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New eligibility rules mean nearly 2 million on Medi-Cal can now save for a rainy day

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New eligibility rules mean nearly 2 million on Medi-Cal can now save for a rainy day

Millions of Medi-Cal beneficiaries can now save for a rainy day, keep an inheritance, or hold on to a modest nest egg without losing coverage, thanks to an eligibility change phased in over the past year and a half.

The change also has opened the door for thousands who previously did not qualify for Medi-Cal, the health insurance program for low-income residents that covers over one-third of California’s population.

Until Jan. 1, 3 million Medi-Cal beneficiaries — mainly those who are aged, blind, disabled, in long-term care or in the federal Supplemental Security Income program — faced limits on the value of financial accounts and personal property they could hold and still qualify for coverage. Now, nearly 2 million of them will no longer face these restrictions, putting them on par with the roughly 12 million other Medi-Cal beneficiaries who don’t have asset limits.

They still must be below Medi-Cal’s income threshold, which for most enrollees is currently $1,677 a month for a single adult and $3,450 for a family of four. However, the change will eliminate a lot of paperwork for applicants and the county workers who verify their eligibility.

For a long time, this group of Medi-Cal beneficiaries could have no more than $2,000 in the bank — $3,000 for a married couple — though the home they lived in, as well as one car and certain types of other personal property, were exempt.

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“If you had $5,000 in assets, you would have to spend $3,000 on something to prove that you were beneath the limit to qualify,” said Tiffany Huyenh-Cho, a senior attorney at the advocacy group Justice in Aging. “We had people who prepaid rent, spent money on car repairs, bought a new couch or appliances — things to reduce their assets in order to get to the $2,000 limit.”

Now, Huyenh-Cho adds, “you don’t have to remain in deep poverty. You can save for an emergency; you can save for retirement or for a security deposit if you want to move.”

And those who have hoped to leave a little something for their children when they die can now do so, even if they need expensive long-term care.

The first phase of the rule change was implemented in July 2022, when the threshold was raised dramatically to $130,000 for an individual and $195,000 for a two-person household. That was a nonfactor for the vast majority of those concerned; after all, most people with incomes low enough to qualify for Medi-Cal would not have that much saved. For this reason, the total elimination of the so-called asset test ushered in this year is expected to help fewer people financially than the first change did.

Still, there are some people with more than $130,000 in the bank whose savings would have been wiped out in shockingly short order had they needed long-term care in a nursing facility or at home. Now, they can qualify to have Medi-Cal pick up that cost.

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Dr. Joanne Shinozaki, a resident of Granada Hills, hired private full-time caregiving last year for her mother, Fujiko, who has dementia. But it cost nearly $11,000 a month, which Shinozaki quickly realized would burn fast through the roughly $200,000 in savings her father had left when he died early last year. Reluctantly, she put her mom in a memory care home, which was less expensive. But after a 10% increase in January, it is now costing $9,000 a month, although that includes food and utilities.

Fujiko Shinozaki, who has dementia, is currently in a memory care home in Agoura Hills. Thanks to a change in eligibility rules that took effect Jan. 1, she may now qualify for Medi-Cal despite a nest egg her husband left when he died last year.

(Joanne Shinozaki)

Because of the money Shinozaki’s dad left, her mom did not qualify for Medi-Cal under the old rules. Now that money no longer counts against her.

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Shinozaki, a veterinarian who quit her job to coordinate her mother’s care, needs to return to work soon. She has applied for Medi-Cal for her mom and is waiting for it to be approved.

“It would mean being able to bring her back to the house where she’s lived since 1988, if she’s well enough to come home,” Shinozaki says. To do that, she will need to get her mom access to caregivers via Medi-Cal’s In-Home Supportive Services program.

Indeed, another benefit of the change in eligibility rules is that it supports the caregiver economy, says Kim Selfon, a Medi-Cal and IHSS policy specialist at Bet Tzedek Legal Services, which provides free legal assistance to people in Los Angeles County.

