Since the passage of the American Rescue Plan Act in 2021, a number of cities and counties in Ohio and around the nation have used ARPA funding to retire medical debt.

Over the summer, Akron became the latest community in Ohio to adopt a plan to retire such debts.

The city council allocated $500,000 to purchase debts through the non-profit RIP Medical Debt. RIP in turn negotiates with hospitals and debt collectors to buy old debts for pennies on the dollar and then forgives them.

Akron Ward 1 City Council Representative Nancy Holland said these debts take a toll on the community.

"Medical debt is one of the leading causes of personal bankruptcy," said Holland. "It's also a leading cause of divorce, of job disruption, of inability to qualify for most major loans like home loans, it can also cause trouble in a rental application, just to rent an apartment. "

Akron joins Lucas County, Toledo, and Cleveland in using ARPA funds to eliminate medical debts. The anticipated value of retired debts from Akron's allocation is up to $50 million.

After entering into a contract with a local government, RIP Medical Debt reviews hospital debt portfolios to determine which ones will be retired.

Residents who qualify must earn less than 400% of the federal poverty level, and their medical debts must be at least 5% of their annual income.

Allison Sesso is the president and CEO of RIP, and says medical debt can be hard to avoid.

"I think medical debt is different than other kinds of debt, because of the fact that it's inherent in the system," said Sesso. "And it's sort of a trap, you can't avoid it. You can have insurance and yet you still have medical debt. You can do all the right things and you still have medical debt. You don't control the pricing. It is not transparent as a system and so it's really hard to avoid. "

Pre-pandemic research found that 23 million Americans have medical debt, with 3 million owing more than $10,000.

While these debts are accumulated in countless ways, and at different types of healthcare organizations, Sesso said RIP will negotiate with anyone to buy qualifying medical debt belonging to those most financially burdened.

"There's often been questions about whether or not we'll work with certain kinds of hospitals, that maybe are seen as bad actors," said Sesso. "And at the end of the day, we really focus on the patient. If you have debt at a bad actor hospital, you shouldn't be punished for that."

Sesso said to date, RIP has retired $10 billion of debt for 7 million people nationally.

Washington lawmakers and Gov. Robert Ferguson disagree about how to address the state's $16 billion revenue shortfall.

The House and Senate have both passed budgets which would tax wealthy residents and corporations in order to balance the budget.

In contrast, Ferguson's plan cuts social programs and furloughs employees to save the state $7 billion.

Jeffrey Gustaveson is an organizer with Firelands Workers United, an advocacy group for rural Washingtonians. He said he supports lawmaker's efforts to make the tax system more fair.

"They're saying we should support working people," said Gustaveson, "and we're going to unlock new sources of money by increasing taxes on giant corporations, and some of the wealthiest human beings in the face of the planet."

As budget negotiations move forward, Ferguson called relying on untested taxes irresponsible. Lawmakers have until April 27 to finalize a budget acceptable to the Governor.

David Henson, a retired veteran and volunteer for Firelands, highlighted what's known as the Tax on Wall Street, which would apply to people who own stocks and bonds worth over $50 million.

Democrats say it would generate about $4 billion a year for the state.

"But it only affects 4,300 people in the state of Washington," said Henson. "They only pay 4% -- where we're paying, on average, 14% of our income on taxes. I don't think it's robbery."

Ferguson says his budget does not include reductions to vital services. But, Gustaveson countered, the governor's definition of vital is narrow.

He said a 6% cut from all state agencies will harm many services Washington residents rely on including healthcare, housing, and transit.

"There's a very clear message, I think, from the public right now," said Gustaveson, "that they support public programs and they support funding those public programs with fair taxes."

Democratic lawmakers say their proposed taxes would generate $17 billion over two years, bringing the state out of the red.

As many Minnesotans dig out from an early Spring snowstorm, the future of a federal program that helps low-income households pay their heating bills is less certain. State-level voices cite new spending cuts under the Trump administration. The most recent mass layoffs may include the entire staff that administers the Low-Income Home Energy Assistance Program - according to reports seen by the Citizens Utility Board of Minnesota. The "LIHEAP" funds are sent to state agencies for distribution.

Annie Levenson-Falk, Citizens Utility Board of Minnesota director, worries about payment delays for Minnesotans in need if federal staff isn't there.

"It's pretty concerning to see just the complete elimination of the staff on what is a vital and extremely popular program," she explained.

In an e-mailed statement, the Minnesota Commerce Department says so far this season, the program has helped about 107,000 households cover their utility bills. Amid the staffing upheaval, it anticipates running out of funds to help new applicants as early as mid-April.

The loss of LIHEAP staff comes at a time when energy customers are bracing for potentially higher bills economists link to the escalating trade war pursued by President Donald Trump. Levenson-Falk said her organization is watching to see how this region could be affected as America's trade partners respond to sweeping tariffs.

"It's going to really vary depending on where you live. Some utilities get a lot of electricity from Canada and some get much less, but I do think it could have a substantial effect on a lot of Minnesotans," she continued.

Minnesota officials are not only worried about the effects as the last bit of winter weather hangs on. There is also concern about what will happen this summer to households at risk, between the disruption of energy assistance and tariff-induced price hikes.

Levensen-Falk encouraged people who are eligible for aid to keep applying, and reaching out to service providers with questions.


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Backlash is mounting across the U.S. in response to the Trump administration's consistent push to cut federal staffing and programs. North Dakotans not happy with these moves will join another wave of protests this weekend. On Saturday, organizers in towns and cities nationwide will lead what are billed as "Hands Off" events. Demonstrators want to bring renewed focus to the level of cuts pursued by the White House, and the abrupt manner in which they're being carried out.

Lyn Dockter-Pinnick, lead of the grassroots group Red River United Indivisible, feels uneasy about what she calls a "slash and burn" mentality within the administration.

"And so, the concept of "Hands Off" is really not only saying, 'This isn't right, this isn't OK,' but also just concern over the speed and the upheaval that is happening," she said.

She is worried about services for military veterans, such as suicide prevention. The White House says it wants to root out waste and fraud. Dockter-Pinnick says reform is important, but adds that checks and balances are being ignored, citing the influence of wealthy adviser Elon Musk and the Department of Government Efficiency. Regional events this Saturday will be held in Fargo, Grand Forks, Bismarck and Minot.

While North Dakota residents express their frustration, state agencies and nonprofits are adjusting on the fly as cuts are announced. This week, federal officials began laying off ten-thousand Health and Human Services workers.

Seth O'Neill, executive director of the North Dakota Domestic & Sexual Violence Coalition, says that includes staffers who oversee grants his network of crisis centers relies on.

"It's unnerving when you don't know who to call to get answers because you don't know who is still employed at the federal government," he explained.

While the actual prevention grants haven't been cut yet, O'Neill is still worried about their fate. He notes that for these crisis centers, federal funding makes up 30% of their budget. Late last month, North Dakota Health and Human Services officials were left scrambling after being notified that several grants, focusing on substance abuse and mental-health treatment, were terminated early.


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