Obamacare Wrinkle: Bill Seeks to Reduce State's Seizure of Medi-Cal Recipients' Assets

California politicians and federal bureaucrats are scrambling to iron out an unexpected wrinkle in the nation’s health care law that is forcing many Americans to choose between health coverage and depriving heirs of much of their inheritance.

By TRACY SEIPEL

California politicians and federal bureaucrats are scrambling to iron out an unexpected wrinkle in the nation’s health care law that is forcing many Americans to choose between health coverage and depriving heirs of much of their inheritance.

California is one of 10 states that recover a broad array of costs from recipients of Medicaid, the health program for the poor that is called Medi-Cal in California. The policy applies to recipients 55 and older — and only after they die.

The seizure of assets has been going on for years but has suddenly become a heated issue since millions of low-income American adults began enrolling in the expanded Medicaid program created by the Affordable Care Act, commonly known as “Obamacare.”

A bill in the California Legislature is aimed at reducing the amount of assets that can be “recovered” from recipients’ estates. But the proposal faces resistance from the administration of Gov. Jerry Brown, which says the state needs the millions of dollars it collects every year to help fund Medi-Cal.

The federal government, concerned that the issue is deterring many from signing up for Medicaid, is essentially telling states to back off and stop trying to recover much of the money.

In contrast to traditional Medicaid beneficiaries — low-income parents, children, seniors and people with disabilities — the new group includes adults without minor children. Many of them are homeowners who have been laid off or are unemployed and are now getting by on dwindling savings. They are eligible for Medicaid if they earn up to 138% of the federal poverty level, which in 2013 was $15,856 for an individual or $21,403 for a couple.

One of the Medi-Cal recipients is Campbell resident Anne-Louise Vernon, 59. She contends that California’s aggressive cost-recovery program is unjust because people whose higher income levels allow them to get subsidized private health insurance through the new Obamacare health care exchanges don’t have to pay back anything.

Vernon said she requires constant medical care because of severe nerve damage in her arms and arthritis in her legs –conditions that have prevented her from finding a job. The divorced mother of two said her home is her only real asset.

Medi-Cal, she said, has now essentially imposed a “reverse mortgage” on her home in exchange for health insurance.

“What is fair about that?” asked Vernon.

When Medicaid was signed into law by President Lyndon Johnson in 1965, “asset recovery” was optional. In 1993, however, the federal government began requiring all states to recoup the expenses of long-term care for Medicaid recipients ages 55 or older. States were given the option to recover all other Medicaid costs for those recipients — and California jumped at the chance.

State finance and health officials this week declined to comment on the pending legislation. But in the past, they have insisted that the provision doesn’t affect the vast majority of Medi-Cal beneficiaries — and noted that the average recovery amount is about $15,000.

Still, Vernon and Richmond resident Chris Darling, 62, who also enrolled in the expanded Medi-Cal program, worry that their future medical costs will eat up their estates. Darling even started an online petition on MoveOn.org to fight the state’s asset grab.

“It strikes me as horrible to have to choose between having health protection and your estate,” said Darling, who called the situation “Orwellian.”

Now, Darling and Vernon are pinning their hopes on both state and federal efforts to curtail asset recovery efforts.

On Tuesday, a state Assembly health committee will take up proposed legislation that would limit Medi-Cal recovery only to what’s required under federal law: the cost of long-term care in nursing homes.

Authored by state Sen. Ed Hernandez, D-West Covina, SB 1124 has already sailed through two Senate committees.

Should it pass Tuesday and then get the blessing of the Assembly appropriations committee in mid-August, it would be voted on by the Legislature by the end of August. Brown would have until the end of September to decide whether to sign it.

“I don’t know of any other program that demands repayment after a recipient dies,” said Hernandez, who chairs the Senate’s health committee. “We don’t do it for Medicare. We don’t do it for people getting coverage through the (Covered California health care) exchange, and most other states don’t require estate recovery. People are really frightened about this policy.”

In a Feb. 21 memo, the federal Centers for Medicare & Medicaid advised states to eliminate recovery of Medicaid benefits beyond long-term care services for the newest group of low-income adults Medicaid recipients, whose health care costs are being paid 100% by the federal government. That will be reduced to 90% in 2020.