Advocates who work with Medi-Cal enrollees and applicants say they often have to explain the difference between assets and income.

“I think a lot of people are confused,” says Stephanie Fajuri, program director at the Center for Health Care Rights, an L.A.-based nonprofit that helps people navigate Medi-Cal and Medicare. “They say, ‘What do you mean? I could be making $1 million a year?’ And we say, ‘No, that’s income.’”

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So, let’s be clear: Under the new rules, yes, you can have a second house. But if you are renting it out, that’s income — and given today’s rental prices, it will probably disqualify you from full Medi-Cal benefits. You can also keep an investment account regardless of the balance, but distributions from it as well as any interest, dividends and capital gains it generates are also income.

Again, most beneficiaries are unlikely to have a large pool of assets and still have income low enough to qualify for Medi-Cal. But if you suddenly inherit a modest sum — or even a large one — now you can keep it, though it may briefly affect your coverage.

Unfortunately, the 1.1 million Medi-Cal beneficiaries receiving Supplemental Security Income are still subject to an asset test, because different rules apply to them.

Advocates and legal aid attorneys say there hasn’t been enough public education about the elimination of the asset limits and that many people still believe their bank accounts or personal property rule them out.

People may also fear the state will take their house and other assets after they die to recoup what it spent on their care. That worry could intensify now that people can keep all their assets and still be on Medi-Cal. But a 2017 change in the law restricted the state’s ability to put a claim on your house or other assets after you die and made it relatively easy to insulate them entirely.

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The state can claim only up to the amount Medi-Cal spent on certain medical services, including long-term and intermediate care and related costs. Even in those cases, it cannot touch your home or any other asset if you have protected it by putting it in a living trust or through some other legal move that keeps it out of probate court. And the state can’t put a claim on it if there is a co-owner who outlives the Medi-Cal beneficiary.

“Now that people can hold unlimited assets, they need to be more cognizant of protecting them should they need long-term care,” says Dina Dimirjian, a staff attorney at Neighborhood Legal Services of Los Angeles County.

The Department of Health Care Services, which oversees Medi-Cal, has published an FAQ on the elimination of the asset test. Another good source of information, and legal assistance, is the Health Consumer Alliance.

The end of the asset test will also cure a big bureaucratic headache for beneficiaries and applicants while freeing up countless hours for Medi-Cal eligibility workers in county offices.

“People had to navigate this and figure out what counts and what doesn’t count, and they had to prove it, and the county had to verify it,” said David Kane, a senior attorney at the Western Center on Law & Poverty. “It’s a good thing we can say goodbye to it.”

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KFF Health News, formerly known as Kaiser Health News, is a national newsroom that produces in-depth journalism about health issues.

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Trump signs order to limit state AI regulations, with California in the crosshairs

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Trump signs order to limit state AI regulations, with California in the crosshairs

The battle between California and the White House escalated as President Trump signed an executive order to block state laws regulating artificial intelligence.

The president’s power move to try to take over control of the regulation of the technology behind ChatGPT through an executive order Thursday was applauded by his allies in Silicon Valley, who have been warning that many layers of heavy-handed rules and regulations were holding them back and could put the U.S. behind in the battle to benefit most from AI.

The order directs the attorney general to create a task force to challenge some state AI laws. States with “onerous AI laws” could lose federal funding from a broadband deployment program and other grants, the order said.

The Trump administration said the order will help U.S. companies win the AI race against countries such as China by removing “cumbersome regulation.” It also pushes for a “minimally burdensome” national standard rather than a patchwork of laws across 50 states that the administration said makes compliance challenging, especially for startups.

“You have to have a central source of approval when they need approval. So things have to come to one source. They can’t go to California, New York and various other places,” Trump told reporters at the Oval Office on Thursday.

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California Gov. Gavin Newsom pushed back against the order, stating it “advances corruption, not innovation.”

