New NCL analysis of medical debt policies highlights need for reform

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By Sam Sears, Health Policy Associate, National Consumers League

The National Consumers League (NCL) recently published a new issue brief focused on hospital’s medical debt practices. With over 100 million Americans grappling with medical debt, and 1 in 7 of them reporting to KFF Health News that they’ve been denied care, it is prudent to evaluate these anti-consumer hospital policies.

The analysis, which was completed by Magnolia Market Access, found that 340B hospitals are significantly more aggressive with their medical debt policies – 340B hospitals are twice as likely to deny or defer chare and also significantly more likely to take legal action against a patient. Additionally, our analysis found that for-profit hospitals are significantly less aggressive in their practices against patients with medical debt than nonprofit or government hospitals, and that screening for financial assistance does not resolve medical debt issues.

Medical debt is unpredictable and can have long lasting consequences. Nearly 50% of Americans struggling with medical debt have it reported to their credit report, and over 40 million people owe nearly $88 billion that has been sent to collections. The Biden Administration has taken action to combat and address medical debt, which you can read more about here on our blog. However, there are additional actions that policymakers may take.

NCL has, and continues to fight to protect consumers from excessive troubles due to medical debt, including working with policymakers to combat anti-consumer debt collection policies hospitals continue to practice. The findings from the analysis conducted in this issue brief further highlight the need for 340B Drug Pricing Program reform, to ensure the savings that hospitals receive are reinvested in ways that continue to benefit consumers and patients.

Hospital Medical Debt

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About the National Consumers League (NCL)

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 nclnet.org.

NCL celebrates landmark progress in ticket fee reform 

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December 18, 2024

Contact: National Consumers League – Lisa McDonald, lisam@nclnet.org, 202-207-2829

Washington, DC – The National Consumers League (NCL) applauded Congress for including the bipartisan TICKET Act (S. 1303/H.R. 3950) in the year-end funding legislation. This marks a significant milestone in NCL’s decade-long fight to secure stronger consumer protections for live event fans. NCL looks forward to working with Congress and President Biden to see these landmark reforms signed into law.

The TICKET Act, backed by more than a dozen consumer and fan advocacy organizations and live event industry stakeholders, introduces key regulations to protect consumers, including:

  • Requiring all-in pricing to eliminate hidden fees.
  • Banning speculative ticketing and deceptive marketing practices.
  • Guaranteeing refunds for canceled or postponed events.
  • Mandating an FTC study on BOTS Act enforcement.

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

“Live event fans are one step closer to saying goodbye to hidden ticket fees that have frustrated consumers for decades. The TICKET Act will also end deceptive speculative ticket sales and ensure fans get their money back when events are canceled or postponed. These long-overdue reforms are a victory for consumers, and we thank congressional leaders for their commitment to making this law a reality.

Special thanks go to Senators Cantwell, Cruz, Klobuchar, and Schumer and Representatives McMorris Rodgers, Pallone, Schakowsky, Bilirakis, and the co-sponsors of S. 1303/H.R. 3950, whose dedication made this bipartisan consumer protection victory possible.”

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A trusted source for reliable health information

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For more than a century, the National Consumers League (NCL) has been a vigorous advocate for consumers, playing a pivotal role in protecting health and safety, by providing vital and reliable information on medical and food products so that individuals and families can make informed decisions about matters that affect their well-being.

Since being chartered in 1899, the organization has worked to create and strengthen protections for consumers. These critical protections were led initially by the work of its first general secretary, Florence Kelley, who helped spread the word about the importance of typhoid vaccines to mitigate a disease outbreak at the end of the 19th century and helped lead the League’s efforts to promote the Pure Food and Drug Act of 1906, which laid the foundation for the Food and Drug Administration (FDA).

Indeed, the work and mission of NCL shares much with the FDA, an agency that embraces a basic responsibility to provide the public with accurate, science-based information so that Americans can make well-informed decisions about their health. We’ve seen great success in this area, thanks in part to the work done by NCL. Nevertheless, we still face great challenges, and I am confident that NCL will play a very important role in addressing these as well.

