Older North Dakotans and a key advocacy group are hopeful that seniors will see relief from the heavy burden of prescription drug costs - and they're hailing a big step announced this week.

The Biden administration unveiled the first 10 medications that will be subject to price negotiations under the Medicare program. The action is part of the Inflation Reduction Act approved by Congress.

Bismarck resident Bob Entringer has used one of the medications on the list since 2017. When he retired and switched to Medicare, he found out the blood thinner would be almost $500 for a 90-day prescription.

"I didn't envision the cost, actually," he said. "When I went on Medicare, it was literally sticker shock."

Entringer has found ways to work around it, but said it can be complicated. The negotiated prices won't take effect until 2026, and other drugs will be eventually added. Policy experts note that other IRA provisions are already helping beneficiaries.

The pharmaceutical industry is fighting these moves, saying they'll result in a range of ripple effects.

A key industry group has said a number of these drugs already have rebates and discounts. But Josh Askvig,
AARP North Dakota state director, countered that for too long, drug makers have prioritized profits over the people who desperately need some of these medications.

"We know the number one reason seniors skip or ration their prescriptions is because they can't afford them," he said, "and this must stop, and this is an important step in that direction."

The IRA has already capped insulin prices for Medicare recipients and Askvig said they're monitoring a similar pilot program approved by the North Dakota Legislature. Limited in scope, he said he hopes it will eventually be expanded to more populations.

According to AARP, Medicare Part D spent $50 billion on the first 10 drugs selected for negotiation between June 2022 and May of this year. For Entringer, those figures are alarming as he prepares for other medication expenses when his wife transitions to the program in a few years.

"She's on 11 prescription medications - she's got an auto-immune disease," he said, "so it could get very costly for us."

It's estimated that one in three Kentuckians struggles to pay medical bills, and the issue continues to be a driving factor in personal bankruptcy cases. Local organizations are working to address the issue by partnering with debt-buying agencies to relieve residents' medical debt.

Reverend Kent Gilbert, pastor of Union Church in Berea, said during the pandemic, several churches teamed up with a debt consolidator to eliminate millions of dollars of medical bills. He said without boosting consumer protections, such as those enacted recently to stop surprise medical billing, the problem will worsen.

"What this really tells us is that we need to stop this debt from happening in the first place, and I think that should be our ultimate goal," Gilbert continued.

Research shows Black Americans, people living in the South and those living in states that have chosen not to expand Medicaid are more prone to carrying significant medical debt.

Kentucky Voices for Health is also tackling the issue by partnering with RIP Medical Debt, a charity that uses donations to forgive delinquent debt. For more information visit KYVoicesForHealth ."

Kelly Taulbee, director of communications and development with Kentucky Voices for Health, said while systemic changes are needed to address skyrocketing health-care costs, many Kentuckians need immediate help paying bills. She explained that through her organization's partnership with RIP Medical Debt, $1 donated helps eliminate more than $100 in medical debt. She said eligible cases are identified using consumer data from health-care providers to locate accounts that meet the criteria for debt relief.

"Donations made completely abolish that medical debt, no strings attached, no tax consequences. These portfolios are bought at a fraction of the original costs, and then once the debt is relieved, recipients are notified that their debt is gone," Taulbee said.

A 2018 consumer survey found 72% of Kentucky adults have struggled with health-care affordability. In eastern Kentucky, nearly 80% of people reported having problems and 1/3 said they'd been contacted by a debt-collection agency.

Small Business Saturday has come and gone and the North Carolina Sustainable Business Council urged people to keep "shopping local" this season.

The council said supporting homegrown businesses creates jobs and makes communities healthier. One of those businesses is the Little River Pecan Farm, with 100 pecan trees on a 10-acre section of sixth-generation land.

Crissy Neville, the farm's owner, emphasized the need to support local growers. She said shopping at local farms and agro-tourism sites preserves family businesses, but can also benefit the environment.

"Shipping is not involved, trucking is not involved," Neville pointed out. "Essentially, you know, you're buying locally, and that's the best thing that you possibly could do for lowering your carbon footprint."

Neville cited the added benefit of knowing where your food comes from. Studies estimate processed food in the U.S. travels more than 1,300 miles, and produce may travel more than 1,500 miles before reaching the table if it is not grown locally.

Rebekah Miel, owner of Miel Creative Studio in Durham, works with purpose-driven organizations to help them amplify their work. She pointed out local businesses often help their communities in ways beyond offering their products or services.

"Small businesses donate 250% more to local nonprofits and community causes," Miel explained. "That is also exemplified in our business. Our 'Design to Give' model means we give at least 5% back to local nonprofits, 1% of which is to local environmental nonprofits."

Anne Shaw, state director for the Small Business Center Network, said there is nothing "small" about the power of small companies. Their overall contribution to the workforce is enormous.

"The 1 million small businesses that exist in North Carolina, they employ 1.8 million employees," Shaw emphasized. "Which represents about 44% of North Carolina employees."

Shaw added research also shows on average, a local retailer will recirculate about 48% of their revenue back into the local economy, compared to about 14% of revenue from a national chain.


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A new report from the Consumer Financial Protection Bureau found the repayment process for federal student loans has been filled with errors.

Repayments began in October following a three-year pandemic-related pause. Since then, complaints of inaccurate bills, late notices and poor customer service have only increased.

Rep. Ayanna Pressley, D-Mass., said borrowers are struggling to reach loan service providers on the phone while more than 20,000 people received grossly incorrect bills.

"Now imagine opening your mail and seeing a bill for 100,000 dollars. This is ridiculous," Pressley asserted.

Pressley pointed out borrowers' financial situations are as precarious now as they were when the pandemic began and argued they deserve student debt relief. Critics countered American taxpayers should not be saddled with college loan debt they did not incur.

Officials with the Consumer Financial Protection Bureau said they are working to protect student loan borrowers from incompetent or predatory student loan servicers, including the more than 800,000 people who missed their first payment since the pause was lifted because their bills were mailed out too late.

Rohit Chopra, director of the bureau, said borrowers should be cautious, especially when talking to third-parties contracted by loan servicers for bill payments.

"If you're having trouble, please file a complaint," Chopra urged. "We're often able to get those individuals across the country fixes and sometimes clear answers on what really needs to happen."

The Supreme Court struck down President Biden's student loan forgiveness plan earlier this year, affecting more than 800,000 student borrowers in Massachusetts who would have been eligible to have some if not all their debt erased.


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