Legislative Update
Janice Lanier JD RN
Liaison Public Policy Committee
Budget season is upon us.
Every new general assembly must enact the state’s biennial budget by June 30th so the bill can go into effect July 1st. This heavy lift occurs in the first year of a new general assembly. While it is called the “budget bill”, the lengthy piece of legislation (often thousands of pages long) is much more that a series of appropriations. Many significant policy changes are tucked inside its pages. It affects every aspect of state government, including the fate of many programs and pet policy proposals championed by various legislators, executive branch agency heads, and special interest groups.
The actual bill always originates in the Ohio House of Representatives; however, the governor provides his (or her) initial budget proposal that signals the needs and priorities of the executive branch before the bill actually is introduced. Given the relatively short period of time legislators have to meet the mandated deadlines, testimony from state agency heads about their programs and priorities often begins before the bill is formally introduced. That is the case this year.
That process began in earnest when Governor Mike DeWine held a press conference on February 3rd to alert the public as to what programs, services, and initiatives he believes the state should fund and how the state will meet the $218 billion projected cost; $108 billion for fiscal year (FY) 2026 and $110 billion for FY 2027. By law, unlike the federal government, Ohio legislators must enact a balanced budget by the required legal deadline.
The house finance committee began its meetings this week; and more significantly, various house standing committees began to hear budget-related testimony from state agency leaders. Committee witnesses’ testimony usually provides an overview of the programs they operate and what the financial future is likely to hold based on data provided by the executive branch budget experts. These standing committees will also hear budget testimony from groups and individuals affected by the bill. Cutbacks in services, proposed tax increases and other funding mechanisms along with implications a particular proposal might have on the public are all part of this intense process.
Step 1—the Governor’s budget—Highlights
Following is a brief list of items that are included in Gov. DeWine’s proposal. Many of them have both direct and indirect effects on health. As with all proposals, the devil is in the details . Advocates and opponents will be looking closely at how these changes, as they are fleshed out in the budget, affect their constituents and their interests:
- Childcare programs—The previous general assembly approved childcare programs but did not fund them, preferring to leave those decisions to the budget process. In addition to funding childcare, the governor proposed a childcare tax credit to support working parents and families up to $1000/year for each child up to age six. The state’s cost is expected to be $450 million.
- More vision screenings and eyeglasses for children in grades K-3.
- School based health centers would receive additional funding and technical support.
- $34 million would fund grants to implement school bus safety recommendations.
- The increased revenue needed to finance these, and many other programs, would come from significant increases in the so-called “sin taxes”. The tax on a pack of cigarettes would go from $1.50 per pack to $3.10. Currently Ohio’s cigarette tax is 29th highest in the U.S. Proponents believe the increase may help deter young people from starting to smoke. The tax on vaping products would increase from 17% to 42%. Other activities could also be hit by higher taxes, including sports betting, which would increase from 20% to 40 % and used to fund stadiums and youth sports programs. The tax from marijuana sales would increase from 10% to 20%. Legislators from both sides of the aisle greeted the proposed tax hikes with skepticism, predicting that the size of the proposed increases would lead to a decrease in sales thus diminishing the predicted income derived from the taxes.
- Possible change to the name of the Department of Mental Health & Addiction Services to the Department of Behavioral Health. The change is intended to better reflect the actual mission of the department and eliminate the stigmas associated with the terms “mental health” and “addiction”.
Sources: Glyn, E & Bischoff , L. (2/3/25) DeWine proposes tax increases for cigarettes, sports gambling, & a new child tax credit. Columbus Dispatch.
Gongwer-Ohio ( 2/5/25) Morning tip sheet. Gongwer News Service.
Trau, M (2/3/25) Ohio governor’s proposed budget includes public education funding, tax hikes on weed, tobacco, and betting. Ohio Capital Journal retrieved from https://ohiocapitaljournal.com/2025/02/03/ohio-governors-proposed-budget-includes-public-ed-funding-tax-hikes-on-weed-tobacco-and-betting/?emci=63ad48f4-6fe2-ef11-88f8-0022482a97e9&emdi=962cde2b-e7e2-ef11-88f8-0022482a97e9&ceid=144598.