Our nation has enacted important laws to help protect consumers, and we have marshaled extraordinary progress in science and technology in the development of new treatments and cures for diseases. Despite these and other advances that enable us to improve our health, we are today witnessing a troubling new development in, and threat to, public health. Notably, we are experiencing a worrisome decline in our nation’s life expectancy that is in part linked to an increasing prevalence and cumulative impact of a number of chronic diseases — heart, vascular, metabolic (such as obesity and diabetes), and lung and kidney disease, and to troubling rates of overdoses, suicides, and gun violence.

Just as regrettable is the growing problem of misinformation about public health, science, and medicine. A stream of misinformation and often unfounded opinions, most often spread via the Internet and social media, is eroding the public’s trust in science and government agencies, such as the FDA, making it increasingly difficult for the public to verify facts and advice from these trusted sources.

While not a new problem in our nation’s history, the digitization of our culture and the rapid growth of social media have exacerbated the pervasiveness and impact of the problem. This is an area where NCL’s powerful voice and unimpeachable credibility can have an enormous impact. Neither the FDA, nor the entire federal government can combat the spread of misinformation on its own. It is going to require a concerted non-governmental response. Few organizations are better positioned to succeed at this task than the National Consumers League.

It wouldn’t be the first time NCL rose to the occasion. During the COVID-19 public health emergency, NCL was an essential voice – helping Americans better understand the virus, its variants, and how to protect themselves from infection. The organization testified before the FDA and Centers for Disease Control and Prevention panels on vaccine development and safety and advocated for limits on social media misinformation during that crisis.

Similarly, NCL has provided enormous public benefit through its work to help consumers understand food labeling, to hold companies accountable for the claims they make regarding food and health care products, and with programs such as Script Your Future that help raise awareness of the importance of medication adherence among patients, particularly those with chronic health challenges.

There is an old saying that a lie can get halfway around the world before the truth can get out of bed. Given the speed and reach of social media today, that analogy can be applied to misinformation, which is disseminated far too quickly to be adequately countered with trustworthy facts. However, we don’t have the luxury to surrender. The lives and well-being of too many people depend on our ability to provide the public with reliable information grounded in science.

I am confident in our ability to overcome this latest challenge, thanks in large part to allies like the National Consumers League with its long track record of empowering generations of Americans to make well-informed decisions to secure their health and their futures. I look forward to NCL’s continued activism, engagement, and leadership.

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Robert M. Califf, M.D. is Commissioner of the Food and Drug Administration.

NCL hails FTC ban on hidden junk fees in ticketing and lodging

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December 17, 2024

Media contact: National Consumers League – Lisa McDonald, lisam@nclnet.org, 202-207-2829

Washington, DC – Today, the FTC announced its final rule banning hidden junk fees in live-event ticketing and short-term lodging. NCL has long advocated for such a ban at the federal level and applauds the Commission for enacting this critical consumer protection regulation.

“Sellers in these industries can no longer lie to consumers to make a buck. The FTC’s final rule is a common-sense policy that will make the ticketing and lodging marketplaces fairer for everyone involved,” said NCL Vice President John Breyault. “The price that’s advertised is the price that you should pay.”

This single rule by the FTC will result in billions of dollars in savings for consumers. A non-partisan federal study of the ticketing industry found that primary and secondary ticket sellers charged fees averaging 27% and 31%, respectively, of the ticket’s price. Regarding lodging, the Council of Economic Advisers *estimated that consumers lose $3.3 billion annually to hotel junk fees.

Further reading:

2024 public comments of the National Consumers League and 51 other organizations supporting the FTC’s proposed rule to ban junk fees

2024 public comments of the Break Up Ticketmaster Coalition (NCL and 14 other organizations) supporting the FTC’s proposed rule

2023 testimony of NCL’s CEO before the United States Senate on the need to prohibit junk fees

2023 public comments of the National Consumers League and 41 other organizations supporting the FTC’s advanced notice of proposed rulemaking on junk fees

2022 public comments of the National Consumers League supporting a petition for rulemaking to ban drip pricing, which resulted in this final rule

2018 public comments of the National Consumers League and the Sports Fans Coalition urging FTC intervention in the ticketing industry

*Links are no longer active as the original sources have removed the content, sometimes due to federal website changes or restructurings

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About the National Consumers League (NCL) 

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 calls on Congress to include TICKET Act in continuing resolution

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December 16, 2024

National Consumers League Calls on Congress to Include TICKET Act in Continuing Resolution

Contact: National Consumers League – Lisa McDonald, lisam@nclnet.org, 202-207-2829

Washington, DC – The National Consumers League (NCL), America’s oldest consumer and worker advocacy organization, is urging Congress to include the bipartisan TICKET Act (H.R. 3950) in any Continuing Resolution (CR) passed this session. The TICKET Act represents the most significant live event ticketing reform in nearly a decade, addressing key concerns in the live event marketplace for all stakeholders.

