Leading consumer groups call on FTC and CFPB to update study on accuracy of consumer data

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July 23, 2021

Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 and Linda Sherry, (202) 544-3088, linda.sherry@consumer-action.org

Washington, DC—Leading consumer groups are calling on the Federal Trade Commission (FTC) and the Consumer Financial Protection Bureau (CFPB) to update a key 2012 study on the accuracy of consumer data at the credit bureaus in a letter sent to both agencies.

The National Consumers League and Consumer Action, two leading consumer advocacy organizations working to promote pro-consumer policies on the federal level, noted in their letter to FTC Chairwoman Khan and Acting CFPB Dirctor Ueijo that policy leaders in Congress and the White House had been citing the 2012 study in recent hearings and events and they were concerned that the data policymakers were using was almost 10 years old.

“Much has happened since 2012 that impacts the accuracy of consumer data, starting with the rise of technology, increased data breaches by bad actors, the NCAP settlement and of course a pandemic and economic crisis. It is critical that we re- examine the accuracy of the credit bureau data in light of these developments…” the Consumer Action and National Consumers League letter reads. “…We worry about the unintended consequences if policymakers fashion new laws based on old facts.”

A full copy of the letter can be found here.

About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Addressing vaccine hesitancy with community-driven messaging

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy, featuring an interview with Jens Dakin, Managing Director of AM LLC

After months of vaccine review and approval informing an arduous national vaccination campaign, nearly half of the country has been fully vaccinated against COVID-19. However, despite these efforts, we’ve narrowly missed the national goal of 70 percent of Americans receiving at least one dose by July 4. Even though there is overwhelming evidence in support of the COVID-19 vaccines and their safety, vaccine hesitancy still looms.

On July 8, the NCL health team met with Jens Dakin, Managing Director of Strategic Engagement at AM LLC. AM LLC is a health and research informatics firm that provides public health related, mission critical services in information, communications, and technology to federal, state, and local government clients. Since March 2020, AM has partnered with government agencies to control, isolate, and mitigate the spread of COVID-19 through various community engagement and vaccine quality assurance measures. Below is a snapshot of our conversation.

Nissa: For over 120 years, the National Consumers League has advocated for consumer protections in health care. A big part of our work involves fostering vaccine confidence. We do this through direct consumer engagement, testifying before federal vaccine committees, like the CDC and FDA, and our Script Your Future campaign, where we engage with pharmacy students to increase vaccine uptake. We would love it if you could tell us a little about AM Trace work in vaccine confidence.

Jens DakinJens: Thank you, and nice to meet you both. AM was founded about 10 years ago to provide services to the federal government in research, communications, and healthcare IT. When COVID-19 spread to the US there was a lot of effort by the federal and state governments to keep people safe with COVID-19 threat mitigation, and then to get people to take the vaccine. AM now provides capabilities in five critical services to state and local governments, including staffing and training of public health personnel, technology support infrastructure, public awareness outreach campaigns, stakeholder collaboration. We work with key public servants to help increase capacity pertaining to COVID operations.

Spencer: When you first enter a community, how do you get your foot in the door and begin to understand the specific needs of the community so you can begin to build your campaign strategy?

JD: Ultimately, we don’t like to enter a community cold. We undertake lots of research before hitting the ground to understand the demographics and the local context. It is important for us that our local partners know the area, the people and have the access we need. Whether it’s an African American community, or a White, rural Republican-leaning county, we can make some educated guesses, but we certainly cannot make assumptions about the individuals without the local data and insight. This initial research frames how we empathize and engage with the community, allowing us to develop more credible messages that will resonate better. We don’t tend to advocate mass media campaigns, especially now when there is a need to persuade the vaccine holdouts, because the mass campaigns haven’t worked with them.

NS: On mass vaccination campaigns, I recently came into contact with an old friend that has become increasingly anti-vaccine and cited vaccine lotteries and giveaways as suspect. Do you think that these mass efforts are causing more harm than good?

JD: I believe that they have achieved what they set out to do. They have worked to an extent, to get the people who want to be vaccinated, vaccinated. Unfortunately, there is now considerable distrust in government authority in our society – much of it caused by the spread of misinformation and disinformation. Your friend views her belief as completely rational based on the information she has. For the vaccine holdouts, the message needs to come from a trusted voice and delivered in a non-intrusive way. What we are seeing working in some cases is developing a series of different “micro-interventions”, in the form face-to-face conversations, a series of emails or chats on a group message board. We can even learn lessons from deradicalization programs that have helped to sway people away from the path towards terrorism, where we listen, understand, and engage with empathy.

