Elizabeth Hicks – Consumer Choice Center

Tomorrow’s Tariffs Will Hurt Everyone

By Sabine El-Chidiac and Elizabeth Hicks

While tariff threats have been a roller coaster ride of will he or won’t he, reports indicate that President Donald Trump’s plan to tack on a 25% tariff on Canada is on track to becoming a reality on February 1. Given the harm tariffs have on Canadians and Americans alike, the best course of action would be to eliminate tariffs as a policy option and focus on working out the issues the United States has with Canada diplomatically. Not only would tariffs from the United States be devastating to both American and Canadian economies, but the proposed retaliations by Canada would further hurt the pocketbooks of the citizens of both countries.

Ontario Premier Doug Ford has been very clear when it comes to Trump’s proposed tariffs: impose tariffs on Ontario, and Ontario could cut off electricity to 1.5 million homes in New York, Michigan, and Minnesota. The federal government also said they would respond with the “single largest trade blow the U.S. economy has ever endured” if Trump follows through with his plan for tariffs, and a future government will likely feel compelled to do the same due to the harsh economic implications tariffs will have on Canada. Rather than allow tariffs to be imposed at any point, the U.S. and Canada must find an off-ramp to protect consumers on both sides of the border. Canada needs a new approach based on political reality and the unique economic interests of both parties in this dispute.

Tariffs are simply another word for taxes, and imposing such taxes on Canada will affect Canadians’ day-to-day lives even more than the cost-of-living crisis already has. Canadian economist Trevor Tombe predicts that if the U.S. follows through on tariffs and Canada retaliates, the Canadian household cost would be $1,900 CAD per person annually. In the U.S., that impact would be nearly $1,700 CAD per person. This is one of the more conservative estimates.

Tariff showdowns tend to be more about a battle of wills and less about positive economic outcomes.

The 1930 U.S. Smoot-Hawley Tariff Act resulted in world trade falling by 66% and U.S. exports and imports crashing by about two-thirds, prolonging the Great Depression. More recently, the 2018 steel and aluminum tariffs imposed by Donald Trump resulted in skyrocketing manufacturing costs for U.S. industries. The ongoing softwood lumber tariffs imposed on and off by the United States have significantly raised American housing prices.

In response to the Smoot-Hawley tariffs, Canada retaliated and imposed harsh tariffs on the United States under Prime Minister R.B. Bennett, sending Canada’s export markets into a spiral and sparking a Canadian economic depression. A very similar story has predictably played out over the 2018 steel and aluminum tariffs and again with Canadian retaliatory tariffs in the softwood lumber feud.

Canada is the United States’ second largest trading partner, with imports from Canada to the U.S. totaling almost $344 billion in 2024 through October. Canada and the U.S. are neighbours and long–time allies, and the integration of our supply chains has resulted in lower prices for consumers in both the US and Canada while increasing the global competitiveness of both countries.

Premier Ford has been promoting a “Fortress Am-Can” program that would have the US and Canada working as a team on various energy-related policy issues, and there has been rhetoric from the Conservative party leader Pierre Poilievre about striking a “great deal” with Donald Trump by increasing Canada’s energy exports to the U.S. This direction can be workable answers to the tariff standoff, and could extend this pause to a permanent reversal on tariff policy.

Many Canadian consumers can barely afford the necessities of life such as groceries, clothing, and housing. Adding tariffs and retaliations to the mix may be the last straw that leads to Canada’s next great depression.

Day 1 tariffs are bad for everyone — including President Trump

Today, on the day of President-elect Trump’s second inauguration, his proposed Day One actions are beginning to take shape. Axios reportsTrump is now weighing immediate tariffs on Canada and Mexico under the guise of a “national economic emergency.” With Canada ramping up its plans for retaliatory tariffs to slam America “dollar for dollar,” cooler heads in the new Trump administration must prevail if Americans are going to be spared the blow to their household budgets.

Trump understands the practical politics of having leverage over both allies and opponents, but he risks losing all of it in a North American trade war.

Trump ran in 2024 on his plan to saddle Canada and Mexico with a 25 percent tariff as leverage to get their help on his immigration agenda, but the fact remains that Trump’s voters will be the ones feeling the direct impact. Day 1 tariffs would make February’s Super Bowl the most expensive for consumers in recent history.

