Dear Chair Ward and Honorable Members of the House Labor and Commerce Committee: I am writing on behalf of the American Diabetes Association (ADA) and the over 780,000 adult Virginians living with diabetes to express our support for House Bill 1725 - prohibiting a large health care facility or medical debt buyer from charging interest or late fees on medical debt and easing the burden of medical debt by offering payment plans. For people diagnosed with diabetes, their medical expenditures are 2.6 times higher than would be expected without diabetes. For families impacted by diabetes, they are also twice as likely to have medical debt when compared to families that do not have a member with diabetes. The ADA strongly supports efforts to minimize financial burdens that can put access to care out of reach for people with diabetes. People with medical debt have reported this burden as a driving factor for delaying care or not filling their prescriptions. For people with diabetes, it is critical that we eliminate financial barriers that may result in them forgoing the care that they need to manage the disease. Unmanaged diabetes can lead to costly and devastating complications including cardiovascular disease, blindness, amputations, kidney failure and death. Limiting interest from accruing on medical debt will help minimize the financial burden on patients. Large interest rates increase the amount that patients owe, significantly impacting their ability to afford medical treatment. Additionally, the ADA supports the inclusion of this provision to improve transparency and ensure that hospitals work with patients to establish reasonable payment plans. People with diabetes incur monthly costs associated with managing their disease and we encourage any monthly limit to consider a person’s ongoing treatment costs. Payment plans and monthly limits should be individualized, and patient centered. Thank you for the opportunity to express ADA’s support for HB 1725. We are encouraged to see the legislature address the burden of medical debt and ensure that people with diabetes can afford the tools they need to manage the disease with dignity. For the reasons outlined, I urge you to support HB 1725. Thank you very much for your attention. If you have any questions, I am available at mbillger@diabetes.org Sincerely, Monica Billger State Government Affairs Director American Diabetes Association

Comments Document

Dear Chair Ward and Members of the House Labor and Commerce Committee, I’m writing in support of HB 1725 on behalf of ZERO Prostate Cancer, the leading national nonprofit with the mission to end prostate cancer and help all those who are impacted, and on behalf of the patients and patient advocates we represent. 9% of Virginians are in medical debt. Medical debt and income lost to illness has been linked to over 60% of bankruptcies in the US, and half of cancer patients and survivors have had medical debt related to their cancer, according to a 2024 American Cancer Society survey. Patients with cancer-related medical debt are three times more likely to be behind on screenings, and the impacts of medical debt are disproportionately borne by those at-risk for prostate cancer. ZERO Prostate Cancer supports the passage of HB 1725, which would give patients needed protections from the financially toxic impacts of medical debt. Please follow up with georgia@zerocancer.org with any questions.

Comments Document

The American Lung Association strongly supports this bill as an integral way to address the burden of medical debt on people with lung disease and other health conditions in Virginia. House Bill 1725 provides reasonable protections to shield patients from the negative impact of medical debt, including protecting patients from extraordinary medical debt collection methods, including wage garnishment and foreclosure on primary homes, eliminating interest and late fees on medical bills, and ensuring patients have access to affordable payment plans capped at 5% of their monthly income. The American Lung Association thanks the Virginia General Assembly for their continued commitment to the health and wellbeing of the residents of the Commonwealth. The American Lung Association strongly supports House Bill 1725 which would shield patients from negative consequences of medical debt. We encourage swift action to move the bill out of committee and passage by the General Assembly.

Comments Document

The Virginia Grassroots Coalition, representing 50 groups with over 10,000 Virginia members submits this comment in support of HB1725, the Medical Debt Protection Act. At the federal level, the Consumer Financial Protection Bureau (CFPB) has documented the serious problems that medical debt causes. As the CFPB concluded: The growing promotion and use of medical cards and installment loans can increase the financial burden on patients who may pay more than they otherwise would pay and may compromise medical outcomes. When people are unable to pay their medical bills, research shows this can deter them from seeking needed healthcare in the future. The use of medical cards and installment loans, and their promotion by medical providers, has ripple effects on the broader cost of healthcare, consumer wellbeing, and the economy. CFPB Report on Medical Credit Cards and Financing Plans May 4, 2023 Additional excerpts from the CFPB's research are explained in the attached document.

Comments Document

The Virginia Grassroots Coalition, composed of over 50 groups of over 10,000 Virginians, submits this comment in support of the HB 1725, the Medical Debt Protection Act. We urge the Subcommitte and Committee to support it.

Comments Document

The American Lung Association strongly supports this bill as an integral way to address the burden of medical debt on people with lung disease and other health conditions in Virginia. House Bill 1725 provides reasonable protections to shield patients from the negative impact of medical debt, including protecting patients from extraordinary medical debt collection methods, including wage garnishment and foreclosure on primary homes, eliminating interest and late fees on medical bills, and ensuring patients have access to affordable payment plans capped at 5% of their monthly income. The American Lung Association thanks the Virginia General Assembly for their continued commitment to the health and wellbeing of the residents of the Commonwealth. The American Lung Association strongly supports House Bill 1725 which would shield patients from negative consequences of medical debt. We encourage swift action to move the bill out of committee and passage by the General Assembly.

