Ten consumer advocacy organizations call for action on aviation consumer protection priorities in letter to DOT

August 27, 2021

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

The Honorable Pete Buttigieg
United States Department of Transportation
1200 New Jersey, SE
Washington, DC 20590

RE: Promoting DOT’s Aviation Consumer Protection Mission and Passenger Priorities

Dear Secretary Buttigieg:

The undersigned consumer advocacy organizations appreciated the opportunity to meet with you on July 27. We welcomed your close attention to our recommendations for actions the Department of Transportation (“DOT” or “Department”) should take to promote and enhance consumer protection in the air travel marketplace. We are encouraged that under your leadership, consumer protection will not be an afterthought at the DOT.[1]

In that regard, we write today regarding the key priorities we identified during our meeting and to request meetings with appropriate officials as you move forward on implementation.

First, as we discussed, we hope you will be publicly and personally highlighting consumer protection as a key part of DOT’s mission. DOT is the sole consumer protection agency, at any level of government, with authority over the air travel industry. Your public statements about your expectations for consumer protection in the air travel marketplace will put the airlines on notice that the DOT under your leadership will vigorously enforce existing consumer protections and seek new ways to better protect travelers as the industry emerges from the COVID-19 pandemic, and going forward.

Second, on the specific priorities we raised with you, all of which you were receptive to addressing, we ask that you help arrange for us to meet with the appropriate officials at DOT and FAA with authority to address these priorities. Those priorities include:

  • Taking immediate action to address the airlines’ practice of issuing expiring travel vouchers for flights not taken on account of the pandemic. The four major U.S. airlines had $10 billion in unused travel credits on their books at the end of 2020. Many billions of dollars in credits will expire this year, due in no small part to inconsistent airline rules regarding when such credits must be used.[2] As was the case last year, travelers continue to be caught in an untenable situation: either endanger their health by flying despite the risks to themselves and others from the resurgent COVID-19 virus, or lose their substantial ticket investments. We request that you publicly call on the airlines to grant refunds, or at the consumer’s option, provide indefinite extensions and transferability of vouchers, for travel that was scheduled to have occurred since the pandemic began. We also urge you to investigate whether the airlines’ failure to do so would constitute an unfair or deceptive practice under DOT’s §41712 authority. We appreciate that DOT has recognized the importance of addressing the more than 100,000 complaints it received in 2020 related to ticket refunds stemming from the COVID-19 pandemic. However, the ongoing enforcement action against Air Canada[3] and the planned NPRM on airline ticket refunds[4] do not adequately address the magnitude of this unprecedented situation. To date, no domestic airline has been fined by DOT for any anti-consumer transgressions identified during the pandemic. Conversely, DOT has not hesitated to fine passengers when justified, with fines totaling more than $1 million in 2021 alone.[5]
  • Fulfilling Congress’s directive that DOT address airlines’ family seating practices. Under the airlines’ current family seating practices, families traveling with small children must either forgo purchasing the most affordable classes of tickets or risk being seated far from their children during their flight. Recognizing this situation as indefensible, Congress directed the DOT to review and “if appropriate, establish a policy” directing air carriers to ensure that young children can be seated with their families at no additional cost.[6] But to date, DOT has limited its response to publishing a web page to educate the public about family seating and the availability of the DOT’s complaint process.[7] Separating young children from their families during flights not only creates needless anxiety; it also poses a safety risk during in-flight emergencies, and even puts children at increased risk of sexual assault.[8] We urge DOT to act on Congress’s directive and initiate a rulemaking to mandate that families with small children be seated together at no additional cost. In our view, the airlines’ family seating practices also constitute an unfair or deceptive practice under DOT’s §41712 authority,
  • Acting on Congress’s mandate that FAA establish minimum seat size standards. There currently exists no federally-mandated minimum seat size standard for U.S. airlines. Combined with badly out-of-date Federal Aviation Administration (“FAA”) emergency evacuation testing standards, the lack of a minimum seat size standard puts passengers at significant risk. Congress,[9] consumer groups,[10] an FAA advisory committee,[11] and the DOT’s Inspector General[12] have all called attention to this risk. The FAA’s continued resistance to establishing a minimum seat size standard led Congress to direct the FAA to do so no later than October 2019. It is now nearly two years since that deadline passed. The DOT should implement this Congressionally-mandated action without further delay.