NS: I really like the idea of “micro-interventions”. Is there a designated period of time you allow yourself in a particular community to test these messages and strategies to see if they land before moving on from that group?

JD: We have to test and adjust all the time. This is an evolving situation. You really just need to remember that when you convince someone to get vaccinated, you’re potentially saving their life. If you keep building that relationship with the community, that can end up going a long way. This is why it’s so important that our local messengers, or canvassers, are all from the communities we are engaging within.

NS: Could you provide some examples of success stories as a result of these interventions?

JD: In NYC, AM’s teams have spoken with over 180,000 residents and as a direct result of our personalized messaging campaigns and direct engagement within [mainly minority] communities, encouraged over 50,000 people to book vaccination appointments. In Anchorage AK, AM’s teams identified, contacted, and built relationships with individuals living in both urban and rural communities with the goal of addressing vaccine hesitancy and booking vaccination appointments. During a single 6-week span of all the unvaccinated people they spoke with, they arranged for nearly 20 percent of them to get vaccinated.

NS: Who do you use in community outreach to build these relationships?

JD: We don’t tend to use professional canvassers. We prefer to recruit and train local canvassers specifically from their community. We speak with the community and individuals to find out who the local influencers are – who they trust. We meet with them and ask them to work with us because need them to become our message multipliers within that community.

NS: The COVID-19 vaccine development and approval process has been as novel as the disease itself. We’ve had the privilege of witnessing science unfold in real time, and along with that, comes a lot of trial and error, as we’ve seen with the momentary pause in the J&J vaccine and the new cases of myocarditis in pediatric populations. How do you mitigate the derailment of messaging, which have been extensively tested, by rise in these developments?

JD: Well, we know that with these holdouts, and these “wait and see” groups, science and facts won’t sway them. The issue is not necessarily about vaccine information, there is a lot of information out there. So, if you’re using science to try to convince people who are ideologically entrenched in one belief or another, they might not understand what you’re trying to say which will turn them off, or they may come up with counter arguments or “counter-facts” that support their own beliefs. They may also exist in information silos, or information echo chambers, that feed them information which confirm their biases. So no, using science will often not work with hold out groups. Which is why we need to find more innovative methods that focus on more accessible and personal benefits of vaccination.

NS: AM trace has a great vaccine confidence toolkit for community leaders which mentions the importance of decision autonomy for patients in vaccine confidence. With public sentiment headed towards vaccine mandates, to possibly issuing vaccine passports– do you see any challenges with that? How can advocates help reduce weariness around these initiatives in a way that is aligned with an individual’s constitutional rights?

JD: As communicators, we should not have any say in developing policy. Whether vaccine mandates are right or wrong, is not an issue I will discuss here. What I will say is that for those employers and institutions who are mandating it, when developing their campaign is that words matter, and the messaging and messengers matter. Employers need to understand that their ‘single’ workforce is made up of many separate communities each with their own concerns and beliefs. You need to understand the behavioral and emotional context that people exist in order to have the best chances of success. The toolkit you mentioned provides communication planners with an overview of what to consider when developing behavior change campaigns. It works very well in the COVID-19 context.

NCL Health Policy Intern Spencer Cramer contributed to this blog.

Don’t forget to take advantage of Healthcare.gov Special Enrollment Period

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By Special Guest Kelley Schultz, Executive Director, Commercial Policy, America’s Health Insurance Plans and NCL Director of Health Policy Jeanette Contreras

More than 2 million Americans nationwide—1.5 million in healthcare.gov states, and an additional 600,000 individuals in states that run their own exchanges—have signed up for coverage during the 2021 Marketplace Special Enrollment Period that extends through August 15. Earlier this year, President Biden launched a new special enrollment period for the 36 states using healthcare.gov—and states that run their own marketplaces followed suit—to help people get health coverage and peace of mind.

Millions of Americans still have the opportunity to enroll in new health insurance plans through the healthcare.gov marketplace, whether they’re uninsured or currently enrolled and wish to switch plans.

The American Rescue Plan Act of 2021 temporarily increased the availability and generosity of the Affordable Care Act’s premium subsidies. As a result, 3.7 million Americans are eligible for expanded financial assistance to make premiums more affordable, including people who didn’t qualify for financial assistance before.

