Texas v. United States – How consumers can protect themselves amid threats to the Affordable Care Act

Nissa ShaffiLast week a federal judge in Texas, Justice Reed O’Connor, ruled that the Affordable Care Act (ACA) is unconstitutional. The case against the ACA is being led by Texas Attorney General Ken Paxton on behalf of a group of 18 Republican state attorneys general, two governors, and two individual plaintiffs.

The lawsuit argues that because the individual mandate penalty has been repealed (effective 2019), it would render the entire ACA invalid, as the entirety of the law relies on the mandate. The lawsuit makes the claim that the absence of an individual mandate penalty would mean that the entire ACA would be unconstitutional.

While this news is disheartening, it is important for consumers to know that the ACA is still the law of the land. The ruling is currently at the federal district court level and is going to be appealed, led by California Attorney General Xavier Becerra, representing a group of 17 attorneys general in other states. Attorney General Becerra described the ruling as an “assault on 133 million Americans with preexisting conditions and the 20 million Americans who rely on the ACA’s consumer protections for healthcare.”

Although the federal deadline for open enrollment has passed, there are some states that have their own individual exchanges, with extended open enrollment deadlines:

NCL encourages residents of these states who are not enrolled in a marketplace plan to take advantage of these extended deadlines. You can also see if you qualify for a Special Enrollment Period, which allows individuals to sign up for health insurance outside of the Open Enrollment Period if they have had changes in certain life events. If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can apply at any time.

So take heart consumers. NCL believes strongly that this ruling–which comes from a right-wing Texas judge–is overbroad and will be reversed on appeal.

The need for increased funding for Alzheimer’s research

Nissa ShaffiOn November 28, in collaboration with Biogen and Eisai, The Hill hosted Preparing for a Treatment – Alzheimer’s Diagnosis and Care, which featured Senator Ed Markey (D-MA) and Senator Thom Tillis (R-NC), along with experts throughout the memory care and Alzheimer’s space. Senators Markey and Tillis discussed the vital need and urgency in funding for Alzheimer’s research and the need for a bipartisan effort towards a cure.

Senator Markey stated that more than five million Americans currently live with Alzheimer’s, and by 2050 that figure could triple to 16 million. Alzheimer’s remains one of the most underfunded and underdiagnosed chronic illnesses, despite having devastating effects equivalent to that of cancer or diabetes. Senator Markey reminisced on the Apollo moon landing in the 60s, recalling that the journey to the moon was an impressive feat for our nation and that we must now venture into the journey of the mind, similarly vastly unexplored area.   

Senator Tillis emphasized the importance of continued development of new treatments for Alzheimer’s. He warned against disengaging in collaborative efforts with pharmaceutical companies on account of a few bad actors, as diminished engagement with pharmaceutical and biotech companies could have devastating effects on risktaking and innovation.  

Experts from the panel agreed with the Senators that there is a great need for increased research in the biotechnology, pharmaceutical, and primary care spaces. The panelists stated that Alzheimer’s is currently the only disease that has no cure, methods of prevention, or strategies to slow down progression. However, there have been significant advancements made in the detection of Alzheimer’s in the form of amyloid positron emission tomography (PET) scans 

Amyloid PET scans allow physicians to detect the development of amyloid plaques, which are clumps of insoluble plaques in the brain that destroy connections between nerve cells. These images can afford physicians the ability to detect Alzheimer’s in patients 10-15 years before a diagnosis, potentially transforming primary care delivery and forging a path towards prevention.   

The panelists also discussed the Bold Infrastructure for Alzheimer’s Act (S.2076), which would expand the public health infrastructure to support patients, caregivers, and communities in the Alzheimer’s space. Additionally, the bill would require greater reporting and analysis of state and national data on cognitive decline, caregiving, and health disparities. Introduced by Senators Susan Collins (R-ME), Shelley Moore Capito (R-WV), and Catherine Cortez Masto (R-NV), S. 2076 now enjoys 57 bipartisan cosponsors, including Senators Markey and Tillis.     

