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Yahoo
01-07-2025
- Business
- Yahoo
As pharmacies close, Ohio Chamber blasted for siding with middlemen
The Ohio Chamber of Commerce in Columbus, Ohio. (Photo by Graham Stokes for Ohio Capital Journal. Republish photo only with original article.) Owners of small pharmacies — many themselves members of local chambers of commerce — are accusing the Ohio Chamber of Commerce of siding with huge corporate middlemen who are driving them out of business. That undermines Ohioans' health and costs the state's businesses and taxpayers far more in the long run, the pharmacists say. Pharmacies of all sizes are battling with drug middlemen known as pharmacy benefit managers, or PBMs, over provisions in the state budget governing how prescription drugs are priced and how pharmacies are paid for dispensing them. Measures intended to help pharmacies were built into the Ohio House version of the state operating budget, stripped out by the Ohio Senate, and are now in the hands of a conference committee working against a June 30 deadline. New data show Ohio pharmacy closures even worse than originally thought Ohio and other states have been hemorrhaging pharmacies for years, and at an accelerating pace. Last year, Ohio lost 215 pharmacies and the total number dropped below 2,000 for the first time in memory, according to an online tracker launched by the Ohio Board of Pharmacy. That creates serious health concerns, especially in underserved areas where many face health and transportation challenges. The loss of a community's sole pharmacy can make it nearly impossible for some to get their medicine or professional advice about how to manage their diabetes or blood pressure. Closures of isolated pharmacies creates deserts, and they're growing. In Meigs County in Southeastern Ohio, for example, nearly 40% of the census tracts are part of what the pharmacy board calls pharmacy deserts. 'As more pharmacies close in Ohio, we're going to see poorer health — we're not going to see positive outcomes,' said Denise Conway, owner of Conway's Danville Pharmacy. 'We're going to see more ER visits. It's just going to cost employers more.' CVS in 2017 bought and closed the Lonsinger's, the sole pharmacy in Danville, leaving the nearest one in Mount Vernon, 12 miles away. 'One man broke down crying,' librarian Betty Carpenter in 2019 told The Columbus Dispatch about an elderly resident. 'He said, 'I can't walk to Mount Vernon.' He could walk to Lonsinger's.' Also in 2019, Conway and her husband bought a Danville building and opened a pharmacy there while Knox County opened a health clinic on the premises. It was a rare example of a health care desert restored to life. Other Ohio communities aren't likely to be so fortunate. SUPPORT: YOU MAKE OUR WORK POSSIBLE 'We're down to about 300 independents,' said Dave Burke, a pharmacist, former state senator and executive director of the Ohio Pharmacists Association. 'We're really afraid as an organization that people are going to lose access to care. Care that keeps them out of the hospital. Care that shortens their stay in the hospital. And care that keeps them employed.' Burke and many other pharmacists blame the rush of closures on the conduct of the big PBMs, the middlemen that are part of giant corporations. They decide on behalf of insurers what drugs are covered, and they decide how much to reimburse pharmacies for the drugs they dispense. The three biggest PBMs — CVS Caremark, OptumRX and Express Scripts — control nearly 80% of the covered prescriptions in the United States. Critics say that enables them to extract huge, non-transparent discounts from drugmakers. They say it also enables them to force pharmacies into disadvantageous, take-it-or-leave-it contracts. Critics say that reimbursements under them are low and that they impose arbitrary rules and fees. Each of the big-three PBMs is part of a vertically integrated, Fortune 15 health conglomerate. Each of those also owns a top-10 health insurer. In addition, CVS owns the largest retail pharmacy chain and they all own mail-order pharmacies. So the big three get to decide how much to reimburse their own pharmacies as well as those of their competitors. Pharmacists and their advocates say the disputed language in the state budget would end those conflicts and rectify many problems. It would prohibit PBMs from imposing rules (and subsequently charging fees) that go beyond those of the Ohio Board of Pharmacy. It would end the murky system of reimbursements by requiring PBMs to pay pharmacies the prices listed in a public database — the National Average Drug Acquisition Cost, or NADAC, survey. And it would require PBMs to pay pharmacies roughly $10 for each prescription they dispense. With the NADAC reimbursement meant to ensure pharmacies break even on the drugs, the dispensing fees are meant to cover overhead such as payroll, supplies, rent, and insurance. 'By definition the calculation is break-even,' Burke said. 