The number of people with Affordable Care Act health coverage is on the rise, but many are not able to access the care they need to get and stay healthy.

Adam Fox - deputy director of the Colorado Consumer Health Initiative - said the Biden Administration has an opportunity to update the ACA's Essential Health Benefits, services that almost all individual and small-employer insurance plans across the country are required to cover.

He said all Americans need access to fundamental services.

"Like dental, which is currently covered for children, but not adults," said Fox. "It should cover the full range of reproductive health services, and perinatal and postpartum care for people who are giving birth, as well as hearing and vision benefits."

Colorado has made some headway expanding benefits to address health care needs, including gender-affirming care and coverage for all people regardless of their immigration status.

Some insurers providing coverage through the ACA have warned that expanding essential benefits will drive up insurance premiums and health care costs in general.

Fox said he believes updating essential benefits would actually lower costs, and improve the quality of health coverage for all people - whether they get insurance through ACA marketplaces like HealthCare.gov, employer-sponsored plans, or programs like Medicaid.

"The reality is many of these services, that are proactive and preventative care," said Fox, "help people maintain their health and avoid much more costly health interventions, are likely to save costs."

It's been more than 13 years since the Affordable Care Act established rules defining ten categories of health services that most insurance policies must cover.

Fox noted that many states have not done anything to update or expand benefits.

"And what we need is federal action to update essential health benefits," said Fox, "ensure that the full range of whole person care is covered, and that that is made a requirement across the country."

This week, Ohio approved adult-use marijuana sales as part of a 2023 ballot measure, with sales anticipated to start mid-June.

Ohioans age 21 and over can now legally purchase marijuana across the state. In December, a law was enacted allowing people to grow and possess marijuana, but with no legal avenues to purchase it. Gov. Mike DeWine and some Republicans sought swift action to prevent black market sales.

Jim Canepa, cannabis control superintendent for the Ohio Department of Commerce, said after years of experience in liquor control, his role is to fairly and responsibly permit folks who grow, process, sell and test cannabis.

"My focus right now is really on coming up with the rules that are required and set forth, and the timeline set forth, in the initiated statute," Canepa explained. "They are June 7th to have the applications ready, and September 7th to start issuing permits."

The Joint Committee on Agency Rule Review approved the rules without objection, enabling a dual licensing program for existing medical marijuana dispensaries to also sell nonmedical cannabis products.

Ariane Kirkpatrick, CEO of the cannabis company Harvest of Ohio, said her dispensaries are ramping up to meet the anticipated demand.

"How are we going to do staffing?," Kirkpatrick asked. "We're looking at parking, so, at the different ordinances of the cities of where we're located, to make sure we have the proper parking. Looking at drive-through, because some of our locations might have been limited already as far as capacity."

The new legislation allows for people age 21 and older to buy and possess up to 2.5 ounces of cannabis, or 15 grams of cannabis extract, and the home cultivation of up to six plants for personal use and up to 12 plants with two or more adults in the household.

Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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Massachusetts residents struggling to pay high food prices are acquiring a growing amount of debt to pay their bills, according to a new report.

The Urban Institute found 60% of adults reported using credit cards to buy groceries but only 20% managed to pay the minimum monthly payment.

Kassandra Martinchek, senior research associate at the Urban Institute, said nearly 25% of families have dipped into savings to keep everyone fed.

"Some families are really struggling to even meet their basic needs and are taking riskier financial strategies that could leave them less capable to cope with a future financial shot," Martinchek pointed out. "Something like losing their job."

While U.S. inflation slowed last year, the average Massachusetts household continued to spend more than $270 a week on groceries with Boston ranking in the top 20 cities with the highest grocery prices.

The report shows adults with very low food security were also more likely to experience challenges in repaying their debt compared with those with less severe food hardship. For families taking advantage of "buy now, pay later" options, 37% reported missing payments on their loans.

Martinchek emphasized missed debt payments during a time of price hikes could have long-lasting effects.

"They could have constrained access to affordable credit options and struggle to take advantage of different wealth building opportunities," Martinchek noted.

Martinchek added it is especially the case for historically disadvantaged households. The report suggests policymakers strengthen social safety nets to help families as pandemic aid expires, and to bolster credit counseling and debt-management services.

Ohio lawmakers are exploring ways to address the state's looming retirement crisis.

According to The Pew Charitable Trusts, if the personal retirement savings situation remains unchanged, Ohio could expect to see a more than $11 billion increase in state spending over the next two decades.

House Bill 501 would create a Joint Legislative Study Committee tasked with studying retirement options for small businesses and state-facilitated workplace programs to improve access to retirement savings.

Amy Milam, associate state director of outreach and advocacy for AARP Ohio, said people are more likely to save for their golden years when they can do so by having a percentage of their paycheck deducted.

"In Ohio, we have 42% of Ohio's private sector workers -- that's roughly 1.8 million people -- who do not have access to a retirement savings plan through their employer," Milam reported.

Nationwide, around 64% of Hispanic workers, and 45% of Asian American workers lack access to an employer-provided retirement plan. According to an AARP report, almost three of four workers with less than a high school diploma lack a work-based retirement plan, a much higher percentage than those with a bachelor's degree.

Milam added more than a dozen other states have created partnerships with employers to offer state-sponsored plans to give employees access to Individual Retirement Accounts.

"Giving employees a simple way to save for retirement on the job means that fewer Ohioans will need to rely on public assistance later in life," Milam emphasized. "Which will benefit the individual and will also benefit the state by saving taxpayer dollars."

In some states, investment companies have pushed back on state-sponsored plans, seeing them as competition. But a 2023 survey by AARP found 92% of Ohio business owners support legislation creating a public-private retirement savings option for workers.