This Special Enrollment Period is a crucial opportunity as the country comes out of the COVID-19 pandemic and the financial hardship experienced by many—a quarter of U.S. adults say they or someone in their household has been laid off, with even more seeing reduced pay. The expanded opportunity for people to enroll in marketplace health plans with enhanced affordability is a major development that will provide much needed assistance to Americans who have faced economic stresses over the past year.

The deadline to enroll in coverage during the healthcare.gov Special Enrollment Period is August 15. States that run their own exchanges may have different deadlines, so consumers should check when their state’s special enrollment period ends. Additionally, current enrollees should return to healthcare.gov to check to access enhanced subsidies to lower their monthly premium and see if they can get additional savings by switching to a high-value plan with lower cost sharing.

The relief bill extended subsidies to 3.7 million people to help lower their monthly premiums and out-of-pocket costs, including people with incomes over 400% of the Federal Poverty Level ($51,040 for an individual or $104,800 for a family of four). Anyone with incomes below 150% of the federal poverty level ($19,140 for an individual or $39,300 for a family of four) is eligible for a high-value plan with a $0 premium and a very low deductible.

These increased subsidies make quality health insurance coverage more affordable for millions of Americans who are encouraged to visit healthcare.gov or their state exchange to see how they can sign up. Health coverage will start on the first day of the month after you select a plan, so it is important that enrollees consider this timeline while making their decisions.

Some SEP resources:

  • For help selecting a plan in any number of languages, you can access a navigator in your area here.
  • More information about the health insurance marketplace and the Special Enrollment Period can be found here.
  • Use a decision tree tool to see if you are eligible for the special enrollment period and get other fast facts here.

NCL commends HHS interim final rule regarding surprise billing protections

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Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242

Washington, DC—The National Consumers League (NCL) welcomes the Department of Health and Human Services (HHS) announcement of an interim final rule regarding surprise billing protections, to take effect on January 1, 2022. This rule is a major element of the implementation of the No Surprises Act, which was passed in December as part of the omnibus spending bill. It will eliminate surprise medical bills which have devastated American consumers for far too long.

Patients can be vulnerable to surprise medical bills when they unknowingly receive out-of-network care. This often happens in emergencies, where a patient does not have the luxury to choose an in-network provider, or when an out-of-network doctor such as an anesthesiologist provides ancillary care at an in-network facility. These charges can lead to sky-high bills for patients, often while they are dealing with unforeseen circumstances. Patients frequently forgo necessary care in fear of receiving surprise bills that could possibly subject them to medical debt. Surprise medical bills negatively impact patients, employers and taxpayers, leading to $40 billion in premium increases every year because certain providers can leverage their ability to leave the network for higher reimbursement rates.

Thankfully, the No Surprises Act and the new rule announced by HHS put a stop to most of these surprise billing practices, promising a major victory for consumers. The new rule:

  • Prohibits out-of-network cost-sharing for emergency care that is higher than in-network rates
  • Prohibits out-of-network charges for ancillary care provided at an in-network facility
  • Prohibits surprise billing for out-of-network air ambulance services
  • Requires advance notice and patient authorization for non-emergency care performed out-of-network

Under these new protections, consumers will be “held harmless,” and will gain relief from unscrupulous surprise charges. The requirements for transparency in billing and advance notice for out-of-network care will allow consumers to play a greater role in their own healthcare and ensure that they are safeguarded from unexpected costs while seeking care.

NCL applauds members of Congress and HHS Secretary Xavier Becerra for their bipartisan leadership in passing these protections into law and implementing the new rule. The No Surprises Act had been in legislative limbo for years, with no definitive agreement in place for its passage. The work of Senators Maggie Hassan (D-NH), Bill Cassidy (R-LA), and Patty Murray (D-WA) and former Senator Lamar Alexander (R-TN), alongside Representative Frank Pallone (D-NJ) and former Representative Greg Walden (R-OR) to at last secure the passage of the No Surprises Act is applauded. Their efforts will result in desperately needed protections for American consumers and fix one of the many flaws in America’s healthcare system.

