Guest Blog: Sweet Treats, Bitter Reality: The Human Cost of Cocoa

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By Emily McKay, NCL Spring Communications Intern

For many, April brings the joy of Easter with children awakening to an Easter Basket filled with treats or searching in the grass for eggs and chocolate. But while children here delight in eating a chocolate bunny, 1.56 million children are working in West African cocoa fields, harvesting the very cocoa that makes our Easter candy possible. [^1]  How does a consumer know if the chocolate they are eating involves child labor?    

Thankfully, organizations like Be Slavery Free, an Australian coalition campaigning against modern slavery are making it easier for consumers to hold chocolate companies accountable. By ranking brands based on their child labor policies and transparency, the 6th annual chocolate scorecard has helped bring meaningful change.  

Cocoa, one of West Africa’s major exports, is predominantly grown in Côte d’Ivoire and Ghana, which together produce 50% of the world’s cocoa supply.[^2] The region’s cocoa industry began booming in the late 19th century when Ghanaian farmers discovered they could earn ten times more from cocoa than from palm oil. By 1886, British colonial authorities began promoting cocoa cultivation through training programs and seed distribution. By 1936, Ghana’s annual cocoa output had reached 311,000 tons.    

Around the same time, in Côte d’Ivoire, the Kru people—an indigenous ethnic group—began cultivating cocoa as well. [^3] In 1946, French colonial authorities recognized cocoa’s potential and expanded its cultivation across the country. By 1960, Côte d’Ivoire had gained independence, and the chocolate industry was flourishing. In 1977, Côte d’Ivoire surpassed Ghana to become the world’s leading cocoa producer.[^3]   

Sadly, exploitative labor practices have long plagued the chocolate industry. Today, the global chocolate market is worth over $100 billion, yet many cocoa farmers live on less than a dollar a day. [^4] Child labor is widespread, and many children involved in cocoa farming are subjected to exploitation and, in some cases, modern slavery.    

In recent years, the U.S. government has withdrawn funding for programs aimed at fighting child labor and slavery worldwide—including within the cocoa industry. As government efforts wane, the responsibility falls to consumers to become informed and take action against child exploitation.   

Today, 82% of chocolate companies publicly disclose data on child labor—up from just 45% a few years ago. This progress is encouraging, but disclosure alone is not enough. Consumers must continue pushing for real change. Twenty-five years ago, chocolate companies pledged to eliminate child labor. Yet the practice remains entrenched. In a time when regulatory action is lacking, it is up to us—as informed, ethical consumers—to make responsible choices and demand accountability from the companies behind our favorite treats.   

[1] https://www.dol.gov/agencies/ilab/our-work/child-forced-labor-trafficking/child-labor-cocoa   

[2] https://www.kakaoplattform.ch/about-cocoa/cocoa-facts-and-figures#:~:text=In%20the%20last%20cocoa%20season,is%20the%20largest%20producer%20country.   

[3] https://www.antislavery.org/wp-content/uploads/2017/01/1_cocoa_report_2004.pdf   

[4] https://fairworldproject.org/wp-content/uploads/2020/10/GA-NORC-report-press-release-Child-Labor-and-Farmer-Poverty.pdf  

Don’t throw auto safety in reverse

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By Daniel Greene, Senior Director of Consumer Protection & Product Safety Policy

If traffic safety were a war, we’d be losing.   

Our nation suffers approximately 40,000 deaths and 2.6 million injuries to traffic crashes each year.   

That’s enough fatalities to fill the average Major League Baseball stadium.  Enough injuries to affect nearly every resident of the state of Alabama. 

Traffic crashes cost society nearly a trillion dollars in medical bills, emergency services, lost productivity, insurance costs, workplace loss, legal costs, and property damage.  That’s enough money to buy more than 26 million mid-size SUVs; ten million more than the total number of cars sold in 2024.   

No Congressional district has been spared.  No community is immune.   

Yet, the death and destruction on our nation’s roads does not have to be the price we pay for commuting to work, dropping the kids off at school, or picking up groceries.  By harnessing revolutionary safety technologies, educating the motoring public, and improving the design, construction and performance of motor vehicles, we can dramatically improve roadway safety.   

Fortunately, there is a federal agency responsible for carrying out such activities.  The National Highway Traffic Safety Administration (NHTSA) is our nation’s principal automobile safety regulator, charged with reducing death and injuries associated with traffic accidents.  NHTSA carries out its lifesaving mission by establishing safety standards, investigating defects, enforcing recalls, and providing states resources for driver education, risky driving countermeasures, and roadside safety. 

NHTSA has delivered.  Safety features that were once rare and unique are now common and conventional: seatbelts, airbags, and crumple zones, to name a few.  Many of these features were adopted to comply with increasingly ambitious safety standards. The result: fewer fatalities and injuries on our nation’s roads. 

From 1968 through 2019, NHTSA’s safety standards prevented over 860,000 deaths, 49 million injuries, and damage to 65 million vehicles, generating over $17.3 trillion in societal benefits.  In 2019 alone, standards prevented 40,000 deaths, 1.9 million injuries, and damage to 3.8 million vehicles.  

