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By Noam N. Levey, KFF Health News Worried that President-elect Donald Trump will curtail federal efforts to take on the nation’s medical debt problem, patient and consumer advocates are looking to states to help people who can’t afford their medical bills or pay down their debts. “The election simply shifts our focus,” said Eva Stahl, who oversees public policy at Undue Medical Debt, a nonprofit that has worked closely with the Biden administration and state leaders on medical debt. “States are going to be the epicenter of policy change to mitigate the harms of medical debt.” New state initiatives may not be enough to protect Americans from medical debt if the incoming Trump administration and congressional Republicans move forward with plans to scale back federal aid that has helped millions gain health insurance or reduce the cost of their plans in recent years. Comprehensive health coverage that limits patients’ out-of-pocket costs remains the best defense against medical debt. But in the face of federal retrenchment, advocates are eyeing new initiatives in state legislatures to keep medical bills off people’s credit reports, a consumer protection that can boost credit scores and make it easier to buy a car, rent an apartment, or even get a job. Several states are looking to strengthen oversight of medical credit cards and other financial products that can leave patients paying high interest rates on top of their medical debt. Related Articles Some states are also exploring new ways to compel hospitals to bolster financial aid programs to help their patients avoid sinking into debt. “There’s an enormous amount that states can do,” said Elisabeth Benjamin, who leads health care initiatives at the nonprofit Community Service Society of New York. “Look at what’s happened here.” New York state has enacted several laws in recent years to rein in hospital debt collections and to expand financial aid for patients, often with support from both Democrats and Republicans in the legislature. “It doesn’t matter the party. No one likes medical debt,” Benjamin said. Other states that have enacted protections in recent years include Arizona, California, Colorado, Connecticut, Florida, Illinois, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, and Washington. Many measures picked up bipartisan support. President Joe Biden’s administration has proved to be an ally in state efforts to control health care debt. Such debt burdens 100 million people in the United States, a KFF Health News investigation found . Led by Biden appointee Rohit Chopra, the Consumer Financial Protection Bureau has made medical debt a priority , going after aggressive collectors and exposing problematic practices across the medical debt industry. Earlier this year, the agency proposed landmark regulations to remove medical bills from consumer credit scores. The White House also championed legislation to boost access to government-subsidized health insurance and to cap out-of-pocket drug costs for seniors, both key bulwarks against medical debt. Trump hasn’t indicated whether his administration will move ahead with the CFPB credit reporting rule, which was slated to be finalized early next year. Congressional Republicans, who will control the House and Senate next year, have blasted the proposal as regulatory overreach that will compromise the value of credit reports. And Elon Musk, the billionaire whom Trump has tapped to lead his initiative to shrink government, last week called for the elimination of the watchdog agency . “Delete CFPB,” Musk posted on X. If the CFPB withdraws the proposed regulation, states could enact their own rules, following the lead of Colorado, New York, and other states that have passed credit reporting bans since 2023. Advocates in Massachusetts are pushing the legislature there to take up a ban when it reconvenes in January. “There are a lot of different levers that states have to take on medical debt,” said April Kuehnhoff, a senior attorney at the National Consumer Law Center, which has helped lead national efforts to expand debt protections for patients. Kuehnhoff said she expects more states to crack down on medical credit card providers and other companies that lend money to patients to pay off medical bills, sometimes at double-digit interest rates. Under the Biden administration, the CFPB has been investigating patient financing companies amid warnings that many people may not understand that signing up for a medical credit card such as CareCredit or enrolling in a payment plan through a financial services company can pile on more debt. If the CFPB efforts stall under Trump, states could follow the lead of California, New York, and Illinois, which have all tightened rules governing patient lending in recent years. Consumer advocates say states are also likely to continue expanding efforts to get hospitals to provide more financial assistance to reduce or eliminate bills for low- and middle-income patients, a key protection that can keep people from slipping into debt. Hospitals historically have not made this aid readily available, prompting states such as California, Colorado, and Washington to set stronger standards to ensure more patients get help with bills they can’t afford. This year, North Carolina also won approval from the Biden administration to withhold federal funding from hospitals in the state unless they agreed to expand financial assistance. In Georgia, where state government is entirely in Republican control, officials have been discussing new measures to get hospitals to provide more assistance to patients. “When we talk about hospitals putting profits