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Bill to create universal health care coverage in Ohio re-introduced in House

State Reps. Michael J. Skindell, D- Lakewood, and state Rep. Michele Grim, D-Toledo, introduced House Bill 174 last week which would establish and operate the Ohio Health Care Plan.
Posted at 12:08 PM, May 24, 2023
and last updated 2023-05-24 12:08:50-04

The following article was originally published in the Ohio Capital Journal and published on under a content-sharing agreement.

A pair of Democrats recently re-introduced a bill that would give universal health care coverage to all Ohioans.

State Reps. Michael J. Skindell, D- Lakewood, and state Rep. Michele Grim, D-Toledo, introduced House Bill 174 last week which would establish and operate the Ohio Health Care Plan. The bill has 18 democrats co-sponsors.

Under HB 174, the health care plan would “provide universal and affordable health care coverage … consisting of a comprehensive benefit package that includes benefits for prescription drugs” for Ohio residents and people employed in Ohio. Ohioans enrolled in the Ohio health care plan would not have copayments or any other fees.

“I believe universal health care is a human right,” Grim said. “I don’t believe anyone should be going bankrupt because they can’t pay their medical bills.”

She said people should be able to afford prescriptions, medical procedures and preventive care.

“We are making sure that we are investing in the health of the citizens of Ohio and I think it’s important that everyone has access to health care,” she said.

More than 743,000 Ohioans were uninsured in 2021, according to KFF, a nonprofit organization focused on health care.

“If we continue down this path, people can not afford health care — delaying treatment and having significant consequences because of delayed treatment and going into bankruptcy,” Skindell said.

He said Ohio’s universal health care plan would benefit not only citizens, but also employers.

“When we talk about employers, you have a system where some employers pay a large amount to make sure that their employees have health care, and other employers do everything they can to avoid providing health care,” Skindell said.

The bill would create a 15 member Ohio Health Care Board with a director that would oversee the Ohio Health Care Agency which would administer the health care plan.

The Ohio Department of Insurance said they are monitoring the bill as it moves through the legislature.

What would be covered under the plan?

The health care board would create a single health benefits package that would cover:

  • Inpatient and outpatient provider care
  • Emergency services
  • Emergency and other transportation to receive covered health care services
  • Rehabilitation services, including speech, occupational, and physical therapy
  • Inpatient and outpatient mental health services and substance abuse treatment
  • Hospice care
  • Prescription drugs and prescribed medical nutrition
  • Vision care, aids, and equipment
  • Hearing care, hearing aids, and equipment
  • Diagnostic medical tests, including laboratory tests and imaging procedures
  • Medical supplies and prescribed medical equipment, both durable and nondurable
  • Immunizations, preventive care, health maintenance care, and screening
  • Dental care
  • Home health care services

The board, however, would prohibit coverage for a medical procedure primarily for cosmetic services, unless required to fix a congenital defect, correct disfigurements from injury or disease, or is determined medically necessary by a licensed provider, according to the bill.
Past bills 

Similar bills have been introduced in previous General Assemblies — including two by Skindell — but they never got out of committee.

President and Executive Director of the Center for Community Solutions John Corlett doesn’t think the bill will pass, but hopes it will lead to more conversation, debate, and studies focused on health care costs.

“Anything that increases awareness about different ways we might want to reform our health care system … that’s all helpful,” he said. “But I think actually becoming law, it’s probably unlikely, at least in the current political environment that we are in right now.”


The Ohio Health Care Fund would be established in the state treasury and would recommend an annual budget to the General Assembly.

The bill’s sponsors didn’t say how much this would cost, but Skindell said people are already fronting the cost of health care by paying for deductibles, out-of-pocket expenses and taxes to cover the uninsured.

“What we’re doing is we’re shifting those revenue sources into a single payer plan to ensure that everybody has access across the board,” Skindell said.

Funding for the health care plan would come from federal, state, and local government sources and programs.

Patients would still be able to pick their own physician and choose which hospital to go to, Skindell said.

“We’re just talking about who’s paying the bill,” he said.

Ohio ranked 39th in the nation when it comes to out-of-pocket spending, 34th in private health insurance spending and 25th in Medicare spending, according to Health Policy Institute of Ohio’s annual Health Value Dashboard.

“The system we have right now is so complex and there are so many layers to it and each of those layers are wanting to make money in the system that we have right now,” said President of Health Policy Ohio Amy Rohling McGee. “It seems like a more simplified system would have a high likelihood of reducing costs overall.”

Vermont passed the nation’s first-ever single-payer health care plan in 2011, but got rid of it three years later due to high costs.

Displaced workers

The bill would eliminate administrative workers in doctor’s offices, insurance companies, and hospitals who determine who is paying the bills and if something is covered by insurance, Skindell said.

“When you have a single payer, you don’t need all that staff to figure that out anymore,” he said.

The bill sponsors didn’t say how many workers would be displaced, but the bill’s language said it would create criteria to come up with appropriate compensation and training for Ohioans who are “displaced from work due to the implementation of the Ohio health care plan.”

The Ohio Department of Job and Family Services would determine which Ohioans have lost their jobs as a result of the Ohio health care plan and help them find similar jobs in the Ohio health care agency.

Corlett is skeptical that would be enough to cover costs for universal health care.

“Someone is going to pay the cost of expanded coverage and covering more services,” he said. “I don’t know if what you save on the administrative side is enough to cover the cost that you could incur on the health care side.”