Trump ally and fellow TV star Kevin O’Leary of the hit show Shark Tank has been making the rounds on air, telling Trump to be “hardcore” with tariffs on China. He even suggested China could see “riots in the streets” if Trump targeted China’s consumer exports, which explains the massive influx of Chinese goods into the U.S. in December.

North America as a trading block is uniquely positioned to thrive during the Trump administration, but instead of promoting growth and lower costs for Americans, framing a destructive trade war is all that’s being discussed. The sophisticated supply chain integration between the U.S. and Canada has resulted in lower prices for consumers, especially when it comes to automobiles. In 2022, Canada exported $12.9 billion in motor vehicle parts and accessories, with $11.4 billion of that flowing directly to the U.S.

In Michigan, 13 percent of the state’s gross state product is reliant on Canadian automotive trade. What’s the point of expanding U.S. oil production and lowering the price of gas at the pump if cars and auto parts are just going to get more expensive nationwide? Considering that $132 billion in oil and petroleum flows from Canada into the U.S. every year, it’s highly unlikely the Trump administration could replace that oil with American product fast enough to avoid sticker shock at gas stations.

Trump and his Canadian bargaining partners don’t seem very committed to rolling back the painfully high costs of living that marked the Biden years; instead, they’re shifting the costs to new sectors.

Everyday Canadians would face significant hardships from a 25 percent tariff on exports to the U.S. Even without the almost certain costs of retaliation, bread in Canada could climb from $3.50 to $5.00 per loaf. Spread across the grocery sector, it amounts to thousands lost annually to price hikes. Atop inflated prices, job losses due to corporate cost-saving measures could spell catastrophe for Canada.

Trump’s hardball mindset is that this is Canada’s problem and that it can be solved simply by submission to his demands, but it’s more likely that the U.S. will then be thrown into a “shallow recession” before he’s even finished decorating the West Wing. As O’Leary warned about potential unrest in China, unhappy Americans dissolve any leverage Trump and Republicans in Congress may have in this trade standoff.

To get a better look at the potential repercussions, we can look at the effects of the 1930 Smoot-Hawley Tariff Act, which imposed tariffs on tens of thousands of imported goods in an attempt to protect American farmers and industry during the Great Depression. The result was an international trade war that caused global trade to fall by 66 percent and U.S. exports and imports by about two-thirds, effectively worsening and prolonging the Great Depression in the U.S.

Of course, Canada responded to Smoot-Hawley in the same way Ottawa is planning right now, sparking their own economic depression north of the border. It’s the epitome of the phrase “cutting off your nose to spite your face.”

At the very least, President Trump should not pursue rash day-one tariffs after his inauguration is over. The market shock will be severe. At best, trade negotiations should proceed with caution and tariffs should be recognized as the tax on consumers that history has shown them to be.

Reality must be our guide if North America is going to rebound and unlock its economic potential in the years to come. Canada and the U.S. can both thrive, and that means we must come together.

Originally published here

SCOTUS Skeptical of an FDA Acting Arbitrarily Against Vape Products

Washington, D.C. – The U.S. Supreme Court today heard oral arguments in FDA v. Wages and White Lion Investments, LLC, a pivotal case concerning the Food and Drug Administration’s rejection of applications to market flavored nicotine vaping devices.

This is a landmark case for regulatory accountability related to public health and consumer choice.

At issue is whether the FDA acted arbitrarily and capriciously when denying numerous premarket tobacco product applications (PMTA), as alleged by the manufacturers and affirmed by the U.S. Court of Appeals for the 5th Circuit, which accused the FDA of a “regulatory switcheroo”.

Elizabeth Hicks, US Affairs Analyst of the Consumer Choice Center, observed today’s arguments and weighed in on the consequences of the case for consumers,

“This case underscores the need for fairness and transparency in regulatory processes. The FDA’s blanket denials have placed enormous hurdles on firms providing harm-reduction alternatives, potentially decimating an industry that millions of adult consumers rely on to transition away from smoking traditional cigarettes.”