As leisure travelers continue to power the airline industry’s taxpayer-supported recovery from the COVID-19 pandemic, the time for action by the DOT to address anti-consumer industry practices is now. The DOT cannot stand by while travelers endure unprecedented delays and cancellations, struggle to obtain refunds, are prevented from sitting with our children, and are squeezed into ever-shrinking and increasingly unsafe seats. The importance of prioritizing accountability for consumer protection has been highlighted anew in recent months, as the domestic airline industry has experienced a series of operational meltdowns, leading to thousands of delayed, canceled, and rescheduled flights, disrupting the travel plans of millions of American consumers.

Thank you again for the commitment you have given us to ensuring protection and fair treatment for the flying public.


Business Travel Coalition
Consumer Action
Consumer Federation of America
Consumer Reports
National Consumers League
Travelers United
Travel Fairness Now


The Honorable Maria Cantwell, Chair, Senate Committee on Commerce, Science, & TransportationThe Honorable Roger Wicker, Ranking Member, Senate Committee on Commerce, Science, & Transportation
The Honorable Kyrsten Sinema, Chairman, Senate Subcommittee on Aviation Safety, Operations, and Innovation
The Honorable Ted Cruz, Ranking Members, Senate Subcommittee on Aviation Safety, Operations, and Innovation
The Honorable Peter DeFazio, Chairman, House Committee on Transportation & Infrastructure
The Honorable Sam Graves, Ranking Member, House Committee on Transportation & Infrastructure
The Honorable Rick Larsen, Chairman, House Subcommittee on Aviation
The Honorable Garret Graves, Ranking Member, House Subcommittee on Aviation
Blane Workie, Assistant General Counsel for the Office of Aviation Consumer Protection, DOT
John Putnam, Acting General Counsel and Deputy General Counsel, DOT


[1] Josephs, Leslie. (2021, July 28) Legroom, vouchers, seating fees: Consumer advocacy groups take complaints to DOT. CNBC.com. https://www.cnbc.com/2021/07/28/legroom-vouchers-seating-fees-consumer-travel-groups-take-complaints-to-dot-.html

[2] McCartney, Scott. (2021, March 17) The Airline and Hotel Pandemic Vouchers That May Prove Worthless. Wall Street Journal. https://www.wsj.com/articles/the-airline-and-hotel-pandemic-vouchers-that-may-prove-worthless-11615986078?mod=article_inline

[3] U.S. Department of Transportation. (2021, June 15) U.S. Department of Transportation’s Office of Aviation Consumer Protection Initiates Enforcement Proceeding Seeking Approximately $25 million Against Air Canada for Extreme Delays in Providing Required Refunds [Press release]. https://www.transportation.gov/briefing-room/us-department-transportations-office-aviation-consumer-protection-initiates

[4] https://www.reginfo.gov/public/do/eAgendaViewRule?pubId=202104&RIN=2105-AF04

[5] Federal Aviation Administration. (2021, August 19) FAA Fines Against Unruly Passengers Reach $1M [Press release]. https://www.faa.gov/news/press_releases/news_story.cfm?newsId=26440

[6] FAA Extension, Safety, and Security Act of 2016. §2309. https://www.congress.gov/114/plaws/publ190/PLAW-114publ190.pdf

[7] U.S. Department of Transportation. (2020, March 4) Family Seating. https://www.transportation.gov/individuals/aviation-consumer-protection/family-seating

[8] Rosato, Donna. (2020, March 4) Airlines Fall Short in Fixing Family Seating Problems. Consumer Reports. https://www.consumerreports.org/air-travel/airline-fixes-to-family-seating-problems-fall-short/

