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.

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.

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. 

Nancy Glick

Science should drive obesity care

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Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

Today, over 100 million Americans, or 40.3 percent of adults, are living with obesity. This makes obesity the nation’s most widespread chronic condition, impacting many more people than diabetes, heart disease, stroke, certain cancers, chronic lung disease, and chronic kidney disease.

Yet, the sad fact is obesity still gets short shrift from health professionals and policymakers, even though it worsens the outcomes of more than 230 chronic diseases, is responsible for an estimated 400,000 premature deaths annually, and costs society an estimated $1.72 trillion a year.  As a consequence, only 10 percent of people with obesity get help from medical professionals, meaning the disease remains largely undiagnosed and undertreated.  This is occurring even though leading medical societies, including the American Medical Association (AMA), agree that obesity is a serious disease requiring comprehensive care.

It doesn’t have to be this way, which is why the National Consumers League worked with the National Council on Aging and leading obesity experts to issue the first Obesity Bill of Rights for the nation, which establishes eight essential rights so people with obesity will be screened, diagnosed, counseled, and treated according to medical guidelines. The goal is to put an end to the prejudice, incorrect beliefs about obesity, misinformation about treatment options, and outdated government policies that keep Americans from getting the same standard of care as those with other chronic diseases.

It will take time for the Obesity Bill of Rights to be incorporated into clinical practice, but specific rights already have significance. This is the case with new “blockbuster” injectable medicines called GLP-1 (glucagon-like peptide-1 receptor) agonists that work by mimicking a hormone produced in the small intestine to reduce appetite and slow digestion. Considered a game-changer in chronic obesity treatment, GLP-1s can help people lose up to 20 percent of their weight in 26 months. Thus, The Right to Coverage for Treatment reinforces calls from obesity specialists and medical societies for an end to exclusionary coverage policies by insurers and government agencies, so GLP-1 medications are a treatment option for adults at higher risk for living with weight-related diseases.

The major challenge has been the Medicare program, which excludes coverage for weight loss drugs due to past safety concerns that no longer exist today. But this could change. On November 26, 2024 the Centers for Medicare and Medicaid Services (CMS) published a proposed rule to allow seniors on Medicare and adults with Medicaid to have coverage for GLP-1s, thereby removing one of the biggest obstacles impeding access to quality obesity care in the country. If CMS’s proposal is finalized, the right to coverage for obesity treatment will become a reality for 7.4 million Americans – a good start in ensuring that people with obesity receive individualized quality care.

However, there is a lot of misinformation about GLP-1 medications, so The Right to Accurate, Clear, Trusted, and Accessible Information is also important, especially because disinformation is raising concerns among health professionals and the public. To date, the Food and Drug Administration (FDA) has approved four GLP-1 drugs based on evidence from large-scale clinical trials that these medicines are safe and achieve substantial weight loss. Yet, critics of these drugs assert these compounds cause severe side effects in all users, claim GLP-1 medications cause depression and suicidal thoughts, and allege the European Union (EU) is investigating this matter.

Responding to these allegations, experts in obesity treatment have assembled the facts from scientific journal articles and government reports. In furtherance of the right of the public to have this information, here is a summary of these findings:

  • Regarding the potential side effects of GLP-1s, several studies dispute the assertion that GLP-1 drugs cause severe adverse effects in all people. The consensus is that because these drugs slow stomach emptying, they can cause gastrointestinal problems that are usually mild to moderate and often go away within one to two months.
  • As to GLP-1s causing suicidal ideation, a recent commentary in JAMA Open Network concludes that large-scale studies do not show any increased risk of suicidal ideation while a 2024 study by researchers at Case Western Reserve University School of Medicine found that people taking a GLP-1 drug had a lower risk of suicidal thoughts compared to those taking a non-GLP-1 compound.  Similarly, the FDA published a detailed report in January 2024 also finding no association. FDA reached this conclusion after analyzing information on adverse events from the FDA Adverse Event Reporting System (FAERS), reviewing a meta-analysis of GLP-1 clinical trials data, and analyzing post-marketing data in the FDA’s Sentinel System.
  • Concerning the investigation by the EU’s European Medicines Agency, EMA’s Pharmacovigilance Risk Assessment Committee conducted a review of health records and issued a finding that no causal association exists between GLP-1s and suicidal thoughts or self-injurious actions.