“They’re running a con. And every day, they push the limits to see how far they can take it,” Newsom said in a statement. “California is working on behalf of Americans by building the strongest innovation economy in the nation while implementing commonsense safeguards and leading the way forward.”

The dueling remarks between Newsom and Trump underscore how the tech industry’s influence over regulation has increased tensions between the federal government and state lawmakers trying to place more guardrails around AI.

While AI chatbots can help people quickly find answers to questions and generate text, code, and images, the increasing role the technology plays in people’s daily lives has also sparked greater anxiety about job displacement, equity, and mental health harms.

The order heavily impacts California, home to some of the world’s largest tech companies such as OpenAI, Google, Nvidia and Meta. It also jeopardizes the $1.8 billion in federal funding California has received to expand high-speed internet throughout the state.

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Some analysts said Trump’s order is a win for tech giants that have vowed to invest trillions of dollars to build data centers and in research and development.

“We believe that more organizations are expected to head down the AI roadmap through strategic deployments over time, but this executive order takes away more questions around future AI buildouts and removes a major overhang moving forward,” said Wedbush analyst Dan Ives in a statement.

Facing lobbying from tech companies, Newsom has vetoed some AI legislation while signing others into law this year.

One new law requires platforms to display labels for minors that warn about social media’s mental health harms. Another aims to make AI developers more transparent about safety risks and offers more whistleblower protections.

He also signed a bill that requires chatbot operators to have procedures to prevent the production of suicide or self-harm content, though child safety groups removed support for that legislation because they said the tech industry successfully pushed for changes that weakened protections.

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States and consumer advocacy groups are expected to legally challenge Trump’s order.

“Trump is not our king, and he cannot simply wave a pen to unilaterally invalidate state law,” state Sen. Steve Padilla (D-Chula Vista), who introduced the chatbot safety legislation that Newsom signed into law, said in a statement.

In addition to California, three other states — Colorado, Texas and Utah — have passed laws that set some rules for AI across the private sector, according to the International Assn. of Privacy Professionals. Those laws include limiting the collection of certain personal information and requiring more transparency from companies.

The more ambitious AI regulation proposals from states require private companies to provide transparency and assess the possible risks of discrimination from their AI programs. Many have regulated parts of AI: barring the use of deepfakes in elections and to create nonconsensual porn, for example, or putting rules in place around the government’s own use of AI.

The order drew both praise and criticism from the tech industry.

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Collin McCune, the head of government affairs at venture capital firm Andreessen Horowitz, said on social media site X that the executive order is an “incredibly important first step.”

“But the vacuum for federal AI legislation remains,” he wrote. “Congress needs to come together to create a clear set of rules that protect the millions of Americans using AI and the Little Tech builders driving it forward.”

Omidyar Network Chief Executive Mike Kubzansky said in a statement that he is aware of the risks posed by poorly drafted rules, but the solution isn’t to preempt state and local laws.

“Americans are rightly concerned about AI’s impact on kids, jobs, and the costs imposed on consumers and communities by the rapid development of data centers,” he said. “Ignoring these issues through a blanket moratorium is an abdication of what elected officials owe their constituents — which is why we strongly oppose the Administration’s recent executive action.”

Investors seemed unimpressed by the possible boost the sector could get from the White House.

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The stock market fell sharply on Friday, led by AI shares.

Bloomberg and the Associated Press contributed to this report.

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California, other states sue Trump administration over $100,000 fee for H-1B visas

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California, other states sue Trump administration over 0,000 fee for H-1B visas

California and a coalition of other states are suing the Trump administration over a policy charging employers $100,000 for each new H-1B visa they request for foreign employees to work in the U.S. — calling it a threat not only to major industry but also to public education and healthcare services.

“As the world’s fourth largest economy, California knows that when skilled talent from around the world joins our workforce, it drives our state forward,” said California Atty. Gen. Rob Bonta, who announced the litigation Friday.

