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."

Coloradans with low bank balances would be on the hook for an extra $225 a year if Congress votes to roll back a new rule capping overdraft fees at $5. Fees had been as high as $35.

The Consumer Financial Protection Bureau, the agency behind the new rule, recently lost its offices and all of its 1,700 workers as the so-called Department of Government Efficiency, informally run by SpaceX and Tesla CEO Elon Musk, went to work remaking the federal government.

Christine Chen Zinner, senior policy counsel at Americans for Financial Reform, said the bureau is critical for protecting American consumers.

"This is a law enforcement agency that protects everyday people when financial institutions cheat and defraud them," Chen Zinner explained. "In the short 14 years that it's been around, it has already recovered $21 billion for everyday people."

The bureau was set to regulate X, Musk's social media site, as it rolls out financial transactions similar to PayPal and Venmo. After workers were sent home, Musk posted "CFPB RIP." The financial industry also disagrees with the agency over what it called aggressive policing of wrongful home foreclosures and credit reports, fraudulent credit card charges and predatory junk fees.

The agency's fate could be decided in federal court. Nearly 77 million people voted for Trump.

Andrea Kuwik, policy and research director for the Bell Policy Center, acknowledged nearly 77 million people voted for Trump, and said many did so in part because they were struggling to make ends meet. She noted the bureau was set up precisely to protect people's pocketbooks and savings.

"There are a lot of folks that are struggling," Kuwik emphasized. "This entity has a proven track record of saving people money. Getting rid of that I think is counterproductive."

The 2008 subprime mortgage crash which led to the Great Recession showed what is at stake when financial institutions operate without real oversight. Zinner believes a strong and independent consumer protection agency which does not have to bend to the whims of politicians is essential.

"We simply can't have a fair market unless there is a strong enforcement agency there to enforce those laws and protect people," Zinner contended. "The Trump administration is now giving all sorts of financial companies a green light to defraud and gouge their customers."

Colorado's members of Congress could split over the issue. Senators Michael Bennett and John Hickenlooper have previously expressed support for the CFPB's work. But the House delegation is more mixed. Representative Lauren Boebert, and other Trump allies, are expected to support the rollback of the overdraft safeguard, while Representatives Jason Crow and Joe Neguse are likely to oppose it. A big unknown is Representative Gabe Evans, a Republican who won in a tough district.

Policy analysts have been sounding the alarm on the Department of Education's ability to reach and engage with low-income, disadvantaged and older student loan borrowers in Nevada and around the country.

With massive layoffs at the agency and the sunsetting of the Biden administration's income-driven repayment plan, the efforts will only get harder.

Sarah Sattelmeyer, education, opportunity and mobility project director for the progressive think tank New America, said the department recently closed applications for all income-driven repayment plans and it has left borrowers looking for answers and resources.

"Right now, there are a lot of things going on in terms of slashing federal workers, slashing contracts, sort of rethinking and pulling money out of programs," Sattelmeyer pointed out. "It is hard to serve people when you cut staff and resources in a system that is already underfunded. "

Biden's Saving for a Valuable Education plan, which offered millions of borrowers lower monthly payments and a shorter timeline for repayment is among the programs stuck in limbo. President Donald Trump has expressed disdain for the plan and is unlikely to extend it. A report by New America found the current situation can be especially unsettling for borrowers over 60, who are often caregivers for family members.

Tia Caldwell, a former analyst for New America, noted when older borrowers are approaching retirement age and are still having to repay their college debt, it can mean tough choices between paying their loans or covering everyday essentials. She emphasized if borrowers fall behind on their loans, the government can garnish their wages and even withhold some of their Social Security benefits.

"This affects more than just the individual, because they are very embedded with their community," Caldwell explained. "We see that it looks like around 85% of older borrowers have children and so of course if your parent is losing their tax refunds or having their Social Security garnished, that is going to affect you too."

Caldwell stressed older borrowers are parents, caregivers and supportive members of their communities. She and others at New America are calling on the federal government to streamline the process for loan forgiveness when higher-ed institutions close or borrowers become disabled. They also encouraged the government to keep income-driven repayment plans and limit harsh penalties for those who default.


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Nearly half of Americans age 50 and older are using credit cards to pay for basic living expenses, according to a new AARP survey, and a Minnesota expert has tips on how to keep that debt from becoming a major problem.

In the same national survey, almost nine in 10 respondents say unexpected expenses have contributed to their credit card debt.

Kevin O'Laughlin, a certified financial advisor at TruMix Advisors in the Twin Cities, said the results aren't surprising, since rising consumer costs take a bite out of savings and Social Security payments can't always keep pace.

He encouraged older adults concerned about their balance going up to do some careful planning.

"I think it comes down to taking a real hard look at where are there opportunities to supplement one purchase for another," he said.

That means, if possible, holding off on non-necessary purchases. Other tips apply to people of any age, including paying more than the minimum monthly amount due on cards. O'Laughlin said you can also call the credit card company and request a lower interest rate or see about transferring your balance to one that has a more desirable rate.

If you're still paying a mortgage, O'Laughlin said seeking a refinancing deal shouldn't be ruled out. As these challenges escalate for seniors, he said, it's a reminder to prioritize the basic needs of this demographic.

"Whether that's through an increase to Social Security checks, or maybe just streamlining the ability to work, part time or in some limited capacity, in retirement to supplement their cash flow needs."

If it all seems overwhelming, he said there are financial planners and programs willing to guide older adults at no charge. O'Laughlin's firm takes on pro bono cases, and he pointed to Lutheran Social Services as another resource. The Minnesota Financial Planning Association also does outreach for these services.