Why we need more Black health professionals in the workforce

By NCL Health Policy Associate Milena Berhane

A lack of diversity in the health care workforce has been a persistent issue in the United States, posing significant implications to health equity, particularly for the Black or African American community.

An estimated five percent of physicians identify as Black, despite making up 13 percent of the U.S. population. A recent study utilizing U.S. Census Bureau information found that the proportion of Black physicians in the United States has only increased by four percent in more than a century — from 1900-2018. This study also reported that the percent of Black male physicians has remained relatively stagnant since 1940. Diversity issues also exist in other health care professions, with an estimated 7.8 percent of nurses, 3.8 percent of dentists, and 2.5 percent of physical therapists being Black.

The education, testing, application, and interviewing process required to pursue a career in health care is rigorous and costly. In addition to a four-year degree, candidates are also required to take standardized exams, pay expensive application fees, and pay for travel to interview. Most medical students expect to spend up to $10,000 for the application process. Once accepted to a health professional program, the tremendous monetary and time costs of schooling are immense obstacles for many. Medical school attendees accumulate an average $200,000 of student loans by the time they are finished with their programs.

Due to generations of systemic racism in our country, Black Americans are less resourced — financially and in terms of social capital — than their white counterparts. The rigorous process of applying to and remaining in health professional programs creates a pipeline that excludes disadvantaged students from the ability to pursue careers in clinical care.

The barriers to enter the workforce have further negative impact on communities and health equity. Black patients face a variety of issues that can influence their ability to access medical care, including medical mistrust caused by historical unethical medical mistreatment faced by Black Americans, dismissal of health concerns that Black patients express to health care providers, and others. Time and time again, Black patients have shared their experiences of medical providers ignoring their health concerns, and therefore being undertreated and going undiagnosed for their conditions. In addition, research indicates that Black patients report poorer patient-provider communication and shared decision-making. These issues lead to Black patients receiving lower quality care from medical providers, further worsening health conditions that could be treated.

Racial bias and a lack of culturally competent medical care in the healthcare system has led to poorer health outcomes for Black patients. Black Americans of all ages already face higher rates of hypertension, asthma, diabetes, and other health issues due to systemic racism and how it has affected the environments they live in, the food they have access to, their education prospects, income, etc. These inequities compiled with a culturally incompetent and bias medical system leaves Black Americans with little ability to receive proper medical treatment and improve their health and well-being. Although medical schools are attempting to teach the importance of culturally competent care, it is crucial that Black patients are also able to access healthcare providers that look like them and come from their communities.

Clearly, the current make up of racial diversity of the health care workforce has failed to keep up with the demographic shifts in the United States. Although public health efforts are important in addressing and improving health equity, inequities within the medical system must be addressed simultaneously. The COVID-19 pandemic has only highlighted and exacerbated health inequities. Increasing the amount of Black health professionals across the United States is a critical step in ensuring better health outcomes for Black patients and their overall well-being.

Illicit drugs and the digital marketplace

By NCL Health Policy Associate Milena Berhane

Technology has brought into the homes of millions of consumers many wonderful tools for accessing the drugs and medical products we need. We, as consumers — at the touch of a few buttons — have access to drugs and devices that would have required far more time and effort to acquire in the past. But with that ease of access, we also have millions of tainted or suspect products peddled to consumers, including counterfeit drugs.

At any one time, there are 35,000 active pharmacies online, according to ASOP Global. Ninety-five percent of them do not comply with applicable laws and pharmacy standards. Counterfeit products sold by this 95 percent are manufactured in often unsafe conditions and contain little or no active ingredients.

Those in charge of online registries could better control this. These registries control the websites that can be set up on the Internet, managing domain name extensions such as .com, .gov, and .org, and .pharmacy. It is critical that Internet registries and registrars monitor the activity on their domains and ensure that illegal activity is prevented.

Consumers look for drugs online for both cost and convenience reasons. It’s understandable that consumers are turning to the Internet for cheaper options when the cost of many prescription drug costs is so high. Those who do undoubtedly don’t understand the risk of illegal online pharmacies; research shows only an estimated 37 percent see little danger in ordering from such a pharmacy. In addition, 7 in 10 Americans incorrectly believe that appearing at or near the top of Internet search results legitimizes such a website.

