Legislative Update
Janice Lanier JD RN
Liaison Public Policy Committee
HB 96—Biennial Budget is front & center
The Ohio house has been holding subject matter hearings on the state’s budget in some of the house standing committees for the past several weeks. For example, the Medicaid committee and health committee heard from numerous witnesses addressing health-related matters, while the workforce development & education committee focused on K-12 education issues. Those hearings provided information about needs and shortfalls for a multitude of programs. The finance committee will now begin its hearings and deliberations. The committee chairs will be submitting their reports to the finance committee chair Rep. Brian Stewart, and he intends to meet one-on-one with all the house members to learn their budget priorities and concerns. The finance committee will then likely consider an omnibus amendment to make changes to the original bill before it goes to the full house for more discussion and changes. The goal remains to send the bill to the senate by April 9th. Legislators are planning a two-week spring break/Easter recess in mid-April.
Ohio Department of Medicaid
Because costs for the Medicaid program are shared by the federal and state governments, budget decisions are made more complicated than usual this year due to the uncertainty that exists at the federal level. What funding can states expect to see from Washington remains an open question. For example, potential changes to the federal share of the Medicaid expansion program would cost the state $396 million/year for every 5% reduction said Medicaid Director Maureen Corcoran. (Source: Gongwer-Ohio (2/27/25) Medicaid oversight explores impact of federal changes. Gongwer News Service, Columbus). Also, according to Corcoran, the house and senate differ with respect to these predictions.
Historically, to encourage states to participate in the expansion of Medicaid eligibility and lower the number of uninsured individuals in the U.S., the federal government agreed to pay 100% of the costs incurred covering these individuals from 2014-2016 with that percentage gradually decreasing until it reached a capped low of 90% in 2020. (For others, the federal contribution is 65% of the costs). Currently, the federal government continues to pay the 90% cost for this group, but whether that will survive is unclear. Ohio, under Gov. John Kasich, decided to opt into the expansion initiative after a lot of political maneuvering. Those federal dollars are an important source of income for Ohio’s budget. The fate of these so-called Group VIII individuals is now the subject of considerable debate in D.C.
HB 96 currently includes a provision specifying that if the federal Medicaid match drops below 90% Ohio would discontinue all medical assistance coverage to individuals in the affected group. Director Corcoran is asking lawmakers to at least consider a gradual reduction rather than a total cessation of coverage eligibility.
Interestingly, elimination of Medicaid expansion (the Group VIII individuals) will have a ripple effect on those who provide home and community-based care. Many of these caregivers are on Medicaid because they cannot afford to purchase health coverage from the ACA Marketplace. Many are part of Group VIII. If the trigger remains in the budget and Medicaid expansion goes away, individuals caring for people with developmental disabilities or other people needing home care who rely on these caregivers will find themselves without the care they need because their caregivers have been forced to seek employment elsewhere. (Source: Gongwer-Ohio (3/4/25) House committee hearings-Medicaid committee. Gongwer News Service, Columbus.)
Several witnesses before the house health and Medicaid committees were advocating for an increase in Medicaid reimburse rates by 3.4% in FY 26 and 2.3% in FY 27 to support raises for these direct service personnel. The cost would increase $67.3 million in FY 26 and $184 million in FY 27. State general revenue fund (GRF dollars—tax dollars) allocated to the increase would be $24.2 million in FY 26 and $66.4 million in FY 27. (Source: Gongwer-Ohio (3/4/25) House committee hearings-Medicaid committee. Gongwer News Service, Columbus.)
The federal government and Ohio lawmakers are also considering changes to hospital taxes or franchise fees and a work requirement for Medicaid eligibility. Hospital franchise fees are considered part of the state share, allowing Ohio to draw down more federal dollars without investing more tax dollars. The fee has been used to help cover the cost of rate increases granted in the previous budget affecting direct service providers in the Home and Community Based Services (HCBS) line item. The hourly wage increase has helped ease the shortage of these workers and some Ohio legislators expressed support for increasing the wages even more to preserve the gains that are making home care more accessible.
(Source: Gongwer-Ohio (2/27/25) Medicaid oversight explores impact of federal changes. Gongwer News Service, Columbus.)