[9] Silk, Robert. (2020 August 17) Travel Weekly. https://www.travelweekly.com/Travel-News/Airline-News/Congress-FAA-to-set-standards-for-seat-size-delay

[10] FlyersRights.org. (2021 August 17) The Case of the Incredible Shrinking Airline Seat. https://flyersrights.org/f/the-case-of-the-incredible-shrinking-airline-seat

[11] Federal Aviation Administration. “Emergency Evacuation Standards Aviation Rulemaking Committee. https://www.faa.gov/regulations_policies/rulemaking/committees/documents/index.cfm/committee/browse/committeeID/757

[12] U.S. Department of Transportation Office of Inspector General. (2020 September 16) FAA’s Process for Updating Its Aircraft Evacuation Standards Lacks Data Collection and Analysis on Current Evacuation Risks. https://www.oig.dot.gov/sites/default/files/FAA%20Oversight%20of%20Aircraft%20Evacuations%20Final%20Report%20-%2009-16-20.pdf

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.

NCL applauds full approval of Pfizer-BioNTech vaccine

August 24, 2021

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

Washington, DC—The National Consumers League (NCL) applauds the Food and Drug Administration (FDA) for granting the Pfizer-BioNTech vaccine full licensure approval. The FDA’s gold standard approval is a testament to the remarkable safety and efficacy of the Pfizer-BioNTech vaccine. Though the vaccine will now be marketed under the name Comirnaty, it will remain free to U.S. residents.

Today’s announcement is a historic victory for science, and a signal that the Moderna vaccine will also receive full licensure approval in the coming weeks. NCL has long-advocated for access to vaccines as life-saving interventions. It is our hope that this news will instill more vaccine confidence in the nation and persuade the vaccine hesitant to get vaccinated.

While the vaccine has been approved for people 16 years of age and older, it remains available under Emergency Use Authorization for children ages 12 to 15. Parents of adolescents can share a collective sigh of relief as they send their kids to school this fall. Already, 45 percent of children ages 12-15 have had at least one dose of the vaccine, but only 32 percent are fully vaccinated. Full approval may help to ease concerns that hesitant parents have about the safety of the vaccine.

The approval of the vaccine will allow more employers to implement vaccine mandates in states where the state legislature has banned these measures. Advocating for workers as well as consumers, NCL supports vaccine mandates that provide paid sick leave, financial incentives, and exemptions for verifiable religious or medical reasons.

Over 200 million Americans have received at least one-dose of a COVID-19 vaccine, but we are far from reaching herd immunity.  Only 51.5 percent of the total population is fully vaccinated. The Delta variant now accounts for over 137,000 new cases on average each week and is spreading faster than earlier strains of COVID-19. The only way to end this pandemic and prevent the emergence of further variants is to increase vaccinations. NCL remains committed to increasing vaccine confidence and uptake. We are hopeful today marks a turning point in our fight to end this pandemic.

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.

NCL supports employer COVID-19 vaccine mandates

August 18, 2021

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

Washington, DC—As the nation’s pioneering organization advocating on behalf of consumers and workers, the National Consumers League (NCL) supports government and employer mandates requiring vaccination. NCL has long championed vaccine education and access to these lifesaving medical interventions. In recent weeks, it has become evident that employer mandates are effective at nudging reluctant people to get the COVID-19 vaccine. As the virus continues to spread and mutate around the globe, we remain concerned for the safety of essential workers, the immunocompromised, and children that are not yet eligible for the vaccine.

Fifty-seven of America’s health care organizations share our concerns, releasing a joint statement calling on all health care and long-term care employers to require their employees to be vaccinated against COVID-19, with California being the first state to implement this mandate. President Joe Biden followed with an announcement that federal workers and contractors will need to show proof of vaccination or be subject to weekly or twice-weekly COVID-19 tests. Governors led the way in California, Virginia, and New York requiring state employees to be vaccinated or adhere to similar testing protocols. Private employers can play a key role in increasing vaccinations, providing incentives to employees who get the shot.