'You are paying (Medicaid's) post-rebate cost of the drug. The only way to cover the bottle, the cost of the lid, the bag, the heat, the lights, the payroll is the dispensing fee.' The provisions that the state Senate stripped out of its budget version mirror reforms the Ohio Department of Medicaid undertook in 2022. Following concerns among pharmacists and investigations by a newspaper and the state auditor, the department mounted its own probe of drug transactions. It learned that in 2017, two PBMs — CVS Caremark and OptumRx — billed the state $224 million more for drugs than they paid the pharmacies that had bought and dispensed them. The Medicaid department fired the PBMs, created its own, single PBM, based reimbursements on the NADAC survey and started paying pharmacists a $10 per-prescription dispensing fee. Despite the higher reimbursements and dispensing fees, an analysis released earlier this year found that the new arrangement saved the state $140 million. That led many to conclude that the middlemen were skimming a hefty portion of the money flowing through the system. Ohio Medicaid got rid of big middlemen, paid pharmacies more and saved $140 million, report says Even so, applying the same rules to non-Medicaid transactions would 'harm small businesses and their employees,' said Rick Carfagna, a former state representative who is now the senior vice president of government affairs at the Ohio Chamber of Commerce. 'PBMs are business-to-business entities, and they exist only because a company or health plan hires them,' Carfagna said in an email. 'When you increase dispensing fees on a per-prescription basis, you're impacting the ability of employers, including small businesses, local governments and labor organizations, to balance their budgets by controlling their health care costs. These increased fees eventually find their way downstream, in whole or in part, to all of those employers utilizing PBMs.' Carfagna didn't respond directly when asked whether Ohio's independent and small-chain pharmacies are themselves small businesses that have been rapidly disappearing. Conway, who is herself chair-elect of the Knox County Chamber of Commerce, said Carfagna and the Ohio Chamber used deceptive language in fighting for the PBMs. 'The Ohio Chamber in their testimony called the dispense fee a tax,' she said. 'It's by no means a tax. It's the cost of running a business. A dispense fee has always been built into the model of reimbursing a pharmacy. You can't put a zero there. It's the cost of running a business.' Burke, executive director of the Ohio Pharmacists Association, said the Ohio Chamber's position also ignores that Ohio Medicaid saved money when it increased dispensing fees and switched to a transparent system of reimbursements. Several other states, most recently Minnesota, have adopted similar arrangements. 'Every state that has gone to a transparent model hasn't gone back to the traditional one,' Burke said. 'They're saving money and they're not going back.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
12-06-2025
- Politics
- Yahoo
Ohio House Dem Leader Russo on plans, ‘There will be more time for this discussion at a later point'
Ohio House Minority Leader Allison Russo, D-Upper Arlington. (Photo by Graham Stokes for Ohio Capital Journal. Republish photo only with original story.) Ohio House Minority Leader Allison Russo is continuing to stay quiet about any potential future political plans she might have in wake of her announcement last week to step down from her leadership at the end of the month. 'I want to get through this transition first, make sure that the new leadership team has all the support and they get into place,' the Democratic lawmaker from Upper Arlington said when asked if she is considering a run for statewide office. 'I'm going to take some time off. I'll be with my family during July, and there will be more time for this discussion at a later point.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX All four statewide executive offices of governor, attorney general, auditor, and secretary of state are up for open election in 2026, with all of the current Republican incumbents term-limited out of running for the same positions again. Former Ohio Health Department Director Dr. Amy Acton is currently the only Democratic candidate running for Ohio governor. Republican candidates include businessman Vivek Ramaswamy and former Morgan County school board president Heather Hill. Democrats are waiting to see if former U.S. Sen. Sherrod Brown will run for Senate or Ohio governor, or nothing at all. Current Republican Ohio Auditor Keith Faber is running for attorney general in 2026; current Republican Ohio Treasurer Robert Sprague is running for secretary of state in 2026; and current Republican Ohio Secretary of State Frank LaRose is running for auditor in 2026. Current Republican Ohio Attorney General Dave Yost had been running for governor, but recently dropped out of the race after the Ohio Republican Party endorsed Ramaswamy. Bryan Hambley, a cancer doctor with University of Cincinnati Health, is the only announced Democratic candidate for Ohio Secretary of State. No other Democrats have yet announced their candidacy in 2026 for Ohio auditor, treasurer, or attorney general. The last time any Democratic candidates won any of Ohio's statewide executive offices was in 2006, when Ted Strickland was elected governor, Marc Dann was elected attorney general, Rich Cordray was elected treasurer, and Jennifer Brunner was elected secretary of state. They were all swept out of office in the 2010 cycle. The vote for a new Ohio House Minority Leader is expected to happen the last week of June, right before the lawmakers go on summer break, Russo said. 