Someone setting out to do this in a league of opportunity. But that leads to the second thing, which is i do worry that a leak as important as it is overshadows a decision that was leaked and then turned into law. I think your second point was mine, which is i think the fact of the league is so much less consequential than the content of the leak. And i think, to the extent that anyone whos questioning the Supreme Court, its not the fact that an opinion got out, but the fact that it is willing to just really make the law in its own conservative image. I think i might take a different take on that because the norms of the process is our trans substantive. So if you want to lead on this than, what about lower courts . What about confidentiality . Anywhere . So, im not institutionalist enough to think that yes, it shouldnt distract from the fact that dobbs is a major decision that revoked or read that existed for 50 years, but essentially if the Supreme Court can no longer do its work, then it doesnt matter what the issue is. That affects the entire term. If we end up with a more scenario in the future where my only little clicks of the Supreme Court are running opinions and disclosing those for reasons to others, that sort of a breakdown of a latitude that we have not seen before. Right, let us and on that, and then in a timely fashion. Thank you both ncs for organizing this annual review. And for the panelists for joining us. And all the audience online and cspan for joining us. We have a new justice on the court as of today. We have a huge number of challenges before the court next term, including related to affirmative action, todays grand on the independent state legislatures, doctrine, which will have enormous effect on Voting Rights, major decisions related to the Voting Rights act, and access to justice. And so, its certain that we will be back here again next year, hopefully with somewhat better news. But no doubt with a court that has the same majority and probably the same aggressive posture. So thank you very much for joining us. Next, a look at what congress can do about Health Care Costs and medical debt. Patient advocates and Health Care Officials testify this is. About an hour and 20 minutes. The committee of banking housing and urban affairs will come into order. Todays hearings a hybrid format. Our witnesses will testify in person. Thanks to all five of you for making the effort to be here. Some of you came as far from cleveland, so thank you for that. The members will virtually. Thinking of saying a loved one brush to the hospital in an ambulance or learning you have a chronic disease that is going to require years of k are and monitoring, these kind of medical ordeals or some of the scariest moments in a familys life. They can happen at anytime to anyone without warning. Suddenly, you are coordinating doctors visits and calls with insurance companies. You are nervously checking your savings account. Youre spending hours on in turnable phone calls trying to get answers. Youre dealing with it all while worrying whether your husband or your mother or your child will make it out of the hospital, and whether their Health Problems will continue. As the cost of Prescription Drugs rise, hospital bills skyrocket, death collector start calling, families are forced to figure out how to make ends meet instead of focusing on their health. Families all over the country are telling us that we heard from penelope wind guard in after School Teacher from North Carolina who lost her Health Coverage while battling Breast Cancer while her medical bills began to pile up, her doctors eventually stops in her. Soon after, she had an aneurysm in addition sedition loss, both required the surgery because of the financial situation caused by her diagnosis, miss wynne guard was forced to wait. And then seek care from a limited list of providers who were allowing side and payments. That collectors called her, they harass her every single day. Now her credit soaring cause of her health. Now she needs additional testing to ensure that cancer does not return, which has added another 2,000 to her debt. So instead of focusing on battling her illness, she has to figure out how to handle debt collectors. Miss wing guard is far from alone. In the United States, 43 million americans hold 88 billion dollars of medical debt, and this problem is growing. It can happen to anyone, low income families, black and hispanic, households, the veterans, young adults, and older adults are hit particularly hard. Debt collectors make this already exhausting experience worse. They call over, and over, and they make threats, even contact patients employers. Take for example many hedges from delaware county, ohio. Shes so type one diabetes when she was five. For most of her adult life until the passage of the Affordable Care act, she was unable to get health and 14 shirts because she had a preexisting condition. After losing her business and the 2008 reception, her medical bills pageup, she was unable to pay them. Thats when the debt collectors started calling, and calling, and calling, and calling. Miss hedges did her best, she tried to negotiate, even begged for relief, and the harassment continued. At one point, she said she was afraid to leave her house. This harassment is part of the Business Model. A counselor medical debt collector agency owned by hudson, toys were about harassing