Consumers may feel their medical bills are unyielding, inflexible, set in stone. But that’s not always true: A new study shows patients can often reap financial benefits by disputing charges that seem erroneous or by negotiating for financial relief.
Of consumers who don’t reach out to question a medical bill, 86% said it’s because they didn’t think it would make a difference— but “the experiences of those who did reach out provide evidence to the contrary,” according to a new University of Southern California study.
About 26% of people who called because they disagreed with a charge or couldn’t afford to pay it got their medical bill corrected after the outreach, according to the study, published in August. Roughly 15% got a price reduction, 8% got financial assistance and 7% saw their bills canceled outright.
“Of the people who did reach out, most of them got some recourse through self-advocacy,” said report-co-author Erin Duffy, a research scientist at the USC Schaeffer Center for Health Policy and Economics.
Researchers polled 1,135 U.S. adults from Aug. 14 to Oct. 14, 2023.
About 1 out of 5 respondents reported receiving a medical bill with which they disagreed or could not afford within the prior 12 months. About 62% of them contacted the billing office to address the concern.
“If you can’t afford to pay something, or [if a bill] doesn’t seem right or match what your care experience was, you should call and ask questions about that,” Duffy said.
Savings can extend into the hundreds or even thousands of dollars, depending on factors like a patient’s health insurance and the type of medical visit or procedure, said Carolyn McClanahan, a physician and certified financial planner based in Jacksonville, Florida.
Bills ‘go all over the place’
A 2023 Consumer Financial Protection Bureau analysis of medical bills for adults age 65 and older found that patients “face a complex billing system with a high likelihood of errors and inaccurate bills.” Often, inaccurate bills result from erroneous insurance claims and occur more frequently among consumers with multiple sources of insurance, the CFPB said.
Common errors included missing or invalid claim data, authorization and pre-certification issues, missing medical documentation, incorrect billing codes and untimely filing of claims, the report found. Such mistakes contributed to the “rejection of claims that would otherwise be paid,” it said.
“[Bills] go all over the place,” said McClanahan, the founder of Life Planning Partners and a member of CNBC’s Advisor Council. “And there’s no transparency or rhyme or reason for how [providers] decide to charge.”
Doing nothing and avoiding payment of medical bills is likely not a good course of action: It could have negative financial consequences, such as late fees and interest, debt collection, lawsuits, garnishments and lower credit scores, according to a separate CFPB resource.
Consumers should ask up front what a medical visit or procedure will cost, or inquire what the estimated cost will be, she said.
Sometimes, consumers will pay “a heck of a lot less” if they pay in cash rather than via insurance, McClanahan said. However, cutting a check could have other consequences like the sum not counting toward one’s annual deductible, she added.
If you feel you were overcharged, request an itemized bill from the provider or hospital, and look for errors or duplicate charges, according to PatientRightsAdvocate.org. Research the fair market price for a service and use that information to negotiate, the nonprofit group said.
If something seems egregious, question it.
Carolyn McClanahan
physician and certified financial planner based in Jacksonville, Florida
The phone number for your medical provider’s accounting or billing office will be on your billing statement, the CFPB said.
Here are three other questions to consider asking about your itemized bill, according to the regulator:
Do charges reflect the services you received?
If you have insurance, do the bills reflect the payment by your insurance and reflect what the provider understood would be covered?
Do any of the charges indicate a service was “out-of-network” when it wasn’t?
When calling a provider about a medical bill, keep a journal about the communication, McClanahan said. Write people’s names and what was discussed, and get a commitment of when you’ll hear back.
Students on campus at Massachusetts Institute of Technology in Cambridge, Massachusetts.
Education Images | Universal Images Group | Getty Images
Harvard University is no longer the ultimate “dream” school, at least among current college applicants.
This year, Massachusetts Institute of Technology secured the top spot of most desirable colleges, according to a new survey of college-bound students by The Princeton Review.
Harvard fell from No. 1 after a prolonged period of controversy, marked by antisemitism on campus and the resignation of Harvard President Claudine Gay amid allegations of plagiarism.