'I'm not making any endorsements,' she said. 'The decision about who will leave this caucus next is up to the entire caucus, not one individual member.' Ohio House Speaker Matt Huffman, R-Lima, said he has no idea who is going to replace Russo. 'I said to members of our caucus, obviously, they're free to vote however they want, but we're just going to wait to see what comes out of the minority caucus and deal with that,' he said. Russo is term-limited and her term ends on Dec. 31, 2026. 'I'm looking forward to shifting my focus to policy work and being back on committees,' she said. 'I'm excited about the potential of the new leadership team and the energy that brings and to work alongside those folks.' Follow Capital Journal Reporter Megan Henry on Bluesky. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
10-06-2025
- Politics
- Yahoo
Voter rights groups say Ohio GOP voting overhaul threatens the state's citizen initiative process
Field staffers for the Coalition to Regulate Marijuana Like Alcohol deliver boxes containing petitions with 222,198 signatures to Ohio Secretary of State Frank LaRose, July 5, 2023, at the loading dock of the Office of the Ohio Secretary of State, 180 E Broad St in Columbus, Ohio. (Photo by Graham Stokes for Ohio Capital Journal. Republish photo only with original article.) A coalition of government watchdog groups are warning state legislation could hobble Ohio's initiative process. Direct democracy has been available to Ohioans since 1912, and citizen-led groups can organize initiated statutes or constitutional amendments. The proposals would create strict new paperwork requirements and add other administrative hurdles like requiring many circulators wear a badge identifying themselves as 'paid' even if they're given something as small as a pen for signature collection. Above and beyond changes to the initiative process, the bills would also eliminate ballot drop boxes and require all voters to show proof of citizenship to cast a ballot. 'Bottom line, this is attack on direct democracy,' Jen Miller from Ohio's League of Women Voters argued. 'This is an attack on local control. It's an attempt to bully, intimidate, harass, and possibly prosecute people just because they want to take part in democracy,' Common Cause Ohio Executive Director Catherine Turcer praised the people who grab clipboards and collect signatures to put proposals on the ballot. 'This extreme legislation is an attempt to bully, intimidate, and hassle these front-line heroes,' she argued. The paperwork involved in signature gathering is already complex and time consuming. She explained circulators have to fill out a standard form — name, address, employer, etc. — when they turn in petitions. But the new bills would ratchet up the stakes of that relatively banal procedure. Right now, if the circulator messes something up, they can cross it out and write their initials. Opponents warn of harm to eligible voters if Ohio lawmakers require citizenship documents 'And it is accepted as a change that was legally made,' Turcer explained. 'House bill 233, and Senate bill 153, would make it so that any error here, anything that you made a mistake on, it would mean that the entire booklet would be invalid. And just, I can't imagine the number of signatures that would just get tossed out.' She added that provisions requiring circulators to wear a badge identifying themselves as 'paid' if they accept 'anything of value,' sets an unrealistic standard. 'If I were to give a clipboard and a pen to a volunteer, and a t-shirt that says the name of the campaign,' she explained, 'anything of value would then mean that a circulator would have to get a badge.' That's more paperwork, she said, and thus more chances for something to go wrong. Turcer also criticized a provision requiring an individual to be registered to vote prior to signing a petition, rather than by the time the petition gets filed with election officials. 'One of the things that we often do is check registration before we before people sign,' Turcer explained, 'so that we can get somebody registered as we're doing a ballot measure.' Taking that opportunity away doesn't just reduce their signature count, Turcer argued, 'it also stops that opportunity for a voter-to-voter conversation about, well, this is why you should get registered. These are the things that are coming up on the upcoming ballot.' Ohio Unity Coalition Executive Director Petee Talley drew a straight line from 2023's Issue 1 defeat, which rejected a GOP-led effort to make it harder to amend the state constitution, and the current slate of legislation. She argued the latest bills are 'retribution' for that defeat. Talley took particular offense at the provision requiring signature gatherers wear a badge if they're compensated. 'If I wanted to give a can of cold pop and a slice of pizza to someone and maybe even a t-shirt that (Turcer) alluded to, suddenly they're going to have to add wearing a badge to all of that stuff?' she asked. 'It's nothing but intimidation. It's nothing but bullying,' she argued. 'It's voter harassment, and this is an attack on our voice and our rights, and we're not going to stand for it.' Miller walked through the follow-on consequences of requiring paid circulator badges. Some voters will mistakenly think volunteers who got a slice of pizza are actually getting a paycheck, she said. 