Ohio Health Policy News

In advance of the Nov. 7 election, the Health Policy Institute of Ohio launched online resource pages for State Issue 1 and State Issue 2.

• State Issue 1 would amend the Ohio Constitution to establish a state constitutional right to "make and carry out one’s own reproductive decisions," including decisions about abortion, contraception, fertility treatment, miscarriage care and continuing pregnancy.
• State Issue 2 would change Ohio law to legalize and regulate recreational marijuana for adults aged 21 and above.

In keeping with its status as an independent and nonpartisan organization, HPIO regularly creates resource pages to make information on the health impact of relevant statewide ballot issues easily accessible to voters.

A months-long investigation by the Washington Post concludes that decisions made by policymakers over the past several decades have led to poorer health outcomes and lower life expectancy for Ohioans compared to those in other states (Source: “How red-state politics are shaving years off American lives,” Washington Post, Oct. 3).

Many of those early deaths can be traced to decisions made years ago by local and state lawmakers over whether to implement cigarette taxes, invest in public health or tighten seat-belt regulations, among other policies, an examination by the Washington Post found.

“States’ politics — and their resulting policies — are shaving years off American lives,” according to the Post.

Ohio has plummeted nationally when it comes to life expectancy rates, moving from middle of the pack to the bottom fifth of states during the last 50 years, the Post found. Ohioans have a similar life expectancy to residents of Slovakia and Ecuador, relatively poor countries.

According to analysis from Jennifer Karas Montez, director of the Center for Aging and Policy Studies at Syracuse University, roughly 1 in 5 Ohioans will die before they turn 65.

HPIO’s 2023 Health Value Dashboard provides additional insight on how Ohio compares to other states and D.C. on a wide range of metrics.

A bipartisan bill was put forward this week that seeks to address Ohio’s nursing shortage, which began during the pandemic and has not improved (Source: “Bipartisan bill hopes to help Ohio's nursing shortage with staffing requirements,” Statehouse News Bureau, Sept. 29).

Rep. Haraz Ghanbari (R-Perrysburg) said the bill he and Rep. Elgin Rogers (D-Toledo) are proposing will create nursing staff requirements for hospitals that he called "legally enforceable."

The bill also creates a $20 million education loan-to-grant program for those who commit to working in nursing in Ohio for five years.

The bill is backed by the Ohio Nurses Association. The group said a statewide survey showed 7 out of every 10 direct care nurses are considering leaving bedside nursing due to current conditions, and 58 of those who have left cited patient care load as a factor. But the survey indicated around 43% of nurses would consider returning if enforceable minimum staffing standards were passed.

Ohio voters will decide this fall whether the right to an abortion should be added to the state constitution, after officials said this week that enough signatures were gathered to get the proposal on the ballot (Source: “Ohio voters will decide on abortion access in November ballot,” Associated Press, July 25).

However, it’s an open question how much support the amendment will need to pass, as Republican lawmakers have set a special election next month on whether to raise the threshold from a simple majority to 60%.

In language similar to a constitutional amendment that Michigan voters approved last November, the measure would require restrictions imposed past a fetus’ viability outside the womb — which is typically around the 24th week of pregnancy and was the standard under Roe v. Wade — to be based on evidence of patient health and safety benefits.

Secretary of State Frank LaRose determined Tuesday that Ohioans United for Reproductive Rights submitted nearly 496,000 valid signatures, comfortably enough to put the amendment before voters on Nov. 7. The coalition had submitted more than 700,000 signatures.

Ohio Gov. Mike DeWine vetoed legislation Thursday that would’ve preempted local bans on flavored tobacco (Source: “Ohio Gov. DeWine vetoes tobacco measure that would prohibit local bans,” Ohio Capital Journal, Jan. 6).

“This measure is not — is not in the public interest,” DeWine said of HB 513.

Because a new General Assembly has begun, DeWine’s office contends lawmakers can’t initiate a veto override.

Speaking Thursday, DeWine acknowledged the merit of uniform statewide policy. “The easiest way to do that, it seems to me, is to have a statewide ban of flavored cigarettes and flavored vaping,” DeWine said.

State health director Dr. Bruce Vanderhoff noted Ohio’s rates of tobacco use are higher than national averages, and tobacco remains the leading preventable cause of death in the state. According to Vanderhoff, deaths attributable to tobacco use top 20,000 a year. And treating tobacco-related illness isn’t cheap. According to the Health Policy Institute of Ohio, he said, health care costs tied to cigarettes are about $6.8 billion a year.

The Ohio House passed legislation Wednesday that would legalize the possession of test strips used to identify the presence of fentanyl in illicit drugs (Source: “Ohio House votes to decriminalize fentanyl test strips,” Nov. 30).

The policy is aimed at expanding access to the strips, a harm-reduction approach designed to reduce the near-record level of Ohioans who fatally overdose on opioids year over year.

