Pictures of large medical bills are sometimes shared on social media to show how patients can be blindsided by unexpected costs for care, but as the new year begins, consumers will be offered federal protections to avoid health-care sticker shock.

On Saturday, the No Surprises Act takes effect. Supporters said it will block out-of-network providers from sending large bills to patients who did not choose who cared for them in an emergency situation.

Patricia Kelmar, health care campaigns director for the Public Interest Research Group (PIRG), said getting statements in the mail can be very hard for the many Americans who don't have much in the savings accounts to cover the expenses.

"And when you think about the average out-of-network bill for anesthesia is $1,200, these costs can create a real burden on consumers and can lead to medical debt," Kelmar explained.

She noted under the law, your bill cannot be sent to collections while you have a complaint under review. Groups such as the American Medical Association have sued the federal government, saying while they back the law, they oppose the arbitration process drawn by regulators. And the North Dakota Health Information Management Association worries it could force smaller providers out of business.

The statewide group said consumer protections are needed, but argued the process caters to larger providers who have more patient volume.

Kelmar contends the law is trying to establish reasonable fees based on average contracted rates in a community.

"We're seeing higher-than-average, higher-than-market prices from many specialties that use surprise billing as a way to increase their profits," Kelmar contended.

She added more emergency rooms are being staffed by private-equity firms using contracted specialists.

Groups such as PIRG pointed out while the law will make a difference, they have suggested changes of their own. Kelmar noted the measure addresses air-ambulance service from-out-of-pocket providers, but leaves out ground transport.

"Your ground transportation, the ambulance that we think of when we call 911, those bills from an out-of-network ambulance could still be your financial responsibility," Kelmar cautioned.

According to federal estimates, the law will impact roughly 10 million surprise medical bills each year. Nearly 30 states have similar protections in place, but policy experts say they're often limited in scope. North Dakota is among the states without these protections.

As the new year quickly approaches, Wisconsin business owners and shoppers alike are bracing for the prospect of tariffs from a new administration that could affect both their livelihoods and families. Eau Claire Outdoors is a shop that sells gear for camping and backwoods experiences.

Kate Felton, shop owner, said she carries products manufactured both in the U.S. and elsewhere. She worries about shoppers being able to afford the brands she stocks if U.S. manufacturers increase prices as a result of tariff backlash.

"The Trump tariffs really couldn't come at a worse time for small businesses. Certainly, there's no good time for this to come - but this moment in particular is just a very dangerous moment for prices to increase on small businesses," she explained.

Eau Claire small businesses saw record-low sales this past year, she added, including the lowest turnout for Small Business Saturday in over a decade. Felton said the uncertainty has also made her and her husband reconsider plans to start a family. President-elect Donald Trump has promised to impose a new slate of tariffs as soon as he enters office in January.

Tariffs, or taxes on imports, are paid by businesses purchasing goods from other countries. Economists say tariffs are typically passed on to consumers of anything the U.S. imports, from electronics and home goods to gas.

Thomas Kemp, University of Wisconsin-Eau Claire economics department chair, suspects a significant number of businesses in the state would feel the effects.

"Let's say a small Wisconsin business is dependent upon a Chinese supplier for, say, machinery and equipment, that's going to impact them significantly. Or if they're a retailer that sells primarily goods and services made in China, they're going to be impacted by this," he explained.

In 2022, Wisconsin, imports totaled $41-billion, the highest level recorded in state history, according to Wisconsin Economic Development. The state ranks 20th nationally for imports.

As Michiganders mail their Christmas cards and gifts, postal union members warn that proposed changes could slow mail delivery. The plan to cut costs in the Postal Service includes ending evening pickups in remote regions, holding some mail overnight before processing, and reducing transportation frequency, potentially causing widespread delays - especially in rural communities.

Michael Mize, president of the Michigan Postal Service Union, said there is a shift taking place within the Postal Service that's not in the best interest of the people it serves.

"The problem is, in my opinion, is we're trying to make this a business where we can show a profit - and that is not what the Postal Service has ever been about. It's about service to the American people," he said.

The Postal Service reported a net loss of $9.5 billion for the end of fiscal year 2024 in September - $3 billion more than the previous year.

To address financial challenges, the Postal Service also consolidated operations as part of Postmaster General Louis DeJoy's 2021 "Delivering for America" plan, which aims to stabilize the finances.

Roscoe Woods, legislative director of the Michigan Postal Workers Union, believes some of the debt comes from non-compliance with collective bargaining agreements.

"Since DeJoy took over, there has pretty much been a widespread decision made: Don't worry about the contract, we'll just pay the grievances," he contended. "Let's just do what we gotta do."

Mize shared the action he feels is needed to push back against the proposed changes.

"We have to continue to work with our Congressional people to see resolutions and billsget passed to stop some of these things," he said.

The American Postal Workers union worries that a slowdown could drive customers away, weakening a vital service that working people nationwide depend on.

A New York law takes effect in January, banning the use of PFAS in clothing.

The law is another step in ending the unnecessary use of the long-lasting substances known as "forever chemicals" in everyday products. The New York law covers a wide array of clothing and is a response to research showing continuous exposure to the chemicals can have a host of negative health effects.

Kate Donovan, northeast regional director of environmental health for the Natural Resources Defense Council, said PFAS chemicals have many uses in clothing manufacturing.

"PFAS is used in lots of consumer products but in particular, in clothing for its water repellency, as well as stain resistance and wrinkle-free properties," Donovan outlined. "These are the types of clothing and apparel that we would see PFAS being used in."

New York joins seven other states also banning the use of PFAS in textiles, although many brands and companies are already eliminating them on their own in their products. Before this law, New York had already banned the chemicals in food packaging and firefighting foam.

Bills banning other forever chemical uses will be reintroduced in the 2025 legislative session. Three bills propose ending the use of PFAS in household products, personal care and cosmetics, and menstrual items.

Donovan pointed out in addition to people's health, the manufacturing processes for the products affects the environment.

"We have lots of industrial and commercial processes in the state that use PFAS for their equipment or their machinery," Donovan noted. "What happens is, these manufacturing and industrial processes release PFAS into wastewater, into air, and other discharges that enter into our environment."

She added half of the water systems in the state contain some level of PFAS chemicals, with more than 250 local waterways exceeding state-regulated levels. The state Department of Health estimates 548 public water systems exceed the federal maximums for PFAS. Implementing the proper treatment infrastructure would come with significant costs.


get more stories like this via email