Despite the reshuffling, there remains a common element at the top of the rankings, according to Robert Franek, The Princeton Review’s editor-in-chief. “Each of the schools are exceptional,” he said.
However, regardless of which institution they attend, for most students, the biggest problem remains how they will pay for their degree.
Cost is a major concern
A whopping 95% of families said financial aid would be necessary to pay for college and 77% said it was “extremely” or “very” necessary, The Princeton Review found. Its 2025 College Hopes and Worries Survey polled more than 9,300 college applicants between Jan. 17 and Feb. 24.
Often, which college those students will choose hinges on the amount of financial aid offered and the breakdown acrossgrants, scholarships, work-study opportunities and student loans.
MIT is one of the hardest schools to get into, with an acceptance rate of 4.5%. It’s also among the nation’s priciest institutions — tuition and fees, room and board and other student expenses came to more than $85,000 this year.
But MIT also offers generous aid packages for those who qualify. Among the Class of 2024, 87% graduated debt-free, according to the school.
Top colleges are seeking exceptional students from all different backgrounds, according to James Lewis, co-founder of the National Society of High School Scholars, an academic honor society.
To that end, many institutions will provide scholarships or discounted tuition, in addition to other sources of merit-based aid, he said.
For qualified applicants, “if they can go after those institutions, don’t self-select out,” Lewis said.
The return on investment: a good job
In part due to the high cost of college, students are also putting more emphasis on career placement, according to Christopher Rim, president and CEO of college consulting firm Command Education.
At MIT, for example, 2024 graduates earn a starting salary of $126,438, according to the latest student survey — nearly twice the national average. The percentage of MIT graduates employed in the months immediately after graduation has edged lower in recent years, while the share enrolling in graduate school has trended higher.
“Because it’s getting harder to find a job, students are more focused on what they are going to do after college,” he said. “That’s a big thing for them.”
When asked what they consider the greatest benefit of earning a college degree, most students said it was a “potentially better job and income,” The Princeton Review found.
Fewer said it was “exposure to new ideas, places and people.”
The median down payment among homebuyers in December was $63,188, according to a recent report by Redfin. That’s up 7.5%, or about $4,000, from a year prior.
“That is mostly reflecting the fact that home prices have increased,” said Chen Zhao, an economist at Redfin.
On top of high home prices, other issues homebuyers face include high inflation, volatile mortgage rates and limited savings balances.
The typical homebuyer down payment was equal to about 16.3% of the purchase price in December, when the median home-sale price was $428,000, per Redfin data.
While homebuyers are putting down more cash for their home purchases, down payments continue to be a major hurdle.
A new report by Bankrate found that 81% of would-be buyers say that down payment and closing costs are obstacles toward owning a home some day. For 52%, the hurdle is “very significant” while for 29% it’s “somewhat significant.”
The survey conducted by YouGov Plc polled 2,703 U.S. adults in mid January.
What to know about low-, no-down-payment loans
There are low- and no-down-payment mortgage options across federal agencies like the Fair Housing Association, the Department of Veteran Affairs and U.S. Department of Agriculture.
The Department of Veterans Affairs offers VA loan programs, and those who qualify can put down as little as 0%. Mortgages from the U.S. Department of Agriculture, referred to as USDA loans, aim to help buyers purchase homes in rural areas and also offer 0% down payment options.
Federal Housing Administration loans, or FHA loans, can require as little as 3.5% down for qualifying borrowers, which include first-time buyers, low- and moderate-income buyers and buyers from minority groups.
You don’t get anything for free.
Melissa Cohn
regional vice president at William Raveis Mortgage
Recently, more people are using mortgage options sponsored by the government. About 15% of mortgaged home sales used an FHA loan in December, up from mid-2022’s decade-low of roughly 10%, Redfin found. The share of those who used a VA loan rose to 6.7%, from 6.2% a year earlier.
The increase could be a sign of buyers having an upper hand in the market, said Redfin’s Zhao. Typically, sellers prefer to avoid FHA loans because they can involve a longer processing time, she said. For this reason, buying with an FHA loan can be less advantageous in a highly competitive housing market.
While low-down payment mortgages can help someone achieve homeownership, there may be additional costs involved.