Oregon and Washington have already eased off on their recovery efforts. Brown’s budget advisers, however, are urging him to oppose Hernandez’s legislation. An analysis by the state’s finance department says California would lose $15 million annually.

A Brown spokesman said the state won’t exempt the newest recipients from asset recovery because California has to prepare to cover the 10% of their Medi-Cal costs that the federal government won’t be picking up.

On average, the state in the last decade has collected about $60 million annually from Medi-Cal recipients’ estates. Half of that is returned to the U.S. Treasury because Medicaid is funded equally by the federal government and the states.

Considering that the state now spends more than $26 billion a year on Medi-Cal, Hernandez argues that $15 million is a negligible loss.

“I take my fiduciary responsibility to the state very seriously,” Hernandez said, but that’s “not a lot to spend to do away with a practice that unnecessarily scares needy people out of getting themselves covered.”

WHAT THE BILL WOULD DO

Limit seizure of assets of Medi-Cal recipients age 55 and older to amount spent on long-term care in nursing homes.

Eliminate asset seizure from estates of surviving spouses of deceased Medi-Cal recipients.

Require the state to provide Medi-Cal recipients, at no charge, a list of Medi-Cal expenses subject to “recovery.”

(Source: Office of State Sen. Ed Hernandez)

Article used by permission. Original article by Tracy Seipel appeared June 11 in the San Jose Mercury News.

US police seek motive after deadly LA airport shooting

US authorities sought a motive Saturday after a gunman armed with an assault rifle and a stock of ammunition opened fire at the Los Angeles International Airport, killing a federal official. The attack Friday, which injured seven other people, caused…

LA airport shootingUS police seek motive after deadly LA airport shooting (via AFP)

US authorities sought a motive Saturday after a gunman armed with an assault rifle and a stock of ammunition opened fire at the Los Angeles International Airport, killing a federal official. The attack Friday, which injured seven other people, caused…

Continue reading “US police seek motive after deadly LA airport shooting”

One dead in LA airport shooting: coroner

The shooting at Los Angeles International Airport on Friday killed one man, aged around 40 years old, the local coroner’s office said.

One dead in LA airport shooting: coroner
(via AFP)

The shooting at Los Angeles International Airport on Friday killed one man, aged around 40 years old, the local coroner’s office said. LA County Coroner’s Office spokesman Craig Harvey would not confirm reports that the man was a Transportation Security…

Continue reading “One dead in LA airport shooting: coroner”

How to Defuse the Gravity Bomb

The Morro Bay/Cayucos joint sewer system and the gravity system pegged for Los Osos incubate immune pathogens with a high mortality rate and no certain cure to date. Civil engineer/environmental scientist Dr. John Alexander offers to defuse Morro Bay and warns Los Osos.

The Morro Bay/Cayucos joint sewer system and the gravity system pegged for Los Osos incubate immune pathogens with a high mortality rate and no certain cure to date. Civil engineer/environmental scientist Dr. John Alexander offers to defuse Morro Bay and warns Los Osos.

Currently unrelated plans to upgrade the Morro Bay/Cayucos Wastewater Treatment Facility and to build a conventional wastewater facility out of town in Los Osos both share at least one characteristic in common, according to Dr. John Alexander of Alexander Research in Cayucos: They are both dangerous.
    
“The $25 million ‘upgrade’ to the (Morro Bay/Cayucos) sewer system is far too costly and will not solve the contamination problem,” Dr. Alexander said. “The consultants have not kept abreast of the changes with immunity of pathogens, and the mutation which takes place in the so-called secondary treatment of a standard treatment plant.
    
“The proposed (Morro Bay/Cayucos) program will have exactly the opposite effect of the intention,” he told The Rock. “It will be a breeding place for pathogens. Those pathogens are already creating pandemics resulting in 60%-70% mortality. Chlorine is just no longer adequate. For about $4 million, a physical chemical treatment could be added to the present plant. This would add at least 30% to the plant’s capacity and overcome the contamination problem.”
    