Key provisions of the TICKET Act include:

  • Banning hidden fees through all-in pricing requirements.
  • Prohibiting speculative ticketing and other deceptive marketing practices.
  • Requiring refunds for canceled and postponed events.
  • Commissioning an FTC study on enforcement of the BOTS Act.

Earlier this year, the TICKET Act passed the House with overwhelming bipartisan support (388–24) and gained endorsements from a broad coalition of stakeholders, including the, Consumer Reports, Artist Rights Alliance, Recording Academy, Live Nation/Ticketmaster (LNE), Coalition for Ticket Fairness, Vivid Seats, StubHub, and the National Independent Venue Association and other consumer groups.

Despite previously supporting the bill, the Fix the Tix Coalition—has backed away from the bill. We think that is misguided.

“The TICKET Act is a hard-fought compromise and, we believe, Congress’ best chance to deliver meaningful reforms that benefit fans, venues, and artists as early as next summer’s concert season,” said John Breyault, NCL’s Vice President of Public Policy, Telecommunications, and Fraud. “We are disappointed that groups that had previously supported the bill have reversed themselves, though the bill has not significantly changed since they originally endorsed it. We are concerned that Ticketmaster/Live Nation, which owns primary and secondary ticketing platforms, manages hundreds of artists and owns, controls, or has exclusive contracts with hundreds of venues, may be exerting undue influence at the expense of consumers. Congress should resist special interests, and stand up for consumers by including this package of positive reforms in the CR.”

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NCL calls on FDA to ban Red No. 3 from the food supply

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Contact: National Consumers League – Lisa McDonald, lisam@nclnet.org, 202-207-2829

Washington, DC – The National Consumers League (NCL) anxiously awaits FDA’s final action on a citizen petition to ban Red No. 3 from the food supply, something that has been too long in coming. Red No. 3 is a petroleum based color additive known to cause cancer in laboratory animals and is now banned for used in cosmetics and externally applied drugs. Yet, the food dye is still widely used in foods and beverages consumed by children who are more susceptible to the effects of chemicals in foods. The bigger problem is that the FDA has been impeded for years in taking action against additives like Red No. 3 because Congress has not given the agency the same authority as the Environmental Protection Agency has to make safety decisions about chemical safety, nor has it appropriated the funds for the FDA to respond effectively. At a time when more than 10,000 food chemicals are allowed in foods and beverages, it is time for Congress to make food additive safety a priority and give the FDA the authority it needs.

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About the National Consumers League (NCL) 

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 and FDA: Allies in Action

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Sixteen years ago, the Food and Drug Administration (FDA) invested in the NCL’s launch of its Script Your Future initiative. It turned out to be an extremely wise use of public resources. The program is still making a difference in people’s health and lives today, providing education on the importance of medication adherence, building confidence in vaccines, offering information on alternatives to opioids, and raising awareness of drug safety and how to engage in safe drug disposal. Because of Script Your Future, more patients are knowledgeable about their medication options, including the growing field of biosimilars.

The success of this program is emblematic of the long-standing, productive relationship between the FDA and NCL. During my nearly four decades with the agency, I have greatly appreciated a partnership that has benefited all who rely on the safety and efficacy of medicines and healthy foods. I began my relationship with NCL when Linda Golodner was the organization’s CEO and have continued our collaboration with Sally Greenberg and her team.

NCL’s history as an advocate for public health is linked to the very creation of the FDA. Under Florence Kelley’s historic leadership of the League, the organization played a critical role, during President Theodore Roosevelt’s Administration, in the passage of the Pure Food and Drug Act, which, for the first time, created legal protections declaring that consumers had the right to safe products. The bill also created the precursor for what would become the FDA.