Advocates of prohibition on flavored e-liquids, including groups like the American Medical Association, have characterized these products as targeting youth rather than adult consumers. Arguments in front of SCOTUS focused on whether the FDA had been transparent and consistent in why product applications were denied and what was lacking in the marketing plans of the applicants.

Associate Justice Clarence Thomas observed that the FDA guidance was indeed “a moving target” that shifted throughout the process, while Associate Justice Neil Gorsuch lamented that applicants where not granted conditions for jury trials in administrative cases, as the Court outlined in SEC v. Jarkesy.

Hicks continued, “The FDA’s rejection of Triton and Vapetasia’s applications demonstrates a failure to balance or even understand public health priorities and opportunities provided by less harmful nicotine products. While we all agree on the need to keep these products out of the hands of young people, denying adult smokers access to safer alternatives like flavored vaping devices could have dire consequences for harm-reduction efforts. Regulatory decisions should be evidence-based, not rooted in unachievable or shifting standards that are unreasonable to provide.”

The Consumer Choice Center calls on policymakers and regulators to prioritize consumer access to safer alternatives and ensure regulatory clarity around nicotine products.

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The Consumer Choice Center is an independent, nonpartisan consumer advocacy group championing the benefits of freedom of choice, innovation, and abundance in everyday life for consumers in over 100 countries. We closely monitor regulatory trends in Washington, Brussels, Ottawa, Brasilia, London, and Geneva.

Find out more at www.consumerchoicecenter.org

Health and life insurance policies should accept the science on nicotine

Washington, D.C. – Today the Consumer Choice Center launched its policy primer offering simple reforms to provide Americans with more competitive, reasonable, and accurate insurance rates. The result of reform would be more choice and lower costs for consumers in the insurance market.

The primer, Fixing What’s Broken: Practical Consumer-Friendly Insurance Reforms to Save Money, focuses on two pressing issues for American consumers. First, it analyzes how insurance providers can adapt to the emerging scientific reality of tobacco harm reduction and consumer trends toward less harmful nicotine alternatives to smoking. Second, this primer explains different models for structuring consumer auto insurance and suggests how costly legal battles can be minimized, in turn lowering costs and premiums.

Elizabeth Hicks, US Affairs Analyst at the Consumer Choice Center, commented on the health & life insurance policy recommendations, saying, “Anyone who’s ever applied for health or life insurance has had to answer if they use nicotine, and that inevitably leads to higher premiums. But those who use less harmful non-combustible nicotine products such as vaping or pouches don’t face nearly the same risk. Why should they pay the same high premiums as smokers?”

By discerning the significant differences between traditional tobacco products and non-combustible nicotine alternatives for health and long-term medical costs, insurers and consumers together stand to save millions.

“The health insurance industry, as well as policymakers, should want smokers to cease smoking or switch to less harmful alternatives. Insurance plans are long overdue for accurately calculating risk around nicotine-use and restructuring consumer’s rates,” added Hicks.

Guided by state insurance commissioners, actuarial calculations at insurance firms should be recalibrated to reflect the current scientific reality on tobacco harm reduction, giving smokers an immediate financial incentive to make the switch to less harmful products. It makes no sense to penalize nicotine users who do not use combustible products.

“This change would not only reflect scientific consensus, but also promote a better economic calculation on future costs and risk profiles in the healthcare space. It would give more options to insurance firms and spur them to compete for potential customers,” concluded Hicks.

The policy primer can be read in full HERE.

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Consumer Coalition Sends Letter to OPM Opposing Health Insurance Denials

On September 19th, the Consumer Choice Center, alongside individuals impacted by the actions of Blue Cross Blue Shield (BCBS), sent a letter to the Office of Personnel Management regarding BCBS denying legitimate medical claims from members of the Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) agencies for equipment needed to do their jobs safely and effectively.

Blatant denials in health insurance coverage are on the rise and pose a great threat to consumer choice. In 2022, an estimated 15 percent of all claims submitted to private payers faced denial, including treatments and services that received pre-authorization. However, the reality might be much worse considering the severe lack of quality data collected by regulators from health insurance companies regarding their coverage denial rates.

There is a clear need for health insurance reform. As the Consumer Choice Center has stated before, one easy solution is to require health insurance companies to be more transparent in their coverage decisions to ensure consumers are aware of a company’s denial rates and standards they use to determine what is and what is not a medical necessity.