The COVID-19 pandemic has also played a role in these risks, with an increased sale of online goods, including prescription drugs. About 31 percent of consumers who bought prescription medication online did so for the first time in 2020 because of the pandemic. As a result, now more than ever, we need to ensure that illegitimate online pharmacies are far better regulated, and frankly, put out of business.

The examples are stark. In 2021, the Drug Enforcement Administration (DEA) seized more than 9.5 million counterfeit pills, which is more than what was seized in 2020 and 2019 combined. Due to these high numbers, in late 2021, the DEA warned that “fake prescription pills are widely accessible and often sold on social media and e-commerce platforms — making them available to anyone with a smartphone, including minors.”

We believe that online platforms have the responsibility to enforce their terms and conditions. These registries and registrars are choosing profit over safety by allowing online pharmacies to sell fake drugs and products.

For this reason, the National Consumers League is supporting the DRUGS Act (H.R. 6352/S.3399) which aims to holds Internet registries and registrars responsible for any illegal and illegitimate drugs being sold through their online platforms. Modeled after a pilot “trusted notifier” program, this bill would require registries to suspend a website, conduct an investigation, and then shut the platform down if it is found to be selling illegal substances.

In the meantime, NCL will continue to educate consumers about the dangers of counterfeit drugs. NCL’s FakeRx Action Center provides consumers with the tools to protect themselves from fake drugs and illegal online pharmacies — as well as a place to report counterfeits. Consumers have a duty to do their homework, but we have to make it far harder for fakes and counterfeits to be peddled to unwitting consumers. The DRUGS Act will go a long way to make that a reality.

Airline executive testimony conflicts with travelers’ reality

By Eden Iscil, Public Policy Associate

Last month, the Senate Committee on Commerce, Science, and Transportation held a hearing titled “Oversight of the U.S. Airline Industry,” which featured the CEOs of the major domestic airlines (American, Delta, Southwest, and United). With the federal government’s $50 billion bailout of the aviation industry serving as the primary focus of the hearing, airline CEOs managed to avoid serious scrutiny despite the massive service failures seen in 2021 and early 2022.  

The underlying problem centers around the air traffic companies choosing to incentivize employees to leave their jobs, despite receiving billions of dollars in assistance from the federal government with the primary condition being not to fire workers. The bailout, officially known as the Payroll Support Program, served as an undeniably central piece to America’s quick economic rebound from the early COVID-19 recession. Yet, airlines still could not service hundreds of thousands of flights over the past seven months due to a lack of staffing. This caused a meltdown of delays and cancellations in the summer and early fall of 2021 and again during the end-of-year holidays over the previous two weeks. 

While certain conditions understandably contributed to flight schedule changes, such as the Omicron variant, the airlines’ lack of preparation remains a consistent problem. For example, in October 2021, Southwest Airlines cancelled more than 2,000 flights, blaming weather and FAA issues. But these excuses do not hold water, as consumers quickly pointed out that while Southwest cancelled 28 percent of its schedule, competitors only cancelled around 3 percent of their flights. A couple weeks later, CEO Gary Kelly acknowledged staffing shortages that had led to Southwest’s service problems. 

The reality travelers have faced does not match the rosy picture airline executives painted at the Senate hearing. Southwest’s Kelly expressed pride in not cutting hours or laying off employees throughout the pandemic. Yet, his airline was still understaffed at the end of October (according to Southwest’s own hiring goals) after the airline reduced its workforce by 28 percent at the onset of the pandemic. To get around the prohibition on involuntary firing, air traffic carriers like Southwest incentivized early retirement and extended time off packages. The results of these practices are visible in every major airport nationwide. 

Additionally, American Airlines CEO Doug Parker told senators that “large events” of cancellations “don’t happen very often” and that a shortage of employees is not a problem. Just a week later, airlines began experiencing staffing troubles, which led to more than 18,000 flight cancellations between Christmas Eve and January 3. Given the predictable spike in COVID infections we have seen during periods of high travel for almost two years, especially during the winter holidays, it is unclear why airlines were entirely unprepared for the latest holiday traffic.  

