Asbestos victims fear GOP fight will cost them Medicare

Washington Post

by Phil Galewitz

Julie Johnson grew up in Libby, Mont., a picturesque Rocky Mountain community that was unknowingly poisoned for decades by asbestos from a mineral mine six miles away.

Her grandfather, who was a miner, her grandmother and an uncle died of asbestos-related disease. Her parents also have the disease, which has no cure. But Johnson didn’t think it would hit her — until doctors found a spot on her lung last year.

Federal officials in 2009 declared the area the first national public health emergency and have called it the nation’s worst environmental disaster.

Without health insurance, Johnson, 45, has relied on two programs created to cover health-care costs for Libby residents. But the state-federal grant program is scheduled to end this summer, and Columbia, Md.-based W.R. Grace, which owned the shuttered mine and funds a medical plan for Libby residents, has been in bankruptcy since 2001. That had Johnson worried about how she’ll keep up with mounting health bills.

The 2010 federal health law is providing help. It expanded Medicare coverage to people who were residents of the Libby area, which has about 10,000 people, for a total of at least six months over a 10-year period before the diagnosis of an asbestos-related disease. But now, residents worry that the provision will fall victim to Republican-led efforts to repeal the law.

“Losing this benefit would really knock the bottom out of people’s lives,” said Gayla Benefield, a Libby resident and Johnson’s mother.

The Libby provision, written by Senate Finance Committee Chairman Max Baucus (D-Mont.), marked just the third expansion of Medicare eligibility since the federal health insurance program was established for the elderly and disabled in 1965.

The Congressional Budget Office estimates that the expansion will cost $300 million over the next decade.

“This provision is important because it will provide vital medical services to Americans who — through no fault of their own—have suffered horrible effects from their exposure to deadly poisons,” Baucus said.

Rep. Denny Rehberg (R-Mont.) is among those fighting to overturn the health-care law — and potentially the Libby provision. “It’s tragic that assistance for so many deserving folks up in Libby was tied to the anchor of Obamacare, with all of its mangled policy, unconstitutional mandates and reckless deficits,” he said. Rehberg, who represents the entire state, has made repeal of the law a key issue in his campaign against Sen. Jon Tester (D).

Rehberg said he will continue working to help the people of Libby but would not say whether he supports keeping the Medicare option for them.

For Johnson, who now lives in Kalispell, about 90 miles east of Libby, being on Medicare means long-term security. She is one of about 600 people from Libby who have signed up for Medicare as a result of the law, according to the Social Security Administration. “I feel good knowing I have this [coverage] and it’s never going to go away,” she said. “W.R. Grace proved that they are not to be trusted, and I definitely wasn’t banking on having their medical plan for the rest of my life.”

Despite the Medicare expansion, Grace has no plans to close its Libby medical plan, which has paid out about $21 million since 2000 and covers about 1,100 people, said William Corcoran, a vice president at Grace.

Grace, a chemicals manufacturer, has been paying medical bills for Libby residents for years and agreed in 2008 to spend $250 million for an environmental cleanup of the town.

The company, which was driven into bankruptcy protection by tens of thousands of asbestos poisoning claims mostly unrelated to Libby, reached a tentative civil settlement in 2008 to pay $3 billion to asbestos victims nationwide.

Both Grace and the government grant program cover Libby residents’ health-care costs related to asbestos disease, supplementing individual private insurance. In contrast, those under Medicare have all of their health costs covered.

Many people have not yet enrolled in Medicare because they can still get help from the grant program, which doesn’t expire until July, said Tanis Hernandez, outreach coordinator of the Center for Asbestos Related Diseases. “The Medicare coverage will be extremely important” when the grant program expires, she said. The Medicare expansion could eventually enroll as many as 1,500 Libby residents, she said.

Exposure to asbestos is known to cause cancer and other lung diseases. Asbestos-related disease can take decades to show up on X-rays and other tests.

Like many of the nearly 2,000 people from Libby who have asbestos-related disease and the 400 who have died from it, Johnson never worked at the mine. They were exposed when miners brought home tremolite, a form of asbestos that was laced in the vermiculite ore, on their clothes. Residents took vermiculite from the mine to use for insulation, and tailings — waste from the mine — was spread as ground filler around town, including on school and community sports fields.

Out of a population of more than 10,000 people in Libby and the surrounding valley, new cases are being diagnosed at a rate of about four a week, Hernandez said.

“I thought I was fine, and I was not a smoker and was the least exposed of my siblings,” said Johnson who works as a receptionist at a veterinary clinic. But there were early signs: She caught pneumonia when she was eight months pregnant, developed swine flu and, in the past few years, developed ear infections that took months to clear.

These days, when she shows her Medicare card at the doctor’s office, Johnson sometimes gets strange looks. “They say, ‘You look so young. How can you be on Medicare?’ Then I explain I’m from Libby.”

This article is produced through a collaboration between The Washington Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente.