"Near worthless" is an entirely overblown characterization. The central factor is not the strike price, but the spread between your strike price and what you can eventually sell at (which should hopefully be higher than any strike price set at the last 409A). If you get an initial grant at $1/share, and then a later grant of the same number of options at $5/share, then is the later grant worth 1/5 of the initial one? No - if you end up selling for $15/share, then it's a difference between getting $14/share and $10/share pre-tax. It only ends up being a much worse deal if the strike price of the later grant is very close to what you later sell at, in which case your company is flatlining.
The real problem comes from the fact that any amount of stock that would generate significant return becomes prohibitively expensive to exercise. If you're granted 100k shares at $5/share, and they could eventually sell at $15/share; it does you very little good, because there's no way you can swing the half a million bucks it'll take to exercise in order to make your uncertain $1M profit.
On the other hand, if it's an amount of options you can afford to exercise (e.g. 1k shares @ $5 = $5k… most people could scrap together the funds for that.), your profit is unlikely to be more that 2-5x, which likely would return $10k, and at the most $25k on your $5k investment. A lot of risk and trouble to go through for very little gain…
That said, with a 7+ year time period to exercise after leaving the company, it's not an issue
