The 340B drug discount program should be helping patients in need, not boosting pharmacy chain profits

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By Sally Greenberg, Chief Executive Officer, National Consumers League

The federal 340B drug discount program is a worthy and critical program. Created by Congress in 1992, it mandates that pharmaceutical manufacturers participating in the Medicaid program must offer prescription medicines at discounted rates to community health centers and safety-net hospitals serving low-income and uninsured patients. Over the years, this program has given vulnerable patients access to the drugs they need and freed up resources for the qualified facilities to offer more health care services to indigent communities.

Over the past decade or so, however, this valuable program has been increasingly corporatized by for profit entities known to increase costs for consumers including middlemen like pharmacy benefit managers and pharmacy chains. Too many of the dollars circulating through the 340B program are benefiting the well-off and for-profit corporations, instead of consumers with significant health and financial needs. News stories have shined a spotlight on big health systems using the program to bolster profits, while hallowing out critical resources in underserved areas. However, more attention needs to be given to the billions of 340B dollars going to major pharmacy chains like CVS, Walgreens, Walmart and Rite-Aid that are not benefiting the patients this program is intended to serve. Increasingly, however, policymakers at the federal and state level are suggesting bailing out these for-profit entities under the guides of “contract pharmacy” legislation.

Here’s the problem: In 2010, the federal government issued guidelines allowing 340B-eligible health providers to contract with for-profit retail pharmacies to dispense medications, with virtually no rules or safeguards. Since that time, the number of pharmacies participating in the 340B program has grown from 789 in 2009 to over 25,000 today. If this meant more access to affordable drugs for consumer, that would be one thing, but this has not been the case. As contract pharmacies have increased, so too has consumer challenges affording their medicines, nearly in parallel. For example:

  • Even though 340B contract pharmacies are receiving drugs at discounted prices, there is no evidence they are passing those savings onto consumers. One analysis from the respected IQVIA firm found that 340B discounts were shared with consumers in only 1.5 percent of eligible pharmacy claims.
  • Although the 340B program is intended to benefit underserved, vulnerable communities with high proportions of poor and uninsured patients, hospitals in the program are contracting with pharmacies that are not, in fact, in areas afflicted with poverty and a scarcity of health care services.
  • The vast majority of 340B contract pharmacy arrangements are with the aforementioned big national chains like CVS and Walgreens, which are enjoying enormous profits as a result of their participation in the drug discount program. Contract pharmacies collected an estimated $13 billion in gross profits in 2018, with a 72% profit margin on 340B drugs (because they are getting those drugs at a steep discount, which they don’t share with consumers). Needless to say, fattening corporate pharmacy profits should not be this program’s mission.

Contract pharmacy abuse of the 340B program has not gone unnoticed by policymakers in Washington. In January 2024, leaders in the U.S. Senate questioned CVS Health and Walgreens as part of as part of an ongoing investigation into how health care entities use and generate revenue from the 340B Drug Pricing Program. The Government Accountability Office (GAO) and the Department of Health and Human Service Office of the Inspector General (OIG), also highlighted issues with the program’s integrity as it relates to contract pharmacy use. 340B is in desperate need of transparency and oversight, not unfettered expansion.

Yet that is exactly what is happening in some U.S. states. This matter is taking on a greater urgency now as several states are contemplating legislation that doubles down on the problem instead of fixing it. Consumers would be shocked to learn their state representatives are ushering through changes that would further solidify the profitable role these large corporate contract pharmacies are playing in the abused 340B program. Policymakers at the state and federal level need to address a fundamental question – where do 340B savings go? And when the answer is to corporate pharmacy giants – not patients – it’s time to reconsider ill-conceived policies giving contract pharmacies even more access to 340B drug discounts.

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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.

PBM reforms needed now in order to expand access to lower cost biosimilars that would benefit all Americans

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February 22, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

Washington, DC – The National Consumers League (NCL) recently submitted a letter to the U.S. House and Senate leadership expressing our collective support for Pharmacy Benefit Managers (PBM) reforms to improve consumer and patient access to biosimilars. Given the ongoing surge in prescription drug costs, expanding access to lower cost biosimilars represents a bipartisan solution that would benefit all Americans.