As stated by Secretary Becerra, “Health insurance should offer patients peace of mind that they won’t be saddled with unexpected costs. The Biden-Harris Administration remains committed to ensuring transparency and affordable care, and with this rule, Americans will get the assurance of no surprises.” This rule will protect consumers and lead to a better functioning healthcare system. We hope that Secretary Becerra will continue to build on the positives of the new interim rule as HHS develops the final rule to implement the No Surprises Act and give healthcare consumers the protections that they deserve.

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About the National Consumers League

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.

Intern Spencer Cramer

Gun violence is a public health crisis—We must treat it like one

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Intern Spencer CramerBy Spencer Cramer, NCL Health Policy Intern

Spencer is a student at Brandeis University, where he is studying Politics and Health: Science, Society & Policy.

Most Americans are all too familiar with our country’s gun violence epidemic. In a typical year, around 40,000 Americans are killed by a firearm, including deaths from homicides, suicides, and accidents. Gun related fatalities in other high-income countries pale in comparison to those of the U.S. Based on 2010 data from the Organization for Economic Co-operation and Development (OECD), Americans were over 10 times more likely to be killed by a gun than people in Australia, a country that once dealt with a similar gun violence problem. This crisis comes in the form of street crime, domestic violence, accidents involving children, and the mass shootings that seem to occur on a multi weekly basis.

Of particular concern has been the rise in gun violence during the COVID-19 pandemic. Last year, 2020, saw a 10 percent increase in gun deaths over the previous year, fueled primarily by a 25 percent rise in homicides and accidental gun deaths. Experts say the recent spike is due to the economic and social stresses of the pandemic, and the numbers are showing no signs of abating as we open back up post-COVID.

What can we do to address this terrible situation? Sadly, the typical debate pits stricter gun control measures against Second Amendment absolutists who believe any gun reform measure to be a threat to their freedom. But those absolutists have outsized power. According to a recent poll, approximately 2 in 3 Americans support stricter gun control measures, with certain policies like enhanced background checks gaining even higher support. Yet attention to the spike in gun violence perversely spikes sales of firearms.

For many years, thoughtful experts have argued that America’s gun violence problem must be viewed as a public health crisis. That approach allows researchers and policymakers to tackle the problem from multiple angles, like understanding why people commit violence, creating safer environments, and implementing common-sense gun violence prevention measures.

The first step to a public health effort should be far-ranging research on gun violence so we can have the proper knowledge to inform policy solutions. Unfortunately, until very recently the federal government was barred from researching gun violence. The Dickey Amendment has been attached to federal spending bills since 1996 and had banned the Centers for Disease Control and Prevention (CDC) from researching gun violence. For the first time, in 2018, the Dickey Amendment was reinterpreted, allowing research to be conducted as long as it does not specifically advocate for gun control policies. After this reinterpretation, Congress proceeded to provide $25 million in funding for gun violence research.

Unfortunately, this funding is a pittance compared with the scope of the crisis. For reference, the National Institutes of Health (NIH) provided $170 million in funding for back pain research in 2019. To meet the scale of the gun violence epidemic, we must dramatically increase funding for research so we can properly direct resources to fight the problem.

We often view gun violence as an issue of criminal justice that narrowly focuses on prosecuting homicides and gun crimes. Many policy solutions therefore involve traditional gun control methods: assault weapons bans, enhanced background checks, and stronger law enforcement tactics to target gun crimes. But by treating gun violence as a public health issue, researchers can undertake a wide-ranging holistic approach that accounts for the numerous societal factors that contribute to gun violence.

A public health approach to the gun violence epidemic—if done well—could be as successful as the campaigns to reduce smoking and automobile accidents. To combat cigarette smoking, we engaged in a multi-pronged strategy involving tobacco taxes, age restrictions, public awareness campaigns, and bans on smoking in many public spaces. These measures have resulted in the adult smoking rate to fall by nearly 70 percent since the 1960’s. Similarly, to deal with vehicular accidents and deaths, we instituted new safety measures in cars and on roads, improved licensing restrictions, enacted tough DUI laws, and better traffic enforcement. As a result of these solutions, deaths from car crashes have fallen dramatically over the last few decades.

Similarly, strategies to combat gun violence can include better mental health services, doctors consulting their patients on gun safety, better firearm safety training, or improved designs of guns that reduce the risk of accidents. It may also involve creating a safer society overall, where lower poverty rates and better economic prospects will naturally lead to less violence. Of course, better gun control policies are needed, but we should think of them as one important part of a larger public health strategy for fighting the gun violence epidemic.

