The state budget process has concluded, and the legislature has started its summer recess. As we pass the midpoint of the year, here is an update about the final budget signed into law by the governor, and other priority issues.
- State Budget Update – HB 110
Last month, the Ohio Senate and House convened the Conference Committee, which worked to hash out the differences between the House and Senate on the budget bill, including a few health care-related items for consideration. The Conference Committee finalized the state budget plan based on the contents of the bills passed in each legislative chamber, and the legislature approved the bill just short of their June 30 deadline. Late Monday night, the final version of HB 110 passed in the Senate (by a vote of 32-1), and House (by a vote of 82-13).
Very early in the morning on July 1, Governor DeWine had signed the budget bill into law, issuing 14 line-item vetoes striking out specific provisions from the budget at the time of signing.
The $75 billion budget contains:
- A state education reform package, and funding support for Ohio higher education, including STEMM and workforce training programs.
- A 3% personal income tax cut.
- A commitment of $250 million in support grants for broadband Internet connectivity.
- Investments in long-term and nursing home care, including home and community-based care.
- $170 million for the H2Ohio initiative, a water quality plan put in place by the governor to combat water contaminants and algal blooms, and to make improvements to Ohio’s wastewater infrastructure.
- Lawmakers made changes on several items following advocacy from the physician community, including ODA, regarding several concerns with the substitute versions of the bill. A provision that would have scrapped and restarted the rebid process of the Medicaid managed care system was eliminated. Additionally, as encouraged by physician groups and others, legislators retained language that will extend Medicaid coverage of new mothers from 60 days after birth to up to 1 year postpartum.
Legislators also kept language in the bill that will allow for Medicaid coverage of Nicotine Replacement Therapy products to help Ohioans quit use of tobacco, as well as language that will require insurers and pharmacy benefit managers (PBMs) to make certain drug data disclosures to patients and their health care providers.
Despite concerns about a “medical conscience” clause included in the budget bill, the problematic language stayed in the final version. We will be working with affected parties as well as the Ohio Department of Insurance to assess the impact the language will have in Ohio.
Although the legislature is now taking a break for the summer, ODA will be shifting gears away from the budget and continuing to work on other ongoing advocacy initiatives on your behalf.
- HB 159 – Prohibit Sun Lamp Tanning Services for Minors
Sponsored by Rep. Brett Hillyer (R-Uhrichsville) and Rep. Mary Lightbody (D-Westerville), this ODA priority legislation was reintroduced at the beginning of March 2021. This legislation would prohibit minors from using tanning bed services, protecting the youth in our state from exposure to dangerous UV radiation that drastically increases the chance of developing skin cancer.
In mid-May, Dr. Shannon Trotter testified in a hearing before the House Health Committee on behalf of ODA in support of HB 159. Others in the medical community, including the Ohio Hematology Oncology Society, the Ohio Osteopathic Association, and the Academy of Medicine of Cleveland and Northern Ohio, also provided supportive testimony for HB 159 during this hearing.
Dr. Trotter told the committee that protecting the public, especially adolescents, and requiring appropriate oversight of the indoor tanning industry will “have a profound effect on improving public health and reducing overall health care costs.”
She also detailed the scientifically proven link between UV radiation from tanning beds and the development of skin cancer, and explained how as a practicing dermatologist, she has seen firsthand many cases of patients who utilized indoor tanning services at a young age develop devastating and life-changing, if not fatal skin cancers.
ODA will continue to push for HB 159 to be passed in the Ohio Legislature, reinforcing the federal actions taken to increase protection for adolescents and young adults against the dangers of indoor tanning.
- HB 248, SB 111, HB 244 – Vaccinations
After a series of opponent hearings in the Ohio House Health Committee, House Bill 248, a broad anti-vaccination proposal opposed by a large coalition of groups in the medical and business communities (as well as public health experts) did not have the votes to pass out of the committee in its current form. Numerous physicians were among the hundreds of individuals to submit written testimony opposing HB 248 in advance of the hearings on June 15 and June 22. Our efforts helped prevent the bill from advancing forward out of the committee with a vote before the legislators left for their summer recess.