“We are hopeful PBM reforms will be included in a final March healthcare package,” said NCL CEO Sally Greenberg.

The letter can be found here.

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About the National Consumers League (NCL)

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

NCL urges Congress to improve air travel as FAA reauthorization progresses

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February 15, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

Washington, DC – Last week, the U.S. Senate Commerce Committee advanced the five-year reauthorization of the Federal Aviation Administration (FAA). The legislation does contain some victories for consumers, but it does not contain the deep reforms of an uncompetitive industry that are sorely needed.

“Passengers are crying out to Congress to implement real reforms that make flying less miserable,” said NCL Vice President of Public Policy, Telecommunications, and Fraud John Breyault. “The Senate Commerce Committee could have used its twice-a-decade opportunity to swing for the fences on behalf of the flying public. Unfortunately, they settled for a bunt single.”

NCL, in coalition with other consumer and passenger rights organizations, has called for stronger safeguards to be included in the FAA reauthorization bill for years. Last February, NCL and eight other advocacy groups sent a letter to House and Senate Commerce Committee leaders urging support for a range of critical reforms to the airline industry. Key among those demands was a change to allow state attorneys general to enforce consumer protection laws against airlines, something that federal law currently prohibits them from doing. Thirty-seven bipartisan state attorneys general have also supported this reform, which both the House of Representatives and the Senate have so far ignored in their bills.

“Congress is running out of time to get this right,” said Breyault. “We strongly urge members of the Senate to make protecting the flying public a bigger priority as this bill moves to a floor vote.”

Several of the passenger rights coalition’s other priorities were included in the bill reported out of the Senate Commerce Committee. These reforms include a requirement that children be seated with their family and caregivers without additional fees, a requirement that air travel vouchers not expire before five years, standards for refunds in the event of a delay or cancellation, minimum customer service call center requirements, and creating an assistant Secretary of Aviation Consumer Protection.

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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.

Consumer struggles with Native American healthcare

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By Sam Sears, Health Policy Associate, National Consumers League

My name is Sam Sears, and I am the new Health Policy Associate working at the National Consumers League. I am excited to be working with Robin, Sally, and the rest of the staff at NCL. Consumer issues regarding health care, specifically access and confidence, are wide-reaching and I am thrilled to be able to lend my growing expertise and experience to support the cause and NCL.

I always thought I would end up in healthcare, but my younger self had always envisioned my work with a much more narrowed focus. Academically, my background is in policy and gender studies, where I focused on equal protections for women and queer, specifically related to intimate partner violence and protections and reproductive justice. After graduation, I worked as a barista while also taking placements through a temp agency here in DC, focusing on nonprofits and advocacy organizations. It was, in part, due to the temp placements that I found myself working on broader health policy issues such as the 340B Drug Pricing program and health care access for individuals.

Before joining NCL, I worked at the National Council of Urban Indian Health (NCUIH) for two years, where I was able to learn quite a bit about the healthcare delivery system for Native Americans and the barriers to access that they often face. While NCUIH’s focus is centered on ensuring that Native Americans living in urban settings have access to quality, accessible, and culturally competent health services, much of the work is done collaboratively with other advocates and organizations working within the space. Because of this, my work at NCUIH often was encompassing issues facing the larger community.

Upon joining NCL, I realized that a prominent problem for Native Americans is a much larger area of concern for all Americans and their healthcare – the pervasive and misleading Medicare Advantage plan advertisements seen on television. In fact, in a letter to Centers for Medicaid and Medicare Services (CMS) and Dr. Brooks-LaSure, the CMS Tribal Technical Advisory Group, a group of 17 representatives comprised of elected Tribal leaders or appointed representatives and representatives of national Indian organizations headquartered in DC, highlighted how Medicare Advantage (MA) plans have been “aggressive and invasive when marketing their plans”.