NCL believes that all vaccine mandates should be implemented with the consideration that workers will need to receive paid leave to get the vaccine and to potentially recover from side effects resulting from vaccination. The American Rescue Plan Act makes tax credits available to employers to cover the cost of providing paid leave to employees to receive and recover from COVID-19 vaccinations. These tax credits can also be utilized to support employees as they take time off to vaccinate their children against COVID-19. Incentives like hourly bonuses and paid time off rewards are extremely important to hourly workers.

Additionally, mandates should be developed in consultation with labor unions who represent workers. The American Teachers Federation and the AFL-CIO are two labor unions that have publicly stated they are supportive of vaccine requirements for workers. The SEIU 2015, California’s largest caregiver union, released a set of principles to aid employers with implementing mandatory COVID-19 vaccines, encouraging them to make the vaccine accessible either at work or near the workplace.

Companies can legally mandate that all employees re-entering the workplace and new hires be vaccinated for COVID-19, providing exemptions pertaining to religion or disability. Politically motivated laws prohibiting mandates for vaccines only make it harder for public health officials to quell the pandemic, ultimately hurting consumers. Seven states have passed laws prohibiting mandates for vaccines under an emergency use authorization. However, since these bans hinge on FDA licensure approval of the vaccines, they will be nullified once a vaccine is granted full approval.

More than 198 million Americans have safely received the COVID-19 vaccine. Given the remarkable evidence of safety and efficacy of the COVID-19 vaccines, consumers should rest assured that vaccines are effective measures to protect public health and vital to national efforts in ending the pandemic. Through our education and outreach efforts, NCL will continue to support efforts to vaccinate the nation.

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.

What’s in that gummy bear could be hazardous to your kid’s health

CBD-infused foods and candies are often packaged and marketed to appeal to children, but buyer beware – there are a number of harmful ingredients that could be in a seemingly harmless gummy bear. Parents, teachers, guardians, and loved ones should know that none of the non-prescription CBD products on the market today – and the false medical claims often used to market these to consumers – have been tested or approved by the FDA.

Intern Spencer Cramer

Redesigning our communities to fight health disparities

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.

The COVID-19 pandemic has fostered a better understanding of how a public health emergency can devastate different groups of Americans already negatively impacted by health problems. These health disparities, which are differences in health outcomes based on factors such as race, ethnicity, or socioeconomic status, are deeply influenced by “social determinants of health.” Social determinants of health are factors in our environments and societies that have a large impact on someone’s health status, independent of their personal choices or lifestyle.

These social factors are the main contributors to health disparities, which represent one of the ugliest faces of inequality in America today. An example of how social determinants of health and health disparities are inextricably linked can be seen in the maternal mortality crisis, where Black women are more than three times more likely to experience a pregnancy-related death than white women. This disparity can be attributed to institutional racism, lack of access to maternal health services, and the aggregate stress of dealing with discrimination on a daily basis.

Even more illuminating, one of the best predictors of health outcomes is a person’s zip code. In many major U.S. cities, the gap in life expectancy between the highest and lowest zip codes is 20+ years. Similar gaps can be seen between different cities and states. Additionally, it is clear that locations with predominantly low-income populations and many people from racial or ethnic minority groups generally experience worse health outcomes than wealthier, white areas. Geographic location is an excellent predictor of health status for a couple of reasons. Our society still has a tremendous amount of segregation, as people of the same race, ethnicity, and socioeconomic background tend to live near each other. This means that the health inequities facing these groups become disproportionately concentrated in certain neighborhoods.

Another reason for these geographic health disparities is how under-resourced the physical neighborhoods are. Poorer and heavily minority neighborhoods are less likely to have parks, green spaces, quality grocers, and health services, and they are more likely to be afflicted by environmental pollution and other societal abuses. Urban planning has a huge impact on public health. Ensuring that we build our cities to equitably distribute public services and amenities will be a critical strategy in addressing social determinants of health and eliminating health disparities.

