Danielle Ivory stories from The Center for Public Integrity

Weighing safety of weed killer in drinking water, EPA relies heavily on industry-backed studies

Syngenta AG — 2011-10-13T10:44:59-04:00

Companies with a financial interest in a weed-killer sometimes found in drinking water paid for thousands of studies federal regulators are using to assess the herbicide’s health risks, records of the U.S. Environmental Protection Agency show. Many of these industry-funded studies, which largely support atrazine’s safety, have never been published or subjected to an independent scientific peer review.

Meanwhile, some independent studies documenting potentially harmful effects on animals and humans are not included in the body of research the EPA deems relevant to its safety review, the Huffington Post Investigative Fund has found. These studies include many that have been published in respected scientific journals.

Even so, the EPA says that it would be “very difficult for someone to put a thumb on the scale” to slant the outcome.

Atrazine is one of the most widely used herbicides in the U.S. An estimated 76 million pounds of the chemical are sprayed on corn and other fields in the U.S. each year, sometimes ending up in rivers, streams, and drinking water supplies. It has been the focus of intense scientific debate over its potential to cause cancer, birth defects, and hormonal and reproductive problems. As the Huffington Post Investigative Fund reported in a series of articles last fall, the EPA failed to warn the public that the weed-killer had been found at levels above federal safety limits in drinking water in at least four states. Some water utilities are suing Syngenta to have it pay their costs of filtering the chemical.

Now the EPA is re-evaluating the health risks of atrazine, which was banned in the European Union in 2004 due to a lack of evidence to support its safe use. That ban includes Switzerland, where atrazine’s manufacturer, Syngenta, is headquartered. The EPA expects to announce results of its re-examination of the herbicide in September 2010. It could take action ranging from restrictions on its use on crops to an outright ban. Or it could permit continued use without additional restrictions.

The company, one of the world’s largest agribusinesses, says the chemical has been used safely for decades and restrictions could prove devastating to farmers who are heavily dependent on the inexpensive herbicide. Atrazine poses “no harm” to the general population or to drinking water supplies, said company spokesman Steven Goldsmith.

EPA records obtained by The Huffington Post Investigative Fund show that at least half of the 6,611 studies the agency is reviewing to help make its decision were conducted by scientists and organizations with a financial stake in atrazine, including Syngenta or its affiliated companies and research contractors.

More than 80 percent of studies on which the EPA are relying have never been published. This means that they have not undergone rigorous “peer review” by independent scientists, a customary method to ensure studies are credible and scientifically sound before they can be published in major journals.

At the same time several prominent studies by independent academic scientists in well-respected scientific journals — showing negative reproductive effects of atrazine in animals and humans — are absent from the EPA’s list.

That finding may raise concerns about how the agency is doing its work. Rep. Henry Waxman, chairman of the House Energy and Commerce Committee, which oversees environmental regulators, told the Investigative Fund, “it’s critically important that EPA use all of the information at its disposal.”

Agency scientists may review studies not on the list, but EPA senior policy analyst William Jordan said that the 6,611 studies are those considered “relevant to the assessment of atrazine.”

‘Not Just Atrazine’

EPA spokeswoman Betsaida Alcantara said the list was not exhaustive and that some studies may not be on the list because they were not given an eight-digit “master record identification number,” which the agency uses to keep track of studies. There is “no uniform practice” for assigning numbers to studies submitted by people other than those working for herbicide, fungicide or pesticide manufacturers, she added.

EPA officials said that with a limited budget the agency must rely heavily on research sponsored by parties with a stake in the outcome. The agency’s “test guidelines” governing how experiments are conducted – the types and number of lab animals to be used, for instance. These provide sufficient safeguards against skewed results, officials said.

“Companies have a very strong incentive to follow the guidelines,” said EPA senior analyst Jordan. “We hope and think that we have written the guidelines with enough detail that it would be very difficult for someone to put a thumb on the scale, as it were, to slant the outcome, [or] to make something look safer than it is.”

Jennifer Sass, a senior scientist specializing in health issues at the Natural Resources Defense Council, argues that relying on a company to test the safety of its own product — an “inherent conflict” of interest — is part of a larger pattern at the EPA. “It’s not just happening with atrazine,” she said.

Hundreds of herbicides, pesticides, and other chemicals are regulated by the EPA, whose decisions can have significant implications for public health and on the abilities of an array of multinational companies to earn billions of dollars in the U.S.

By law, industry influence often is built into the regulatory process of the federal government. At the Food and Drug Administration, for instance, clinical trials conducted by pharmaceutical companies are used to determine whether pills and devices work and are safe. Makers of pesticides, herbicides, and fungicides also must pay for studies on their products. If they meet agency rules for conducting the testing, the EPA must accept them.

The ‘Funding Effect’

But is industry-funded research always reliable? A pair of scientists funded by the National Science Foundation, the U.S. Department of Agriculture, and the EPA scrutinized a Syngenta-funded Canadian study — one that is not on the EPA’s list. The scientists said they found numerous inaccuracies and misleading statements.

The scientists who questioned the study, University of South Florida biologists Jason Rohr and Krista McCoy, published their critique in the March 2010 issue of the journal Conservation Letters. In all, they tallied what they said were 122 inaccurate and 22 misleading statements, of which 96.5 percent appeared to support atrazine’s safety. The widely cited study focused on the herbicide’s effects on fish and other aquatic creatures.

Rohr and McCoy also asserted that the Canadian study, which was done in 2008, misrepresented more than 50 other studies. For example, it incorrectly suggested that only one scientist had demonstrated the chemical’s gender-altering effects on frogs. In fact, several other scientists demonstrated such effects.

The study dismissed one of Rohr’s papers as invalid, noting wrongly that the researcher had filtered atrazine out of a water tank while trying to assess the chemical’s effect on the aquatic organisms in the tank.

The Canadian study also misrepresented results, figures, and conclusions of other studies, according to the University of South Florida biologists.

Rohr, who served on an EPA advisory panel examining atrazine last year, told the Investigative Fund that he felt compelled “to set the record straight given the potential policy and environmental implications of these misconceptions and inaccuracies.”

The author of the Canadian study, University of Guelph (Ontario) biologist Keith Solomon, declined to respond to questions from the Investigative Fund about his financial ties to Syngenta, the company’s influence, or the inaccuracies and mischaracterizations the South Florida biologists said they had uncovered. Solomon noted that other scientists had come to similar conclusions, and that governments in the U.S. and Australia had not found any significant risk to creatures living in water.

While the critiqued study is not on the EPA’s list, several other studies by Solomon are.

Wendy Wagner, an expert in environmental policy at the University of Texas law school, said that the criticism of the Canadian study demonstrates a phenomenon sometimes referred to as “the funding effect.”

“It is next to impossible to squeeze all of the discretion out of a researcher, and when he has a strong incentive to find a particular result, the result can be unreliable and badly biased research,” said Wagner, an authority on the influence of politics and special interests on science. “There is compelling evidence that bias still pervades sponsored pesticide research – research that presumably is done in accord with EPA’s guidelines.”

Meanwhile, some independently-funded academic research published in major scientific journals is missing from the list of papers the EPA is using to make its decisions on atrazine. Absent are studies published in Proceedings of the National Academy of Sciences, Environmental Health Perspectives, and Nature. Many works by independent academic scientists such as Tyrone Hayes and Rohr – who have demonstrated a range of potential reproductive and hormonal effects of the chemical – are not on the list.

Some peer-reviewed studies from prestigious journals fail to meet the agency’s standards, said EPA analyst Jordan, citing as an example work by scientists such as Hayes, who recently found that low doses of atrazine could turn male frogs into female frogs.

Jordan explained that the agency couldn’t rely on Hayes’ and the other scientists’ research in part because the government lacked protocols for testing chemicals on frogs. So the EPA developed those guidelines and asked Syngenta to study the issue. The company’s researchers reported that they were unable to replicate Hayes’ findings. Jordan said the Syngenta study “superceded” Hayes’ and the other scientists’ studies. The EPA, on its Website, currently states that atrazine causes no such adverse effects on frogs and that “no additional testing is warranted” to address the issue.

Environmental groups have in the past criticized the EPA for allowing chemical companies to wield disproportionate influence over regulatory decisions. While evaluating the safety of atrazine in 2003, the EPA allowed representatives from Syngenta to participate in closed-door negotiations with the agency, according to documents obtained by the NRDC in 2004.

Missing Evidence

Dale Kemery, an EPA spokesman, defended the practice of omitting some studies. The agency’s safety “review may not include every study that has been conducted, since some may not meet the standards that are appropriate for a regulatory setting or they may not be on target for the issues to be assessed.”