A Kaiser Family Foundation report on the 1,200 unique ads, mostly for MA plans, aired during the enrollment window found that 27% led beneficiaries into thinking they were being recruited for traditional Medicare plans. For Native Americans, this aggressive marketing has led people to enroll in plans that do not include local Indian Health Service providers, meaning they lose coverage and no longer able to go to the doctors they trust to care for them in a culturally competent manner. This confusion is not limited to just Native Americans, as Dr. Brooks-LaSure has stated previously.

It’s important to note that CMS has been addressing the misinformation and confusion from these ads. In April of 2023, the agency released a final rule regarding Medicare Advantage marketing and communications, amongst other Medicare part plans and related topics. Specifically, CMS must now pre-approve all television MA plan advertisements that will air during the open enrollment period, minimizing the opportunity for misinformation and predatory practices within the ads. CMS has also significantly increased its ability to investigate complaints about misleading agents and advertisements. This regulation, while large and with rolling applicability dates, will apply to the 2024 contract year for MA plan marketing and communication, meaning that the open and re-enrollment period at the tail end of the 2024 calendar year will be drastically different.

As I stated earlier, many of the issues that I had worked on while with NCUIH are also applicable to the broader population and community who struggle with access to healthcare. So, I am excited to be able to continue to work on these consumer issues with NCL. And I am eager to see how NCL could support and expand on the work I’ve been able to touch on through my other positions.

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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.

Top Ten Scams report: Explosion of crypto reports raises alarm 

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February 6, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

WASHINGTON, D.C. — Cryptocurrency is being used in an increasing number of scams, leading to some of the highest median losses every reported to the National Consumers League (NCL). In its annual 2023 Top Ten Scams report, NCL found that the percentage of crypto-linked scam reports more than doubled year-over-year, making up almost 1-in-10 complaints received. The report, published annually, analyzed more than 2,700 consumer fraud complaints filed with NCL’s Fraud.org campaign last year.  

The median loss for reported investment frauds, including cryptocurrency, ballooned to $20,000. Just two years prior, the number was $1,750. The complaints in this category frequently described schemes where victims were encouraged to put money into cryptocurrencies and cryptocurrency-linked investments that later turned out to be fraudulent.  

“Year after year, complaints to Fraud.org paint a heartbreaking picture,” said NCL Vice President of Public Policy, Telecommunications, and Fraud John Breyault. “It is clear that the problem of fraud is not going away on its own. It is past time for policymakers at every level to take this issue seriously and do everything they can to crackdown on this epidemic.” 

A record year for natural disasters appears to have been reflected in the numbers as well: reports of fake charity scams were up almost 200% compared to 2022. These complaints often involve fraudsters impersonating non-profit aid groups, particularly following crises like the wildfires in Maui. 

The top ten scam categories reported to Fraud.org in 2023 were:  

  1. Prizes/Sweepstakes/Free Gifts  
  2. Internet: General Merchandise  
  3. Phishing/Spoofing  
  4. Investments: Other (incl. cryptocurrency) 
  5. Fake Check Scams 
  6. Advance Fee Loans, Credit Arrangers  
  7. Friendship & Sweetheart Swindles  
  8. Charitable Solicitations 
  9. Family/Friend Imposter  
  10. Home Repair 

“Reporting fraud is an important step for victims,” said NCL Consumer Services Coordinator James Perry. “When someone reaches out, we can connect them with the right resources and begin to walk them through the recovery process. The information they share also helps inform decisions around fighting these scams.” 

Scammers contacting victims through the internet and phone calls initiated three out of four fraud incidents, with the internet replacing phone calls as the number one method of contact in 2023. The Top Ten Scams report also showed a worrying trend in scams targeting young consumers. Compared to 2022, complaints from consumers aged 18-25 increased by 13.12%. 

“The prevalence of scams online should worry everyone, especially as more of daily life becomes virtual,” said NCL Public Policy Manager Eden Iscil. “This is particularly troubling for younger individuals who we know statistically are more likely to become victims of fraud than any other age group. As consumers now grow up online, this problem will only get worse if we don’t dedicate resources to safeguarding our most vulnerable.”  

