US interest rate rises coming? Economics news to read this week

US interest rate rises coming? Economics news to read this week
  • This weekly round-up brings you the latest stories from the world of economics and finance.
  • Top economy stories: US signals larger interest rate rises; China sets low economic growth target as it seeks ‘stability’; Japan narrowly avoids recession.

1. Larger interest rate rises may be on the way, US Fed indicates

The US Federal Reserve will likely need to raise interest rates more than expected in response to recent strong economic data, Chair Jerome Powell says. He also told the Senate Banking Committee that the Fed is prepared to move in larger steps if the “totality” of incoming information suggests tougher measures are needed to control inflation.

Some of this unexpected strength may have been due to warm weather and other seasonal effects, but Powell says it may also be a sign the Fed needs to do more to temper inflation, perhaps even returning to larger rate increases than the 0.25 percentage point steps officials had been intending to use.

The Fed’s policy rate is currently in the 4.50-4.75{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} range. In December, officials saw that rising to a peak of around 5.1{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}, but investors now expect this may move at least 0.5 percentage points higher.

US inflation has fallen from an annual rate of 9.1{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in June to 6.4{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in January, but Powell says this remains too high. “The process of getting inflation back down to 2{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} has a long way to go and is likely to be bumpy,” he told the Senate Banking Committee, adding that “the social costs of failure are very, very high”.

Changes to US interest rates have a knock-on effect around the world, as many countries that peg their currency to the dollar alter their rates in line with the Fed.

2. China prioritizes ‘economic stability’ amid low growth expectations

China has set a 5{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} growth target this year as it looks to “prioritize economic stability” following a bumpy 2022, reports the Financial Times. The goal is its lowest in decades and is below most economists’ expectations – and it could have implications for global growth.

The country’s GDP grew by just 3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} last year – falling short of a target of 5.5{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}, and proving to be one of its worst showings in decades. The slowdown was a result of three years of COVID-19 restrictions, a crisis in the country’s vast property sector, a crackdown on private enterprise and weakening demand for Chinese exports.

China annual GDP growth, {515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}

US interest rate rises coming? Economics news to read this week

China’s GDP grew by just 3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in 2022 – one of its worst showings in decades.

Image: International Monetary Fund

Premier Li Keqiang has stressed the need for economic stability and to expand consumption following last year’s dip in GDP. China’s annual consumer price inflation slowed to 1{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in February – its lowest rate in a year – showing that consumers are behaving cautiously.

“We should give priority to the recovery,” Li said. “The incomes of urban and rural residents should be boosted through multiple channels. We should stabilize spending on big-ticket items and promote recovery in consumption of consumer services.” He has set a goal to create around 12 million urban jobs this year, up from last year’s target of at least 11 million.

The Economist says the “undemanding growth target removes any pressure to stimulate the economy further” and will prevent the further build-up of debt. China’s local governments are facing a debt crisis, according to Reuters. It points out that Li has set a fiscal deficit target of 3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} of GDP this year – a marginal uptick from 2022 – and says there are no plans for direct transfers to boost consumer spending.

China's growth is expected to slow after the reopening boost.

The IMF’s forecasts for China’s economic growth.

Image: International Monetary Fund

The International Monetary Fund (IMF) predicts 5.2{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} growth for China’s economy this year. It also points out how lower growth in China could pull down global growth. “When China’s growth rate rises by 1 percentage point, growth in other countries increases by around 0.3 percentage points.”

3. News in brief: Stories on the economy from around the world

Japan narrowly avoided a recession in the fourth quarter of 2022, with GDP growth of just 0.1{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} following a contraction in the third quarter. Real wages fell by 4.1{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in January compared with a year earlier – their fastest drop in nearly nine years, as four-decade-high inflation squeezed consumer purchasing power in the world’s third-biggest economy. Wage trends are under close market scrutiny because Bank of Japan officials say pay hikes are essential to it scaling back its loose monetary policy.

Eurozone retail sales rebounded much less than expected in January compared with December and were still lower than 12 months earlier, underlining the weakness of consumer demand and the broader economic slowdown. Sales rose by 0.3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} on the month and were down 2.3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} on the year.

