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This is reform? California wants to let its billionaires go on Medicaid

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This is reform? California wants to let its billionaires go on Medicaid


Politicians and investigative journalists have long complained about the billionaires that have no taxable income and pay no taxes despite their wealth. In response, politicians have advanced many constitutionally dubious proposals to tax wealth on grounds of equity and fairness.

It is odd, then, that there has been so little attention paid or protest given to the pending proposal in California — phase II of its 2021 reform — to strike all asset testing for those above age 65 in determining eligibility for long-term care benefits from Medicaid.

Lest anyone dismiss this as another crazy California idea that will never be enacted, like universal state government health insurance and racial reparations, this Medicaid expansion proposal is well on its way to approval, part of a series of incremental steps over the last several years that have already loosened Medicaid eligibility standards.

And this one offers a dangerous precedent for other states. Because Medicaid is jointly financed by the federal government, at fifty cents on the dollar or more, non-California taxpayers, including many middle-income workers living in states with stricter Medicaid rules, will actually end up paying a huge chunk of this costly California policy’s billion-dollar annual price tag.

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Medicaid was designed as a jointly financed federal-state program to provide health care for the poor. It also pays for nursing-home care and increasingly for home healthcare for individuals, especially the disabled and elderly who spend down their assets before becoming eligible. Eligibility for various types of long-term care benefits is determined by medical need and a set of income and asset tests, which differ by state and have changed over time, but are within a federal framework.

California has long played loose with eligibility, benefits and other rules, even beyond the allowable leniencies in federal law. For example, under “Phase I” of the state’s 2021 reform legislation, its asset-test maximum for Medicaid eligibility is $130,000 (compared to just $2,000 in most states) for individuals and $195,000 (compared to $3,000) for couples.

Also, the “look-back” period to identify and disallow strategic transfers of assets to gain Medicaid eligibility is only 30 months, whereas federal law calls for 60 months. California’s look-back also does not apply if the applicant is not in a nursing home at the time of application. Federal law penalizes such strategic transfers, regardless of whether the person is institutionalized. California also turns a blind eye to as much as $12,000 in daily transfers of wealth to relatives per day, meaning that the wealthy can strategically shift as much as $4.4 million per year in order to pass the asset test.

California also completely disregards applicants’ net housing equity, which most states start to count as an asset after exempting the first $688,000 to $1,033,000. Retirement assets, including spousal retirement assets, are also disregarded, unlike in most other states.

Estate recovery from deceased recipients only applies to assets going through probate, thus bypassing retirement and insurance assets entirely. Unlike in some states, no liens are placed on housing. Despite the great wealth held in California, with home values averaging $750,000, the Medicaid program’s estate recovery efforts have lagged over the years, falling from $72 million collected in 2015 to $17 million in 2020.

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Many of these leniencies directly contradict federal law, yet they were somehow approved by federal regulators at the Center for Medicare and Medicaid Services (CMS), without request for public comments, through a series of state plan amendments. Today, Phase II of California’s pending proposal — the total elimination of asset testing — is before CMS.

California officials told CMS that the total disregard of assets would annually cost the federal government only $115 million. Their own budget showed an increase of 37,000 newly eligible individuals and a $400 million total cost.

This is low compared to the approximately $35 billion that California spends on long-term care benefits through Medicaid. My own rough calculation, based on data from the Health and Retirement Study on asset holdings and another survey on long-term care needs, is that the annual additional cost to Medicaid from California’s disregard of assets will actually be at least $1.2 billion, with over 100,000 newly-eligible individuals.

Roughly half of this bill will be picked up by the federal government, not just by California taxpayers.

Even more concerning than the bad policy — which is contrary to the financial self-reliance of those who can afford it — is the poor precedent this circumvention of federal law would set for other states in designing their own Medicaid programs. Also, the complete lack of democratic process and bureaucratic transparency at a time of massive federal budget deficits is profoundly disturbing.