The EPA considers industry-sponsored studies “scientifically more robust than are the studies generated by people in academia,” said Jordan, the agency's senior policy analyst. “That’s generally because companies spend more money on their studies and can attend to details that are potentially important that people in academia just can’t afford to do.”

Jordan added that agency oversight of the thousands of unpublished studies on the list is just as rigorous as a peer-review by scientists prior to publication in a scientific journal. “I know that people might not agree with this proposition, but I believe that the scientists at EPA constitute a peer-review,” he said. “Our scientists go over the studies with a fine tooth comb.”

EPA officials said they were not able to provide a list of all omitted research.

A spokeswoman for CropLife America, the Washington D.C.-based trade association that represents pesticide and herbicide manufacturers, said EPA oversight is thorough, regardless of whether studies have appeared in peer-reviewed journals.

“Whether or not they have been published, the studies submitted to EPA for registration support of pesticide products are subject to scientific review by EPA scientists that is equally, if not more, rigorous and demanding than the pre-publication peer review conducted by any scientific journal,” said spokeswoman Mary Emma Young.

Some people are skeptical about the rigor of the EPA’s scrutiny. “What worries me,” said the University of Texas’ Wagner, “is the possibility that there isn’t time or energy within EPA to give a lot of oversight to this unpublished, industry-funded research, especially when the number of unpublished studies for a chemical like atrazine are in the thousands.”

A former EPA official, epidemiologist Lynn Goldman, said it is normal and necessary for the agency to accept unpublished and industry-funded studies, most of which would not be interesting enough to publish in scientific journals.

“This is the way that the system was built by Congress. It could be changed but the EPA does not have the authority to turn the system upside down,” said Goldman, a former assistant administrator for toxic substances during the Clinton administration.

The existence of a list of relevant research for EPA review has played a prominent role in public arguments for the herbicide’s safety. Journalists, scientists, and advocates for atrazine have frequently cited the “6,000” studies.

In 2005, Anne Lindsay, then a top official in the EPA’s Office of Pesticide Programs, brought up the number of studies during congressional testimony. “Atrazine is one of the most well-examined pesticides in the marketplace,” she said, noting that “there are nearly 6,000 studies in EPA files on the human health and environmental effect of atrazine.”

Syngenta now cites the number in its press materials and on its website – not merely as a tally of studies but as proof of its safety. “Atrazine passes the most stringent, up-to-date safety requirements in the world,” said spokesman Paul Minehart. “In 2006, the U.S. Environmental Protection Agency (EPA) re-registered atrazine in 2006 based on the overwhelming evidence of safety from nearly 6,000 studies.”

U.S. Congressman renews attempts to ban controversial herbicide atrazine

2011-10-12T22:58:22-04:00

A member of Congress is seeking to ban one of the nation's most widely-used herbicides, which has turned up in drinking water in some states. Rep. Keith Ellison (D-Minn.) is for the second time proposing legislation that would outlaw any use or trade of atrazine.

Atrazine is most commonly sprayed on cornfields, and can run off into rivers and streams that supply drinking water. As the Huffington Post Investigative Fund reported in a series of articles last fall, the U.S. Environmental Protection Agency failed to warn the public that the weed-killer had been found at levels above federal safety limits in drinking water in at least four states. A coalition of Midwestern communities -- along with the nation’s largest private water utility -- is suing atrazine’s manufacturer, Syngenta, seeking to have it pay to filter the chemical from public water.

Steven Goldman, spokesman for Syngenta, did not comment specifically on the proposed bill or on the prospect of a nationwide ban.

"What we can say is that three government agencies in Rep. Ellison's home state of Minnesota determined in January of this year that 'atrazine regulations protect human health and the environment in Minnesota,'" he said.

The herbicide has long been controversial. The European Union in 2004 outlawed its use, citing insufficient information to prove its safety. In a reversal of Bush administration policy, the EPA announced last October that it would re-evaluate the risk of cancer or birth defects from exposure to the herbicide, as well as its potential to disrupt the hormone and reproductive systems of humans and amphibians.

The EPA’s Scientific Advisory Panel is scheduled to meet next week to discuss the human health effects of atrazine in drinking water.

“No one should ever have to worry if the water they drink is making them sick or preventing fertility,” said Ellison said in his announcement. “Forty years of good, hard environmental work has not eliminated our need to be vigilant in removing toxins like atrazine from our waterways.”

This is not the first time Ellison has tried to outlaw atrazine. He introduced legislation in 2007 seeking to bar the use, production, sale, or trade of any pesticide containing atrazine. It died in a health subcommittee in September 2008.

Impact on farming would be minimal, Ellison said, citing U.S. Department of Agriculture estimates that “an atrazine ban would result in crop losses of only 1.19 percent.”

Syngenta's Goldsmith disagreed, citing figures from an 2003 EPA study. "The total negative impact on corn, sorghum and sugarcane growers in the US would exceed $2 billion if atrazine were not available," he said.

"This is just one economic analysis, not a prediction. And note that this work is seven years old now," EPA spokesman Dale Kemery said. "Clearly we evaluate many scenarios on potential impacts to make sure we have robust info to support our decisions."

In a coma, with the plug pulled on health insurance

2011-10-12T21:47:44-04:00

With her heart set on a career as a chef, Heather Galeotti enrolled in a San Francisco culinary school. One winter night, her life took a near-fatal turn when she was hit by a car. The 22-year-old lay in a coma for nearly six months.

Galeotti’s shaken family told the hospital that she was covered by her father's health care plan with Kaiser Permanente. The hospital confirmed her status with Kaiser and proceeded to treat her. Medical bills piled up to more than $4 million.

Then in July 2007, five months into Galeotti’s treatment, Kaiser stunned the family with a letter. The Galeottis would have to find another way to pay the bills. Based on information received from her father’s employer, Kaiser said that the young woman’s coverage had not been in effect when she was hit.

"We were just blindsided," said her mother, Maureen Galeotti. "There was no way we could afford it." The case was shifted to Medicaid, where Galeotti’s bills would have to be covered by taxpayers.

Ten months later, California insurance regulators ordered Kaiser to cover Galeotti’s care, saying that Kaiser had no basis for denying payment "other than to achieve a significant financial windfall" at the expense of her family, the hospital and the state’s Medicaid program.

Like many insurance disputes, the Galeotti case has its share of miscommunication, bureaucratic wrangling and missing documents. But it remains a stark example of a murky practice by some insurance companies and employers – cutting off coverage retroactively for some patients with expensive medical claims.

The new health care reform bill bans retroactive decisions by insurers in policies sold to individuals, except in cases of fraud. However, as it stands the ban would not apply to group policies, such as the one held by the Galeotti family, which cover some 150 million Americans.

Heather Galeotti’s story, reported here for the first time, came to the Huffington Post Investigative Fund through its citizen journalism project, which seeks to shed light on the inner workings of the insurance industry. Former and current employees at Kaiser responded to the Fund’s online requests for help from insiders. Their tips led the Investigative Fund to identify the Galeotti family and obtain records of the case, including internal Kaiser e-mails.

Major insurers in California, including Kaiser, agreed in 2008 to stop retroactively cancelling coverage – a practice known in the industry as rescission. At the time, Kaiser announced that it had not rescinded anyone’s coverage since 2006. But the new agreements and increased regulatory scrutiny only applied to patients buying their own individual coverage, not to group policies.

Even so, Kaiser may have violated state law in the Galeotti matter. While declining to comment on an individual case, Lynne Randolph, spokeswoman for the Department of Managed Health Care in California, said that a retroactive cancellation of coverage through an employer is "permissible only when the coverage is cancelled for non-payment of premiums." The Galeottis continued to pay their premiums throughout their daughter’s medical crisis.

Despite the state order, officials at Kaiser, the nation’s largest nonprofit health plan, continue to maintain that the insurer’s actions in the Galeotti case should not be considered a retroactive termination of coverage. That’s because — according to Kaiser officials — a month before the car hit Galeotti, the employer’s group plan notified the family that her coverage had lapsed on Dec. 31, 2006. Kaiser was never informed, so it initially agreed to pay the bills, Kaiser officials said. However, that account is strongly denied by the Galeotti family. The family’s lawyer said they never received such a notice, and Kaiser said it does not have a copy in its records. Lawyers for the group plan declined repeated requests for interviews.

Kaiser acknowledged that it made an error by not paying Galeotti's bills, but blamed the mistake on the late notification from the group plan and "a lack of coordination" among departments inside the insurer. Spokesman Won Ha pointed out that Kaiser provides approximately 40 million patient services each year and he described the circumstances presented by the Galeotti matter as rare, with "no regular frequency over the long run."

