During the first year of the global pandemic, medical consumers in Colorado received more than one million low-value healthcare services - diagnostic tests, screenings and treatments where the risk of harm outweighs any likely benefit to the patient.

Cari Frank, vice president for communications with the Center for Improving Value in HealthCare - the group behind a new report, said consumers and insurers paid $134 million for these services in 2020.

"Even in spite of COVID, when people weren't accessing health-care services the same way," said Frank, "we still saw high numbers of these low-value care services. And they cost a lot of money, both to the health plans and to the patient, and actually can cause harm to patients."

The most obvious example of low-value care is when providers prescribe opioids for acute back pain without first trying alternative medication - a remedy that comes with significant risk of addiction and even death.

Health providers across the nation, working with medical boards and other professional associations, have created a list and guidelines for low-value services through an initiative called Choosing Wisely.

Frank said getting the word out can help bring down overall health costs. She said many services now considered low-value care were considered best practices at one time.

"A lot of things are just, historically, the way the provider has treated patients," said Frank. "And it takes a while when the guidelines change, for there to be an actual adoption of the guidelines."

The average cost for low-value services is $130 - but some, including peripheral catheters for patients with late-stage kidney disease, cost more than $14,000 per incidence.

Frank noted that every patient is different, and some procedures flagged as low-value may actually be the right course for patients.

"There might be family history, or there might be medical history where they have tried some other alternative," said Frank. "So there still needs to be that kind of communication between the provider and the patient."

A bill reforming the New York-New Jersey Port Authority is coming back before New York's Legislature.

The reforms it would implement date back to the Bridgegate scandal of former New Jersey Gov. Chris Christie. The bill increases oversight measures and transparency regarding capital planning. Although it passed with bipartisan support during last year's legislative session, Gov. Kathy Hochul vetoed it.

Rachael Fauss, senior policy analyst for the group Reinvent Albany, said the reforms can improve the agency.

"It would require much more public consultation, notification and hearings about the Port Authority's capital plan," Fauss explained. "Port Authority is actually the second-biggest public authority in New York State."

The legislation would add nonvoting members such as mass transit users to the Port Authority's board. It also requires members of the Port Authority to appear before the legislatures in New York and New Jersey when there is a public hearing. In her veto message, Hochul said she wants a more collaborative bill with New Jersey officials but Fauss feels signing the bill would have opened communication. So far, the bill is in committee.

New Jersey's Legislature has yet to pass a similar bill to enact the reforms. The hope is to increase public awareness about the agency's more than $9 billion budget. The Port Authority's primary opposition to the bill centered around how the changes might restrict its operations.

Fauss noted there are concerns the agency is too independent.

"Public authorities of states are often seen as being independent agencies, but that can go too far, and they can act without accountability," Fauss contended. "There is that sort of gut reaction of, 'Well, don't we want this authority to be independent?' But, obviously, we think that has gone too far because it was used for political purposes."

While it remains to be seen how the bill could shake out in the coming session, it could get bogged down in politics. Given New York enacted congestion pricing, which New Jersey has long opposed, it is uncertain whether the two states will come together about the legislation and Port Authority's reforms.

By Kristoffer Tigue for Inside Climate News.
Broadcast version by Mike Moen for Minnesota News Connection reporting for the Solutions Journalism Network-Public News Service Collaboration

Andrew Garberson has a message for drivers in cold-climate states like Minnesota: Yes, you can still drive an electric car.

Public scrutiny over how well EVs perform in cold weather has grown in recent years following high-profile incidents, like one in Chicago last winter, when several Tesla drivers found themselves stuck in line for hours, waiting for their turn at public charging stations as temperatures dipped below zero. Many drivers reported that the cold had not only sapped their batteries of power but also made charging them a major hassle.

Cold weather temporarily reduces the available energy of EV batteries and slows their ability to charge—though they’ll function normally again in warmer conditions. Heating the car’s cabin during winter also requires energy from the battery, meaning less fuel for travel.

Research has found that freezing temperatures can reduce the average driving range of an electric vehicle anywhere from 25 percent to 41 percent, depending on the circumstances. So, a car that can drive 100 miles on a single charge when it’s 70 degrees Fahrenheit outside may only be capable of going 59 to 75 miles in freezing temperatures.

But Garberson, who lives in Iowa and works as the head of growth and research for the EV advocacy group Recurrent, said incidents like the one in Chicago have been overblown in the media, and that drivers shouldn’t avoid buying an electric car just because they live somewhere with cold winters.

“I drive an EV every day, and my winter is almost as harsh as yours [in Minnesota],” he said. “The anxiety around winter and reduced range, while it’s not inaccurate, is just a bit overhyped.”

EVs aren’t the only cars to suffer performance issues under frigid conditions. Conventional gasoline cars lose between 10 percent and 20 percent of their driving range when the temperature drops from 77 degrees Fahrenheit to 20 degrees, according to the U.S. Department of Energy.

If drivers are properly prepared, most EVs should hold up fine in cold situations, Garberson said. Drivers can take certain steps to ensure their commute goes as smoothly as possible, he added, such as preconditioning their batteries before charging them—a setting on most modern EV models that warms the battery to an optimal temperature, allowing for faster charging.