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It is not too late for CMS and Congress to call these harmful actions into question and stop them.

Mark J. Warshawsky is a senior fellow at the American Enterprise Institute. He served as Vice-Chair on the federal Commission on Long-Term Care in 2013.



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Sharks are congregating at a California beach. AI is trying to keep swimmers safe | CNN

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Sharks are congregating at a California beach. AI is trying to keep swimmers safe | CNN




CNN
 — 

On summer mornings, local kids like to gather at Padaro Beach in California to learn to surf in gentle whitewater waves. A few years ago, the beach also became a popular hangout for juvenile great white sharks.

That led to the launch of SharkEye, an initiative at the University of California Santa Barbara’s Benioff Ocean Science Laboratory (BOSL), which uses drones to monitor what’s happening beneath the waves.

If a shark is spotted, SharkEye sends a text to the 80-or-so people who have signed up for alerts, including local lifeguards, surf shop owners, and the parents of children who take lessons.

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In recent years, other initiatives have seen officials and lifeguards from New York to Sydney using drones to keep beachgoers safe, monitoring video streamed from a camera. That requires a pilot to stay focused on a screen, contending with choppy water and glare from the sun, to differentiate sharks from paddleboarders, seals, and undulating kelp strands. One study found that human-monitored drones only detect sharks about 60% of the time.

SharkEye – part research program, part community safety tool – is using the video it collects to analyze shark behavior. It’s also feeding its footage into a computer vision machine learning model – a type of artificial intelligence (AI) technology that enables computers to glean information from images and videos – to train it to detect great white sharks near Padaro Beach, close to the city of Santa Barbara.

“Automating shark detection … can (also) be really helpful for a lot of communities outside of ours here in California,” Neil Nathan, a project scientist with BOSL, who graduated from Stanford University with a master’s degree in environmental studies a few years ago, told CNN.

A rise in the popularity of drones, and the proliferation of social media, may make it seem like sharks are everywhere. It doesn’t help that warming ocean temperatures are pushing sharks into new habitats, and that juvenile great whites, which can grow to about eight to 10 feet long, like to hang out near the shore, making them more visible to beachgoers.

Yet shark attacks are rare. In 2023, 69 people globally were at the receiving end of unprovoked bites – which is in line with the average of 63 annual incidents between 2018 and 2022. Just 10 of them died, according to the Florida Museum of Natural History’s International Shark Attack File.

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Although there hasn’t been a fatal attack recorded at Padaro Beach, some community members were concerned when sharks began loitering there.

That’s why SharkEye has been regularly running drone flights to monitor the coastline for about five years, once spotting 15 juvenile great white sharks in a single day.

Early tests indicate that the AI technology is already performing “incredibly well,” detecting most sharks a human can, and sometimes sharks that a human missed, perhaps because it was swimming too deep to spot easily, said Nathan.

This summer, the project began field testing its technology by pitting drone pilots against AI. Its pilot surveys the area and counts the number of sharks she spots. Then SharkEye’s model analyzes the video to see how many sharks it can find.

Today, the community alerts are based on human analysis. If all goes swimmingly, those reports may become AI-assisted – with manual monitoring and checks – by the end of the season, or the start of next summer, said Nathan. In the future, the process may even become totally automated, making it faster and potentially more accurate.

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AI and wildlife

AI technologies are being harnessed in myriad ways to mitigate human-wildlife conflict. In India, AI-enabled cameras are alerting villagers when tigers are closing in on their livestock, and in Australia, technology is being used to manage some of its dangerous creatures.

Ripper Corp and academics pioneered what they say are the first shark identification algorithms in the world, which were put to use in drones a few years ago. The latest version of the software is being tested across the Australian state of Queensland, Mexico and the Caribbean to detect sharks and crocodiles.