But because insurance companies are rarely required to report to state or federal regulators how many times they have denied claims or canceled coverage — let alone to justify why — only the industry knows the statistics.

Records and e-mails obtained by the Investigative Fund suggest that retroactive decisions might not be isolated incidents in group plans. A senior official in Kaiser’s regulatory services, referencing the Galeotti matter, wrote in a May 2008 e-mail to senior-level staff: "This type of case comes to special services 3-5 times a month."

Peter Harbage, former assistant secretary for the California state health department, said retroactive cancellations or denials should be treated no differently in individual or group policies.

"Call it whatever you want. It's not different to the family," said Harbage, now a health policy consultant and former analyst for the New America Foundation. "The family thought they had coverage. Their insurer told them they had coverage, but then suddenly it's like they never had that coverage, and they're left with the bill."

Harbage added: "If you're not safe in the group market with an insurer as well-respected as Kaiser, then you're not safe anywhere. There's no such thing as an isolated case."

California Enforcement

The practice of retroactively cancelling individual health policies garnered some national attention in 2008 when Rep. Henry Waxman (D-Calif.), then chair of the House Oversight and Government Reform Committee, held hearings that highlighted the consequences for patients and their families.

The hearings followed a 2006 series in the Los Angeles Times, which explored how insurance companies were looking for ways to cut costs under pressure from shareholders, policyholders and the government. In some cases, the newspaper reported, certain expensive illnesses could automatically trigger an insurer to investigate whether a patient should have been deemed eligible for insurance in the first place.

California health officials began investigating improper retroactive cancellations after the newspaper reports, but only for people with individual policies.

The state’s managed health department recently declared that its 2008 agreements with insurers "to halt illegal rescissions have been comprehensive, swift and binding." Still, some consumer advocates and state lawmakers have questioned the strength of enforcement. A recent report by the Institute of Health Law Studies at the California Western School of Law found that fewer than 300 out of 6,000 people who had been retroactively dropped by their insurer had been reinstated under terms of the agreements.

The health care bill signed Tuesday by President Obama bans rescission in individual health insurance policies, except when insurers can prove fraud on the part of the policyholder.

Still, only about 14 million people hold individual health insurance policies. Experts have argued that patients are more protected in a group: There are usually no requirements for patients to fill out medical history surveys and insurers do not want to risk angering an employer and losing the entire group.

As the Galeotti case shows, however, even people with group policies can be vulnerable.

A Question of Eligibility

San Francisco General Hospital admitted Galeotti on Feb. 27, 2007. She had been run over by a large sport utility vehicle in an incident that police described as a fight between two romantic rivals. "I was conscious enough to hear my friend saying 'Don't die on me, hon, don't die on me,'" Galeotti said in a recent interview.

At first, Kaiser informed the hospital that Galeotti was covered. Its case managers closely monitored her progress and the cost of her treatment. As a student, she came under the policy her father, a custodian, held through the General Employees Trust Fund in Daly City, Calif. Since the young woman was hospitalized she could not attend classes at the California Culinary Academy, meaning that her coverage would eventually lapse without an extension under the policy’s incapacitated child clause. The hospital encouraged the family to contact the Trust Fund.

That is when the problems began.

In June 2007 the Trust Fund sent the Galeotti family a letter denying the application, saying inaccurately that their daughter had already graduated from school and was no longer eligible. The family appealed the denial, saying that the graduation date had been pushed back because she had taken medical leave — a fact confirmed to the Investigative Fund by school officials.

The Trust Fund did not reverse its decision. According to Kaiser, a hospital social worker then mentioned to a Kaiser representative that Galeotti's eligibility was in question. Kaiser contacted the Trust Fund, which on July 23 sent the insurer a one-line fax stating that Galeotti was "last eligible Dec. 31, 2006" under her father’s plan. Kaiser officials said that the Trust Fund told the insurer that it had sent the family a letter in January alerting them that their daughter was no longer covered and offering to let her buy continuing coverage, but the family’s lawyer said no such letter arrived.

Two days after receiving the one-line fax, Kaiser informed the Galeottis that it had been directed to terminate the young woman’s health coverage, effective Jan. 1, 2007 — almost two months before she had been admitted to the hospital. Kaiser told the family that if Galeotti wanted to restore her coverage retroactively, she could buy into a new plan.

In interviews and in a written statement, Kaiser’s Ha said it was not up to the insurer to verify whether Galeotti should be covered. "The group employer — not Kaiser Permanente — makes all decisions about canceling or starting coverage for its plan participants based on its eligibility determinations," he said.

The Trust Fund’s lawyers declined comment on the Galeotti matter.

The Hospital’s Complaint

The case would have stayed off the regulators’ radar if not for officials at San Francisco General.

Under Medi-Cal, the state’s Medicaid program, the hospital was not getting paid the full amount of its charges for Galeotti’s care. So hospital officials began exploring the reasons she was dropped by Kaiser. They filed a complaint with state regulators.

For months, records show, the insurer debated Galeotti’s coverage with the state Department of Managed Health Care. In May 2008, after she had been on Medicaid for nearly a year and was re-learning how to walk, the regulators faxed a stern letter to Kaiser, documenting her "improper termination." The letter said, "Given the Plan’s significant financial obligation to SF General, and the fact that the Plan continued to receive premium on the Family Account, Kaiser’s motives… are suspect."

In September 2008, the insurer paid the hospital. The regulators did not issue a fine.

Even with the payments from Kaiser and some coverage from Medicaid, the Galeotti family said it still owes about $1 million for rehab, medications and other fees.

For Galeotti herself, the recovery has been difficult. She has been living with her parents and undergoing physical therapy since September 2007, re-learning how to walk and talk. "There are good days and bad days," she said. "I still don't walk normally and I'll be in and out of a wheelchair for the rest of my life. I'm frustrated. But I'm here."

Kaiser said it has made "minor adjustments" in its procedures to avoid similar problems with processing claims. Spokesman Ha emphasized that the Galeotti case involved an "unusual and complex sequence of events."

Still, he said, "Kaiser should have handled the processing of this claim better."

Cities sue manufacturer of weed-killer found in tap water

2011-10-12T20:46:00-04:00

A coalition of communities in six Midwestern states filed a federal lawsuit Monday seeking to force the manufacturer of a widely-used herbicide to pay for its removal from drinking water.

Atrazine, a weed-killer sprayed primarily on cornfields, can run off into rivers and streams that supply municipal water systems. As the Huffington Post Investigative Fund reported in a series of articles last fall, the U.S. Environmental Protection Agency failed to notify the public that atrazine had been found at levels above the federal safety limit in drinking water in at least four states.

The lawsuit was filed in U.S. District Court for the Southern District of Illinois by 16 cities in Kansas, Illinois, Indiana, Ohio, Missouri, and Iowa. The communities allege that Swiss corporation Syngenta AG and its Delaware counterpart Syngenta Crop Protection, Inc. reaped billions of dollars from the sale of atrazine while local taxpayers were left with the financial burden of filtering the chemical from drinking water.

Many water utility managers told the Investigative Fund that they could not afford the expensive carbon filters that are needed to remove atrazine.

Syngenta spokesman Paul Minehart told the Investigative Fund that the company had not yet received word of a federal action, but said that current levels of atrazine in drinking water are safe.

“What Syngenta can say is that EPA re-registered atrazine in 2006, stating it would cause no harm to the general population,” Minehart said. “In the current economy many organizations, including water systems, are looking for additional sources of revenue. It is not surprising that some water systems would say they cannot afford additional filtering but, for atrazine, there is no need.”

Atrazine has long been a controversial product. The European Union in 2004 banned its use, saying there was not enough information to prove its safety. The EPA recently announced that it would be re-evaluating the herbicide’s ability to cause cancer and birth defects, as well as its potential to disrupt the hormone and reproductive systems of humans and amphibians.

Last week, a study published in the Proceedings of the National Academy of Science reported that male frogs exposed to levels of atrazine below federal limits could become functional females, with the ability to mate and lay eggs.

Citizens in all sixteen of the cities named in the lawsuit get their drinking water from sources next to or surrounded by agricultural fields where farmers use atrazine. Some of these cities sell their water in bulk to other nearby towns.

According to EPA data from 2008, at least two of the cities — Coulterville, Ill. and Monroeville, Ohio — found atrazine in their river water at levels above 30 parts per billion (ppb). To comply with federal law, the level of atrazine in drinking water must not exceed 3ppb on annual average.

