Nancy Glick

A Call Not to Make Americans Hungry Again

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By Nancy Glick, Director of Food and Nutrition Policy

1968 was a pivotal year in U.S. history, and not only for the anti-war protests and the assassinations of Martin Luther King Jr. and Robert F. Kennedy. That same year, CBS News aired “Hunger in America,” a Peabody-winning documentary that opened the eyes of Americans to the fact that over 10 million people – nearly 20 percent of the public – were suffering from hunger and malnutrition in a land of plenty. 

Later that year, a group of 25 religious, labor, legal, medical, and other professionals, including the Citizens’ Board of Inquiry into Hunger and Malnutrition, published a scathing report documenting widespread hunger and malnutrition across the country. Called “Hunger U.S.A.,” the report identified 282 “hunger counties,” especially in areas like Appalachia, the Mississippi Delta, and Native American reservations, and described the dire conditions for people experiencing hunger,  made worse by federal programs that discriminated against the poor and favored agricultural companies.  

The report and the documentary shocked the nation, prompting significant public and political pressure that led President Richard Nixon to convene the first-ever White House Conference on Food, Nutrition, and Health in Washington in December 1969. Attended by 5,000 delegates representing various interest groups, the conference produced more than 1,800 recommendations to improve anti-hunger programs. The conference was also the stimulus for Congress to pass landmark legislation – such as the 1974 Food Stamp Act, the 1975 School Breakfast Program and Summer Food Program, and authorization of the Supplemental Feeding Program for Women, Infants, and Children (WIC) – that now make it possible for more low-income families to have a healthy diet.   

Fast-forward 56 years after the White House Conference , and the nation is staring at the possibility of another wave of massive hunger in America. Despite how much has changed over the last five decades, an estimated 47.4 million Americans now experience food insecurity, including over 13 million children. The consequences for malnourished people are wide-ranging. Adults experience more severe illnesses, disability, muscle wasting, and chronic diseases, while children may face stunted growth, developmental delays, learning difficulties, and reduced cognitive function. 

Given this reality, one would think that reducing hunger in America would be a priority for the White House and members of Congress. Yet, passage of the President’s One Bill Beautiful Bill Act (OBBBA) in July shows this is not the case. OBBBA cut $186 billion in funding for roughly one in eight people in the U.S. who buy groceries with help from the Supplemental Nutrition Assistance Program (SNAP), also known as the food stamp program. When the cuts take effect in 2027, the Urban Institute projects that 22.3 million families will lose some or all of their SNAP benefits. Additionally, the Congressional Budget Office (CBO) estimates that 3.2 million adults will be cut from the SNAP program in a typical month due to expiring exemptions. This includes 1 million older adults, 800,000 parents, and 1.4 million adults in areas with insufficient jobs.  

But now, nearly 42 million people could lose their SNAP benefits this year – as early as November 1. This reason is an ongoing fight in Congress over how to end a federal government shutdown, where food-insecure Americans are being used as pawns. Senate Republicans insist that Democrats vote to approve a “clean” budget spending bill with no changes. In contrast, Democrats want the bill to include an extension of expiring tax credits that will make health insurance cheaper for millions of Americans and to reverse Medicaid cuts.  

The haggling has been ongoing since October 1, when the government shut down, and efforts to reach a compromise have failed. Thus, the Trump Administration is using continued funding for SNAP benefits as a pressure tactic to raise the ante on Senate Democrats. This took the form of the USDA announcing on its website on October 26 that “the well has run dry,” and there will be no SNAP benefits issued on November 1. 

What the USDA didn’t say is that the department has access to a nearly $6 billion contingency fund that paid for SNAP benefits during past government shutdowns. Many Congressional Democrats and Republicans had encouraged the Trump administration to use this funding to preserve food stamps through November, as the government was expected to remain closed. But the Trump administration declined, even though USDA said weeks ago that it could reprogram money to prevent benefit cuts. 

People receiving SNAP benefits should not be used as a bargaining chip in a game of chicken between Republicans and Democrats. Therefore, Democratic attorneys general and governors from 25 states filed a lawsuit in federal court on October 28, arguing that the federal government had a legal obligation to maintain funding for food stamps, which Congress made permanent in the 1960s.  

Soon, we will know if the federal court sides with state attorneys general and governors and compels USDA to use its contingency fund so nutritionally vulnerable Americans will continue to have enough food. If not, over 40 million children and adults can only hope that cooler heads will prevail, that Democrats and Republicans will come to the negotiating table, that the shutdown will end, and that SNAP benefits will be restored.  

But no one should declare victory. This is a dark moment in our history. 

Nancy Glick

Reversing Progress on Obesity Care

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By Nancy Glick, Director of Food and Nutrition Policy

“One step forward, two steps back” describes situations where progress is hindered by setbacks. This accurately reflects the state of obesity care today. 

On the positive side, the disease that now affects more than 100 million adult Americans is finally getting recognition as a priority health issue. This is due to several important developments demonstrating the value of treating obesity as a serious chronic disease: 

There is widespread scientific consensus that obesity is a high-risk condition

Starting with the American Medical Association’s (AMA) action in 2013 to classify obesity as a serious chronic disease requiring treatment, numerous chronic diseases, obesity and nutrition organizations now agree that obesity is a distinct disease due to its complex biological mechanisms and its worsening effect on over 230 other chronic diseases. Based on this consensus, in 2024, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to establish treatment of obesity as a medically necessary service under Medicare and Medicaid, paving the way for covering weight loss drug under these programs in the future.

