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.

New York could see major effects from President-elect Donald Trump's proposed budget cuts.

Elon Musk and Vivek Ramaswamy's Department of Government Efficiency is set to slice $2 trillion in federal spending. While their focus is cutting agency budgets and the government's workforce, safety nets will be in their crosshairs.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said states will have flexibilities if cuts occur, but they will make using services harder.

"In practice, these flexibilities will mean things like cutting back eligibility, adding red tape so that it's harder for families and people to get through the process, which cuts down on enrollment," Alker explained. "We know that from the unwinding that we've just been through."

She added benefits could be limited and providers who see a lot of low-wage working families might face reimbursement cuts. There has been consideration to cut Medicaid's expansion match rate to a regular rate, which would move most costs to states. Estimates show New York's cost for expansion group under a reduced federal match rate could be more than $5 billion, if it occurs.

The Supplemental Nutrition Assistance Program could face cuts as well.

Mayra Alvarez, president of the Children's Partnership, said the proposed changes outlined in Project 2025 could make the program harder to access while increasing inefficiencies.

"Everything from increasing time limits for the program for adults without dependents," Alvarez outlined. "Also, eliminating categorical eligibility, which would remove the state options of increasing the gross income limits from 130 % of the poverty line to up to 200%."

In 2022, 53% of SNAP participants in New York were families with children, and close to 3 million people statewide relying on the program. Nationwide, SNAP has helped lift more than 3.4 million people out of poverty in 2023.

In the Wyoming governor's new supplemental state budget, the biggest line item by far is wildfire recovery.

Gov. Mark Gordon on Monday gave a virtual speech to kick off several days of agency budget meetings, in which legislators request supplements to the 2025-2026 biennial budget adopted in March.

Gordon noted the historic nature of the 2024 wildfire season, which he said burned 850,000 acres across the state and cost more than $55 million in suppression efforts. The price tag emptied several state coffers, he said, and he requested $130 million be added to the new budget for similar purposes.

"Without further appropriation, Wyoming will not have sufficient unobligated funds to effectively respond to future fires or other potential emergencies such as flooding or rapid runoff or massive winter and spring snowstorms," Gordon contended. "Which as we know are not uncommon to Wyoming."

The funds would also help with recovery efforts after wildfire, such as preventing invasive plant species from taking over burned landscapes and providing assistance to restore lost infrastructure and stabilize watersheds.

Gordon also requested funds to both mitigate past federal actions and prepare for future ones. One example is the federal COVID-era American Rescue Plan Act, designed to fund local governments' infrastructure projects. The deadline for the plans was this year. Many proposed project in Wyoming were delayed, Gordon said, because of "federal deadlines and supply-chain issues." He asked for more than $20 million in mineral royalty grants to fill the gaps.

"The unprecedented influx of federal programs, beginning with the CARES Act, skewed Wyoming's homegrown approach to addressing community emergencies and needs," Gordon argued. "This is the time we can return to the more conservative and direct approach our state is accustomed to."

Gordon also asked for two additional senior attorneys to be funded for the Attorney General's Office to continue challenging federal regulations, which, he said, "hinder our ability to manage agriculture, energy, water and wildlife."


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As President-elect Donald Trump prepares to take office, federal health programs affecting 85 million low-income Americans, including more than 12 million in California, may face cuts to reduce inflation and debt.

As of 2024, California has the largest state Medicaid program in the U.S. Programs such as Medicaid, CHIP, and SNAP could be affected by fiscal tightening in the upcoming year.

Mayra Alvarez, president of the Children's Partnership, told an Ethnic Media panel Medicaid cuts would deeply affect families.

"It's these public programs that are core to helping families meet the day-to-day needs of raising healthy kids," Alvarez contended. "These have been bipartisan programs that have helped our families thrive."

Political experts said Congress is expected to act swiftly on its agenda next year, with key actions likely starting in January, before the presidential inauguration.

Medicaid is funded by the federal government and individual states but each state runs its own program.

Joan Alker, executive director of the Georgetown University Center for Children and Families, who also participated on the panel, said cuts to the program will have widespread effects.

"Medicaid accounts for about 56% of all federal money that is flowing to states, is coming in through Medicaid," Alker pointed out. "If we do see big cuts to Medicaid, that will affect all areas of states' budget."

Key proposals include setting federal funding caps, reducing federal match rates, and eliminating mandatory benefits such as nursing home care. Medicaid advocates are also concerned plans to replace benefits with private insurance vouchers could offer less coverage.