To be clear, employees absolutely should not report to work when they are ill (hopefully by taking paid sick leave). Given the record-breaking transmissibility of the Omicron variant, workers’ safety needs to remain paramount. It is unfortunate that airlines did not take steps to rectify previous mistakes and increase staffing ahead of the winter travel season in order to avoid the enormous wave of cancellations. In addition to the headaches and last-minute adjustments stranded travelers needed to make, the service failures were especially impactful as this was the first holiday season for many people to enjoy with loved-ones since before the pandemic.

MLK 2022: Reflecting on victories

By Sally Greenberg, NCL Executive Director

This weekend we celebrate the life of the great American civil rights icon and hero, Reverend Dr. Martin Luther King Jr. This is a good time to reflect on civil rights victories won by Dr. King during his lifetime and the work left do to achieve his vision for voting rights and protections.

This past year, I revisited the site of Dr. King’s 1968 assassination in Memphis and spent the day walking through the powerful civil rights museum attached to the motel where Dr. King was shot. The museum provides the most complete history I’ve ever seen of America’s legacy of slavery and its aftermath. It was so inspiring but also so sad. I contemplated how different the world might be if we had the wisdom of Dr. King’s words and deeds to guide us all these decades.

Greenberg (right) and friend at MLK Rally for Voting Rights in Washington, DC on January 17, 2022.

During Dr. King’s lifetime and because of his work, the nation made great strides in the movement for racial equality:

  • the 1954 decision in Brown v. Board of Education overturning the doctrine of “separate but equal” and forcing the integration of public schools in America, argued by brilliant litigator and future Supreme Court Justice Thurgood Marshall
  • the 1955 Montgomery Bus Boycott, when 40,000 Black bus riders—the majority of the city’s bus riders—boycotted the system. Black leaders met to form the Montgomery Improvement Association (MIA). The group elected Martin Luther King Jr., the 26-year-old-pastor of Montgomery’s Dexter Avenue Baptist Church, as its president, and decided to continue the boycott until the city met its demands. After several federal court cases, Montgomery’s buses were integrated on December 21, 1956, and the boycott ended. It had lasted 381 days.
  • Civil Rights Act of 1957, the first major civil rights legislation since Reconstruction allowing federal prosecution of anyone who tried to prevent someone from voting and creating a commission to investigate voter fraud
  • The 1963 March on Washington organized and attended by civil rights leaders such as  Philip RandolphBayard Rustinand Martin Luther King Jr. when Dr King gave his “I have a dream speech”
  • The Civil Rights Act of 1964 and the Voting Rights Act of 1965, banning all voter literacy tests and provided federal examiners in certain voting jurisdictions.
  • The Fair Housing Act, which became law on April 11, 1968, just days after King’s assassination. It prevented housing discrimination based on race, sex, national origin and religion. It was also the last legislation enacted during the civil rights era.

Greenberg marching across the Frederick Douglass Memorial Bridge.

Sadly, as we start this 2022 MLK weekend, many states have chipped away at voting rights and protections. The Brennan Center reports that an unprecedented 19 states have enacted 33 laws that will make it harder for Americans to vote.

A bill to counteract these attacks on voting rights, “Freedom to Vote: John R. Lewis Act” combines the Freedom to Vote Act and the John R. Lewis Voting Rights Advancement Act is awaiting action in the Senate but its prospects for passage are dimming.

If enacted, it would push back against the undermining of voting rights, affecting everything from how votes are cast to how they are tallied across the country. And it would sweep beyond that, remaking campaign finance laws and calling for a significant redraw of the nation’s House districts.

On this MLK Jr. weekend, the best tribute we could pay to Dr. King and his legacy and sacrifice would be to pass the Freedom to Vote Act in the Senate and get it to President Joe Biden’s desk. I’m still hoping for that miracle to happen.

Jeanette Contreras portrait

Reason to celebrate: No more surprise medical bills in the new year!