over patients, we get lots of nodding in the legislature from Democrats and Republicans,” said Liz Coyle, executive director of Georgia Watch, a consumer advocacy nonprofit. Many advocates caution, however, that state efforts to bolster patient protections will be critically undermined if the Trump administration cuts federal funding for health insurance programs such as Medicaid and the insurance marketplaces established through the Affordable Care Act. Trump and congressional Republicans have signaled their intent to roll back federal subsidies passed under Biden that make health plans purchased on ACA marketplaces more affordable. That could hike annual premiums by hundreds or even thousands of dollars for many enrollees, according to estimates by the Center on Budget and Policy Priorities, a think tank. And during Trump’s first term, he backed efforts in Republican-led states to restrict enrollment in their Medicaid safety net programs through rules that would require people to work in order to receive benefits. GOP state leaders in Idaho, Louisiana, and other states have expressed a desire to renew such efforts. “That’s all a recipe for more medical debt,” said Stahl, of Undue Medical Debt. Jessica Altman, who heads the Covered California insurance marketplace, warned that federal cuts will imperil initiatives in her state that have limited copays and deductibles and curtailed debt for many state residents. “States like California that have invested in critical affordable programs for our residents will face tough decisions,” she said. ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.Two years ago, we questioned the sustainability of a rapid e-fuels pathway for shipping. Our position hasn’t changed, but we’ve watched the industry yo-yo between fossil-based alternative fuels and e-fuels. Anchored in energy economics (using renewable energy most efficiently) and our pragmatic view, we argued that LNG has an important role to play in the fuel transition short to medium term, while e-fuel is likely to be part of a longer-term solution. In this piece we will focus more on the commercial development needed to successfully transition to these low carbon molecules, rather than the physical characteristics and arguments. “Fast forward two years, there has been a lot of development and, as many will argue, a lot of missing development.” Let’s begin with methanol. The strong growth in methanol dual-fuel (DF) vessel contracting, first led by Maersk in 2021, continued well into 2023, emerging as one of the leading DF options. It represented 12%1 of contracted gross tonnage (GT) over 5,000 GT in 2023. This growth has been supported by a relatively low capex premium on DF engines, along with a promising supply-side outlook, as new projects continue to be announced. As a result, methanol DF vessel contracting grew in prominence. While we do not intend to fuel the “LNG vs Methanol vs Ammonia” debate – since, as brokers we remain fuel-agnostic and believe that all fuels will play a role in the future – it’s clear that LNG and methanol have been competing closely across principals’ desks over the past couple of years. This is evident in the sharp decline in LNG dual-fuel vessel contracting in 2023 dropping from 28% in 2022 to 14.7% of contracted GT above 5,000 GT, largely due to methanol’s growing popularity. Some of this decline, however, can also be attributed to a surge in gas prices following the sanctions on Russian gas. But in late 2023, we saw the first sign of LNG regaining momentum when liner giant CMA CGM changed an order of eight 9,200 TEU vessels from methanol DF to LNG DF2. While this news passed somewhat quietly, a similar move by Danish competitor Maersk did not. Maersk surprised the industry by revealing plans to invest in LNG DF vessels3. This diversification from previous commitments was justified with the rationale that betting on just one fuel would be risky. Instead their portfolio mix would include the methane molecule, although emphasising that focus is on bio-LNG and not on fossil LNG. Our 2022 argument supports the shift, and like Maersk, points out a more fundamental challenge in the fuel transition: the limited availability of green methanol. They emphasised the need to achieve their decarbonisation goals in a commercially competitive way. In other words, while several e-methanol projects are approaching final investment decisions (FIDs), there remains a shortage of green methanol at acceptable prices. This highlights a key issue in the fuel transition: the need for more movement in green e-fuel project developments. The high cost of low-carbon fuels is a challenge for all fuel alternatives, but we stand by our original position and emphasise our concern for the outlook for methanol. LNG (though a fossil fuel, it still offers clear reductions in GHG emissions) and bio-LNG (a, potentially, carbon-neutral variant) are largely driven by demand from sectors outside shipping. Similarly, we expect the first large-scale demand for low-carbon ammonia to come from industries like coal-fired power plants (for co-firing) or as a hydrogen carrier. This means that shipping, as an offtake sector, doesn’t have to be the primary driver of demand for LNG or ammonia, which is crucial given the industry’s longstanding preference for the cheapest product cracked from crude oil, on the spot market. In contrast, most e-methanol project developers are counting on shipping to be their main offtakers. For these projects to reach FID, shipping companies will need to commit to long-term offtake agreements at prices multiple times higher than conventional fuels, with first volumes expected in 3 to 4 years (the typical production