One way to create healthier communities for all would be to increase the amount and quality of green spaces like parks or urban forests. A large body of research suggests that urban green spaces provide a wide variety of health benefits to residents ranging from increased opportunities for exercise, cleaner air, and improved mental well-being. Urban trees are proven to be particularly important for removing pollutants and addressing other environmental risks, while improving many different health outcomes. Unfortunately, green spaces, parks, and urban trees are concentrated in whiter, richer, and healthier neighborhoods. Investing in parks and green urban spaces in disadvantaged communities can go a long way towards boosting health outcomes and increasing economic opportunities for those residents.

Perhaps nothing is more important for a community’s health than access to quality, nutritious, and affordable food. Unfortunately, millions of Americans live in food deserts, areas where there is little supply of nutritious, whole foods. Again, food deserts predominate poorer neighborhoods and racial and ethnic minority communities. Living in a food desert means that people cannot access healthy or substantial food at an affordable price, inadvertently resorting to more expensive, lower nutrition food from places like convenience stores. Poor diets driven by this lack of food access cause tons of health problems and are a key driver of health disparities. As a society we often associate diet with personal choice. However, people living in food deserts usually have no option other than to eat low-quality food, and subsequently suffer from the health consequences. Ensuring that all neighborhoods and communities can easily access healthy food at affordable prices will surely help to reduce disparities in areas such as obesity, diabetes, heart disease, and others. What we eat everyday has an astronomical impact on our health, so we must make equitable access to good food a priority when creating healthier communities.

Similarly, many of the same neighborhoods plagued by food deserts also suffer from a stunning lack of access to health and medical services. Many healthcare resources are concentrated in areas with higher insurance rates, especially places with high rates of private insurance, leaving neighborhoods with many uninsured or Medicaid-eligible residents without needed health providers. The health consequences caused by the uneven distribution of health services can be devastating and can result in the delay in crucial preventive health screenings. To address this, we can provide incentives, like additional funding or student loan forgiveness to health care providers who practice in underserved communities, and implement public policies to achieve an equitable geographic distribution of medical resources.

A final factor that leads to these health inequalities between zip codes is pollution. It is certainly no secret that environmental pollutants are often horribly damaging to human health. They can cause diseases ranging from asthma to cancer, and are devastating for any community that they afflict. And of course, pollution has a disparate impact on lower-income and predominately minority communities. Developers frequently choose to build factories and other waste-producing sites in these communities because their residents have fewer resources and less political and social capital to advocate against them. Nobody should be subjected to residing in the midst of toxins and waste.

This will require a massive shift to clean energy, responsible development, and safer waste disposal. We can create more health equity by eliminating the health costs brought upon poor and minority communities by pollutants. Designing our neighborhoods and cities with a focus on public health and health equity will help to close the gaps in health outcomes between different zip codes, and should be one of our top priorities as we battle health disparities and social inequities.

April Verrett, President of Service Employees International Union Local 2015

Earlier this year, I rolled up my sleeve…

SEIU President April VerrettBy Guest Blogger April Verrett, President of SEIU 2015

…for my COVID shot. I was tired of feeling like the virus was winning. I was sick and tired of feeling at the mercy of the whims of this unrelenting, mutating disease. I was angry that this pandemic was beating the hell out of us. So despite any fears and reservations I had about a new vaccine, I was ready to fight. And I wanted to lead by example and show that the vaccine was safe, effective, and the best way to fight against COVID-19.