By NCL Director of Health Policy Jeanette Contreras

Consumers have grown to expect surprise medical bills as a given in the fragmented U.S. healthcare system. Even people with large employer-sponsored health insurance coverage could expect to receive a surprise bill for an out-of-network medical service. A 2021 report from the U.S. Department of Health and Human Services outlined how more than half of U.S. consumers reported recently receiving an unexpected medical bill — many related to essential services like childbirth, elective surgeries, or emergency services. Thanks to the No Surprises Act, signed into law as part of the Consolidated Appropriations Act of 2021, surprise medical bills will be a thing of the past.

Beginning January 1, 2022, federal protections ban surprise medical bills any time a person receives emergency care, including some non-emergency services. For example, the new law bans out-of-network charges for out-of-network providers who work at an in-network facility. It also requires that cost-sharing for emergency services, like co-pays and co-insurance, be based on in-network rates.

Healthcare providers and facilities will be required to give patients easy-to-understand notice regarding out-of-network care, explaining that it could be more expensive. Providers will also need to tell patients whom to contact if they think the provider or facility has violated the surprise billing protections. Patients will be able to dispute a claim if they receive a medical bill that is higher than the estimated cost given in advance of care.

Whether or not a patient has insurance, they can submit a complaint about a medical billing issue if they have a question or are concerned that their provider may not be following the new rules. For more help, consumers can go to the CMS.gov webpage to submit a claim online or call the No Surprises Help Desk at 1-800-985-3059, 8am-8pm ET seven days a week; (TTY: 800-985-3059).

NCL, H&R Block partner to help consumers prepare for 2022 tax season

By Eden Iscil, Public Policy Associate

This week, NCL partnered with H&R Block to provide a free webinar on recent changes and other items to be aware of as we enter tax filing season. The event included a short presentation by Manuel Dominguez (Tax Agency Analyst at H&R Block) outlining the biggest changes tax filers should know, followed by a Q&A session with the panel of tax experts. Moderater NCL’s Vice President of Public Policy, Telecommunications, and Fraud, John Breyault, was joined by panelists Joanna Ain (Associate Director at Prosperity Now), Dominguez, and Garrett Watson (Senior Policy Analyst at the Tax Foundation). If you missed it, you can watch the event on NCL’s YouTube channel here. 

One of the biggest takeaways from the discussion is this: your tax return could look very different from what you may expect due to changes stemming from the 2021 American Rescue Plan (President Biden’s COVID relief bill). For example, parents who received advance Child Tax Credit (CTC) payments throughout 2021, could see a smaller refund than previous years since part of that credit was given in monthly payments throughout the year. Additionally, consumers who were eligible but did not receive an Economic Impact Payment (a.k.a stimulus checks) could see larger-than-expected refunds. 

Other credits that have seen changes include the Child and Dependent Care Credit, with allowable expenses increased to $8,000 for one dependent and $16,000 for two or more dependents. In addition, the Earned Income Tax Credit (EITC) saw an increase in the credit amount and income thresholds for taxpayers with no qualifying children as well as a “loopback election” which allows filers to use either 2019 or 2021 income for the purposes of claiming the EITC (in order to get the highest credit value). 

Another change that could affect filings involves charitable contributions. Normally, filers who choose the standard deduction cannot claim a deduction for charitable contributions. But this year, single filers can claim a deduction of up to $300 for cash contributions to qualifying charitable entities ($600 for joint filers). 

Given the new assistance provided by the federal government, the IRS will be sending new tax documents that filers need to have available when filing. Letter 6419 relates to any advance CTC payments received in 2021. Letter 6475 relates to the third Economic Impact Payment (stimulus check) which went out under President Biden. These documents are important to keep as they will ensure the information you input when filing taxes matches IRS data; if there are discrepancies, your tax return may be delayed.  

For consumers who do not receive a Letter 6419 regarding advance CTC payments, the CTC Update Portal can help. Filers who do not receive a Letter 6475 regarding the third stimulus check should check their eligibility for the Economic Impact Payment and its correlated tax credit here 

Confused? You’re not alone! 

