NCL commends CFPB’s rule to eliminate medical debt from credit reports

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The National Consumer Law Center and a coalition of other leading consumer-focused organizations, including the National Consumers League, released the following press statement on January 7, 2025.

Sally Greenberg, NCL’s CEO, said “The magnitude of medical debt in America is crippling:100 million Americans carry medical debt that is not caused by profligate spending, but often by medical emergencies. Thus, punishing Americans who carry this debt by harming their credit scores, forcing them to turn to predatory lending if they need a car or home loan multiplies the harm. The CFPB’s rule stopping credit reporting agencies from sharing medical debt with lenders will prevent adding to the burden of the 15 million Americans with lowered credit scores due to medical debt. NCL supports this important rule.”

CFPB Rule Removes Medical Debts from Credit Reports

January 7, 2025 — Press Release

15 Million Americans Will See Credit Scores Improve 

Washington, DC– Today, the Consumer Financial Protection Bureau (CFPB) finalized a rule to stop the harmful impact of medical debt on consumers’ credit scores. The rule will stop credit reporting companies from sharing medical debts with lenders and prohibit lenders from making lending decisions based on existing medical debt.

“Medical debt has damaged the financial record of tens of millions for far too long, causing credit rejections and pushing costs even higher for Americans struggling financially,” said Chi Chi Wu, senior attorney at the National Consumer Law Center. “The CFPB continues with its impressive record of protecting consumers, providing critical relief to the 15 million Americans with unjustly lowered credit scores due to medical debt.”

Even though medical debt has minimal predictive value in forecasting about whether people will pay their loan payments, vast amounts of medical debt information remains in the credit reporting system. Medical debt unjustly damages the credit scores of millions, limiting their ability to obtain affordable credit, rent safe housing, or even get a job. It also assists debt collectors in seeking to coerce payments, including for inaccurate or false medical bills.

The big three credit reporting agencies (Equifax, Transunion, Experian) voluntarily removed some medical collections information starting in 2022, but in 2024 the CFPB found that 15 million Americans still had more than $49 billion in outstanding medical debt on their credit reports. Consumers left behind by industry efforts were more likely to live in the South and in predominantly Black and Latino/Hispanic neighborhoods.

“Today’s medical debt rule will lessen the financial burdens for all households, but particularly for Black and Latine families, who carry more medical debt due to decades of intentionally racist policies and practices across health care, employment,housing, education, and financial services,” said Amanda N. Jackson, consumer campaign director for Americans for Financial Reform. “A good credit score is critical for participating in the U.S. economy, and this rule will continue to help lessen the negative credit impacts of medical debt.”

This rule is part of a larger initiative by the CFPB to address hidden junk fees charged by banks and financial companies that disproportionately impact low-income consumers. Since its formation, the CFPB has obtained over $21 billion in relief for over 205 million people. Despite its success and its popularity with the public, the agency’s future is at risk. Most recently, advisors to the President-elect have called for the CFPB to be shuttered. The medical debt credit reporting rule itself could also be overturned by Congress using the Congressional Review Act (CRA), which allows Congress, with the President’s signature, to overturn new regulations.

“The medical debt rule shows how important the CFPB is to working people who are losing ground to corporate profiteering,” said Lauren Saunders, associate director at NCLC. “Working class folks must speak up to ensure the CFPB’s rule to limit medical debts on credit reports, and the CFPB itself, survive attacks by corporate America.”

The final rule does not apply to medical debts on credit cards, including specialized credit cards, which advocates had urged the CFPB to include. It also does not apply to credit reports used for non-lending purposes, such as employment and tenant screening

“Medical debt shouldn’t harm credit records regardless of how it shows up,” said April Kuehnhoff, senior attorney at NCLC. “And it shouldn’t damage the ability of Americans to get a job or an apartment.”

Additional Quotes

“When banking gets mixed up with health care, it causes a lot of heartache,” said Adam Rust, director of financial services for the Consumer Federation of America. “The CFPB’s new rule places a sensible boundary between the two. People often pay medical debt they know they do not owe to protect their credit scores. Others avoid seeking medical care, fearing it will harm their creditworthiness. The new rule means that medical debt collectors cannot weaponize the credit reporting system to their advantage, and sick people will not forego treatment just because they want to borrow money in the future.”

“The crushing financial burdens of medical debt should not continue to undermine people’s ability to take out a loan or qualify for a mortgage,” said Christine Chen Zinner, senior policy counsel at Americans for Financial Reform. “While today’s rule will help over 100 million people saddled with medical debt, this rule will critically lessen the negative credit impacts stemming from decades of racist housing, employment, healthcare, and other policies and practices that have left Black and Latine households with higher amounts of medical debt.”