Sri Lanka has moved closer to receiving a $2.9 billion bailout from the International Monetary Fund (IMF), after securing financing assurances from China, India and all its major bilateral creditors.

US President Joe Biden has unveiled plans to raise taxes on the wealthy and boost federal spending. His proposed budget would increase taxes on anyone earning over $400,000 per year in order to cut $3 trillion from the US deficit over the next 10 years.

The Bank of Canada has left its key overnight interest rate on hold at 4.50{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}, becoming the first major central bank to suspend its monetary tightening campaign in the face of an anticipated easing of high inflation.

Australia’s central bank could pause its aggressive cycle of interest rate increases as soon as April. It has made 10 hikes that have lifted rates to an 11-year-high of 3.6{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}.

The UK economy grew by 0.3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} on the month in January, following a 0.5{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} dip in December. And the British Chambers of Commerce says the UK economy is on track to shrink less than expected this year, avoiding the two quarters of negative growth that mark a technical recession.

South Africa’s economy contracted by 1.3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in the fourth quarter of 2022 compared with the previous three months, as an escalation in rolling power cuts hit sectors from agriculture to mining. Ratings agency S&P Global has downgraded its outlook for South Africa to “stable” from “positive”, citing infrastructure constraints and the severe power crisis.

France’s food retailers will offer “the lowest possible prices” on a selection of items for a three-month period, following an agreement with French Finance Minister Bruno Le Maire. The discounts, designed to help shoppers cope with food price inflation, are expected to cost retailers “hundreds of millions of euros”, Le Maire says.

4. More on finance and the economy on Agenda

The global financial system needs wide-scale reform, according to UN Secretary-General António Guterres. He says the system was created by wealthy countries to serve their own interests and is extremely unfair to the world’s least developed countries. As a result, he wants a “revolution of support” to aid these poorer nations.

The Indonesian government’s food aid program used to provide bags of rice to villages, but it led to people only receiving their full allocation 24{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} of the time. Since swapping this for a debit card system that allows people to buy the equivalent amount of food at local shops, millions of Indonesians now receive the full amount of food intended for them 81{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} of the time, according to new research.

The outlook for Asia’s economies this year has brightened, according to the International Monetary Fund. However, subtle policy trade-offs between controlling inflation and ensuring financial stability are needed, it says.

Where is the global economy heading in 2023? Plus other economics stories you need to read this week

Where is the global economy heading in 2023? Plus other economics stories you need to read this week
Where is the global economy heading in 2023? Plus other economics stories you need to read this week

1. In which is the world economy heading in 2023?
The 12 months ahead looks better than at first feared for the world-wide financial system, but stays fraught with pitfalls, which includes the opportunity escalation of the war in Ukraine and the emergence of a transatlantic trade war, the last panel at the Globe Economic Forum’s Yearly Assembly in Davos concluded.

Global Financial Fund (IMF) Handling Director Kristalina Georgieva told Davos that what experienced improved was the possible for China to enhance growth, but she warned: “We have to be cautious”. World advancement is continue to expected to sluggish to a person of its most affordable prices in current a long time, senior UN economists say. They count on development to drop to 1.9{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} this 12 months from 3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in 2022 because of intersecting crises these the Ukraine war, surging inflation, credit card debt tightening and the local weather crisis. The Environment Lender sees progress sliding to 1.7{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}.

A world wide recession is viewed as likely by two-thirds of respondents to the Entire world Economic Forum’s Main Economists Outlook: January 2023, of which 18{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} take into account it very probably – a lot more than two times as numerous as in the prior survey in September 2022. Even so, the report also factors to tentative grounds for optimism, including a probable easing of the expense-of-living and vitality crises.

Issues about trade and the fracturing of globalization ended up a essential topic at Davos. Numerous speakers claimed that multilateralism and cooperation stay effective equipment for prosperity, and that financial fragmentation and trends such as “friendshoring” – relocating supply chains inside a group of nations around the world with shared values – will be expensive since they will lead to inefficiencies and duplication, and hence to inflation.