The Rand Corporation coined the term “truth decay” to call attention to the blurring of the line between opinion and fact. It is important that “truth decay” not become a new obstacle to Americans receiving quality obesity care.

Congress must protect consumers from PBM abuse

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By Sally Greenberg, Chief Executive Officer

The post-election lame duck session of Congress could be one of the most influential for consumers – if our elected officials are willing to act. As Americans struggle with high prescription drug costs, insurance middlemen pharmacy benefit managers (PBMs) siphon dollars from the drug pricing system into their own pockets. Two bills sitting in Congress aim to change this by increasing transparency, ensuring PBM rebates are passed directly to consumers, and disconnecting PBM profits from the price of medicines.

S. 3973: The Pharmacy Benefit Manager Transparency and Accountability Act, would require PBMs to pass on rebates from drug manufacturers directly to consumers, ensuring they benefit from cost savings at the point of sale. It also delinks PBM profits from drug prices, eliminating the incentive to drive up costs.

S. 3430: The Prescription Drug Price Relief and Consumer Protection Act establishes stronger regulations on PBMs, ensuring transparency in drug pricing and rebate negotiations, and making sure PBMs act in the best interests of consumers.

These bills will create a much fairer system, ensuring that savings reach consumers and medications are made more affordable. Congress must advance these bills this year to protect consumers from PBM exploitation now and lay the groundwork for additional healthcare reforms next session.

Although this session – and year – is coming to a close, meaningful healthcare reforms that directly benefit consumers can start now.

Millions would benefit as Biden Administration expands coverage for anti-obesity medications under Medicare and Medicaid

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November 26, 2024

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

Washington, DC – The National Consumers League (NCL) applauds the action by President Joe Biden to allow millions of Americans on Medicare and Medicaid to have coverage for new and very effective anti-obesity medicines (AOMs), thereby removing one of the biggest obstacles impeding access to quality obesity care in the country.

At a time when obesity has become the nation’s most widespread chronic disease, it worsens the outcomes of more than 230 other chronic diseases, and is responsible for an estimated 400,000 premature deathsannually, the proposed rule issued by the Centers for Medicaid and Medicare Services (CMS) has the potential to save lives and improve the health outcomes of 7.4 million Americans. This includes approximately four million adult Medicaid enrollees who would gain new access to anti-obesity medicines and an estimated 3.4 million Medicare beneficiaries whose treatment with AOMS would be covered, reducing their out-of-pocket costs by as much as 95 percent.

The cost of new anti-obesity medicines is an obvious concern to organizations like NCL, the public health community, and policymakers. However, CMS’s proposed expansion of Medicare and Medicaid coverage for a new class of injectable GPL-1 (glucagon-like peptide-1 receptor) agonists that can achieve a substantial weight loss (up to 20 percent) represents an important investment in the improved health of Americans.

“Today’s proposed action is a major step forward in ensuring that adults with obesity get the same quality care and access to treatments as those with the 230 chronic conditions where obesity is a significant factor,” says Nancy Glick, National Consumers League Director of Food and Nutrition Policy. “Today, only 10 percent of people with obesity get help from medical professionals, meaning the disease remains largely undiagnosed and undertreated. If CMS’s proposed rule is implemented, it will go a long way towards closing this obesity treatment gap, especially since health insurance companies closely align coverage decisions with Medicare policy.”

