Editorial: Uninsured young people gai...

Editorial: Uninsured young people gain in coverage

There are 8 comments on the Santa Fe New Mexican story from Dec 26, 2011, titled Editorial: Uninsured young people gain in coverage. In it, Santa Fe New Mexican reports that:

It's so easy to be cynical about government. The year-end tax stalemates, the debt-ceiling and spending fights.

Join the discussion below, or Read more at Santa Fe New Mexican.

josh125 I have Not

Los Alamos, NM

#1 Dec 27, 2011
A prior thread on here was cut by Josh125 speaking to some administrator. I suspect this may be all pooh-pooh, mainly because it coincided with a neighbor of ours beating on our ceiling and also turning on his stereo, directly below our bed in the morning. This was to cause my Honey to have either seizures or the both of us to at least lose sleep. I heard all 3 attempts this a.m., and prevented them. Those of you who follow this thread already know the rest.

The guy is tied into Pat, my mother, her friend Creamer, and the LAPD. This was because our hearing was scheduled this week in Mexicola, at ISD.

My mother tried to force us, too, to accept some mail that I worked out with the ISD Judge this week NOT to accept. ISD made sure it arrived AFTER the 7-day deadline. The mail was really funny. First ISD stated it did not know why I had the complaint. Secondly, they apparently are admitting defeat, just using the hispanic neighbor and other hispanics, all solely and only from Mexicola, to harass us and enforce it-when I explained it to people yesterday, it got around really fast, and all of the people who had been harassing, especially from mexicola, stopped, THAT DAY! As Ayn Rand stated in one of her books, people only do that when they know they are inferior, or at least their arguments, to the person they are harassing, it's a way of counteracting the supposed betrayal of their own body and mind to knowing that fact, and their inability to deal with their own feelings of inferiority. In northern New Mexico, this is pretty common, which is why, as numerous studies done during the Johnson admin and prior to it, the good people get up leave, leaving ruin in their wake. Espanola used to produce the same amount of geniuses and high-achievers any other place did, they left tho after graduating and took their effectiveness and earning potential with them.I know of 2 Doctors who did the same, all due to treatment they received in Espanola, too. This is the third place I have lived in the last ten years, different racial groups, different culture each time, same problem and end result. When a society wants to commit suicide, it develops human cancers who then destory anything good that is left.

Anyway, I did review the material, and it is pretty funny. ISD dropped the overpayment thing, then sent me some stuff about MAD or medicaid problem I have already detailed here. The worker, ortiz, stated the 3 parts of NM state law, and they were easily oversome with their own words. I will later put the whole thing here, but I'm still tired, so I can't do it right now.

Essentially the state's case is that because a PCO is part of COLTS, I fit into it. Then, Paula Ortiz stated she called Matthew Torres at Santa Fe Social Security and asked him what insurance plan I was on, and she claimed he stated Evercare. This is funny, because the other material I've received in the mail this week stated otherwise, and Torres does not state or say which insurance plan I am supposed to choose, so having him state is a way for an extrememly stupid person to distract away from the fact that the MAD and me make that decision, not Social Security. SS already decided I'm supposed to be on medicaid alone, and that was decided by Federal Law.

On the Benefits handbook for Aging and Long Term services, it lists me under medicaid 001 and 004. It states on the next page, COLTS uses medicaid for full medicaid funding, but the dummies at Mexicola ISD apparently didn't strike that. In the laws they quoted, it states a medical team has to meet, and decide to have me put into a nursing home.
josh125 I have Not

Los Alamos, NM

#2 Dec 27, 2011
In the same Benefits handbook I quoted in prior, it states COLTS recipients have to meet the requirements for Institutional Medicaid, which on the prior, and same page as the medicaid 001 and 004, it states Institutional Medicaid REQUIRES a current 30-day stay in a nursing home to be actioned. It also states assets may not exceed 101K$ for the spouse if a community waiver is used to allow the person to stay at home. That would preclude my SSI be defintion, since right above it states I cannot have any assets over $3k.

I have not had a group of doctors decide to put me into a nursing home, and I have not then stayed there 30 days, nor gotten a waiver, as none of that applies to me-it applies to people like my Doctor's mother, who gets SSI, was then committed to a nursing home and put on Evercare. I also have a copy of my current medicare/CMS bill, I am getting billed by medicare/CMS, and NOT Evercare, or any of the other companies that ISD has had send me junk, either.

