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News

Jul 14, 2023

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Julia previously served as the Connelly Policy Advocate at CCLP, supporting CCLP's legal and legislative efforts to advance economic justice and racial equity in Colorado.

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CCLP at Federal CFPB Hearing: Medical debt is a solvable crisis

by | Jul 14, 2023

CCLP in the News, Equity work, Health, Research and Policy Analysis

On Tuesday, July 11, 2023, Julia Char Gilbert, CCLP’s Connelly Policy Advocate, was a panelist at the Consumer Financial Protection Bureau hearing on medical billing and collections in Washington, D.C. Watch a recording of the hearing here, and read her prepared remarks below.

 

Good morning, and thank you to Director Chopra, Deputy Director Martinez, CFPB staff, the U.S. Department of Health and Human Services, the U.S. Department of the Treasury, and the other speakers today for your work on this very important issue.

My name is Julia Char Gilbert, and I’m a Policy Advocate at the Colorado Center on Law and Policy, an anti-poverty advocacy nonprofit in Colorado.

I’d like to begin today by sharing the story of a community member named Misty.

When Misty was 23, she had open-heart surgery for a congenital heart defect. The surgery left her with $200,000 in medical bills that she was unable to pay. At the time, Misty was married to an abusive partner and wanted a divorce. But she got her health insurance through her husband, and because her medical debt had ruined her credit, Misty could not get housing, a car, or a credit card without her husband. As a result, Misty was forced to stay in an abusive relationship for years.

Misty’s story – and the fact that there are tens of millions of other Americans like Misty – should signal to us that there is something very wrong with our health care system.

I’d also like to underscore that medical debt is an urgent equity issue: Medical debt reflects and amplifies inequities in our society.

The communities that are least well served by our health care system and our economic systems are the communities that have the highest rates of medical debt. People of color, low-income people, people with disabilities, and women are all disproportionately impacted.

Furthermore, medical debt takes a toll on your health, and it creates barriers to economic stability. So, when we have marked disparities in who carries medical debt, we should be concerned about who is bearing the brunt of those downstream harms as well.

We applaud the CFPB and the Biden-Harris Administration for their leadership on medical debt to date. In particular, I’m pleased to share that the CFPB’s recent interpretive rule on preemption of the Fair Credit Reporting Act has catalyzed stronger consumer protections at the state level.

Just last month, Colorado became the first state in the country to prohibit credit reporting of medical debt, and New York is soon to follow. Medical debt is a poor predictor of creditworthiness, and we believe people deserve a fair chance at getting back on their feet after a major medical event. We estimate that these protections will provide relief for 1.4 million households in Colorado and New York, and we’re hopeful that other states will follow suit.

We’re excited about these victories, and we also know more work is needed.

We urge bold action to reduce harm for people who’ve incurred medical debt, including a nationwide ban on credit reporting of medical debt and stronger consumer protections around harmful financial products.

We also urge interventions further upstream to protect people from incurring medical debt in the first place. For example, we need more robust requirements for hospital financial assistance programs, to ensure that low-income patients aren’t facing bills they could never reasonably be expected to pay.

Medical debt is a crisis, but it is a solvable crisis. And we believe the CFPB and other federal agencies are well positioned to take additional action.

Thank you for your time and your continued leadership.

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Recent articles

CCLP testifies in support of TANF grant rule change

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CCLP's Emeritus Advisor, Chaer Robert, provided written testimony in support of the CDHS rule on the COLA increase for TANF recipients. If the rule is adopted, the cost of living increase would go into effect on July 1, 2024.

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.