“With this rule requiring removal of medical bills from credit reports, the CFPB protects millions of medical debt-strapped Americans from certain additional financial struggles triggered by the archaic credit reporting system,” said Christine Hines, senior policy director at the National Association of Consumer Advocates.

“Finalizing this rule is a big win for Mainers and people all over the country,” said Nora Flaherty-Stanford of Maine People’s Alliance. “More than 40% of Mainers say they’ve taken on medical debt in the last five years, and for most of them, it’s still hanging over their heads. We all know that’s not right, and as we celebrate this good news, we’re calling on our members of Congress to stand strong in supporting this rule and the CFPB.”

“Someone’s history of unexpected medical debt has no correlation with their willingness or ability to repay future bills, so it should have no bearing on a person’s access to credit, an apartment or a job,” says Ruth Susswein, Consumer Action’s director of consumer protection.

“Medical debt burdens millions of families across the country and can unfairly tarnish a person’s credit record, making it more difficult to qualify for an affordable loan, get a job, or even rent an apartment,” said Chuck Bell, advocacy program director for Consumer Reports. “Many consumers have medical debt on their credit reports that is inaccurate or under dispute because our medical billing and insurance reimbursement system is so complex and confusing. No one’s credit record should be ruined by medical debt since it’s not a reliable predictor of credit risk. The CFPB’s ban on medical debt reporting provides critical protection to consumers and will help ensure they can get the health care they need without fearing that their credit record will be damaged beyond repair.”

“This new rule is good news for at least 14 million people – including financially responsible families that have accumulated medical debt from unpredictable health issues, high out-of-pocket costs, insurance claim denials and billing errors,” said Patricia Kelmar, senior director of health care campaigns for U.S. PIRG. “We’ve known for years that medical debt is not predictive of credit-worthiness. The new rule builds on the CFPB’s important work on medical debt reporting and is yet another example of how the CFPB protects consumers from unfair practices.”

“Banning the reporting of medical debt will end the weaponization of credit reporting against those who are unlucky enough to get sick or injured and run up bills they cannot afford to pay,” said Renée Steinhagen, executive director, New Jersey Appleseed Public Interest Law Center and a member of the NJ for Healthcare Coalition. “Thanks to the new CFPB rule, they need no longer worry about their credit being ruined, which can make it harder to buy or rent a home or a car or even interfere with getting a job.”

“One in five New Jerseyans struggle with repaying medical debt,” said Beverly Brown Ruggia, Financial Justice Program director at New Jersey Citizen Action. “In a nation where good credit is essential for accessing housing, employment, and even medical care itself, it is unconscionable that anyone should face financial ruin and lose access to these basic necessities simply because they or a family member got sick. With this rule, the CFPB has stepped in once again to protect the most vulnerable among us from unfair treatment and potential financial devastation.”

“This landmark rule ensures consumers are no longer unfairly penalized for medical debt,” said Jennifer Holloway, staff attorney leading the Medical Debt Project at Tzedek DC. “By removing medical debt from credit reports, the CFPB helps individuals and families access housing, employment, and credit opportunities and advances racial and disability justice. This rule recognizes that access to medical care should not result in lifelong financial setbacks and will improve patients’ well-being by reducing stress and anxiety. Ultimately, this is a vital step toward supporting healthier and more financially secure communities.”

“The magnitude of medical debt in America is crippling:100 million Americans carry medical debt that is not caused by profligate spending, but often by medical emergencies. Thus punishing Americans who carry this debt by harming their credit scores, forcing them to turn to predatory lending if they need a car or home loan multiplies the harm,” said Sally Greenberg, chief executive officer at National Consumer League. “The CFPB’s rule stopping credit reporting agencies from sharing medical debt with lenders will prevent adding to the burden of the 15 million Americans with lowered credit scores due to medical debt. NCL supports this important rule.”

“This rule is a significant win for struggling Maryland families,” said Marceline White, executive director of Economic Action Maryland Fund (Economic Action). “More than 876,000 Maryland households have a medical debt they are unable to repay. No one should have their credit downgraded because they or a loved one fell ill and sought medical care.” 

“NALCAB – the National Association for Latino Community Asset Builders applauds the Consumer Financial Protection Bureau (CFPB)’s final rule banning medical debt from credit reports. According to a report by the Urban Institute, adults who live in communities where the majority of the population are people of color are more likely to have medical debt in collections reported on their credit reports.  Today’s announcement will help boost the economic trajectory of Latinos and therefore further stimulate economic growth,” said Clarinda Landeros, Director of Public Policy, NALCAB. 