Additionally, more preventative care and coverage should be encouraged. In the case of CBP and ICE agents, having better hearing protection now as a preventative safety measure will alleviate costs in the long term. The faster we can address and prevent a medical issue, the less people’s health and wallets will suffer.

This is why we hope that the Office for Personnel Management will take the necessary steps to ensure federal employees receive the equipment that they need to do their jobs safely and effectively.

Consumer Choice Center Urges Immediate Action on Insurance Denials for Federal Agents’ Protective Equipment

September 19, 2024

The Honorable Rob Shriver
Director
Office of Personnel Management
19000 E St NW
Washington D.C. 20415

Dear Director Shriver,

We are writing to you about an important consumer issue that requires your attention and immediate action. Our coalition is made up of consumer advocates and individuals that have been directly impacted by the actions of Blue Cross Blue Shield (BCBS) who have decided to deny legitimate medical claims from members of the Customs and Border Protection and Immigration and Customs Enforcement (ICE) agencies for equipment needed to execute on their mission safely.

It has come to our attention that federal employees across a wide range of agencies and occupations are encountering issues of insurance delays and denials following the purchase of legitimate, medically necessary preventative equipment. Under Blue Cross Blue Shield’s federal insurance information, medical necessity is defined as “healthcare services that physician, hospital, or other covered professional or facility provider, exercising prudent clinical judgment, would provide to a patient for the purpose of preventing, evaluating, diagnosing, or treating an illness, injury, disease, or symptom.^[1]”

Despite the inclusion of preventive equipment in the clearly defined definition of medical necessity, Blue Cross Blue Shield has been unduly denying federal agents, specifically CBP and ICE agents, access to protective hearing equipment that can prevent permanent and irreversible hearing loss that would result in future claims for hearing aids on a regular basis for the remainder of the patient’s life. We have received numerous reports of CBP and ICE officers (many of whom have signed this letter) receiving denials for equipment that was previously accepted without issue.

Multiple federal employees have cited instances where they were able to receive molds for hearing protection from BCBS, only to later deny their claim. This indicates a concerning pattern of the insurance company reversing its opinion and promised action, not only creating legitimate medical concerns for officers, but also adding confusion and uncertainty to their roles.

Many of these same agents cite existing hearing loss sustained in the line of duty and have expressed concerns that continuing without this preventative equipment could result in further permanent hearing loss. Officers are routinely asked to engage in activities that involve routine exposure to loud noises, such as helicopters and ATV patrols. Additionally, several officers have been subject to unexpected loud explosions and weapon fire, as well as extremely loud environments in commercial vehicle settings, all of which pose a serious risk of long-term hearing damage.

Not only does denying federal agents access to medically necessary equipment compromise the safety of federal employees, but it also increases the risk of permanent injury, resulting in additional long-term costs for the individual and federal government overall. On principle, insurance companies cannot be allowed to pick and choose when they honor their policies. Allowing them to ignore, dispute, and deny legitimate claims is a dangerous precedent that the Office of Personnel Management has a statutory duty to address.

It is the responsibility of the Office of Personnel Management to “elevate and honor service to America by leading Federal agencies and the workforce in people management policies and programs.”

We trust that the Office for Personnel Management will take the necessary steps to ensure federal employees receive the equipment that they need to fulfill their mission.

Sincerely,

Elizabeth Hicks

US Affairs Analyst

Consumer Choice Center

Aldo Aviles, Customs and Border Protection

Robert Nieto

David Neuss

CC:

The Honorable Kim Keck Chief Executive OfficerBlue Cross Blue Shield 200 E. Randolph Street Chicago, IL, 60601	The Honorable Pam Kehaly President Blue Cross Blue Shield Arizona 2444 W Las Palmaritas Dr Pheonix, Arizona, 85021
The Honorable Kevin Lanning Chief Executive Officer Compass Rose Health Plan 11490 Commerce Park Dr. Ste 220 Reston, VA, 20191	The Honorable Arthur A. Nizza Chief Executive Officer GEHA1900 E St NW Washington D.C., 20415
The Honorable Paul Hogrogian National President MHBPPO Box 981106 El Paso, TX, 79998	The Honorable Stephanie Stewart Director NALC 20547 Waverly Ct Ashburn, VA, 20149
The Honorable Thomas J. Grote Chief Executive Officer Aetna 151 Farmington Avenue Hartford, CT, 06156	The Honorable Brian Thompson Chief Executive Officer United Healthcare Insurance Company 9700 Health Care Ln Minnetonka, MN, 55343
The Honorable Randy Griffin Chief Executive OfficerAPWU Health Plan 6515 Meadowridge Rd STE 195 Elridge, MD, 21075