New therapeutic agents are revolutionizing obesity medicine

When the Food and Drug Administration (FDA) approved the first GLP-1 (glucagon-like peptide-1 receptor) agonist to treat obesity in 2021, Americans learned that these injectable medicines could help people lose between 15 percent and 25 percent of their weight on average after one year. Thus, enthusiasm for GLP-1s has soared to levels rarely seen in medical practice. According to the findings of a 2024 survey of 3,000 adults commissioned by the professional services firm PWC, between 8 percent and 10 percent of US adults are currently taking GLP-1s. 

GLP-1 medicines are cost-effective 

In September, the Institute for Clinical and Economic Review (ICER) gave its highest cost-effectiveness rating to the widely prescribed weekly injectable GLP-1 weight loss drugs, semaglutide and tirzepatide, citing price reductions and studies showing cardiovascular benefits. Additionally, FDA recently approved the first generic version of an older GLP-1, liraglutide, which is injected daily. 

New research shows that treating obesity lowers overall healthcare costs

Because even a modest weight loss (a drop of 5-10 percent) produces significant health improvements when a person has overweight or obesity, studies are beginning to project the potential savings to the economy from covering obesity medications. One large study of privately insured adults and Medicare beneficiaries published December 5, 2024, in JAMA Network Open estimated an annual savings of $2,430 per person who achieved a 10 percent reduction in excess weight and a $5,444 reduction in health expenditures with a 25 percent weight loss.  

Reflecting these developments, coverage of GLP-1 drugs increased in 2023 and 2024, particularly among large employers. According to the firm Mercer, which conducts an annual National Survey of Employer-Sponsored Health Plans, coverage for GLP-1 drugs in 2024 rose to 44 percent of all large employers (those with 500 or more employees) and up to 64 percent of corporations with 20,000 or more employees.  

Additionally, the Office of Personnel Management (OPM) required Federal Employee Health Benefits (FEHB) carriers to cover at least one GLP-1 weight loss drug in 2024, and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) covered these medicines for chronic weight management. At the same time, several states provided some level of GLP-1 coverage for their employee health plans and 13 state Medicaid programs covered GLP-1 weight loss drugs as of August 2024.  

But, as the saying goes, that was then, and this is now. Due to dramatic cuts in federal and state budgets, the nation is shifting course with the inevitable result of moving backwards in delivering quality obesity care. While not the complete picture, the National Consumers League notes these troubling reversals:

  • In April 2025, the Trump Administration announced that Medicare will not cover anti-obesity medications, stating that the 2024 CMS proposal to cover GLP-1 weight loss drugs “is not appropriate at this time.” 

If obesity were cancer or heart disease, policymakers might think twice about not allowing access to cost-effective medications. Yet, the reality is that obesity is still not viewed as a serious disease. Thus, obesity remains largely undertreated in this country, due in part to payers, federal agencies, and state governments restricting or eliminating coverage for anti-obesity medicines that are changing the standard of care.  

Recognizing that people with obesity deserve the same level of attention and care as those with other chronic diseases, the National Consumers League partnered with the National Council on Aging (NCOA) and leading obesity specialists to develop and issue the first Obesity Bill of Rights for the nation on January 31, 2024. Specifically, the Obesity Bill of Rights defines quality obesity care as the right of all adults and establishes eight essential rights, including the right to coverage for the full range of treatment options, ensuring that Americans with obesity recieve the care specified in medical guidelines. 

To ensure Americans have these rights, NCL and obesity advocates are urging policymakers to adopt a long-term view about the importance of covering anti-obesity medications. Our message is simple: there may be short-term budget savings from restricting or eliminating coverage, but if obesity goes untreated among a large segment of the population, the nation will pay the costs in higher annual expenditures on obesity-related chronic diseases, disability, lost productivity, and premature deaths.  

Complicating matters, not having insurance coverage is what drives many consumers to go online and opt for ‘cheap, easy, and doctor-approved’ compounded GLP-1 products that may cause harm or could be fakes. According to the Food and Drug Administration, these products may contain incorrect dosages, the wrong ingredients, excessive or insufficient amounts of active ingredients, or possibly bacteria, all of which can lead to serious health consequences. Thus, while several medical organizations and state attorneys general have issued alerts to warn consumers, advocates agree that providing coverage for FDA-approved GLP-1 drugs is the best way to put a damper on this exploitative market.  

For all these reasons, NCL urges insurers and federal and state policymakers to consider the significant health and patient safety benefits, as well as the reduced medical expenditures from treating obesity, when weighing decisions about coverage.  

An Important Day for Safer Cars and Products

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By Sally Greenberg, NCL CEO

From left to right: Torine Creppy, Safe Kids Worldwide President; Janette Fennel, Kids and Car Safety President; Sally Greenberg; Brett Horn, Charlie’s House Founder

On a recent Sunday in October, I flew to Kansas City to celebrate the 30th Anniversary of Kids and Car Safety. The organization was formed by my friend and colleague, Janette Fennell, who dedicated her life’s work to preventing injury to children after she and her husband were kidnapped in their car. More on this story later, but it has a happy ending.