President Trump imposed the fee through a Sept. 19 proclamation, in which he said the H-1B visa program — designed to provide U.S. employers with skilled workers in science, technology, engineering, math and other advanced fields — has been “deliberately exploited to replace, rather than supplement, American workers with lower-paid, lower-skilled labor.”

Trump said the program also created a “national security threat by discouraging Americans from pursuing careers in science and technology, risking American leadership in these fields.”

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Bonta said such claims are baseless, and that the imposition of such fees is unlawful because it runs counter to the intent of Congress in creating the program and exceeds the president’s authority. He said Congress has included significant safeguards to prevent abuses, and that the new fee structure undermines the program’s purpose.

“President Trump’s illegal $100,000 H-1B visa fee creates unnecessary — and illegal — financial burdens on California public employers and other providers of vital services, exacerbating labor shortages in key sectors,” Bonta said in a statement. “The Trump Administration thinks it can raise costs on a whim, but the law says otherwise.”

Taylor Rogers, a White House spokeswoman, said Friday that the fee was “a necessary, initial, incremental step towards necessary reforms” that were lawful and in line with the president’s promise to “put American workers first.”

Attorneys for the administration previously defended the fee in response to a separate lawsuit brought by the U.S. Chamber of Commerce and the Assn. of American Universities, arguing earlier this month that the president has “extraordinarily broad discretion to suspend the entry of aliens whenever he finds their admission ‘detrimental to the interests of the United States,’” or to adopt “reasonable rules, regulations, and orders” related to their entry.

“The Supreme Court has repeatedly confirmed that this authority is ‘sweeping,’ subject only to the requirement that the President identify a class of aliens and articulate a facially legitimate reason for their exclusion,” the administration’s attorneys wrote.

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They alleged that the H-1B program has been “ruthlessly and shamelessly exploited by bad actors,” and wrote that the plaintiffs were asking the court “to disregard the President’s inherent authority to restrict the entry of aliens into the country and override his judgment,” which they said it cannot legally do.

Trump’s announcement of the new fee alarmed many existing visa holders and badly rattled industries that are heavily reliant on such visas, including tech companies trying to compete for the world’s best talent in the global race to ramp up their AI capabilities. Thousands of companies in California have applied for H-1B visas this year, and tens of thousands have been granted to them.

Trump’s adoption of the fees is seen as part of his much broader effort to restrict immigration into the U.S. in nearly all its forms. However, he is far from alone in criticizing the H-1B program as a problematic pipeline.

Critics of the program have for years documented examples of employers using it to replace American workers with cheaper foreign workers, as Trump has suggested, and questioned whether the country truly has a shortage of certain types of workers — including tech workers.

There have also been allegations of employers, who control the visas, abusing workers and using the threat of deportation to deter complaints — among the reasons some on the political left have also been critical of the program.

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“Not only is this program disastrous for American workers, it can be very harmful to guest workers as well, who are often locked into lower-paying jobs and can have their visas taken away from them by their corporate bosses if they complain about dangerous, unfair or illegal working conditions,” Sen. Bernie Sanders (I-Vt.) wrote in a Fox News opinion column in January.

In the Chamber of Commerce case, attorneys for the administration wrote that companies in the U.S. “have at times laid off thousands of American workers while simultaneously hiring thousands of H-1B workers,” sometimes even forcing the American workers “to train their H-1B replacements” before they leave.

They have done so, the attorneys wrote, even as unemployment among recent U.S. college graduates in STEM fields has increased.

“Employing H-1B workers in entry-level positions at discounted rates undercuts American worker wages and opportunities, and is antithetical to the purpose of the H-1B program, which is ‘to fill jobs for which highly skilled and educated American workers are unavailable,’” the administration’s attorneys wrote.

By contrast, the states’ lawsuit stresses the shortfalls in the American workforce in key industries, and defends the program by citing its existing limits. The legal action notes that employers must certify to the government that their hiring of visa workers will not negatively affect American wages or working conditions. Congress also has set a cap on the number of visa holders that any individual employer may hire.