Yet another threat dealing with the environment overall economy is trade wars more than clean power subsidies. The EU is examining its point out help guidelines to help the environmentally friendly energy marketplace, in response to the subsidies and tax breaks contained in the US Inflation Reduction Act.

Slowing exports from important Asian economies are also stoking fears of a additional slowdown in the world-wide financial system. Japan’s export progress slowed sharply in December as China-certain shipments fell for the initially time in 7 months, with a slump in revenue of cars, automobile sections and chip-creating machinery. And South Korea’s economic system contracted for the to start with time in 2.5 yrs in the fourth quarter of 2022 – its exports of substantial-tech products and solutions have been slipping because of the weaker international financial state and China’s modern slowdown.

2. US and Japan facing credit card debt troubles
The world’s major and third-greatest economies are both equally facing up to issues around debt. The US could facial area a fiscal crisis in the following couple of months just after the governing administration strike its $31.4 trillion personal debt ceiling. At the same time, the Bank of Japan has downgraded its financial outlook, shortly just after Finance Minister Shunichi Suzuki warned that the country’s finances are becoming ever more precarious.

The US Treasury has started applying “extraordinary measures” on cash management to attempt and maintain off a debt default till 5 June. The country’s personal debt ceiling is a authorized limit on how considerably the federal government can borrow. It is set by Congress and was prolonged to its latest amount in December 2021 next requires from the Democratic Get together. That restrict has now been strike subsequent a standoff between the Republican-managed Household of Reps and President Joe Biden’s Democrats on lifting the credit card debt ceiling once more.

Most analysts consider a offer will be achieved and a default will not happen, Bloomberg reviews, pointing out that the financial debt ceiling has been elevated 45 times in the past 40 yrs. But in the meantime there is most likely to be inventory marketplace volatility.

If a default does happen, the US’ credit score rating would decrease, main to better curiosity premiums. That would set pressure on households and enterprises, as it would translate into increased borrowing fees for autos, residences and all other loans. The repercussions for the economic climate could guide to companies cutting positions in huge quantities.

Japan’s governing administration debt will exceed JPY 1,100 trillion ($8.47 trillion) for the initially time at the finish of the fiscal yr that operates to March 2027, a draft estimate witnessed by Reuters exhibits, as the nation stays greatly dependent on borrowing.

Japan’s inflation price has not long ago strike a 41-year-high. This has stored alive expectations that the Lender of Japan could stage out its ultra-small desire premiums – it opted to maintain premiums unchanged on 18 January to allow it to go on servicing its credit card debt repayments – although some analysts do not hope this any time shortly, simply because of uncertainty about irrespective of whether wages will increase adequate to offset rising dwelling prices.

Prime Minister Fumio Kishida states wage hikes will be key to setting up a constructive cycle of advancement. Japan raised its bare minimum wage by a document amount of 3.3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} past calendar year, but it is failing to hold tempo with inflation.

Information in temporary: Tales on the overall economy from around the earth
Pakistan is facing an financial disaster on a identical scale to Sri Lanka, which could cause a humanitarian catastrophe. It is searching for US aid for a $1.1 billion IMF offer, as it struggles with superior money owed and the fallout from catastrophic floods very last 12 months. The Pakistani rupee fell by 9.6{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in opposition to the dollar on 26 January – its major just one-day fall in over two many years.

China has retained benchmark lending fees unchanged for a fifth month, but analysts say future cuts are probable as the central financial institution has pledged to assist the COVID-hit economic system. The economic climate grew by just 3{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in 2022, significantly down below the formal focus on, but the government’s abrupt conclusion to its zero-COVID coverage has raised hopes of a restoration.

The Bank of Canada is the first key central financial institution to say it will very likely keep off on more fascination charge raises in the fight in opposition to inflation. “Recent developments have reinforced our self confidence that inflation is coming down,” financial institution Governor Tiff Macklem mentioned just after boosting prices by 25 basis points to a 15-year-higher of 4.5{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}.

