Ohio Counseling Conversations
Ohio Counseling Conversations
Couch to Capitol: March 2026 Legislative Updates
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Laws passed in Columbus do not stay in Columbus, they show up as stress, grief, fear, and conflict in our clients’ lives. We sit down as Ohio counselors to translate what just moved at the Statehouse into what it changes in the therapy room, from school-based messaging on pregnancy to new barriers that can delay or derail care. If you want a clear, clinically grounded Ohio legislative update for mental health counselors, this is your map.
We break down major Ohio House bills now headed to the Ohio Senate, including House Bill 485 (the Baby Olivia Act) and House Bill 347 (the She Wins Act), and we talk about why accuracy, informed consent, and system-created barriers matter for ethical, evidence-based counseling. We also cover House Bill 249’s sweeping “gender performance” language and what laws like this can do to LGBTQ youth mental health, plus House Bill 172’s threat to teen access to short-term confidential crisis counseling when a parent is not a safe option.
Then we shift to the business and access realities that shape every caseload: behavioral health well checks in House Bill 724, insurer recoupment reform in Senate Bill 162, an OhioHealth antitrust lawsuit tied to health care costs, and new KFF polling that names prior authorization as a leading obstacle for patients, especially those seeking mental health care. We close with federal developments impacting immigration-related stress in sessions, graduate student loan caps that could shrink the counseling pipeline, culturally responsive supports for Latino youth, and renewed efforts to stop paid conversion therapy.
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Links Mentioned on the Episode:
• Ohio Legislature Bill Tracker: legislature.ohio.gov
• ACA Legislative Action Center: counseling.org/government-affairs
• NBCC LEAP Act Action: votervoice.net/NBCCGrassroots
• ACLU Ohio — HB 249 Opposition: action.aclu.org
• Ohio House Member Contact: ohiohouse.gov
• Ohio Senate Member Contact: ohiosenate.gov
• AG Yost / OhioHealth Lawsuit: ohioattorneygeneral.gov/Media/News-Releases/February-2026
• KFF Prior Authorization Poll (Feb. 2026): kff.org
• SB 162 Senate Committee: legislature.ohio.gov/legislation/136/sb162
• Trevor Project Crisis Line: 866-4-U-Trevor
• Crisis Text Line: Text HOME to 741741
Bills Requiring Ohio SENATE Contact (passed House earlier this week):
• HB 220 — Prior Authorization Reform → SUPPORT
• HB 347 — Abortion Waiting Period → Share mental health impact
• HB 249 — Drag Ban → Share LGBTQ+ youth mental health research and ethics
Bills in Ohio Senate Committee — Watch & Contact:
• HB 485 — Baby Olivia Act (2nd Senate Ed. Committee hearing this week)
• SB 162 — Recoupment Timing (sub-bill adopted, advancing) → SUPPORT
• HB 172 — Teen Mental Health Access → OPPOSE urgently
Connect with Us on Any or All Socials at our Link Tree!
- OCA Link Tree: https://linktr.ee/ohiocounseling
Created by the OCA's Media, Public Relations, and Membership (MPRM) Committee & its Podcast Subcommittee
·Hosted by Marisa Cargill & Victoria Frazier
·Pre-Production & Coordination by Marisa Cargill, Victoria Frazier, Mariah Payne, and Chase Morgan-Swaney
·Editing by Marisa Cargill & Victoria Frazier
Welcome And Why Policy Hits Practice
SPEAKER_01Welcome to Ohio Counseling Conversations Couch to Capital, your quick connection from the counseling office to where laws meet lives.
Client Impact Bills Start Here
Baby Olivia Act And Counseling Fallout
SPEAKER_02In this segment, we break down the latest legislative and judicial updates, policy changes, and advocacy efforts that impact counselors across Ohio. Whether you're licensed, in training, or just passionate about the field of counseling, we've got what you need to stay informed and empowered. Welcome back to Catch to Capital. The decisions being made right now at the Statehouse and in Washington are changing what care looks like, who can get it, and what it costs. I'm your host, Dr. Marissa Cargill. And I'm Victoria Frasier. The Ohio House held a session earlier this week, and several bills we've been watching just moved. Let's get into it. We're covering Ohio bills in two groups. First, bills that affect the clients and communities we serve, then bills that affect how we practice and run our businesses.