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Bonta’s office said educators account for the third-largest occupation group in the program, with nearly 30,000 educators with H-1B visas helping thousands of institutions fill a national teacher shortage that saw nearly three-quarters of U.S. school districts report difficulty filling positions in the 2024-2025 school year.

Schools, universities and colleges — largely public or nonprofit — cannot afford to pay $100,000 per visa, Bonta’s office said.

In addition, some 17,000 healthcare workers with H-1B visas — half of them physicians and surgeons — are helping to backfill a massive shortfall in trained medical staff in the U.S., including by working as doctors and nurses in low-income and rural neighborhoods, Bonta’s office said.

“In California, access to specialists and primary care providers in rural areas is already extremely limited and is projected to worsen as physicians retire and these communities struggle to attract new doctors,” it said. “As a result of the fee, these institutions will be forced to operate with inadequate staffing or divert funding away from other important programs to cover expenses.”

Bonta’s office said that prior to the imposition of the new fee, employers could expect to pay between $960 and $7,595 in “regulatory and statutory fees” per H-1B visa, based on the actual cost to the government of processing the request and document, as intended by Congress.

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The Trump administration, Bonta’s office said, issued the new fee without going through legally required processes for collecting outside input first, and “without considering the full range of impacts — especially on the provision of the critical services by government and nonprofit entities.”

The arguments echo findings by a judge in a separate case years ago, after Trump tried to restrict many such visas in his first term. A judge in that case — brought by the U.S. Chamber of Commerce, the National Assn. of Manufacturers and others — found that Congress, not the president, had the authority to change the terms of the visas, and that the Trump administration had not evaluated the potential impacts of such a change before implementing it, as required by law.

The case became moot after President Biden decided not to renew the restrictions in 2021, a move which tech companies considered a win.

Joining in the lawsuit — California’s 49th against the Trump administration in the last year alone — are Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, North Carolina, New Jersey, New York, Oregon, Rhode Island, Vermont, Washington and Wisconsin.

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Some big water agencies in farming areas get water for free. Critics say that needs to end

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Some big water agencies in farming areas get water for free. Critics say that needs to end

The water that flows down irrigation canals to some of the West’s biggest expanses of farmland comes courtesy of the federal government for a very low price — even, in some cases, for free.

In a new study, researchers analyzed wholesale prices charged by the federal government in California, Arizona and Nevada, and found that large agricultural water agencies pay only a fraction of what cities pay, if anything at all. They said these “dirt-cheap” prices cost taxpayers, add to the strains on scarce water, and discourage conservation — even as the Colorado River’s depleted reservoirs continue to decline.

“Federal taxpayers have been subsidizing effectively free water for a very, very long time,” said Noah Garrison, a researcher at UCLA’s Institute of the Environment and Sustainability. “We can’t address the growing water scarcity in the West while we continue to give that water away for free or close to it.”

The report, released this week by UCLA and the environmental group Natural Resources Defense Council, examines water that local agencies get from the Colorado River as well as rivers in California’s Central Valley, and concludes that the federal government delivers them water at much lower prices than state water systems or other suppliers.

The researchers recommend the Trump administration start charging a “water reliability and security surcharge” on all Colorado River water as well as water from the canals of the Central Valley Project in California. That would encourage agencies and growers to conserve, they said, while generating hundreds of millions of dollars to repair aging and damaged canals and pay for projects such as new water recycling plants.

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“The need for the price of water to reflect its scarcity is urgent in light of the growing Colorado River Basin crisis,” the researchers wrote.

The study analyzed only wholesale prices paid by water agencies, not the prices paid by individual farmers or city residents. It found that agencies serving farming areas pay about $30 per acre-foot of water on average, whereas city water utilities pay $512 per acre-foot.

In California, Arizona and Nevada, the federal government supplies more than 7 million acre-feet of water, about 14 times the total water usage of Los Angeles, for less than $1 per acre-foot.