Lawyer Stephen Tillery, who is representing the sixteen cities in this complaint, said that these cities alone have spent upwards of $350 million trying to filter atrazine from their drinking water.

Investigative Fund reporter Danielle Ivory discussed atrazine last fall on the TV program Democracy Now. To watch, click here.

In reversal, insurance plan will cover boy's prosthetic

Michigan,United States — 2011-10-12T15:11:24-04:00

A Michigan health insurance plan will make a one-time exception and cover a $30,000 prosthetic arm for a 12-year-old boy after his denied claim became a national story cited during the Senate health care debate.

The Huffington Post Investigative Fund reported two weeks ago that Benjamin French, who was born without a right arm, was ineligible for reimbursement because he had exhausted a lifetime maximum benefit for prosthetic devices. The report was part of the Investigative Fund’s ongoing coverage of how the health industry handles insurance claims.

The boy, who has three siblings, has needed over time seven prostheses since he was five months old. After Benjamin was fitted with the most recent arm, the French family learned that the claim had been denied by Blue Cross and Blue Shield of Michigan. The nonprofit insurer administers the health plan of the Michigan Conference of Teamsters Welfare Fund, which covers the French family.

It would have cost Benjamin’s parents more than half their combined annual income to pay for his new arm. Sen. Debbie Stabenow (D-Mich.) discussed the family’s situation during the floor debate in the Senate Nov. 21, calling on lawmakers to “eliminate those lifetime caps that get in the way of a 12-year-old boy being able to have the artificial arm that he needs … so he can lead a normal life.”

Just before Thanksgiving, Benjamin’s mother, Kristen French, received a phone call from a Teamsters representative, who said the union had authorized a one-time exception to the lifetime maximum payment. The French family later received a letter dated Nov. 25 from the Welfare Fund confirming that its board of trustees had voted to cover 75 percent of the price tag.

It is unclear how the insurance plan will handle Benjamin’s future prosthetic needs.

“They would not even talk to me before this. They just kept saying, ‘There is nothing we can do,’” French wrote in an e-mail to the Investigative Fund. “Amazing how media coverage can change their attitude.”

Helen Stojic, a spokeswoman for Blue Cross and Blue Shield of Michigan, declined to comment on an individual case. She indicated that the Teamsters fund set the insurance plan’s lifetime cap on prosthetic coverage. Blue Cross and Blue Shield “generally does not have separate maximums on prosthetics” in its health plans, she said.

Richard Burker, executive director of the Teamsters fund, said the reversal in the French family’s case was a one-time exception and does not signal a policy change by the union’s insurance plan. The plan’s caps on prosthetic coverage will continue, Burker said.

Editor's note, Dec. 3, 2009: Asked how the Teamsters Welfare Fund sets annual and lifetime coverage limits, Burker said, “I can’t tell you what is in the minds of the trustees when they formulate the plans and benefits.” The Michigan Conference of Teamsters Welfare Fund made available new information Thursday about its health benefit plans. Richard Burker, executive director, said in an e-mail that on November 24th the Teamsters Fund Trustees increased the lifetime cap on prosthetic coverage in those few plans that still maintain a separate dollar maximum for prosthetic benefits, by adding another $30,000. Any such member who hit a lifetime cap during 2009 will be credited up to $30,000. Burker said it was inaccurate to report that he had characterized the Teamsters Fund’s decision as a one-time exception for Benjamin French. He said that he is prohibited by privacy laws from discussing an individual case, but that the Fund administers its health plans uniformly and does not make one-time exceptions.

For 12-Year-Old without an arm, insurance has run out

2011-10-12T15:11:24-04:00

Benjamin French was born with his right arm missing below the elbow. In his 12 years, he has been fitted with seven prostheses. His most recent replacement will cost nearly $30,000 and his doctor says he will soon grow out of it.

But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit.

Benjamin’s family happens to live in Michigan, one of 33 states where insurance companies are allowed to set annual and lifetime caps on prosthetic coverage. The family’s policy with Blue Cross Blue Shield of Michigan covers a maximum of $30,000 per lifetime for prosthetics, plus $1,000 per year for repairs. In states such as Colorado and Maryland, the law says there can be no such cap on prosthetics.

“It seems really unfair,” said Benjamin’s mother, Kristen French. “The insurance company can do this in one state, but not in another? It’s ridiculous.”

The French family represents one small part of a health care system rife with inequities and inconsistencies: Some people have insurance, some do not. [Clarification Nov. 17, 2009: Original language implied Blue Cross Blue Shield of Michigan is a for-profit insurer; it is nonprofit.] For those who are insured, individual policies operate under different rules than group policies. Each insurance company and every individual policy has different requirements, exclusions, and benefits.

And, as in the case of Benjamin French — people with nearly identical health problems may have vastly different experiences with their private health insurance companies depending on their state of residence. Another example of the inequity: If Benjamin’s family were poor enough to qualify for Medicaid, most if not all of the cost of his new arm would be covered.

The French’s case emerged from the Huffington Post Investigative Fund’s citizen journalism project, which is calling on readers to help provide information, data and anecdotes about the inner workings of the insurance industry. One common theme among the responses is the wide variation in state rules.

States hold the primary regulatory authority over health insurance and each has different laws governing which benefits must be offered to its residents. Some of the state rules deal with major health issues and sometimes – as happened with treatment for mental illness – they have prompted insurers to expand coverage nationwide. Some states have adopted mandates for more specialized coverage, including the removal of birthmarks and varicose veins. Arkansas, Georgia and Vermont even require insurers to pay for personal trainers for people who need to lose weight for health reasons.

When a state lacks a mandate for a specific benefit, that doesn’t necessarily mean insurance companies won’t cover it anyway. For example, a handful of states do not require insurers to provide coverage for chemotherapy or treatment for Alzheimer’s disease – though that coverage is common in many insurance plans. Fourteen states do not require insurers to cover prostate cancer screening, though many plans may offer the benefit anyway.

Prosthetics is one area where the lack of a mandate seems to cause problems for many patients.

Within this decade, 17 states have passed laws requiring that insurers pay for prosthetics on par with federal programs such as Medicaid, but in the other 33 states, insurers do not have to offer coverage for prosthetic devices and also can set annual or lifetime caps on coverage. These caps on prosthetics are similar to the caps on mental health coverage that were recently made illegal by a federal mental-health parity law, scheduled to go into effect in January.

“These rules are illogical and arbitrary,” said Kimberly Hoyt, a specialist in Denver, Colo., who designs and fits prosthetic limbs. “You have to be an investigative reporter to figure out which states have parity laws and which states don’t.” Since Colorado became the first state to pass prosthetic parity legislation in 2001, Hoyt said, she has seen fewer denials overall for prosthetic limbs, but gets frustrated when she sees patients, such as college students, who cannot get coverage because they are insured in states with looser rules.

According to a Web survey conducted by the Amputee Coalition of America, amputees reported a wide variety of caps placed on their personal prosthetic coverage. Some said their insurance would pay no more than $1,000 per year. Some reported lifetime limits as low as $7,000. Many said their insurance would cover the cost of one prosthesis per lifetime, with no coverage for replacements or repairs. By comparison, Benjamin French’s lifetime cap of $30,000 seems generous.

But French said her son’s new arm will cost more than half of the family’s combined income. The couple has four children. Her husband, William French, was laid off from his job at DHL delivery in February. He just started a new job with a salary of about $30,000. Kristen French works part-time at Sam’s Club, where she expects to make about $12,000. The family has long had health insurance through their union affiliation.

Having to change her son’s prosthetic is like “buying a brand new car every two years,” French said.

A spokesman for Blue Cross Blue Shield of Michigan said the insurance company could not comment on individual cases.

Health care legislation pending in Congress could lead to some increased national consistency in insurance plans, but none of the bills would remove the right of states to require different types of coverage.

Insurance companies generally oppose state mandates, saying such rules complicate policies rather than help consumers. “I’m not going to talk about any one mandate specifically. There are already too many on the books,” said Susan Pisano, spokeswoman for the health insurance industry’s largest trade group, America’s Health Insurance Plans. “Too often the responsibility for this issue is laid at the doorstep of the insurance companies, when it needs to be shared with consumers, employers, and health care providers.”

Others say the mandates force insurers to offer more comprehensive coverage. “Insurers try to argue that some of these mandates are absurd, but I think it’s telling that there are some states that don’t offer, for example, maternity coverage,” said Edwin Park, a health insurance analyst at the Center for Budget and Policy Priorities, which focuses on programs and policy that affect low and moderate-income families. “It depends on the state, but it can be a crapshoot.”