facility lead time). This presents a significant challenge—especially considering that even Maersk, a champion of methanol and leader in decarbonisation, has not been able to make this model commercially viable. Regulations like FuelEU Maritime, and hopefully the IMO’s upcoming Global Fuel Intensity Requirement, will play a crucial role in making low-carbon fuels, including e-methanol, commercially viable. The challenge, however, lies in the fact that many of these fuels depend on long-term shipping offtake agreements to get production projects off the ground. This is complicated by the gradual phase-in of these regulations and the lead time between FIDs and actual fuel production. By the time these regulations start to have a real impact—likely around 2030 to 2035—when fuel prices might become more competitive and willingness to pay increases, the necessary fuel volumes may not yet be available. This timing mismatch presents a major hurdle for the adoption of low-carbon fuels in shipping, and in particular e-methanol (as we argue the other fuels may come with or without us). In the long term, we believe e-fuels like ammonia, which unlike e-methanol and e-LNG, doesn’t rely on biogenic CO2 as a feedstock, will play a significant role in shipping’s fuel mix. A recent study by the Maersk McKinney Møller Centre for Zero Carbon Shipping (MMMZCS) estimated that the global availability of biogenic CO2 is around 370 million tons4—enough to produce around 43% of the e-fuels required to meet shipping’s current energy demand. However, it’s unlikely that shipping will be able to secure all of this, given competition from other sectors. In other words, biogenic CO2 could become a major constraint if shipping focuses solely on e-methanol and e-LNG for large-scale decarbonisation. Ammonia offers a promising alternative, but its main challenge lies in engine technology development. While the progress made by key engine manufacturers like MAN and WinGD is encouraging, and initiatives like the recent ship-to-ship5 transfer of ammonia fuel demonstrate its potential, we are still years away from seeing a significant number of ammonia dual-fuel vessels in operation. So, where do we go from here? As shipping emissions continue to rise, we stress the point, again, that waiting for a perfect end-game solution could hinder shipping’s green transition. We have vocalised concerns about the availability of low-carbon methanol for the methanol dual-fuel vessels set to enter operation in the coming years. While we view ammonia as an appealing long-term solution, we cannot afford to wait for it, as emissions keep accumulating. In the meantime, LNG presents a well-to-wake (WTW) GHG reduction of approximately 17% compared to conventional fuels when burned in a high-pressure two-stroke engine, according to the FuelEU Maritime regulation. Whilst there are valid concerns about upstream methane leakages, several initiatives and regulations (e.g., the Global Methane Pledge)6 are working to ensure these issues are effectively addressed and reduced. Bio-LNG is a very attractive low-carbon fuel for shipping, with the potential to be blended with LNG up to 100%. In conclusion, while the industry grapples with the availability of essential fuels like e-methanol and ammonia, the continued use of LNG and bio-LNG as transitional solutions is vital. In the past, we’ve been challenged on our position of championing fossil-based alternative fuels, but we maintain that not only does it offer immediate reductions in greenhouse gas emissions but also provides a pathway for scaling up low-carbon fuel adoption whilst ensuring that renewable energy resources are deployed for global benefit. We’re pleased to see that these challengers and indeed the data is now starting to align with our stance so that greater progress can be recognised. As we look ahead, collaboration between stakeholders, including brokers, shipowners, and fuel developers, will be essential to overcome hurdles and ensure a smooth transition. The journey may be complex, but with informed guidance and strategic planning, the path forward can lead to a more sustainable future for shipping. Source: Clarkson Plc.The NI Football League has reported record figures both on and off the pitch as another bumper Boxing Day served up some cracking festive action for fans. Over 22,000 supporters flocked to stadiums to witness the goals, drama and excitement of live football across Northern Ireland on Thursday afternoon in both the Sports Direct Premiership and Playr-Fit Championship. The 18,835 fans in attendance at the six Premiership games set a new record not only for the traditional Boxing Day games but also for a single round of fixtures since official records began – with no less than three of the games being fully sold out in advance of Christmas . READ NEXT: Michael Conlan to 'pursue new direction' as he makes announcement READ NEXT: NI midfielder sends social media into meltdown with late winner against Rangers NIFL Chief Executive Gerard Lawlor said: “We’re delighted to be breaking more attendance records, but we can only do this with the support of our fans who have backed their clubs not only on Boxing Day, but all year round!” “The potential and appetite for live football at NIFL matches continues to be huge for our fans, and with the much-needed development of our stadiums high on our agenda for 2025, our ambitions must be to break this record again in the near future.” In the build up to the festive fixtures the excitement amongst fans was tangible with over 3.5m video views on NIFL social media platforms and 4,500 new followers - marking the biggest growth in the league's digital history. Sign up to our free sports newsletter to get the latest headlines to your inbox