As a general matter, it’s often hard to celebrate advances in product and auto safety because they happen in the aftermath of injuries to children and adults from poorly designed products. 

Indeed, I began working with Janette in 2002 to address the danger of drivers backing over children, typically toddlers, who are too small to be seen behind cars with no camera, which cars didn’t have in 2002.  The first time I met Janette, she was hosting a press conference in suburban Washington, D.C. She had a speaker at the microphone who described the agony of backing over his grandchild. Hard to believe I hadn’t thought about this obvious hazard to children before. 

Back to Janette’s history. In 1996, she and her husband Greig were forced into their trunk one evening when returning from a party in San Francisco, their 9-month-old strapped in his car seat in the backseat.  The kidnappers thankfully kept the baby in his seat and placed him on the front lawn. He was unharmed. The robbers drove the couple to a remote location, demanded their ATM cards and PINS and cleaned out their accounts. She and Greig found a cable inside their Lexus that allowed them to pop open the trunk. 

Janette swore that if she got out alive, and thankfully she did, she would dedicate the remainder of her life to saving kids in and around cars.  

After this harrowing press event, I drove back downtown and on the way, decided Consumers Union, where I worked as product safety counsel at the time, should work with Kids and Cars to get a safety standard enabling drivers to see behind them as they backed up their vehicles. 

As of Model Year 2018, after a decade and a half of passing a law, then bringing a lawsuit against the National Highway Traffic Safety Administration (NHTSA) to get it implemented, (this included many families who had lost children coming to Washington and a concerted consumer advocacy campaign), every passenger motor vehicle is required to have a backup camera. 

Back to my story about sadness and product safety. While in Kansas City, I met up with child safety advocate, Brett Horn and toured Charlie’s House, the model home he built as a tribute to his 2 ½ year old son, who was crushed 20 years ago under a chest of drawers that toppled over on him. Over 400 kids have died in furniture tip overs. Thanks to Brett and other safety advocates the STURDY Act passed in 2022, requiring the Consumer Product Safety Commission to set mandatory safety standards for all dressers and similar products made or sold in the U.S.  

Every room in Charlie’s House – which is used to train parents and community members – has examples of hazards to children, such as lighters shaped as toys, colorful laundry pods, power tools, handguns with locks, refrigerators that lock shut,  and small batteries that can be swallowed and children can die from. Believe me, there are things you’ve never thought of that kids get into. We all need to be educated about those hazards and ensure every home is made as safe as possible for kids. 

 While at Charlie’s House, the CEO of Safe Kids Worldwide, Torine Creppy, arrived to tour the house and afterward we all headed out to Olathe, Kansas, for the Kids and Cars 30th Anniversary Celebration. As we enjoyed Kansas barbecue, Janette told her compelling story once again. To me the most rewarding part of the event was hearing these encouraging statistics: 

  • The number of children strangled by power windows has drastically decreased thanks to safer switches. Kids and Car Safety (KACS) is responsible for the passage of a law that mandated a regulation on all new vehicles manufactured on or after October 1, 2010, to have the safer ‘pull up to close/push down car window switches.  

In addition, many people are surprised to learn that hundreds of cars are stolen with children in the back seat every year. Cars are stolen from gas stations, convenience store parking lots, and even home driveways. Kids and Cars keep the data as no other group does, the first step to attacking the problem.  

Though the most well-known and beloved technology in cars today are those backup cameras – not only because they provide a critical measure of safety, but they also give drivers a vast view of what is behind them as they backup into parking spots, garages, parking ramps and around dangerous corners. If I had a dollar for every person who tells me how much they love their car cameras, I’d be rich!   

Don’t ever forget, the auto industry did not want to implement these safety changes, nor did the NHTSA, and both fought against them. But the advocates prevailed. And as with so many safety technologies, they provide a myriad of additional benefits. 

My day in Kansas City reminded me once again why I do this work. Saving lives of children first, and protecting the rest of us, will never get old. My hat is off to Brett Horn and Janette Fennell and Kids and Cars – who have set a high bar, refused to cave to industry or government resistance, and told their stories over and over again and invited others to tell theirs. Hats off to them and others who have dedicated their lives to making our lives safer and more rewarding.   

Guest Blog: A Life in the Shadows of North Carolina Fields

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By Yesenia Cuello

A former child farmworker and the daughter of immigrants reflects on her life and the current moment.

I was 14 the first time I worked in a tobacco field alongside my family.

We entered a field we couldn’t see the end of. We slit holes in black trash bags to wear over our clothes, keeping us dry from the dew. The spray from the tractors across the road made our noses itch and our eyes water. We ignored what we were told was “vitamins for the plants” being sprayed.

The tobacco stood taller than most of us, making it impossible to see between the rows as the sun caused the air to wave and the humidity to climb, heavy and suffocating.

When we finally stopped sweating, and the air felt cool against the back of our necks, even as our vision blurred, we assumed the worst had passed. We didn’t know then that our daily labor exposed us to the nicotine equivalent of a pack of cigarettes, chronic heat illness, and pesticide drift with lifelong health impacts.

We stayed together and took care of each other as we worked. The only thing we knew was that we needed the money.

