Ohio budget

New state budget raises Ohio smoking age to 21

Ohioans must wait until age 21 to legally buy cigarettes, cigars, vape pens and other tobacco products, under a provision in the state budget bill signed Thursday morning by Gov. Mike DeWine (Source: “Ohio raises legal smoking age to 21,” Cleveland Plain Dealer, July 18, 2019).

The new law also applies to rolling papers, filters, blunt wrappers, liquids and other accessories involved with smoking or vaping. DeWine on Thursday vetoed a provision that would have phased the higher age in for anyone who turns 18 years old before Oct. 1.

The state budget also creates a new tax on vaping products assessed at 10 cents per milliliter.

Gov. DeWine vetoes price transparency provisions in new budget

In signing the state's biennial budget Thursday morning, DeWine also issued 25 line-item vetoes, most of which were health-care related (Source: “Ohio Gov. Mike DeWine signs state budget bill; nixes ‘price transparency’ measures,” Cleveland Plain Dealer, July 18, 2019).

Among the items he nixed were “price transparency” measures requiring hospitals to provide patients with billing estimates in advance, and “surprise billing” language that required insurers to reimburse out-of-network medical services when performed at an in-network facility.

State lawmakers have pursued these types of reforms for years over objections from state hospitals and other health-care providers.

In his veto message, DeWine wrote he supports the idea of making medical billing more transparent, but said the measures were potentially duplicative of those happening at the federal level.

DeWine calls for raising legal age to buy tobacco to 21

Ohio would become the latest state to increase the legal age to buy cigarettes under Gov. Mike DeWine’s proposed two-year operating budget (Source: “DeWine calls for raising Ohio’s legal age to buy cigarettes to 21,” Columbus Dispatch, March 15, 2019).

DeWine wants to increase the threshold from 18 to 21 for all tobacco products in Ohio, including vaping and e-cigarette products.

“We know statistically that if we can get someone to 21 and they’re not smoking, the odds are very great that they’re not going to smoke,” DeWine said.

“Our smoking rates in Ohio are driving a lot of our Medicaid costs. They are harming families. Second-hand smoke is harming people. This is a public health issue.”

Seven states have raised the legal age to purchase tobacco to 21, as have about 450 local governments.

DeWine calls for rebid of Medicaid managed care contracts

Gov. Mike DeWine announced this week plans to rebid the state’s contracts with private health insurance companies that manage billions of dollars of Medicaid benefits (Source: “Ohio to rebid costly private Medicaid contracts,” Dayton Daily News, Feb. 5, 2019).

DeWine last week ordered the Ohio Department of Medicaid to rebid its managed care contracts. There are no details yet on what changes could be coming, but rebidding the contract lets state officials look for cost savings and explore ways to improve health care by tying payments to quality outcomes.

“The goal is to obviously save taxpayers’ dollars and try to get a better deal for the state of Ohio,” said Dan Tierney, spokesman for DeWine.

DeWine unveils plan to triple maternal home-visiting program

During a news conference on Tuesday at Nationwide Children’s Hospital in Columbus, Gov. Mike DeWine announced the creation of an advisory panel to look into how to expand home-visitation programs to help combat Ohio’s high infant mortality rate (Source: “Gov. Mike DeWine looks to help new mothers by boosting funding for home-visitation program,” Cleveland Plain Dealer, Jan. 15, 2019)

Right now, about 4,000 Ohio families participate in home-visiting programs, which are paid for annually by $19.6 million in state funds and $8.6 million in federal dollars, according to Sandy Oxley of the Ohio Department of Health. DeWine said he’s looking to at least triple the number of families served by the program, noting that about 100,000 Ohio families are eligible. 

The newly formed Governor’s Advisory Committee on Home Visitation will be "tasked with making formal recommendations about how to best increase the state’s investment in effective homes visitation programs," according to a release from the Governor's Office. "They will meet weekly over the next five to six weeks to inform the Executive State Budget, to be presented to the Ohio General Assembly in early 2019."

“This is the best money we can spend,” DeWine said. “It’s the most important thing we can do in regard to children.”

Ohio, other states attempting to reign in drug costs

In an effort to reign in drug costs, more states are are trying to regulate middlemen who play a crucial role by managing drug benefits for employers and insurers, while taking payments from drug companies in return for giving preferential treatment to their drugs (Source: “States Rush to Rein In Prescription Costs, and Drug Companies Fight Back,” New York Times, Aug. 18, 2018).