In January 2024, NCL worked with the National Council on Aging and leading obesity experts to issue the first Obesity Bill of Rights for the nation, which establishes eight essential rights so people with obesity will be screened, diagnosed, counseled, and treated according to medical guidelines. The Right to Coverage for Treatment is one of these essential rights and will become a reality for millions of Americans on Medicare and Medicaid if CMS’s proposal goes into effect.

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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.

Sally Greenberg: Fluoridated water is essential for public health, not a danger

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Sally Greenberg: Fluoridated Water is Essential for Public Health, Not a Danger

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

Washington, DC— In response to recent media coverage about Robert F. Kennedy Jr. and Florida Surgeon General Joseph A. Ladapo campaigning against water fluoridation, Sally Greenberg, CEO of the National Consumers League (NCL), issued the following statement:

“Robert F. Kennedy Jr.’s statements on fluoride could jeopardize a proven public health measure. Consumers are best served by reliable, evidence-based health information, not alarmist misinformation.”

The comments made by Kennedy and Ladapo echo similar claims from the 1960s, when groups like the John Birch Society suggested that fluoridation of drinking water was a “communist plot.” Today’s anti-fluoride activists point to a 2019 Canadian study that found that pregnant mothers exposed to higher fluoride levels during pregnancy, gave birth to baby boys with slightly lower IQ’s, as measured at ages 3-4. In this study, mothers were asked to self-recall beverage consumption per day and did not take into account the children’s fluoride exposure in early childhood.

The Center for Disease Control and Prevention (CDC) calls fluoridated drinking water one of the most successful public health interventions in U.S. history, with its origins dating back to 1945 in Grand Rapids, Michigan. Since then, water fluoridation has been proven to significantly reduce rates of tooth decay, especially in economically disadvantaged and vulnerable populations. The CDC estimates that fluoridated drinking water reduces tooth decay by approximately 25% in children and adults. Health authorities, including the American Dental Association and World Health Organization, affirm that fluoride is safe at the levels currently used in the U.S.

“Fluoridated water is a vital measure to protect public health and reduce health disparities in dental care,” says Greenberg. Recent examples of removing fluoride from water, such as Calgary, Canada (2011) and Juneau, Alaska (2007), resulted in an explosion of dental decay. In both cities, the absence of fluoride in the drinking water corresponded with an increase in cavities and dental surgeries, particularly among children. For more information, visit CDC’s resources on fluoride.

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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.

Nonprescription Analgesic/Antipyretic drug development in children 2 to less than 12 years of age

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November 15, 2024

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

WASHINGTON, DC – Sally Greenberg, NCL CEO testifies at the FDA about Nonprescription Analgesic/Antipyretic Drug Development in Children 2 to less than 12 Years of Age.

A full video of the U.S. Food and Drug Administration meeting can be found here:

Nonprescription Analgesic/Antipyretic Drug Development in Children 2 to less than 12 Years of Age

Sally Greenberg, CEO of the National Consumers League, testifies at 1:32:24.

Trump’s nomination of Robert F. Kennedy Jr. for Secretary of Health and Human Services threatens public health

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November 15, 2024

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

WASHINGTON, DC– President-elect Trump’s decision to nominate Robert F. Kennedy Jr. as Secretary of Health and Human Services (HHS) is a grave error, prioritizing conspiracy theories over evidence based science and medical research that is a foundation of our public health system.

The nomination is a staggering blow to the integrity of our nation’s healthcare delivery system. Kennedy, one of the loudest anti-vaccine voices during the COVID-19 pandemic, has been vocal about his theory that vaccines cause autism, a theory unsubstantiated by medical research. Vaccines are one of the most significant achievements in modern medicine, virtually eradicating childhood diseases such as smallpox and polio, saving millions of lives, and ensuring that our children grow up healthy and safe. The World Health Organization has repeatedly affirmed that vaccines are a cornerstone of public health, drastically reducing child mortality and preventing devastating diseases.