Dr. Alexander is glad to share information or data with consultants, and offers his help without charge.

Troubling Research
     
The Morro Bay/Cayucos plant, built in 1954 and upgraded in 1984, is one of only three in the entire state that doesn’t meet all required clean water standards. Under a waiver, it is permitted to dump partially treated sewage into the ocean north of Morro Rock. Environmental groups want state water regulators to cut in half the time projected (2015) to bring the plant up to federal standards for secondary treatment, yet Dr. Alexander warns that rushing to meet secondary treatment standards is “exactly the wrong thing.”
     
“Secondary treatment is the most deadly part of the whole situation, because when they mix the sewage we’re beginning to get [pathogens] that are not curable anymore, and secondary treatment is actually growing this bacteria. Not only is it incubating the bacteria that is already what you might call poisonous, but (that bacteria) is mutating over to the other bacteria. One family could contaminate thousands.”
    
For decades it was widely accepted that active offshore currents quickly diluted effluents, and that was the basis of the discharge waiver. That isn’t as true anymore. Now, also surviving release into the ocean are pathogens, including bacteria resistant to antibiotic drugs, that pass through the plant’s incomplete treatment process. According to a recently released report by John Alexander Research on “Drug Resistant Bacteria in Conventional Water Treatment Systems,” “Studies reported in the scientific and medial literature dating back to at least the 1970s show failure of treatment to kill or remove all pathogenic bacteria. Thus, this is hardly new knowledge.”
    
What is less known by the public is the extent of the problem, the increased threat to public health, its historical context, and the real potential for an outbreak. “Multiple drug-resistant bacteria are particularly problematic due to the decreasing number of therapeutic options,” the report warns, options that include the latest and most commonly effective “wonder drugs.” These cornerstone drugs of modern medical treatments, the report acknowledges, “seem to be in trouble.”
    
“A less understood and even more troubling mechanism for the transfer of multi-drug-resistant bacteria is also found at the local sewer treatment plant,” the report also states. “As bacteria wind their way through these treatment processes, the selective pressures against them increase. In consequence, there is a greater effort by bacteria to pass on survival-enhancing genetic information. Additionally, as the environmental stresses increase, the bacteria up-regulate numerous other survival mechanisms to assure that they and their genetic material survive. These survived mechanisms can include increased chlorine resistance.”
    
“The fact is,” said Dr. Alexander, “all the contaminated sewerage goes to one place, and then they do secondary treatment, which is doing nothing but incubating the bacteria so there are enough of them to grow the pathogens. This was a fairly reasonable (procedure) for many years, but unfortunately, bacteria and viruses have become immune to treatment. Our ‘wonder drugs’ just aren’t cutting it at all.
    
“At one time they had a natural life cycle, but these pathogens have developed an immunity because of our misuse of ‘wonder drugs.’ We now have bacteria and virus that can take a temperature of 450 degrees. The old 250 degree (standard) doesn’t mean anything anymore (in that particular set of species).”
    
Emphasizes the report: “The take-home message is that drug resistance and the transfer of multi-drug resistance among and between species occurs in wastewater treatment plants. This information is now over a decade old.”

The Gravity Menace
    
The expensive Tri-W gravity plant for Los Osos, approved by the RWQCB and other state regulatory agencies, but defeated by voters at the polls last September, is a potential menace in the making, in town or out, according to Dr. Alexander. “It doesn’t make any sense at all. The fact that they gather the waste from thousands of people and put it in one common ‘mixing ground.’ All you’ve got to do is have one family that has ‘the bug.’ They get mixed up with the rest of [the bacteria] between incubation and mutation, and one family could end up producing trillions of pathogens that are contaminated and without cure… Dilution doesn’t work anymore. These pathogens are surviving even in saltwater… And they can spread around the world.
    
“Either of the programs the RWQCB is demanding is more dangerous than the bomb,” Dr Alexander said. “In either case, (these systems) are breeding deadly pathogens that are already pandemic with high mortality.
    
“[The RWQCB] has absolutely no concern their one-track programs are totally obsolete in the modern world. It hinders the technology that will eliminate our water shortage and the energy shortage. They spend their time trying to kill a flea on an elephant… Now, the very system they’re developing is one of the biggest hazards in life.”
    