Abortion Waiting Period Stress And Ethics
SPEAKER_00First up, House Bill 485, the Baby Olivia Act, passed the Ohio House last November and had its second Senate Education Committee hearing this week. The bill requires Ohio public schools to show students in grades 5 through 12 a specific fetal development video every year, the Baby Olivia video, along with a high-definition ultrasound starting in the 2026 to 27 school year. Medical organizations, including the American College of Obstetricians and Gynecologists, have raised serious concerns about the video's accuracy, including how it describes a fetal heartbeat before a heart has fully formed, and how it shows development at a stage earlier than it actually occurs. As mental health counselors, our concern here is less about what's being taught and more about who walks into our offices afterward. Think about the clients you already serve, teens and young adults working through pregnancy loss, abortion grief, or trauma related to adoption, survivors of sexual violence, LGBTQ plus youth navigating their identity, parents carrying their own reproductive history. This content shown annually without mental support. This content shown annually without mental health support built in will stir things up for many of them, and those feelings will show up in your sessions. For counselors working with children, teens, and families, this bill matters because its effects will come through your door. Expect more requests for help processing grief, trauma, identity questions, and family conflict tied to reproductive values. Our job is to be ready. This bill is in the Ohio Senate Education Committee. Counselors can contact their Ohio Senator to share with they see clinically. All of the bills discussed today will be linked in our show notes.
SPEAKER_02From one high-stakes bill to another, House Bill 347, called the She Wins Act, passed the Ohio House floor earlier this week and is now headed to the Ohio Senate. The bill requires a doctor to meet with a pregnant person at least 24 hours before an abortion to provide what it calls informed consent. It also gives the state medical board the power to require doctors to share specific risks of abortion, including so-called abortion reversal, a procedure the American College of Obstetricians and gynecologists has said is not backed by science. Opponents say the bill conflicts with the reproductive freedom amendment Ohio voters passed in 2023 with 57% support. A previous version of this same waiting period was already blocked by a court. Critics also point out that this burden falls hardest on people who already faced the biggest barriers to care: those with low incomes, those in rural areas, and those from communities with less access to health services. Research is clear, worst waiting periods increase stress, especially for people who have already made up their mind and now face extra travel, time off work, and child care costs. Clients dealing with these barriers will carry that stress into your office. And requiring doctors to share medically disputed information as part of informed consent is not just a medical issue. It raises real questions about what ethical, evidence-based care looks like. Our code of ethics calls us to support client self-determination and to speak up when systems create barriers to care. That applies here. This bill is now in the Ohio Senate, and you can contact your Ohio Senator now and share the mental health case. Time matters.
Drag Ban Bill And LGBTQ Youth Harm
Ending Teen Confidential Crisis Sessions
SPEAKER_00That one is a lot to sit with, and so is this next one. House Bill 249, the Indecent Exposure Modernization Act, passed the Ohio House floor on Wednesday, March 25th and is now headed to the Ohio Senate. The bill bans drag performances and what it calls gender performances from any place where a minor might be present. It defines a covered performance as anyone expressing a gender identity different from the sex they were assigned at birth. LGBTQ plus groups, the ACLU of Ohio, and legal experts have testified that this language goes far beyond drag performers. It effectively makes the everyday visible existence of transgender people in public spaces a crime. Penalties can reach a fourth-degree felony. As mental health counselors, we work directly with LGBTQ individuals, their families, and in their communities. We see every day what happens when laws send the message that people, especially LGBTQ plus youth, don't belong. Research from the Trevor Project and others is consistent. LGBTQ plus youth who face rejection and hostility, including from laws like this one, are far more likely to experience depression, anxiety, self-harm, and thoughts of suicide. This is not abstract. These are young people on counselors' caseloads across Ohio right now. Our code of ethics is clear. We do not discriminate, we do not treat sexual orientation or gender identity as disorders, and we provide affirming care. This is not a political stance. It is what the evidence in our ethics require. This bill is now in the Ohio Senate. Contact your senator urgently. ACLU of Ohio has an action link, which we've included in the description.