NHTSA has also successfully taken unsafe vehicles off our nation’s roadways.  Since 1968, NHTSA has participated in the recall of more than 390 million vehicles, 66 million pieces of motor vehicle equipment, 46 million tires, and 42 million car seats due to safety defects.   

NHTSA has compelled manufacturers to replace tens of millions of volatile and explosive airbags, millions of defective tires prone to tread separation, and millions of sticky car seat buckles that entrap children.  The agency has facilitated the remedy of millions of vehicles with incidents of unintended acceleration, millions of faulty ignition switches that deactivate the engine and airbags while a vehicle is in motion, and “self-driving” technology that cannot safely perform the driving task. 

NTHSA is on the cusp of ushering in new transformational safety technologies that may exceed the lifesaving effects of seatbelts and airbags.  The Bipartisan Infrastructure Law mandates that NHTSA support the deployment of several sophisticated safety technologies:   

  • Drunk and impaired driving prevention technology: Over 13,000 people were killed in drunk driving crashes in 2022.    
  • Crash avoidance technology: Forward collision warning and automatic emergency brakes have been shown to reduce injuries associated with front-to-rear crashes by 56 percent.  Lane departure warnings could reduce single-vehicle, sideswipe, and head-on crashes causing injury by 21 percent.  Blind-spot detection has been shown to reduce lane-change crashes that result in injuries by 23 percent.   
  • Driver monitoring systems: Distracted driving claimed an estimated 12,405 lives in 2021.  Drowsy driving caused 664 deaths that same year.   

Many of these requirements are actively being implemented but are not yet finalized.   

With NHTSA on the beat, safety is a priority and not an afterthought.  It must be built into the design, construction, and performance of each vehicle.  It must be engrained in every bolt, sensor, and line of code of a vehicle.   

But this vital safety agency is under unprecedented assault.  Championed by Elon Musk and the Department of Government Efficiency, the Trump Administration has launched a shock and awe campaign, taking a chainsaw to the key pillars of a well-functioning government.  The indiscriminate firing of civil servants, unlawful impoundment of congressionally directed spending, and work stoppages have had deeply destabilizing effects across the federal government.  The chaos has wreaked havoc on NHTSA’s ability to carry out its most basic functions.    

Approximately 1 in 20 NHTSA employees were fired in the February purge of probationary workers.  That included researchers studying impaired driving and traffic safety measures.  Several members of the Office of Defect Investigations, which is responsible for investigating defects and mandating recalls, have been dismissed.  The Office has been increasingly scrutinizing Tesla, which Elon Musk owns.  Employees within the Department of Transportation cannot access their former colleagues’ files, making it virtually impossible to continue their work.  

Through an Executive Order, the Trump Administration has directed federal agencies to “identify at least 10 existing rules, regulations, or guidance documents to be repealed” for every new rule, regulation, or guidance that is promulgated.  As of December, NHTSA had yet to finalize 19 rulemakings mandated by Congress, all through bipartisan legislation.  In the Fall Unified Regulatory Agenda, NHTSA identified 56 ongoing rulemaking proceedings, some of which had been completed prior to Trump taking office.  It may not even be possible for NHTSA to identify the hundreds of existing rules, regulations, and guidance documents necessary to finalize Congressionally directed and ongoing rulemakings while complying with the 10-to-1 rule. 

If the past is a prologue, vital automobile safety activities may fall by the wayside.  During the Biden Administration, NHTSA finalized 29 rules creating or modernizing safety standards.  The first Trump Administration finalized only nine such rules.  The Biden Administration conducted 224 investigations of potential safety defects.  The first Trump Administration initiated only 103.   

Worse yet, deeper cuts may be forthcoming.  Every federal agency was required to produce an Agency Reduction in Force and Reorganization Plan by March 13, 2025.  Such plans must seek to achieve significant staff reductions, reduced budgets, and reduced real property footprint. 

Some are calling on NHTSA’s budget to be slashed by 60 percent and the workforce reduced by 30 percent, returning the agency to 1990s-era levels.  Such plans include cutting state safety grants by 75 percent, slashing crash test facilities and testing by 75 percent, and ending vital safety initiatives like the adoption of the first female crash test dummy.  Most Americans do not want to trade in their current vehicle for a 1990s model.  We shouldn’t revert to a 1990s-era auto safety regulatory agency.   

The death and destruction on our nation’s roads is not an inevitability, but a choice. A choice to not treat traffic safety like the public health emergency it so clearly is. A choice to remain complacent.  A choice to accept the status quo.   

I contend that America should make a different choice: no more victims.  Let’s chart a course towards vision zero, in which there are no traffic fatalities or serious injuries.  And let’s ensure we equip NHTSA with the resources, staff, and authorities necessary to make that vision a reality.   

“America first” shouldn’t put product safety last

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By Daniel Greene, Senior Director of Consumer Protection & Product Safety Policy

Who wants “shock and awe” when plugging in an electronic device?  What parent wants a “chainsaw” to be taken to the institutions validating that toys are safe?  What senior wants to “dismantle” the safety net helping prevent falls and common injuries to the older Americans? 