That shot was more than just a way to protect myself. Like so many have noted, wearing masks and getting vaccinated are comparable to the solidarity and community spirit our grandparents and great grandparents displayed during WWII, where the nation united and everyone did their part. That’s why our Union members referenced the iconic WWII “Rosie the Riveter” image when they launched their “We Can Do It!” vaccination campaign earlier this year. Our Union helped tens of thousands of our long-term care providers, their families, and their vulnerable clients access vaccinations across the state.In the style of the famous Rosie the Riveter poster, a person is pictured wearing mask, flexing arm, and showing vaccination bandage, saying We Can Do It

I was so relieved months earlier when the vaccine became available to essential workers in California. The more than 400,000 long-term care providers I represent every day—primarily women of color—were among the first in line. Often, their communities were the hardest hit by the pandemic. Black and brown neighborhoods throughout the state consistently suffered the highest illness and death rates.

COVID took deadly aim at our members and their elderly, sick and disabled clients. They lost many of the fragile people they cared for while they themselves struggled on the terrifying font lines of the war against COVID, often without the PPE to protect themselves. These caregivers suffer lingering trauma from seeing the ravages up close in nursing homes and private homes up and down the state. Like my sister Christine, a nurse assistant at a nursing home in Bakersfield, where they lost 19 of their patients and more than a hundred of her colleagues fell ill with COVID. It breaks my heart that this is not a unique example. I heard story after story like Christine’s.

There’s one thing that slowed this devastation and protected our members and the vulnerable people they care for: vaccination. Our members see firsthand that it’s the best weapon available to rein in this pandemic, protect against infection and hopefully slow the development of dangerous variants. It’s simple: where vaccination rates are higher, rates of infection, hospitalization and death are lower. Counties across the nation again experiencing at-capacity hospitals are, sadly, the counties that have resisted the vaccine.

I’ve never seen as much misinformation thrown at our members and our communities as I’ve seen around COVID vaccines. So, we recently started a follow-up ‘We Can Do It!’ effort to dispel the dangerous—life-threatening, really—myths about vaccination.

This summer, as employers and local and state governments began to look at ways to urge more vaccination, SEIU 2015 member leaders formed a working group to ensure that Union members would have a voice in any policy, including vaccine mandates. This group developed a set of principles to guide employers and partners in our state’s continued vaccine rollout, such as making sure the vaccine is readily available and accessible, that sick days are provided for the frequent resulting flu-like symptoms and that it’s carefully scheduled to avoid staffing shortages. Days after outlining this guidance, our Governor mandated all healthcare workers to get vaccinated. Our members overwhelmingly support vaccination, but they also want to ensure that it’s accomplished thoughtfully and respectfully for our members who remained concerned.

We can do it. Together, we will defeat COVID-19.

April Verrett is President of SEIU 2015, the largest union in California, representing more than 400,000 long-term care providers (home care, skilled nursing facility, and assisted living center workers) throughout the state. Its members are as diverse as the state’s population, but united in their commitment to caring for California’s most vulnerable: seniors and the disabled. In October, Verrett will receive an award from NCL named for our first Executive Secretary Florence Kelley. To learn more about the evening of awards, click here. 

National Consumers League supports efforts to expand Medicaid coverage

August 13, 2021

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

Washington, DC—The National Consumers League (NCL) has long supported increased access to health coverage for all consumers, regardless of ability to pay. Among other provisions within the American Rescue Plan Act (ARPA) that aim to make health coverage more accessible, the law provides states that have not yet adopted Medicaid expansion with significant financial incentives to do so.

Beginning April 2022, ARPA would extend enhanced federal matching funds past the public health emergency for five years. This incentive is particularly critical to addressing maternal mortality in the United States, ensuring birthing people have access to health coverage in the most vulnerable stage of their lives. Currently, states can extend Medicaid coverage for up to 12 months postpartum following pregnancy for the duration of the pandemic. But once that period ends, states will have to file a section 1115 waiver to continue to extend those benefits through April 1, 2022 when the new law kicks in. To date, three states have approved 1115 waivers expanding Medicaid for up to one year postpartum.

