ANNAPOLIS, Md. -- With many people needing internet service more than ever during the pandemic, a Maryland economist is recommending an extra tax on internet service providers, to get them to offer better access across the state.

Anirban Basru, chairman of the Maryland Economic Development Commission, told fellow commissioners this week the tax would be an inducement for broadband firms to help to close the digital divide.

He pointed out it's not just rural areas of Maryland that don't have broadband. Some big-city neighborhoods also have been left off the internet grid.

"There are many parts of the city of Baltimore, for instance, that do not have broadband access," Basru said. "And as it turns out, much of this absence of broadband access can be found, predictably, in West and East Baltimore. Again, not fair along social justice and other dimensions."

Gov. Larry Hogan has provided at least $25 million in federal and state funds to improve urban and rural broadband since the COVID-19 crisis began. But many communities still lack service, or can't afford the monthly cost, even if it is available.

Basru said internet providers have a disincentive to extend into rural areas because they aren't likely to recoup their investment. He said he isn't proposing the tax to raise revenue, but to induce companies to invest in less densely populated areas and in poorer communities.

"This is the bargain: In order for a broadband access supplier to enjoy access to the densely populated markets in Montgomery County, they have to invest significantly in rural areas, or they will be subject to the tax I have proposed," Basru explained.

Basru hopes policymakers will consider his tax suggestion, especially as the pandemic has made lack of internet access more dire.

Last year, a report from the Maryland Task Force for Rural Internet found more than 324,000 Maryland residents still lack broadband access.



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Reports from the Insurance Commissioner's office and the state Attorney General reveal an analysis of what they call "the true costs of health care" in Washington. Based on the results, the Economic Opportunity Institute is asking state lawmakers to do more to address consolidation and sharply rising costs.

Health-care costs nationwide have been on the rise. The institute's senior policy associate, Sam Hatzenbeler, said the AG's report shows costs in Washington state outpace the national average. What she described as "insufficient regulation" has led to more consolidation of health-care providers and much higher prices for patients.

"We are seeing that they're able to monopolize the market and charge higher and higher prices," she said. "Patients, labor, business - we're saying, 'Enough is enough.' The bottom line is that Washington consumers are being priced out of the health care that we need."

The Institute has launched a Fair Health Prices campaign to educate consumers and prompt state lawmakers to take action. The group is calling for more affordable drug prices, regulating health-care provider mergers and addressing anti-competitive contracting strategies.

All these proposed fixes, Hatzenbeler said, would increase accountability on spending and help slow the skyrocketing costs of health care - costs the state Insurance Commissioner's report projects will go even higher.

"Annual out-of-pocket expenses for people with insurance can reach up to almost $19,000 a year," she said. "The Office of Insurance Commissioner just approved a 9% average increase for plans in 2024; that is on top on an 8% average increase that we saw in plans this year."

The Institute also said 81% of Washington residents report worrying about health-care cost increases. Large providers have said higher costs are driven by aggressive medical research and the latest treatments for illness and disease. Despite these claims, the United States has the lowest life expectancy rate among the world's developed nations.

It's estimated that one in three Kentuckians struggles to pay medical bills, and the issue continues to be a driving factor in personal bankruptcy cases. Local organizations are working to address the issue by partnering with debt-buying agencies to relieve residents' medical debt.

Reverend Kent Gilbert, pastor of Union Church in Berea, said during the pandemic, several churches teamed up with a debt consolidator to eliminate millions of dollars of medical bills. He said without boosting consumer protections, such as those enacted recently to stop surprise medical billing, the problem will worsen.

"What this really tells us is that we need to stop this debt from happening in the first place, and I think that should be our ultimate goal," Gilbert continued.

Research shows Black Americans, people living in the South and those living in states that have chosen not to expand Medicaid are more prone to carrying significant medical debt.

Kentucky Voices for Health is also tackling the issue by partnering with RIP Medical Debt, a charity that uses donations to forgive delinquent debt. For more information visit KYVoicesForHealth ."

Kelly Taulbee, director of communications and development with Kentucky Voices for Health, said while systemic changes are needed to address skyrocketing health-care costs, many Kentuckians need immediate help paying bills. She explained that through her organization's partnership with RIP Medical Debt, $1 donated helps eliminate more than $100 in medical debt. She said eligible cases are identified using consumer data from health-care providers to locate accounts that meet the criteria for debt relief.

"Donations made completely abolish that medical debt, no strings attached, no tax consequences. These portfolios are bought at a fraction of the original costs, and then once the debt is relieved, recipients are notified that their debt is gone," Taulbee said.

A 2018 consumer survey found 72% of Kentucky adults have struggled with health-care affordability. In eastern Kentucky, nearly 80% of people reported having problems and 1/3 said they'd been contacted by a debt-collection agency.

Small Business Saturday has come and gone and the North Carolina Sustainable Business Council urged people to keep "shopping local" this season.

The council said supporting homegrown businesses creates jobs and makes communities healthier. One of those businesses is the Little River Pecan Farm, with 100 pecan trees on a 10-acre section of sixth-generation land.

Crissy Neville, the farm's owner, emphasized the need to support local growers. She said shopping at local farms and agro-tourism sites preserves family businesses, but can also benefit the environment.

"Shipping is not involved, trucking is not involved," Neville pointed out. "Essentially, you know, you're buying locally, and that's the best thing that you possibly could do for lowering your carbon footprint."

Neville cited the added benefit of knowing where your food comes from. Studies estimate processed food in the U.S. travels more than 1,300 miles, and produce may travel more than 1,500 miles before reaching the table if it is not grown locally.

Rebekah Miel, owner of Miel Creative Studio in Durham, works with purpose-driven organizations to help them amplify their work. She pointed out local businesses often help their communities in ways beyond offering their products or services.

"Small businesses donate 250% more to local nonprofits and community causes," Miel explained. "That is also exemplified in our business. Our 'Design to Give' model means we give at least 5% back to local nonprofits, 1% of which is to local environmental nonprofits."

Anne Shaw, state director for the Small Business Center Network, said there is nothing "small" about the power of small companies. Their overall contribution to the workforce is enormous.

"The 1 million small businesses that exist in North Carolina, they employ 1.8 million employees," Shaw emphasized. "Which represents about 44% of North Carolina employees."

Shaw added research also shows on average, a local retailer will recirculate about 48% of their revenue back into the local economy, compared to about 14% of revenue from a national chain.


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