The bipartisan efforts by states come as President Trump and his administration put pressure on drug companies to freeze prices and reduce out-of-pocket costs for consumers struggling to pay for drugs that often cost thousands of dollars a month.

Twenty-four states have passed 37 bills this year to curb rising prescription drug costs, according to Trish Riley, the executive director of the National Academy for State Health Policy, a nonpartisan forum of policymakers, and several state legislatures are still in session.

In Ohio, Medicaid officials announced this past week that they had a new way to pay for prescription drugs. Pharmacy benefit managers will no longer be allowed to keep any of the payments they receive from drug manufacturers. The money must be passed on to Medicaid health plans and used for the benefit of Medicaid recipients, starting Jan. 1.

Ohio officials said they wanted to know whether the benefit managers had been overcharging the state, but were frustrated in trying to obtain drug pricing information.

Auditor report: Medicaid spending on addiction treatment soars since 2010

A state report released this week found that the number of Ohio Medicaid recipients who have an opioid addiction has quadrupled since 2010 (Source: “Medicaid spending on opioid treatment soars in Ohio, auditor reports,” Mansfield Journal, June 26, 2018).

According to the state auditor's report, In 2010, the state’s cost of treating opioid addiction through medication-assisted therapies was more than $13 million in 2010 and jumped to $110 million by 2016.

The number of unique individuals on Medicaid receiving medication-assisted treatment for addiction jumped from about 6,500 in 2010 to nearly 48,000 in 2016, according to the report. 

Ohio cancels plan for $1.1 billion Medicaid cut to hospitals

The state has canceled a planned $1.1 billion Ohio Medicaid cut to hospitals, saying an uptick in the economy and reshuffling money in the health care program has prevented the reduction (Source: “Ohio cancels $1.1 billion Medicaid cut to hospitals,” Cleveland Plain Dealer, June 11, 2018).

The cut would have represented 5 percent of what Ohio Medicaid pays hospitals to treat some 3 million program recipients who qualify based on their incomes, health conditions and disabilities, among other factors.

Gov. John Kasich's administration had proposed cutting hospital rates by about $500 million beginning Jan. 1, said Greg Moody, director of the Ohio Office of Health Transformation. Then additional Medicaid cuts were added by the House and Senate last summer, when lawmakers crafted a two-year state budget, Moody said.

Hospitals had been bracing for the across-the-board cuts to go into effect in January. But the administration announced it was able to delay those cuts to July 1, thanks to reconfiguring Medicaid rates the state pays to managed care organizations. Then at the end of May, the administration told hospitals it wouldn't have to make the cuts at all.

HPIO releases update to Private Health Insurance Basics

The Health Policy Institute of Ohio has released an addendum to its Private Health Insurance Basics series titled “2017 Update: Current policy issues impacting the individual health insurance market in Ohio.”

HPIO released its latest edition of Private Health Insurance Basics as a series of six fact sheets in October 2016. The new fact sheet serves as an update to the original series, giving policymakers and stakeholders the latest information on the most relevant policy issues related to the individual private health insurance market.

The fact sheet includes information on:

  • Current and expected trends in premium price increases
  • ACA marketplace enrollment
  • Federal state innovation waivers

OSU study: Opioid epidemic costs Ohio up to $8.8 billion a year

A new Ohio State study found that the opioid epidemic costs Ohio between $6.6 billion to $8.8 billion a year — about the same amount the state spends annually on K-12 education (Source: ”Price tag of Ohio’s opioid epidemic: Up to $8.8 billion a year,” Columbus Dispatch, Oct. 26, 2017).

According to the OSU report that was released Wednesday, the state has had success cracking down on opioid prescriptions. However, many addicts have switched to street drugs such as heroin, making expanded access to treatment the more pressing need.

And though treatment needs have skyrocketed, the state has not responded: It has the capacity to treat only 20 percent to 40 percent of the 92,000 to 170,000 Ohioans abusing or addicted to opioids. The shortage is especially acute in rural areas hit hardest by the drug crisis.

Ohio is among the nation’s leaders in opioid-related overdose deaths, with a record 4,050 fatalities in 2016, a 33 percent increase from 2015.