To view the full 2023 Top Ten Scams report, click here.  

Methodology  

The National Consumers League Top Ten Scams report analyzed 2,756 complaints submitted by consumers to NCL’s Fraud.org campaign in 2023. This data is self-reported by victims and should not be considered a nationally representative sample. NCL shares complaint data with a network of law enforcement and consumer protection agency partners who combine it with other data sets to identify trends in fraud and build cases. 

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About the National Consumers League (NCL)

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

NCL’s Greenberg urges MD Senate Finance Committee to support living wage legislation

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February 1, 2024

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

Washington, DC – The CEO of the National Consumers League, Sally Greenberg, today testified before the Maryland Senate Finance Committee urging them to end the subminimum wage for tipped workers under Senate Bill 160.

“The restaurant industry is still not fully recovered from the pandemic,” says Greenberg. “States that pay tipped workers the full minimum wage report higher restaurant sales, employment growth rates.”

Greenberg’s full testimony can be found here.

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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.

Americans now have an Obesity Bill of Rights

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January 31, 2024

Media contact: Nancy Glick, 202-320-5579, nancyg@nclnet.org; Simona Combi, 571-527-3982, simona.combi@ncoa.org

Washington, DC – Because obesity – the most prevalent and costly chronic disease in the United States –remains largely undiagnosed and untreated a decade after the American Medical Association (AMA) classified it as a serious disease requiring comprehensive care,[1] the National Consumers League (NCL) and National Council on Aging (NCOA) today introduced the nation’s first Obesity Bill of Rights and launched a grassroots movement – Right2ObesityCare – to advance changes in federal, state, and employer policies that will ensure these rights are incorporated into medical practice.

Developed in consultation with leading obesity specialists and endorsed by nearly 40 national obesity and chronic disease organizations, the Obesity Bill of Rights establishes eight essential rights, so people with obesity will be screened, diagnosed, counseled, and treated according to medical guidelines and no longer face widespread weight bias and ageism within the health care system or exclusionary coverage policies by insurers and government agencies.

“Our goal with the Obesity Bill of Rights is to define quality obesity care as the right of all adults and empower those with the disease to ask questions and demand treatment without discrimination or bias regardless of their size or weight” said Sally Greenberg, Chief Executive Officer of the National Consumers League. “For too long, adults with obesity have encountered a health care 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.”

As described by Patricia Nece, J.D., Immediate Past Chair of the Obesity Action Coalition, “For my entire life, I’ve been a target of ridicule simply because of my weight. People rarely take time to look beyond my weight to see me.”

Currently, only 30 million[2] of the estimated 108 million adults living with obesity[3] have been diagnosed with the condition, and only about 2% of those eligible for anti-obesity medications have been prescribed these treatments.[4] The consequence of untreated obesity for the nation is worsening outcomes for over 230 obesity-related chronic diseases,[5] approximately 400,000 premature deaths a year,[6] and an estimated $1.72 trillion in direct and indirect costs to the U.S. economy.[7]

Defining Quality Obesity Care for All
The Obesity Bill of Rights establishes and promotes eight essential rights to drive transformational change and define the core requirements for people with obesity to receive person-centered, quality care:

  1. The Right to Accurate, Clear, Trusted, and Accessible Information on obesity as a treatable chronic disease
  2. The Right to Respect by all members of the integrated care team when screening, counseling, and providing treatment
  3. The Right to Make Treatment Decisions about one’s health goals and obesity care in consultation with the individual’s health providers
  4. The Right to Treatment from Qualified Health Providers including counseling and ongoing care from health providers with expertise in obesity care
  5. The Right to Person-Centered Care that is personalized, respects the individual’s cultural beliefs, meets their specific health goals, and considers the person’s whole health and not just their weight status
  6. The Right to Accessible Obesity Treatment from Health Systems, so those with severe obesity receive care in settings that allow for privacy, using size and weight-accessible equipment and diagnostic scans
  7. The Right for Older Adults to Receive Quality Obesity Care that comprises a respectful, comprehensive care approach consistent with their personalized medical needs
  8. The Right to Coverage for Treatment with access to the full range of treatment options for the person’s disease as prescribed by the individual’s health provider