Firearm deaths have shown no signs of letting up—in fact they are exploding. Gun violence has reached horrific levels in the U.S. and tragically destroys many lives. By recognizing this epidemic as a public health crisis, we can address the issue from many different societal perspectives. We need gun control, but we also need stronger mental healthcare, community interventions, poverty reduction, even safer firearms. Any successful public health effort must embrace an all-of-the-above approach. America’s campaigns against cigarettes and automobile deaths should serve as examples to lead our struggle against gun violence. By finally investing in robust research and multiple solutions for gun violence, we can start to eliminate the scourge of gun violence in our society.

Addressing health inequities for LGBTQ communities: During PRIDE month and 365 days a year

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

Last summer drew striking parallels to the summer of 1981, when another public health threat raged on: the HIV/AIDS crisis. Exactly 40 years ago, the first cases of AIDS were reported by the Centers for Disease Control and Prevention (CDC). Similar to COVID-19, patients struck by a novel illness desperately sought answers to what was ailing them. An absence of public health guidance led to a culture of paranoia, stigma, and discrimination that ostracized patients already vulnerable and afraid.

It wasn’t until 1985 that President Reagan officially publicly uttered the word “AIDS.” Inaction on part of the Reagan Administration to identify AIDS as a public health emergency, and fear-based messaging targeting the LGBTQ community, egregiously mischaracterized AIDS as a “gay plague.” His reticence up until that point hindered urgent dialogue and impeded critical funding for research for the disease.

Since its initial reporting, more than 32 million people have died from the disease and 38 million currently live with the HIV virus, which can later develop into AIDS. Exacerbated by an ill-coordinated and inadequate response, HIV/AIDS was once a death sentence. Over time, thanks to concerted public health efforts, our society has made great strides in HIV testing, education, and prevention strategies. Presently, with credit to biomedical advancements in treatments, such as antiretroviral therapies, the illness is now a treatable and manageable chronic condition.

As we celebrate these monumental victories in medical ingenuity, we must also acknowledge the vast health inequities that continue to persist for LGBTQ individuals. In 2016, the National Institutes of Health (NIH) formally recognized LGBTQ individuals as a health disparity population. There is mounting evidence that indicates the disproportionate disease burden experienced by the community with regard to mental health, diabetes, hypertension, cancer, heart disease, and exposure to violence.

Research shows that LGBTQ individuals who live in communities with high levels of anti-LGBTQ prejudice die sooner—12 years on average—than those living in more accepting communities. Queer and Trans people of color (QTPOC) face even higher rates of fatal violence, as 44 transgender and gender non-conforming people died to anti-trans violence in 2020.

Due to workplace discrimination against sexual and gender minorities (SGMs), there is a high prevalence of health coverage insecurity among LGBTQ individuals. As Johns Hopkins professor, William Padula, elaborates, “most employer-based healthcare plans are cookie cutter plans, meaning they are the same for everybody. People in the LGBTQ community may need a little more, especially those who are transgender.”

Early data from the COVID-19 pandemic reveals LGBTQ individuals have faced higher rates of unemployment than non-LGBTQ people. Due to the various vulnerabilities experienced by this community, data also shows that LGBTQ people are more inclined to adhere to social distancing, vaccine uptake, and general pandemic-related precautions. This is an interesting revelation when considering the general weariness many LGBTQ people have towards health care providers due to fear of stigma and discrimination.

LGBTQ and QTPOC individuals are identity rich people that often navigate multiple intersections in society. In order to better serve the needs of these patients, health providers and advocates will need to become increasingly adept in providing culturally competent care. Inclusive practices as simple as asking a patient what their pronouns are can help reduce anxiety and foster trust when seeking care. The CDC has culled a comprehensive state-by-state list of LGBTQ affirming healthcare facilities, hotlines, and resources.

June marks PRIDE month, a celebration of the impact the LGBTQ community has made on all aspects of society to assert everyone’s dignity to love and live in alignment with their truth. NCL supports the Equality Act and commends the Administration’s $6.7B investment in the CDC’s Ending the HIV Epidemic initiative that aims to reduce new HIV cases by 2030. To honor the legacy and sacrifices of LGBTQ persons, we need to advance legislative efforts that support access to healthcare, increase funding for research, and encourage meaningful, affirming change for our LGBTQ friends, family, and peers.