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.

The Trump administration announces its new wave of tariffs Wednesday, and with U.S. Department of Agriculture funding still a question mark, Minnesota farmers are having trouble planning ahead.

Ag economists say the latest tariffs and retaliatory moves by trade partners could be blows felt by farmers and ranchers, especially for beef and pork.

Cindy VanDerPol and her husband, owners of Pastures A Plenty Farm in western Minnesota, are monitoring market upheavals due to tariffs and just saw a one-year pause in federal grants to help supply locally grown food to schools. She said it makes it hard to map out what they need to buy for the year.

"Do we go and purchase more laying hens? Do we purchase broiler chickens to be processed later on?" VanDerPol asked. "Those all are uncertainties right now."

She pointed out they would already have made such moves. VanDerPol added the uncertainty does not just potentially limit her farm's output but also demand for local meat processors. As in the first Trump administration, the USDA is weighing emergency aid for farmers if needed. But economists warned countries like Brazil are bigger ag competitors now and if a trade war heats up, foreign markets could just look there.

Federal officials have released some agriculture funding initially frozen during downsizing efforts led by the White House.

Jennifer Fahy, communications director for Farm Aid, said there are still not enough details about grants seeing movement again, leaving farmers in the lurch.

"The very fact that this money that is legally due to them is being held up and they're not getting any answers on when they might receive it, if at all, it's creating inordinate stress that really is completely unnecessary and damaging to our entire food system," Fahy contended.

Fahy noted it also could mean layoffs for farmworkers, as some operations downsize or close.

Gary Wertish, president of the Minnesota Farmers Union, said when other things like rising interest rates are factored in, farmers face a crisis similar to the 1980s, when the nation lost millions of farms.

"That's where we're fearful of, that we could very easily be back into that '80s crisis time frame," Wertish cautioned.

Minnesota lawmakers this session are emphasizing new protocols to shield state agencies from fraud. A watchdog group says so far, it appears they're on the right track.

The motivation to address this issue is tied to the high-profile "Feeding our Future" case, when dozens of people were accused of stealing pandemic relief money intended for kids' meals. It's estimated roughly $250 million was misspent, and dozens of convictions have since followed.

At the state Capitol, both Republicans and Democrats have openly discussed the need for tighter controls, which is encouraging to Matt Ehling, a board member for Minnesotans for Open Government.

"It's been a growing problem for quite a few years now," he said, "so it's nice to see that both sides of the aisle are focused on this issue this year."

One bill calls for a new state Office of Inspector General to get ahead of suspicious behavior. Ehling said the Office of Legislative Auditor does good work, but sees the need for another arm that goes beyond reviewing problems after the fact.

A separate proposal could stir backlash by no longer awarding some grants to nonprofits without a bidding process. Backers of keeping that option have argued it helps smaller groups in underserved areas get access to funding.

The Minnesota Council of Nonprofits has said it agrees that state funds must be used for their intended purpose, but worries some restrictions would make inequities worse.

Ehling said it's unfortunate that, at the height of the pandemic, federal relief packages meant to help people in need were targeted by fraudsters.

"Bad actors were able to take advantage of that, because the money was coming in so fast," he said, "and the resources to oversee the money were simply not appropriately put in place."

When those COVID spending packages were approved, states were tasked with distributing aid. Ehling's group hopes that if there's a new Office of Inspector General, it will operate with transparency. And a bipartisan group of lawmakers has said that with grant reforms, there should be assurances that smaller community groups are given a fair shot.


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AARP says it's getting thousands of phone calls from seniors worried about getting through to Social Security, as program operations are dramatically overhauled by the Trump administration. The concern is being felt in North Dakota. From staffing cuts to pursuing the closure of nearly 50 regional field offices, the White House and top advisor Elon Musk are seeing backlash over these moves. There are reports of wait times stretching several hours. It comes amid a new requirement that says beneficiaries can no longer verify their identity by phone. They have to do it in person or online.

Josh Askvig, state director of AARP North Dakota, says that could be tough in a largely rural state.

"It would be possible that folks would have to drive three to four hours or more to get to a location. And if you're not comfortable working with apps on your iPhone or Android device, you're looking at potentially a full day of driving, and that's a significant barrier," he explained.

The national AARP says it's fighting to protect these services, so that monthly payments aren't disrupted. It also calls on the administration to scrap the new verification rule and restore the phone option.

The White House says it's trying to root out fraud while insisting benefits won't be cut. But Democrats argue these changes will lead to missed or late checks for beneficiaries.

Askvig said the chaos that's unfolding could lead to another problem lurking in the shadows.

"We're also concerned that this change will lead to scammers using the confusion the agency has created around this to potentially exploit and prey on Americans as well," he added.

AARP and other senior advocates hope their allies reach out to Congress to intervene. They say Social Security operations have been under-resourced for some time, and they hope their renewed calls for service improvements turn more heads amid public frustration. Nearly one in six North Dakota residents receive Social Security benefits.