Legislative Update: April 15, 2025
Jan Lanier, JD RN Chair Public Policy Committee
Please see the April 7th Legislative Update for more extensive information about HB 96
The full house, in a largely party-line vote (60-39), approved an amended substitute budget bill (Am SUB HB 96). Five republicans joined the democrats in opposing, Reps. Levi Dean (Xenia), Ron Ferguson (Wintersville), Jennifer Gross (West Chester), Jason Stephens (Kitts Hill—former Speaker), and Michelle Teska (Clearcreek TWP).
According to finance committee chair Rep. Brian Stewart (Ashville) the house removed every proposed tax increase in Gov. DeWine’s budget proposal and warded off numerous requests for fee increases and reined in burdensome regulations.
Making the most headlines have been proposals for funding Ohio’s public schools, Medicaid coverage, and library funding. One of the biggest changes in HB 96 was the creation of a ceiling on how much money public school districts could carry over each year. If a district’s carryover balance exceeds 30%, county budget commissions would be required to lower property taxes the following year. Additional dollars (Approximately $500 million) were added to the state’s expenditures for the private school vouchers program (already costing over $900 million in the past 2 fiscal years) and created an additional educational savings account for private school vouchers.
The budget does not treat public health particularly well, underfunding or eliminating a variety of programs, which seems to be the pattern in Ohio. However, helping Cleveland build a domed stadium for the Browns did find favor from most republicans. Not surprisingly, the Bengals have begun lobbying the Ohio senate for similar
treatment when that chamber begins its budget deliberations after legislators return to Columbus following their spring break. Proponents point out that no general revenue funds (aka taxpayer dollars) are allocated for this project. The proposal would require the issuance of state secured bonds with the bond payouts to investors/bond holders coming from revenue generated by the stadium. The state’s guarantee means that if those payouts are not forthcoming, the state will be on the hook to repay investors. That investor payback could bring taxpayer dollars into the picture.
In addition, the house-passed version of HB 96 did increase the pay for judges and other local public officers. Although not part of HB 96, the state’s transportation budget (HB 54) which has been enacted, quietly provided pay increases for the newly expanded house leadership team established by Speaker Matt Huffman (Lima) to “increase efficiency in the house”. Prior to Huffman’s ascension to the Speaker position the house majority leadership team was made up of six individuals. The team now has nine members, and each was awarded an increase in pay that goes with holding those positions. (Representatives and senators receive a base salary and another several thousand dollars in stipends if serving as caucus leaders or committee chairs, vice chairs, or ranking minority members). The current version of HB 96 would establish the Public Office Compensation Advisory Commission that will at the beginning of every odd-numbered General Assembly review and make recommendation about the compensation amounts of General Assembly members and the elective statewide elected officials. (Technically, legislators are not allowed to raise their own pay. That is why pay increase proposals usually surface during “lame duck” when a general assembly is about to adjourn permanently. While it is possible to enact a pay increase bill at the end of a general assembly, the optics are not always good, which can serve as a deterrent to these efforts. That was the case in 2024. This general assembly is attempting to circumvent the restrictions).
Healthcare -elated
- A late addition approved by the house is directed at pharmacy benefit managers (PBMs). Tim Barhorst (R-Fort Loramie) was the architect of the amendment that addressed a subject that has been considered by the general assembly in previous sessions. This budget amendment was not well-received by several powerful coalitions including the Ohio Chamber of Commerce, the Ohio Business Roundtable, and the Pharmaceutical Care Management Association who said the amendment “undermines the ability of the state’s business community to design drug benefits that best meet the needs of employers and their families.”
Amendment opponents predicted fees would increase between $10.50 and $15.47 per prescription. Amendment supporters argued that PBMs were supposed to lower costs, but that has not been the case because of rebates to PBMs. According to former state legislator and pharmacist David Burke, “PBMs actually have increased drug costs.” Rep. Barhorst discounted the opponents’ criticism saying, the three largest health plans that own PBMs are the ones leading all of this and they are using other organizations, like the chamber to be the spokespersons.
- Requires that a health benefit plan reimburse CRNAs at the same rate as physicians.
- Modifies Medicaid electronic visit verification (EVV) to allow providers the opportunity to review and correct certain claims and data and prohibits entities from denying a claim that is not supported by the EVV system and prohibits entities from auditing solely based on information in the EVV system.
- Provides $1million each FY to support medical education opportunities in family medicine and psychiatry.
- Provides $250,000 in FY 26 to Dayton Children’s Hospital for pediatric therapy students.
- Limits the number of Medicaid nursing facility private room incentive payments to 15,000 beds rather than the original 5,000 beds and the Ohio Department of Medicaid (ODM) must submit quarterly reports to the Joint Medicaid Oversight Committee (JMOC) on licensed private room occupancy.
- Removes the provision that would have prohibited a Medicaid provider from seeking a payment that exceeds the median rate of private insured services.
- Revises provisions that provide a temporary assessment for Federally Qualified Health Centers (FQHCs) and hospitals if ODM terminates medical assistance for the Group VIII eligibility group.
- Prohibits the distribution of Medicaid funds to provide mental health services that promote or affirm social gender transition.
- Permits Medicaid coverage of doula services in only six counties with the most infant deaths
- Requires the Ohio Department of Health’s (ODH’s) annual abortion report to include information on age, in-state versus out-of-state resident, and total number of abortions performed on minors.
- Requires a hospital with a maternity unit that accepts Medicaid to enter into a transfer agreement upon request with any free-standing birthing center located within a 30-mile radius.
- Exempts intellectual and developmental disability services from the house-added prohibition on using Medicaid funds for DEI initiatives.
- Provides $1million each FY to Memorial Hospital for the Mid-Ohio Cardiovascular Health Improvement Initiative.
- Appropriates $250,000 each FY for local government lead abatement programs.
- Limits employee eligibility for the childcare credit program to 400% of the FPL.
- Clarifies that if ODM terminates medical assistance for the Group VIII eligibility group, the required fund transfers do not include federal share GRF dollars.
- Required any unmanned aerial vehicle( UAVs ) purchased through the Drones for First Responders Pilot Program to comply with federal regulations.
- Prohibits a government entity from placing menstrual products in the men’s restroom of a public building.
- Removes a provision of the bill that requires additional regulatory requirements for solid waste facilities.
(Source: Gongwer-Ohio (4/9/25) Highlights of Substitute House Bill 96 Omnibus Amendment. Gongwer News Service. Columbus, OH).
Other last -minute changes:
- Added language recognizing only two sexes in Ohio.
- Bars government from flying flags that are not official state, American, or POW/MIA flags.
- Disallows Medicaid funds from going to DEI.
- Establishes personal income tax deductions, of $750 or less, for Ohioans who donate to pregnancy resource centers.
- Removes county coroner as an elected official & requires that position to be appointed by each board of county commissioners, grandfathering in currently elected coroners.
- Eliminates the Ohio Election Commission and directs the issues, now handled by the Commission, be resolved instead by the Secretary of State’s Office.
- Hikes motor vehicle registration fees $5 with the increase to be used by the state highway patrol.
- Requires age verification to obtain online porn.
(Source: Donaldson, S. (4/9/25) Ohio passes budget mostly along party lines. What made the cut? WOSU, Columbus, OH)