Recurrent also reviews EV models every year to see how much cold weather impacts their range, which could help shoppers choose which model would work best for their needs, Garberson said. This year, the organization looked at 13 popular models, analyzing real-world driving data from over 10,000 vehicles. It found that those models lost 21 percent of their range on average when temperatures drop to 32 degrees Fahrenheit. But the loss varied drastically by model and year.

The Tesla Model X had the smallest range loss, with an 11 percent decrease, while the Volkswagen ID.4 had the largest at 37 percent. The biggest factor, Garberson said, was whether the vehicle had a heat pump, which is more efficient than conventional heating systems and therefore reduces overall power use. Studies show that the power needed to heat the car’s cabin is a big reason for range loss.

The EV models that did not utilize a heat pump, including the ID.4, saw their batteries reduced by an average of 28 percent, compared to an average of 13 percent for cars with heat pumps, Recurrent’s analysis found. Overall, heat pumps added roughly 10 percent extra range to cars during freezing conditions, the report said.

Garberson said cars built in 2020 or later are more likely to have heat pumps installed than older models. Many popular models now have them or will soon have them, he added, noting that Ford added heat pumps to its 2024 F-150 Lightning and is adding them to its Mustang Mach-E in 2025.

“A lot of the [car companies] have added heat pumps because they’ve realized how important it is for people in northern climates,” Gaberson said. “So that’s my No. 1 piece of advice, is just do a little bit of research about the technology in the car because it can make a 10 to 15 percent difference in overall range.”

Ingrid Malmgren didn’t know her Tesla Model Y, which she bought in November 2022, had a heat pump when she decided to take her family on a four-hour road trip from her Vermont home to Quebec City, Canada, last February. The day they left, she said, the high was 7 degrees Fahrenheit.

“I’m not gonna lie, I was nervous about it,” said Malmgren, who works as the senior policy director for Plug In America, another EV advocacy organization. “But it was a complete non-issue. We charged once along the way.”

Malmgren said her experience is a common one for first-time EV buyers. A recent Plug In America survey of more than 3,000 EV owners found that 70 percent of the respondents worried about battery range before buying an electric car. The survey, however, also found that only 35 percent remained concerned after owning an EV.

“What we’ve found with our Plug In America survey is that a lot of people have concerns about cold weather operation of electric vehicles,” she said. “But once they get in an electric vehicle, once they start driving an electric vehicle consistently, they find that these concerns go away.”

The vast majority of the EV owners who remain concerned about range own EVs built before 2020 and live in rural areas, Malmgren added, where charging infrastructure is scarcer and drivers typically travel longer distances.

The survey also ranked owner satisfaction for different EV models, including for the car’s battery range. Out of the 14 different EV models included, Rivan’s R1T truck received the highest satisfaction rating for range performance from the survey respondents. Tesla’s Model Y sedan received the second-highest rating.

Charging speed may be another factor prospective EV buyers want to consider. Garberson said newer models can typically charge faster than older models. His 2021 Hyundai Kona can charge in 30 to 40 minutes, he said, while his wife, who drives a 2023 Hyundai Ioniq 5, can charge her car in 12 to 14 minutes. Some used EVs that were built a decade or more ago, while cheaper, may take even longer to charge or require multiple charges a day, he added.

The most important thing to consider is your driving habits, Garberson said, adding that most drivers won’t even notice when their EV loses range during cold weather.

“The average daily driving distance, it’s like 30.2 miles,” he said. “So it doesn’t matter what EV you have. Any difference in range and cold conditions—or hot conditions, for that matter—isn’t going to be something that materially impacts your daily driving.”


Kristoffer Tigue wrote this article for Inside Climate News.


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Two new laws designed to protect California consumers take effect this year - cracking down on hard-to-cancel subscriptions and certain types of bank fees.

Assembly bill 2863 - which takes effect July 1 - will require subscription services to be as easy to cancel as they are to sign onto.

Robert Herrell - executive director of the Consumer Federation of California - said right now, canceling a recurring subscription can be a time-consuming nightmare.

"And that's not a bug in the system. That's a feature of those systems," said Herrell. "Many companies know that if they make it really hard for you to cancel, people will just either give up or forget about it, or whatever."

The new Click or Call to Cancel law also requires companies to remind customers once a year that the subscription is active.

The Federal Trade Commission just passed a similar national rule, which is already being challenged in court.

It's unclear whether the new Republican majority will challenge the regulation under the Congressional Review Act.

A second law - which took effect January 1 - bans state-chartered banks and credit unions from charging fees for non-sufficient funds, in cases where the card was rejected and the sale never went through.

Herrell noted that state data show these NSF fees, which can be up to $40 each, are very lucrative for financial institutions.

"A scary number of state-chartered credit unions are absolutely addicted to this revenue stream," said Herrell. "And what that means is that they are profiting directly off the backs of poor, working-class people, because that's what the data overwhelmingly shows about who's paying NSF."

More good news - starting in February more financial institutions must register with the state and submit data for monitoring.

These include companies that provide debt settlement, student debt relief, financing of private post-secondary education, and income-based cash advances.