Other committees begin to meet
As newly established committees start to meet several committee chairs are trying to clarify with house leadership which bills would go to what committee. Both the house and senate have health committees and Medicaid committees. House health committee chair, Rep. Jean Schmidt (R-Loveland) raised the question as to how Speaker Huffman (R-Lima) plans to handle the potential dual jurisdiction between the two committees. She is hoping that her committee hears a proposal considered by the previous general assembly that would create a license for prescribed pediatric extended care centers in a childcare center that provides nursing and therapy services to children with complex medical conditions. Medicaid covers the services. Neighboring states such as Kentucky already have these facilities, and proponents believe there is nothing that should hold Ohio back from establishing a similar option for Ohio parents. The previous bill was sponsored by Reps. Cindy Abrams (R-Harrison) and Rachel Baker (D-Cincinnati); however, Rep Schmidt worked closely with the two sponsors to help develop it. Sponsors agreed that they did not want to rush the process last year and did not expect the legislation would pass in 2024. They introduced it in late fall in hopes it could have some introductory hearings and help lawmakers be prepared to move the bill expeditiously through the 136th General Assembly.
Rep Schmidt also hopes that the health committee will hear a bill she plans to re-introduce this year to revise the laws governing third party payers’ coverage of breast cancer screenings and examinations. Rep. Sedrick Denson (D-Cincinnati) is a cosponsor of this legislation.
Chair of the house Medicaid committee, Rep. Jennifer Gross (R-West Chester) expressed her eagerness to collaborate with the chairs of multiple committees, including the health committee, which Rep. Gross also serves on.
(Source: Gongwer-Ohio (January 28, 2025) Health chair anticipates overlap with new Medicaid committee. Gongwer News Service).
Non-budget proposals—Bills, bills, bills—lots of them
(See the February Bill Tracker on the ANA-Ohio webpage for an overview of many of these bills)
Although the general assembly has been open for business for only a month The senate had 86 bills and the house 63 at the time this bill tracker was developed. One of the new bills of special interest to nurses is HB 52 sponsored by Rep. Kellie Deeter (R-Norwalk) that revises the law regarding the practice of certified registered nurse anesthetists (CRNAs). Rep. Deeter, a freshman legislator, is a CRNA that had extensive experience representing the legislative interests of nurse anesthetists before being elected to the house in 2024. The bill was introduced February 4th and referred to the house health committee on February 5th. It has 21 co-sponsors including Reps. Rachel Baker (D-Cincinnati) a nurse researcher and Jennifer Gross (R-West Chester) an advanced practice registered nurse. The bill would establish that CRNAs practice in consultation with physicians, dentists, and podiatrists rather than under their supervision. That consultation occurs in accordance with policies established by the settings in which these individuals are practicing. Nursing care activities are delineated in the bill and include selecting, ordering, and administering treatments, drugs, and intravenous (IV) fluids for conditions related to the administration of anesthesia or the performance of clinical support functions. CRNAs may direct a registered nurse, licensed practical nurse, or respiratory therapist to provide supportive care that includes administering treatments, drugs, and IV fluids for conditions related to either the administration of anesthesia or the performance of clinical support functions . This authority does not extend outside of settings where the CRNA practices and does not give broader prescriptive authority to CRNAs.
Another bill to note is HB 12 sponsored by Rep. Jennifer Gross (R- West Chester) and DJ Swearingen (R-Huron). Like its predecessor HB 73 from the 135th general assembly, this bill addresses the prescribing, dispensing, and administration of drugs being prescribed for off label purposes. The previous bill passed both the house and senate, but the house refused to concur with the changes the senate made so the bill died at the close of the previous general assembly. This version continues to exclude nurses from provisions dealing with regulatory board disciplinary action immunity. The language reads as follows:
Occupational licensure boards shall not consider prescribing, dispensing, or administering a drug to a consenting patient, including for off-label use by a prescriber, pharmacist, hospital, inpatient facility, or pharmacy to be unlawful, unethical, unauthorized, or unprofessional conduct and shall not pursue professional discipline, fines, or other regulatory sanctions.
Another provision in the new bill called the free speech provision, states:
Health related licensing boards shall neither infringe on free speech nor pursue or threaten to pursue professional discipline or fines against a prescriber, pharmacist, or other licensed health care professional (would seemingly include nurses) for publicly or privately expressing an opinion regarding the safety, risks, benefits, or efficacy of a drug or other medical intervention because the opinion does not align with opinions of the board.
Governor DeWine line item vetoed similar language in HB 315 in the waning hours of the recently completed lame duck session of the 135th General Assembly His veto was not over-ridden.