Parents across the nation, regardless of their political affiliations, share the same goal: to see their children grow up healthy and strong. By advancing vaccine skepticism, Mr. Kennedy jeopardizes not only children’s health but also public confidence in science, medicine, and the agencies tasked with protecting public safety—a foundation that has taken over a century to build.

If he is confirmed for the position, Mr. Kennedy, an environmental lawyer by training with no experience in the health or medical community, would oversee critical agencies such as the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH). His anti-science stance raises serious concerns about his ability to lead a department responsible for infectious disease control, food and drug safety, Medicare and Medicaid policy, and life-saving medical research.

In addition, Mr. Kennedy has proposed drastic changes to the FDA, including loosening regulations on raw milk and eliminating the user fees that fund the oversight of drugs and medical devices. These fees are essential for ensuring timely reviews and approvals for medical devices and drugs. Eliminating them delay the availability of new medical innovations and treatments that serve public health.

This is not the first time that Trump has recommended an unqualified individual for Secretary of Health and Human Services. In 2016, President Trump selected Tom Price, whose tenure ended after just three months due to ethical issues and misuse of taxpayer funds.

The Department of Health and Humans Services deserves a leader committed to advancing science, protecting public health, and upholding the integrity of the nation’s healthcare systems. With this nomination, President-elect Trump is proposing putting the fox in the henhouse, essentially putting our public health under an unsuitable leader who would dismantle the very programs that protect our health and the nation’s food supply.

The National Consumers League calls on the U.S. Senate to reject this nomination. Furthermore, we urge President-elect Trump to withdraw this appointment and select a candidate who will champion science, uphold public trust, and protect the health of the nation.

Medical debt, a growing crisis for Americans, and the Biden Administration’s bold moves to tackle it

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By Sam Sears, Health Policy Associate, National Consumers League

Consumers, unfortunately, accrue debt quite often throughout their lives – be it a mortgage, a car loan, credit cards, or even student loans. However, there is one type of debt that consumers have no way of knowing when it will be incurred – medical debt.

At the National Consumers League (NCL), we have been fighting to protect consumers from the unfair burdens of medical debt, both as it relates to access to care and exposing the inadequacy of the 340B Drug Pricing program. However, medical debt as a whole has a moment in the spotlight this October as the Biden Administration tackles the issue.

As I’m sure consumers have noticed, the cost of everything has gone up– groceries, rent, and even healthcare. Many families are forced to make tough decisions between putting food on the table or paying their medical bills. For some, it means putting off medical care to avoid the cost of the visit.

Medical debt now plagues more than 100 million Americans across the nation. As KFF Health News found, 1 in 7 people with debt shared that they’ve been denied access to a hospital, doctor, or other healthcare provider, and two-thirds have put off care they or a family member needs because of the cost. Shockingly, nearly 50% of those Americans have medical debt reported on their credit report, and over 40 million people owe around $88 billion, which has been sent to collections. This makes medical debt the single largest source of debt in collections, outpacing auto loans and credit cards.

The harsh reality is medical debt doesn’t just linger on a credit report; it devastates lives and can have lasting consequences. NCL has previously covered how medical debt collection practices can leave consumers in a “never-ending spiral of debt.” Hospitals across the nation are suing patients over their medical debt, and patients may not know that they must go to court or have the resources to hire a lawyer to protect themselves. As a result, creditors may seek default judgements in which a court authorizes them to garnish a patient’s wages as part of a payment plan, or place a lien on their home, cars, or other property.

Over the past few weeks, the issue of medical debt has been highlighted in the national conversation. A new proposed rule from the Department of Defense would introduce a sliding-scale discount program for civilians who receive care at a military medical treatment facility (MFT). Health and Human Services Secretary Xavier Becerra also announced that the Center for Medicare and Medicaid Services (CMS) will be adding questions about medical debt to the Medicare Current Beneficiary Survey (MCBS), an annual survey of Medicaid beneficiaries used to understand their health needs. These new questions will allow CMS to further understand the impact of medical debt on the day-to-day lives of seniors and people with disabilities.