The RWQCB hadn’t taken much of an interest in pathogens until the revised, post-dated CDOs were received by selected Los Osos homeowners in early April, with pathogens added to nitrates and fill-in-the-blank “other” as pollutants for which individual home owners are now responsible for cleaning up—or face fine and liens and who knows what else.
    
But that hasn’t changed the RWQCB’s pursuit of a conventional sewer for Los Osos. Even though all that sewage into one big plant is a disaster waiting to happen, Dr. Alexander asserted, adding that there is no such thing as an earthquake-proof sewer treatment plant. An earthquake could rupture sewer lines and knock out power to the plant—and the public health impact could be devastating. “Additionally,” the report states, “if the sewer mains are leaking, this increases the potential risk for materials reaching the environment, aquifer, rivers, or beach and ocean.” And, in the post-9/11 world, it can’t be overlooked that with its capacity to disseminate pathogens near and far, a central sewer plant could be an easy target for terrorism, which is a tougher target with individual household units.
    
“The tendency now is to go b
ack to individual systems, so we don’t have this massive problem to treat. The individual system certainly could have an overflow, but one little overflow is nothing compared to what you will have if you have millions of gallons of raw sewage floating around.
    
“Certainly, the system they are using now [in Morro Bay], even without the MRSAs [methicillin-resistant staphloccus aureus, a virulent strain of common staph bacteria] and ecoli 157, are making lots of people sick because they’re only half treating it, and the pathogens are not being killed by chlorine.”

Progress Made
    
John Alexander Research is working with the Center for Disease Control in Atlanta to analyze various pathogens, discover their dissemination points and how they can be stopped. Alexander Research has developed a system called PH Pasturization, according to Dr. Alexander, which kills “identifiable” bacteria that have built up a resistance to even chlorine. They are also working on other promising approaches, including one that eliminates the water contained in the pathogens by “zapping the water and the water alone by using electro-magnetic energy.” He believes they are on the right track, but more conclusive proof is needed before scientists can claim success.
    
A broader, more frightening question lies in whether any of these pathogens can be found in our drinking water. Dr. Alexander doesn’t think so but can’t completely rule it out, since there is no conclusive proof today that as-yet-unidentified pathogens are not in the drinking water.
    
Dr. Alexander believes the public needs to pay closer attention to the pathogen problem and protest their concern to local and state officials who permit it. “It is despicable to let a handful of people, for personal gain, destroy the lives of thousands of people. It takes guts to fight city hall, but with so much at stake it is cowardly to give up,” he said. “Many Los Osos citizens think they have no choice and are willing to put up with the nonsense being pushed upon them. Thank goodness our forefathers had more intestinal fortitude.”

— Ed Ochs

Proposition 218: What Is It?

You have a right to vote. Use it or lose it—and pay dearly

You have a right to vote. Use it or lose it—and pay dearly

    Proposition 218 is the State’s “Right to Vote on Taxes Act,” passed into California law by voters in 1996. Prop 218 provides voters their Constitutional right to vote on whether or not they want to be taxed for a specific amount that will be added to their property tax bill.
    The law was created to protect taxpayers from local governments abusing their authority by taxing residents for public works projects without their consent. The County must comply with Proposition 218 procedures for notice, hearing, benefit analysis, and consent of the property owners.
    Voters in Los Osos need to know that the upcoming Prop 218 is the first vote (assessment) for the major part of the wastewater project, with other votes to come later. Per AB 2701, the County has until July ’08 to pass a 218, so there will still enough time for the County to conduct another homeowner 218 vote if this one fails. If this one passes, however, and those future Prop 218 votes fail, then the County can and will bill homeowners for special taxes in the form of rates and charges. Homeowners will have no say in the imposition of additional charges if this initial Prop 218 passes, as this first vote opens the floodgates and any additional costs can be passed on as rates and charges without homeowner approval.
    Voters not only have the right to vote on whether or not they want to be taxed, they also have the right to vote “No” on the Prop 218 ballot without fear of recriminations by the electioneering Regional Water Board and County, and without feeling coerced to vote “Yes” under duress from sledgehammer-type political pressure from vindictive government agencies.
    The Prop 218 “Right to Vote on Taxes Act” requires that everyone who benefits pays, not just a portion of the town. All residents in the basin use and benefit from clean water and clean bay, and must share the costs of a mega wastewater plant. Cleaning the water and the bay, correcting seawater intrusion, solving water resource and supply problems, all of which benefits the entire basin, is the primary responsibility of the State, to whom the waters belong, not the responsibility of current homeowners in the “Prohibition Zone.”

