A new report from the Arizona PIRG Education Fund finds that Arizonans are getting hit with what are known as facility fees, leading to higher costs for medical care.

Maribeth Guarino, health-care advocate with PIRG, said facility fees can be thought of as a flat charge, added to a patient's bill only for stepping through the door of a doctor's office to seek care. She said facility fees are arbitrary and cost anywhere between a few dollars and thousands of dollars.

"We're seeing them more because hospitals are buying up independent clinics, physician's offices and other independent provider care settings and then charging these fees as though they're hospital locations, even though nothing has changed except the logo and the letterhead," she explained.

According to Guarino, 15 states around the country, including Florida and Texas, have laws on the books relating to facility fees, but Arizona isn't one of them. She noted states could better prioritize patient protections by ensuring they're informed about the fee before receiving care. And while several federal proposals have been introduced to address the issue, none has made it to the president's desk.

Guarino said the Federal Trade Commission has issued a rule to prohibit what she terms "junk" fees, and hopes the Federal Trade Commission will apply that rule to items such as facility fees. And for patients, she recommends reviewing your bill after you have received care.

"And do your best to shop around, if you can, before you get services," she advised, "because even though there aren't always laws in place to protect patients, sometimes you'll be surprised how much information is out there if you just ask directly."

Guarino added there is no guarantee you'll get that answer, but it doesn't hurt to ask. She said patients should only pay for the services they receive, and providers need to be transparent about the fees they charge.

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.