The number of people with Affordable Care Act health coverage is on the rise, but many are not able to access the care they need to get and stay healthy.

Adam Fox - deputy director of the Colorado Consumer Health Initiative - said the Biden Administration has an opportunity to update the ACA's Essential Health Benefits, services that almost all individual and small-employer insurance plans across the country are required to cover.

He said all Americans need access to fundamental services.

"Like dental, which is currently covered for children, but not adults," said Fox. "It should cover the full range of reproductive health services, and perinatal and postpartum care for people who are giving birth, as well as hearing and vision benefits."

Colorado has made some headway expanding benefits to address health care needs, including gender-affirming care and coverage for all people regardless of their immigration status.

Some insurers providing coverage through the ACA have warned that expanding essential benefits will drive up insurance premiums and health care costs in general.

Fox said he believes updating essential benefits would actually lower costs, and improve the quality of health coverage for all people - whether they get insurance through ACA marketplaces like HealthCare.gov, employer-sponsored plans, or programs like Medicaid.

"The reality is many of these services, that are proactive and preventative care," said Fox, "help people maintain their health and avoid much more costly health interventions, are likely to save costs."

It's been more than 13 years since the Affordable Care Act established rules defining ten categories of health services that most insurance policies must cover.

Fox noted that many states have not done anything to update or expand benefits.

"And what we need is federal action to update essential health benefits," said Fox, "ensure that the full range of whole person care is covered, and that that is made a requirement across the country."

Arizona ratepayers could end up paying more for utilities if state regulators decide to change the ratemaking process.

The Arizona Corporation Commission is set to vote on a proposed policy statement today, which would allow Arizona utilities to move from a historical "test year" model to a formula rate plan. A formula rate plan is used to adjust a utility's base rates outside a general rate case, many times because of increases in the average cost of utility service.

Diane Brown, executive director, Arizona Public Interest Research Group Education Fund, called the proposed change "seismic," and is concerned ratepayers could experience "higher utility bill aftershocks on an annual basis," as a result.

"There appears to be a full-court press to approve a policy statement that essentially upends a long-standing ratemaking process without providing the necessary time and attention to details," Brown contended.

Supporters of formula rate plans said they can help stabilize a utility's rate of return without a full rate case review. Brown argued ratepayers in states using formula rate plans have experienced "higher costs alongside decreased transparency and less opportunities for public engagement." Groups are calling on the commission to grant more time for the decision, to allow experts and consumers a chance to weigh in.

Consumer groups believe the proposed policy statement, which was made public late last month, has been rushed for a vote. Brown argued there is no need to change a system that has worked well, for one lacking specificity, which could usher in unintended effects.

"The commission should slow down the significant shift in ratemaking by addressing questions and requests that stakeholders have presented to commissioners and staff," Brown asserted.

The commission countered stakeholders have had enough time to voice their opinions following workshops held in March and October of this year on the issue, all in an effort to provide Arizonans with reliable service and predictability in utility costs.

When surveyed, 77% of Americans prefer to buy goods made in the United States, especially during holidays, and 82% said they would buy more if available.

A new poll from the American Alliance for Manufacturing conducted the survey.

According to Amazon's Small Business Impact report, independent sellers in Kentucky sold more than 22 million items last year. But despite a strong consumer preference, online retailers are not required to provide country-of-origin labeling.

Scott Paul, president of the Alliance for American Manufacturing, said while U.S.-made gifts may have a slightly higher price tag, they do not come with ethical baggage as some items made in other countries.

"There's no tariffs paid on them. They're not necessarily subject to inspection," Paul outlined. "We know from reports that a lot of them are not made particularly well, that have some toxins in them, and may come from supply chains that have forced labor. "

Around 20% of holiday shoppers will use Chinese apps such as TikTok and Temu this holiday season. The Alliance's online 2024 Holiday Gift Guide lists products from more than 100 manufacturers and makers from all 50 states.

Paul pointed out shoppers have a variety of reasons for seeking out U.S.-made products ranging from sustainability to ethical supply chains. He noted three in five Americans said they have made a conscious effort to buy American-made products in the past year.

"It could be about patriotism and supporting local jobs but whatever the reason for it, it's actually something that I think unites a lot of people in our country," Paul asserted. "That's really important, especially as we get closer to the holidays."

More than 363,000 small businesses operate in Kentucky, employing 42% of workers in the Commonwealth, according to federal data.

Small businesses are reminding people to shop locally as the holiday shopping season kicks off this week.

Local communities around the country, including in Idaho, are readying for Small Business Saturday, which takes place the day after Black Friday.

Jenn Hensley, executive director of the Downtown Boise Association, said small businesses donate 250% more to community causes than big businesses, and keep the money spent at them local.

"Sixty-eight of every $100 spent at a locally owned business stays in the community. That's compared to $43 spent at a national chain," Hensley pointed out. "So, $25 more stays here. We're supporting local causes when we shop local businesses. We're also keeping our money local."

Hensley noted there are more than 700 businesses in downtown Boise and 96% are locally owned. She argued small businesses provide a more curated shopping experience than big businesses. Downtown Boise has events planned to mark Small Business Saturday this weekend.

Up to 90% of new jobs are created by local businesses. Hensley emphasized shopping locally can also help address issues communities are facing, such as housing affordability.

"When you are shopping in those stores, you are directly addressing those issues," Hensley contended. "In the sense that you are keeping your dollars here locally with a person who lives in a house down the street, who supports your kid's soccer team, who shops at other local shops. And so it's really important that we support these folks."

Small Business Saturday has been around since 2010, as a counterpart to Black Friday and Cyber Monday, which take place after Thanksgiving.


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