The number of Medicare enrollees is projected to rise over the next few years as the baby boomer population ages. More than 2 million Illinoisans are currently enrolled in the federal health care program, according to Healthinsurance.org,

The Office-Based Facility Association, a coalition of practitioners, is calling for a change in what they view as an ineffective and unfair pricing structure of the Medicare Physician Fee schedule.

Jason McKitrick, executive director of the association, said other payers linking themselves to Medicare is one of the issues.

"When you've got ongoing cuts to Medicare, that means you've likely got ancillary cuts going on with the private side, with the Medicaid side, etc.," McKitrick explained. "It's the Centers for Medicare and Medicaid Services, CMS, ultimately, that's the agency and the federal government that sets the rates for the Medicare Physician Fee Schedule."

The association pointed out the current fee schedule addresses doctor's fees only, not the costly and necessary supplies and equipment needed for their practices. According to the Centers for Medicare and Medicaid Services data, there are 300 office-based services under the fee schedule for which Medicare reimbursement is less than the direct costs, before even considering other costs like overhead and physician work.

Dr. Sreenivas Reddy, a vascular interventional radiologist in Hinsdale, said in addition to seeing patients, he has to monitor overhead expenses such as office space and employee salaries, both affected by inflation. Not having the proper medical equipment and supplies, he added, limits his ability to perform specialized procedures and forces patients to seek care elsewhere.

"That makes these patients go to the hospital-based facilities," Reddy noted. "We have to close our offices and try to join these hospital-based models. They would love to come to the office, get the procedure done in one or two hours, versus it takes like a whole day in the hospital setting."

Reddy emphasized physicians' reimbursement, based on the current physician pay schedule, has been on the downtrend for the last five years. The group has further concerns about a decrease in the number of private practices causing more medical deserts for interventional radiology, cardiology, vascular surgery, radiation and oncology care.

If the federal government finalizes the budget reconciliation bill in play, pro-consumer voices in Minnesota warn the changes will not be friendly to monthly bills for energy customers.

The analysts pointed to new findings from the nonpartisan think tank Energy Innovation, which looked at provisions in the Senate version from this week. It said the plan would cause Minnesotans' home electricity costs to rise by 28% over the next decade.

Annie Levenson-Falk, executive director of the Citizens Utility Board of Minnesota, said it is because Republican lawmakers are poised to eliminate clean energy tax credits while expanding new oil and gas leasing.

"If we can't build as much wind and solar and renewables, then we're not just going to be building more gas plants, but running inefficient, more costly gas plants, more than we would have to," Levenson-Falk explained.

Levenson-Falk pointed out many Minnesotans are already struggling with utility costs, and the advancement of cleaner energy sources has prevented things from getting worse. Fossil fuel-linked groups are cheering the proposed measure, including America's Power, which argued incentives for renewables are no longer needed and they are pushing out energy sources such as coal prematurely.

The debates remain at the forefront with energy demand predicted to spike in the coming years. Levenson-Falk noted the new report showed transitioning back to a fossil-fuel vision would lead to a slower rollout of additional power capacity.

"Our power plants are old and they need to be upgraded or replaced," Levenson-Falk stressed.

Levenson-Falk acknowledged the need for more power grid upgrades with a diversified energy portfolio. But after up-front construction costs, she added operating solar and wind farms is not as expensive because there is no fuel needed, benefiting ratepayers.

Even with congressional moves potentially stalling progress, she emphasized clean energy would still be a part of the mix as utilities develop their own strategies.


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New Minnesota laws take effect this week but consumer and environmental watchdogs are looking back on one from last year designed to bolster product repair rights for consumers and reduce waste.

A new scorecard from the Public Interest Research Group details manufacturers' compliance with a wave of recent laws removing roadblocks for product owners and independent technicians to access parts, tools and manuals when repairing electronics. Tuesday was the anniversary of Minnesota's version.

Katelynn Rolfes, conservation advocate for the nonprofit Environment Minnesota, said based on the report, it appears some companies are dragging their feet.

"Some of the companies did really well, particularly repairs with Apple phones. But other companies, they're slow to catch up," Rolfes explained, citing appliance companies as an example. "They just aren't offering the information consumers need."

Several dishwasher manufacturers received low marks for product manual availability. The report authors said even though consumer electronics companies had better scores for smartphones and laptops, tablet repair materials lag behind, even for the same manufacturers.

For repair situations where consumers still face headaches, Rolfes noted their household finances and the natural resources they rely on wind up suffering.

"If you can't repair something that you own, you end up buying another one of those things," Rolfes pointed out. "That's just not sustainable, not for our wallets and not for the planet."

Under Minnesota's law, dubbed the Digital Fair Repair Act, consumers who feel they are being stonewalled can file an antitrust report form with the state Attorney General for a possible investigation.


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Ohio's fast-growing electric vehicle sector could face serious setbacks if proposed changes to federal clean energy tax credits move forward.

A new Senate Finance Committee proposal would scale back provisions in the Inflation Reduction Act which industry leaders said have fueled innovation, jobs and supply chain investments in the state.

Kevin Kushman, CEO of the Cincinnati-based EV charging firm Electrada, said the credits, especially the 45W Commercial Clean Vehicle credit, have helped make Ohio a hub for electric fleet infrastructure and manufacturing.

"If the total cost of ownership for the decision-making is based upon, evaporates or changes radically, then the decisions are basically brought to a screeching halt," Kushman pointed out. "Everyone sits on their hands, and what would have been a potential transition stalls."

The International Council on Clean Transportation estimated weakening the IRA could imperil more than 130,000 U.S. auto manufacturing jobs by 2030.

Kushman added the Senate's plan creates uncertainty for both businesses and workers in Ohio and beyond.

"This is one of the largest transitions of energy consumption in our lifetime, moving transportation from hydrocarbons to power," Kushman emphasized. "Maybe you could have a college graduate or someone in the trades that spends the next 20 years of their career in this space because Ohio decided to get behind it and stay behind it."

Industry advocates warned the rollback could deter future investment and stall the state's momentum as a clean energy leader. They are urging lawmakers to adopt a phased transition rather than abruptly cutting incentives businesses rely on to plan long-term growth.


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