Healthcare Denied: Should Insurance Companies Direct Doctors?

Step Therapy: Health Insurance Companies Control Patient Care

Step therapy, also known as “fail-first” therapy, is a shockingly common strategy used by health insurance companies to cut their costs. This method forces patients to experiment with cheaper drugs and treatments before the health insurance company finally approves more expensive options, even if their doctor determines early on that the pricier treatment is the best path forward.

This approach might make sense for the health insurance companies’ bottom line, but it’s a massive insult to patients. The experimentation on low-end treatments causes delays in receiving vital care, and in some cases even threatens their life.

‘Step Therapy’ vs Patient’s Dignity

Health insurance companies use step therapy protocols for a number of health conditions which significantly affect the quality of patient care.

Cancer patients, for example, often can’t afford to wait. Step therapy protocols require patients to try old or less effective chemotherapy treatments before they can receive newer more targeted immunotherapies like Keytruda or Opdivo.

These new immunotherapies are an innovative breakthrough in medicine that save lives for specific types of advanced or aggressive cancer. Additionally, the treatment works differently by firing up and training the immune system to actively destroy cancer cells in the body. A very different path from traditional chemotherapy, which kills cancer cells while also destroying the patient’s immune system.

Patients with multiple sclerosis (MS), a debilitating nerve disorder, also commonly must deal with step therapy protocols. Although there are cutting-edge treatments available on the market like Ocrevus or Lemtrada, which have shown to slow down the rate at which MS progresses while increasing the quality of life for MS patients, health insurance companies are known to have these patients try older and less potent options like Avonex or Copaxone.

If these patients “fail” or their condition worsens on the older options, then health insurance companies might consider covering the newer more expensive medications. These delays, if coverage is granted at all, can cause lasting harm and exacerbate preventable problems.

Step therapy protocols are even used for obesity treatment. Now that innovative GLP-1 weight loss medications have entered the market like Ozempic and Wegovy, it seems as though many patients are eager to get their hands on them to help control their weight and boost overall health.

Some health insurance companies require patients to try options like diet, exercise, or older medications like Phentermine or Orlistat before approving newer treatments. These older treatments may not work well for everyone. Forcing patients to stick with outdated, less effective options just to save insurance companies money is unfair and needs to change.

It is an affront to the dignity of human beings suffering through an illness to not be approved for the best possible treatment as quickly as possible.

A Better Way to Balance Healthcare Costs

The step therapy model we have within our healthcare system now puts money above patient care and choice, but there are better ways forward to balance healthcare costs while ensuring patients get the treatment they need when they need it.

A simple solution would be to allow doctors to override step therapy when they believe a newer or more effective treatment is needed. This would give physicians the power to choose the best care without unnecessary delays, leading to better patient outcomes. Quick access to the right treatments can help prevent further health complications and reduce long-term healthcare costs. Another option that should be explored is patient-centered plans that prioritize transparency. Consumers should have more options when choosing their health insurance, and more transparency from the health insurance companies regarding what their plans will and will not cover, how they determine step therapy protocols, transparent pricing, and all other pertinent information that will help consumers decide which health insurance company and plan is right for them.

Healthcare denied: Blatant Coverage Denials

Health Insurance Coverage Denials: A Threat to Consumer Choice

Health insurance companies are facing justified criticism for denying claims more often and becoming increasingly unlikely to cover vital, sometimes life-saving, treatments. These denials go beyond complex medical procedures or expensive experimental drugs – they are now affecting even basic preventative care, which consumers expect as baseline components of their health insurance plans. Unfortunately, this reveals another layer of a growing trend wherein insurance companies put profits above patients. To help patients stop health issues before they start, we need to make changes that hold health insurance companies accountable while still allowing patients the choices in healthcare they deserve.

