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."

Fraud prevention experts are getting the word out in Idaho on how to avoid scams.

Events across the state in October aim to help people identify and protect themselves from thieves.

Cathy McDougall, director of outreach for AARP Idaho, said if you suspect someone of a con, it is best not to engage with them.

"It's better to be rude and hang up than be robbed from them," McDougall recommended. "Don't respond to suspicious emails from people that you did not initiate contact."

AARP Idaho is hosting an event alongside the Idaho Department of Finance and Idaho Commission on Aging. The first is in Twin Falls on Tuesday. Fraud prevention events will be in Idaho Falls on Wednesday, Coeur d'Alene on Friday and Garden City on Oct. 30.

McDougall noted cons have been around for a long time because they work. She pointed out one scam prevalent in Idaho is the romance scam. McDougall advised people not to send their money to suspicious places or people.

"That's always a red flag," McDougall cautioned. "If you're thinking you're in a relationship with someone and they're asking for you to invest in a cryptocurrency website."

McDougall added if someone is scammed, it is important to report it as quickly as possible.

"There's a very small window of time that law enforcement can actually take steps to try to recover your money," McDougall stressed. "Because after usually around 48 hours, they're just going to be gone."

In response to a growing medical debt crisis in Wyoming and across the nation, the U.S. Consumer Financial Protection Bureau has proposed banning medical debt from credit reports.

Mona Shah, senior director of policy and strategy for the advocacy organization Community Catalyst, said they have heard from countless individuals who were not able to qualify for an apartment, or a car loan, or a job, just because of a bad credit score linked to an unplanned medical event.

"No one plans on taking on medical debt," Shah noted. "A lot of people with medical debt actually are insured, but a lot of the services they need may not be fully covered. And that's how people end up with medical debt."

The United States has the most expensive health care in the world, and currently 41% of adults, about 100 million Americans, carry medical or dental debt. Some hospitals and the debt-collection industry have warned the bureau's move could force providers to require payment up front, and could allow consumers to take on loans they cannot afford or pay back.

Others argued employers, landlords and banks need to know about medical debt as they calculate their risks. But Shah pointed to a recent report from the bureau, which showed medical debt is significantly less predictive of a patient's likelihood of making rent and paying back loans than other forms of debt.

"The other important thing to mention when talking about medical debt is that there is a significant amount of hospital billing errors," Shah emphasized. "In one study, 80% of hospital bills had some sort of error to them."

Shah's group is also pushing the Consumer Financial Protection Bureau to prohibit the use of deferred-interest credit cards -- which medical providers offer to patients as a way to ensure they get paid -- and do not currently count as medical debt.

"They are very misleading, because they tell individuals that it's 0%, but that interest rate is only for a certain promotional period," Shah stressed. "After that promotional period ends, it's as high as 27%. And that interest will apply retroactively."

The 100 million Americans currently carrying medical or dental debt could get some relief, after the Consumer Financial Protection Bureau took steps to prohibit credit agencies from including that debt on credit reports.

As Julia Char Gilbert - Connelly policy advocate with the Colorado Center on Law and Policy - explained, bad credit scores due to medical debt can create big problems.

"Families are increasingly facing barriers to accessing rental housing, a credit card, certain forms of employment," said Gilbert, "all because that medical bill is showing up on their credit report."

The CFPB proposal begins a rule-making process that will include a call for public comments.

Gilbert said 700,000 Coloradans currently saddled with medical debt should see relief sooner. A new Colorado law bans medical debt from Coloradans' credit reports.

Critics of the move have argued that employers, landlords and banks need this information as they calculate their risks.

Proponents say excluding medical debt from reports makes the system more fair, since low-income people and people of color are disproportionately burdened by medical bills.

Gilbert also pointed to one CFPB study of five million credit records - showing that medical debt is not a good predictor of whether or not someone can make rent or repay loans.

"And so this change to how we do credit reporting in the United States helps make our credit reporting system more accurate," said Gilbert, "and better at doing what it's intended to do - which is understanding whether a consumer is a good person to extend a loan to."

Under the new Colorado law, Gilbert said it's up to credit agencies to make sure medical debt is not listed on your credit report.

But she said if you have an important life event coming up - applying for a job, apartment, credit card or loan - it's worth double checking.

"If your medical debt is still showing up on your credit report, and you're a resident of Colorado, that shouldn't be happening under the new law," said Gilbert. "And you have the right to file what's called a dispute, and make sure that that information gets cleaned up."




get more stories like this via email