“Collectively, these rights will ensure that adults with obesity have trusted, accurate information about their disease, respectful and nondiscriminatory care from medical professionals, and insurance that provides access to all treatments deemed appropriate by their health providers,” said Ramsey Alwin, NCOA President and CEO. “In town halls across the country, older adults told us they often feel invisible when seeking obesity care. The Obesity Bill of Rights recognizes and aims to address their unique challenges.”

Putting the Bill of Rights into practice

With the goal of reversing the trajectory of the nation’s obesity epidemic, NCL and NCOA will spearhead Right2ObesityCare, a new grassroots movement to engage people with obesity, their caregivers, health professionals, community leaders, employers, and a network of obesity and chronic disease organizations to drive adoption of the Obesity Bill of Rights in clinical settings.

Using the online hub www.right2obesitycare.org to mobilize stakeholders, Right2ObesityCare will focus on national and state policy efforts, including developing a set of national “obesity goals” for full implementation of the Obesity Bill of Rights by December 31, 2029. Plans include hosting regional town halls, workshops, and advocacy forums across the country; scheduling meetings with federal and state legislators and regulators; and arming interested citizens and advocacy leaders with materials and tools to advocate for implementation of the Obesity Bill of Rights in their communities and workplaces. NCL and NCOA also will pursue development of a model law that stakeholders can use to incorporate the Obesity Bill of Rights into state law.

“The Obesity Bill of Rights brings us a step closer to creating a society where all individuals are treated with respect and without discrimination or bias regardless of their size or weight. Establishing eight essential rights for people living with obesity strengthens efforts to end such blame, shame and discrimination and give individuals who want and need it, access to safe and effective options to improve their health,” added Joe Nadglowski, President and CEO of the Obesity Action Coalition.

Advocacy on implementing the Obesity Bill of Rights also gives policymakers new impetus to pass legislation that will remove the regulatory and insurance obstacles that keep many people with obesity from getting the care prescribed by their health providers.

According to Rep. Brad Wenstrup, DPM (R-OH), “By tackling obesity head on, we can better prevent numerous additional diseases like type 2 diabetes, high blood pressure, and heart disease. My bill, the Treat and Reduce Obesity Act (TROA), expands Medicare beneficiaries’ access to treatment options to include FDA-approved medications, clinical psychologists, registered dieticians, and nutrition professionals. Not only would this legislation help Americans live healthier and longer lives, but it can also save taxpayer dollars over the long run.”

Added Rep. Gwen Moore (D-WI), “Obesity is a chronic condition – not a personal or moral failing. We need to ensure our health care system treats it as a disease, so that Americans with obesity can access holistic, high-quality care that meets the full spectrum of their needs. I am proud to be a co-lead of the Treat and Reduce Obesity Act, which puts us on a path toward effectively treating obesity, helping create healthier outcomes for Americans and supporting enhanced quality of life for Medicare beneficiaries who need comprehensive care.”

Development of the Obesity Bill of Rights

A year in development, the Obesity Bill of Rights is the product of extensive research combined with four town hall meetings hosted in senior centers and churches in California, Delaware, Mississippi, and Oklahoma between June and August 2023. At these town halls, more than 250 older adults, community leaders, and local clinicians described a health care system that is inhospitable to delivering quality obesity care, and physicians described having limited time for counseling, not enough training in obesity management, and inadequate coverage and reimbursement for obesity care.

After turning this knowledge and the lived experiences of older adults into a first draft, NCL and NCOA hosted a roundtable at The Obesity Society annual meeting in October 2023 where leading obesity experts reviewed the preliminary document and made recommendations. NCL and NCOA then sought feedback from specialists in minority health, aging, and rural health, as well as health professionals and other stakeholders who provided additional guidance. The final step was to circulate the updated Obesity Bill of Rights to a wide group of stakeholder organizations, resulting in initial endorsements from 36 obesity, public health, and chronic disease organizations and medical societies.