Leading the nonprofit organization NC FIELD (North Carolina Focus on Increasing Education, Leadership & Dignity) was the first time I learned that what I experienced as a teenager was about food and labor justice. As part of NC FIELD’s leadership, I helped bring national attention to child labor, including advocating for the first federal minimum age for workers permitted to apply pesticides. We learned our words matter.

Advocating for the rights of those in our fields has become even more important over the years in North Carolina. Some who worked before us told us about breaks under shaded trees, cold lemonade, and the dignity of friendship with the farmer. Hard work was met with deep appreciation.

That’s not our story.

We were picked up by a van before sunrise. There were no scheduled breaks. We were yelled at to move faster or be fired. Water, if provided, was scarce or dirty; we were paid in envelopes of cash, and then we were transported back home. We didn’t know the farmer, and we knew not to ask their name.

We developed our own sense of belonging alongside those who embraced us. I remember a few local church ladies and teachers who showed kindness and took the time to understand us. They saw us, but to others, I was just labor — temporary, not part of their Southern heritage or the community.

Our invisibility isn’t accidental. It’s by design. The system bullies us into staying quiet, ignorant of the dangers of this work, and remain unseen in both life and death. Workers like us grew up with little access to healthcare through Medicaid, food assistance, or other safety nets. The assumption is that those resources are not for us or, by seeking that help, could endanger those we love.

During the pandemic, we were briefly called “essential.” Today, we’re labeled criminals, thieves of the American Dream. We pause before stepping outside our homes to attend church services or go to the grocery store.

And yet, the food supply still depends on the labor of thousands of migrant farmworkers in North Carolina. Eastern North Carolina drives our state’s place as one of the top 10 states in agricultural products sold, according to federal data.

I know what will happen if the immigrants who work North Carolina’s farms are taken away. If deportation forces continue to tear us from our communities, the impact will be catastrophic: crippling farms, driving up food prices, and destabilizing the food system that families across the nation depend on every single day. The consequences will ripple far beyond the fields, leaving damage that will be felt for generations.

We live with chronic stress, fear of robbery in migrant housing where it is illegal to lock doors, U.S. Immigration and Customs Enforcement (ICE) raids on farms and backcountry roads, at our children’s schools, and in our hospitals.

We go out, holding our documents in one hand and our child’s hand in the other, regardless of our legal status or citizenship.

That’s the reality of being a person of color and speaking Spanish in North Carolina today.

Who will keep farms thriving and stores supplied when thousands of us are gone? We remain essential regardless of the immigration system that facilitated our dehumanization. To deport farmworkers on a mass scale is to gamble with everyone’s food security.

This system may have been built on our silence, but our silence has not kept us safe. So, we are sharing our stories. We help make our state and the U.S. thrive. We will continue to work, hope and pray for the dignity of human existence.

Yesenia Cuello is a co-founder and the executive director of NC FIELD, a community-based organization that helps marginalized communities overcome barriers to resources. This column is syndicated by Beacon Media and is available to republish for free on all platforms under Beacon Media’s guidelines.

NCL’s Child Labor Coalition has worked in collaboration with NC FIELD for years.

Separating Fact from Fear About Tylenol Use in Pregnancy

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By Lisa Bercu, NCL’s Senior Director of Health Policy

I remember like it was yesterday when I found out I was pregnant with each of my kids, now seven and ten years old.  I felt a mix of joy, excitement, and worry all at once.  But more than anything, I felt protective, thinking about how to keep them safe and give them the best start in life. As President Obama remarked, “To have a child is to have your heart walking around outside your body,” which I think perfectly sums up the realities of being a parent.  

That’s why I was so concerned when President Trump made unsupported claims that acetaminophen (commonly known by the brand name Tylenol) may cause autism when used in pregnancy, and that young children shouldn’t take acetaminophen for “virtually any reason.”  Moms deserve clear, science-based information, and not fear or guilt.   We need to feel confident making decisions that protect our health and our children’s health.   

Here’s what we know so far: research has not proven that taking acetaminophen during pregnancy causes autism. Most of the studies that have looked at this question have not shown a clear cause-and-effect link. The two best studies we have so far, published in 2021 and 2024, give doctors and parents the most reliable evidence to date that acetaminophen is safe to use in pregnancy when needed.  

 What we also know is that autism doesn’t have a single cause and is due to many different factors, including genetics and environment. In addition, the rise in autism is due to increased awareness and the medical community better recognizing and diagnosing it.  

It’s also important to know that untreated illness in pregnancy can be dangerous.  Untreated fever, particularly in the first trimester, increases the risk of miscarriage, birth defects, and premature birth, and untreated pain can lead to maternal depression, anxiety, and high blood pressure.   

Medical experts, including the American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine, and the American Academy of Pediatrics, have all reaffirmed that acetaminophen is safe when taken as needed, in moderation, and after consultation with a doctor.  In addition, leading autism organizations, including the Autism Science Foundation and Autism Speaks, agree that acetaminophen use in pregnancy has not been proven to cause autism.    

Pregnancy is not easy.  While President Trump implies that moms should just “tough it out” when they’re not feeling well, that’s not how real life works. Many of us are still trying to do it all while pregnant – working, managing households, and running after older kids. Illness doesn’t politely wait until after delivery and ignoring it isn’t always safe.  