With less cash upfront, you will need to borrow more, making your monthly mortgage payment much higher, experts say. And you could also face higher mortgage rates.
“The best priced loans are going to do a larger down payment, so the less you put down, the higher the rate is, the greater the risk,” said Melissa Cohn, regional vice president at William Raveis Mortgage.
With a down payment of less than 20%, you may be subject to private mortgage insurance, or PMI, which is added to the monthly mortgage payment.
Meanwhile, mortgage lenders tend to offer better loan terms to borrowers who put more cash up front, or make 20% down payments. Benefits can include lower interest rates, reduced fees and favorable repayment terms. While a 20% down payment can be daunting, it’s certainly not a requirement. You can buy a house with much less up front. Here’s what to know.
PMI can cost anywhere from 0.5% to 1.5% of the loan amount per year, depending on factors such as your credit score and your total down payment, according to The Mortgage Reports. For example, on a loan for $300,000, mortgage insurance premiums could cost from $1,500 to $4,500 a year, or $125 to $375 a month, the site found.
“You don’t get anything for free,” said Cohn.
‘Time isn’t a nemesis’
In Bankrate’s survey, respondents said they expect that coming up with a down payment will take years.
But “time isn’t necessarily a nemesis,” said Mark Hamrick, senior industry analyst at Bankrate. “Having more time is quite virtuous.”
The time it takes to save can work in your favor. As you build your down payment savings, you can also work on paying down debt and improving your credit, so that you improve your chance of being approved for a mortgage at the best-available rate, Hamrick said.
While you’re building your down payment, look for other programs that can help you get there faster.
Aside from federally backed low-down-payment mortgage options, consider state or local assistance down payment assistance programs, which can offer aid to those who qualify, experts say. Such programs can offer grants and loans to help cover part or all of a homebuyer’s down payment and closing costs, per The Mortgage Reports.
“The good news is the federal government isn’t the only game in town,” Hamrick said. “It’s really about trying to be aware and take advantage of any potential applicable program.”
Browse online through the state agency and see if you meet the qualifications for any assistance programs or grants available in your state or area, Cohn said.
“For people who don’t have the luxury or haven’t been able to save enough, that’s a good option,” she said.
U.S. President Donald Trump addresses the Conservative Political Action Conference (CPAC) annual meeting in National Harbor, Maryland, U.S., February 22, 2025.
Brian Snyder | Reuters
U.S. importers and their customers are about to experience the full force of President Donald Trump’s unprecedented use of emergency economic powers.
To that point, 25% tariffs on imports from America’s top two trading partners, Canada and Mexico, went into effect at midnight Tuesday, as did an additional 10% tariff on Chinese imports. Canadian energy will be tariffed at a lower rate of 10%, also as of midnight Tuesday.
It’s difficult to overstate how far-reaching the impact of these tariffs will be, or how quickly they will be felt.
U.S. trade with Mexico, Canada and China last year accounted for around 40% of America’s total commerce in goods around the world.
And unlike traditional trade policy, these tariffs are designed to deliver a financial sting right away, trade experts told CNBC.
“From a technical standpoint, the imposition of the tariffs is basically a light switch. They’re on or they’re off,” said Daniel Anthony, the president of Trade Partnership Worldwide, a policy research firm.
Literally overnight, the cost of importing, for example, $100,000 worth of limes from Mexico increased by $25,000 Tuesday. This is money that the importer will need to pay directly to U.S. Customs and Border Protection when the limes cross the border.
Even if a glitch prevented tariffs from being collected starting at exactly 12:01am Eastern Time Tuesday, they would still be tallied, and importers could expect to receive a tax bill retroactively, said Nicole Bivens Collinson, a Washington trade lobbyist and managing principal at Sandler, Travis & Rosenberg.
“It’s like when you get an Uber bill and you forgot to tip, and add it on later,” she said.
Along with the two new North American tariff rates, Trump also signed an order Monday doubling his earlier 10% tariff on imports from China, for a total 20% additional tariff rate on the nation.
