used in brewing. And Ehrenreich says Toast Ale’s beers taste similar to their conventionally brewed counterparts.

In the U.S., Toast Ale beer is sold in New York City and Long Island and can be purchased online, with profits donated to charities and local food organizations that work to curb food waste, the company says. But Toast Ale has also shared its recipe online so home brewers can join the fight against food waste. As Ehrenreich puts it, “We want to inspire a movement worldwide.” 


Missed our Food Recovery Entrepreneurs Webinar Series? Watch them all here!

We are excited to share all of the webinars from our Food Recovery Entrepreneurs webinar series, which addressed some of the most pressing issues and ideas in the food recovery space, including policy, behavior change, strategic partnerships, farm surplus management, and technology. This webinar series was hosted by the Food Law and Policy Clinic of Harvard Law School (FLPC) and the Food Recovery Entrepreneurs Workshop Steering Committee, which was founded after the 2016 Food Recovery Entrepreneurs Workshop, and is made up of the following members:

These webinars feature engaging speakers from a variety of innovative food recovery organizations, valuable insights into strategies developed, lessons learned, and partnerships formed.

Watch (or re-watch) the webinars.

Keep an eye out for more news about this year’s Innovators Workshop!

Health Care Largely ‘Wins’ in Latest Budget Deal, Analysts, Medical Societies Say

Originally published by Healio on February 12, 2018. Written by Janel Miller.

Health care policy analysts and medical societies are applauding the budget agreement signed last week by President Donald Trump, citing financial support in several critical areas.

“The recent compromise budget bill is largely a win for physicians and health care more broadly,” Philip A. Verhoef, PhD, MD, FAAP, FACP, assistant professor of medicine and pediatrics, University of Chicago, told Healio Family Medicine.

The plan provides the Childrens’ Health Insurance Program, or CHIP, with a total of 10 years of funding, which is 5 years longer than a previous agreement; NIH with $1 billion in funding each year for the next 2 years; states with funding to combat the opioid crisis, renovate and expand Veterans’ Administration hospitals and clinics; and 2 years of funding for community health centers and National Health Service Corps Program funding for 2 years, according to Verhoef.

Another health care policy expert agreed that the bill, which received bipartisan support, is a meaningful one.

“Tucked into the continuing resolution is the most significant piece of health care legislation to pass since the 21st Century Cures Act was enacted in December 2016,” Pari Mody, associate of Arnold & Porter Kaye Scholer LLP, told Healio Family Medicine. “The bill includes several changes that will impact health care providers, including many that providers should count as wins.”

She said this includes the retroactive, 2-year delay of the Medicaid disproportionate share hospital payment reduction that went into effect at the end of September, the aforementioned CHIP funding extension, and many more components.

“The [continuing resolution] also includes purported technical changes to the Quality Payment Program, which were backed by physician associations. Significantly, beginning in 2019, this section makes clear that the Merit-based Incentive Payment (MIPS) score adjustment is limited to ‘covered professional services,’ and excludes Part B drug payments,” she said in the interview. “Other wins in the bill include a temporary, transitional payment system for home infusion therapy services, expansion of telehealth under the Medicare program, funding for community health centers, and permanent repeal of the Medicare therapy cap.”

Both Verhoef and Mody had several caveats regarding the bill.

“Although there is a lot for providers to be happy about … it’s not all good news,” Mody said. “[The resolution] decreases the Medicare Physician Fee Schedule conversion factor for 2019 and reduces funding to the Prevention and Public Health Fund, which was established under the Affordable Care Act to provide sustained, mandatory public health funding.”

Robert Greenwald, JD, clinical professor of law and faculty director of the Center for Health Law and Policy Innovation at Harvard Law School, told Healio Family Medicine, “Now that an agreement has been reached, certain vital health programs are safe for the time being. The Children’s Health Insurance Program, which covers over 9 million children, is funded until 2027 and Community Health Centers, which serve the health needs of our nation’s most vulnerable, are funded for the next two years. Going forward, we must continue to prioritize programs that promote and secure the health of U.S individuals and families.”


Read the rest of the article at


What Medicaid Work Requirements Might Mean for People With HIV

Originally published by The Body on February 8, 2018. Written by Tim Murphy.

Have you heard that the Trump administration has told states to go ahead and request approval to add work requirements to Medicaid coverage? And that Indiana and Kentucky have already received approval from the feds to do so?

Meanwhile, Utah, Arizona, Kansas, Arkansas, Wisconsin, North Carolina, New Hampshire, and Maine are awaiting their approvals, while Alabama, Idaho, and South Dakota are considering putting in waivers for approval.

