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

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

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

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

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

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

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

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

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

Some SEP resources:

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

NCL commends HHS interim final rule regarding surprise billing protections

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

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

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

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

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

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

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

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

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About the National Consumers League

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

Intern Spencer Cramer

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

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Intern Spencer CramerBy Spencer Cramer, NCL Health Policy Intern

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

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

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

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

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

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

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

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

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

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

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

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

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

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

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

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

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

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

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

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

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

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

NCL comments on pediatric COVID-19 vaccines before CDC’s Advisory Committee on Immunization Practices

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

Washington, DC—Today, June 24, 2021, NCL Director of Health Policy Jeanette Contreras, submitted written testimony to the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices in support of pediatric COVID-19 vaccines. Her comments appear below.

José R. Romero, MD, FAAP, Chair
Advisory Committee on Immunization Practices
Centers for Disease Control and Prevention
1600 Clifton Road, N.E., Mailstop A27
Atlanta, GA 30329-4027

RE: Docket No. CDC- 2021-0060; rescheduled from June 18; new docket no. CDC-2021-0034

Good afternoon. My name is Jeanette Contreras, and today I am representing the National Consumers League (NCL), which for over 120 years has championed the overwhelming safety and efficacy of vaccines and promoted vaccine education. Consumer access to these lifesaving medical interventions is critical. I am also speaking today as a mother of two boys, ages 8 and 9. I appreciate the opportunity to provide public comment before this advisory committee.

The U.S. has reached a tragic 600,000 deaths as a result of COVID-19. The virus continues to spread and mutate around the world. Sadly, 330 children and adolescents are among the 600,000 deaths. Although preexisting medical conditions clearly predispose children to severe disease, healthy children are also at risk for severe COVID-19 and multisystem inflammatory syndrome (MIS-C). Though MIS-C is a rare condition associated with COVID-19, Black and Hispanic children are disproportionately affected, making up 64% of the cases observed in children 1-14 years of age.

Though there is reason to be concerned about the increase in cases of myocarditis or pericarditis following the second shot of the Pfizer and Moderna vaccines, consumers should be reassured that the safety monitoring system, Vaccine Adverse Event Reporting System (VAERS), is working as intended. Federal health officials are investigating the rare cases of which the most common symptoms reported were chest pain, elevated cardiac enzymes, ST or T wave changes, dyspnea and abnormal echocardiography or imaging. We applaud the Centers for Disease Control and Prevention (CDC) for releasing clinical guidance to providers alerting them to consider myocarditis and pericarditis in adolescents or young adults with acute chest pain, shortness of breath, or palpitations. So far, 80 percent of patients reported have made a full recovery.

We commend the coordinated efforts of the U.S. Food and Drug Administration and CDC to monitor the safety and efficacy of the vaccine. The COVID-19 vaccine has been administered safely to over 150 million Americans, and we are on target to reach herd immunity by October, with at least 70% of Americans vaccinated. Given the remarkable evidence of safety and efficacy of the COVID-19 in adults, parents should be assured that the vaccine will keep their children safe.

Our children are vaccinated for measles, rubella, polio, diphtheria, typhoid, and other routine childhood vaccines that have for decades prevented deadly illnesses that historically killed millions of children. Today, thanks to vaccine adherence, these illnesses have virtually been eradicated and far rarer than COVID-19. Unfortunately, uptake for routine pediatric immunizations have declined during the pandemic. It is essential we ensure that children are up to date with their vaccines. We are excited that data show the COVID-19 vaccine can safely be co-administered along with routine pediatric vaccinations. As we consider future educational outreach campaigns to increase vaccine confidence, we should encourage families to seek recommended immunizations for their children along with the COVID-19 vaccine.

As states lift public health emergency protocols across the country, too many of our children remain unnecessarily unprotected. According to the American Academy of Pediatrics, as of June 10, over 4 million children have tested positive for COVID-19 since the onset of the pandemic. About 14,500 new child cases were reported last week. We are only beginning to understand the long-term health effects associated with COVID-19, which include extreme fatigue, rapid heart rate, memory loss, gastrointestinal problems and other symptoms that are lasting months after infection. There is a need to collect more data on the long-haul effects on children, and to provide assistance to families who are struggling to find care for their children. We urge the CDC to provide guidance to providers and patients on what to look for when treating children who were previously infected with COVID-19.

