To amend section 109.02 and to enact sections 3920.01, 3920.02, 3920.03, 3920.04, 3920.05, 3920.06, 3920.07, 3920.08, 3920.09, 3920.10, 3920.11, 3920.12, 3920.13, 3920.14, 3920.15, 3920.21, 3920.22, 3920.23, 3920.24, 3920.25, 3920.26, 3920.27, 3920.28, 3920.31, 3920.32, and 3920.33 of the Revised Code to establish and operate the Ohio Health Care Plan to provide universal health care coverage to all Ohio residents.
SB78 would create the Ohio Health Care Plan, a statewide universal health coverage system administered by a new Ohio Health Care Agency and overseen by an Ohio Health Care Board. The bill establishes a single-payer-style structure for residents and people employed in Ohio, with broad eligibility, automatic enrollment procedures, and a comprehensive benefits package that includes hospital and physician services, emergency care, mental health and substance use treatment, prescription drugs, dental, vision, hearing, home health, rehabilitation, preventive care, and medical equipment. It also prohibits copayments and direct billing for covered services, preserves free choice of participating providers, and bars discrimination in the delivery of covered care.
The bill creates a detailed governance and financing framework. It divides the state into seven regions, creates regional health advisory committees, and sets up consumer complaint and dispute resolution processes. It also establishes a health care fund, a capital account, a purchasing budget, and annual system, provider, capital, purchasing, and research budgets. Funding would come from federal participation, employer payroll taxes, business gross receipts taxes, and additional income taxes on higher earners. The bill also directs the state to seek federal waivers and funding through Medicaid, Medicare, CHIP, and the federal employees health benefits program, and it includes transition provisions for displaced workers in the health insurance industry.
The bill’s impact on state law would be substantial, effectively replacing much of the current private and public coverage structure with a state-run universal plan and giving the new board broad authority over benefits, provider reimbursement, claims processing, capital spending, and cost control. It amends section 109.02 to carve out a role for the new agency’s counsel alongside the attorney general, and it creates new statutory sections governing eligibility, administration, provider participation, budgeting, and federal waiver requests. It would also affect employers, insurers, health care facilities, providers, and state agencies by shifting payment and coverage responsibilities into the Ohio Health Care Fund and by limiting duplicative private coverage once the plan is in place.
The general sentiment reflected in the available context is limited but appears to be supportive among the bill’s sponsors and cosponsors, who are all Democrats. No committee transcript or vote record is provided, so there is no recorded floor or committee debate to show broader bipartisan support or opposition. The bill’s structure suggests a strong policy preference for universal coverage, cost control, and administrative simplification.
The main points of contention likely concern the bill’s scale, financing, and government role in health care. Potentially controversial issues include the new payroll, gross receipts, and income taxes; the replacement or restriction of private health coverage; the state’s authority over provider budgets and reimbursement; and the feasibility of obtaining federal waivers and funding. Other likely concerns are the transition away from existing insurance arrangements, the impact on insurers and health-related businesses, and the breadth of regulatory control given to the new board and agency.
SB78 would add a new chapter to the Revised Code creating a statewide universal health care system and would materially alter Ohio law governing health coverage, provider payment, and health care administration. It would establish new state entities, new funding mechanisms, new eligibility and enrollment rules, new dispute procedures, and new budgetary controls, while also amending section 109.02 to recognize the Ohio Health Care Agency’s legal representation structure. The bill would affect residents, employers, insurers, providers, and state agencies by shifting many health coverage functions into a single state-administered program and by requiring federal waiver and funding coordination.
No committee testimony or vote history is provided, so there is no documented debate record to measure support or opposition. Based on the bill’s sponsorship and cosponsorship, the proposal appears to have been introduced by lawmakers favoring universal health care and a single-payer model. The available context does not show formal opposition, but the policy itself is likely to generate significant scrutiny because of its tax financing, restructuring of coverage, and broad state control over the health system.
Likely areas of contention include the proposed employer payroll tax, business gross receipts tax, and higher-income surtaxes used to finance the plan, as well as the bill’s replacement of duplicative private coverage and its limits on provider billing and reimbursement. Insurers and health care-related businesses may object to the displacement provisions and the subrogation/secondary-payer rules, while providers may be concerned about budget caps, centralized claims administration, and board authority over rates and capital spending. Supporters would likely emphasize universal coverage, elimination of copays, and administrative simplification, while critics would focus on cost, implementation risk, and the need for federal waivers.