However, AI is not yet used widely for shark detection. Surf Life Saving New South Wales, which protects dozens of beaches along the state’s coast, including Sydney’s iconic Bondi Beach, uses drones in 50 locations. But a spokesperson told CNN that their drones aren’t currently utilizing AI.

A group from one Australian university that worked on AI-enhanced shark-spotting tools wrote in 2022 that the technology can struggle when encountering conditions that weren’t present in the training data.

SharkEye plans to make its model free and available for researchers to amend or build on, and to create an AI-powered app that’s easy for people like lifeguards and drone hobbyists to run their footage through. That could help keep people safe, but also allow humans to better understand and protect sharks.

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Nathan said it remains to be seen how much retraining will be required for SharkEye to expand to other locations. He’s hopeful that if drone pilots fly at the same speed and altitude, they won’t have too many issues elsewhere in California, where the coastline is similar.

Officials in Honolulu said this month that they’re considering launching a drone shark surveillance program, according to local media. If SharkEye’s technology were to be used in places like Hawaii, where tiger sharks are the biggest concern, and the hue of the water differs, more retraining might be necessary. But Nathan said that SharkEye is open to working with other localities to help adapt the model.

“Communities want to have that knowledge and that awareness so it’s easier to more safely share the water with these creatures,” said Nathan. “Sharks are an incredible species that we still are always learning new things about.”



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Car plunges off California’s Devil’s Slide cliff into ocean, killing three passengers: cops

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Car plunges off California’s Devil’s Slide cliff into ocean, killing three passengers: cops


Three people died Friday when their car tumbled down a cliff and into the ocean near the Devil’s Slide on California’s famed Highway 1.

Cops got a call about a single-vehicle crash just before noon that day, forcing police, fire crews and other first responders to mobilize for a cliff rescue, according to SFGate.

The car — a gray two-door sedan — careened off the southbound side of the road and dropped about 300 feet down an embankment between Pacifica and Montara, according to a California Highway Patrol spokesperson and news reports.

Three people died after a car fell off a cliff on Highway 1 in California. KTVU
The crash happened near the Devil’s Slide trail. KTVU

Authorities shut down the road for several hours as rescuers rappelled to the vehicle, which lay on its roof as seawater lapped around the wreckage.

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“It was a recovery mission, and it was steep cliffs and tough terrain,” a member of Cal Fire told Fox 2 KTVU. “The car was partially submerged, so our rescuers were taking on waves.”

The impact was so violent that it catapulted pieces of the vehicle away from the wreck.

When they reached the site, rescuers quickly pronounced two of the vehicle’s occupants dead.

Police at the scene of the deadly single-vehicle accident. KTVU
The car at the bottom of the cliff. KTVU
Pieces of the car near the location of the crash. KTVU

But an incoming high tide curtailed their efforts, which included hauling heavy machinery down the cliff so first responders could cut the car apart and recover the bodies, the station said.

A third person — also dead — was found inside the car on Saturday, the outlet said.

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Cops haven’t released the victims’ identities, and the investigation is still ongoing, the highway patrol said.



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Latest Line: A good week for Kamala Harris, bad week for California unions

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Latest Line: A good week for Kamala Harris, bad week for California unions


Kamala Harris

President Joe Biden ends his re-election bid and supports Vice President Harris, California’s former Senator and Attorney General and San Francisco’s former District Attorney, to run in his place, as Democratic leaders quickly unite in support of her historic campaign.

 

 

 

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Unions

California’s powerful labor unions lose key California Supreme Court ruling unanimously upholding a voter-approved Proposition 22 that allows gig-work companies like Uber and DoorDash to treat their drivers and delivery workers as independent contractors instead of employees.

 

 

 

Gavin Newsom

Democrats’ quick move to support Vice President Kamala Harris for president after President Biden ended his re-election bid snuffed out talk of California’s governor as a viable alternative. But recent U.S. Supreme Court ruling boosts Newsom’s effort to clear illegal encampments of homeless people that have hurt Newsom’s national image.



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