Taken together, Canada, China and Mexico accounted for $2.2 trillion worth of U.S. overseas trade in 2024, according to federal census data. About $840 billion of that came from trade with Mexico, $762 billion from Canadian imports and exports and $582 billion from China.
Extraordinary power
Container at the Port of Vancouver in Vancouver, British Columbia, Canada, on Feb. 28, 2025.
Ethan Cairns/Bloomberg via Getty Images
Part of the reason Trump could do this so quickly is because the White House is invoking a sweeping national security law to justify the new levies.
Until now, the International Emergency Economic Powers Act, IEEPA, had been used mainly to impose emergency sanctions on foreign dictators or suspected terrorist groups.
But the Trump administration argues that the illicit global fentanyl trade and immigrants at the Mexican border both qualify as “unusual and extraordinary” foreign threats to American national security, justifying Trump’s use of emergency powers under IEEPA.
Trump is using the law in a broader way than any president has before, Trade Partnership Worldwide’s Anthony explained.
Trump is also inviting legal challenges, he said, by pushing the boundaries of presidential authority.
For now, consumers will bear the brunt of the tariffs in higher prices, experts say. The Tax Policy Center estimates that Trump’s Mexico and Canada tariffs alone will cost the average household an additional $930 a year by 2026.
The imposition of massive new tariffs on U.S. imports from Canada, China and Mexico are a sharp reminder of how much power Trump wields over global commerce.
But they also hint at the limitations of this power.
In the case of so-called de-minimis shipments, the Trump administration imposed new levies on millions of shipments entering the United States, before the federal government had the means to actually collect the fees.
The de minimis mess
Oscar Wong | Moment | Getty Images
So-called “de minimis” imports are international shipments valued at $800 or less. Historically, these low-value, person-to-person imports have been exempt from U.S. tariffs.
Several of the world’s biggest e-commerce companies take advantage of the de-minimis loophole by shipping their products directly to consumers from overseas.
Fast fashion sites, like Temu and Shein, ship goods directly from China to American consumers. They have helped fuel an explosion in U.S.-bound de-minimis shipments in recent years.
But collecting tariffs on de-minimis goods is harder than it looks.
“There’s a whole infrastructure system set up for normal shipments that come in to the country,” said Collinson, who previously served as a U.S. trade negotiator. But this system doesn’t exist for de-minimis imports, she added.
Last year alone, the U.S. accepted more than 1.3 billion overseas shipments that qualified for de-minimis tariff exemptions, according to federal data.
To process that many new shipments, the federal government will need to hire more customs agents, experts said.
Nonetheless, in early February Trump announced that the United States would begin collecting tariffs on low-value shipments from overseas.
Trump’s order gave the U.S. Postal Service mere days to implement a system to begin collecting tariffs on millions of small packages every day.
It also sowed chaos throughout the international postal system, culminating on Feb. 4 with an announcement that USPS had suspended all parcel delivery services from China and Hong Kong “until further notice.”
A day later, the postal service reversed course and resumed processing the de-minimis parcels. But it did not collect any tariffs on them.
Soon after, the Trump administration issued an amendment to the China order, formally delaying any effort to collect tariffs on de-minimis imports until “adequate systems are in place to fully and expediently process and collect tariff revenue” on them.
The U.S. Postal Service didn’t immediately respond to a request for comment.
A month later, the White House put similar de-minimis waivers in place Sunday for Canada and Mexico, ahead of imposing the new 25% tariffs.
It’s unclear when a de-minimis tariff collection system might be up and running.
A U.S. Customs and Border Protection spokeswoman told CNBC, “The dynamic nature of our mission, along with evolving threats and challenges, requires CBP to remain flexible and adapt quickly while ensuring seamless operations and mission resilience.”
But Anthony noted that the delay for China was “open ended.”
“Part of the challenge is [federal] personnel and bandwidth,” he said. Customs and Border Protection may not have the staff or resources available to handle the new volume of shipments and packages, he said.
Officials must also determine how the levy will be assessed and paid, and how customs officials will process tens of millions of new data points furnished by shippers for each individual package, the experts said.
“Anyone can develop a good policy, but whether that policy can actually be effectuated is critical,” Collinson said.