Both the health care reform bills in the House and Senate have provisions that would push the states toward more uniform insurance laws, but health care would still remain patchwork from state-to-state. Both bills would identify at the federal level a minimum amount of essential benefits, but states could legislate stronger mandate laws.

The Senate Finance Committee’s health care bill would also enable insurers to put together nationwide plans. These plans would only have to include benefits mandated by a majority of the states. However, states could decline to offer these plans to their residents if they felt they were inadequate.

But some argue that adding a layer of federal regulations will not make the insurance laws seem any less arbitrary.

“These mandates tend to depend on which political constituency is the most organized and vocal. Some people suggest that federal mandates might be more rational than they are from state to state, but I’d argue that you’d find the same problems or worse problems at the federal level,” said Joel Ario, Pennsylvania’s insurance commissioner and an official at the National Association of Insurance Commissioners.

Ario said that the federal government could play a role in creating minimum standards, but that the states should have the ability to mandate stronger coverage. “We’ve seen how this has worked in the past with environmental laws, with civil rights laws,” he said.

Rape victim's choice: Risk AIDS or health insurance?

2012-01-27T17:11:10-05:00

Christina Turner feared that she might have been sexually assaulted after two men slipped her a knockout drug. She thought she was taking proper precautions when her doctor prescribed a month’s worth of anti-AIDS medicine.

Only later did she learn that she had made herself all but uninsurable.

Turner had let the men buy her drinks at a bar in Fort Lauderdale. The next thing she knew, she said, she was lying on a roadside with cuts and bruises that indicated she had been raped. She never developed an HIV infection. But months later, when she lost her health insurance and sought new coverage, she ran into a problem.

Turner, 45, who used to be a health insurance underwriter herself, said the insurance companies examined her health records. Even after she explained the assault, the insurers would not sell her a policy because the HIV medication raised too many health questions. They told her they might reconsider in three or more years if she could prove that she was still AIDS-free.

Stories of how victims of sexual assault can get tangled in the health insurance system have been one result of the Huffington Post Investigative Fund’s citizen journalism project, which is calling on readers to provide information and anecdotes about the inner workings of the insurance industry. The project aims to uncover details and data that can inform the larger debate over how to fix the nation’s health care system. As the Investigative Fund reported in September, health insurance companies are not required to make public their records on how often claims are denied and for what reasons.

Some women have contacted the Investigative Fund to say they were deemed ineligible for health insurance because they had a pre-existing condition as a result of a rape, such as post traumatic stress disorder or a sexually transmitted disease. Other patients and therapists wrote in with allegations that insurers are routinely denying long-term mental health care to women who have been sexually assaulted.

Susan Pisano, spokeswoman for the health insurance industry’s largest trade group, America’s Health Insurance Plans, said insurers do not discriminate against victims of sexual assault and ordinarily would not even know if a patient had been raped.

"These issues you are bringing up, they deserve to be brought up,” said Pisano. "People who have experienced rape and sexual assault are victims and we want them to be in a system where everyone is covered."

Turner’s story about HIV drugs is not unusual, said Cindy Holtzman, an insurance agent and expert in medical billing at Medical Refund Service, Inc. of Marietta, Ga. Insurers generally categorize HIV-positive people as having a pre-existing condition and deny them coverage. Holtzman said that health insurance companies also consistently decline coverage for anyone who has taken anti-HIV drugs, even if they test negative for the virus. “It’s basically an automatic no,” she said.

Pisano, of the insurance trade group, said: “If you put down on a form that you are or were taking anti-HIV drugs at any time, they [the insurance companies] are going to understand that you are or were in treatment for HIV, period. That could be a factor in determining whether you get coverage."

Some doctors and nurses said that the industry’s policy is not medically sound. “The chance of a rape victim actually contracting AIDS is very low. It doesn’t make any sense to use that as a calculus for determining who get health insurance,” said Dr. Alex Schafir, faculty instructor at Providence St. Vincent Hospital in Portland, Ore.

Nurses who deal with sexual assault cases say the industry’s policy creates a significant problem for those treating women who have been assaulted. “It’s difficult enough to make sure that rape victims take the drugs,” said Diana Faugno, a forensic nurse in California and board director of End Violence Against Women International. “What are we supposed to tell women now? Well, I guess you have a choice – you can risk your health insurance or you can risk AIDS. Go ahead and choose.”

Turner, now a life and casualty insurance agent, said she went without health coverage for three years after the attack. She second-guesses her decision to take the HIV drugs. “I’m going to be penalized my whole life because of this,” she said.

Several women told the Investigative Fund that after being sexually assaulted they had been denied care or ruled ineligible for health insurance because of what were deemed pre-existing conditions stemming from their assaults -- particularly post traumatic stress disorder, or PTSD.

A 38-year-old woman in Ithaca, N.Y., said she was raped last year and then penalized by insurers because in giving her medical history she mentioned an assault she suffered in college 17 years earlier. The woman, Kimberly Fallon, told a nurse about the previous attack and months later, her doctor’s office sent her a bill for treatment. She said she was informed by a nurse and, later, the hospital’s billing department that her health insurance company, Blue Cross Blue Shield, not only had declined payment for the rape exam, but also would not pay for therapy or medication for trauma because she “had been raped before.”

Fallon says she now has trouble getting coverage for gynecological exams. To avoid the hassle of fighting with her insurance company, she goes to Planned Parenthood instead and pays out of pocket.

A New Mexico woman told the Investigative Fund she was denied coverage at several health insurance companies because she had suffered from PTSD after being attacked and raped in 2003. She did not want to disclose her name because she feared that she would lose her group health insurance if she went on the record as a rape victim. “I remember just feeling infuriated,” she said.

“I think it’s important to point out that health plans are not denying coverage based on the fact that someone was raped,” said Pisano of the insurance trade group. “But PTSD could be a factor in denied coverage.”

“That might not be a discriminatory action, but it certainly would seem to have a discriminatory impact,” said Sandra Park, staff attorney at the Women’s Rights Project at the American Civil Liberties Union. “Insurance discrimination against rape victims will only further discourage them from coming forward to law enforcement and seeking medical help.”

Even when patients have coverage, there are fundamental disagreements between insurance companies and doctors about what mental health treatment is medically necessary. The Investigative Fund spoke with doctors, psychologists, and licensed clinical social workers around the country who work regularly with victims of sexual assault. They said that their patients have been experiencing an increase in delays and denials, particularly for talk therapy.

“There’s a lot of anger about this in the medical community,” said Dr. George Shapiro-Weiss, a psychiatrist in Middletown, Conn. “You don’t realize what an Alice in Wonderland web this has become.”

“A lot of my patients are being told that their treatment isn’t medically necessary,” said Keri Nola, an Orlando, Fla., psychologist, who said about 75 percent of her patients are victims of sexual violence.

Several therapists cited problems with managed care companies that specialize in mental health. Such firms generally work under contract with health insurers to hold down costs while still authorizing appropriate care.

Some therapists and patients said the managed care companies have cut off necessary treatment for sexual assault victims in the name of cost containment. “The companies are peppering them with questions about their symptoms, and about their histories, and asking, ‘Well, are you sure you really need therapy?’” said Jeffrey Axelbank, a New Jersey psychologist. “For someone who has been traumatized, it can feel like another trauma, and it makes the therapy less effective.”

Pisano, of the insurance association, said it was not fair to draw a larger pattern from such anecdotal evidence. “These situations are evaluated on a person-by-person basis,” she said. “There is nothing routine about this.”

Jim Wrich, a Madison, Wis., a consultant who helps employers evaluate the companies that manage their mental health care, said his work has made him wary of the industry. “This is absolutely routine – these denials,” Wrich said. “The default position is to reject care.”

Magellan Behavioral Health Services, Inc., one of the nation’s largest managed-care companies with more than 58 million customers, said that it does not routinely turn down treatment requests from victims of sexual assault or other clients. “We’re not denying care. We are exercising our responsibility to make sure that medical necessity is met,” said Dr. Lawrence Nardozzi, Magellan’s medical director. “I think the process works well.”

Asked if cost is a factor in the company’s decisions, Magellan spokeswoman Erin Somers said: “If all the safeguards are in place to determine whether treatment is medically necessary and appropriate” then “the cost takes care of itself.”

A former care manager for Magellan said in an interview that she felt pressure to deny care for cost reasons. Lois Gorwitz, a psychologist with thirty years of experience who went to work for Magellan in California in 2000, said her superiors would tell her: “We are not denying this person treatment, we are denying them their benefit. If they want the treatment they can still pay out of pocket.” But, Gorwitz said, “You know that means that the person is not going to get the treatment because they can’t afford to pay out of pocket.”