The problem is the English illiteracy and anti-white bigotry of the people who work for ISD. A work requirement instituted back in the day for ISD and all NM government jobs REQUIRES fluency in English, which none of these people have. If the pre-requisites for COLTS, it states PCO AND SSDI AND SSI AND the institutional medicaid must all be present, not or, as numerous hispanic and non-english fluent people have pointed out. They keep acting cocky, as if somehow their stupidity and lack of English fluency is indicative of an actual fact of life and policy they have discovered, rather than just their own relative and low intelligence. Espanola has high school graduates, the few who actually do, with only a sixth-grade knowledge of english, making them incompetent to work for the state, but they are hired anyway. HSD has okayed over a half dozen emergency hires of people who are not qualified at all, as the Santa Fe Reporter has already shown, to do ANY of the jobs they have been hired to do in HSD leadership. They do however, as one litigant who protested against it pointed out, have last names just like the friends and co-workers of the people who hired them. That means we are paying extra taxes for nothing being done at all, but supporting people who are genetically tied to their co-workers, and having no other qualification to work, either. Pure nepotism.

To illustrate the above, I'll point out how and/or work in English. AND means both terms in a phrase or sentence have to be together for the end result to occur.

1 + 2 = 3 3+4=7

In Spanish

un y dos son tres tres y quatro son siete

1 AND two together are 3. three and four together are seven.

Now the way Espanola ISD works, it's stating that or, used when either term alone and not together are used, it's the same as and. That's not true in spanish or english, ever. But, they then cop a very domineering and falsely superior attitude, as if stating something stupid makes it true. If you have ever watched Fox on tv, the president of mexico, he does the same thing. So does Mitt romney and New Gingrich. It's an aspect of mexican culture, and one our governor uses all the time. Remember how she kept having video of herself reading the state budget shown on tv? Then she's claiming she doesn't understand or know where the money is going? She's lying, doing the straight-faced mexican lie her ancestors did, such as Toribio Ortega, when he fought against the U.S. and then moved here. The same Fox does and did. I posted here years ago, George Silvers, of the same tribe I wrote about before (mine), stated spanish fencers and swordfighters fought the same way-getting the sword up in your face, and claiming superiority, when he and his students were able to outsmart it and prove that technique ineffectual right away.
josh125 I have Not

Los Alamos, NM

#3 Dec 27, 2011
. It's just another form of childish intimidation, having to do with the falses senses of status the spanish used and imposed to control the Indians in Mexico. Mexican Indians under Juarez, realized that and took over, and then outlawed the Catholic Church later to stop it's imposition through communion. That's the real reason why mexican and hispanic authorities keep pimping the virgin of guadelupe stuff now for the illegal aliens, to keep them under submission to them.

Or means either, not together. It's the opposite of and. Espanola ISD is stating that as long as they meet one or most of the requirements for COLTS, it's the same as meeting all. That's not true at all-try not meeting a contract and watch whether you get paid or sued instead. In mathematics, they are stating it like this:

1 or 2 = 3 3 or 4=7


1=3 3=7

None of the above example statements are true at all. You have to have both numbers together, with AND, to effect the answer.

I have not spent 30 days in a nursing home, I am not even eligible for it. I also did not get medicaid added to pay for care in addition to my medicare, I am categorically eligible for it by receiving SSI, and Matt Torres and ortiz know that too. Ortiz tried pulling a Espanola trick by stating Torres said I had it, I guess in a feeble attempt to make it look like he decided it, and he's an authority for SS and mad, which he is not-NM makes the other decisions, they just didn't follow Federal law. That's why I am appealing NM ISD's decision, not Social Security's. Torres is stating what is, not how it's supposed to be, if he is even stating that. NM ISD, through Espanola ISD, put me into medicare and medicaid qmb. It's funny too, as the prior head of constitutent services for ISD wrote me a letter, giving a totally different and contradictory reason from the reason they have now. They stated before that I was receiving medicaid, with medicare. That's not true tho, as I've already shown I am supposed to be receiving medicaid alone, and my option under Federal and state law would be for Salud, and I have been denied that. They do not get to choose otherwise. I've repeatedly asked for the waiver they claim I have signed, and they can't provide it as they are committing felony fraud, by stating I signed it when I never did. I also have not been reviewed by a team of Doctors, nor spent 30 days in a nursing home. This latest mailing makes them a total laughing-stock. I guess they thought pulling a mexican would work, but it made them look worse.
josh125 I have Not