Women need options to treat pain and fever during pregnancy.  Unlike ibuprofen, which carries known risks later in pregnancy, acetaminophen has been trusted for decades as the best over-the-counter choice for managing fever or pain while pregnant.    

If you have any concerns about taking medications during pregnancy, it’s always a good idea to talk with your doctor. You can also check out MotherToBaby.org, which has reliable, evidence-based information on medications like acetaminophen, and you can even call or chat with trained specialists to get answers to your specific questions.                                   

At the end of the day, we all want the same thing: healthy moms and healthy kids. The best way to get there is to rely on up-to-date and high-quality evidence and to have open conversations with your doctors.  

Frances Perkins Is Rolling in Her Grave: Today’s Child Labor Rollbacks Are a National Shame

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By Sally Greenberg, NCL CEO

America once swore we would never go back. Never again would children be robbed of their childhoods—or their lives—in sweatshops, factories, and slaughterhouses. That promise was won through the relentless efforts of Florence Kelley and Frances Perkins, pioneering leaders of the National Consumers League.

Kelley’s crusade began in childhood, when her father, a Pennsylvania Congressman, took her into steel and glass factories where she saw children her own age toiling under dangerous conditions. That early exposure fueled her career as a factory inspector, documenting abuses, and pushing for laws to ban factory work for children under 14.

Perkins shot into the political limelight in March 1911 in the wake of the Triangle Shirtwaist fire, which tore through a high-rise industrial building in Greenwich Village, killing 146 workers, most of them young immigrant women, some only 14 years old. The doors were locked to prevent theft. Perkins was working for the National Consumers League, and was visiting a friend nearby when the fire erupted and became an eyewitness to the disaster. She dedicated her life to ensuring children never again died—or lost their childhood—in pursuit of profit.

Years later, as Secretary of Labor (1933-1945) under President Franklin D. Roosevelt, Perkins helped structure the Fair Labor Standards Act (FLSA) of 1938, which banned most child labor and enshrined worker protections built on compassion and common sense.

Fast forward to 2025—and we’re tearing their legacies apart. Legislative efforts in Florida, Iowa, and Ohio in 2025 attempted to loosen child labor standards in opposition to the federal Fair Labor Standards Act. The media has been reporting for years about the widespread abuses in meatpacking, roofing, and manufacturing—jobs once legally off-limits to the youngest workers who are now given the “opportunity” to risk life and limb for their employers.

In Florida, lawmakers tried to gut protections for teens: bills like HB 1225 and SB 918, would allow 16- and 17-year-olds to work unlimited hours and days without meal or rest breaks—even during school—and open the door for 13-year-olds to work in summer months. The Governor’s office drafted the legislation and talking points for sponsors, revealing a coordinated effort to exploit child workers.

In 2023, Iowa openly defied the Fair Labor Standards Act, as legislators loosened limits on hazardous work, weakening work-permit requirements for 16- and 17-year-olds, in direct conflict with FLSA rules.

In Ohio, Republicans reintroduced legislation to allow 14- and 15-year-olds to work longer hours during the school year, in direct conflict with FLSA protections.

These aren’t just local outrages; they echo a national effort to rollback child labor protections. According to the Economic Policy Institute, since 2021, at least 28 states have introduced legislation to weaken child labor laws, and 17 have passed them. From 2015 to 2022, the number of minors employed in violation of child labor laws increased by 283% and the number of minors employed in violation of hazardous occupation orders increased by 94%.

Let’s be honest: this isn’t about kids receiving work experience. It’s about cheap labor replacing the immigrant labor we are losing, or so says Governor Ron DeSantis of Florida. Allowing minors to work longer hours—sometimes overnight, in dangerous jobs—diminishes their education, endangers their safety, and undermines their future earnings. It’s a race to the bottom, sanctioned by lawmakers, cheered on by corporations driving profits, and in some cases cloaked in deception as apprenticeships or workplace training at less than minimum wage.

Back on that clear Spring day in 1911, Frances Perkins watched in horror as young girls leapt from the burning Triangle Shirtwaist factory. She vowed never again—and built laws that put children’s safety above profit. But today, lawmakers are dragging us backward, gutting protections and treating children as disposable labor to feed corporate bottom lines. This Labor Day, we say no. No rollbacks. No to profiteers. No to products being produced with child labor. And, no to a United States where children are once again sacrificed for profit.

Guest Blog: What Protections Generation Z Needs from Artificial Intelligence

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By Logan Baker, Communications Summer Intern

Artificial intelligence is not on the way; it’s already here. It’s recommending your next playlist, filtering your job applications, deciding what shows up on your feed, and even answering your Google search. As AI gets smarter, faster, and more prominent in our lives, it raises the question: What is protecting my generation, Generation Z, from AI? 

Gen Z is the first to grow up with AI incorporated into our everyday lives. It is beginning to shape how we think, how we learn, and how we see the world. While AI has created exciting possibilities, it also brings serious risks we cannot afford to ignore. 

One of my biggest concerns is how AI affects our mental health. The algorithms behind our favorite apps are designed to maximize engagement, not our well-being. AI pushes content that keeps us scrolling, even if it feeds anxiety and depression. This generation needs protection from those systems and companies need limits on how they can target young users and how often. 