Gorwitz quit after two years. “It’s a very uncomfortable feeling of not being able to offer help,” she said.

Asked for a response, Magellan’s Somers said, “I think you should keep in mind that there have been a lot of changes at Magellan in the last seven years. I think the people who work at Magellan now are not having that experience.”

In reversal of Bush policy, EPA launches new study of atrazine’s health effects

2011-10-12T13:10:46-04:00

The Environmental Protection Agency today reversed its stance on the potential hazards of atrazine, one of the most commonly-used herbicides in the country, saying it will re-examine how the chemical affects human health.

EPA officials said in a statement that the agency will take a close look at the weed-killer’s potential to cause cancer, as well as birth defects, low birth weight, and premature births. Agency scientists also will conduct research for the first time examining whether atrazine interferes with the hormone and reproductive systems of humans and amphibians.

The announcement marks a departure from the agency’s policies on atrazine during the Bush administration, when officials said that the concentrations of the herbicide measured in drinking water did not endanger public health. As recently as June, Steve Bradbury, deputy office director of the EPA’s office of Pesticide Programs, told the Huffington Post Investigative Fund “we have concluded that atrazine does not cause adverse effects to humans or the environment.”

Today, EPA spokesman Dale Kemery told the Investigative Fund, “This administration is taking a hard look at the atrazine decision made by the previous administration.”

As the Investigative Fund reported in a series of articles in August, the EPA failed to notify the public about data it had collected showing that atrazine has been found at levels above the federal safety limit in drinking water in at least four states. After the Investigative Fund analyzed and published the data, the EPA posted its data online and said it would continue to update it.

Atrazine, manufactured by the Swiss firm Syngenta, is primarily sprayed on cornfields and other major crops. The European Union has banned the use of atrazine, saying there was not enough information to prove its safety, and the EPA has long fielded criticism from environmental activists for allowing the chemical to remain on the market.

The EPA’s announcement of its new atrazine study follows a private September meeting between the EPA's senior staff and the Senate Environmental and Public Works Committee, led by Sen. Barbara Boxer (D-Calif.) According to a senior staffer on the committee, Boxer’s team encouraged the EPA to open a new analysis of the risks of atrazine and to keep the public informed about the levels of the weed-killer in drinking water.

The committee plans to hold a hearing on atrazine and the EPA later this year, the staff member said.

The EPA said it will announce its specific plan for evaluating the effects of atrazine next month, and that the study would conclude in September 2010. Officials said the report also will include results from a National Cancer Institute Agricultural Health Study due next year.

“I think it is important for the EPA to evaluate the effects of atrazine on humans and I am very pleased to see that they are emphasizing transparency in this evaluation process,” said Jason Rohr, a specialist in ecotoxicology at the University of South Florida who served on the EPA’s atrazine panel this past spring. “Given atrazine's consistent effects on freshwater vertebrates, it would not surprise me if a weight-of-evidence approach also revealed consistent effects on humans.”

In September, Rohr and colleagues published an article in the journal Environmental Health Perspectives examining more than 100 scientific studies of the weed-killer. They concluded that the chemical affected the developmental, behavioral, immune, hormone, and reproductive systems of aquatic animals.

That contrasted with an EPA statement in July, when the agency updated its Web site to say: “atrazine does not adversely affect amphibian gonadal development… and EPA believes that no additional testing is warranted to address this issue.”

“At the very least,” Rohr said, “the public should be notified when atrazine levels in their drinking water exceed the maximum contaminant level set by the EPA.”

In health care, number of claims denied remains a mystery

2011-10-12T11:26:07-04:00

Are health insurance companies generally being fair and honest when they reject claims from policy holders?

That would seem to be an important question in deciding how best to fix the U.S. health system. But it hasn’t been a focus of the raging health-care debate — possibly because the answer is not publicly available.

“This is one of the dark corners of the black box that is private health insurance,” said Karen Pollitz, a professor at the Georgetown University Health Policy Institute.

Data on how often insurance claims are denied — and for what reasons — is collected and analyzed by the insurance companies themselves. But except in California, the companies aren’t required to provide those records to any state or federal agency. “The number is knowable, but not known by regulators or policy makers or patients,” Pollitz said.

The main health-care reform bill being considered in the House does seek to address the matter. It would require health insurance companies to report data on claims policies, practices and denials to a central commissioner.

The issue of claims surfaced recently in California. The state Nurses Association issued a press release saying that data it obtained from the Web site of the state’s Department of Managed Health Care showed that in just the first half of 2009, California’s six largest HMOs had rejected more than 31 million claims — 21 percent of those they had received.

The way the nurses group tells it, state officials didn’t even know they had the data.

Don DeMoro, a policy director for the nurses’ association, said that he received a phone call from the managed care department after its press release came out.

“They said, ‘You couldn’t have gotten this data from us. We don’t collect it ourselves,’” DeMoro said. “‘The data is there,’ I told them, ‘but it’s hard to find.’ I walked them through the steps and waited while they clicked through their own Web site. Once they saw that the data was there, they politely said, ‘Thank you’ and hung up.”

Lynne Randolph, spokesperson for the state agency, said she does not know what DeMoro might have been told, but said, “We’ve always known about this data.”

(To check the California data, go to the managed care agency's searchable financial reports. On the pull down menu, select ‘full service,’ choose a company name and ‘annual.’ When the list comes up, click on the company name and you will download a spreadsheet. The claims data is contained on the tab labeled ‘Schedule G.’)

In any case, Randolph contends that the nurses’ group misrepresented the meaning of what it found. She said the total number of “claims denied” include duplicate claims and claims that were eventually appealed and accepted, in addition to actual denials. “You can’t just look at the numbers in schedule G,” she said. “I guess it might look that way to a layman, but that data obviously does not reflect actual denials.”

Tim Labas, assistant deputy director in the Office of Health Plan Oversight at the state agency, estimated that the actual denial rate across the board in California is probably somewhere between 10 and 20 percent. “That might still seem high,” he said. “But there are legitimate reasons why claims are denied.”

The state officials said they consider the claims data they collect to be a kind of early warning system. If they notice large jumps in claims denials for an insurance company, they have the authority to request more specific information, said Mark Wright, an official in the health plan oversight office. The office said it could not cite an example of when it made such a request.

“We could require the insurance companies to report all of the data to us, but I think it would just be too much information for us to handle,” Wright said. “We’d be overwhelmed.”

The National Association of Insurance Commissioners (NAIC), whose stated mission is to “assist state insurance regulators, individually and collectively, in serving the public interest” said the group did not know the state reporting requirements for insurance companies, nor does it collect data on the actual number of claims denials.

State regulators tend to focus on individual complaints from consumers. But only a fraction of consumer problems with health insurance result in formal complaints.

A national survey published by the Kaiser Family Foundation in June 2000 found that 51 percent of those surveyed had experienced some type of problem with their health insurance, but only two percent had made a formal complaint. Nearly 90 percent of those surveyed could not name the agency that regulates health insurance in their state.

In recent testimony before the House Subcommittee on Domestic Policy, Pollitz, the Georgetown professor, said that collecting claims data is important because “regulators must be able to monitor patterns of health insurance enrollment and disenrollment in order to know whether insurers are avoiding or shedding.”

Robert Zirkelbach, spokesperson for the insurance industry’s trade association, America’s Health Insurance Plans (AHIP), said his organization had not taken a position on the proposed reporting requirement in the House bill.

AHIP represents, among others, UnitedHeathOne, Wellpoint, Inc., Aetna, Inc., Humana, Inc., CIGNA Healthcare, and the Health Care Service Corporation, all of whom sent executives to testify before the subcommittee on Thursday.

AHIP submitted testimony to the record as well, noting that the organization had completed an internal investigation of 700 million claims voluntarily submitted by 19 unnamed insurance companies in 2006 and found the denial rate to be only about 2.36 percent.

But Pollitz said that consumers and regulators, not insurers, need more “detailed, descriptive information about how coverage works.” This data about health insurance is generally lacking at both the federal and state levels.

Last year the House Committee on Oversight and Government Reform requested information from 50 state health insurance regulators. They found that most states didn't know the answers to basic questions. Only four states — Hawaii, Kansas, Texas, and Washington — knew how many times insurers had dropped people’s coverage. Only ten states knew how many individual health insurance policies were in effect in their jurisdictions. More than one-third of state commissioners did not know which health insurance companies even offered policies in their state. The federal agency responsible for maintaining health insurance standards and oversight, the Center for Medicare and Medicaid Services, does not gather compliance data, nor does it track state enforcement.