Legislators considering an unrelated spending bill added an anti-vaccine amendment to the bill and hurriedly passed it in a floor vote. The amendment to Senate Bill 111, which concerns the allocation of $422 million in federal relief funds, would have prohibited any public or private entity from:
- Requiring any individual to receive a vaccine that has not been given full FDA approval; or,
- Requiring unvaccinated individuals to abide by any precautions or measures not also required of vaccinated people.
Obviously, this language would have posed a major problem for hospitals, nursing homes, and health care facilities treating vulnerable patients. Although the House passed the amended version of Senate Bill 111 and sent it back to the Senate for concurrence, the Senate effectively blocked the new version of the bill from moving forward by voting unanimously to put the federal relief funding into a different bill.
Members of the Senate have criticized the House for its efforts to legislate employment conditions of private employers and businesses. Additionally, Governor DeWine has stated his opposition to legislation that discourages people from being vaccinated or limits businesses from enacting protocol for the purposes of keeping their employees and clientele safe through vaccination.
In a late-night and last-minute move the day before the legislature went on break for the summer, elected officials swiftly passed legislation that would prohibit Ohio public schools and colleges from mandating COVID-19 vaccinations.
The amendment to House Bill 244 specifically prohibits public schools and universities in the state from requiring vaccinations available under Emergency Use Authorization (EUA) from the FDA – a category under which all three publically available COVID-19 vaccinations currently fall.
Schools and colleges would also not be allowed to require unvaccinated people to adhere to different measures than vaccinated people, such as mask-wearing or social distancing. Provisions in the amended language specifically exclude these prohibitions from applying to hospitals owned or operated by state high education institutions.
For decades in Ohio, schools and colleges have required students to get vaccinated against a variety of infectious diseases, though state law does require them to recognize medical, religious, and philosophical exemptions.
Although the governor has previously indicated he would veto other anti-vaccination legislation, it is unclear whether he will explicitly do so with HB 244. If enacted, this legislation would not go into effect until 90 days after it is signed into law, and recent reports have estimated that it is highly likely that some or all of the COVID-19 vaccinations may receive full FDA approval sometime in the next several months.
- HB 153 – Non-Medical Switching
HB 153 would place restrictions on removing a medication from a prescription drug formulary during a plan year (would apply to both private plans and Medicaid). This legislation, sponsored by Rep. Beth Liston (D-Dublin) and Rep. Sara Carruthers (R-Hamilton) and introduced in late February, would also prohibit private health plans from increasing patient cost-sharing or from moving drugs to a more restrictive tier during a plan year. ODA previously supported this issue during the 133rd general assembly, and is advocating in support of the bill again this session. This legislation has had several hearings in the House Insurance Committee, the most recent of which took place last month. ODA will continue to push for support for HB 153.
- HB 135 – Co-pay Accumulator
This ODA-supported legislation would require health insurers and PBMs to count all payments made by patients directly or on their behalf toward their deductibles and out-of-pocket costs. It was reintroduced in mid-February by Rep. Susan Manchester (R-Waynesfield) and Rep. Thomas West (D-Canton). The bill has had several hearings in the House Health Committee and ODA will continue to advocate for its passage in the coming months.
- HB 122 – Telemedicine
HB 122, legislation concerning telehealth, was introduced by Rep. Mark Fraizer (R-Newark) and Rep. Adam Holmes (R-Nashport) in February. The bill seeks to make some of the changes concerning telemedicine services during the pandemic permanent, add additional practitioners including psychologists and occupational therapists to existing law’s telemedicine services provisions, and require health plans to reimburse health care professionals for covered telehealth services. ODA is monitoring the bill and it is now in the Senate Health Committee after passing out of the House in April.
- HB 221 – APRN Independent Practice
The APRN independent practice issue has returned for this general assembly as HB 221. ODA is in continued opposition to allowing advanced practice registered nurses to practice independently with no physician oversight. HB 221 is sponsored by Rep. Tom Brinkman (R-Mt. Lookout), who sponsored APRN independent practice legislation in the last general assembly, and Rep. Jennifer Gross (R-West Chester), who is a nurse practitioner. The bill has yet to have any committee hearings, but ODA will be keeping an eye on the issue in the coming months.