Privacy is another huge issue. Every time we interact with AI, we are asked to give up our personal data. That data is not forgotten; it is stored, analyzed, and used to train more algorithms. We are all guilty of opting into data collection without truly understanding what we’re agreeing to. Gen Z, like all consumers, needs clearer privacy policies as well as the ability to opt out of privacy agreements without losing complete access. Additionally, stronger laws are needed to protect sensitive information like location and facial recognition data. 

Although misinformation has been a growing threat, AI makes it easier than ever to generate fake news and content that looks real but isn’t. This is especially dangerous in a world where 54% of U.S. adults get their news from social media. Platforms (especially social media) should be required to label AI-generated content clearly so that Gen Z has the tools to spot AI-generated content. Such protections would help people feel more comfortable navigating social media and would reduce the fear of falling for harmful AI-generated content. 

It is no secret that AI has the power to do incredible good, but with great power comes great responsibility. Me and my fellow members of Gen Z should not have to sacrifice our mental health or privacy for to power the AI revolution. To continue thriving in this brave new world, protections need to be put in place to help us co-exist with AI without companies using it to take advantage of us.

Advertising sports betting with smartphone notifications: what NCL learned and how regulators can act.

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By, Eden Iscil, Senior Public Policy Manager

Following the growth of online sports betting and increased data documenting associated harms, NCL has released its first report on sports betting companies’ advertising practices. The report focuses on sports betting apps and how they use smartphone notifications to advertise to consumers. After concluding its study, NCL believes that sports betting companies’ use of push notifications for marketing purposes may violate federal law as a prohibited unfair practice. The full report is available here.

Why does this matter?

It sounds benign at first, but using push notifications to advertise an addictive product is a rather aggressive practice. Notifications on your phone will demand your attention whether you are on the street, at work, at home, or in bed. From the minute you wake up to the second you fall asleep, app notifications can be hard to dodge once they get going. Should a corporation really be able to use that channel to market its products?

Sports betting is not a typical product or service. These companies are not selling shoes or T-shirts. They are aggressively advertising their platforms for gambling, an activity that has well-documented addictive and harmful effects, from increased rates of suicide and intimate partner violence to an elevated risk of bankruptcy.

The U.S. government (rightfully) considered the advertising of cigarettes over the radio to be too extreme and banned those marketing practices decades ago. Now imagine if a tobacco company sends a text every day, multiple times a day, to encourage you to smoke their cigarettes. That is basically what sports betting apps are doing.

Findings

Over the course of four weeks, NCL collected more than 100 notifications from the three biggest sports betting apps—FanDuel, Draft Kings, and BetMGM. We found that, overall, 93% of the notifications contained advertising material. 62% contained what we refer to as “bet pushes,” or language urging the user to open the app and place a bet, often explicitly with words like “bet now.” Fifty percent of the notifications contained promotional offers (bonuses, bonus bets, and odds boosts), a practice which would be largely prohibited by the NCL-endorsed legislation in Congress known as the SAFE Bet Act. (These rates varied among the three companies.) More detailed findings on the content of the notifications can be found in the full report.

We also noted additional practices from the apps that raise concerns beyond the content of the notifications. FanDuel, which is the biggest sports betting platform by market share, automatically grants itself permission to send users notifications once it has been downloaded on an iPhone. This is especially worrying given the general expectation among users that apps will ask for consent before sending notifications. The other two apps downloaded for the study, Draft Kings and BetMGM, did ask for permission before beginning to send notifications, but did not disclose the extensive amount of advertising that would follow. None of the three apps’ native settings on iPhone allow the user to disable advertising notifications.

If a sports betting company wants to send a consumer marketing text messages, federal law requires it to receive express written consent first. If it wants to send marketing emails, it must provide a way to unsubscribe within the email. But when it sends marketing push notifications—more customizable and information-dense than an SMS, while more visible than an email—it does neither of those things, delivering marketing notifications without express written consent and without an embedded mechanism to opt out of the practice.

Considerations for regulators

Consumer protection agencies already have the legal authority to act. The Federal Trade Commission (FTC) should take a serious look at how these apps are using push notifications to advertise to consumers, many of whom are likely to have a gambling disorder. The FTC has extensive resources to tackle this issue, including its ability to prohibit unfair and deceptive acts or practices (15 USC §§ 45, 57a) and its broad authority to investigate market practices (15 USC § 46).

After concluding its study, NCL believes that the aggressive use of push notification advertising by sports betting apps’ may be an unfair practice prohibited by the FTC Act.

Substantial injury

The chance for substantial injury to consumers is a real and documented threat. Microsoft has published data showing that personalized push notifications can increase user engagement for mobile apps by up to 300%.[1] One company’s analysis of 63 million app users found that users receiving notifications at least once a day had 820% higher app retention rates compared to users receiving zero notifications.[2] Another firm’s analysis reported that push notifications boost average app sessions per user by 182%, purchases per user by 116%, and average user lifetimes by 73%.[3] That is an extremely high level of attention-capture for any product, but especially one as addictive (and potentially harmful) as sports betting.