The National Consumers League supports efforts such as S. 2076 that would make strides in addressing Alzheimer’s disease. NCL is also proud to be a partner in WomenAgainstAlzheimer’s We Won’t Wait Campaign, which seeks to unite women in a widespread effort to define Alzheimer’s as the 21st Century’s primary economic justice issue and health crisis for women. The Campaign promotes advocacy, education, and action on five key pillars: public fundingsex-based researcheconomic justice, diagnosis and treatment, and brain health. 

Gray market erectile disfunction medications pose risk to consumers

Did you know the vast majority of online pharmacies are illegitimate? A review by the National Association of Boards of Pharmacy (NABP) found that only 2.4 percent of online pharmacies comply with U.S. pharmacy laws and practice standards. This alarming statistic sheds light on the growing threat of illegal, online pharmacies – a component of the gray market – to consumer health. While many online pharmacies may present themselves as a legal, safe, and/or cheaper option, purchasing medicines from these websites could come at the cost of safety and security if consumers do not take the appropriate precautions. 

Medications for erectile dysfunction (ED) – which affects 24 percent of men in the United States over the age of 18 – are among the most commonly sold medications on the gray market. Due to a number of factors including the stigma some consumers experience around sexual health conditions and treatments, many patients suffering from ED don’t talk to their doctors or have prescriptions filled. This creates an environment where consumers may instead seek out unsafe, illegitimate online pharmacies to get these prescription medicines.

In accordance with our mission to ensure all Americans have access to safe, effective medicines, the National Consumers League (NCL) partnered with Bayer to develop a white paper, Increased Consumer Risk from Erectile Dysfunction Medication Advertised and Sold on the Gray Market, to analyze the possible dangers consumers face by purchasing ED medications from illegal online pharmacies. NCL presented the paper’s findings in November at the Alliance for Safe Online Pharmacies (ASOP) Global Foundation’s Spotlight on Illegal Online Drug Sales Research Symposium in Washington, DC.

Based on the research, the white paper recommends five concrete policies to improve consumer safety, including:

  • Enhancing consumer awareness about the gray market and promoting health literacy;  
  • Encouraging healthcare providers to talk about the risks of illegal online pharmacies with their patients;  
  • Supporting collaborative law enforcement actions to combat illegal sales on the gray market; 
  • Increasing access to ED medicines by making them available over-the-counter, with robust consumer education and information programs; and
  • Adding to the body of evidence on the dangers of the gray market.     

To learn more about the research and the dangers of the gray market, read the full white paper here.

Seven groups join chorus of elected officials, organizations in challenge of U.S. State Departments decision regarding ubiquitous health termsSeven groups join chorus of elected officials, organizations in challenge of U.S. State Departments decision rega

November 15, 2018

The Honorable Michael R. Pompeo
Secretary of State U.S. Department of State

Dear Mr. Secretary,

The undersigned groups are deeply concerned by reports from several sources that the U.S. Department of State is considering a proposal to prohibit U.S. diplomats around the world from using the terms “sexual and reproductive health” and “comprehensive sexuality education.” This proposal is counterproductive, banning widely accepted language that has been in use for decades. We strongly oppose any such change.

The term “sexual and reproductive health” encompasses a broad array of issues affecting both women and men, including pregnancy, prepartum and postpartum care, maternal and perinatal health, perimenopause and menopause issues, puberty issues, pap smears and cervical cancer testing, contraception, abortion, Ebola, Zika, stillbirths, female genital mutilation, infertility, adolescents and sex education, testing and treatment of sexually transmitted diseases including GC and Chlamydia (both on the rise according to the Centers for Disease Control) and HIV prevention, testing and treatment, posttraumatic stress syndrome, depression related to hormone changes, and importantly, violence against women.

The United States has tremendous influence around the world in promoting better health outcomes for all of the world’s citizens. Efforts to change or control the language and restrict the use of certain words that U.S. diplomats are permitted to use is unwise as we believe that by prohibiting the terms “sexual and reproductive health” and “comprehensive sexuality education” will undo decades of global progress for women’s access to healthcare and basic human rights.

