Latest news with #OhioChamberofCommerce
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
30-06-2025
- Business
- Yahoo
Ohio could soon restrict how Ohioans spend SNAP benefits
COLUMBUS, Ohio (WCMH) — One of the provisions in Ohio's multi-billion dollar operating budget would restrict what people using SNAP benefits, formerly known as food stamps, can buy at the grocery store. In the budget, which passed with only Republican support, the state is directed to ask the federal government for a waiver to restrict the use of SNAP benefits on pop. If the waiver is declined, the state must re-apply every year until it is approved. Supporters of this portion of the budget say taxpayer dollars should not be spent on 'junk food,' but a group of 15 organizations, including the Ohio Beverage Association, the Ohio Chamber of Commerce, and the Ohio Diary Producers Association are urging Gov. Mike DeWine to veto that part of the budget. In a joint letter, those groups said they are confident Ohio can find better ways to promote wellness without sacrificing food access, business sustainability or personal dignity. Ohio House Speaker Matt Huffman (R-Lima) said moves like this will help lower Medicaid and health care costs in the state. 'One of the things that drive Medicaid costs are poor health results by the things people do,' Huffman said. 'That's not just a policy decision, it's also an economic decision. We want to encourage people not to do it, not just cause it's good for them, but also, the state doesn't end up having to pay as much money.' DeWine must decide what portions of the budget to into law by July 1. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
03-04-2025
- Business
- Yahoo
Ohio Chamber hosts child care leaders to press for state budget changes to help workers and families
The Ohio Chamber of Commerce building in downtown Columbus. (Photo by David DeWitt, Ohio Capital Journal.) As Ohio legislators were working to finish the House's draft of the state operating budget for the next two years, the Ohio Chamber of Commerce held its Childcare Policy Summit across the street with advocates and business leaders stressing the importance of child care to workers and business. 'We can't just warehouse kids, we can't just provide custodial child care to kids,' said David Smith, executive director of Horizon Education Centers. The chamber held the summit for the second time in two years as it leans in to the issue. Its senior vice president of government affairs, Rick Carfagna, said it is 'the largest workforce throttle that we have at the moment.' 'We have an entire demographic of Ohioans that are skilled, they are college educated, they are creative, they are hard-working people, men and women alike, and they are simply not looking for work at all,' Carfagna told the Capital Journal. Before the summit even began, he spoke to lawmakers in the House Children and Human Services Committee, supporting bills to address the cost of child care and the building up of the child care workforce. Language from the bills the committee was considering when Carfagna met with them now appear in the House's version of the state budget. House Bill 2 aimed to establish the 'Child Care Cred Program,' to split the cost of child care three ways: funding from the state, a share from employers, and the rest from employees who are eligible for the child care. Another part of the new draft budget is a Child Care Recruitment and Mentorship Grant Program to help 'increase the number of licensed child care providers in Ohio and assist recruited entities and individuals,' according to the budget language released this week. It contains a $3.2 million appropriation in fiscal year 2026 for 'child care provider recruitment.' SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Smith was part of a panel discussion about the 'workforce behind the workforce,' child care workers who take care of children so their parents can go to school or maintain their place in the workforce. Meanwhile, Ohioans have been having trouble staying in the workforce because of the lack of affordable child care and lack of access to any child care at all in some regions of the state. Advocates in and out of Tuesday's summit have said raising the eligibility level for Publicly Funded Child Care and reimbursement rates for child care workers should be top of mind for lawmakers if they want to help the situation. In the Ohio House's version of the budget, the Publicly Funded Child Care eligibility remained at the current level of 145% of the federal poverty line, rather than the governor's proposal — and the one child care advocates hoped for — of 200%. In Ohio, the federal poverty level for a family of four is $32,150 a year. Carfagna said the chamber hoped the federal poverty level would be increased, but 'that alone isn't good enough.' As a former a lawmaker who's gone through the budget process, Carfagna said he understands there are numerous priorities being dealt with in the budget, and that legislators have to weigh them. 'There are a lot of big price-tag issues that all just kind of hit you from different corners, so legislators, probably rightfully so, need to be careful to not overpromise,' he said. One big item that has been widely supported by child advocates all over the state was a proposal by Gov. Mike DeWine in his executive budget to create a refundable income tax credit of up to $1,000 for Ohio children up to age 6. That provision did not make it to the House draft. The Child Care Voucher Program, a previously existing program that subsidizes some children's admission into qualified child care centers, did have its eligibility brought to 200% of the federal poverty line in the House budget draft. According to the budget document, however, the voucher program would have a budget of $50 million for each year of the biennium, rather than the previous proposal of $75 million in fiscal year 2026, and $150 million in 2027. In addition to a lack of affordability and access is a problem in which the staffing needed to take care of young children is just not there, advocates said. Tami Lunan, organizing director for the Ohio-based CEO Project who was not part of the summit but has been testifying in favor of child care measures at the Statehouse as part of the the budget process. She said new money for the child care sector should go directly to providers. 'We want to see something transformational, and I think looking to our workforce is a big part of that,' Lunan said. Lunan said the industry already has low wages and high turnover, and continuing to underfund the staff maintains the narrative that the workforce is not as important as in other professions. 