Yep. Welcome to Medicaid in the Trump/GOP era, when the goal of the federal government is not to extend program coverage to as many people as possible — as it was under Obama, whose Affordable Care Act urged states to dramatically expand income eligibility requirements for the program — but to deny it from as many as possible.

Case in point: Indiana’s been allowed to kick people off Medicaid for three months if they don’t file their paperwork on time. And it’s not the only state seeking the ability to do stuff like that. The administrator of the Centers for Medicaid & Medicare Services (CMS) under Trump, Seema Verma, was the architect of Kentucky’s waiver application, as well as Indiana’s Medicaid policy, initiated under former governor, now vice president, Mike Pence.

But before HIV-positive folks on Medicaid panic too much, let’s note a few things. First, most people on Medicaid either already do work or are disabled, and even the not-so-compassionate Trump administration directs states to exempt from the work requirement Medicaid recipients who are “medically frail,” although that term is not defined.

“We would like [the Trump administration] to be clear that ‘medically frail’ always includes people with HIV and hepatitis,” says Carl Schmid, deputy executive director for the national advocacy group The AIDS Institute.

Second, some states, including Kentucky and Indiana, fortunately include HIV in their definition of “medical frailty.” So, if you are an HIV-positive resident of one of these states and truly cannot work because of physical or mental illness, you’re not going to be automatically kicked off your Medicaid because of it.

Third, the administration guides states to exempt pregnant women, those with mental health and substance issues including opioid addiction, primary caregivers of dependents, full-time students, and some other groups from the work requirement.

Nonetheless, notes Phil Waters at Harvard Law’s Center for Health Law and Policy Innovation, “Even if people living with HIV are formally exempt from the requirement, the complexity involved with tracking and administering an exemption almost guarantees mistakes will be made and folks will end up punished.”

In late January, 15 Medicaid recipients in Kentucky filed suit against the work requirement, saying that it violates federal laws, such as the Administrative Procedure Act, as well as the constitutional requirement that presidents “take care that the laws be faithfully executed.”

Said MaryBeth Musumeci, who tracks Medicaid for the Kaiser Family Foundation, “Everyone will be closely watching this litigation.”

Also, in late January, dozens of AIDS organizations around the country (under the umbrella of the Federal AIDS Policy Partnership) sent the Trump administration a letter opposing Medicaid work requirements.

“The Medicaid program is a critical source of health coverage for life-saving care and treatment for people living with HIV,” the letter read. “More than 40% of people living with HIV in care count on the Medicaid program for treatment that keeps them healthy and productive. Ensuring uninterrupted access to effective HIV care and treatment is important both to the health of people living with HIV and to public health.”

“When HIV is effectively managed,” the letter continues, “the risk of transmitting the virus drops to near zero. This guidance from CMS encouraging states to condition receipt of medically necessary care on satisfying a work requirement threatens to reverse the progress we have made in providing early access to prevention, care, and treatment to people living with HIV.”

In states that have requested the feds for a Medicaid work requirement, HIV/AIDS advocates are nervous. “We’re one of the states that didn’t fully expand Medicaid under Obamacare, so we already have limited services,” says Stan Penfold, executive director of the Utah AIDS Foundation. Utah, he said, already has a rule providing that those who don’t recertify for Medicaid annually within 30 days get temporarily thrown off the program. Plus, he says, the state’s very narrow Medicaid expansion doesn’t cover single, childless men — which often includes gay men, the group with the highest HIV rates.

“What’s most alarming to me,” says Bill Keeton of the AIDS Resource Center of Wisconsin, “is that we’ve done a good job here from a cost perspective. We’ve saved more than $4 million a year because we make sure our HIV-positive Medicaid patients get comprehensive care. Ninety percent of our patients are achieving viral suppression. Now, you’re going to throw that programming into limbo by creating six-month gaps in eligibility for folks struggling to find jobs? They’re going to get sick, and costs are going to go up. They’re going to go on ADAP” — the AIDS Drug Assistance Program, the federal/state health payer of last resort for people with HIV/AIDS –“and all you’ve done is shift costs back from one program to another.”

Work requirements and enrollment lockouts are part of a pattern by many states — now encouraged by the Trump administration — to find ways of making it harder for people to stay on Medicaid. Kentucky, for example, is among several states allowed to charge Medicaid recipients a modest monthly premium. It was just allowed to raise that premium to 4% of one’s income — the highest bump ever approved by the feds. That means that someone whose monthly income is about $1400 could end up paying $40 a month for Medicaid. And failure to pay triggers being kicked off the program for up to six months. Indiana Medicaid recipients also pay a premium for coverage.