Need for Data & Transparency on Coverage Denials

Throughout the country, health insurance companies are denying more and more claims for necessary medical care. In 2022, an estimated 15 percent of all claims submitted to private payers faced denial, including treatments and services that had received pre-authorization.

This number could be much higher, as current reporting requirements for health insurance companies don’t require full disclosure of their denials. The Affordable Care Act granted federal regulators the ability to collect information from health insurance companies on their coverage denials, however only a fraction of the information has been collected thus far. What little information and data was released has been deemed by experts as so crude and inconsistent that it is essentially meaningless.

This lack of transparency leaves patients blindly entering into health insurance plan contracts without knowing fully what they will and will not cover – and if they face a coverage denial, then the choice is often to let their health deteriorate or pay the exorbitant out-of-pocket costs.

Real Life Consequences of Coverage Denials

When you acquire health insurance, the hope is that you won’t need to use it, but it’s there to help in case you do. Unfortunately, even while paying all of your premiums and deductibles, a claim for coverage can still be denied.

One egregious example of coverage denial is what was experienced by Sayeh Peterson, who never smoked cigarettes and still learned that she had stage 4 lung cancer at age 57. Her doctors suggested genetic testing to help investigate the cause. The genetic tests showed that a rare genetic mutation had caused her illness, which then helped her medical team to create an effective treatment plan to aggressively attack the cancer. While preventative tools like genetic testing are required by law to be covered by health insurance companies in her state, her health insurance company had denied the coverage, leaving Sayeh with over $12,000 in medical bills to pay on her own.

Another example is that of U.S. Customs & Border Protection (CBP) agents in Arizona being denied coverage by Blue Cross Blue Shield of Arizona (BCBS) for necessary preventative hearing protection. These agents are plagued with loud noises that can cause significant hearing damage from things like trucks, helicopters, and other gear needed to do their job. To prevent hearing damage and additional healthcare costs from dogging the agents, CBP wants FDA-approved Phantom hearing protection as it guards the user’s hearing while letting you stay alert and in communication with others. Despite BCBS plans covering preventative care, they have refused coverage of Phantom hearing protection to CBP agents, stating it is not a “medical necessity”.

What health insurance companies are failing to understand is that by prioritizing preventative and effective care early on, they save vast sums of money in the long run as morbidities are addressed earlier. This prevents conditions from spiraling out of control to the detriment of both the patient’s and insurance company’s bottom line.

Time For Reform

The health insurance industry must prioritize patient care over cost-saving measures.

One easy solution is to require health insurance companies to be more transparent in their coverage decisions. Providers must be open with consumers about denial rates and the standards they use to determine what is and what is not a medical necessity.

Making this information public will spark competition, push insurers to improve approval processes, and aid consumers in evaluating their coverage options. It’s important we have accountability mechanisms built in where there is easy recourse for patients to rectify a wrongful coverage denial.

Another common sense solution is to encourage preventative care – whether that be genetic testing, hearing protection, or whatever else – so as to alleviate consumer costs in the long term. The faster we can address a medical issue, the less patients’ health and wallets will suffer.

Healthcare Denied: Pre-Authorizations Denials

Insurance Holdups & Hassles

The US healthcare system has a lot of problems, but here’s a big one: health insurance companies demand pre-authorization for many vital treatments and services. They say it is to keep costs down, but in reality, it makes it even more challenging for patients to get the healthcare they need…when they need it.

Mandatory pre-authorization rules delay treatment, create more paperwork for doctors’ offices, and interfere with doctors and patients making medical decisions together.

The solution? More transparency and accountability regarding plan coverage and fewer healthcare services requiring a pre-authorization. This way, patients and doctors can make timely individualized healthcare choices without jumping through unnecessary hoops. Having medical issues, whether life threatening or routine, is stressful enough as it is without waiting for insurance providers to green light your treatment.