We are committed to lifting the stigma related to sexual reproductive health communications, especially between women and their healthcare providers. Sexual health issues are very common for both sexes, with about 7 in 10 women having experienced a sexual health issue and 15-20% of men having described some kind of sexual problem when meeting with their healthcare provider.

Reproductive health is specific to reproductive processes, functions, and the reproductive system across all stages of life. Sexual and reproductive health issues are frequently preventable or treatable, yet a multitude of barriers often stand in the way of women and men discussing their concerns with a healthcare provider, leaving them to suffer in silence. Among those barriers is the culture of embarrassment or stigma that already exists in discussions about sexual and reproductive health.

Breaking down barriers that hinder or prevent conversations about sexual and reproductive health requires support and education at many levels. We believe the U.S. Department of State’s proposal to prohibit the terms “sexual and reproductive health” and “comprehensive sexuality education” will only hurt, not help, the progress that has been made and hinder ongoing efforts to further break down barriers.

For these reasons, we urge the Administration to abandon the proposal to prohibit the use of “sexual and reproductive health” and “comprehensive sexuality education.”

Thank you for your attention to our concerns about the damage this proposed prohibition of terms will have. The United States should be a leader in promoting sexual and reproductive health for men and women.


Sheryl A. Kingsberg, PhD
Immediate Past President
The North American Menopause Society

Ms. Sally Greenberg
National Consumers League
Healthy Women International

Other Groups Endorsing this Request

American Medical Women’s Association
American Sexual Health Association
Healthy Women International
Society for the Study of Women’s Sexual Health
National Association of Nurse Practitioners in Women’s Health

What California is doing to lower maternal mortality

Nissa ShaffiThe United States currently has the worst maternal mortality rate in the developed world, at 26.4 deaths per 100,000 live births, compared to 9.2 in the United Kingdom, 8 in France, and 5.5 in Australia. To put this in perspective, the United States currently has a higher maternal mortality rate than Saudi Arabia and Libya and is barely better than Mexico, Iran, and Russia. An even more devastating reality is the maternal mortality rate among black women, who are 243 percent more likely to die from pregnancy- or childbirth-related causes than women of any other race in America.

There is some good news amid these grim numbers. The state of California has successfully worked in collaboration with public and private healthcare stakeholders to decrease the maternal mortality rate to seven deaths per 100,000 live births.

In 2006, the California Department of Public Health (CDPH) and the California Maternal Quality Care Collaborative (CMQCC) worked together to assemble a multidisciplinary committee of clinical experts to investigate this epidemic. This committee’s focus was to determine the causes of maternal deaths and the demographics of women most affected, along with identifying opportunities to turn the numbers around.

Within the first two years of its launch, the committee was able to identify placenta accreta and preeclampsia (pregnancy-induced high blood pressure) as the two most preventable causes of maternal mortality.  Placenta accreta is a condition in which the placenta affixes to the uterine wall and fails to separate postpartum, which results in severe obstetric hemorrhaging. Upon discovering a correlation between the rise in cesarean sections (C-sections) and placenta accreta cases, the CMQCC sought to reduce the number of C-sections that were medically unnecessary.

Additionally, the CMQCC revamped California’s hemorrhage guidelines to help make childbirth safer for mothers in the state. As a result, California has created a state model that has resulted in a dramatic decrease in maternal mortality, while the rest of the country continues to experience an increase in rates.

California has set an example for the rest of the country. Other states would do well to take a page from its example and turn around this alarming trend of increased maternal fatalities. In addition, a bill currently being voted on in Congress, the Maternal Health Accountability Act (S.1112), would be a federal remedy to help address this issue. The bill would require states to monitor and assess pregnancy-associated deaths and develop appropriate measures to improve the quality of maternal care. We should all ask our members of Congress to help pass the Maternal Health Accountability Act (S.1112), a bipartisan bill that could potentially save countless lives and reverse the damaging trend of maternal mortality in the United States.