“It is time for the federal government to take a more active role in health insurance regulation,” Pollitz said.

Water utilities lack proper filters for weed-killer

2011-10-12T11:14:04-04:00

Results from a federal drinking water monitoring program show that many public water companies are ineffective at removing a widely used weed-killer from their water supplies.

As the Huffington Post Investigative Fund reported earlier this week, the Environmental Protection Agency has failed to notify the public about data showing that the herbicide atrazine has been found at levels above the federal safety limit in drinking water in at least four states. Atrazine has been studied for its potential link to breast cancer, prostate cancer, and birth defects, and the EPA considers it to be a potential endocrine disruptor. It is banned in the European Union.

But the EPA’s data also reveals that many public water filtration systems are not removing the herbicide. In many places, atrazine levels in untreated water sources such as rivers directly match the levels that come out of the tap.

A carbon filter with granular activated carbon — in other words, a giant Brita-like filter — should absorb all or most of the atrazine. But the EPA’s atrazine monitoring data shows that many water utilities in the Corn Belt do not use carbon filtration. Many use rapid sand filters instead. They are cheaper and last longer, but are unable to remove organic compounds such as PCBs, phthalates, pharmaceuticals, and pesticides such as atrazine.

“Carbon filters might have to be replaced every couple of years whereas sand filters could last 20 to 30 years,” said Alan Roberson, director of security and regulatory affairs at the American Water Works Association, a non-profit organization representing water utilities.

To recover the cost of filtering atrazine, water companies in six states are preparing a lawsuit against the makers of atrazine, the Swiss company Syngenta.

When you compare the raw and finished water of an effective carbon filtration system, you see something like the chart below, which shows weekly levels of atrazine in river water and drinking water as measured last year in Bowling Green, Ohio.

Bowling Green added carbon filters to the water system in 2000. “We installed the filters to take care of taste and odor problems, but it [also] gets the atrazine out of there,” said Chad Johnson, assistant superintendent at the water utility. “These filters are expensive, though. Our new building cost about five million dollars.”

Every year, the utility replaces six of the 12 filter vessels at a cost of $126,000, Johnson said. He said the water plant had received $5 million in stimulus funds, which will be used to partially fund an $11 million project to install new membranes, which will remove nitrates and other chemicals from the water.

Atchison, Kan., is among water systems that do not have adequate filters in place. The chart shows weekly levels of atrazine in river water and drinking water as measured last year.

“I’ll be darned,” said Michael Matthews, the utilities director in Atchison, Kan., upon hearing that atrazine was barely being filtered from his drinking water. “That’s bad.”

Water plant managers said the economic downturn has made it even harder to convert to more effective filters. “Right now, we can’t afford anything,” said Lloyd Littrell of the Beloit, Kansas water plant, where rapid sand filters are used.

“It’s impossible to get atrazine out of the water with these filters. There’s no way to remove it,” he said. “But people need this water. We can’t just shut our doors and tell people to drink from the river.”

Stan Schafer of the Baxter Springs plant, where sand filters are used, said it was difficult to get funding for water cleanup even prior to the recession. “Shoot, I’d like another filter,” he said. “But they’re expensive. We did a $2.5 million update about three years ago and that system is falling apart.”

A civil engineering professor at Virginia Tech University, Marc Edwards, said that the cost of granular activated carbon treatment could double the total cost of drinking water treatment in some rural and poor communities.

“We are used to paying very little for tap water,” Edwards said. “It is hard for some rural communities to justify the higher costs of advanced treatment.”

“Most water systems don’t have the resources to buy a new filter,” said Kirk Leifheit, Assistant Chief of the Drinking Water Program at the Ohio EPA. “They are reporting to us needs in the billions.”

The EPA only monitors the river water and drinking water in about 150 water systems, so it is unknown whether other communities might be experiencing problems filtering atrazine. Washington, D.C., and Maryland, for example, are not part of that program.

However, atrazine is heavily used in the Maryland area, according to data from the U.S. Geological Survey. The Washington Aqueduct, which treats water from the Potomac River for about 1 million in the DC area, does not filter for atrazine.

Water systems in 57 cities are preparing a lawsuit against the atrazine manufacturer, the Swiss company Syngenta, to recover the cost of filtering the chemical out of drinking water. Utilities in Illinois, Ohio, Kansas, Indiana, Missouri, and Iowa are preparing to file suits in state courts. A hearing in Illinois is scheduled for Monday.

“Many of those water providers have incurred an enormous amount of expenses at a time when their tax base is shrinking,”said Stephen Tillery of the Korein Tillery law firm in St. Louis, who represents the water systems. “They’re cash strapped.”

Jere White, executive director of the Kansas City Corn Growers Association and the Kansas Grain Sorghum Producers Association, has been fighting atrazine regulation at both a local and national level since 1995. He has been vocal about opposing the class action lawsuit against Syngenta.

“The difference between them [the lawyers] and an ambulance chaser is the fact that with an ambulance chaser, you at least assume that there’s an ambulance and an injury,” White said in a phone interview.

White is also chairman of the Triazine Network which has been fighting atrazine regulation since 1995. The Network and the Corn Growers, according to White, receive regular funding from Syngenta — for travel, speaking engagements (including EPA hearings), and education, though he pointed out that it has never been earmarked specifically for “advocacy.” The Network, according to its website, “strives to keep the beneficial triazine herbicides available in the United States.”

Updated Aug. 27, 4:54pm: In an interview today, Jere White of the Kansas Corn Growers Association said he does not oppose all regulation of atrazine. As he characterized it, his organizations are seeking scientific justification from the EPA for stricter laws regulating the chemical.

EPA fails to inform public about weed-killer in drinking water

Illinois,United States — 2011-10-12T11:00:27-04:00

One of the nation’s most widely-used herbicides has been found to exceed federal safety limits in drinking water in four states, but water customers have not been told and the Environmental Protection Agency has not published the results.

Records that tracked the amount of the weed-killer atrazine in about 150 watersheds from 2003 through 2008 were obtained by the Huffington Post Investigative Fund under the Freedom of Information Act. An analysis found that yearly average levels of atrazine in drinking water violated the federal standard at least ten times in communities in Illinois, Indiana, Ohio, and Kansas, all states where farmers rely heavily on the herbicide.

In addition, more than 40 water systems in those states showed spikes in atrazine levels that normally would have triggered automatic notification of customers. In none of those cases were residents alerted.

In interviews, EPA officials did not dispute the data but said they do not consider atrazine a health hazard and said they did not believe the agency or state authorities had failed to properly inform the public. “We have concluded that atrazine does not cause adverse effects to humans or the environment,” said Steve Bradbury, deputy office director of the EPA’s Office of Pesticide Programs.

Officials at Syngenta, the Swiss company that manufactures atrazine, declined requests for interviews about the testing results. In a statement on its Web site, the company says that atrazine “poses no threat to the safety of our drinking water supplies. In 2008, none of the 122 Community Water Systems monitored in 10 states exceeded the federal standards set for atrazine in drinking water or raw water.”

Atrazine has become an issue of concern for environmentalists and consumer groups as the use of the herbicide has soared in the United States over the past few decades. Some scientists who have studied atrazine said the information about its higher levels in drinking water should be made public.

“This is an issue of the EPA not being forthright about what they know,” said Robert Denver, a neuroendocrinologist at the University of Michigan who has served on two of the EPA’s scientific advisory panels on atrazine.

“It is the responsibility of the EPA and Syngenta to inform the public of accurate levels of atrazine in their drinking water,” said Jason Rohr, a specialist in ecotoxicology at the University of South Florida who studies the effects of atrazine in animals, and who served on the EPA’s atrazine panel this past spring.

Atrazine is sprayed on cornfields and other major crops during the summer months and can run off into rivers and streams that supply drinking water. It is also commonly used on golf courses.

Studies of atrazine’s potential links to prostate and breast cancer have been inconclusive. Based on the recommendations of its scientific advisory panels in 2000 and 2003, the EPA has listed atrazine as “not likely” to be a carcinogen but does officially consider it to be a potential hormone disruptor – a risk factor explored by researchers testing animals.

In recent years atrazine has been the subject of intensive debate among scientists about its effects on the reproductive systems of frogs and other vertebrate animals. In some studies, male frogs that were exposed to high levels of atrazine have been documented to grow eggs.

In 2004, the European Union banned atrazine because it was consistently showing up in drinking water and health officials, aware of ongoing studies, said they could not find sufficient evidence the chemical was safe.