Nearly 40 consumer, aging, and public health organizations endorse the Obesity Bill of Rights

To date, the following organizations have endorsed the first-ever Obesity Bill of Rights: 1) the Academy of Nutrition and Dietetics; 2) Alliance for Aging Research; 3) Alliance for Women’s Health & Prevention; 4) American College of Occupational and Environmental Medicine; 5) American Medical Women’s Association; 6) American Nurses Association; 7) American Society on Aging;  8) American Society for Nutrition; 9) Association of Black Cardiologists; 10) Association of Diabetes Care & Education Specialists; 11) Bias180; 12) Black Women’s Health Imperative; 13) Choose Healthy Life; 14) ConscienHealth; 15) Council on Black Health; 16) Defeat Malnutrition Today; 17)  Gerontological Society of America; 18) Global Liver Institute; 19) Health Equity Coalition for Chronic Disease; 20) HealthyWomen; 21) Lupus Foundation of America; 22) MANA; 23) National Asian Pacific Center on Aging; 24) National Black Nurses Association; 25) National Hispanic Council on Aging; 26) National Hispanic Health Foundation; 27) National Kidney Foundation; 28) Noom, Inc.; 29) Nurses Obesity Network; 30) Obesity Action Coalition; 31) Obesity Medicine Society;  32) Patients Rising;  33) Partnership to Advance Cardiovascular Health; 34) Preventive Cardiovascular Nurses Association; 35) The Obesity Society; and 36) WeightWatchers.

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About NCL

The National Consumers League, founded in 1899, is America’s pioneer consumer organization. The organization’s 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.

About NCOA

The National Council on Aging is the national voice for every person’s right to age well. We believe that how we age should not be determined by gender, color, sexuality, income, or ZIP code. Working with thousands of national and local partners, we provide resources, tools, best practices, and advocacy to ensure every person can age with health and financial security. Founded in 1950, we are the oldest national organization focused on older adults. Learn more at www.ncoa.org.

 

[1] Obesity Medicine Association. June 19, 2013. “AMA House of Delegates Adopts Policy to Recognize Obesity as a Disease. Accessible at https://obesitymedicine.org/blog/ama-adopts-policy-recognize-obesity-disease/:

[2] PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

[3] Hales CM, et al. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. Centers for Disease Control and Prevention. NCHS Data Brief. No. 360. February 2020.

[4] PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.

[5] Obesity Care Advocacy Network. Fact Sheet: Obesity Care Beyond Weight Loss

[6] Hurt Rt, et al. Obesity epidemic: overview, pathophysiology, and the intensive care unit conundrum. J Parenter Enteral Nutr. 2011 Sep;35(5 Suppl):45-135

[7] Milken Institute (October 2018), “America’s Obesity Crisis: The Health and Economic Costs of Excess Weight.”

National Consumers League supports table saw safety standard proposed by the Consumer Product Safety Commission

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December 8, 2023

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

Washington, DC – The National Consumers League (NCL) submitted comments to the Consumer Product Safety Commission (CPSC) this week on the Commission’s proposed rule to require a safety standard for all table saws. The “Safety Standard Addressing Blade-Contact Injuries on Table Saws” proposal is projected to prevent more injuries and save more money than any rule ever proposed at the agency.

“NCL applauds the CPSC for moving toward a final rule to make table saws safe and to prevent the over 50,000 injuries – many of them finger amputations – that occur each year from table saw accidents,” said NCL CEO Sally Greenberg.

Pam Gilbert, NCL Board member and former Executive Director of the CPSC noted, “The matter of table saw safety has been an ongoing concern of the CPSC and National Consumers League for more than a decade; we believe this rule would finally bring much-needed safety technology to this ubiquitous woodshop tool found in millions of US households.”