The Trump Administration’s unprecedented assault on our bedrock federal institutions may undermine a key line of defense against dangerous products and household hazards: the Consumer Protection Safety Commission (CPSC).   

 The CPSC protects the public against unreasonable risks of injury or death from consumer products through education, safety standards, regulation, and enforcement. The agency is charged with regulating 15,000 types of consumer products.

During the Biden Administration, the CPSC finalized over fifty rules and standards, including banning crib bumpers and establishing standards for adult portable bed rails, mattress flammability, and infant sleep products.  In Fiscal Year 2024, the Commission actively facilitated the establishment of 26 voluntary safety standards and negotiated and implemented 333 recalls involving 41 million products. The CPSC submitted over 56,000 takedown requests to e-commerce platforms and sellers, resulting in more than 58,000 banned or previously recalled products being removed from such sites.  The agency conducted approximately 1,000 inspections, surveillance efforts, and recall effectiveness checks to ensure compliance with product safety law.   

In recent weeks, the Trump Administration has begun to execute an ambitious plan to reduce the size of government.  It’s curbed the authority of independent federal agencies like the CPSC, imposed spending freezes, and fired civil servants. Every federal agency is required to produce an Agency Reduction in Force and Reorganization Plan by March 13. Such plans must seek to achieve significant staff reductions, reduced budgets, and reduced real property footprint.

Efforts to dramatically reduce the CPSC’s resources, staff, and facilities could substantially diminish the Commission’s ability to carry out its mission: product safety.    

Product safety should be standard.  The norm, not the exception. Not a choice, but an expectation. 

After all, these are products we rely on – products we are in constant contact with, such as appliances, toys, furniture, electronics, clothing, and power tools. They’re in our living rooms, bedrooms, kitchens, and sheds.  They’re what we wear and where we sleep.  They’re used to cook and clean. They’re what our children play with.    

Safety cannot be assumed, however.  It must be established and maintained.  For in the product safety space, there is a dangerous safety paradox which may compel producers to put profits over people. 

Competitive pressures encourage producers to drive down prices by cutting corners and ignoring readily available safety features. After all, consumers are price sensitive. Twenty-five cents can make the difference between executing a sale and losing business to your competitor.   

Further, consumers assume that every product for sale is safe. They cannot readily identify risks associated with a particular product.  Consumers are completely at the mercy of representations made by the producers.  Consider this example.  Can we really expect the everyday furniture shopper to tell whether a dresser complies with tip-over standards?  Of course not.  Between 2013 and 2023, 217 deaths were attributed to furniture tip overs. Yet, it is nearly impossible to distinguish safe from unsafe furniture.  

In such an environment, safety can take a back seat to savings.   

Many manufacturers of table saws refuse to equip their devices with safety features that prevent or mitigate the severity of contact injuries. These manufacturers save a few hundred bucks per saw.  But nearly 50,000 consumers must seek medical treatment for table saw injuries each year, costing society $1.28 billion to $2.32 billion annually.  There are approximately 10 amputations a day that could be totally prevented with safe saw technology.   

Over one million crib bumpers were sold each year despite being attributed to 83 fatalities and 60 injuries. Manufacturers generated hundreds of thousands of dollars in revenue from selling these products.  

Many manufacturers failed to meet voluntary safety standards for adult portable bed rails, resulting in 310 fatalities between 2003 and 2021. They saved $5.40 per unit.  

It’s a perilous race to the bottom that poses a clear and present danger to the American people.   

Approximately 49,000 product-related deaths and 34 million product-related injuries occur each year. These are not just statistics. These are lives cut short.  Livelihoods ruined.  Maimed breadwinners.  Injured children.   

Falls, fires, poisoning, and suffocation remain persistently high, accounting for four out of five deaths. Everyday product categories – such as stairs, ramps, beds, pillows, chairs, exercise equipment, bathtubs, and bicycles – are frequently involved. The young and the elderly are particularly vulnerable.

Consumer product incidents account for $1 trillion in costs to society each year, for medical bills, emergency services, lost productivity, insurance, workplace loss, legal costs, and property damage.  

And, of course, there are some costs that simply cannot be captured in dollars and cents. Clearly, the cost of care and loss of income of an injured breadwinner is measurable in dollars, but we cannot measure the psychological loss of their role as a provider.  

Prudent government intervention is necessary to address the unacceptable risk posed by harmful consumer products. The CPSC provides that prudent government intervention.   

This small agency with a large mission has delivered.  CPSC standards and enforcement activities have helped spur a 43 percent decline in residential fires, a 47 percent decrease in fire deaths, and a 41 percent reduction in fire injuries. Child poisonings have decreased by 80 percent.  Bicycle injuries dropped by 35 percent. Deaths from refrigerator door entrapments and garage door incidents have been virtually eliminated. Crib deaths have plummeted by 80 percent. Injuries associated with baby walkers have been slashed by 88 percent. Pool and pool equipment injury rates have decreased by 55 percent.