Fortunately, there are government-sponsored tax preparation services available for free. The Volunteer Income Tax Assistance (VITA) program offers help to people who make less than $57,000, filers with disabilities, and individuals with limited English language knowledge. Additionally, the Tax Counseling for the Elderly (TCE) program is aimed at people 60 and older, with specialization in pensions and other retirement-related issues.  

Lastly, taking the following steps can ensure that you receive your tax return as quickly as possible. First, filing your taxes online is much quicker than filing your taxes by physical mail. Because of backlogs in processing returns from 2021, returns mailed to the IRS will almost certainly result in slower-than-normal refunds being issued. Filing as early in tax season as possible is a great way to reduce the risk of tax identity fraud. Second, keeping those CTC and stimulus check letters (Letter 6419 and Letter 6475, respectively) as well as any previous notices given by the IRS will help avoid any errors and discrepancies which would otherwise cause a lag. Third, using direct deposit to receive refunds can save time by not relying on physical checks sent through the U.S. Mail. 

 If you would like to hear our panelists cover what you should know before filing your taxes in their own words, video of the full webinar can be found here 

Capital One eliminates predatory overdraft charges

By Sally Greenberg, NCL Executive Director

Low- and middle-income consumers suffer serious economic harm when they are forced to pay predatory overdraft fees. These fees are triggered when consumers charge more to their bank account — either on a debit card or by writing a check — than the funds existing to cover the charge. These can mean that a $5 charge —when there isn’t enough money in the account to cover it — costs a consumer more like $40 due to an overdraft fee of $35. And if the customer makes other charges not covered by the balance, each one of them can add a $35 overdraft fee.

Some good news, though, came recently from the CEO of Capital One, Rich Fairbanks. He announced that the company will stop charging these harsh fees and return “simplicity and humanity” to banking.

It used to be that covering an overage was a courtesy extended to bank customers at no cost. Sadly, that changed during the 1990s and 2000s, when overdraft fees became a profit center. And the profits are kind of shocking: $15.5 billion in 2019 for banks and credit unions on overdraft fees alone, according to the Consumer Financial Protection Bureau. For some financial institutions, these fees represent more than half of their profits. Reforms are badly needed.

A recent Washington Post editorial identified overdraft best practices:

  • Don’t charge more than one fee per overdraft
  • Provide at least a day grace period
  • Notify customers with a text or email alert about the overdraft
  • Limit the number of fees per year
  • Don’t assess fees at all if the overdraft is under $50

It’s just plain wrong for any industry to rack up big returns on the backs of low- or middle-income consumers. That’s known as a predatory practice for good reason. The National Consumers League hopes the example set by Capital One — to do away with harsh overdraft fees — will be a model for the industry. Banks are entitled to a fair profit, but overdraft fees are clearly a predatory practice. We applaud Capitol One for taking the first step and urge other industry members to follow suit; if nothing else, we hope the industry will move on its own toward the “best practices” playbook outlined above.

Addendum: As of this writing, Ally Bank, PNC, Santander, J.P. Morgan Chase, and Capital One Banks have either eliminated or reduced overdraft fees. We are very pleased to learn of these very important developments, which will greatly reduce the burden of overdrafts, particularly on low-income consumers. We thank these banks for taking important steps to reduce crippling charges for overdrafts

In memoriam: Karen Ferguson, pension champion

By Sally Greenberg, NCL Executive Director

America lost a renowned pension advocate and lifelong public interest lawyer recently with the death of Pension Rights Center founder Karen Ferguson.

Karen formed the Center in 1976 and, along with devoted board and staff, led the battle to protect the rights of workers entitled to pensions when their retirement funds were placed in jeopardy. All who knew Karen couldn’t help be moved by her deep intelligence, kindness and passion for pension rights and protections.

Ferguson and I met in 1981 when I was between jobs and awaiting bar results. I cold-called the Pension Rights Center and offered my services as a volunteer; she could not have been nicer to this stranger calling from out of the blue. She welcomed my help and introduced me to her right-hand, Karen Friedman, who became a dear friend. Yin and yang, the two Karens, fondly known as K1 and K2, were a dynamic duo that have shaped federal pension laws and policies for nearly half a century.