Healthcare Open Enrollment starts today

Nissa ShaffiOpen Enrollment is back! From November 1, 2018 to December 15, 2018, consumers will be able to shop for insurance coverage options through the individual health insurance marketplace. Even if you are currently insured, you can still take advantage of the Open Enrollment period to compare plan options and select a plan that better suits your budget and needs.

The Centers for Medicare & Medicaid Services (CMS) recently announced that marketplace premiums have dropped by 1.5 percent nationally. With regard to pre-existing conditions, all marketplace plans sold through HealthCare.Gov are required to provide comprehensive coverage to consumers and cannot discriminate against enrollees on the basis of health status. In addition, when you apply for insurance via the marketplace, you will be able to determine if you qualify for a premium tax credit. To find out if your monthly income range qualifies for a premium tax credit, please click here.

The National Consumers League encourages consumers to seek coverage via the Affordable Care Act (ACA) compliant plans offered on the marketplace. These plans are required to cover the essential health benefits mandated by the ACA, ensuring that you have access to comprehensive care.

If you need assistance navigating the marketplace, you can find a healthcare navigator in your area to help in comparing coverage options that meet your needs. To find a navigator in your area, please click here. Most importantly, in order to have coverage that is effective by January 1, 2019, you must sign up by December 15, 2018.

Time to talk about women’s sexual health

Sexual health is an integral part of overall health and wellbeing. Research has found that good sexual health offers a host of positive benefits, including improving social and emotional health. But far too often, women’s sexual health concerns are not addressed by healthcare professionals.


Although a survey of U.S. women found that seven in 10 have experienced a sexual health issue, a culture of discomfort around women’s sexual health often inhibits open conversation about women’s sexual health concerns even between clinicians and their patients.

In fact, surveys of U.S. women and healthcare professionals have found that each group often looks to the other to start a conversation about sexual health. A poll of U.S. healthcare providers by the Association of Reproductive Health Professionals (ARHP) and HealthyWomen found that 74 percent of providers rely on their patients to initiate a discussion about sexual health, while a survey of U.S. women found that 73 percent preferred for their clinician to broach the subject.

There are many reasons for this disconnect – from patients’ lack of awareness that their symptoms can be treated, to a lack of training or time for healthcare professionals to address their patients’ concerns, to a general discomfort with women’s sexual health among all parties. The end result is that women often don’t receive adequate care for important sexual health issues.

To help break down these barriers, NCL has joined together with other leaders in the field of women’s and sexual health to launch the Alliance for Advancing Women’s Health. The Alliance is committed to working together to help women advocate for their sexual health during clinical visits and to give clinicians the tools they need to ask about and address their patients’ sexual health concerns.

Over the course of the coming year, we’ll be working to raise awareness about the barriers to open conversations about women’s sexual health, and we’ll develop a discussion guide and user-friendly tools to help women and clinicians start and sustain conversations about sexual health concerns. In the meantime, you can find helpful resources from our member organizations at www.advancingwomenshealth.org.

We believe a sea-change is needed to make sure women of all ages and backgrounds have their concerns heard without feeling judged or ashamed. By raising awareness of sexual health issues and working to normalize these conversations, we hope to improve women’s sexual health and overall quality of life.

National Prescription Drug Take Back Day

Nissa ShaffiThis Saturday, October 27, 2018, is the Drug Enforcement Administration’s (DEA) National Prescription Drug Take Back Day. This initiative is a national effort that aims to provide consumers with safe and convenient avenues to dispose of their expired or unused prescription medications. Failure to properly dispose of medications can lead to devastating consequences, as medications can become misplaced, stolen, or misused.


National Prescription Drug Take Back Day ensures that used, expired, and potentially highly addictive prescription medications such as opioids do not end up in the wrong hands. In April 2018 alone, national take back efforts were able to collect close to 474.5 tons of prescription medications.

The National Consumers League encourages consumers to clean out their medicine cabinets and participate in National Prescription Drug Take Back Day this Saturday, October 27, 2018. To find a drug take back location near you, please click here. Drug take back efforts will run from 10 am to 2 pm. To make phone inquiries, call 1-800-882-9539.