Finally, HB 96 proposes to cut 340B pharmacy reimbursement to safety-net hospitals by $476 million over 2 years. These cuts will also have significant implications for federally qualified health centers (FQHCs). Currently, FQHCs can purchase drugs on the 340B list at a discount and bill Medicaid at a higher rate. The proceeds are then used to pay for other services offered by these clinics. The budget proposal allows the state Medicaid program to benefit from the discount instead. A bipartisan amendment is being circulated that would eliminate proposed changes to the 340B program. (Source: Gongwer-Ohio (3/6/25) Lawmakers considering nixing budget’s drug pricing changes. Gongwer News Service, Columbus).
Ohio Department of Health requests
Two major budget requests from the Department of Health (ODH) ($1.02 billion in FY 26 and $1.03 billion in FY 27) would provide comprehensive eye exams and glasses for Ohio children. Parental consent would be required to get the examinations as needed, and it would also require working with the parent’s health insurer. Outside of Medicaid, many insurance plans do not adequately cover eyeglasses said ODH director Bruce Vanderhoff. No other states have a program like this he added.
Another proposed new program from ODH focuses on the creation of a new children’s dental program that would allow the deployment of mobile dental units in nine counties (Clinton, Crawford, Gallia, Highland, Hocking, Monroe, Noble, Paulding, and Washington). The program, as envisioned by ODH, would include fundamental care like cleaning and common dental maladies along with screenings.
The budget also includes a statewide ban on flavored e-liquid sales, advertising, and marketing to stem the use of these products among young people. The budget language would establish a vape and e-cigarette retailer registry used to identify who is illegally selling these products to minors. Although HB 96 would establish the registry, it does not include funding. (Source: Gongwer-Ohio (2/27/25) New programs, ban of flavored vape products part of health’s budget. Gongwer News Service. Columbus)
The marijuana saga continues
In November 2023, Ohio voters legalized adult recreational use of marijuana through a voter-initiated statute rather than relying on an amendment to the state’s constitution. While a legislative initiative is easier to get before the voters, it means legislators can cut, change, or otherwise modify what voters approved. To further complicate matters, the Ohio house and senate disagree about what changes are needed to the citizen-passed initiative. Two pending bills (SB 56) and (HB 160) cap the number of dispensaries in Ohio at 35, tighten the rules for packaging and marketing, and limit the potency of extracts from a maximum of 90% down to 70%. The bills differ in several respects, however. HB 160 keeps:
· The voter-approved plant limits at six per person and 12 per household
· Grow limits for Ohio largest cultivators at 100,000 sq. feet
· State sales tax at ten percent (10%) BUT it directs that the bulk of the state’s revenue go to Ohio’s general fund.
People are allowed to smoke anywhere on their residential property and share what they grow while friends visit. Finally, the house version deals with intoxicating hemp by requiring every THC product to be treated like marijuana and sold only at the state’s regulated dispensaries—not in local gas stations.
The senate bill takes a different approach. It would:
· Limit home growth from 12 plants down to six
· Mandate that marijuana can be used only at a private residence
· Combine the state’s medical and recreational marijuana programs under the Division of Cannabis Control
· Require marijuana be transported in the trunk of a car when traveling
· Limit the number of active dispensaries to 350
· Ban Ohioans from using marijuana that is not either from a licensed Ohio dispensary or cultivated in the consumer’s home.
The bill originally dealt with taxes and how funds would be distributed, but those provisions were removed by the senate general government committee hearing the bill. It passed the full senate on a party line vote 23-9 on February 26th.
(Source: Henry, M. (March 6, 2025) Ohio house republicans introduce their own proposal to rewrite state’’s recreational marijuana law. Ohio Capital Journal).
State establishes DOGE caucus in the Ohio House
A newcomer to the house, Rep.Tex Fisher (R-Boardman) initiated the formation of a new caucus designed to provide a means through which republican members of the house can come together to develop proposals that address tax issues, starting with property taxes.
Fisher is caucus chair and Rep. Ron Ferguson ( R-Wintersville) is the co-chair. Fisher reports the caucus now has 25 members including Reps. Adam Bird (R-Cincinnati), Nick Santucci (R-Howland Township), Jennifer Gross (R-West Chester), and Jean Schmidt (R- Loveland). Rep. Gross said the caucus is really looking at the next budget cycle to be able to eliminate certain taxes. Starting now, however, will help them get a better grasp of some of the issues and develop potential legislative solutions and responses for future state budgets. Caucus members will be expected to introduce at least one piece of DOGE-related legislation every year to demonstrate how serious the caucus is about fulfilling its mission.