US GDP grew by 2.9{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} on the year in the fourth quarter – quicker than envisioned but however its slowest pace in 2.5 several years. It could be the final quarter of solid GDP progress, as the total outcomes of the Federal Reserve’s financial plan tightening feed through. “The US financial state isn’t falling off a cliff, but it is shedding stamina and threats contracting early this 12 months,” Sal Guatieri, a senior economist at BMO Capital Marketplaces, instructed Reuters.

The European Central Financial institution (ECB) President Christine Lagarde told Davos 2023 that inflation “is way way too high” and that “our dedication at the ECB is to provide it back again to 2{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in a well timed manner”. On the other hand, ECB policymakers have laid out diverging sights on foreseeable future charge hikes. Eurozone inflation was 9.2{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} in December.

The German federal government has laid out an enhanced outlook for advancement this 12 months. Europe’s greatest financial state now expects a .2{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} rise in output in 2023 – owning forecast a .4{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} contraction again in October – many thanks to measures to offer with the electrical power crisis and strengthening enterprise sentiment. German producer charges rose in December at a slower amount than the prior month as inflation eases in because of in element to reduced energy charges.

Australian inflation shot to a 33-yr superior in the fourth quarter of 2022, as the price tag of journey and electrical power jumped. Annual inflation rose to 7.8{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}, more than two times the rate of wage expansion.

Iran’s currency has strike a record minimal in opposition to the US dollar, as ties concerning the EU and Tehran deteriorate amid stalling endeavours to revive talks on limiting Iran’s nuclear potential. The rial has lost 29{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} of its price in about 4 months. The EU is talking about a fourth round of sanctions in opposition to Iran.

Providers in Europe with junk-rated financial debt – this means there is a greater risk of payments currently being missed – have raised $1.4 billion from bond sales in January. It marks a craze of buyers returning to riskier credit card debt right after rising fascination charges and Russia’s war in Ukraine froze marketplaces previous yr.

S&P Global’s flash Composite Obtaining Managers’ Index (PMI) for the Eurozone climbed to 50.2 this month from 49.3 in December, marking a shock return to modest growth and suggesting the financial downturn in the bloc may perhaps not be as deep as feared. Germany’s PMI rose for a third consecutive thirty day period, to 49.7 from 49., when France’s PMI slipped to 49. from 49.1. Britain’s dropped to 47.8 from 49., this means private-sector financial action is falling at its speediest price in two several years, suggesting a risk of recession.

S&P Global’s flash PMI for the US has risen to 46.6 this thirty day period from a ultimate examining of 45. in December. This suggests that the downturn in business enterprise exercise eased marginally in January – although it nevertheless contracted for a seventh straight month.

A lot more on the overall economy on Agenda
The financial outlook for 2023 will come to feel various based on wherever you are in the world, in accordance to the World Financial Forum’s Chief Economists Outlook. The the vast majority of chief economists surveyed for the report count on moderate or powerful progress in the Middle East and North Africa and in South Asia, when far more than 9 out of 10 feel growth will be weak in the US and Europe.

The IMF has released a new fund to support reduced and middle-revenue countries raise their resilience to lengthy-phrase shocks like weather disasters and pandemics. This is how it will get the job done.

Can central lender electronic currencies assist stabilize global monetary markets? They are emerging as a significant priority for central bankers, but there is a need to take care of queries about their interoperability and how they suit into the broader financial sphere, say Environment Financial Forum blockchain and electronic assets specialists, Sandra Waliczek and Claire Buonocore.
Resource: Planet Economic Forum

Blind people still get medical bills they can’t read : Shots

Blind people still get medical bills they can’t read : Shots

Lucy Greco (left), a web-accessibility specialist at the University of California, Berkeley, is blind. She reads most of her documents online, but employs Liza Schlosser-Olroyd as an aide to sort through her paper mail every other month, to make sure Greco hasn’t missed a bill or other important correspondence.

Shelby Knowles for KHN


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Shelby Knowles for KHN


Lucy Greco (left), a web-accessibility specialist at the University of California, Berkeley, is blind. She reads most of her documents online, but employs Liza Schlosser-Olroyd as an aide to sort through her paper mail every other month, to make sure Greco hasn’t missed a bill or other important correspondence.