As I dropped my 8-year-old at camp yesterday, I was telling him how beginning July 1 we won’t need to wear masks. He asked me “is that because everybody will be vaccinated- except me?” My husband and I are vaccinated, but our family is still at risk of being infected by any of the emerging variants. And when school-aged children return to the classroom in the fall, we may face a spike in pediatric cases.

Through our education and outreach efforts, the National Consumers League will continue to support efforts to vaccinate the nation across lifespan. The absence of a COVID-19 vaccine for pediatric populations will lead to continued transmission and leave children at risk for infection. To achieve meaningful herd immunity, we will need to ensure that children have access to a safe and effective COVID-19 vaccine, and also consider the unique disparities that children of color experience in the face of the pandemic.

Thank you to the Committee for your consideration of our views on this important public health issue.

Sincerely,

Jeanette Contreras, MPP
Director of Health Policy
National Consumers League

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About the National Consumers League

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

Maternal vaccines: Safe for mom and baby

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

In the last few weeks, I’ve noticed an old friend from high school, a mother of an infant, consistently posting anti-vaccine content to her social media. Her posts, which were initially mere reflections, have transformed into full-on conspiracy theories about the safety of the COVID-19 vaccines and cast doubts about to the speed of their approval.

At first, I bypassed these posts, not wanting to create tension with an old friend. However, as they became more inflammatory, I realized that she was essentially spreading falsehoods about vaccines. As a public health advocate, I decided to reach out and offer my perspective. I assured my friend that vaccines have gone through rigorous testing and approval by multiple regulatory bodies in order to be deemed safe for widespread use.

She argued that she went through her entire pregnancy without being vaccinated and that she felt mask-wearing and proper hygiene would offer sufficient protection, ending her thoughts with, “maybe I’m crazy, because I think with this big push, that maybe there’s something else in it that the public doesn’t know about.” While my friend may need more and better information to convince her of the benefits of getting vaccinated, it’s important to know what the science says about vaccine safety for expectant or new mothers.

Per the  Centers for Disease Control and Prevention (CDC) guidance, vaccines are an extremely safe and effective method of avoiding communicable diseases. Certain vaccines for pregnant people not only help the mother stay healthy, but the antibodies developed in response to the vaccine penetrate the placenta and offer protection to the unborn child as well. If you are pregnant or planning on becoming pregnant, the specific vaccines you should receive depend on your age, lifestyle, medical conditions, and other factors. You should consult your doctor for the most up to date information.

The CDC recommends that pregnant women receive two vaccines during the gestational period, the inactivated flu (injection) vaccine, and the tetanus, diphtheria, and pertussis or Tdap vaccine. Vaccines that are not recommended during pregnancy include the nasal influenza vaccine, the human papillomavirus (HPV), measles, mumps, and rubella (MMR), and Varicella (chickenpox) vaccines. Some travel vaccines, such as yellow fever, typhoid fever, and Japanese encephalitis are not recommended during pregnancy, but can be administered based on a health provider’s advice.

Vaccines also offer immense protections via lactation. With exception to live virus vaccines like smallpox and yellow fever, most vaccines provide safety to new moms and babies during pregnancy and postpartum via lactation. There is also evidence that breastfed babies respond better to routine pediatric immunizations than those on formula. The CDC has provided a chart of vaccines that are safe for use in lactation.

An even more convincing case for maternal vaccines are the protections offered against COVID-19.  Data  shows that pregnant people are more vulnerable to severe illness with COVID-19. COVID-19 complications during pregnancy include hospitalization, intensive care, or the use of a ventilator or special equipment to breathe, or illness that results in death. Additionally, pregnant people with COVID-19 are at increased risk of adverse pregnancy outcomes, such as preterm birth.

The CDC has found the COVID-19 vaccine to be safe for pregnant and lactating people. The CDC and Food and Drug Administration (FDA) have safety monitoring systems in place to gather data regarding adverse reactions to vaccines. Currently, neither the mRNA (Pfizer and Moderna) nor the viral vector (Johnson & Johnson) COVID-19 vaccines have demonstrated adverse outcomes and have been deemed safe for use in pregnant populations. While more data are needed to assess potential adverse reactions in pregnant individuals before or early in pregnancy, the agencies have vowed to closely monitor that information.

Expectant and new mothers are often faced with a host of difficult decisions about their own health and the health of their babies. Adding to the uncertainty brought on by COVID-19, it’s understandable that people are apprehensive. Through compassionate and non-judgmental conversations, we can help encourage vaccine confidence. Even though my friend seems adamant in her stance, I still see an opportunity to turn the tide. There are so many great resources to help address these concerns, like these ones by the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians. It’s up to everyday immunization advocates like you and me to quell concerns related to vaccine safety to ensure our friends and loved ones are safe.