Then, just over a decade later, NCL defied not only the conventional wisdom of the time, but also staunch opposition from powerful political forces to get the Sheppard-Towner Maternity and Infancy Protection Act enacted into law. Also known as the “Maternity Act,” Sheppard-Towner became the first-ever federally funded social welfare program, providing states with federal matching funds for health clinics for pregnant women, as well as mothers and their children, visiting nurses to help care for pregnant and new mothers, midwife training, and dissemination of health and nutrition information.

When I began working with NCL early in my tenure at the FDA, it was already an organization that had established enormous credibility as a valuable ally for patients and consumers. What I found firsthand is that NCL is an honest, reliable broker on a wide range of issues and has an unwavering commitment to the well-being of consumers and workers. In our work at the FDA, NCL has been a valuable ally that has effectively advanced responsible policies on food and medication safety.

Today, NCL is continuing to build on its 125- year volume of accomplishments, focusing on the important challenges of today. NCL is providing a necessary voice on issues such as prescription drug access and affordability, stopping the spread of counterfeit medications, improving food and beverage labeling, and promoting nutrition and healthy lifestyles.

The science behind medical and food innovation is constantly and rapidly evolving, and as it does, so will the issues affecting population health and welfare. So, in addition to congratulating NCL on its 125th anniversary, I want to emphasize how important it is that we continue to have NCL shaping a future defined by health, safety, and access to the best care medical science continues to provide.

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Before her retirement earlier this year, Dr. Janet Woodcock held numerous leadership positions at the Food and Drug Administration, including Acting Commissioner, Principal Deputy Commissioner, and Director of the Center for Drug Evaluation and Research. In 2017, NCL recognized Dr. Woodcock with the Florence Kelley Consumer Leadership Award. 

Pioneering access to affordable healthcare

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The drive to achieve accessible, affordable, high-quality healthcare for every man, woman, and child in the United States has been a long one, and it has been a central pillar of the National Consumers League’s (NCL’s) mission and history. Having served as Secretary of Health and Human Services during the creation and implementation of the Affordable Care Act (ACA), I have a great awareness and appreciation for the role NCL has played in bringing health security to more Americans and preventing those protections from being diminished or taken away by opponents of progress.

As I said, it’s been a long battle and one that is far from complete. You can go back to the Franklin D. Roosevelt Administration to witness NCL’s impact on health reform. Josephine Roche, a former president of NCL, was by President Roosevelt’s side writing the first-ever universal healthcare bill to be introduced in Congress. Components of that legislation became the groundwork for the creation of Medicare and Medicaid. 

In building a healthier nation, NCL also played a key role in the passage of the Sheppard– Towner Maternity and Infancy Protection Act, the first venture of the federal government into Social Security legislation and the first major law that came to exist after the full enfranchisement of women. Before its passage, most of the expansion in public health programs occurred at the state and local levels. The act provided support for women and their babies through pregnancy and childbirth and resulted in a decrease in infant mortality rates. It was repealed after lobbying by the American Medical Association, which argued it was “socialized medicine” in 1929, but when the Social Security Act was passed in 1935, it included many of the same provisions.

Since that time, NCL’s name has been there whenever opportunities occur to improve the health and well-being of consumers and working Americans or when efforts to roll back hard-won healthcare benefits need to be fiercely opposed. The Department of Health and Human Services has one of the most far-reaching portfolios of any cabinet department, and, as Secretary, I valued NCL’s ability to weigh in on so many of those issues, be they Medicare reform, prescription drug affordability, or food safety.

What I appreciate about NCL’s work in this space is that its mission involves not just policy advocacy, but also practical guidance for consumers trying to navigate the complexities of our healthcare system. The organization has been an invaluable resource in helping people better understand their healthcare coverage options; protect themselves against fraud; realize the importance of being up-to- date on vaccines; and, through the excellent Script Your Future program, practice better medication adherence.