The results are clear.  The CPSC saves lives.  It protects the health and safety of the American people and creates clear rules of the road for manufacturers, retailers, and distributors.  It ensures that safety is engrained in the design and manufacturing of each product.  It gives industry a safe space to pursue their profit motive while fulfilling their obligation to protect customers. And through product recalls and enforcement it establishes a level playing field that ends the race to the bottom.  Thus, we must preserve the CPSC and ensure the agency has the appropriate tools, resources, and personnel to carry out its lifesaving mission.   

Guest Blog: Trump’s Executive Orders Could Jeopardize Immigrants’ Health Coverage

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By Mekdes Agezew, NCL Health Policy Spring Intern

As President Donald Trump begins his second term in office, he has signed a series of executive orders (EOs) aimed at reversing policies implemented by the Biden administration. In his first week alone, Trump revoked 78 of Biden’s executive orders and actions, impacting areas such as immigration, climate change, oil exploration, gender equality, federal diversity programs, and health care coverage.

<strong>Trump’s Immigration Policies and Their Impact on Health Care Access</strong>

One of President Trump’s executive orders expanded the power of Immigration and Customs Enforcement (ICE), to increase arrests and deportations of undocumented immigrants. As of February 3rd, DHS reports 5,693 deportations via X. and on February 6th the White House confirmed that 461 individuals arrested by ICE were released. Included in this is the removal of Colombian nationals via military planes on January 26, 2025. Colombian President Gustavo Petro initially resisted but ultimately conceded after threats of economic tariffs, and sent an aircraft of their own to pick up around 200 individuals being deported.

Although these deportation efforts primarily target undocumented immigrants, their effects extend to broader immigrant communities, including millions of U.S.-born children in mixed-status families. During Trump’s first term, restrictive immigration policies and increased enforcement created widespread fear, discouraging immigrant families from enrolling in healthcare programs such as Medicaid. The expanded “public charge” rule, later reversed, exacerbated these concerns by making immigrants fear that using public benefits could jeopardize their residency or citizenship applications. As of 2023, nearly three-quarters of immigrant adults, including nine in ten who are likely undocumented, reported uncertainty about using non-cash assistance due to fears of jeopardizing their immigration status.

During Trump’s first administration, which also increased immigration enforcement, KFF found that there was a decrease in health care use and participation in Medicaid and CHIP because of immigration-related fears. Now, with the Administration’s doubling down on a more forceful immigration agenda, fears are intensifying. His rollback of policies expanding Medicaid and ACA coverage, combined with rising enforcement actions, is expected to increase the number of uninsured immigrants and reduce participation in vital healthcare assistance programs.

<strong>Proposed Medicaid Funding Cuts and their Impact</strong>

Medicaid provides high-quality, affordable health care to Americans, including children, pregnant women, veterans, seniors, and low-income individuals. It covers essential services such as primary care, hospital stays, prescription drugs, and preventive care. While undocumented immigrants are ineligible for any federally funded coverage, lawfully present immigrants are often eligible, with a five-year waiting period. However, some states have expanded coverage by eliminating the waiting period.

Currently, the Trump administration is exploring ways to reduce federal spending and cut taxes, including cuts to Medicaid’s budget. On January 28, 2025, the White House issued a memo freezing federal loans and grants to review whether federally funded programs align with the Trump administration’s goals. This caused widespread confusion about Medicaid’s future, which was only exacerbated by reports from states that they were unable to access the systems used to draw down federal health dollars. Later, officials clarified that Medicaid—since it provides direct payments—was not included in the freeze. However, the program remains a target for Republican officials. House Republicans released a draft budget resolution on February 13 as part of their budget reconciliation strategy. With Medicaid being the largest program

overseen by the Energy and Commerce Committee; it is the primary plausible source for the minimum $880 billion cuts the Committee needs to find. Additionally, a bill was introduced within both chambers that would prohibit states from using Medicaid funding to provide healthcare benefits for illegal immigrants. If federal Medicaid funding is cut, states will be forced to either cover the costs themselves or scale back the program. States that choose to continue Medicaid may tighten eligibility requirements, reduce benefits, or limit enrollment, making healthcare access even more challenging for low-income and immigrant families. For instance, Idaho state Rep. Lori McCann states that if the state repeals its Medicaid expansion, more than 89,000 Idahoans could lose their coverage. Ultimately, this could increase the number of uninsured individuals and aggravate health disparities.

<strong>The Potential Impact of RFK Jr.’s Health Policies</strong>

On February 13, 2025, the Senate confirmed Robert F. Kennedy Jr. as Secretary of Human Health Services (HHS). As an anti-vaccine zealot, Sec. Kennedy. continues to voice his opposition to childhood vaccine mandates and question the safety of all vaccines. Secretary Kennedy also staunchly opposes pharmaceutical companies and their influence. As Secretary, RFK Jr can influence Medicaid’s vaccine coverage policies, potentially limiting access to childhood immunizations and other preventative vaccines for millions of low-income and immigrant families.