June 10 testimony before FDA’s Vaccines and Related Biological Products Advisory Committee

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Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—Today, June 10, 2021, NCL’s Associate Director of Health Policy Nissa Shaffi, testified before the Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee, about the ongoing rollout of COVID-19 vaccines for pediatric populations. Her testimony appears below:

Arnold Monto, M.D., Acting Chair
Vaccines and Related Biological Products Advisory Committee
Center for Biologics Evaluation and Research
Food and Drug Administration
10903 New Hampshire Ave, Silver Spring, MD 20993

RE: Docket No. FDA- 2021-N-0458; for Vaccines and Related Biological Products Advisory Committee

Good afternoon. My name is Nissa Shaffi, and I am representing the National Consumers League (NCL). I have no conflicts of interests regarding today’s remarks.

The National Consumers League was founded in 1899, by the renowned social reformer Florence Kelley. General Secretary Kelley’s support of vaccinations played a key part in mitigating a critical smallpox outbreak towards the end of the 19th century, and her stalwart advocacy for immunizations has informed NCL’s bedrock principles for vaccine education, confidence, and safety.

122 years later, we are honored to persist in our pursuit to advance vaccines as vital public health interventions, and we extend our gratitude to the Vaccines and Related Biological Products Advisory Committee for the opportunity to present comment during this public hearing session.

Emergency Use Authorization (EUA)

NCL appreciates that the FDA recognizes that Emergency Use Authorization is not intended to replace the rigor of full approval, and that randomized clinical trials are critically important for the definitive demonstration of safety and efficacy of a treatment.

The diligent review and public engagement that went into the EUA process for the COVID-19 vaccines currently available have helped our nation reach key milestones in immunizations.

As our adult populations have benefitted from these critical public health efforts, we are energized to extend that momentum towards our youngest citizens. Through our education and outreach of consumers, we support FDA in its efforts to develop a safe, effective, and expedited pathway towards a COVID-19 vaccine via an EUA to help prevent the spread of the virus in pediatric populations.

Safety and Effectiveness

We have great trust in the FDA’s safety monitoring systems and call on the Agency to perform ongoing post-market surveillance to ensure the vaccine’s continued safety and efficacy.

As we’ve observed with recent vaccine safety concerns, consumers rely heavily on public health agencies to communicate and respond to any potential adverse events regarding the COVID-19 vaccine. We call on the FDA to continue to sustain its robust interagency collaboration as we endeavor to vaccinate the nation.

Pediatric Population Vaccine Uptake

Although children are at a lower risk of COVID-19 compared to adults, and tend to experience milder symptoms, pediatric populations now account for 22% of new COVID cases, compared to 3% last year. As with adults, children and adolescents with underlying chronic health conditions are at higher risk for COVID-19-related hospitalization and death.

The absence of a vaccine for pediatric populations will lead to continuing transmission that will consistently put children at risk for infection.

Furthermore, vaccine uptake for routine pediatric immunizations have declined dramatically during the pandemic. It is essential for public health officials, advocates, and parents to ensure that children are up to date with their vaccines, and that children eligible for the COVID-19 vaccine receive their shots. Data shows that the COVID-19 vaccine currently available for children ages 12-15 is safe and effective, and has been recommended to be co-administered along with routine pediatric vaccinations.

Health Disparities

While COVID-19 has impacted the entire country, it has largely devastated communities of color. Children of color, specifically Black and Hispanic youth, have been especially vulnerable. This has been even more apparent with the prevalence of Multisystem inflammatory syndrome in children, a rare but serious COVID-19-associated condition, that has been observed in children 1- 14 years of age, 64% of which were reported to be Black or Hispanic.

To achieve meaningful herd immunity, we will need to ensure that children have access to a safe and effective COVID-19 vaccine, and also consider the unique disparities that children of color experience in the face of the pandemic.

Thank you to the Committee for your consideration of our views on this important public health issue. 

Sincerely,

Nissa Shaffi
Associate Director of Health Policy
National Consumers League

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About the National Consumers League

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

NCL concerned as Senate bill puts consumers at risk from unregulated CBD

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Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—On May 19, Senators introduced the Hemp Access and Consumer Safety Act (S. 1698) which directs the U.S. Food and Drug Administration (FDA) to regulate hemp-derived cannabidiol (CBD) products as dietary ingredients or supplements. The National Consumers League (NCL) has long been concerned about the risks posed to consumers by unapproved cannabis-derived products. There is little research on the health and safety of CBD products, and as such the NCL does not support any legislation that would bypass the FDA’s regulatory authority and rigorous scientific review.

