The New York State Legislature passed two bills aimed at easing medical debt back in May, and a new report indicates they're much needed.

The first bill bans medical liens and wage garnishment; the second regulates the billing of so-called "facility fees," and requires that patients be informed about those fees up front.

In a report on hospital debt, the Community Service Society of New York found 112 nonprofit hospitals sued more than 53,000 patients across the state between 2015 and 2020.

Dr. Elisabeth Benjamin - vice president of health initiatives with the society - said she thinks facility fees help hospitals get money from people when they aren't supposed to be charged.

"We helped one woman who went in for her preventive mammogram and she was charged a $250 facility fee," said Benjamin. "Well, that's just a secret end run around the Affordable Care Act prohibition on charging copays for preventive services. You're not supposed to charge a patient a dime when they get a preventive service like a mammogram."

Hospitals had qualms about the facility fees bill. They said they shouldn't have to give notice about these fees every time a patient is seen, but could do it annually.

Currently, 13 states and Washington, D.C. have similar laws against predatory medical debt collection tactics.

While the New York bills regulate the collection of medical bills, they wouldn't prevent hospitals from suing patients. Rather, they limit how the funds can be collected.

Benjamin said all non-profit hospitals are supposed to offer certain patients financial aid on a sliding scale, but her group's research has found this isn't always the case. It supports the idea of developing a common application for hospital financial assistance.

She called the current system a disservice to patients.

"One of the things that makes it so problematic is every hospital is allowed to design and implement its own application," said Benjamin. "Higher education figured this out. This is a really big burden, and that's why they set up a common application."

She added that - in the Community Service Society's report - some hospitals weren't aware of what was being done in their name, while others knowingly continued these practices.

By establishing new rules across the board - that declare a person's home and wages as off-limits - Benjamin said she hopes patients will be more at ease the next time they need health care.

After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.