We are already seeing the consequences of declining vaccination rates. For example, Texas is experiencing an outbreak of measles amongst youth, totaling 58 cases at the time of writing, with 13 people hospitalized. Measles spreads easily and quickly in unvaccinated children and adults. This outbreak is the worst seen in the US in 30 years. The US is also facing the worst flu season in 15 years with nearly 400,000 hospitalizations and 16,000 deaths from the flu as of February 8. Further restrictions to vaccine access would pose serious public health risks,

particularly for children who rely on Medicaid for immunizations against diseases such as measles and polio.

The Impact of Halting Lower Drug Prices and Expanded Health Coverage Former President Biden prioritized lowering prescription drug costs and expanding health coverage under ACA and Medicaid, which NCL supports. In January 2021, Biden’s Executive Order 14009 strengthened these programs, extending enrollment periods and allowing more individuals and families to access health care. And in October 2022, Biden further issued Executive Order 14087 to reduce prescription drug prices, addressing the skyrocketing costs that burden low-income families. Over a quarter of adults have difficulty affording their prescription medications, and over half of adults worry about being able to afford them. When looking at race/ethnicity, 61% of Black adults and nearly 70% of Hispanic adults report worrying about their ability to afford their medications. By revoking these initiatives, the Trump Administration puts the health of low-income and vulnerable immigrant families and the communities they reside in, at greater risk.

While Mr. Trump has yet to announce a comprehensive health care plan, his actions suggest a shift away from affordability and accessibility, leaving whole communities across the US at risk, and it won’t be only immigrant communities, though they suffer more than most.

<strong>Conclusion</strong>

By rescinding executive orders that expanded Medicaid, ACA coverage, and lowered drug prices, Trump is engaging in a reckless experiment that runs the risk of spreading illness and disease; in doing so, he and his HHS Secretary put all Americans at risk. While the consequences of this experiment will be felt by all, immigrant families and communities are expected to be hit even harder.

Nancy Glick

Preventing Foodborne Illness Is Worth the Investment

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Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

“We’re not going back” is a rallying cry not usually associated with food safety policy. But if the Trump Administration heeds the call from the trade association for the processed meat industry to withdraw a needed proposed food safety rule, Americans will indeed go back to facing preventable foodborne illness outbreaks. 

The rule in question – to allow USDA’s Food Safety and Inspection Service (FSIS) to establish standards that will keep Salmonella contaminated chicken carcasses and poultry parts from entering the market – comes at a time when Salmonella infections are on the rise in the U.S.  According to data from the Centers for Disease Control and Prevention (CDC), Salmonella bacteria cause over 1 million human infections in the United States each year, putting more Americans at risk for serious illness, including fever, bloody diarrhea, and sometimes life-threatening complications. Moreover, CDC estimates that foodborne Salmonella causes 29 illnesses for each case that is detected – meaning significantly more people are getting sick than records show.  

The National Consumers League (NCL), as part of the Safe Food Coalition, praised FSIS for issuing the proposed rule in January 2025, as did many public health and medical societies. Why? One reason is because chicken is a major source of illness from Salmonella, causing an estimated 195,634 illnesses each year at a cost of $2.8 billion annually, according to Consumer Reports. In fact, CDC estimates that about one in every 25 packages of chicken at the grocery story are contaminated with Salmonella.  

The other reason is the good news. Today, advances in technology make it possible for inspectors to rapidly detect and mitigate Salmonella and other foodborne pathogens throughout the poultry supply chain. Thus, the FSIS rule is predicated on new technologies for early detection of foodborne bacteria.  

But, the Meat Institute, speaking for the $227.9 billion meat and poultry processing industry, has asked the Trump Administration to withdraw the rule as a way to reduce “burdensome” regulations. The group says the new FSIS rule, which was three years in the making, will “add cost to the production and supply of food, exacerbating food price inflation to the detriment of consumers.”  

However, NCL actually speaks for consumers, and we challenge this position. Polls show that Americans favor stronger food safety oversight. In a 2022 survey, 74 percent said it would be worth a 1 to 3 percent increase in the cost of food to pay for added safety measures.  

Moreover, Americans recognize that foodborne illness has widespread consequences, both in terms of people’s lives and costs to society. Starting with the human toll, CDC estimates that 48 million people get sick, 128,000 are hospitalized and 3,000 people die each year from foodborne diseases. In terms of the cost to the economy, a study by researchers from USDA’s Economic Research Service puts the cost to the economy at $75 billion (in 2023 dollars) annually, which includes medical care, lost productivity, and premature deaths, including those associated with secondary chronic illnesses.   

For all these reasons, Americans are not willing to give up food safety protections for the possibility of saving a few pennies when buying poultry products. Instead, consumers – along with public health officials and infectious disease specialists – are calling on the Trump Administration to finalize enforceable safety standards for poultry products as part of the new “Make America Healthy Again” initiative because the FSIS rule will result in safer food and fewer illnesses.  

The DEIA dilemma: What would Abraham Lincoln say

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By Sally Greenberg, NCL CEO

One of the dates seared into my memory from a young age is February 12 —President Abraham Lincoln’s birthday. We’ve had some truly heroic presidents, but it’s hard to compare any to the towering figure of Abraham Lincoln.

One of my favorite Lincoln quotes is this: “I am a firm believer in the people. If given the truth, they can be depended on to meet any national crisis. The great point is to bring them the real facts.”