Consider the impact of these advertising practices on a user who suffers from a gambling disorder. Research has shown:

  • 19% of individuals with a gambling disorder had considered suicide in the past year compared to 4.1% of the general population.[4]
  • 7% attempted suicide compared to 0.6% of the wider population.
  • One study found a 10% increase in intimate partner violence rates in households engaged in sports betting after their preferred team lost.[5]
  • In states that legalized online sports betting, bankruptcy filings increased by as much as 25-30% compared to pre-legalization rates.[6]

Sports betting apps are using a highly effective marketing practice to push a product that has strong links to substantial bodily and financial injury.

Not reasonably avoidable

The three sports betting apps do not clearly disclose that allowing notifications will result in the receipt of advertising notifications. FanDuel did not ask for permission before sending notifications. BetMGM did not first disclose that it would send advertisements over push notifications when requesting permission for notifications. BetMGM used the standard iPhone notification request language: “‘BetMGM Sports’ Would Like to Send You Notifications[.] Notifications may include alerts, sounds, and icon badges. These can be configured in Settings.” Draft Kings included the following language before requesting permission to send notifications: “Stay in the Know[.] Make your betting experience even better. Turn on notifications, and we’ll keep you in the know with exclusive offers like deposit matches, bonus bets, and more.” From this language, the consumer would not know that approximately 98% of the notifications they are consenting to will contain advertising, or that roughly 86% will contain bet pushes (language directly aimed at inducing betting, often with the words “bet now”). An individual cannot reasonably avoid something they are not made aware of.

If a consumer decides they want to opt out of advertising notifications, the apps do not natively make it possible to do so (at least for the versions available on iOS at the time of the study). None of the in-app settings for FanDuel, Draft Kings, or BetMGM allow users to disable advertising push notifications, despite providing controls for other advertising channels, such as email. BetMGM has a checkbox for “individual offers” delivered to the user’s “phone,” but BetMGM customer support clarified that it applies only to phone calls, not app notifications. iPhone settings allow users to disable notifications entirely for an app, but doing so would block important notifications that may otherwise be desired, like notifications of new login attempts or cash balance withdrawals.

In short, a consumer looking to avoid advertising notifications would first have to be aware of the practice (which the apps do not clearly disclose), find the settings to disable all notifications for the app, and then decide between continuing to receive the invasive marketing or potentially missing critical account security alerts. The companies do not design or implement their practices to be reasonably avoidable.

Not outweighed by countervailing benefits

The use of push notifications by sports betting apps to advertise creates a high risk of substantial injury for consumers for the sole purpose of increasing the companies’ profits. NCL is not aware of any credible research documenting a countervailing benefit from consumers experiencing regular exposure to sports betting advertising.

Opportunity for large-scale research

The FTC has investigative authority under § 6(b) of the FTC Act and access to greater resources than NCL. The agency could fully document and publish its findings on the sports betting industry’s use of push notifications for advertising purposes, providing much-needed insight into current business practices and better informing policy work at the Commission, in Congress, and in the states.

NCL’s full report on sports betting apps’ advertising notifications can be found here.

[1] “Push notifications: Help or hindrance,” Microsoft Azure, March 3, 2016. https://azure.microsoft.com/en-us/blog/mobile-push-notifications-help-or-hindrance/

[2] “How Push Notifications Impact Mobile App Retention Rates,” Airship, 2019. https://grow.urbanairship.com/rs/313-QPJ-195/images/airship-how-push-notifications-impact-mobile-app-retention-rates.pdf

[3] “Why Push Notifications Are Important to Your Cross-Channel Strategy,” Braze, June 10, 2024. https://www.braze.com/resources/articles/why-push-notifications-are-important-to-your-cross-channel-strategy

[4] Vijayakumar and Vijayakumar. “Online gambling and suicide: Gambling with lives,” Indian Journal of Psychiatry, January 13, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC9983450/

[5] Matsuzawa and Arnesen. “Sports Betting Legalization Amplifies Emotional Cues & Intimate Partner Violence,” October 30, 2024. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4938642

[6] Hollenbeck, Larsen, and Proserpio. “The Financial Consequences of Legalized Sports Gambling,” October 23, 2024. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4903302

Guest Blog: Modernizing Government or Undermining Worker Protections? A Closer Look at the Secretary of Labor’s Agenda

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By Alyssa Bredefeld, NCL Child Labor Intern

The U.S. House Committee on Education and the Workforce held a hearing on Wednesday, June 6th, where Secretary of Labor Lori Chavez-DeRemer was questioned. The hearing focused on what Committee Chairman Tim Walberg (R-Mich.) described as the “Trump administration’s plans for a smaller and more effective government for taxpayers”—a statement that reflects the administration’s “slash and burn” ideology, set in place by the Department of Government Efficiency (DOGE). This department rapidly dismantled vital policy and aid programs in the name of streamlining. Unsurprisingly, the hearing was riddled with empty promises and evasive answers that signaled a lack of commitment to stopping child labor and the exploitation of American workers. The Secretary’s responses foreshadowed diminished protections for American workers and an increase in the number of children working in unsafe conditions.

One of the most urgent concerns was the proposed budget cuts to the Department of Labor’s Wage and Hour Division, which investigates labor violations and enforces labor laws. Representative Lucy McBath (D-Ga.) highlighted the current severe staffing shortages, noting that the division went from went from 1,000 staff in 1948 to 611 by the end of the Biden administration—despite our workforce being much larger. She added that “investigators in a dozen states told The New York Times that their understaffed offices could barely respond to the number of complaints, much less open their own independent investigations.” With the Trump administration shuttering many state Wage and Hour offices and pressuring federal employees to retire or accept buy outs, that number of 611 inspectors could continue to drop quickly and significantly.

