April 13, 2026 Legislative Update
Legislative Update
April 13, 2026
Jan Lanier, JD, RN
Introduction
Members of the Ohio House of Representatives and Senate are returning to the statehouse in mid-April where they will tackle a few pressing issues before taking a break for the May 5th primary election that will end in mid-May. When they return to Columbus in May, they will know how the General Election ballot has shaped up for both political parties, which will impact strategies for the remaining months of the current general assembly.
A longer summer/fall break will find the law makers heading home in late June to campaign for the November General Election where all members of the house (99) and 17 of 33 members of the senate will face voters. In addition, Ohio will have a new governor/ lieutenant governor and new faces in the executive branch offices including secretary of state, attorney general, treasurer, and auditor. The results of the General Election will further define how the last few weeks of the 136th General Assembly will unfold. This so-called lame duck session is typically characterized by shortcuts, procedural and political strategizing, and questionable decision-making when numerous amended bills, often with unrelated subject matter (called Christmas Tree bills), move through the legislature at a dizzying pace that makes for more confusion than usual among legislators of both political parties.
Although legislators were in their home districts during their spring break, that did not mean they were idle. Committees did not meet and sessions were not held in either the house or senate; however, 179 bills were introduced in the house, and 85 new bills were introduced in the senate. There are now a total of 808 house bills and 418 senate bills for legislators to consider, with more to come. Generally, these bills are not likely to pass, but they signal a legislator’s or political party’s priorities moving forward.
Bills of Interest
Not all bills receiving attention are newly introduced. HB 508 revising the standard care arrangement (SCA) language that currently requires APRNs who wish to practice in Ohio to have a standard care arrangement with a physician. Under the bill, an SCA would be required only until the APRNs have completed 5,000 hours of clinical practice. The bill sponsored by Reps. Jennifer Gross (R-West Chester) and Rachel Baker (Cincinnati) (both nurses) has received several hearings before the house Medicaid committee. ANA-Ohio is supporting this bill and asking its members to email their state representative urging a “yes” vote to move the bill out of committee and ultimately to a floor vote. The bill was included on a list of bills that could see floor action prior to the recent Easter break; however, that has not happened yet. (Source: Kano, K. (3-16-26) Over a dozen bills marked for votes ahead of Wednesday house session. State Affairs, Gongwer-Ohio).
HB 535 sponsored by Rep. Brian Lorenz (R-Powell) is a proposal that addresses nurse staffing in Ohio hospitals. It does not include specific nurse to patient staffing ratios in law. Instead, it builds on current staffing standards law by adding penalty language for those hospitals that do not comply with the staffing plan approved by the nurse-led staffing committee and adopted by the hospital. Staffing plans must be based on evidence-based staffing standards and other variables, including those set forth in the bill. Failure to comply could result in a monetary fine. The Ohio Department of Health would have authority to audit a hospital’s compliance and must also post the staffing plans submitted by the hospitals it regulates.
Rep Lorenz offered sponsor testimony before the house health committee in January and faced no questions from committee members.
HB 521 is another staffing bill that does include the actual minimum staffing ratios in law. It is sponsored by democrats Reps. Crystal Lett (Hilliard) and Christine Cockley (Columbus) but has not had a hearing yet.
Finally, SB 373 sponsored by Sens. Louis Blessing (R-Cincinnati) and Nickie Antonio (D-Lakewood) was introduced March 11, 2026, and referred to the senate health committee on March 25th. It parallels HB 535 and, ike HB 521, has had no hearings to date.
What did the House agree to?
HB 347 ( Aka–SHE WINS) sponsored by republican Reps. Mike Odioso (Green Twp) and Josh Wiliams (Sylvania TWP) was recommended for passage by the house health committee on a party line vote (9-4) with all democrats voting “no”. The bill also passed the full house on a party line vote (64-32). It will now go to the senate. The measure permits an elective abortion to be performed or induced only if a physician meets with the woman at least 24-hours before the abortion to provide specific information and document the woman’s informed consent, except in cases of a medical emergency. The bill also authorizes civil penalties including damages and lawyer’s fees because of breach of the duties set forth in the bill.