As we enter the age of the second Donald Trump presidency, I’m reminded of Lincoln’s wisdom, wit, and kindness—qualities sorely lacking in the current occupant of the Oval Office. And unlike Lincoln, the truth too often eludes Mr. Trump.

This brings me to what the Trump administration is currently doing to try to erase diversity in America. They are waging war on DEIA (Diversity, Equity, Inclusion, and Accessibility), forcing federal agencies to wipe any reference of DEIA from their websites. In the process, they insult and demean millions of Americans and undermine the remarkable diversity that defines our beautiful democracy.

During his famous Gettysburg Address, Lincoln called upon Americans to “bind up the nation’s wounds.”  The Trump administration could have heeded that advice and worked to represent all people after the very polarizing election Instead, their attacks on diversity deepen our divides.

Misconceptions about DEIA abound. DEIA initiatives—like implementing accessibility measures for people with disabilities, addressing gender pay inequity, and diversifying recruitment outreach—exist to correct discriminatory organizational practices. As Erica Foldy, a professor at NYU’s Wagner Graduate School of Public Service, explains, DEIA efforts don’t discriminate; they put employers “on the path of creating more merit-based companies, more merit-based firms,” aiming to ensure that qualified people of all backgrounds have an “equal chance of being hired; you’re going to be paid the same as employees at comparable levels.”

Research from management consulting firm McKinsey & Company found that companies with more diversity financially and socially outperform those that are less diverse.

“The most successful companies understand that DEI isn’t just a ‘”nice-to-have,'” said Christie Smith, the former vice president for inclusion and diversity at Apple. “It’s a driver of innovation, talent attraction, and competitive advantage.”

I was among the many in my generation who marched on Washington for civil rights, women’s rights, reproductive rights, and LGBTQ+ rights. We wrote letters, met with members of Congress, and donated to causes that helped make America great—by making it more inclusive.

The fight didn’t start here. Long before I became head of this organization, the women who founded NCL were championing the rights of children, women, minorities, and immigrants. Florence Kelley, NCL’s first general secretary, was a founding member and signed the original charter forming the NAACP in 1909. She refused to stay in hotels that barred Black guests and was an outspoken advocate for federal anti-lynching laws—a law that wasn’t passed until 2022!  Her protégé, Frances Perkins, went on to serve as Secretary of Labor under FDR and, in one of her first acts, desegregated the cafeteria at the Department of Labor.

So championing DEIA – even if they didn’t call it that – has always been in NCL’s DNA. And so many Americans before us waged brave and bruising battles to secure these rights.  Rosa Parks refused to give up her seat to a white person on a segregated bus, and her protest sparked the Montgomery bus boycott, paving the way for the 1964 Civil Rights Act, signed by President Lyndon Johnson, which prohibited discrimination on the basis of race, religion, and national origin.

Japanese Americans, many of them U.S. citizens who were born in the U.S., were unjustly imprisoned after Japan attacked Pearl Harbor in 1941. They finally received reparations 47 years later through an act of Congress.

Jewish Americans formed the Anti-Defamation League in 1913 after Leo Frank, a Jew, was falsely accused of murder and lynched by a mob in Georgia.

Throughout the 20th century, gay and lesbian Americans were routinely harassed, arrested, fired from jobs, and discharged from the service until they’d had enough and fought back against yet another police raid. The Stonewall Riot in 1969 at a gay bar in New York City changed history – and many marches later and the formation of gay rights groups like the Human Rights Campaign secured myriad reforms and protections for the LGBTQ+ community.

President George H.W. Bush signed the Americans with Disabilities Act (ADA) in 1990, ensuring basic accessibility measures we take for granted today. So, when you see curb cuts and wheelchair-accessible restrooms, we can thank President Bush and the movement behind the ADA.

I began my career with the Anti-Defamation League in the 1980s, lobbying for hate crimes legislation when it was a novel concept.  At first it was a hard sell, but today, every state has hate crime laws. If you paint a swastika on a synagogue or burn a cross on a lawn, that’s not just vandalism—it’s a hate crime because we recognize that targeted violence against certain groups (all DEIA Americans) is an attack on our democracy.  And. I’m pretty sure we aren’t repealing those hate crime laws!

I am saddened that so many Americans have fought and gained hard-won rights and protections that are now under attack. Memo to Trump and his allies: America’s embrace of difference and diversity makes us a beacon to the rest of the world.

Finally, Lincoln once said, “The philosophy of the schoolroom in one generation will be the philosophy of government in the next.”  So, though the Trump administration may try to erase our land of difference and diversity, good luck with that.

The far-right thinks they have a right to control what we say, think, read, and do, but Americans don’t take kindly to being told what to do.

Most of us have grown up in a country that is far more diverse and embracing of differences than the generations before us. Diversity, alas, is our superpower and our future. You can try to erase it or ban it, but the genie is out of the bottle—and no executive order or website purge will put it back in. One way or the other, it is here to stay.

And hallelujah for that.