If you’re an HIV-positive Medicaid recipient in a state requesting work or other restrictive waivers, what can you do? Start by reaching out to your local AIDS or health advocacy organization to see whether there’s a grassroots effort to get your state to undo — or at least to soften the terms of — the request. But what if there isn’t? Then, consider starting one yourself. All it takes is a concentrated flow of visits, calls, and even tweets to your state Medicaid office — or to elected state officials with clout. Help them understand the ways in which such seemingly modest cuts could severely hurt the state’s overall public health.

In Indiana, for example, last year, 25,000 people lost Medicaid coverage due to a failure to pay their premium. That’s a lot of people in one state suddenly without health care.

Introducing new logos for CHLPI, HLPC, & FLPC

Notice anything different at

 Today we have launched new logos for the Center for Health Law and Policy Innovation (CHLPI) of Harvard Law School and its two clinics – the Food Law and Policy Clinic (FLPC) and the Health Law and Policy Clinic (HLPC). We believe the new coordinated looks represent who we are: leaders and innovators in the space of health and food law and policy, both individually and collectively. Check out our new logos below!



Amazon, Berkshire Hathaway, JPMorgan Chase to Form New Health Care Company for Employees

Originally published by on January 30, 2018. Written by Andy Polhamus.

Amazon, along with Berkshire Hathaway and JPMorgan Chase, will form an independent health care company for their employees in the United States, the three companies have announced. In an announcement short on specific details but long on ambitious goals geared toward reducing employee health care costs, leaders described the new venture as “free from profit-making incentives and constraints.”

“The ballooning costs of health care act as a hungry tapeworm on the American economy. Our group does not come to this problem with answers. But we also do not accept it as inevitable,” Warren Buffett, Berkshire Hathaway Chairman and CEO, said in a press release. “Rather, we share the belief that putting our collective resources behind the country’s best talent can, in time, check the rise in health costs while concurrently enhancing patient satisfaction and outcomes.”

The new company, the name of which has not yet been announced, will promote “technology solutions” to provide employees of Amazon, Berkshire Hathaway and JPMorgan Chase who live in the U.S. with “simplified, high-quality and transparent health care at a reasonable cost,” per the press release.

“The health care system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” Jeff Bezos, Amazon’s founder and CEO, said in the announcement. “Hard as it might be, reducing health care’s burden on the economy while improving outcomes for employees and their families would be worth the effort. Success is going to require talented experts, a beginner’s mind, and a long-term orientation.”

Details about the new company’s management and operations are still forthcoming.

It was not immediately clear what changes the partnership could bring to the industry. However, Jamie Dimon, chairman and CEO of JPMorgan Chase, hinted in a statement that coverage might eventually extend beyond patients employed by the three founding businesses. “Our people want transparency, knowledge and control when it comes to managing their health care,” Dimon said in the prepared statement. “The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans.”

Changing the outlook on U.S. health care

In a statement emailed to, Robert Greenwald, faculty director of the Center for Health Law and Policy Innovation and professor at Harvard Law School, said the venture pointed to a systemic issue with American health care.

“We have failed as a nation to produce a health care delivery system that affords comprehensive health coverage to everybody, Greenwald wrote. “Seeing the increased need to take action due to recent efforts to sabotage the health care system, these companies have stepped up to cut costs and hopefully provide better care to their employees.”

Greenwald also questioned how much the private sector should influence health care.

“While these companies are moving forward with a progressive and well-intended idea, other businesses often make decisions that put profits over people,” he said.

Memo Diriker, PhD, MBA, DBA, Director of the Business, Economic, and Community Outreach Network (BEACON), Franklin P. Perdue School of Business at Salisbury University, pointed out that the U.S. is the only industrialized country to rely heavily on for-profit medical insurance.

“The proposed company does not have a profit motive. That alone is a game changer,” he said. “In addition, since the founding principle of the proposed company is to reduce costs, the impact on overall health care costs is bound to be positive. Finally, if this initiative leads to price competition in the broader health insurance market, consumers win.”

Further, Diriker added, a model that is not profit-based could change the relationship between insurance companies and clinicians. “Health care providers have a very difficult relationship with insurance companies,” he said. “Frequently, they may find that they have different objectives when it comes to what happens with a patient’s care plan. If the proposed company does not have a profit motive, and if the objective is funding evidence-based high reliability care, this too will be a game changer.”

As for whether the idea would spread to other large companies, he said, “it all depends on how this initiative fares in the marketplace. “If costs indeed come down, the floodgates could open.”