January 15, 2025 Honorable Alfonso H. Lopez Chair, House Labor and Commerce – Subcommittee #2 House Committee Room A - 008 General Assembly Building 201 North 9th Street Richmond, Virginia 23219 RE: Support HB 1766 and HB 1767 Dear Delegate Lopez, I am David E. Balducchi, retired from the U.S. Department of Labor, a member of the Advisory Board of Social Action Linking Together (SALT), elected member of the National Academy of Social Insurance, and a resident of Springfield, Virginia. I understand that on January 16, your committee will be considering HB 1766 and HB 1767, two bills offered by chief patron, Delegate Marty Martinez. I write in support of HB 1766, which will increase weekly unemployment benefits for qualified individuals – if otherwise eligible - by $100 higher than the current weekly benefit amount. Higher benefits support local businesses and economies, as unemployment benefits are the fastest working dollar - resulting in a stronger multiplier effect. In addition, the bill requires establishing a work group to study making annual adjustments to the Commonwealth’s weekly benefits based upon the average weekly wage. Some thirty-three states set their maximum benefits as a portion of the state’s average weekly wage, and Virigina should investigate this approach. As well, I support HB 1767, which provides that for new claims effective on or after July 1, 2025, an individual’s weekly unemployment benefit amount shall be paid for a maximum duration of 26 weeks. According to the U.S. Department of Labor, duration should be uniform, so that claimants at all benefit levels can qualify for maximum duration, and experience has shown that, during ordinary times, a duration of 26 weeks is necessary. I urge that members of the Subcommittee #2 to support these bills. Sincerely, David E. Balducchi Member, Advisory Board Social Action Linking Together

January 15, 2025 Honorable Alfonso H. Lopez Chair, House Labor and Commerce – Subcommittee #2 House Committee Room A - 008 General Assembly Building 201 North 9th Street Richmond, Virginia 23219 RE: Support HB 1766 and HB 1767 Dear Delegate Lopez, I am David E. Balducchi, retired from the U.S. Department of Labor, a member of the Advisory Board of Social Action Linking Together (SALT), elected member of the National Academy of Social Insurance, and a resident of Springfield, Virginia. I understand that on January 16, your committee will be considering HB 1766 and HB 1767, two bills offered by chief patron, Delegate Marty Martinez. I write in support of HB 1766, which will increase weekly unemployment benefits for qualified individuals – if otherwise eligible - by $100 higher than the current weekly benefit amount. Higher benefits support local businesses and economies, as unemployment benefits are the fastest working dollar - resulting in a stronger multiplier effect. In addition, the bill requires establishing a work group to study making annual adjustments to the Commonwealth’s weekly benefits based upon the average weekly wage. Some thirty-three states set their maximum benefits as a portion of the state’s average weekly wage, and Virigina should investigate this approach. As well, I support HB 1767, which provides that for new claims effective on or after July 1, 2025, an individual’s weekly unemployment benefit amount shall be paid for a maximum duration of 26 weeks. According to the U.S. Department of Labor, duration should be uniform, so that claimants at all benefit levels can qualify for maximum duration, and experience has shown that, during ordinary times, a duration of 26 weeks is necessary. I urge that members of the Subcommittee #2 to support these bills. Sincerely, David E. Balducchi Member, Advisory Board Social Action Linking Together

I am Commissioner Rapaport available to address any questions regarding HB1933 relating to the throat cancer bill.

My name is George Hoppe, and I am a proud member of the FAIRFAX COUNTY PROFESSIONAL FIREFIGHTERS & PARAMEDICS, IAFF LOCAL 2068. I have served as a 911 dispatcher for six years, during which I have handled countless critical calls, including many that are difficult to forget. Over the years, I have witnessed the profound impact of trauma on my colleagues. Some have left the profession entirely, while others have taken extended absences due to the emotional toll of high-stress calls. Inadequate mental health support exacerbates these challenges, contributing to staffing shortages and increased wait times for 911 services. Burnout and compassion fatigue affect the quality of emergency response and take a significant toll on personal lives. 911 dispatchers are often referred to as the "first of the first responders." We are the initial point of contact in emergencies, tasked with determining the nature of the incident, identifying those involved, and pinpointing the location. Simultaneously, we process and relay critical information, such as warrant checks and responder safety details, all while maintaining composure under pressure. One of our most critical responsibilities is providing life-saving medical guidance over the phone. I have assisted with childbirth and guided a caller through resuscitating a choking child. While these moments are victories, there are also profound tragedies. I will never forget the sound of a woman going agonal while unable to provide her address or the screams of a parent whose infant was not breathing. Suicide is another difficult reality we face far too often. Whether speaking with someone actively attempting suicide or providing support to a distraught family member, the emotional burden is immense. I have talked individuals down from suicide, but not every call ends positively. A colleague once tried to de-escalate a situation with an older man armed with a handgun, only to hear the gunshot over the radio. Despite her dedication, the emotional toll of that call was evident when she returned to work the next day, no longer the vibrant person we knew. As a trained crisis negotiator, I have de-escalated situations involving individuals armed with weapons, helping them get the care they need safely. I have spoken with a drunk driver heading the wrong way on a highway and frequently interact with emotionally disturbed individuals, striving to connect with them in moments of crisis. The stressors of this profession extend beyond phone calls. Dispatchers must often hold emergency calls due to insufficient resources, alert officers to immediate threats, or respond to mayday calls from firefighters. Listening to radio traffic from real-life events underscores the immense pressure telecommunicators face—pressure that stays with them long after the event. Despite these challenges, I am deeply passionate about my work and committed to serving in this role for the rest of my career. However, we need your support to ensure we can continue to provide critical assistance to those experiencing the worst moments of their lives. Please support this legislation to strengthen resources and care for 911 telecommunicators. Thank you for your time and consideration.

The labor force is essential for continued growth and success within The Commonwealth. Worker's should be appropriately compensated with fair wages, accessible/affordable health care, safe work spaces, and financial security for their retirement. Please vote for legislation to help support hard working Virginians.