Currently, manufacturers and distributors of products containing CBD can petition the FDA for review and approval of a new ingredient as a dietary supplement (21 U.S.C. 350b). This approval process requires manufacturers and distributors to submit scientific data showing that the product is generally regarded as safe (GRAS). “Not only is there insufficient data to designate CBD products as GRAS, the FDA needs further data to determine safe dosage and concentration levels in order to set manufacturing and labeling requirements that ensure consumer safety,” said Jeanette Contreras, NCL Director of Health Policy.

As demonstrated in a white paper published by NCL, companies selling CBD products often focus their research efforts on weak and inexpensive studies, and then use the results for marketing purposes. “Current studies have not enhanced our scientific understanding of CBD, and policymakers should focus on incentivizing further clinical studies to bring new proven medical treatments to patients,” said Contreras. By mandating the FDA to regulate CBD as a dietary ingredient, S. 1698 would only further incentivize CBD manufacturers to forego rigorous clinical trials and the development of FDA-approved medicines. Easier approval as a dietary supplement will disincentivize real scientific research into any potential health benefits or risks of CBD products.

Under S. 1698, CBD manufacturers that make unwarranted claims of treating medical issues will seek expedited approval for their products as dietary supplements, rather than as drugs. We should be encouraging the development of new cannabis-derived medicines that have gone through the rigorous processes of randomized controlled trials and FDA approval. Considering the lack of existing research on CBD, this bill classifying CBD products as dietary supplements would irresponsibly lead to increased consumption of these products and limit the future development of cannabis-derived FDA approved treatments—while putting consumers at risk.

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About the National Consumers League

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

AAPI Heritage Month: The ‘Model Minority Myth’ and its negative impact on health disparities

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Nissa Shaffi

By Nissa Shaffi, NCL Associate Director of Health Policy

The month of May marks Asian American Pacific Islander (AAPI) Heritage Month, a time where we celebrate, honor, and reflect upon the vast contributions members of the AAPI community have made to our collective society. The AAPI community comprises more than 23 million individuals with origins from 20+ countries, who speak more than 200 languages or dialects, and it is the fastest growing subset of the population.

The AAPI community is one that harbors complex cultural and historical narratives, and varied generational traumas, such as colonialism, war, and the trials of immigration. The AAPI community’s resilience against these factors, while commendable, has contributed to the myth of the “Model Minority,” and has led to a host of social and health inequities. The model minority myth is one rooted in “positive” stereotypes. It is the assumption that deems AAPI individuals as docile, over-achieving, high-earning, and well-educated—denoting AAPI individuals as exemplars to other communities of color. While at face value these qualities are considered desirable, they tend to relegate an astoundingly diverse community to a monolith, resulting in a detrimental impact on their overall wellbeing.

Due to these unrealistic cultural standards, AAPI consumers face a host of internal and external barriers when interacting with the healthcare system, and are often deterred from seeking necessary care. According to a 2019 Substance Abuse and Mental Health Services Administration (SAMHSA) study, AAPIs have the lowest help-seeking rate for mental health services than any racial or ethnic group. Cultural identity, faith, stigma, and fear contribute to lower utilization of mental health services. Other systemic barriers such as disparities in access to culturally competent care also influence underutilization.

AAPIs are also the only racial or ethnic group for whom cancer is the leading cause of death. Despite facing a confluence of cancer risks, due to unique exposures and environmental factors, AAPIs are screened significantly less for cancers compared to other Americans. Because the model minority myth implies that AAPIs are “better off,” screening, public health, and cultural needs are often masked.

This is best demonstrated by the case of Susan Shinagawa, a leading Asian American breast cancer activist and cancer survivor, whose multiple attempts to obtain screening for a suspected lump in her breast was denied, due to the belief that “Asian women don’t get breast cancer.”

The pandemic has illuminated disparities experienced by AAPIs, such as being overrepresented among frontline healthcare workers, increasing risk of exposure to COVID-19. As a result, case fatality among AAPI healthcare workers is three times greater than their white counterparts. AAPIs also tend to live in multigenerational households, more than other minorities, where 29 percent of AAPI households consist of two or more generational families, further increasing risk of household transmission. Approximately 30 percent of AAPIs have limited English proficiency, augmenting overall barriers to care and government relief resources. This disparity has been especially cumbersome for AAPI consumers seeking telehealth, an integral part of our lives throughout the pandemic, where 50 percent of AAPIs with limited English proficiency were less likely to utilize telehealth than individuals with English proficiency.