Recently, the White House held a pivotal event hosted by the Consumer Financial Protection Bureau (CFPB), where individuals directly impacted by medical debt shared their heartbreaking stories. In tandem, the White House released a *fact sheet unveiling the Administration’s new actions to address and reduce medical debt for consumers. Following these actions, the CFPB has taken several steps to protect consumers experiencing medical debt.

In his remarks, CFPB Director Rohit Chopra stated that the agency “has been laser-focused on dealing with the growing burdens of medical debt.” NCL commends CFPB and Director Chopra for their ongoing efforts to address the impact of medical debt on patients. Back in June, CFPB issued a proposed rule that would ban unpaid medical bills from being included on credit reports, and prevent the repossession of medical devices. The public comment period for this proposed rule closed on August 12. During the White House event, Director Chopra stated that CFPB is “working to finalize our credit reporting rule now.” But, with nearly 75,000 comments, NCL anticipates that it may take the agency some time to issue a final rule.

Given the complexities of medical bills, the CFPB has also been urging and requiring transparency from hospitals and debt collectors. New guidance was issued to crack down on deceptive medical billing practices, including the illegal collection of medical bills that are false, inflated, or not actually owed. CFPB has received several complaints from patients and consumers over medical debt collections, particularly for bills that the patient does not owe, were already paid by the consumer, insurance, or a government program (such as Medicare or Medicaid), or for debts that are covered by insurance, hospital assistance programs or other programs. More than ever, hospitals and healthcare providers are subcontracting medical billing and collection activities to third parties, who have legal obligations under the Fair Debt Collection Practices Act. CFPB has issued guidance to further clarify these legal obligations as they relate to medical debt and collection practices.

And let’s not forget the shameful practices of some nonprofit hospitals. As tax-exempt institutions, nonprofit hospitals are legally required to provide financial assistance to offset healthcare costs for low-income patients and consumers —yet many fall woefully short. In early October, CFPB published a comprehensive blog post drawing attention to billing and debt issues arising from nonprofit hospitals, many of which provide inadequate financial assistance. Often referred to as ‘charity care,’ federal regulations do not provide further guidance on the eligibility of patients or spending standards for hospitals. Thus, financial assistance policies are left to the hospitals themselves. While some states have intervened in an increasingly bipartisan manner, there are still too few regulations governing what financial assistance should look like or how it should be administered. NCL supports and recognizes the critical role hospitals, particularly nonprofit hospitals, play in their communities. However, the lack of transparency, as well as the predatory practices of some, need to change. NCL applauds CFPB for the spotlight they’ve put on these practices as a driver in the medical debt crisis.

CFPB has also taken steps to remove all medical collections under $500. This last step went into effect on April 11, 2023, and with this change, it’s estimated that roughly half of those with medical debt on their reports will have it removed from their credit history. If you find a medical collection under $500, a paid medical collection, a collection less than a year old, or errors on your report, you can dispute that information with the credit reporting company.  One of the first steps you can take is to check your credit reports for any outstanding medical bills.

NCL stands in strong support of the efforts of the CFPB and the Biden Administration as they work to safeguard consumers and bring transparency to the healthcare and credit reporting systems. NCL shares CFPB’s concerns regarding how consumers accrue these inaccurate, undue bills in the first place. The Biden-Harris Administration continues to prioritize consumers’ access to healthcare and a commitment to protecting vulnerable populations from the unfair consequences that arise from an illness or medical emergency. NCL applauds Director Chopra, the Biden-Harris Administration, and federal agencies for their leadership in addressing the burden of medical debt.

We look forward to the CFPB’s final ruling on medical debt and credit reporting, which could be a game-changer for millions of Americans.

To learn more about your rights, and actions you can take, if you have medical debt on your credit report or need to dispute a medical bill, visit *CFPB.

*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 nclnet.org.