patients, they said they found the first 20 to 30 calls to be, quote, highly effective. If the calls dont work, debt collective often move on to even more aggressive tactics like litigation, forcing people to go through lengthy expensive emotionally draining court proceedings, often while still battling cancer grieving loved one. For patients, litigation can result in garnished property leaves. Weve seen people thrown in jail because they couldnt afford to pay. Its the return of debtors prison. People in the United States of america, i think of that today, are in jail right now because of medical debt. Of course, whenever we find suffering, wall street finds opportunity. Private equity firms are making inroads in the medical Debt Collection market between 2015 and 16, and one third of all Debt CollectionAgency Acquisitions were bought by private equity. Those firms exist, clearly, to maximize investor profits no matter the cost of society. Maybe thats why private equity own death collection agencies are responsible for an outsized number of consumer complaints, many concerning attempts to collect it from people who do not owe them. We must address the growing crisis of medical debt, burdening American Families. President biden has Administration Working to remove barriers to medical Debt Forgiveness for veterans and make it easier and cheaper for them to get care. No one who serves this country should be saddled with debt, for illness or injuries incurred in the line of duty. The Biden Administration wasted no time in implementing the no surprises act which took effect on january 1st. The bipartisan law finally ben surprise medical bills, one way to provide prevent the collection harassment is to protect people from that in the first place. Against the cfpb is also doing important work, exposing abuses americans face well just trying to get health care. And after increasing scrutiny and pressure of the three Credit Reporting agencies, equifax, experience, trans union, all announced that they would significantly changed how medical Debt Collection death is reported. These changes are expected to remove nearly 70 of medical debt and collections from Credit Reports. Its a positive first step, but just a step. This first step gets to a basic fact that we too often ignore, medical debt does not correlate with credit risk. It correlates with illness. It should be obvious anyone can get sick, anyone can get in a car accident. It doesnt have anything to do with your ability to pay your bills or at least it shortened. No one should be forced into poverty, no one should be harassed by shady debt collectors because of a medical emergency or sick Family Member. We have taken important steps to protect americans, but we can do more. Im asking the cfpb to create a position for consumer medical debt. Its also why expanding medicaid coverage to those who live in the 12 states who refused to expand medicaid under the Affordable Care act is long overdue. Im appreciative of two members of this committee, senators who warren and ossoff who were willing to get this done either here or in their safe. Of course, meeting these challenges can be done by the government alone. This country needs private institutions to meet their obligations, Financial Assistance and the no surprise act. We are hearing from two advocates for consumers as well as one of my constituents, robyn king, from cleveland, miss king will tell her story of battling medical debt she never owed after a nursing care home for her mother. Im looking for to hearing more about how we can protect americans from medical debt and debt collector harassment. No one should have their financial future ruin simply because they got sick. So we thank you, mister chairman. Pressing risk accurately is critical for the safety and soundness of the Financial Institutions and to consumers ability to access affordable credit. Because one by orders, default lenders generally look at information about credit history, it helps them estimate the risk of default and price loans. Lenders who cannot access information that they consider predictive of risk are likely to restrict their lending to the borrowers seek out relevant proxies with the Credit Information they are not able to obtain. Or increase the price of loans to all by owners to capture the uncertainty in the risk. This hurts all consumers, especially low income families and those with a long credit history. For all those reasons, the government should not suppress the reporting of accurate Credit Information. Unfortunately, so called consumer groups and allies have sought to remove information from Credit Reports and thereby make them less accurate. Im afraid such actions will have adverse unintended consequences. Todays hearing is titled, quote, growing burden of medical debt, and quote. Its interesting, but inaccurate title. Because evidence suggests that medical debt is actually falling, not growing. According to the cfpbs own estimate, which the chairman side did, medical collection was 88 billion dollars last year. Thats a nominal reduction of 10 over the last three and a half years. Another study shows the average medical debt in collection fell by 40 in the last decade. And that is despite the fact that over the same period, medical spending increased by 70 . 