Committee Work
HB 537 sponsored by republican Reps. Riordan McClain (Upper Sandusky) and Melanie Miller (Ashland) dealing with midwife licensure was heard by the Children’s and Human Services Committee. The bill was introduced 10/21/25 and referred to committee on 10/25/25. Proponents testified on March 18th and opponents on March 25th. The Ohio State Medical Association (OSMA) lobbyist focused her remarks on administrative issues including the regulatory scheme proposed in the bill. The bill recognizes four categories of midwives; certified nurse midwives, regulated by the Board of Nursing; Certified midwives (non-nurses) who would also come under the purview of the Board of Nursing. Licensed midwives would be licensed by the Department of Commerce and traditional midwives, who, though mentioned in the bill, are not regulated at all. OSMA suggested that all midwives be regulated by the Board of Nursing. It noted that not all states have robust requirements for midwives, but the bill would qualify out-of-state midwives for licensure in Ohio, thereby potentially weakening Ohio’s ability to protect the public from unsafe practitioners. While the bill mentions traditional midwives, it does not require them to be licensed. Licensure is an important method of providing oversight. Finally, all midwives (including traditional midwives) should be required to enter into a collaborative agreement with a physician. An OB/GYN also supplemented the lobbyist’s testimony by focusing on patient safety concerns. (Source: Fisher, P. (3-18-26) Practitioners, mothers push for midwife licensure. State Affairs: Gongwer-Ohio.)
HB 718 sponsored by Reps. Karen Brownlee (D-Cincinnati) and Jodi Salvo (R-Bolivar) was introduced 2/25/26 and referred 3-10-26 to the Community Revitalization Committee. Sponsor testimony was heard by the committee 3-17-26 and proponents testified on 3-24-26. The bill addresses several categories of mental health care providers including qualified mental health assistants, qualified mental health specialists, and qualified mental health practitioners; as well as various peer supporters such as peer recovery professionals, youth peer supporters, and family peer supporters. The measure seems to be moving quickly, likely in response to the shortage of mental health providers across Ohio.
The Chemical Dependency Professionals Board will become the Behavioral Health Professional Board. Per the bill, the board will certify the various categories of supporters and require them to practice under supervision. Among others, psych mental health practitioners and psych CNSs may be the supervisors of these individuals. The board will establish training requirements and engage in activities and duties that typically comprise a regulatory board’s responsibilities. HB 718 defines “peer support services, prevention services, and youth peer support services”. The practice of activities that define the scope of practice for the individuals within the board’s authority can only be provided by individuals certified by the board unless the duties are within other professionals’ legally authorized scope of practice. (Source: Fisher, P. (3-24-26) Bill praised for potential to address behavioral health care shortages. State Affairs, Gongwer-Ohio).
Medicaid Possibilities
SB 386 sponsored by Sens. Louis Blessing (R-Colerain Twp.) and Beth Liston (D-Dublin) a practicing physician and HB 780 sponsored by Rep. Karen Brownlee (D-Cincinnati) a licensed social worker, have the potential to save $400 million annually said the bills’ sponsors. The proposals would shift Medicaid from its current managed care organization model to an administrative services organization model (ASO) like that implemented in Connecticut 13 years ago.
According to Rep. Brownlee, an ASO would integrate Medicaid care management for medical and behavioral health and nursing care creating a single line of Medicaid administration that would allow for simplified management, reduced administrative costs, and lead to better access to health care. Most Medicaid services would be fee-for-services with regular evaluations of and increases in reimbursement rates, as well as streamlined documentation,” she added. (Source: Kano, K. (4-10-26) Twin plans propose implementation of Connecticut’s Medicaid model. State Affairs. Gongwer-Ohio).
A representative of Health Care for All (formerly SPAN) reported that since Connecticut made its changes the state has saved more than $4 billions of taxpayer money and improved quality of care. Sen. Blessing believes the plan would work in Ohio as witnessed by the state’s already becoming basically its own pharmacy benefit manager for Medicaid. Contrary to the theory that having multiple managed care organizations in the Medicaid program would force them to compete against each other and drive down costs, that has not been Ohio’s real-life experience. Liston agrees saying, “Ohio is not seeing a per member per month savings and not seeing significant outcomes”. Connecticut also saw significant provider participation increases, which improved access across the state. (Ibid.)
Both bills were introduced in late March and referred to the Medicaid committee in their respective chambers. The senate bill is scheduled for its first hearing on 4-14-26.