“As we work to create a country where healthcare is a human right, we must eliminate the many burdens of a healthcare system that puts profit over people,” said Katie Goldstein, Director of Housing and Healthcare Campaigns at Popular Democracy. “Too often, our people risk financial ruin when they seek medical care due to high costs and long term medical debt that impacts credit ratings and makes it more difficult to secure housing and employment. By eliminating medical debt from credit scores, today’s much-needed CFPB ruling will ease some of these barriers, will protect folks from predatory debt collectors, and will encourage more people to seek medical care with less fear of financial repercussions.”

“The National Fair Housing Alliance applauds the Consumer Financial Protection Bureau (CFPB)’s final rule banning medical debt from credit reports,” said Nikitra Bailey, executive vice president of the National Fair Housing Alliance. “Medical debt devastates the budgets of millions of families, especially those living in the South making it difficult for people living in the region to secure quality credit opportunities to purchase a home, start a business, or finance a car to get to work. It also disproportionately impacts Black and Latino consumers who are more likely to lack wealth to immediately address surprise medical expenses because they were long denied fair housing and lending opportunities. These medical debts can then result in collections reported on their credit reports, although the medical debits are not an accurate reflection of the consumer’s ability or willingness to repay debts. The CFPB’s final rule will help provide a more equitable path to access to credit and therefore further stimulate economic growth, especially in the South.”

“It surprises Alaskans when health insurance fails to protect them from the extremely high costs of healthcare in our state,” explained Claire Lubke, economic justice lead at Alaska Public Interest Research Group. “All it takes is an accidental visit to an out-of-network provider and we end up in a situation where 40% of Alaskans are holding medical debt, including military members and those with access to tribal health services. Allowing medical debt on credit reports punishes Alaskans for receiving medical care they need and often don’t realize is uncovered until it’s too late. AKPIRG commends the CFPB for improving access to necessary financial services for Alaskans who are working hard to overcome medical debt.”

“Medical debt often stems from unpredictable, unavoidable circumstances and shouldn’t stop access to financial opportunities. In Oregon, 30% of residents have incurred medical debt in the last two years. Of those residents, 85% report significant impacts, from increased stress and anxiety to financial hardship and delayed medical care. Oregon Consumer Justice applauds the Consumer Financial Protection Bureau for finalizing this vital rule addressing medical debt on credit reports,” says Jagjit Nagra, executive director of Oregon Consumer Justice. “This rule is a critical first step in protecting consumers and promoting financial equity. In Oregon’s upcoming legislative session, we look forward to championing legislation that will further extend this rule’s impacts to exclude medical debt in employment and tenant screening and medical debt incurred using medical credit cards.”

“This rule not only relieves patients and their loved ones from the financial burden of medical debt on their credit reports, but also relieves them from the real and harmful physical and mental impacts of medical debt on their health,” said David Zhao, Equal Justice Works Fellow, sponsored by Amgen Inc. and Munger, Tolles & Olson LLP, at Public Counsel. “In Los Angeles, one in ten adults is substantially burdened by medical debt, leading them to be 2-3.5 times more likely to be food insecure, forgo prescriptions, and be unstably housed. Under the CFPB’s new rule, patients can break the cycle of delaying further medical care due to the stress and anxiety of having their medical bills show up on their credit reports.”

Related Resources

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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’s latest podcast highlights the disparities with the 340B drug pricing program

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January 6, 2025

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

Washington, DC – The National Consumer League (NCL) has released a new episode of its We Can Do This podcast, shedding light on the inequities and lack of transparency surrounding the 340B Drug Pricing Program. This federal initiative was designed to provide medications at reduced prices to low-income patients, but it has been manipulated by large healthcare entities to generate billions in profits with minimal oversight. As a result, the program’s intended beneficiaries—low-income patients—are often forced to pay full price for medications they cannot afford.

In this episode, NCL’s CEO Sally Greenberg is joined by Amy Hinojosa, President and CEO of MANA, a National Latina Organization, and founding member of the Health Equity Collaborative, and Dr. Ge Bai, an expert on healthcare accounting, finance, and policy at Johns Hopkins University about the shocking lack of transparency around a program that has more than doubled in cost to taxpayers reaching more than $120 Billion in 2022. Both experts emphasize the importance of accountability to ensure that the 340B program truly benefits those it was designed to serve.

