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.

As the fall harvest season inches closer, Wisconsin farmers are hoping for promising yields but if the rural roads around them are crumbling, the outlook could change.

A state funding program is trying to make it less of a problem. Gov. Tony Evers' office just announced a second round of grant opportunities under the Agricultural Roads Improvement Program. Local communities have until Sept. 30 to sign up for project money, with $100 million up for grabs.

Julie Bomar, executive director of the Wisconsin Farmers Union, said many large trucks and farm equipment have trouble navigating certain county roads because of the shape they are in.

"In the era of corporate consolidation, it feels oftentimes like larger co-ops and corporations that are picking up milk just want to have the easiest route possible and don't want to get far off of the major highways," Bomar observed.

She suggested smaller dairy farms need every competitive advantage to stay profitable, and a smoother road for trucks hauling their products is one of them. Herd sizes have remained stable but federal data show the number of Wisconsin dairy farms has decreased by 30% since 2017.

It is not just traditional infrastructure, like roads, needing attention with Bomar arguing policymakers cannot lose sight of the processing gap felt by smaller- to mid-sized farms.

"Many of our members feel incredibly frustrated because there's nobody to choose from," Bomar explained. "There's only like one milk processor that's going to come by and pick up and that just leaves them in a very risky situation."

She wants to see rural processing facilities expand and be maintained. Back in June, a top U.S. Department of Agriculture official visited Wisconsin to announce $12 million in grant funding for the purpose. As for the state road repair program, the first round of funding awarded nearly $50 million, supporting 37 road improvement projects around the state.


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Nearly 100 local groups, officials and labor leaders welcomed federal and agency representatives to Sault Ste. Marie for a two-day discussion and listening session.

The meeting focused on fostering economic growth in the Upper Peninsula and northern Lower Michigan. The gathering organized by United Today, Stronger Tomorrow, and other community groups, highlighted promoting and accessing federal programs to meet community needs, such as lack of affordable housing and job creation.

Linda Hoath, executive director of the Sault Ste. Marie Visitors Bureau, feels the listening session was a huge success.

"What I saw was information being shared with many that hadn't been is shared before; how can we work together to help you?" Hoath observed. "I think it was one of the best things that has happened in the eastern UP in a very long time."

The historic funding from the Bipartisan Infrastructure Law and American Rescue Plan Act provided more than $650 million in the Sault Ste. Marie Lock and Dam rehab project and $2 million to upgrade the International 500 Snowmobile Race Track for year-round use.

During the listening session, participants identified barriers to federal investments in UP communities and drafted recommendations for the administration and federal agencies. They also learned about funding streams, formed community partnerships and built relationships with key officials.

Kalvin Carter, program director for Up North Advocacy, appreciated the discussion.

"It meant a lot to see them come into our small rural town and listen to us and help us strategize ways that we can use this historic investment wisely," Carter emphasized.

The goals of the listening session were to provide detailed feedback on federal funding flow, build a strong, well-paid workforce, transition to a new clean-energy future and continue collaboration beyond the session.


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Nebraska legislators are in the first full week of the special session focused on Gov. Jim Pillen's goal of decreasing property taxes by as much as 50%.

Among the groups keeping a close eye on the session and the governor's proposal is the Nebraska nonpartisan fiscal research organization OpenSky Policy Institute.

Rebecca Firestone, executive director of the institute, acknowledged they are still analyzing Pillen's plan and modeling its potential effects. She said it appears it would provide "substantial property cuts for large landowners," many of whom don't live in Nebraska.

"For the large portion of Nebraskans who do not own property, what we're looking at is a tax increase for them," Firestone argued. "It's a tax increase on some core aspects of daily living that for many Nebraskans of modest means will be hard."

Firestone cites sales taxes on automotive repair services as an example of a necessary service likely to become more expensive under this plan. A few of the other services to add sales taxes are veterinary services, hair cutting and legal services.

A document on the governor's website maintains with sales taxes, people are "in control," because they can decide what to purchase, when to purchase it and how much they are willing to pay.

In addition to new sales taxes, funding for the governor's plan would come from budget cuts, including to behavioral health, developmental disabilities and other health and human services programs. Firestone called the cuts unsustainable, potentially harmful and lacking in transparency.

"The methodology driving those cuts, which is from this contractor Epiphany and Associates, has not been made public to the people of Nebraska," Firestone pointed out. "Which is what the legislative process is for, and that needs to be a part of any rationale for budget cuts."

Firestone noted while OpenSky "appreciates the scope and ambition" of Pillen's plan, such a "major overhaul" of the state's revenue system warrants more than a special session.

"The Legislature must have the ability to exercise its oversight over how the state spends its money," Firestone contended. "To sort of redo that in a special session doesn't allow the kind of deliberation and careful scrutiny that our state budget deserves."

Pillen's website document states at the current rate of increase, property taxes in Nebraska will be increasing by $6 billion annually by 2026.