In addition to National Take Back Day, consumers can also dispose of unused and expired prescription medications in the following ways:

  • Contact your local pharmacy to see if they offer programs like in-store kiosks to collect unwanted prescription drugs.
  • Use a drug disposal pouch, such as the Deterra pouch, that contain solutions that nullify active ingredients in medications when mixed with water and sealed for disposal.
  • Mix expired and unused drugs with cat litter or old coffee grounds, seal them in an airtight container, and throw it into the garbage.
  • As a last resort, consumers can flush their medications down the toilet, but this method is generally not recommended as the ingredients in some medications can potentially corrupt community water supplies. The Food and Drug Administration (FDA) has issued a list of medications approved for disposal by flushing when other safe disposal options are not readily available.

For more resources on how to safely and effectively dispose of prescription medications, please click here.

Women’s health experts launch the Alliance for Advancing Women’s Health

October 9, 2018

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 is pleased to join with other leading national women’s health and sexual health organizations in announcing the launch of the Alliance for Advancing Women’s Health (AAWH), a new collaborative initiative to advance women’s sexual healthcare by improving the interaction between clinicians and patients about sexual health.

Through AAWH, made possible with support from AMAG Pharmaceuticals, Inc., member organizations will work together to empower women with information to seek better sexual healthcare. AAWH will also work to increase healthcare providers’ understanding of women’s sexual health needs to better address their patients’ sexual health concerns.

“Women’s sexual health is critically important to a woman’s overall health, and it can help to improve social and emotional wellness. But too often, women’s sexual health concerns go unaddressed,” said AAWH Co-Chair Sally Greenberg, Executive Director, National Consumers League. “As women’s health experts and advocates, we know that cultural discomfort with the topic of sexual health, as well as limited clinician time and training, contribute to a lack of dialogue and through this alliance we will seek to change that.”

A survey of U.S. women found that about seven in 10 had experienced a sexual health issue. Despite the reported prevalence of sexual health concerns, a culture of discomfort around women’s sexual health often inhibits open conversation about women’s sexual health even in a healthcare professional’s office. Surveys of patients and healthcare professionals found that most women (73%) preferred their clinician to broach the topic of sexual health, while most clinicians (74%) relied on their patients to initiate the conversation. AAWH members will volunteer their time and expertise to help bridge this gap and improve women’s sexual health outcomes.

“For too long, women and their clinicians have not had open conversations about sexual health concerns, to the detriment of women’s physical, mental, emotional and social wellbeing,” said AAWH Co-Chair Sheryl Kingsberg, PhD, President, North American Menopause Society and Division Chief of Behavioral Medicine, University Hospitals Cleveland Medical Center. “AAWH will work with clinicians and women across the country to foster an open dialogue and to advance sexual health care for women everywhere.”

Learn more about AAWH at https://advancingwomenshealth.org/.


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 statement on Trump Administration’s finalization of Short-Term Plan rule – National Consumers League

August 1, 2018

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 deeply disappointed by the finalization of the Short-Term Limited Duration Insurance (STLDI) Plan rule, which allows the sale of short-term health insurance plans that do not comply with the requirements of the Affordable Care Act.

The following statement may be attributed to Sally Greenberg, NCL executive director:

“The ‘short-term plan’ final rule will allow insurers to offer junk insurance policies to millions of consumers that fail to meet their healthcare needs. Short-term plans exclude coverage for critically important healthcare services; vary premium rates by gender, health status, and age; and put individuals and families at significant financial risk from unpaid medical bills.

In addition, allowing the expansion of these types of plans for periods up to 364 days (and renewal for up to 3 years) undermines the individual market by pulling healthy individuals away and leaving an older, sicker risk pool behind. As a result of this rule, we fear that many who rely on comprehensive coverage – including women, older adults, and people with chronic conditions – will be left without affordable, comprehensive coverage options.”  


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 https://nclnet.org.