Congress should reject proposals to make school more expensive

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By Eden Iscil, Senior Public Policy Manager

A list of policy proposals currently under consideration by Republican majorities in Congress has become public. The 50-page document covers a range of programs and issue areas, looking for ways to pay for the new government’s “big, beautiful” swath of initiatives. Unfortunately, there are a bunch of policies thrown in that would make things worse for consumers. These three bad ideas related to education caught my eye. 

Taxing college scholarships. If you or your kid win a scholarship to help pay for college, the new Congress might want a piece of it. Under the proposal, they would take $5.4 billion each year from scholarship winners. This is especially harmful given a significant portion of scholarships are awarded to students who demonstrate financial need.

Making it harder for low-income children to eat breakfast or lunch at school. A plan to eliminate $900 million yearly in school breakfasts and lunches hinges on requiring children to “submit income verification documentation.” Time and time again, we have found that adding more bureaucracy to government programs reduces the number of people who enroll, even when they are eligible to benefit from the program. In this case, that means kids going hungry, which unsurprisingly is associated with worse academic performance. 

Forcing students to pay their loans while still in school. The answer to the $1.7 trillion student debt problem is not to force students to pay their loans “while actively studying.” Costs for college students are already sky-high; Congress doesn’t need to make them higher. 

Why are these ideas even on the table? Apparently, to give $522 billion to corporations by lowering the corporate tax rate. And, to cover the defunding of tax enforcement for the wealthy, a proposal the leaked memo estimates will allow high-earners and corporations to evade a total of $47 billion in taxes. 

Call your member of Congress and let them know they shouldn’t make students worse off just to pay for more corporate tax cuts.  

References (page number indicates page of Republicans’ memo where the proposal is located): 

Page 11, “Eliminate Exclusion of Scholarship and Fellowship Income” 

Page 34, “Require Income Verification for School Breakfast Program (SBP) and National School Lunch Program (NSLP)” 

Page 30, “End in-school interest subsidy” 

Pages 14 and 15, “Lower the Corporate Rate to 15 Percent” and “Repeal IRA’s IRS Enforcement Funding” 

Nancy Glick

A New CMS Rule Could Be a Gamechanger for Adults with Obesity

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Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

If the story of combatting the nation’s obesity epidemic were a movie, it would be Groundhog Day.

Year in and year out, for over a decade, advocates and obesity specialists worked to get changes in federal policy. They pressed to get bills passed in Congress, drafted white papers, published research findings in medical journals, held roundtables and briefings, and sent letters and emails to policymakers over and over. But, using the Groundhog Day metaphor, the same day would start again.

Until now. Just as the protagonist in Groundhog Day changed his way of thinking and got the girl, the Centers for Medicare & Medicaid Services (CMS) changed its thinking to recognize obesity as a distinct and serious chronic disease requiring treatment. Based on this reinterpretation, CMS published a potentially game-changing proposed rule to establish the treatment of obesity as a medically necessary service under Medicare and Medicaid and allow Part D coverage of FDA-approved anti-obesity medications (AOMs), including new injectable drugs called GLP-1s (glucagon-like peptide-1 receptor agonists), as a result.

However, better obesity care is not a movie, and the proposed rule, while a major development, is not a final action. Before Medicare and Medicaid beneficiaries can get treated with new anti-obesity medicines, the agency must go through a formal rulemaking process to finalize the proposed rule, including receiving and analyzing comments from individuals and organizations concerned about obesity. This process is now underway, and the obesity community is coming out in force to urge CMS to update its Medicare and Medicaid coverage policy for AOMs based on medical evidence that obesity medications treat the disease of obesity and are not merely agents for “weight loss.”

As the organization that partnered with the National Council on Aging (NCOA) and leading obesity specialists across the country to develop and issue the first Obesity Bill of Rights for the nation, NCL submitted comments as the voice of the nation’s consumers and urged CMS to finalize the proposed rules for these reasons:

There Is a Widespread Scientific Consensus That Obesity Is a Distinct Chronic Disease – CMS’s reinterpretation of Medicare Part D policy is grounded in extensive medical evidence that obesity is not a cosmetic condition but a distinct and serious chronic disease requiring treatment. Reinforcing this recognition of obesity as a distinct disease state, major medical organizations now consider obesity a chronic disease due to its complex biological mechanisms and potential for significant health complications. This includes the American Medical Association, American Association of Clinical Endocrinologists, American College of Endocrinology, and all the leading obesity and nutrition organizations.

Obesity Is the Nation’s Most Prevalent Chronic Disease and Is Directly Linked to Numerous Chronic Diseases –Today, obesity affects 41.9 percent of US adults – more than 100 million people – which makes obesity the most prevalent chronic disease affecting Americans, significantly eclipsing the other most prevalent chronic diseases: heart disease, diabetes, chronic kidney disease, cancer, chronic lung disease, Alzheimer’s Disease, and stroke. Even more significantly, more than 230 medical conditions are directly linked to overweight and obesity, meaning these diseases worsen as the degree of obesity increases. Thus, obesity today is responsible for an estimated 400,000 deaths a year.