Effects on Patient Care

Anyone who has ever used the healthcare system before knows that we’re talking about a space where life literally hangs in the balance. Time is not on everyone’s side. Pre-authorization refusals can cause risky holdups in receiving necessary treatment, dragging on for days or even weeks before consumers get a response from their health insurance provider. In 2023, 22 percent of adults insured under Medicaid experienced pre-authorization problems, along with 11 percent of those insured through Medicare and 15 percent using employer-sponsored coverage.

You’ve probably heard someone in your life say, “Thankfully, we caught it in time,” when sharing news of an illness. In too many cases, delays result in a patient’s condition getting worse, so much that they need additional pre-authorizations for health care services as a result of the first pre-authorization. Research shows that of the adults who had more than 10 doctor visits in 2023, 31 percent experienced pre-authorization challenges.

Comparatively, adults who visited the doctor 3 to 10 times had pre-authorization problems at a rate of 20 percent.

Those who visited just 2 times or less had pre-authorization problems at a rate of 10 percent.

This demonstrates that those who need more healthcare services are the ones most likely to be denied pre-authorizations, increasing delays and overall harm to their health.

Patients with serious illnesses are at a major disadvantage with health insurance companies.

Let’s say you have a rare chronic lung disease that requires special medication and treatment. Your doctor finds a groundbreaking treatment, but the insurance company wants to approve it first. If the insurer labels the treatment ‘experimental’, then you will likely be denied pre-authorization and will find yourself stuck in red-tape limbo while your health continues to deteriorate — even if the doctor recommends action.

Patients deserve a choice in their healthcare treatments, without health insurance companies getting in the way of decisions made between patients and their doctors.

Cut Down on Pre-Authorization Rules & Increase Transparency

An easy reform to increase patient choice and enhance care is to reduce the number of medical services that require pre-authorization. Rather than depending on insurance companies to approve treatments beforehand, we would empower doctors to make the best choices with their patients, and reduce outside meddling.

Additionally, if insurance policies were more transparent, patients could easily compare plans based on which treatments need pre-authorization. This would spark competition among insurers and push them to simplify, or perhaps even get rid of pre-authorization approvals altogether in a bid to attract consumers.

Pre-authorization denials reveal a broken approach to healthcare that prioritizes cost-cutting over patient health. By reducing services that require pre-authorization and increasing transparency for coverage upfront, we can rip through the needless red tape holding back patients with better healthcare delivery.

These changes wouldn’t solve all of the pitfalls of the American healthcare insurance system, but it would certainly get us closer to a system that prioritizes patient care above all else.

Big Spending on Broadband Will Fail Without Reforms

President Biden is focused on his legacy. His administration has made massive investments in infrastructure, a pillar of the 2020 election campaign, but much of the work remains. As Biden shifts attention away from pursuing reelection and toward his presidential duties through January, fulfilling his promise to connect America with high-speed internet and broadband could still be what Biden is remembered. But there’s a problem.

Many close to Biden have acknowledged that the administration’s bureaucratic “procedure fetish” is strangling his broadband agenda with red tape. Billions of taxpayer dollars are stuck in limbo, as with every significant Biden spending program ranging from chip plants to EV chargers all falling behind schedule with little to show for the massive public investment.

The 2022 infrastructure bill devoted a massive $42.5 billion to rural broadband expansion, and for good reason. About 25 million Americans don’t have options for wired broadband service, leaving them cut off from untold remote job opportunities, schooling options and telehealth care. The federal government has failed to pair these investments with streamlining reforms to bulldoze the barriers blocking the bipartisan dream of “internet for all.”

Policymakers are running out of time to remove the procedural obstacles and legislative loopholes preventing meaningful progress. They should start with an obstacle that is boringly ubiquitous yet critically important: utility poles.

Poles are a vital piece of the rural broadband puzzle. The companies that will receive federal money to build networks through rural America must connect their fiber lines to thousands upon thousands of poles owned by other companies. Federal law requires most utilities to let broadband providers rent space on their poles, but these rules have glaring loopholes.

Enforcement has historically moved too slowly to be effective, and the Federal Communications Commission’s efforts to speed up this process remain untested. The result is a mess of access challenges that has slowed rural broadband projects for years and created a headache for network builders that will soon be a five-alarm fire for taxpayers who put up billions for the project.