NCL remains concerned that uninsured rates are still high in the states that have not expanded Medicaid. Even under the new law, 37 percent of nonelderly individuals living in the 12 states that have not expanded Medicaid are left uninsured. Ballot initiatives may be an avenue to enhance coverage for uninsured adults in states left to expand Medicaid. Of the states that have expanded Medicaid thus far, Idaho, Maine, Nebraska, Oklahoma, Utah, and Missouri have expanded it as a result of a ballot initiative, while the rest achieved Medicaid expansion either through their governors or state legislatures. Missouri and Oklahoma were able to secure Medicaid expansion by taking the decision straight to the polls, allowing state residents to decide. These victories at the ballot box show that Medicaid expansion is incredibly popular amongst voters in all states, despite the actions of some elected officials. In most cases, it’s largely within the power of the state governor to expand Medicaid to all residents.

Another way states are expanding Medicaid is through Section 1115 Demonstration Waivers, approved by the Centers for Medicare and Medicaid Services (CMS), which allow states to test new approaches to Medicaid in their states. Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, Nebraska, New Hampshire, New Mexico, Ohio, and Utah all have approved Section 1115 waivers to operate their Medicaid expansion programs in ways not otherwise mandated under federal law. Other than New Mexico and Iowa, these Section 1115 waivers impose work requirements as a condition to qualify for Medicaid benefits. Tying health benefits to having a job is problematic in and of itself, but clearly inappropriate to enforce during a pandemic. NCL is encouraged that the Biden Administration has begun the process of withdrawing Section 1115 Demonstration Waivers that include work requirements.

Medicaid expansion is a critical element in achieving health equity, as BIPOC populations are more likely to fall in the Medicaid coverage gap. ARPA includes two years of full federal funding for Medicaid services provided by urban Indian and Native Hawaiian Health Centers. The new law also increases federal Medicaid funding for home- and community-based services (HCBS). Expanding Medicaid would yield economic benefits, as state economies are projected to increase by $350 billion in the span of three years, while also creating 1 million jobs nationwide. NCL supports all efforts leading to Medicaid expansion, which increases access to health care for more Americans.

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.

Diverse research for a diverse America: The value of equitable, real-world research

By Sally Greenberg, NCL Executive Director

While the COVID-19 pandemic has led to hardship for all Americans, it is clear that people of color have been disproportionately burdened. Across the health care continuum, addressing this disparity has become part of the broader conversation about the history of systemic racism and the underlying social determinants of health that negatively affect the mental, physical, and economic health of individuals and entire communities.

The pandemic has underscored persistent health disparities, and there is growing recognition that representation in research and clinical trials can have a profound impact on health outcomes. A lack of representation from racially and ethnically diverse groups in research and clinical trials have typically led to gaps in data, missing the opportunity to assess the full impact of various treatments and drugs across a range of populations. The collection and use of real-world research and data to inform the potential use, risks, and benefits of medical products and treatments can ultimately lead to better health outcomes, particularly for those who have been underrepresented in the past.

Existing efforts to improve inclusion

Efforts to expand diversity and representation in medical research are underway in Congress. Policymakers are encouraging the incorporation of Real World Evidence (RWE) in drug development through the recent Cures 2.0 draft legislation released by Reps. Diana Degette (D-CO-1) and Fred Upton (D-MI-6). While the status quo limits us from effectively reaching underserved populations, the proposed legislation would allow studies that include RWE for some drugs after they have been approved. At the heart of this issue is a growing appreciation that the same therapy can affect different populations in different ways, which is why Cures 2.0 supports collecting data that more accurately reflects the unique experiences and needs of patients across diverse populations.

Recognizing the potential for RWE in maternal health

The lack of representative research in the field of maternal health is undeniable, and its implications are staggering. The dismal state of maternal care in the United States reflects how our health care system has failed women of color, including by not adequately studying treatment options to prevent maternal morbidity and mortality. The need for RWE is clear when you consider the persistent disparities in health outcomes that plague minority communities.

Preterm birth and its disproportionate impact on women of color is a stark illustration of the need to make progress on representative research in maternal health. Preterm birth is the second-largest contributor to infant death in America today. Despite the tremendous physical, emotional, and financial toll that preterm birth continues to take on our country — disproportionately so on women and families of color — not enough therapeutic tools currently exist to prevent it.