Chavez-DeRemer’s response to questioning did little to alleviate concerns. “If you say that more money will always solve the problem, I would probably have to disagree,” stated Chavez-DeRemer, returning to the message of “modernizing and streamlining” the government promoted by DOGE. Chavez-DeRemer refused to answer whether the number of investigations into child labor would decrease, stating only, “I will do everything in my effort to protect against child labor.”

While her promise to protect against child labor may sound reassuring, it means little without policy and action. As Rep. Ilhan Omar (D-Minn.) put it, “the math isn’t mathing.” Without adequate staffing, investigations can’t proceed, allowing wage theft, misclassification, and dangerous conditions to continue unchecked. According to UNICEF, the United States saw an 88% increase in child labor violations between 2018 and 2023. Addressing these numbers before they worsen is critical to protecting the future of the American workforce. The Secretary of Labor’s inability to answer basic questions about investigative staffing signals an unwillingness to put children first and ensure protection for the most vulnerable. This hearing made it abundantly clear that Chavez-DeRemer’s loyalty lies with the Trump administration, not with American workers or children.

Click to access UNICEF_USA_ChildLaborReport.pdf

Alyssa Bredefeld is a senior at the University of Connecticut studying Human Rights and Allied Health Sciences.

Want Lower Drug Prices? Transparency is The Answer. 

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By Sally Greenberg, NCL CEO 

Pharmacy benefit managers (PBMs) have become the uniquely American actors of behind-the-scenes drama in the healthcare system. They are the classic middleman in that they wield enormous power and get between patients and their prescribed medications. They control how much we pay for the medications and decide whether we can get access to the treatments our doctors prescribe.   

Through vertical integration, PBMs have become so intertwined with other players in the healthcare system, including health insurers, chain and mail order pharmacies, group purchasing organizations, and provider groups, it has been difficult for regulators and lawmakers to untangle their oversized – and frankly, anti-consumer – role in the healthcare infrastructure. 

This has been verified by outside researchers and investigations time and time again – a bipartisan Senate Finance report noted that PBMs – not drug makers – were driving up the cost of insulin with their demands for higher and higher rebates on an old and very effective drug for diabetes.  

And recently, the Federal Trade Commission (FTC) reported that the top three PBMs reaped $7.3 billion in profits from marking up drug prices—a clear indication that these middlemen are not negotiating lower prices for consumers but profiting handsomely at their expense. 

As Congress enters the final stretch of negotiating the budget reconciliation bill, we urge our elected officials to include meaningful and broadly supported reforms to pharmacy benefit managers (PBMs).

While PBM reform provisions were included in the House version of the bill, we are disappointed that the Senate version lacks these critical measures. We strongly urge our Senators to incorporate these reforms, which have bipartisan backing in Congress, the support of the White House, and widespread approval from the American public.

The National Consumers League has expressed concern about health policy decisions made in the early months of the Trump administration, including dismantling critical public health programs and undermining public confidence in vaccines. There’s an additional issue, and that is the president’s executive order on prescription drug prices

But in calling for prescription drug prices in the U.S. to be tied to the lowest price charged in other countries, Trump said intriguingly, “We’re going to cut out the middleman and facilitate the direct sale of drugs at the most favored national price directly to the American citizen.” Tying prices to those of other nations is an entirely separate issue that requires additional scrutiny, but questioning the role of the PBMs as middlemen in driving up prices with little value added for consumers is long overdue. 

It’s also not unprecedented in today’s marketplace. Three years ago, entrepreneur Mark Cuban started Cost Plus Drugs, bypassing the PBM middlemen and negotiating directly with manufacturers for low list prices. It has been a model of transparency, in which consumers know they are paying the list price plus a 15% markup and a $5 pharmacy fee. By and large, consumers are getting their medicines much more cheaply than through the conventional process. 

And we’ve seen large drug manufacturers launch their own direct-to-consumer platforms to help Americans directly and more affordably get certain medicines and gain access to other healthcare services. 

This is the kind of “market disruption” that can be beneficial to patients. An immediate advantage is price transparency. In today’s conventional drug prescribing system, few patients can understand what the costs are and who is making money. We have a byzantine system of rebates and discounts that gives PBMs excessive revenue, hiding behind their opaque rebate and other practices, while patients pay higher out-of-pocket costs, and only the PBMs themselves understand how it works – and they like it that way.   

In an ideal world, PBMs would return to their original mission – using their buying power to negotiate lower prices for consumers and self-insured employers. The problem is that the three large PBMs that control over 80% of the drug prescribing market have no motivation to compete for lower prices or offer them to consumers. 

We support alternatives to PBMs – programs like Cost Plus Drugs that deliver pharmaceuticals to consumers directly and do so affordably and transparently. That might be the best medicine for the problem of middlemen reaping billions of dollars of value from the healthcare system without much gain to anyone but themselves. Call it a new way of looking at PBM reform, which Congress has been pushing for many years. Patients and consumers want transparency, so what is Congress waiting for?