“The 340B program was created as a ‘buy-low-sell-low’ initiative. But over the years, it has evolved into a ‘buy-low-sell-high’ program,” said Dr. Ge Bai. “Hospitals can still buy drugs at a low price, but when they sell those drugs, they do so at full price—without any discount. This allows hospitals to reap substantial profits from the difference between the discounted purchase price and the high selling price.”

The episode also discusses the bipartisan 340B ACCESS Act (HR 8574), proposed legislation aimed at restoring transparency and accountability to this critical healthcare program.

The 340B Access Act (HR 8574) seeks to:

  • Ensure that discounts directly reduce patient costs
  • Modernize contract pharmacy arrangements
  • Strengthen eligibility requirements
  • Implement public reporting measures
  • Prevent abuse by middlemen

“Entering this new legislative session, there is a real opportunity to leverage bipartisan support and push the 340B ACCESS Act across the finish line,” said NCL CEO Sally Greenberg. “The bottom line is that this program needs stronger guardrails to ensure that everyday Americans—especially those in underserved communities—have access to affordable medications.”

Additional Resources:

Dr. Ge Bai, PhD, CPA, Johns Hopkins University: Do Nonprofit Hospitals Deserve Their Tax Exemption?

340 B State Press Releases

 

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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.

Hospitals and PBMs hijack discount drug program

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January 6, 2025: On this episode of NCL’s “We Can Do this” podcast, National Consumers League CEO Sally Greenberg speaks with Amy Hinojosa, President and CEO of Mana, a National Latina Organization, and Dr. Ge Bai, an expert on health care accounting, finance, and policy at Johns Hopkins University, regarding a shocking lack of transparency for a program that has more than doubled in cost reaching more than $120 Billion in 2022.

Read more

Fighting for fairness: The Obesity Bill of Rights

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In terms of the number of people it affects and the serious health problems it creates, obesity is the most significant chronic disease in human history. And yet, it is a disease that is too frequently undiagnosed and untreated, and leads to harsh judgments rather than understanding and care.

As a physician who has devoted my career to addressing the disparities affecting obesity sufferers, I am grateful for the work of the National Consumers League (NCL) in communicating the message that people who have this disease matter and that they have the right to quality healthcare without enduring discrimination or bias.

This argument can’t be made strongly enough. Obesity is a disease that people wear. You can’t look at someone and tell if they have cancer, high blood pressure, or diabetes. Often, you can look at someone and determine that they have obesity, and that leads to negative assumptions about their lifestyle instead of an acknowledgment that they have a chronic disease requiring treatment.

NCL and the National Council on Aging demonstrated essential and invaluable leadership by creating the first-ever Obesity Bill of Rights, defining the core requirements for people with obesity to receive person- centered, quality care. They established, for example, the right to respect from all members of an integrated care team, the right to treatment from qualified health providers, the right to receive care in settings that allow for privacy and the use of size– and weight– accessible equipment and diagnostic scans, and the right to coverage for treatment with access to the full range of treatment options for the patient’s disease.

These organizations put muscle behind their message by creating the Right2ObesityCare, a grassroots movement focused on ensuring that these rights are incorporated into medical practice.

As NCL CEO Sally Greenberg said very well when the Obesity Bill of Rights was announced, “For too long, adults with obesity have encountered a healthcare system that is working against them. They have been stigmatized, discriminated against, not treated with respect by their health providers, and have faced significant hurdles and burdensome requirements to receive obesity care.”

This commitment to health equity remains critical at a time in which 1 billion people worldwide and more than 100 million in the United States are living with obesity. This is a disease for which, too frequently, the economic haves and have-nots in our society have significant differences in care and coverage. There are novel therapies— GLP-1 agonists like Ozempic and Trulicity, for example—that can improve blood sugar control and lead to weight loss. Those in the higher socioeconomic strata have generous health insurance plans that cover these drugs. In contrast, those who struggle financially don’t have access even though they tend to have higher obesity rates.

If we’re to address a disease of this extraordinary magnitude, then these inequities must be addressed.

This is, in fact, a disease so far-reaching that it can’t be solved by just one breakthrough therapy or one effective medicine. This will require a multifaceted approach involving virtually every sector of our society and multiple industries. Most of all, it will take vision and leadership to keep making the point that obesity patients matter and that they require care, not judgment.

NCL is providing that voice, and its actions will continue to be critical in combating this ongoing healthcare crisis.

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Dr. Fatima Cody Stanford is an obesity medicine physician, scientist, educator, and policymaker at Massachusetts General Hospital and Harvard Medical School. She is a sought-after expert in obesity medicine, who bridges the intersection of medicine, public health, policy, and disparities

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.