Previous voluntary standards have been ineffective in preventing injuries, thus the need for this mandatory safety standard using proven effective technology that prevents serious injuries from table saws. Indeed, a 15-year trend analysis (from 2004 to 2018) of table saw injuries showed no reduction in table saw injuries from 2010 to 2018, despite the fact that a voluntary standard that became effective in 2010 required new table saws to be equipped with modular blade guard systems.

The Commission expects that the proposed rule would prevent or mitigate an estimated 49,176 injuries treated in hospital emergency departments or other medical settings per year and that net cost benefits, even when factoring the cost of the technology, would range from $1.28 billion to $2.32 billion per year.

The proposed rule would limit the depth of cut of a table saw to 3.5 mm or less when a test probe, acting as surrogate for a human finger or other body part, contacts the spinning blade at an approach rate of 1 m/s. CPSC staff estimated that the proposed rule would prevent or mitigate the severity of 54,800 medically treated blade-contact injuries annually.

To read the views of woodworkers themselves, this YouTube link tells first-hand accounts, some of which have been included in NCL’s comments. One is below:

“My father cut all four of his fingers off with a Radial arm saw years ago. Three fingers are bolted back together so he can only move them at the knuckle, the index finger was lost due to infection. He had to have a skin graft on all his fingers pulled from his thigh, so they now all grow hair so he has to shave them otherwise they grow hair. In airports, he always sets off the metal detectors. When I was looking at table saws about 8 years ago it was between the sawstop contractor (hybrid wasn’t out yet) and Powermatic 3hp cabinet. My father was with me at the time while I was a teenager at woodcraft. One look at his hand and it was obvious which saw I walked out with. 8 years later I still use the Sawstop contractor saw and it looks just like when I bought it, Its a fantastic investment and probably the only one that is relatively easy to justify to your wife. “

As Commissioner Rich Trumka, himself a woodworker, observed in his comments “…[t]he rule would provide the greatest net benefit to society of any rule in the agency’s history that I’m aware of—up to a $2.32 billion net benefit every year.”

The National Consumers League fully supports this Proposed Rule and greatly appreciates the years of dedication and work from the CPSC’s engineers, statisticians, and economists and the leadership of CPSC Chair Alex Hoehn Saric in moving this to the top of the Commission’s agenda.

NCL’s comments can be found here.

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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.

PBMs claim new programs will save consumers money. Let’s take a closer look.

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By Robin Strongin, Senior Director of Health Policy

Consumers have known for quite some time now that the prescription drug pricing system is essentially a black box. Dealings among drug manufacturers, health insurers and pharmacy benefit managers (PBMs) establish which drugs insurance will cover and make accessible to consumers. What’s more, the prices that consumers pay for those medicines vary wildly – often leading to high out-of-pocket costs for us all.

Two of the three major PBM companies that are in the middle of this drug pricing web recently announced that they are establishing new programs (CVS’s CostVantage and Express Scripts’ ClearNetwork) that set transparent formulas for drugs with a pre-set markup and a flat fee for the PBMs. On paper, this sounds like a great idea.

But consumers would be wise to take these claims with a healthy grain of proverbial salt. We know PBMs continue to find new ways to put themselves over patients (more on that here) and we must demand answers to the issues the PBMs are still skirting. For example:

  • Will these new programs actually make prescription drugs more affordable and reduce out-of-pocket costs at the pharmacy counter? Notably, both Express Scripts and CVS Health have acknowledged that employers and plan sponsors may not save any money from this move. There is no sign either that consumers will be able to get the drugs they need for a fair price.
  • While the companies boast increased transparency, they still have not shared – nor said they will share – how much they are paying to acquire the drugs that will be dispensed to patients. PBM clients have long sought this information, but it appears that data will still be hidden in the black box.
  • In the case of CVS Health, the changes the company announced will only be effective at CVS-owned pharmacies. It will not affect how CVS will reimburse millions of prescriptions at the local and independent pharmacies it doesn’t own. A cynic might say this is just another mechanism by CVS to drive more patients to its own pharmacies.