Shelby Knowles for KHN

A Missouri man who is deaf and blind said a medical bill he didn’t know existed was sent to debt collections, triggering an 11{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502} rise in his home insurance premiums.

In a different case, from California, an insurer has suspended a blind woman’s coverage every year since 2010 after mailing printed “verification of benefits” forms to her home that she cannot read, she said. The problems continued even after she got a lawyer involved.

And still another insurer kept sending a visually impaired Indiana woman bills she said she could not read, even after her complaint to the Health and Human Services’ Office for Civil Rights led to corrective actions.

Across the U.S., health insurers and health care systems are breaking disability rights laws by sending inaccessible medical bills and notices, a KHN investigation has found. The practice hinders the ability of blind Americans to know what they owe, effectively creating a disability tax on their time and finances.

Crucial notices are often in small print, impossible to read

More than 7 million Americans age 16 and older have a visual disability, according to the National Federation of the Blind. And having medical information and bills delivered in an accessible manner is the right of each of those people, protected under various statutes, including the Americans with Disabilities Act, the Affordable Care Act, and the Rehabilitation Act, disability rights legal experts said.

But some blind patients told KHN that the letters they receive can be impossible to read. Some websites contain coding that is incompatible with screen reader technology, which reads text aloud. Some health care systems and insurers fail to mail documents in Braille, which some blind people read by touch. And others who are visually impaired can read large print, with the possible aid of glasses or magnifying lenses, but the small-print medical bills they get are indecipherable.

“I tell them sending me small-print mail is like hiring a mime to communicate to me from outside my window,” Stuart Salvador told KHN over Skype instant messaging. The 37-year-old lives in Greene County, Mo., and explained that a case of shingles when he was 28 left him with only residual sight and hearing. “I can tell something is there,” Salvador said, “but I have no idea what I’m supposed to be getting from that.”

Bills are sometimes sent to collections before the patient knows there’s a problem

Salvador said it can take up to six hours for him to effectively convert a printed medical bill into Braille. He said he has been sent to collections multiple times by CoxHealth and Mercy hospital systems through their automatic medical debt referral systems after the health care providers sent him bills he could not read. As a result, he said, his home insurance carrier raised his annual premium by 11{515baef3fee8ea94d67a98a2b336e0215adf67d225b0e21a4f5c9b13e8fbd502}, costing him an additional $133.51 and significant hassle.

Nancy Dixon, a spokesperson for Mercy, said that the health system could not find a bill for Salvador that was sent to collections in its records within the past 10 years, and that its policy is to make reasonable accommodations for any patient who requests them. CoxHealth did not respond to requests for comment.

Salvador noted that it’s challenging for him and other visually impaired patients to fight for access to their billing information. If they realize a problem exists, he and other patients told KHN, communicating with the medical systems and insurers can be difficult. Often, they may not even be aware of the problem until it’s too late.

Like Salvador in this instance, some blind patients don’t keep track of written documentation which otherwise might help with a possible legal challenge when overdue billing issues escalate.

Disability rights attorney Albert Elia, who is blind, said blind people stuck with inaccessible bills often are left with two options: to hope for government action or pursue long, costly lawsuits. The National Federation of the Blind, as well as the American Council of the Blind, have sued and won public settlements regarding inaccessible medical information.

The cycle of inaccessibility repeats — over and over

Meredith Weaver, a senior staff attorney for Disability Rights Advocates, who helped monitor the implementation of a blind accessibility settlement agreement with health care giant Kaiser Permanente, said her clients often ask for documents to be sent in Braille or be readable by online screen readers. They then typically receive one document that works for them before the cycle begins anew.

“It felt like whack-a-mole to continually make those requests,” Weaver said.

After the terms of the settlement agreement with Kaiser Permanente expired in 2018, Weaver said, she began to hear from clients who faced the same barriers yet again.

Kaiser Permanente spokesperson Marc Brown said that the health system conducted an accessibility review after KHN informed it of Weaver’s comments, and he said the company found “no significant defects in the platform, nor do we know of any inaccessibility issues” that would limit someone from paying their bill or using its website. (KHN is not affiliated with Kaiser Permanente.)