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A company that turned homeowners into renters abruptly shuts downMINNEAPOLIS, Dec. 06, 2024 (GLOBE NEWSWIRE) -- As 2024 comes to a close, new reports from Zillow 1 and Houzz 2 indicate that Cottage Chic style will be a dominant design trend of 2025. But homeowners don’t need to wait until 2025 to get in on the trend, because The Tile Shop is ready to help you embrace Cottage Chic design right now with Wexbord and Coralie , the newest tiles in its exclusive collaboration with British brand Laura Ashley. “Cottage Chic design draws inspiration from the rustic charm and cozy style of the English countryside,” said Kirsty Froelich, director of design, The Tile Shop. “The Laura Ashley aesthetic was built on these elements, so it's a perfect fit for our new tiles.” Wexbord is based on a popular upholstery pattern launched in 1981, while Coralie is adapted from Laura Ashley’s beloved wallpaper of the same name. The patterns feature floral details found in nature and evoke an organic feeling of comfort and happiness. In translating these archival designs to tile, “We modified the scale, layout and colors of these heritage prints for our customers,” explained Froelich. “We made the lines feel more organic with curved touches and updated the color palettes, so they're fresh and on-trend. These tiles will work well in traditional, transitional, city cottage and modern farmhouse designs.” The updated colorways—midnight blue, fresh green and dove grey—are also inspired by the English countryside. “These colors are fresh and energizing, but also soothing, and embody that feeling of a cozy cottage and being in nature,” said Froelich. To get the look, Froelich suggests combining multiple colors and prints to give your space a cozy, vintage feel with lots of visual interest: “One of the hallmarks of Cottage Chic style is the mixing and layering of different elements. You can use these tiles with neutrals and let the beautiful Laura Ashley patterns be the focal point, or you can go for a more eclectic look and mix several patterns and colors.” Laura Ashley is one of several exclusive collaborations between The Tile Shop and its world-class design partners, among them Nikki Chu, Alison Victoria, and Morris & Co. All pieces in the Laura Ashley tile collection are available now at tileshop.com and all Tile Shop U.S. locations . Visit tileshop.com/collection/laura-ashley to explore the complete collection. ABOUT THE TILE SHOP Tile Shop Holdings, Inc. ( Nasdaq: TTSH ) is a leading specialty retailer of natural stone, man-made and luxury vinyl tiles, setting and maintenance materials, and related accessories in the United States. The Tile Shop offers a wide selection of high-quality products, exclusive designs, knowledgeable staff and exceptional customer service in an extensive showroom environment. The Tile Shop currently operates 142 stores in 31 states and the District of Columbia. The Tile Shop is a proud member of the American Society of Interior Designers (ASID), National Association of Homebuilders (NAHB), National Kitchen and Bath Association (NKBA), and the National Tile Contractors Association (NTCA). Visit www.tileshop.com . Join The Tile Shop (#thetileshop) on Facebook , Instagram , Pinterest and YouTube . ABOUT LAURA ASHLEY Established in London in 1953, Laura Ashley is one of the world’s best-loved fashion and home furnishings brands. The company’s iconic floral prints and designs epitomize the essence of quintessential British style. Laura Ashley offers a complete range of lifestyle products, including home furnishings, women’s fashion and sleepwear, children's apparel, and hospitality experiences. In 2020, Gordon Brothers acquired the Laura Ashley brand, bringing their expertise to grow Laura Ashley's product offerings and leading licensees across the world. For additional information, visit www.lauraashleyusa.com . ABOUT GORDON BROTHERS Since 1903, Gordon Brothers ( www.gordonbrothers.com ) has helped lenders, management teams, advisors and investors move forward through change. The firm brings a powerful combination of expertise and capital to clients, developing customized solutions on an integrated or standalone basis across four services areas: valuations, dispositions, financing and investment. Whether to fuel growth or facilitate strategic consolidation, Gordon Brothers partners with companies in the retail, commercial and industrial sectors to provide maximum liquidity, put assets to their highest and best use and mitigate liabilities. The firm conducts more than $100 billion worth of dispositions and appraisals annually and provides both short- and long-term capital to clients undergoing transformation. Gordon Brothers lends against and invests in brands, real estate, inventory, receivables, machinery, equipment and other assets, both together and individually, to provide clients liquidity solutions beyond its market-leading disposition and appraisal services. The firm is headquartered in Boston, with over 30 offices across five continents. 1 New technology, old-world style: Zillow reveals 2025’s home trends 2 Houzz 2025 U.S. Home Design Predictions report Tile Shop Media Contact: mark.davis@tileshop.com A photo accompanying this announcement is available at https://www.globenewswire.com/NewsRoom/AttachmentNg/58c25097-83f5-4ce1-84b0-26b9c8813b21 https://www.globenewswire.com/NewsRoom/AttachmentNg/e1eae46d-9135-4a70-9520-f8e0124c2198 https://www.globenewswire.com/NewsRoom/AttachmentNg/2b776a1c-4b0d-4e1e-bade-8775b1799add https://www.globenewswire.com/NewsRoom/AttachmentNg/9747d25e-0ab0-4263-8431-60bcebdef190