70, and over 50 per capita. This is all illustrated on chart one behind me. Now there are likely many reasons for a decline in medical debt, the primary driver was the improving economy. After the tax reform of 2017, those with the lowest wages, those most likely to have medical debt, were making the biggest gains in income. Another driver of the decline was the enactment of obamacare and Medicaid Expansion. Researchers estimate that for every 25 spent on Medicaid Expansion, medical debt and collections decreased by 1. There are many aspects that have made me question the wisdom and efficacy of Medicaid Expansion, including its cost and the lack of evidence that it unsurprisingly, if you are willing to spend massive amounts of other peoples money, you can transfer other individuals debts onto another taxpayer, that is illustrated uncharted. To all Available Evidence suggest that there is no growing burden of medical debt, in fact, the scale of medical debt is often misunderstood as chart three illustrates, medical debt in collection represents less than 1 of all household debts. Two thirds of medical Debt Collections are under 500. And bankruptcy from medical debt is extremely rare as illustrated in charge for. 31 hundredths of 1 of the population suffers bankruptcy each year as a result of hospitalization. And medical debt is not strictly an american phenomenon, any medical system in the developed world, according to the world health organization, even before Medicaid Expansion, the likelihood that out of pocket expenses would exceed a quarter of ones income was roughly, as rare in the United States, eight tenths of 1 , as canada or the uk, about five tenths of 1 . And considerably rare than italy, spain, korea, switzerland, and other countries in the developed world. Recently, Credit Reporting agencies are announced changes that will reduce the amount of medical debt that appears on Consumer Credit reports Going Forward. Now, for Credit Reporting agencies to exclude this information, i dont think its the governments role to meddle with that decision. However, if Credit Reporting agencies had collectively decided the opposite, if every one of them had gotten together and decided they would begin at the same time to add consumers medical debt information on to reports, i suspect the house and protests about greed and collusion would have been deafening. What appears to have occurred here is a political campaign, which included the cfpb, bullied lenders and Credit Agency into removing disinformation. This kind of misuse of power by the Administrative State has grown all too common. Its an example of how congress has become far too comfortable with the executive branch seizing the article one lawmaking authority of congress. We need to be careful that any actions consider to address symptoms, in this case, death from a health condition, dont make matters worse. This new Credit Reporting Agency policy doesnt actually lower the cost of medical care, in, fact it raises costs and reduces access. It may end up discourage people from paying medical bears. It could give Health Care Providers to not treat individuals without the obvious means to pay. And by eliminating one metric in the Credit Rating, it may cause credit agencies, Credit Rating agencies, to use other metrics, or proxies that are less accurate and which could actually hurt low income populations more. These kinds of downstream effects wouldnt be shocking given that the entire effort to micromanage Credit Ratings is coming from an agency that has no expertise on complex medical billing and Health Care Systems. It should remind us that intervention into the market, no matter how Noble Advocates may think they are being, well have consequences, usually unintended consequences. And second, intervention should come after careful deliberation by the peoples representatives, not tic tacs from unelected bureaucrats. Thank, you mister chairman. Thank you sir. I will introduce five witnesses, robin, king of former second grades teachers assistant in cleveland, that works parttime in volunteers when shes not caring for her family. Miss king uses her voice to shed light on the terrible toll that medical debt is taking on average americans. And restored is the executive director of the committee overseeing the advocacy of Consumer Health care rights and the organizations finances and operations. She has two decades of experience and health care advocacy. Doctor benedict, but legal, studies Health Care Financing the pharmaceutical market and its regulations on the effect of Health Care Costs on the personal finances of americans. Hes a senior fellow and Economic Policy studies at the American Enterprise institute. David hymen is a Scott Ginsburg professor at georgetown, is an abject scholar at the cato institute, a doctor as well as a lawyer. He has served most recently as the rawsonville and work terror law professor of medicine and illinois. Bernard haines is the law center, working on a portfolio that includes consumer medical debt policy and energy policy. She recently published a reporting and the intersection between the Racial Health gap and the racial wealth gap and the harms of aggressive and in the harm of aggressive medical Debt Collection. Thank you all for coming and joining us today. I will begin with miss king, welcome. Good morning. Its an honor to be here and a privilege to be able to share my story with this committee. I am here to speak about my experience with medical debt. Its something that affects