'We should expect opposition trackers attempting to catch circulators without their badges,' she added. 'And with the increase in uncivil and polarized rhetoric in political venues, this could result in intimidation or even violence against circulators or voters signing those petitions.' What's more, Miller said, 'boards of elections would have to become badge police.' It's a task they don't have the money, manpower or expertise to carry out, she argued. The requirement voters be registered before signing a petition? Miller said that might be a problem, too. 'We don't even know if boards of elections have the technical capacity right now to verify that a voter registration was valid on the date that the voter signed,' she said. One reason that might not have come up is that, so far, county boards haven't been able to weigh in. The bill's first and second hearing happened during the early voting period for this May's primary election. The third hearing landed on the day boards had to certify the election. Asked whether she thought that was intentional, Miller said, 'I don't think it matters. It's shameful, either way. There is no more important constituent when it comes to democracy bills than the boards of elections.' Follow Ohio Capital Journal Reporter Nick Evans on X or on Bluesky. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
23-04-2025
- Yahoo
Ohio Supreme Court hears arguments in same-sex parental rights case
The Gavel outside the Supreme Court of the State of Ohio, September 20, 2023, at 65 S. Front Street, Columbus, Ohio. (Photo by Graham Stokes for Ohio Capital Journal. Republish photo only with original article.) The Ohio Supreme Court heard arguments Tuesday in a case that centers around whether a same-sex couple shares parenting rights to children born through artificial insemination while they were in a relationship in the same way a heterosexual couple would. The court is taking up a challenge to a First District Appeals Court decision in which the appellate court ordered a legal 'would-have-been-married' test to decide whether things would have been different if the couple's potential marriage had been recognized in Ohio. Priya Shahani and Carmen Edmonds were in an 11-year relationship, and three kids carried the hyphenated last names of the two when they were together. Attorneys say marriage was discussed, Edmonds' lawyer said she proposed and Shahani said yes. But a trip to Boston that could have ended in marriage did not, and their home state didn't recognize same-sex marriage. Ohio also doesn't recognize common-law marriages that occurred after 1991. The U.S. Supreme Court decision in the 2015 Obergefell decision legalized same-sex marriage nationwide, and it required all states to them regardless of where they were performed. But it came after the couple went to Boston, and Shahani and Edmonds were never legally married. When their relationship ended, however, they entered into a shared custody agreement for the three children, an agreement that is in dispute by the couple. The hyphenated names for the children were removed by Shahani after the agreement was already in place. Attorneys want the Ohio Supreme Court to decide whether to apply parental rights to Edmonds in a way that presumes the couple would have been married had it been legal. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Paul Kerridge, attorney for Shahani, called the 'would-have-been-married' standard proposed by the appellate court 'unworkably speculative,' with the potential to cause a ripple effect in the legal world 'because every part, every factor in that standard, would also apply to relationships that didn't include marriage.' 'Really what the First District did here is create common-law marriage without saying that there was a creation of common-law marriage, and creating an exception to a statute without ever saying that's what they were doing,' Kerridge told the court on Tuesday. Obergefell recognizes marriages and allows that same-sex couples should have access to the full 'constellation' of rights under marriage, including parental rights. But does not extend that right to unmarried couples, Kerridge argued. 'Marriages have licenses and they have signatures, and it's a known entity of what kind of relationship and the change in your personal rights and obligations, that's a known entity that you're entering into,' he said. While the case is based on a custody battle, Edmonds' attorney, Jonathan L. Hilton, called custody 'a poor-man's version of parentage.' He said Edmonds struggles to obtain medical records or school records for the children she once shared with Shahani, and didn't receive notice or have legal standing when her last name was removed from the children's surnames. 'So you have children who have hyphenated names — their very identity — being changed, and my client has no more rights in that situation than a babysitter,' Hilton said. The shared custody agreement allows Edmonds to see the kids about 30% of the time, Hilton said. But if a partner of Shahani wanted to enter into the adoption process for the children, Edmonds would have limited rights. Justices went back and forth with the attorneys about whether Obergefell applied to two people who never were legally married, and whether the shared custody agreement was equivalent to a marriage document in terms of giving parental rights. 