One way to dispel the model minority myth and encourage greater health equity for AAPI consumers, is to disaggregate racial and ethnicity data in research studies. Disaggregation of data simply means breaking data into smaller, more precise segments. For example, recent United States census data reveal that AAPIs were less likely overall to live in poverty. However, when that data is disaggregated, it shows that Hmong, Bhutanese, and Burmese Americans experience higher incidence of poverty, in contrast to the greater AAPI community. Disaggregating data not only paints a more accurate picture regarding the different social and demographic characteristics that impact varied health statuses within the community, it influences proper allocation of community resources.

Disaggregation of data can only also happen when there is a prioritization of AAPI participants in research. The most illuminating example of this is highlighted by a 2019 study, which revealed that in the past 26 years, only 0.17 percent of the National Institute of Health’s (NIH) budget was allocated to research focused on the AAPI community. These gaps in funding have led to a paucity in data necessary for public health officials and policy makers to meaningfully address AAPI-specific health disparities. A lack of representation in research impacts how AAPI consumers seek, access, and utilize healthcare. It also impacts the greater community public health goals, impacting health equity for everyone.

Greater investments in culturally competent care, AAPI-focused research, and preventive services, such as screening and early intervention, can help improve overall health outcomes for AAPI consumers. The National Consumers League commends the Biden-Harris Administration’s efforts, such as the COVID-19 Hate Crimes Act and the establishment of a subcommittee on Structural Drivers of Health Inequity and Xenophobia, which aim to ensure the federal government’s response to COVID-19 mitigates anti-Asian xenophobia and bias. These measures are critical in addressing structural inequities experienced by the AAPI community, enhancing community health outcomes as a whole.

NCL supports the Protecting Seniors through Immunizations Act of 2021

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Media contact: National Consumers League – Carol McKay, carolm@nclnet.org, (412) 945-3242 or Taun Sterling, tauns@nclnet.org, (202) 207-2832

Washington, DC—The National Consumers League (NCL) is delighted to support the Protecting Seniors through Immunizations Act of 2021 (H.R. 1978/S. 912), introduced by Senators Mazie Hirono (D-HI), Tim Scott (R-SC), Sheldon Whitehouse (D-RI), and Shelley Moore Capito (R-WV), and Representatives Ann Kuster (D-NH) and Larry Bucshon (R-IN). The bill would expand access to immunizations for seniors by eliminating cost sharing for vaccines covered under Medicare Part D.

The legislation would eliminate out-of-pocket costs for all vaccines recommended by Centers for Disease Control and Prevention (CDC) and covered under Medicare Part D. This would apply to crucial immunizations such as the Shingles and tetanus, diphtheria, and pertussis, or Tdap, vaccines, along with future vaccinations. Currently all CDC recommended vaccines are covered with no out-of-pocket costs under private insurance, Medicaid, and Medicare Part B. Unfortunately, Medicare beneficiaries must often pay out-of-pocket costs of up to $160 for vaccines covered under Part D.

“As healthcare costs continue to skyrocket, policymakers should support legislation that eliminates financial barriers for Medicare beneficiaries to get their CDC recommended vaccines,” said NCL Director of Health Policy Jeanette Contreras. “Research shows that higher cost-sharing means fewer seniors will elect to receive their vaccines. By eliminating out-of-pocket costs for immunizations, older Americans will be better protected from vaccine preventable illnesses.”

More than 50,000 American adults die from vaccine-preventable diseases every year. Among other provisions, this bill would increase education about vaccines for Medicare beneficiaries and would authorize a study to find ways to boost adult vaccination rates. These steps are important at a time when misinformation regarding vaccine safety is spreading rampantly throughout society. Improving access to and utilization of vaccinations will enhance overall health outcomes and help to address existing racial and socioeconomic health disparities.

“Vaccines are amongst the most effective public health measures at our disposal. Routine immunizations can prevent diseases that have the potential to cause severe disease and wreak havoc on our most vulnerable communities,” said Contreras. “We urge Congress to pass the Protecting Seniors Through Immunization Act, to ensure greater equity in access to vaccines, in turn protecting the most vulnerable members in society from unnecessary and easily preventable illness and death.”

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About the National Consumers League

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