And more than half of that — nearly one-fourth of all the water the researchers analyzed — is delivered for free by the U.S. Bureau of Reclamation to five water agencies in farming areas: the Imperial Irrigation District, Palo Verde Irrigation District and Coachella Valley Water District, as well as the Truckee-Carson Irrigation District in Nevada and the Unit B Irrigation and Drainage District in Arizona.

Along the Colorado River, about three-fourths of the water is used for agriculture.

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Farmers in California’s Imperial Valley receive the largest share of Colorado River water, growing hay for cattle, lettuce, spinach, broccoli and other crops on more than 450,000 acres of irrigated lands.

The Imperial Irrigation District charges farmers the same rate for water that it has for years: $20 per acre-foot.

Tina Shields, IID’s water department manager, said the district opposes any surcharge on water. Comparing agricultural and urban water costs, as the researchers did, she said, “is like comparing a grape to a watermelon,” given major differences in how water is distributed and treated.

Shields pointed out that IID and local farmers are already conserving, and this year the savings will equal about 23% of the district’s total water allotment.

“Imperial Valley growers provide the nation with a safe, reliable food supply on the thinnest of margins for many growers,” she said in an email.

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She acknowledged IID does not pay any fee to the government for water, but said it does pay for operating, maintaining and repairing both federal water infrastructure and the district’s own system.

“I see no correlation between the cost of Colorado River water and shortages, and disagree with these inflammatory statements,” Shields said, adding that there “seems to be an intent to drive a wedge between agricultural and urban water users at a time when collaborative partnerships are more critical than ever.”

The Colorado River provides water for seven states, 30 Native tribes and northern Mexico, but it’s in decline. Its reservoirs have fallen during a quarter-century of severe drought intensified by climate change. Its two largest reservoirs, Lake Mead and Lake Powell, are now less than one-third full.

Negotiations among the seven states on how to deal with shortages have deadlocked.

Mark Gold, a co-author, said the government’s current water prices are so low that they don’t cover the costs of operating, maintaining and repairing aging aqueducts and other infrastructure. Even an increase to $50 per acre-foot of water, he said, would help modernize water systems and incentivize conservation.

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A spokesperson for the U.S. Interior Department, which oversees the Bureau of Reclamation, declined to comment on the proposal.

The Colorado River was originally divided among the states under a 1922 agreement that overpromised what the river could provide. That century-old pact and the ingrained system of water rights, combined with water that costs next to nothing, Gold said, lead to “this slow-motion train wreck that is the Colorado right now.”

Research has shown that the last 25 years were likely the driest quarter-century in the American West in at least 1,200 years, and that global warming is contributing to this megadrought.

The Colorado River’s flow has decreased about 20% so far this century, and scientists have found that roughly half the decline is due to rising temperatures, driven largely by fossil fuels.

In a separate report this month, scientists Jonathan Overpeck and Brad Udall said the latest science suggests that climate change will probably “exert a stronger influence, and this will mean a higher likelihood of continued lower precipitation in the headwaters of the Colorado River into the future.”

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Experts have urged the Trump administration to impose substantial water cuts throughout the Colorado River Basin, saying permanent reductions are necessary. Kathryn Sorensen and Sarah Porter, researchers at Arizona State University’s Kyl Center for Water Policy, have suggested the federal government set up a voluntary program to buy and retire water-intensive farmlands, or to pay landowners who “agree to permanent restrictions on water use.”

Over the last few years, California and other states have negotiated short-term deals and as part of that, some farmers in California and Arizona are temporarily leaving hay fields parched and fallow in exchange for federal payments.

The UCLA researchers criticized these deals, saying water agencies “obtain water from the federal government at low or no cost, and the government then buys that water back from the districts at enormous cost to taxpayers.”

Isabel Friedman, a coauthor and NRDC researcher, said adopting a surcharge would be a powerful conservation tool.

“We need a long-term strategy that recognizes water as a limited resource and prices it as such,” she wrote in an article about the proposal.

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