'It seems like you're advocating for a really impossible standard,' Justice Patrick DeWine said to Hilton. 'You have one parent who says 'I wouldn't have got married,' you've got one parent who says 'I would've gotten married.' How can a court really sort that out? Because no one actually knows what someone would have done, and if they would have been married, the rights would have been different.' Justice Jennifer Brunner pointed to the history of the Obergefell case, in which Ohioan Jim Obergefell's husband was terminally ill, and the two got married on a Maryland tarmac before flying back to Ohio, even though it was not recognized in their state. 'There was that issue of consent there, that both parties wanted it regardless,' Brunner said. 'And what proof do we have of that consent to marry when they didn't get married?' Hilton argues the children's hyphenated names, the shared custody agreement, and the engagement prove a plan was in place for Edmonds and Shahani. 'We have (Shahani's) consent here to shared parentage, and the only way that they could've gotten shared parentage would be to have this kind of union,' Hilton said. Justice Patrick Fischer pushed back, saying the supreme court was not facing a question on the custody agreement, but rather on whether parental rights should extend despite the lack of a marriage license. 'If the shared custody agreement continues, as a matter of fact, I know as a matter of law there may be a difference, but as a matter of fact, day-to-day, for the best interests of the children, anything we decide here doesn't change a thing,' Fischer said. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
18-04-2025
- Business
- Yahoo
Trump's tariffs could increase the price of Ohio craft beer
A flight of four craft beers on the bar, June 8, 2023, at Restoration Brew Worx in Delaware, Ohio. (Photo by Graham Stokes for Ohio Capital Journal. Republish photo only with original story.) Ohio craft brewers are worried how new tariffs on aluminum, steel and malted barley could raise the price of a pint of beer or a six-pack. President Donald Trump imposed 25% tariffs on aluminum and steel imported into the United States, and a 25% tariff on Canadian barley — three things that are vital to the craft beer industry. A tariff is a tax on imported goods. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'The tariffs in general have been chaotic and disruptive to our supply chain,' said Collin Castore, co-founder of Seventh Son Brewery in Columbus. 'It's just … kind of pointless.' Seventh Son produces 5,000 barrels of beer annually — 3,500 is roughly its wholesale volume and about 70% of that is packaged in aluminum cans, he said. The brewery uses roughly 750,000 cans per year. 'Breweries are facing potential tariffs on malted barley, aluminum cans, stainless steel equipment, and energy, all required in the manufacturing of beer,' according to the Ohio Craft Brewers Association. 'The increased prices that importers charge to their business customers to offset tariffs are likely to cause consumer price inflation in the best case scenario and closure of small businesses in the worst.' The U.S. relies on Canadian imports for barley, aluminum, and steel — the three key resources in brewing beer. Barley is the base grain for beer, aluminum is used for packaging beer in cans, and stainless steel is used to brew beer. 'There simply is not enough domestic cultivation of barley or production of primary aluminum to sustain the industries that rely on these products without imports from Canada and elsewhere,' according to the brewers association. Seventh Son bought four months worth of aluminum cans earlier this year, which has helped it keep prices the same, Castore said. 'We take raising prices very seriously,' he said. 'And it's also not really a switch that you can toggle on and off terribly easily. … It's not quite as easy as somebody just signing a blanket tariff order.' Just like in any other industry, some people are going to buy less craft beer if prices go up, Castore said. 'If this kind of chaotic environment continues, general consumer sentiment and spending at some point is going to take a hit, and that affects taprooms and six-pack purchases and everything in between,' he said. During Trump's first term in office in 2018, he slapped a 25% tariff on steel and a 10% tariff on aluminum imports. For the first time since 2005, the number of craft breweries decreased nationwide in 2024, according to the Brewers Association. There were 9,612 operating U.S. craft breweries in 2024. During that same year, 434 breweries opened while 501 closed. Craft brewers produced 23.1 million barrels of beer in 2024, a 4% decrease from 2023. There were only about 70 breweries in Ohio when Seventh Son opened in 2013 and today there are more than 440, according to the Ohio Craft Brewers Association. Forty-six breweries opened in Ohio last year and 53 breweries are in planning. Ohio craft breweries' economic impact was $1.27 billion in 2022 and more than 12,000 people were employed by Ohio craft breweries that year. Follow Capital Journal Reporter Megan Henry on Bluesky. SUPPORT: YOU MAKE OUR WORK POSSIBLE