The need for NCL in today’s healthcare sphere is more important than ever. Healthcare is, and always has been, a politically charged, volatile issue. As we saw during the battles to enact the ACA and prevent its repeal, and again during the COVID-19 pandemic and the effort to get people vaccinated, there is no shortage of misinformation designed to thwart public health initiatives. We need NCL, with its impeccable credibility, to combat the misinformation clutter and to cut through the noise with reliable, evidence-supported messaging that the American people can trust.

NCL’s voice is vital, as well, in the continuing battle to make healthcare more affordable and accessible. While the ACA has been an enormous success in reducing the number of uninsured persons in this country, patients and consumers are still dealing with industry machinations that make it more difficult to get the treatments they need and make out-of- pocket costs higher than they should be. NCL continues to be an effective advocate so that patients and their healthcare providers, rather than insurers, can determine the best course of treatment together.

Yes, the road to universal healthcare is a long one, but we wouldn’t be as far in this journey as we have come without the work of the National Consumers League.

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Kathleen Sebelius is the CEO of Sebelius Resources, LLC, a strategic advisory firm, and was Secretary of Health and Human Services under President Barack Obama, and was a 2023 recipient of the Trumpeter Award. 

Saving kids’ lives through safer vehicles

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Virtually every safety feature in automobiles, even those we take for granted, like seat belts and airbags, became standard equipment only after overcoming intense resistance. The technologies that have made cars much safer for both passengers and pedestrians have come about because of the commitment, determination, and resourcefulness of those who refuse to surrender in the fight for positive change.

That’s why I am so grateful for the partnership of Sally Greenberg and the National Consumers League (NCL). The work they have done and continue to do is saving countless lives.

In the 1980s, healthcare professionals were publishing papers on the number of people, predominantly small children, who were being killed or injured by cars backing out of driveways or parking spots. A 1993 report from the National Highway Traffic Safety Administration (NHTSA) found that as many as 200 pedestrians, mostly children, were being killed each year by backing out collisions. At least 50 children every week were being backed over by vehicles.

My organization, Kids and Car Safety, compiled data on the problem and concluded that the only solution would be to mandate a rear visibility standard—cameras that would allow the driver to see what was behind the car, particularly a small child who could not be seen through the rearview mirror or rear window. The regulators were not acting, so we began working with Congress on legislation to require a rear visibility standard allowing drivers to see behind them when backing up. After all, you cannot avoid hitting something or someone you cannot see.

That’s when I teamed up with Sally Greenberg, then with Consumers Union. We began a battle that would take years but was so very necessary to prevent more families from suffering avoidable tragedies. We matched our research and our firsthand witness testimonies against the arguments that rear backup cameras would add too much to the cost of cars and that drivers wouldn’t use them. We argued that they shouldn’t only be offered as an optional feature in luxury cars.

Sally and Consumers Union, along with Kids and Car Safety and NCL, tirelessly insisted that safety could not be offered only to those who could afford it.

Finally, in 2014, a new rule was issued and took effect in 2018, mandating that all vehicles sold or leased in the United States, no matter where they were manufactured, be equipped with a rear backup camera. Today, they are thought to be as essential as seat belts, airbags, side impact protection, and electronic stability control—features that no vehicle should ever be without. And it happened because of advocates like Sally Greenberg and others who simply wouldn’t back down to the powerful, well-financed opposition.

There is more to be done to make cars safer for drivers and their families. On average, about 40 children die annually in hot cars. Often, these are infants and toddlers in rear- facing car seats, and the driver, looking in the rearview mirror, can’t tell if the seat is occupied or not.

We’re pleased to have NCL’s powerful voice engaged in yet another effort to use effective technologies to save lives. Occupant detection systems can distinguish between living beings and inanimate objects in the vehicle and can alert the driver that a child is unattended in the vehicle. This system will save lives, as NCL has compellingly pointed out. There is resistance to making occupant detection systems a mandatory feature in new cars. There always is. Yet, we were successful in adding a lifesaving traffic safety provision designed to prevent hot car fatalities, in the Infrastructure Investment and Jobs Act (IIJA).

Kids and Car Safety and NCL have a solid track record of collaborating on these issues. When lives, health, and safety are at stake, I wouldn’t bet against us.

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Janette Fennell is the Founder and President of Kids and Car Safety, a national nonprofit organization dedicated to preventing injury and death to children and animals in and around motor vehicles.