'I think that's by design that we're not investing in it,' Lunan said. 'Because we don't see those businesses as viable, we don't see those workers as professionals. They look to them more as babysitters.' According to a 2024 analysis by Policy Matters Ohio, Black Ohioans are more likely to be child care workers, making up 18.8% of the industry's workforce, despite only making up 12.5% of the state population that year. The Ohio legislature has heard testimony from several child care workers, advocates, and the Ohio Chamber of Commerce about the need to incentivize work in the child care sector, and improve pay and benefits for those workers. Traditional business solutions won't work for child care providers, said Chris Angellatta, CEO of the Ohio Child Care Resource & Referral Association. 'We have challenges that are very different,' Angellatta said. 'We can't just compete in the labor market and continue to pay people more and just expect families to continue to pay more. It's already expensive.' To help care providers, the House budget draft has a provision to calculate Publicly Funded Child Care based on a child's enrollment with a provider, rather than basing it on the child's attendance. That's something Angellatta said would be 'critical' for both families and providers. 'We all know that just because someone is not in attendance doesn't mean that spot isn't saved for them,' he said. An Early Childhood Education Grant Program to 'invest in Ohio's early learning and development programs' including licensed child care centers, licensed family child care homes, and licensed preschools is included in the House budget draft as well. Eligibility goes up to 200% of the federal poverty line. Discussions about child care in Ohio come down to one primary theme: It can't be fixed by one bill or one source of funding. Instead, the state and everyone involved in decision making have to implement multi-step strategies to improve the start of children's education and the building of a new workforce. 'If you really want to do this, you have to do it in a three-dimensional manner,' Carfagna said. 'You have to attack it from the eligibility standpoint, the capacity side of it, and we need people to staff our child care centers.' For Lunan, the problem can be looked at very simply by those who hold the state's funding decisions in their hands. 'We literally can not have a thriving economy without child care,' she said. The House budget will now move to the Ohio Senate, which will draft its own budget. The two drafts will need to be reconciled before the end of June, when a budget must be sent to DeWine for his signature. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
01-04-2025
- Business
- Yahoo
Lack of child care costs Ohio economy $5.48B each year, new Chamber report finds
Ohio's lack of affordable child care is hurting more than working parents. It's costing the state's economy $5.48 billion in untapped taxes and employer earnings each year, according to a new U.S. Chamber Foundation report. "Child care is a national crisis. Everyone is struggling with child care," Aaron Merchen, the U.S. Chamber of Commerce Foundation's executive director of early childhood education policy, told those gathered for an Ohio Chamber of Commerce child care summit. "You're in good company." The report estimated the economic drag for multiple states: Michigan is losing $2.88 billion each year in economic potential, Florida is seeing a $5.38 billion hit to its economy and Texas is losing $9.39 billion a year in economic output. The new Ohio-specific report details the struggles that working parents know too well. Families spent an average of $572 each month on child care and 70% use some financial assistance program to pay for it. The most popular was the federal child tax credit. One in four parents reported that they or someone else in their families shifted their schedule or worked fewer hours to accommodate for child care. About 22% worked while caring for a child, according to the new report. 'Even if child care issues are not forcing parents out of the workforce, they do have an impact on employment,' said Blanche Delrieu, a business analyst for the Cicero Group, which conducted the review. About 40% of parents attending school or training had a disruption to their education because of child care issues. But the report also details the overall economic impact of that child care access problem, estimating that Ohio is losing out on $1.52 billion in tax revenue and businesses are losing $3.97 billion in earnings from turnover and absenteeism. Publicly funded child care is less accessible in Ohio than in other states. Ohio sets eligibility at 145% of the federal poverty level, which is about $46,600 for a family of four. All surrounding states have a higher threshold, making public assistance easier to access. Ohio does offer child care vouchers for families up to 200% of the federal poverty level, a new program that Gov. Mike DeWine championed. Merchen said that cutoff, wherever a state decides to put it, impacts who can access affordable child care and who can't. "There is a correlation between the line at which you are eligile for state investment in child care costs and the accessibility," he said. DeWine proposed a refundable tax credit of $1,000 per child in his two-year budget. But House Republicans axed that idea along with the cigarette tax hike that paid for it. Instead, they proposed a pilot program where businesses, state government and families each pay a portion of child care costs. The chamber report is the latest sign that businesses are taking child care access seriously. A recent Groundwork Ohio poll found 86% of Ohioans believed that increasing access to high-quality, affordable child care would strengthen Ohio's economy. Business groups like the U.S. Chamber and Ohio Chamber of Commerce are prioritizing access to child care in their discussions with state lawmakers. That's a good sign as child care providers, business leaders and legislators work toward solutions, Merchan said. "Ohio is taking this seriously." Read the report here: U.S. Chamber Foundation report on the cost of child care in Ohio by Jessie Balmert on Scribd State government reporter Jessie Balmert can be reached at jbalmert@ or @jbalmert on X. This article originally appeared on Cincinnati Enquirer: Lack of child care costs Ohio economy $5.48B each year, report finds