For the last several years, experts have warned that fentanyl – a powerful synthetic opioid – has entered the drug supply and is driving increasing rates of fatal overdoses. It’s often present in drugs without the user’s knowledge. The test strips are a cheap (they cost roughly $1) means of ensuring people know what they’re taking. Current Ohio law, however, classifies them as “drug paraphernalia.” Possession of them can yield a fourth-degree misdemeanor, punishable by up to 30 days in jail.

The legislation passed in the House with just four votes in opposition. It now heads to the state Senate, which has been considering similar legislation.

Improving access to fentanyl test strips is one aspect of harm reduction, a public health strategy aimed at decreasing risks surrounding drug use as opposed to an abstinence-only approach. Other strategies, outlined in an HPIO policy brief last year, include increasing access to naloxone (an overdose reversal drug); expanding syringe exchange programs, which reduce risk of bloodborne diseases; and improving Good Samaritan laws, which provide legal shields to those who help people overdosing seek access to emergency care.

As the demand for mental health services grows — and with many psychologists aging and near retirement — Ohio lawmakers are sponsoring a bill aimed at increasing the number of mental health care providers (Source: “Ohio lawmakers propose a new way to increase the number of mental health providers,” Statehouse News Bureau, Oct. 13).

State Senator Theresa Gavarone (R-Bowling Green) said her bill would create more access to mental health professionals by allowing colleges to offer specialized master's degrees.

"It creates a new licensed professional in the state of Ohio who has the ability to prescribe and work under the supervision of a medical professional and just creates greater access for individuals in need of mental health services," Gavarone said.

The National Alliance on Mental Illness in Ohio estimates one in five people experience mental illness each year. Many times, people who need help for a mental health problem cannot get in to see a provider because there aren’t enough of them. The Ohio Department of Mental Health and Addiction Services shows between 2013 and 2019, there was a 353% increase in demand for mental health services.

Gavarone said she doesn’t expect this bill to be taken up before the end of this year but added she wants lawmakers to start considering the proposal soon.

A bill that is aiming to combat racial disparities in infant and maternal mortality rates passed the Ohio House during a session Wednesday (Source: “Doula services could soon be covered by Medicaid after racial equity bill passes Ohio House,” Ohio Capital Journal, June 9).

House Bill 142 would provide Medicaid coverage for licensed doula services.

Between 2008 and 2017, Black women died during birth about two and a half times more than white women, according to the Ohio Department of Health. Black women also have twice the amount of birth complications, which ODH data show cannot be attributed to factors such as the pregnant person’s income, education, marital status, tobacco/ alcohol use and insurance coverage.

Doulas “can save lives,” said Dorian Wingard, partner and COO of Restoring Our Own Through Transformation (ROOTT), an organization dedicated to addressing the needs of women of color. “They can prevent the death of mothers, they can prevent the death of children.”

Doula services can also result in lower rates of preterm births, as well as help save money for families, according to Wingard.

Republican state Rep. Tom Brinkman, one of the bill’s sponsors, said he convinced his fellow Republicans to vote for the bill by explaining that it could allow Ohio to save money, since doula services lead to fewer preterm births, which are expensive for the state.

“The hardest thing was to talk to my colleagues and say, ‘look, we are going to expand Medicaid, which we don’t necessarily want to do because we’re trying to restrain costs, but what it’s going to do is result in overall savings because we won’t be paying for [as many complications],” Brinkman said.

Ohio Senate President Matt Huffman, R-Lima, said this week that he doesn't support an effort to legalize cannabis and won't bring it to a vote in his chamber (Source: “Proposal to legalize marijuana in Ohio faces yet another roadblock in Senate GOP leader,” Columbus Dispatch, Feb. 9).

The Coalition to Regulate Marijuana Like Alcohol recently submitted enough valid signatures for Ohio lawmakers to consider its proposal, which would allow Ohioans age 21 and older to buy and possess up to 2.5 ounces of cannabis and 15 grams of concentrates. They could also grow up to six plants individually and no more than 12 in a household with multiple adults.

If lawmakers don't pass the bill or pass an amended version within the next four months, supporters can collect another 132,887 valid signatures to put their measure on the ballot. "I don't want anybody to misunderstand my position," Huffman said. "I'm not going to bring it to the Senate floor. And if that means people want to go put it on the ballot, have at it."

Gov. Mike DeWine already said he would veto a bill to legalize marijuana in Ohio, calling the idea "a mistake." 

HPIO recently released a fact sheet examining lessons learned from tobacco and alcohol control policies that could inform future cannabis regulation in Ohio.

State lawmakers this week listened to public testimony for the first time on a fast-tracked bill to limit COVID-19 vaccine mandates and expand exemptions, after the bill failed to get enough support in the Ohio House (Source: “COVID-19 vaccine exemption bill gets another look from Ohio lawmakers,” Akron Beacon-Journal, Oct. 6).

Hearings on Wednesday and Thursday were "informal hearings," said Rep. Dick Stein, R-Norwalk, House Commerce and Labor Committee chairman, only to determine "the line between personal freedom and companies' rights... and where that lies."

Republican leadership tried to rush House Bill 435 and pass it out quickly last week, but the speedy timeline resulted in pushback. Legislators are now taking more time to revisit the bill's details.