Here’s what will happen if D.C. doesn’t act: As states award this federal infrastructure funding, broadband providers will ask pole owners for permission to attach fiber along each project route. Some routine requests may be quickly approved, but many may sit unanswered for months.

Others may spark prolonged fights over who should pay to replace old, damaged poles. In some cases, monopoly pole owners — who may have plans to offer broadband service — may refuse to let competing providers rent space.

Billions of dollars of taxpayer-funded broadband projects will halt and devolve into legal disputes that last for months or years. Rural communities will continue to languish without broadband access.

Wise, common-sense reforms would help avoid this debacle. Congress should start by closing the loopholes that exempt rural electric co-ops and municipal utilities from having to share space on their poles. The bipartisan goal of wiring rural America must take precedence over legislative favoritism and special interest carve-outs.

The FCC can help by moving more quickly to resolve pole attachment complaints. Years of slow and ineffective enforcement have let bad actors off the hook while tacitly encouraging pole owners to drag their feet. The FCC recently rolled out a faster process for resolving complaints, but it’s unclear how aggressively the agency will leverage this new tool. If Biden’s FCC appointees want their boss’s signature broadband program to be remembered as anything more than a disaster, they’ll need to enforce the law — quickly, fairly and consistently.

The alternative is to stand by and act surprised as $42.5 billion in broadband funding goes up in smoke, betraying the promises Washington has made to rural communities desperately awaiting broadband access. Those rural consumers know that’s the worst of all worlds.

Biden and Congress need to start taking these risks seriously — and soon — before his big spending on broadband becomes a case study of government failure, and millions of Americans miss out on a connected future.

President Biden has time to make a real difference before the next president is inaugurated and bring Americans closer together with broadband access.

Originally published here

E-Rate Expansion: A Costly Mistake for Consumers

The FCC is preparing to vote on an order to expand the E-Rate program, which although well-intentioned, could end up being a bad deal for consumers. The order proposes to allow schools and libraries to purchase Wi-Fi hotspots and wireless internet services for off-premises use, extending the program’s reach far beyond its original scope.

The Universal Service Fund (USF), which supports the E-Rate program, is funded by a tax on consumers’ phone bills. Currently, this tax sits at a staggering 34.4%, a notable increase from previous years. Expanding the E-rate program would only put further pressure on this tax and make it even more expensive for consumers. With numerous federal and state initiatives already funneling billions of dollars into broadband programs, adding more financial strain onto consumers through tax increases is not the prudent choice.

What Is E-Rate Even For?

The primary aim of the E-Rate program has always been to provide connectivity to schools and libraries but funding off-premises Wi-Fi and wireless services would deviate the program from its intended purpose. This move could dilute the efficacy of the E-Rate program and divert resources from ensuring educational institutions and libraries actually have robust connectivity.

A critical concern within the proposed expansion is the potential for redundant and wasteful overbuilding of existing networks. E-Rate funds have sometimes led to inefficient spending and duplicative infrastructure and the proposed safeguards in the new order are insufficient to prevent this. With so many programs already in existence to address broadband access, this expansion risks unnecessary and wasteful use of funds.

The Start of an FCC E-Rate Overstep

Expanding the E-Rate program to fund consumer devices and off-premises internet services exceeds the FCC’s statutory authority. Congress has specifically limited the E-Rate program to enhancing connectivity within classrooms and libraries, so the FCC’s attempt to extend this mandate goes beyond what the law permits. These actions undermine the legal framework and could result in setbacks that will further delay the FCC’s commitment to streamline federal broadband funding that helps get unserved and underserved consumers connected to the internet.

The FCC should focus on optimizing the existing E-Rate program to fulfill its core mission of increasing connectivity within schools and libraries, not overstepping its authority and increasing taxes. Consumers want to be connected to the internet, but the FCC’s recent actions leave us questioning if and when they will ever bridge the digital divide.

E-Rate Expansion Takeaways

Optimize the existing E-Rate program to focus on connectivity within schools and libraries.

Avoid extending the E-Rate program to off-premises Wi-Fi to prevent increased consumer taxes.

Ensure the E-Rate program adheres to its statutory authority, focusing on classrooms and libraries.

Streamline federal broadband funding to effectively connect unserved and underserved consumers.

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