May 9, 2026 Legislative Update
Legislative Update
May 9, 2026
Jan Lanier, JD, RN
May 5th Primary determines ballot for General Election
Voters have spoken and determined who will be on the ballot in November’s election. Primary elections typically do not attract a large crowd of voters; however, the turnout did exceed expectations this year. There were a few surprises particularly in races where incumbents faced challenges from members of their own parties. Notably, longtime republican lawmaker Rep. Jim Hoops (R-Napoleon) lost his bid to return to the Ohio senate to fill the seat in District 1 currently held by Sen. Rob McColley who is paired with Vivek Ramaswamy in the governor’s race. Former legislator Craig Reidel (R) will run unopposed for that seat in the fall.
Other incumbents who will not be returning to the general assembly in 2027 are term-limited state senator Andrew Brenner (R-Powell) who lost his bid to win a house seat to fellow republican Shawn Stephens; and two-term state representative Beth Lear (R-Galena), who was hoping to replace Brenner, lost to republican Ryan Rivers. Rivers will face democrat Janet Wagner in November while Stephens’ opponent will be democrat Vince McGrail.
Following the primary election, incumbent senator Jerry Cirino (R-Kirtland) who was seeking the support of his senate colleagues in his bid to be the next senate president stepped down in favor of Sen. Bill Reinke (Tiffin) who seemed to be supported by a majority of current senate republicans.
Lawmakers will now return to Columbus where it will be business as usual until late June. Much of the focus will be on passing a capital budget that allocates one-time dollars to various capital projects across the state. They will also act on legislation that they believe reflects the legislative agenda of Ohio republicans, while democrats will counter the majority party by staking out their own philosophical ground in hopes of appealing to their voters in November.
Both democrats and republican spokesmen expressed optimism that their candidates will be successful. House Minority Leader Dani Isaacsohn (Cincinnati) believes this election cycle feels different from previous ones. The House Assistant Majority Floor Leader, Adam Bird (Cincinnati) is optimistic that republicans will maintain their supermajority for the 137th General Assembly. Rep. Bird also identified the five house seats currently held by democrats that his party is targeting in 2026. They include Reps. Mark Sigrist (Grove City), Crystal Lett (Hilliard), Daniel Troy (Willowick), Rachel Baker (Cincinnati), and Karen Brownlee (Symmes TWP). (Source: Fisher, P. (5/7/26) Lawmakers eye path to general election, upcoming legislative priorities. (Gongwer-Ohio).
Realities facing Ohio that will shape what is or is not possible
Medicaid costs, already a predictable philosophical bone of contention in every state budget promise to be the elephant in the room that will affect many decisions of current and future legislatures. The changes to the program made by the federal “One Big Beautiful Bill” were strategically set not to become effective until after the 2026 election results are in. Nonetheless, law makers across the country are aware of the implications moving forward. Currently, Ohio’s Medicaid program covers three million low-income individuals and costs $43 billion each year. Ohio is expected to lose up to $3 billion in state and federal funds for Medicaid in the next two years. (Source: Bischoff, L. (4/15/26) Medicaid shake-up could impact 3 million Ohioans and billions of dollars. Columbus Dispatch.)
The federal bill changes how states can tax hospitals, nursing homes, and other providers to help pay for Medicaid. If existing taxes are not reworked by July 2027, Ohio will lose about $640 million in state funds and $1.5 billion in federal matching money. An additional $733 million to $933 million could be lost if the hospital franchise fee is phased down.
For years, Ohio Medicaid has focused on shifting delivered services to a managed care model that pays companies a per patient fee each month to coordinate care, approve services, and pay claims for their members. Moving to a fee-for-service model is likely to be opposed by the seven entities that hold managed care contracts with the state.
Legislation has already been introduced (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. 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.
HB 780 Has not yet been referred to a house standing committee; however, SB 386 was introduced 3/23/26 and referred to the Senate Medicaid Committee on 3/25/26. The bill had sponsor testimony April 14th with co-sponsors describing the benefits of the proposal and the savings recognized in Connecticut where the state initiated its ASO program about 13 years ago. They also addressed the Ohio experience. Ohio tested the impact of moving away from managed care for pharmacies by eliminating two PBMs that served a portion of Ohio’s Medicaid population. The change saved the state money ($330 million to the state with $1.40 million net savings). Additional impacts saw the number of pharmacists and pharmacies willing to participate in Medicaid increasing and the number of smaller pharmacies closing their doors slowed. (Source: Ibid.)