Today, “17P,” the only FDA-approved treatment to help reduce the likelihood of spontaneous, recurrent preterm birth in the United States is at-risk of being withdrawn from the market in all its forms, including the branded product and five generic versions. Unfortunately there is conflicting evidence from two different clinical trials, one representative of a diverse U.S. population and another studied in a largely white population in Europe. It’s not a straightforward comparison. If 17P is withdrawn, the women most affected by preterm birth, predominantly women of color, would be left without an FDA-approved treatment option.

The FDA is considering the path forward, including additional data collection through leveraging RWE from past patient use. The success of the first (approval) trial for 17P in the impacted communities signals the importance of RWE. Continued access to 17P is, at its core, a matter of health equity. Black women must not yet again be left vulnerable to a system that historically has overlooked them.

National Consumers League calls on Congress, DOT to investigate flight cancellation crisis

August 6, 2021

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

Washington, DC—The National Consumers League (NCL) is today calling on Congress and the U.S. Department of Transportation to take action to address the dramatic increase in flight cancellations that American consumers have been forced to endure this summer. In just the last 48 hours, Spirit Airlines canceled more than 400 flights, nearly 60 percent of its schedule, and American Airlines canceled nearly 350 flights. This follows on the heels of delays for nearly 10,000 flights and hundreds of additional cancellations in June.

NCL is urging Congress and the DOT to address this unacceptable situation and hold the airlines accountable for skirting around the requirements of agreements to accept more than $50 billion in tax-payer funded bailouts in 2020.

The following statement is attributable to NCL Vice President of Public Policy, Telecommunications, and Fraud John Breyault:

“The situation in America’s airports has reached a crisis point. The airlines gladly accepted tens of billions of dollars in bailout money last year in order to save jobs. Nonetheless, they are now blaming thousands of cancellations and delays on not having enough workers.

“Who do they think they are kidding? The airlines are playing fast and loose with consumers, and it must stop. This scandal is stranding millions of Americans at the height of the summer travel season. Secretary Buttigieg and leaders in Congress should immediately take action to hold the airlines accountable for their failure to maintain adequate staffing. Airlines that cannot accommodate their passengers should immediately issue refunds with no questions asked. Interline agreements should be required so that passengers can be easily booked onto alternate airlines to complete their journeys. Congress should immediately open an investigation into whether the airlines’ use of early retirement packages and unpaid furloughs, combined with the threat of layoffs, constituted an illegal evasion of the bailout legislation’s staffing requirements.”

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.

National Consumers League statement on the passing of AFL-CIO President Rich Trumka

August 5, 2021

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

Washington, DC—The National Consumers League is today mourning the passing of AFL-CIO President Rich Trumka. A champion for working families across the United States and around the world, Mr. Trumka was a devoted advocate for the rights for consumers.

The following statement is attributable to National Consumers League Executive Director Sally Greenberg:

“America lost a hero today. NCL’s staff and Board of Directors stand in solidarity with our brothers and sisters in the global labor movement as we mourn the loss of AFL-CIO President Rich Trumka, a storied labor leader and friend to working families.

“President Trumka grew up in the small coal-mining town of Nemacolin, Pennsylvania. The men in his family, including his father and grandfather, were coal miners. He  followed them into the mines and subsequently attended law school at Villanova. NCL was proud to honor him with our Trumpeter Award in 2014. He also graciously introduced our 2012 Trumpeter Awardee, United Mine Workers of America President Cecil Roberts, in 2012.

“Consumers are better off today because the leadership of President Trumka. As we grieve his loss, we rededicate ourselves to upholding the values that he championed his whole life: building an economy that works for everyone, protecting the rights of the less fortunate, and promoting democracy in the United States and around the world.”

President Trumka was a graduate of Penn State, where the UMWA archives are housed today. He will be missed by all.

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.