BISMARCK, N.D. -- As COVID-19 hospitalizations grow, so do the medical bills at a time of economic struggle for many families. But people can take steps to shield themselves from insurmountable debt.

According to state health officials, overall coronavirus cases are slowing but hospitalizations remain at near-record levels. The federal CARES Act allows for people who are uninsured to avoid paying for COVID-related treatment, but Rich LeMay, executive director of Legal Services of North Dakota, said hospitals aren't required to tell patients, and some don't readily provide the information -- and when a patient is admitted, they don't often think to inquire about the final bill.

"Somebody gets sick, somebody gets injured, that's not the first thing they're thinking about," he said. "They're concentrating on maybe one, staying alive - and two, getting healthy again."

Generally speaking, LeMay said, people facing heavy debt can apply for programs such as Medicaid, which can provide three months of coverage retroactively. He added that if bills have been sent to creditors, it's important to read and keep all the documents, making it easier to navigate any legal action.

A 2019 report from the Urban Institute found 9% of North Dakotans had medical debt in collections. There are fears that percentage will grow as more people have needed hospitalization in recent months.

When the bills arrive, LeMay said, try to work with medical providers to establish a plan that won't leave you drowning in debt.

"You can negotiate. You can develop payment plans," he said. "You can do all kinds of things to try to reach some type of settlement."

He said filing for bankruptcy is a last resort, as it affects more than your medical debt. Other balances such as credit cards would be included, even if you wanted to leave those untouched in a bankruptcy filing.

Two of the largest credit card companies in the United States want federal regulators to greenlight a merger and the deal has been met with skepticism from a consumer rights group.

Capital One and Discover Financial Services agreed in February to combine their services in a $35 billion deal.

Patrick Woodall, managing director of policy at Americans for Financial Reform -- which is composed of civil rights, labor and other civic organizations and promotes an equitable financial system for consumers -- noted the merger would pose a hardship for some.

"This disproportionately impacts Black and Latino families who are much more likely to have subprime credit scores, much more likely to struggle paying their credit card bill," Woodall pointed out. "It would give the company the power to extract value and money from these working families."

Corporate mergers often mean excess jobs will be cut. In 2021, Discover opened a customer care center in Chicagoland, but Woodall fears call center and marketing positions there are on the line. Should the merger receive approval, Capital One has vowed to retain all Discover workers for one year. Then, Capitol One's management can legally close all Discover operations.

The Bank Merger Review Modernization Act mandates federal regulators consider the effects of a proposed merger on the community it serves. According to the financial site Experian, Illinoisans hold an average yearly credit card balance of almost $7,000.

Woodall believes the merger will lead to increased credit card costs, which he said are "likely to gouge consumers."

"It's creating a bank so large and so weighted towards credit cards that in the event of sort of an economic downturn, this bank could be in trouble," Woodall contended. "That could cause systemic problems across the broader economy and banking system."

The Federal Reserve and the Office of the Comptroller of the Currency will hold an open meeting July 19 for community input. Woodall hopes federal regulators will "do the right thing" by standing up for the statutory requirements and blocking the merger.

Summer is in full swing and as temperatures increase across the state of Arizona, so do energy bills.

Diane Brown, executive director of the Arizona Public Interest Research Group Education Fund, said Arizonans can easily cut down on their electric bills, from steps as simple as turning off lights or electronics when they are not in use, to investing in a "smart" thermostat to provide better control of a home's temperature.

Brown added people should check with their utility company to ensure they are on the best rate plan, especially if there has been a change in the number of people living under one roof.

"Often your utility can help you cut down on your monthly bill through energy efficiency discounts and rebates," Brown explained. "Helping you to assess if you're on the best rate plan for your household."

For people struggling to pay their bill, she noted utilities offer financial assistance or can point you to a nonprofit to can help. An appliance taking in one watt of electrical current at all times is equivalent to nine kilowatt-hours per year. These so-called "energy vampires" cost the average household between $100 and $200 a year, according to the U.S. Department of Energy.

Brown pointed out cutting energy waste does not require a dramatic change in daily habits or comfort. Just closing curtains during the hottest part of the day can reduce the amount of heat entering a room by up to one-third. She added using ceiling fans to help offset air conditioning is another money-saver; and avoiding using your oven in the summer is another smart strategy.

"Using an air fryer, a slow cooker, microwave or a grill can help to reduce the amount of heat in a room," Brown emphasized. "Which will help to reduce the amount of air conditioning that is being employed, thereby saving money."

Brown acknowledged utility companies often propose raising households' monthly rates and fees. She added if you are behind on an electric bill or anticipate having a hard time paying it, contact the company or the statewide nonprofit Wildfire, to learn more about the Home Energy Assistance Fund.

As Hoosiers gear up for Independence Day, safety experts are stressing the importance of handling fireworks responsibly.

Trevor Hash, division chief for prevention at the Noblesville Fire Department, warned against using illegal fireworks because of the dangers they pose. Injuries are less common now thanks to awareness but there still will likely be injuries.

"As far as injuries go, we've had injuries in the past -- they're not as common because of things like what you're doing right now -- the awareness of you don't want to go out there and touch the dud," Hash explained. "You want to have an adult set them off and have a big perimeter."

Last year, the U.S. Consumer Product Safety Commission reported around 10,000 fireworks-related injuries and eight fatalities in the nation. Hash reminded everyone fireworks can easily ignite nearby structures, vegetation and clothing, leading to severe burns, lacerations and eye injuries. Keep children at least 100 feet away and never let them handle fireworks.

Hash also noted the stress fireworks can cause for people with PTSD and pets.

"Pets around fireworks; pets run out, people chase the pets and then they get injured," Hash observed. "And then the duds. Don't go grab the firework. We want to give those five to 10 minutes to see if they're going to go off. If you can leave those overnight, even better. We definitely want to make sure those go in a bucket of water."

According to Indiana law, only people 18 years of age or older can purchase fireworks.


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