Most notably, nothing CVS Health and Express Scripts have announced will change one of the pervasive anti-consumer elements of the drug pricing system. In their dealings with drugmakers, they can still cut deals that will determine which medicines get preferential placement. This means PBMs could continue to push consumers toward higher-priced drugs and limit access to more affordable generics and biosimilars.

It’s no coincidence that Congress is getting closer to passing PBM reform legislation that would mandate transparency, force the PBMs to pass their negotiated savings from drugmakers to consumers and remove the incentives for PBMs to push consumers to higher-priced drugs. One might say that these moves by CVS and Express Scripts are cosmetic attempts to ward off legislation by touting their own self-reforms.

But, as with so much that goes on in the drug pricing game, these “reforms” may not be what they seem. We need Congress to step in for consumers to help ensure we’re no longer facing a big disadvantage at the pharmacy counter.

Learn more about the PBM problem at nclnet.org/pbms.

NCL applauds House Commerce Committee approval of consumer protection bills

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December 6, 2023

Media contact: National Consumers League – Melody Merin, melodym@nclnet.org, 202-207-2831

WASHINGTON, D.C. – The National Consumers League (NCL), America’s oldest consumer advocacy organization, today applauded the House Commerce Committee for advancing five important consumer protection bills that would implement long-sought reforms to the live event ticketing industry, require all-in pricing in short-term lodging, crack down on online dating scams and protect consumers’ plumbing systems from “flushable” cleaning wipes.

Two bills, the TICKET Act (H.R. 3950) and the Speculative Ticketing Oversight and Prohibition Act of 2023 (STOP Act), would implement much-needed reforms in the live event ticketing industry. The TICKET Act would prohibit hidden event ticket fees by requiring sellers to display the full price—including all mandatory charges—at the beginning of the transaction and in advertising. The STOP Act would prohibit the sale of tickets that the seller does not actually possess, a controversial practice known as speculative ticketing. The bill would also crack down on deceptive “white label” ticket resale websites and require fans to be provided refunds promptly in the event that a concert is canceled or postponed.

“Live event fans achieved an important victory with today’s vote,” said NCL Vice President of Public Policy, Telecommunications, and Fraud John Breyault. “Add-on junk fees for concerts and sporting events have been the bane of consumers’ existence for decades. These reforms are long overdue and promise to make the ticket-buying experience a fairer, easier process for millions of fans.”

Additionally, the committee advanced H.R. 6543, the No Hidden Fees on Extra Expenses for Stays Act; H.R. 2964, the Wastewater Infrastructure Pollution Prevention and Environmental Safety (WIPPES) Act; and H.R. 6125, the Online Dating Safety Act of 2023.

H.R. 6543 would require all-in pricing of hotel, Airbnb, and other short-term lodgings. This will prevent unscrupulous lodging companies from advertising one price to consumers only to hit them with additional fees later. The WIPPES Act will require that disposable cleaning wipes be clearly labeled with a “Do Not Flush” label. This has the potential to reduce estimated $441 million in additional operating costs that U.S. clean water utilities incur due to the flushing of so-called “flushable” cleaning wipes. Finally, the Online Dating Safety Act would require dating websites and apps to proactively notify users that an account they messaged has been banned. Such notifications would do much to intervene in ongoing frauds and likely help to reduce the scourge of romance scams.

“By advancing these bills, the House is demonstrating that consumer protection is a bipartisan issue. We urge the full House approval for these measures,” said Breyault. “Undisclosed hotel resort junk fees have bedeviled travelers for too long, draining consumers’ travel budgets and harming honest hotel operators. Similarly, the damage from ‘flushable’ wipes harms all consumers since the costs to municipal water systems are passed along to all ratepayers. Finally romance scam victims lost $1.3 billion to fraudsters last year. Requiring dating websites to offer them more support will do much to reduce the scourge of these scams.”

The committee’s actions come after NCL testified in support of these bills in a House legislative hearing in September of this year.

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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.