Los Alamos, NM

#4 Dec 27, 2011
NM keeps hiring people at a low level of functioning and effectiveness, for the same reason-the local politicos since Gov. johnson have tried making people dumber by cutting education funding forever, so the reduction is to reduce worker competency and pay. At UNM, that has resulted in lowering standards to such a low level, that less than half of the degrees are not accredited. It's also made the people trying to get them so stupid, they are unable to stay in and pursue the degree to fruition, resulting in the high default rate, and UNM hiring a pres. whose sole claim-to-fame was retention. But he can't make Martinez give more money to education, and even if he did state-wide, APS has already show they will shove it into stadiums and other projects to elect politicos, and NOT to make students better off. No one but the few students in sports in ABQ and their parents want the stadiums, and the politicos also who want contractor votes. But all that does is mean less money for educating, and more to put into a budget category which makes it LOOK like education is improving, without funding improvement at all. It also does not include messy things like taxes, which are gradually going to fixed payments on buildings, rather than educating currently, but it makes it look like the politicos are trying to improve things by throwing around numbers without details about what the money does for students. No one's ACT scores will improve with the Stadiums being built on the West Side.

There seems to be a silly notion that just participating in sports improves grades. But it is not the involvement that does it, it's because during the '90's we cut state and local spending for sports, and then encouraged sports involvement in business hiring, meaning upper-middle class and higher people put their kids into it, and also had to pay for the suits/equipment and some other expenses previously paid for by the school system. That meant poor and disavantaged youth no longer had access, they had more poverty, and sports were a ticket for people with money to keep it.

That meant no more sports by merit, but only by money. That accounts for the connection, not the sports themselves. It's the imposition of a class system, and completely Anti-American, too.

Well, that's enough. Xmas is coming, I'm enjoying the OB being home, and OG treating us well. I'd advise anyone else dealing with the state of NM to read the xenu.net site about Scientology, and the anti-aztlan sites too. I'd also recommend the book I recommended earlier by Loren Christenson, and to disregard anything the state says, and anyone else, as it's just distraction. We're a nation of laws, not men, for a reason.
josh125 I have Not

Los Alamos, NM

#5 Dec 27, 2011
As Promised

Here is my little explanation and list of citations for my getting Medicaid.

From page

on the SSA online site:

"Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. It covers children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments. "

SSI, by definition.

Continues with

"Thirty-two states and the District of Columbia provide Medicaid eligibility to people eligible for Supplemental Security Income (SSI ) benefits. In these States, the SSI application is also the Medicaid application. Medicaid eligibility starts the same months as SSI eligibility. "

Includes New Mexico, we're not listed with the states having more restrictive criteria.


"To be eligible for Federal funds, however, States are required to provide Medicaid coverage for certain individuals who receive Federally assisted income-maintenance payments, as well as for related groups not receiving cash payments. "

"The following list displays the mandatory Medicaid "categorically needy" eligibility groups for which Federal matching funds are provided:

Supplemental Security Income (SSI) recipients in most States "

Includes New Mexico!

Then, from the Benefits Planning Query Handbook, Version 2.0.3C Release Date 09/16/09, "Medicaid State Listings Chart" on page 15

New Mexico is listed as a 1634 state, and so is Florida.

At the bottom of the page, it states:

Source: TC 23001.020 Medicaid State Categories
* 1634 - State uses Federal SSI eligibility for automatic Medicaid


This is a Florida Attorney's site. Florida has the same eligibility criteria NM does.

"In Florida, one dollar of SSI benefits automatically brings Medicaid coverage. To receive SSI, the individual must be aged (65 or older), blind or disabled and be a U.S. citizen."

josh125 I have Not

Los Alamos, NM

#6 Dec 27, 2011
"Supplemental Security Income (SSI) recipients"


"The option to have a "medically needy" program allows states to extend Medicaid eligibility to additional qualified persons who may have too much income to qualify under the mandatory or optional categorically needy groups. "

Explains further on this page:

"Certain aged, blind, or disabled adults who have incomes above those requiring mandatory coverage, but below the Federal poverty level;"

According to NM, I used to be in this group, and they put me into the QMB. But, that was illegal, as I received less than SSI then AND was under 65 but disabled. I had income below that of the mandatory coverage group, since I received less than the normal monthly SSI check, which is the standard for that group.


"Medicare / Medicaid Dual Eligibles

Dual eligibles are individuals who are entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid benefit.