The Cost of Obesity Is Too High and Everyone Is Paying the Price – Obesity, due to its role in causing or worsening chronic disease, accounted for 47.1 percent of the total direct and indirect costs of treating chronic conditions in 2016. Accordingly, some estimates put the national cost of obesity at $1.7 trillion a year –more than what Social Security paid in retirement benefits in 2022.

Compared to Other Serious Chronic Diseases, Obesity Goes Largely Undiagnosed and Untreated – The Obesity Bill of Rights was issued to transform obesity care in the US at a time when obesity remains largely undertreated with costly repercussions in high rates of obesity-related diseases and preventable deaths. Reflecting this reality, only 30 million of the more than 100 million Americans living with obesity in 2022 received a diagnosis of obesity, and only around 2 percent of those eligible for anti-obesity medications were prescribed these drugs. Although multiple factors are responsible for this pervasive gap in obesity care, the most pernicious are access barriers that keep people with obesity from getting the care they need, whether through the exclusion of obesity treatments in many insurance plans, restrictive insurance practices that delay or deny treatment, or out-of-date government policies.

New Anti-obesity Medications Are Safe and Effective and Result in Savings From Improved Health Outcomes – As noted in the CMS proposed rule, there have been major advances in understanding and treatment of the disease of obesity since the Medicare Part D program went into effect in 2006, resulting in new therapeutic agents, such as GLP-1 drugs that can help people lose up to 20 percent of their weight in 26 months. Calculating the potential savings resulting from better health outcomes when obesity is treated, studies are beginning to project the potential savings to the economy from covering obesity medications. One recent study published December 5, 2024, in JAMA Network Open estimated that a 10 percent weight loss resulting from obesity treatment saved $2,430 in reduced medical expenditures, and for a 25 percent weight loss, the reduction in health expenditures is $5,444 per person.

The comment period for the CMS proposed rule closes soon, and then it will be up to the new Trump Administration to finalize this important rulemaking. It is our hope that the new team at CMS will make this a priority. Simply put, this important change in CMS policy will make a significant difference in the lives of millions of Americans.

Guest Blog: Paying Tribute to Jimmy Carter, Pension Champion

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A version of this guest post was originally published by the Pension Rights Center.

By Karen Friedman

When Jimmy Carter was elected President in 1976, I was a young whipper snapper living in an old, disheveled group house in Washington D.C. When I think back on that time, I fondly remember that his Administration—dedicated to energy conservation, peace and human rights—inspired me and many of my friends to become social justice warriors.

It was thus fitting that yesterday a group of my activist friends (albeit a bit older and I hope wiser) joined throngs of other citizens to pay tribute to President Carter who was lying in state in the Capitol’s Rotunda.

President Carter accomplished so much as the many tributes about him reflect. But among his deserved accolades there is one that often gets overlooked: Jimmy Carter was a pension champion.

In 1978,  Jimmy Carter established the President’s Commission on Pension Policy, which was tasked with conducting a 2-year study of the nation’s pension systems and the future course of national retirement income policies. The Pension Rights Center (PRC) provided input to the Commission (through our own Citizens’ Commission on Pension Policy).

Among the most visionary of the study’s recommendations was the call for the establishment of a minimum universal pension system (on top of Social Security) that would require private employers to contribute at least 3% of payroll for all employees over the age of 25. Close to a half century later, despite the efforts of PRC and others, our nation has yet to enact an adequate and secure universal pension system akin to what President Carter recommended.  (Other Commission recommendations, e.g. to improve survivors’ benefits and protect spouses in divorce have since become law.)

The conversation that President Carter began those many years ago is needed more than ever today. We must continue to work together to create a pension system that, in conjunction with Social Security, provides adequate and secure retirement income to our nation’s working families.

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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.

New NCL analysis of medical debt policies highlights need for reform

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By Sam Sears, Health Policy Associate, National Consumers League

The National Consumers League (NCL) recently published a new issue brief focused on hospital’s medical debt practices. With over 100 million Americans grappling with medical debt, and 1 in 7 of them reporting to KFF Health News that they’ve been denied care, it is prudent to evaluate these anti-consumer hospital policies.

The analysis, which was completed by Magnolia Market Access, found that 340B hospitals are significantly more aggressive with their medical debt policies – 340B hospitals are twice as likely to deny or defer chare and also significantly more likely to take legal action against a patient. Additionally, our analysis found that for-profit hospitals are significantly less aggressive in their practices against patients with medical debt than nonprofit or government hospitals, and that screening for financial assistance does not resolve medical debt issues.

Medical debt is unpredictable and can have long lasting consequences. Nearly 50% of Americans struggling with medical debt have it reported to their credit report, and over 40 million people owe nearly $88 billion that has been sent to collections. The Biden Administration has taken action to combat and address medical debt, which you can read more about here on our blog. However, there are additional actions that policymakers may take.

NCL has, and continues to fight to protect consumers from excessive troubles due to medical debt, including working with policymakers to combat anti-consumer debt collection policies hospitals continue to practice. The findings from the analysis conducted in this issue brief further highlight the need for 340B Drug Pricing Program reform, to ensure the savings that hospitals receive are reinvested in ways that continue to benefit consumers and patients.

Hospital Medical Debt

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About the National Consumers League (NCL)

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