State regulators in the U.S. test their local water systems for atrazine a maximum of four times a year, under the federal Safe Drinking Water Act. In 2003, the EPA again approved atrazine for use in the United States but it made some demands of Syngenta for the re-registration.

The EPA and Syngenta negotiated a deal for more extensive monitoring of about 150 vulnerable watersheds. Under that arrangement, the company pays for weekly monitoring and sends the results to the EPA, as well as to the local water companies and most state regulators.

The Natural Resources Defense Council, an advocacy organization, is expected to release a report on Monday that fully analyzes a smaller set of Syngenta’s weekly testing results — from 2003 through 2006 — and reaches conclusions similar to the Investigative Fund’s analysis of all five years of data. The group supplied an advance copy of its report to The New York Times, which today published an article about the tests and other safety questions about atrazine.

Misleading Water Bills

The EPA plans to revisit its rules for atrazine in 2011. Presently the agency requires water systems to notify their customers if the quarterly state tests average higher than 3 parts per billion (ppb) annually. According to the EPA data obtained by the Investigative Fund, cities in four states — Illinois, Indiana, Ohio, and Kansas — had yearly averages of atrazine violating that standard from 2003 to 2008.

In addition, more than 40 water systems in those states showed spikes of atrazine over 12 ppb – which if found in the state quarterly tests would have required the water system to notify the public within 30 days.

In none of those cases were residents notified of the high levels. In fact, the brochures in their water bills – reviewed for this report — contained misleading numbers based on the state testing.

For example, based on the quarterly tests, residents of Mt. Olive, Ill., were told that the highest level of atrazine in their drinking water last year was 2 ppb. However, the EPA data shows a spike in June of 16.47 ppb. The same year, residents of McClure, Ohio, were told that the highest level of atrazine in their drinking water was 3.4 ppb ( read the McClure Consumer Confidence Report). The EPA data shows a spike in June 2008 of more than ten times that amount — 33.83 ppb.

Both of these cities’ water utilities received the weekly EPA data directly from Syngenta, but did not report it. Legally, they didn’t have to. The drinking water act only requires cities to report data collected by the state. State tests are performed infrequently, so they are vulnerable to missing the chemical spikes that consistently occur around the time the weed-killer is being applied. With weekly tests, such as those ordered by the EPA, it is all but impossible to miss these spikes.

Asked why the results of the weekly tests had not been published, the EPA’s Bradbury said “no data is withheld from the public.” Bradbury said the information has been posted on the agency’s electronic public docket. In fact, the weekly test results are one of the only items on the docket that are not posted on the site.

Instead they are listed as available only through the Freedom of Information Act.

In an on-camera interview with the Investigative Fund in June, Bradbury also said that the weekly monitoring had found no spikes in any watershed over 3 ppb. “It’s these spikes that we’re focusing on,” he said. “There have been no exceedances.” In fact, the EPA’s data recorded more than 130 spikes over 3 ppb during 2008 alone — not only in Illinois, Ohio, Indiana and Kansas, but also in Missouri, Louisiana, and Texas. Bradbury declined to elaborate on the apparent contradiction.

The EPA does not consider one-time spikes of atrazine to be dangerous, but several peer-reviewed scientific studies suggest that the chemical may be harmful, particularly to developing fetuses, in doses as low as 0.1 ppb. One study, published this year in the medical journal Acta Paediatrica, found that birth defect rates in the United States were highest for women who conceived during months when atrazine levels were spiking.

“If you happen to become pregnant in June, you care about the levels [of atrazine] in June, not in January,” said Shanna Swan, an epidemiologist at the University of Rochester who has studied atrazine’s effect on semen quality and development.

“For pregnant women, you have a critical period of a couple of weeks to a couple of months,” Swan said. “If you have a peak exposure in that period, that’s what’s relevant to the pregnancy.”

“The annual average might be relevant for [measuring the risk of] cancer, but it’s obviously not okay if they [the EPA] care about regulating for reproductive toxicity,” she said.

Had the EPA, the state or the local water companies made the weekly testing results public, residents could have made different choices about their water consumption, such as using inexpensive household carbon water filters or bottled water.

Asked about the discrepancies between the state and weekly EPA data, an EPA spokeswoman, Deb Berlin, said in an e-mail, “Consumers need accurate information to make health decisions for themselves and their families. EPA and state authorities would be interested in knowing about any situation where a public water system is not reporting accurate information to their customers as required by the Safe Drinking Water Act.”

‘I’d Do More Testing’

Under the terms of its 2003 agreement with the EPA, Syngenta for the past five years has been monitoring water weekly in 10 states, with special emphasis on Illinois, Ohio, and Kansas.

This is how the EPA’s testing program generally works: Syngenta sends boxes containing two tubes to about 150 water utilities. During the summer growing season when atrazine levels are likely to spike, water operators at these utilities take samples on a weekly basis. Every week, they fill one test tube with river water and one test tube with drinking water. They ship these samples to Syngenta labs, where the company analyzes them. Syngenta then reports the data to the EPA, as well as to the water utilities themselves and the state regulators.

Testing at the state level is much more modest. Up to four times a year, but as infrequently as once a year, water utilities ship one test tube filled with drinking water to their state regulator. The state analyzes the water and reports the data back to the water utility. This limited data is reported to the public, as required by federal right-to-know laws.

There are vast discrepancies between the two data sets. The Huffington Post Investigative Fund contacted water plant operators to see if they had noticed.

Some local water officials said they provided weekly samples to Syngenta but did not realize the company was acting under a requirement from the EPA intended to supply more data as a safeguard for their drinking water. They indicated they paid little attention to the results of the tests.

Robert Leonhardt, the water plant manager in Mt. Olive, Ill., received the weekly EPA data but said he was not aware of any of the spikes during the last five years, including a high reading of 16.47 ppb. He said the weekly testing was not a central part of his work. “This is a side thing,” he said.

Steve Kubler, the water plant manager in Chanute, Kan., initially said of the state and weekly tests: “The numbers match up pretty well. I’ve never noticed a discrepancy.” He added, “If I did, I’d do more testing.”

According to that data, his town of Chanute recorded one reading of 6.51 ppb last year. The city reported a high of 1.4 ppb to the public. Asked about the numbers, Kubler said, “Look, what I do with Syngenta — it’s in excess of what I have to do. I don’t know even know why they’re testing.”

In Illinois, Roger Selburg of the state’s Environmental Protection Agency said that he looks at the weekly data. But he said he does not use it to determine violations, nor does he report any of it to the public, because he does not know if the data are reliable or accurate. “We are only required to report the state data,” he said.

Other water officials expressed some surprise and dismay about the levels of atrazine that showed up in the weekly tests. Osawatomie, Kan., showed a spike of 8.70 ppb in May 2008, although the city reported to the public a high of 0.89 ppb for the year. “That’s a pretty good spike,” said Marty Springer, water plant manager at Osawatomie’s plant. “And no one knows about it.”

McClure, Ohio, showed a spike of 33.83 ppb in June 2008, but the town told its residents the highest level that year was 3.4 ppb. “If we had been using Syngenta’s data, obviously we would have hit the maximum contaminant level,” said Christopher Diem, superintendent at McClure’s water utility.

In Baxter Springs, Kan., atrazine spiked above 11 ppb in May 2008 while the town told its residents the highest level during the year was 1.3 pbb.

“We may have passed the quarterly tests for the state, but we’re not passing them weekly or daily,” said Stan Schafer, a water plant operator in Baxter Springs. “Somebody’s got to do something,” he said. “I live here. I drink the water. My parents drink the water. My kids drink the water. I just try to keep it clean.”

Schafer said he regularly receives atrazine testing data from Syngenta, along with the results from the state, but he doesn’t think he is allowed to report it to the public.

That fits with the impression that Kansas state health officials gave Lloyd Littrell, director of utilities in Beloit, about the weekly test results from Syngenta.

“I kept track of those numbers for a couple of years, but I stopped,” Littrell said. “The state of Kansas would not let us report the results. We had several conversations about it. They said it wasn’t certified by the state or something. I stopped trying. If we can’t use it, what’s the point of me looking at it?”

According to the EPA data, atrazine spiked above 20 ppb in May 2008, but Beloit reported a high of 2 ppb to the public.

“It concerns me,” Littrell said. “If it’s an actual health hazard and they know and the EPA knows it’s getting in water — I can’t believe they’re not doing anything about it.”

Download the full Syngenta data by year: 2008 | 2007 | 2006 | 2005 | 2004 | 2003
Download the Natural Resources Defense Council Report: “Atrazine: Poisoning the Well”