SPEAKER_02Next, House Bill 172 would remove the current ability for teenagers ages 14 to 17 to get short-term, confidential mental health care without a parent's permission. Specifically, up to six sessions or 30 days of care during a crisis. That provision exists because for some teens, their counselor is the only safe adult in their life. Opponents of this bill include the Ohio Alliance to End Sexual Violence, the Ohio Domestic Violence Network, Equality Ohio, the Academy of Medicine of Cleveland and Northern Ohio, and Representative Karen Brownlee, herself a licensed clinical social worker. Dr. Eric Shapiro of the Academy of Medicine of Cleveland testified that this bill would work as, in his words, a pro-suicide measure. The data backs that up. States with tighter parental consent laws see fewer at-risk young people getting mental health care. As counselors, we know what happens when those young people don't get help. This is especially dangerous for teens in homes where abuse is happening, where asking a parent to consent to therapy is simply not safe. And for LGBTQ plus youth whose identity may put them at risk of rejection or harm within their family. These are not rare cases. These are kids on counselors' caseloads across Ohio. This bill also takes away something important: the ability of a licensed counselor to use their professional judgment to provide short-term care to a young person in crisis. That is a direct challenge to our role and our responsibility. This is one of the most urgent bills in the episode for mental health counselors. Contact your Ohio legislators now. Your licensed voice carries a lot of weight here.
Pregnancy Registry Proposal And Privacy Fears
SPEAKER_00If that one felt personal, this next one will too. House Bill 754 was introduced last week by Representative Jean Schmidt. It would require medical professionals to file a certificate of life within 10 days of detecting a fetal heartbeat, creating what critics are calling a state pregnancy registry. It would also require documentation of all fetal deaths regardless of how far along a pregnancy was, with each record noting whether the cause was an abortion, a miscarriage, or a stillbirth. This is brand new and early in the process, but counselors need to understand what is being proposed. Counselors who work with clients through pregnancy loss, abortion grief, and reproductive trauma know how private and raw this territory is. Mandatory state records of these experiences put government in the middle of some of the most painful moments in a person's life. That could stop people from seeking both medical and mental health care out of fear of being documented, and that is a serious concern for how we do our work. This bill has no co-sponsors and is very early in committee. Watch this space. Be ready to speak to grief, privacy, and client rights if it gains traction.
SPEAKER_02Here's something we're celebrating. House Bill 724, introduced by Representatives White and Slavo, would require health insurance plans to cover behavioral health well checks, a routine mental health visit similar to an annual physical covered by insurance. Right now, most insurance only pays for mental health care once there is a diagnosable condition. This bill would change that, moving toward a model where mental health care is treated as just as important as physical health from the start. For counselors in private practice and agency settings, this could open the door to earlier care and new ways to reach clients before things reach a crisis point. It also sends a clear message: mental health care is not a last resort. It is routine health care. That is a shift our profession has long called for. This bill deserves our attention and support. While it was just introduced, we will keep an eye out for committee hearings and we encourage you to contact your Ohio representative to express support.
Insurance Recoupment Reform For Practices
OhioHealth Antitrust Lawsuit And Access
SPEAKER_00Okay, let's take a breath because this next one is good news as well. Here is a bill OCA has been actively supporting, and it had real momentum this week. Senate Bill 162 received its fourth hearing and was adopted as a substitute bill. That is a meaningful step forward. So what does it do? House Bill 162 addresses the timing of health insurer recruitment, which is when an insurance company comes back to take money it already paid to a provider, claiming it made an overpayment. Right now, Ohio law allows a two-year window for this review, and it does not have to match what is in a provider's contract. Senate Bill 162 could fix that. The bill ties recruitment timelines to what is actually written in the provider's contract. It stops insurers from changing payment or review terms mid-contract, and it removes the fees that providers currently have to pay just to appeal an overpayment decision. OCA formally supports this bill, and our insurance advocacy committee chair Michael Despacito submitted written testimony on our behalf. He said what many counselors in private and small group practice already know. When an insurer can come back at any time to take money already paid or charge you to fight that decision, it creates financial instability that small practices cannot absorb. When practices close or cut back because the business side becomes unworkable, clients lose access to care. Senate Bill 162 helps protect against that. In a state that is already short on mental health providers, keeping counselors in practice is not just good for counselors. It is good for every Ohioan who needs mental health care. Senate Bill 162 is moving. If you are in private practice or a small group setting and support those who are, this bill directly protects them. Contact your Ohio Senator to express support.