I was awed by Karen Ferguson’s brainpower. As a young lawyer, I observed her interactions with staff, policymakers on Capitol Hill, and federal agencies administering pension protections in the complicated but critically important law, Employee Rights Income Security Act (ERISA), adopted in 1974. ERISA was still in its infancy when PRC was launched. The Pension Rights Center and Ferguson were the one place that could be counted on to have the workers’ backs, bringing intellectual heft and a deep understanding of ERISA to any debate. When truckers’ pensions were in jeopardy, the PRC led the fight, spending seven years working the halls of Congress — with support from the AFL-CIO and the International Brotherhood of Teamsters — to secure millions of pensions for workers and retirees under the Butch Lewis Emergency Pension Relief Act.

A graduate of Bryn Mawr College and Harvard Law School, Ferguson was also instrumental in achieving special resources to enable workers to understand and secure their pensions, pushing strongly for the Pension Counseling and Information Program under the Older Americans Act.

Working women, men, and retirees lost a unique voice this week with the sad news of the death of Pension Rights Center founder and champion, Karen Ferguson. RIP, Karen. Your legacy lives on.

Abortion: The continuous fight for reproductive freedoms

By NCL Health Policy Intern Grace Mills

Grace Mills is a DC native, completing her undergraduate education at American University in Washington, DC. Her major is Public Health, with a minor in Spanish language. She will graduate in May 2022.

Women in the United States have been fighting for reproductive rights for decades. Activists like Margaret Sanger and Mary Ware Dennett argued during the early part of the 20th Century that women must be in control of their reproductive choices; the book “The Birth of the Pill” documents their crusade. Officials tried to prevent these two and many others from speaking and publishing about human sexuality, reproduction, and contraception. In the succeeding decades, activists pioneered the right to contraception, the right to abortion, and the right to bear a child.

Several landmark cases are worthy of mention. In Griswold v. Connecticut (1965), the Supreme Court ruled that a state’s ban on the use of contraceptives violated the right to marital privacy. In 1971, in the case of United States v. Vuitch, the Court rejected the claim that a statute permitting abortion only to preserve a woman’s life or health was unconstitutionally vague. It concluded that “health” should be understood to include considerations of psychological as well as physical well-being. The following year, in Eisenstadt v. Baird, the Supreme Court struck down a Massachusetts law limiting the distribution of contraceptives to married couples whose physicians had prescribed them. This decision established the right of unmarried individuals to obtain contraceptives.

In 1973, Roe v. Wade was a challenge to a Texas law prohibiting all but lifesaving abortions. The Supreme Court invalidated the law on the ground that the constitutional right to privacy encompasses a woman’s decision whether or not to terminate her pregnancy. Characterizing this right as “fundamental” to a woman’s “life and future,” the Court held that the state could not interfere with the abortion decision unless it had a compelling reason for regulation. NCL strongly supports the landmark protections in this case, including a woman’s right to control her own reproductive destiny.

Sadly, Roe v. Wade has been under attack from the right since 1973. After the Trump Administration’s Supreme Court appointments, there is a 6-member majority that appears to favor overturning Roe vs. Wade. States will have the right to pass far more restrictive laws than what Roe allowed for constitutionally. There will always be states that protect women’s right to choose and access to abortion, however, the issues lies in women living in states with restrictive laws or lack of money and/or resources to get to an abortion clinic.

This flies in the face of what the public wants. Indeed, a recent Gallup poll show Americans’ support for abortion in all or most cases at 80 percent in May, only slightly higher than in 1975 (76 percent), and the Pew Research Center finds 59 percent of adults believe abortion should be legal, compared to 60 percent in 1995. The share of Americans in Gallup’s poll who say abortion is morally acceptable reached a record high of 47 percent in May, up from a low of 36 percent in 2009, and a Quinnipiac poll found support for abortion being legal in all or most cases reached a near-record high in September with 63 percent support.

Many red states have recently passed some of the most restrictive and punitive abortion laws. In March of 2018, former governor of Mississippi Phil Bryant, signed into law the strictest abortion ban in the country up until that point. The law bans abortion at 15 weeks (about 3 and a half months), even in cases of rape or incest. But a federal district court judge shut the law down, and the U.S. Court of Appeals for the Fifth Circuit backed the court’s decision. This law is what was challenged in the Supreme Court last week.