"Qualified Medicare Beneficiaries (QMBs), with resources at or below twice the standard allowed under the Supplemental Security Income (SSI) program and income at or below 100% of the Federal poverty level (FPL), do not have to pay their monthly Medicare premiums, deductibles, and coinsurance. "

Uhm, I do more than that, bitches, I get SSI outright. I am not only less than twice, I am under the FPL, AND I get an SSI check, making me strictly categorically needy, not Medically Needy as NM claims. I am entitled to full Medicaid only, nothing less.

This proves it-I was eligible for Medicaid when I went to DVR, but Espanola ISD refused-and my DVR worker Wilma Gonzales had a calendar for Riverside Pharmacy on the wall. She mentioned she knew the family that owned it-I'll bet the **** did. So did my ISD rep. Bernadette Quintana, since her husband owns it, meaning she had a vested self-interest in keeping me off of medicaid, and on DVR's program for outright payment. DVR pays well above medicaid, which uses it's CMS client group of millions to negotiate lower payments for the meds I was ordered to use against my will, and which have removed parts of my memory. You can refuse treatment options of any type under Federal Law, and choose your own-but DVr re-stated that, and told me I only had a choice between their way, and the highway. Wouldn't you know it, they chose the most expensive and detrimental drugs for me to use. Netting Mr. Quintana a sizable profit, much higher than he would normally have gotten. When I started pointing this out, and informed DVR Santa Fe, Wilma split, and so did most of the office, too.

Espanola ISD's pushing me into COLTS, and also stating I will have to accept dual Medicare/Medicaid usage is a violation of Federal Law, and means that NM because of denying me is no longer eligible for Federal Matching funds, which make up 80% of NM Medicaid's funding. I have already gone over the eligibility stuff here, and previously for COLTS. I am not eligible for COLTS, nor any of the other weirdo combinations NM has tried putting me into so far. They do it, basically to cover their **** at ESpanola ISD, and to harass me because, as they have told me straight to my face, I am white (anglo). I'm not anglo, that tribe of rapists and thieves my ancestors fought very hard to push down into the lower S.E. quadrant of Britain, I'm Welsh, from the Votadini tribe, and all of my life my parents, especially my Dad, told me
josh125 I have Not

Los Alamos, NM

#7 Dec 27, 2011
their values and their dominant way of thinking was wrong. I am eligible only for the NM state medicaid, which I will choose the Presbyterian Salud option for, as I have already spent years helping my Honey and the kids make appointments and navigate their services, all without having to sign and fill otu the forms I cannot, or travelling to SF or having any other criteria pushed onto me. I resent being put there. It's also a violation of Federal law, and voids NM from getting Federal matching funds for Medicaid, which is a seriously big revenue stream we don't have to pay the most of right now.

Los Alamos, NM

#8 Jan 10, 2012
Well, we tried to have the hearing yesterday. I'm also being punished by ISD for posting here, so anyone who reads this, you might realize they will seriously take advantage of you if you are silent, and then again if you resist them. Typical mexican cartel tactics.

The Judge did not show up, and the replacement knew absolutely nothing about the case and admitted he could not do it. That's understandable. We tried to work it out with ISD, but al lthe 2 angry women did was whimper when we stated we'd continue the case. They also pretty much lied non-stop. We know from speaking with a lawyer someoen familiar with their software, and also the decisiosn they made with it, is supposed to be open to us, and it definitely was not. They had the hatred I'd seen in he past of peoplewho have been disocvered lying, and will do anythign to defend their bad behavior. They of course did nto bring Jaramillo, who is the middle boss, and the person who threatened and caused the problems. They also did typical Cluster B personality disorder tactics f gaslighting and dismissal.

They stated the MAD were supposed to be there, andthey didn't show up, then they claimed they spoke for them, then...ad inifinitum. When I mentioned we therefore won by default, they made excuses non-stop.

So, still waiting.

They tried to blame me for waiting, but the temp judge had already admitted he could not do it. Also, I'd spoken with a lawyer, and the bottom of the appeals form states you call the same number for food stamps, medicaid, and TANF. It's right there in plain English.

I also told the women how I was able to get the appeal, and they were visibly distraught, and their reaction proved my hypothesis that they were printing the wrong number, no number, or allowing people to disregard any calls-in to stop the process so they would not get caught. Also, the judge stated we could in District at our own expense-I've checked that with a lawyer too, since we are on SSI and handicapped, THEY will pick up that expense, not us. That means anyone reading this will pick up for ISD/HSD and their malfeasance. They erected barriers that after 6 years we were finally able to get around, and still are relying on bluffing, gaslighting and lies to get around.

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