ARE YOU HAVING SEWER PROBLEMS???

You are not alone. You are just the latest victim of the State Water Board’s “Scam of the Century.” Read about the test case of tortured Los Osos and how other small towns up and down the coast are suffering from septic shock, as rogue Regional Water Boards statewide cry pollution without proof so they can replace working septic tanks with spill-prone, unnecessary and excessively expensive central sewers — and force a select group of homeowners to pay for it. Don’t be fooled. Open your eyes and learn the facts before you find yourself paying $500 a month to fix a “problem” that never really existed in the first place — or has been falsely and conveniently attributed to all septics. The whole story of the “Sewer Scam,” how it works and what’s happening today is so incredible that unless you start reading The ROCK right now it will be far, far too late to do anything about it in time.

Click on “Read Article” to access the vital information in these classic, indispensable articles, reports and expert interviews.

 

You are not alone. You are just the latest victim of the State Water Board’s “Scam of the Century.” Read about the test case of tortured Los Osos and how other small towns up and down the coast are suffering from septic shock, as rogue Regional Water Boards statewide cry pollution without proof so they can replace working septic tanks with spill-prone, unnecessary and excessively expensive central sewers — and force a select group of homeowners to pay for it.

Don’t be fooled. Open your eyes and learn the facts before you find yourself paying $500 a month to fix a “problem” that never really existed in the first place — or has been falsely and conveniently attributed to all septics.

The whole story of the “Sewer Scam,” how it works and what’s happening today is so incredible that unless you start reading The ROCK right now it will be far, far too late to do anything about it in time.

To access the vital information in these classic, indispensable articles, reports and expert interviews, simply click on the links from The ROCK ARCHIVES below.

You Are Not Alone! (Sept.-Oct. 2007)
The State Water Boards and the Fleecing of California (Sept.-Oct. 2007)
Dr. Alexander Rips RWQCB: ‘Where’s The Proof?’ (March-April 2006)
CDO Threat Inflicts Heavy Human Toll (July-Aug. 2007)
Retired Judge Goldin on the RWQCB: ‘Kangaroo Court’ (Feb.-March 2007)
Sewer Scam! (Sept.-Oct. 2007)
Well Schooled on the Sewer: An Engineering Student’s Eye-View (Sept.-Oct. 2007)
Proposition 218: What Is It? (Sept.-Oct. 2007)
Will PZ Residents Vote to Give The County a ‘Blank Check’? (Sept.-Oct. 2007)
‘The Prop 218 is Illegal,’ Top California Elections Attorney Says (Feb.-March 2008)
The Protest: The Timothy J. Morgan 218 Letter (Feb.-March 2008)
SOS From Afar: ‘There’s Something Bad Going On…’ (Feb.-March 2007)
Cracking the County’s 218 Code (May-June 2007)
Stickin’ It to the PZ (Feb.-March 2008)
The Rock Interview: Dr. Tom Ruehr (May-June 2007)
The Rock Interview: Dr. Dan Wickham (July-Aug. 2007)
Pio Lombardo: The Benefits of the Decentralized Option (Oct.-Nov. 2007)
How To Defuse The Gravity Bomb (May-June 2006)
Los Osos Welcomes World-Famous ‘Eco’ Designer Patricia Johanson (March-April 2006)
The Rock Report: The Invasion of the Town Snatchers (April-May 2008)
RWQCB Meets to Outlaw ‘Smart,’ Affordable Onsite Systems (April-May 2008)

Find these and other classics in THE ROCK ARCHIVES