Perhaps the most extreme is S.B. 8, the Texas law that went into effect on September 1, 2021 that prohibits abortion after “cardiac activity is detectable,” which is usually around the 6-week mark (about 1 and a half months). The law has a vigilante justice component, letting Texans sue anyone they believe is violating the law and/or is involved in an abortion in some way. This includes anyone who provides transportation to the abortion (even an Uber driver could be culpable) or a physician that performs the abortion after 6 weeks. This is the most draconian legislation so far, in part because many women do not even know they are pregnant at just 6 weeks.

S.B. 8 specifically does not allow state officials to enforce the law, authorizing only private citizens to do so, by suing an abortion provider for damages of ten thousand dollars for each procedure performed — what several Justices referred to, during oral arguments on November 1st, as a “bounty.” The Supreme Court will likely have the chance to review a challenge to the constitutionality of this law, but that’s a few years away and until then, the law remains in force.

NCL strongly supports women’s access to reproductive, abortion and maternal care. We understand that lack of access is directly related to a wide range of health disparities in the United States. It is no surprise that people of color in the United States have less access to the care they need and have more health complications. This is true for reproductive care and family planning. Black and Hispanic women have much higher abortion rates than white women largely directly related to a higher rate of unintended pregnancy.

These facts raise the question about what more can be done to provide women of color better maternal care and family planning resources. We need to reverse the pattern of inequality. NCL supports funding for sex education, full access to maternal care, and family planning to provide women with services, information and resources necessary to make informed decisions about their reproductive health and prevent any unnecessary health risks.

The tenuous hold we have on the right to abortion in every state, with the Mississippi law likely to get the thumbs up from the anti-choice Supreme Court, puts all women at risk. The Texas law is that much more draconian. We lament these attacks on women’s access to health care — especially poor women — that these restrictive abortion laws represent. Lastly, making abortions a crime won’t stop them from happening, it will only drive abortion back into the back alley and make it once again, a dangerous procedure that puts women’s health and safety at risk.

Jeanette Contreras portrait

Listen up: FDA’s proposed OTC hearing aid rule

By NCL Director of Health Policy Jeanette Contreras

Whether it be listening to your grandchildren share a story or having dinner with a friend, many consumers rely on devices to help them hear and understand speech every day. Hearing loss is something that we need to be mindful of at all ages, and as consumers, we look to our nation’s regulators to make sure these devices are safe to use.

Some people with hearing loss are able to work closely with hearing care professionals to finely adjust their hearing aids at sound levels that enable them to hear speech at comfortable levels without causing any harm. But, as more Americans struggle with their hearing, accessible hearing aids becomes increasingly important. Proposed regulations by the Food and Drug Administration will allow hearing aids to be sold over-the-counter to adults with mild-to-moderate hearing loss, a step forward in making them more affordable and accessible.

While these regulations are positive for access, the FDA’s proposed thresholds for volume or output for over-the-counter hearing devices are more in line with those for earbuds people use to listen to music for short periods than they are for hearing aids that are worn for several hours a day. These draft rules would allow a maximum sound output level of between 115 and 120 dBA, which is the equivalent to the volume of a chain saw. According to the CDC, exposure of sounds at 120 dB could become dangerous in as little as nine seconds. As you can imagine, being exposed to this level of sound for long periods of time is unsafe and could increase hearing loss and significantly damage the ear.

Hence, there is widespread concern among hearing care professionals that allowing an unnecessarily high level of amplification can lead to further hearing loss. Leading hearing care associations recommend a maximum output limit of 110 dBA for OTC hearing aids and establishing a gain limit of 25 dB.

As the leading consumer healthcare organization, we applaud the FDA’s efforts to increase access to hearing aids for those who need them. We do hope that the FDA will adjust its proposal, so it is in line with the recommendations of hearing care professionals before finalizing the regulations. Consumers shouldn’t be concerned that they may find their situation worsened by devices that are intended to help.

To learn more about gain and output and how to protect yourself from hearing loss, check out our new infographic.