The Ohio Senate met on August 22 in a veto override session to take up the 11 veto overrides by the Ohio House on July 6. These 11 overrides are part of the 47 vetoes the governor issued to House Bill 49 and signed on June 30. The Senate only took action on six of the 11 items at this time to allow for interested parties to work on the issues. With the Senate support of a House override, the provision remains part of the bill and will become effective 90 days after it is filed with the secretary of state’s office or immediately if it is an appropriation.
Listed below is a synopsis taken from the governor’s veto message of six of the 11 veto overrides from the House updated with the Senate’s vote. View an analysis of veto overrides by The Center for Community Solutions of Cleveland
ITEM NUMBER 3 – House Override Passed 65-30/Senate Override Passed 23-10
Controlling Board Authority
This provision severely limits the power of the Controlling Board to determine amounts by which appropriations may be adjusted and to create new funds. As such, this represents a significant impediment to the authority and effectiveness of the Controlling Board, which could potentially have a negative impact on state agencies’ ability to respond in a timely fashion to issues of emerging or urgent concern. Therefore, this veto is in the public interest.
ITEM NUMBER 23 – House Override Passed 65-30/Senate Override Passed 23-10
Medicaid Coverage of Optional Eligibility Groups
This provision would prohibit the Department of Medicaid from covering any new, optional groups unless expressly permitted by statute. Because federal law requires there to be a single state agency charged with administering the Medicaid program in each state, this provision – by ceding a portion of the Director of Medicaid’s authority to the Legislature – violates that federal requirement and imposes on the Director’s executive authority to manage the state’s Medicaid program. Therefore, this veto is in the public interest.
ITEM NUMBER 26 – House Override Passed 96-0/Senate Override Passed 33-0
Medicaid Rates for Neonatal and Newborn Services
This provision would require that the Department of Medicaid set rates for certain neonatal and newborn services at levels equal to 75% of the Medicare rates for those services, and forces the Medicaid director to reduce the rates for other services to avoid an increase in Medicaid expenditures. This provision threatens access to services for some of the most vulnerable Ohioans and limits the ability of the director to effectively and efficiently manage the Medicaid program. Therefore, the veto of this item is in the public interest.
ITEM NUMBER 27 – House Override Passed 96-1/Senate Override Passed 32-1
Medicaid Rates for Nursing Facilities
This provision would make numerous changes in the formula used to determine Medicaid payment rates for nursing facility services, including eliminating portions of the reimbursement formula that are focused on quality and accountability measures. This provision imposes on the Medicaid director’s executive authority to effectively and efficiently manage Ohio’s Medicaid program and to maintain the fiscal and programmatic integrity the Administration has established for that program by restricting the Director’s ability to establish rates that best ensure the quality and efficiency of Medicaid nursing facility programs. Therefore, this veto is in the public interest.
ITEM NUMBER 31 – House Override Passed 95-2/Senate Override Passed 33-0
Behavioral Health Redesign
This provision would require the Ohio Department of Medicaid to delay the addition of behavioral health services into managed care until Sunday, July 1, 2018. The department’s Behavioral Health Redesign is intended to provide high intensity services for those most in need and ensure for the first time that individuals’ mental and physical health needs are managed together, and not with disregard to, one another. This coordination is necessary to get the right services at the right time to the Ohioans who need them most. The Administration, providers, Medicaid managed care plans, and county boards have been working on the development of the behavioral health benefit package since early 2014. While the Administration supports a delay in coding changes to Monday, January 1, 2018, the care coordination delays mandated by this provision will impose new costs on Ohio taxpayers and private sector providers who have invested in preparing for the anticipated effective date. More significantly, the delay will be detrimental to individuals who would benefit the most from receiving coordinated behavioral health services. Therefore, this veto is in the public interest.
ITEM NUMBER 34 – House Override Passed 66-30/Senate Override Passed 23-10
Controlling Board Authorization Regarding Medicaid Expenditures
This provision requires the director of Budget and Management to transfer monies from the General Revenue Fund to the Health and Human Services Fund and requires the Medicaid director to request the Controlling Board to authorize expenditures from the Health and Human Services fund for purposes of paying for the Medicaid program. While the Administration does not oppose this requirement, the provision also restricts the Controlling Board from releasing funds if the United States Congress amends the federal law governing the federal medical assistance percentage in a manner that reduces the percentage, even if that reduction has no impact in the current biennium. This limits the ability of the Medicaid director to effectively and efficiently manage the Medicaid program and obstructs the Administration’s authority to maintain the fiscal stability and programmatic integrity that it has successfully established for the program. Therefore, the veto of this item is in the public interest.