Websites of many major health insurers pose accessibility problems. ‘It’s shocking to the conscience’

KHN found multiple accessibility issues on the public-facing webpages of Aetna, Anthem Blue Cross and UnitedHealthcare, major insurers that visually impaired and blind customers flagged as having accessibility problems. The errors, which KHN identified with the help of a tool created by WebAIM, a nonprofit web-accessibility organization, include webpage coding that would make it difficult for a blind customer using screen reader technology to shop for a health plan or find an in-network doctor.

After he learned of KHN’s findings, Andrés J. Gallegos, chairman of the National Council on Disability, an independent federal agency that advises the White House and Congress, said the council should look more deeply into the issue.

“It’s shocking to the conscience,” he said, noting the law clearly provides for such accessibility protections.

All three insurance companies said they work hard to make their services accessible and strive to fix member issues.

“It’s the year 2022. Everything is being done electronically; everything is being done online,” said Patrick Molloy, a blind 29-year-old in Bucks County, Penn. “It shouldn’t, in theory, be terribly difficult to make websites and billing platforms accessible to customers with visual impairments. But it’s the world we live in.”

Getting a lawyer involved doesn’t always solve the problem, said Lucy Greco, a web-accessibility specialist at the University of California, Berkeley. The blind 54-year-old sought legal help in early 2020 to stop Anthem Blue Cross from mailing her printed notices she cannot read — which sometimes resulted in lapsed benefits because she could not read the written request to sign and return the documents. She now receives some but not all communication through email, which she had requested, and via the company’s online portal.

Greco pays Schlosser-Olroyd $30 and hour to help sort through bills and personal papers that are still delivered via the mail. Not every blind person can afford such assistance, Greco notes, and even that investment can’t always fix the problem.

Shelby Knowles for KHN


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Shelby Knowles for KHN


Greco pays Schlosser-Olroyd $30 and hour to help sort through bills and personal papers that are still delivered via the mail. Not every blind person can afford such assistance, Greco notes, and even that investment can’t always fix the problem.

Shelby Knowles for KHN

Greco employs an aide to read her mail to her every other month, to help fill in the gaps, but she has still missed insurance notices and bills. She recently raised the aide’s wages to $30 an hour, as Greco wants to ensure she can retain a trustworthy person with all her personal information. But not everyone can afford to hire an aide.

“It makes you feel helpless and it makes you feel dependent on people you might not want to feel dependent on,” she said.

‘It’s not easy to enforce these laws’

Even when federal entities step in to fix such issues, the problems persist. Kate Kelly, a 61-year-old in Greenwood, Ind., who is visually impaired and has hearing loss stemming from multiple sclerosis, was so fed up with receiving multiple bills in standard-sized text from her insurer, Aetna, that she filed a complaint with the HHS Office for Civil Rights in early 2020.

But after the office came to an agreement with Aetna to stop sending her bills in standard-sized text that fall, she said, Aetna soon resumed sending some documents in text too small for her to read. Kelly pushed HHS to reopen her case. This July, records show, the office closed it due to what it said was a lack of jurisdiction, despite its involvement in obtaining the previous resolution.

Kelly said her large-print bills still get delayed — one from March just came in August — and she is now required to sign for them when they’re delivered. When she tried to use the online portal, she said, her screen reader could not read certain numbers and other information.

“It’s hard to fight back; it’s hard to participate in the system,” she said. “You see why insurance companies get away with it, as it’s not easy to enforce these laws.”

Alex Kepnes, an Aetna spokesperson, said company staffers had reached out to Kelly after KHN’s questions and they “regret the inconvenience that this has caused her.” Kelly said she missed Aetna’s call, and although she called the next day and tried once more to reach the company, she had yet to hear back as of Nov. 28. She did receive a complaint form from the company — the text was in small print she cannot read.

Meanwhile, Kelly said, her utility company manages to get her a bill in large type every month. And she promptly pays it.

KHN (Kaiser Health News) is a national, editorially independent newsroom and program of KFF (Kaiser Family Foundation).