SPEAKER_02Now let's look at two developments that are not bills but are directly shaping the world Ohio counselors practice in. In February, Ohio Attorney General Dave Yost joined the U.S. Department of Justice in filing a federal lawsuit against Ohio Health, one of Ohio's largest health systems, which runs 16 hospitals and facilities across the state. The lawsuit claims Ohio Health uses its size to force insurance companies to include Ohio Health in every commercial network they offer. That means insurers cannot create lower cost plan options in central Ohio without Ohio Health in them. And that drives prices up for everyone. The complaint says these practices break both federal antitrust laws and Ohio's own Valentine Act, which prohibit unfair business practices that hurt consumers. AGEOs put it plainly, when competition is blocked, consumers end up being the biggest losers. For counselors, this matters because the cost of health care and the ability to access mental health care are connected. When people have fewer affordable insurance options, more of them end up uninsured or underinsured, and more of them delay or skip the mental health care that they need. Clients employed by small businesses, clients who buy their own insurance, and clients in the communities Ohio Health serves most are all affected by what happens in this case. OCA will continue to follow the outcome of this lawsuit, and we'll include a link to the full Attorney General Youst press release in the show notes.
Counselor Wellness As Ethical Duty
SPEAKER_00We're not done yet. Next up, a new KFF poll from February 2026 confirms what every counselor in practice already knows. Prior authorization, getting insurance approval before providing care, is the single biggest burden insured Americans face when navigating health care. Not cost, not finding a provider, prior authorization. One in three insured adults calls it a major burden. Nearly 70% find it burdensome in some form. Among people with ongoing health conditions, which includes most of the people on a mental health counselor's caseload, 39% say their prior authorization is their single biggest obstacle to getting care. Here is the number that matters most for our profession. People seeking mental health care ran into prior authorization problems at about twice the rate of those who didn't, 26% versus 13%. And among those who faced a denial or delay, one in three said it had a major negative effect on their mental health and emotional well-being. Prior authorization does not just delay care. Fighting for it is itself a source of stress and harm. For counselors, this plays out on two levels at once. Your clients experience prior auth as a wall between them and the help they need. And you experience it as hours taken away from actual counseling, unpredictable income, and the frustration of watching needed care get denied by someone who has never met your client. This is why House Bill 220 matters. It passed the Ohio House floor in session this past week and now heads to the Ohio Senate. We need to help it get across the finish line. Contact your Ohio Senator in support of House Bill 220.
SPEAKER_02We want to say something directly to the counselors listening. You are being asked to hold a lot right now. Caseloads are full, client need is high, and the issues we've covered in this episode, the laws, the lawsuits, the political climate, create their own kind of weight for people who care as deeply as you do. OCA wants to say clearly, taking care of yourself is not separate from doing this work well. It is part of it. Our code of ethics names counselor wellness as a professional responsibility, not a bonus. Supervision, consultation, peer connection, and real rest matter. You cannot do this work well from a place of depletion, and the profession needs you in it for the long haul. OCA's work on bills like Senate Bill 162 and House Bill 220 is part of a bigger commitment to making it possible for counselors to stay in practice and do this work sustainably. Counselor well-being and client access to care are not separate issues. They are the same issue.
SPEAKER_00Let's close with what's moving at the federal level. Four things every counselor should know about. First up, counselors across Ohio are seeing the mental health impact of intensified immigration enforcement up close. Fear, stress, family separation, and grief are showing up in sessions every day. Our code of ethics is clear. We serve all clients with dignity regardless of immigration status. Beyond what we see in our offices, there are serious questions about how enforcement is being carried out, who is being targeted, and whether enough oversight exists to protect children, families, and other vulnerable people. The American Counseling Association is asking counselors to support congressional efforts to ensure accountability in immigration enforcement. Action link in the show notes via ACA. We can cut the part about the show notes.
SPEAKER_02Next on the agenda, this one is about the future of our profession, and the clock is ticking. A new federal spending law called the One Big Beautiful Bill Act created a two-tier system for graduate student loans. Professions like medicine, law, and pharmacy were labeled as professional degrees and kept a higher borrowing limit of$50,000 a year. Counseling was labeled as a graduate degree and was capped at$20,500 a year with a$100,000 total lifetime limit. For most counseling programs, that total cap does not cover the full cost of the degree. The LEAP Act, House Resolution 6574, would fix this by raising limits to$50,000 a year and$200,000 total for all graduate and professional students. The National Board for Certified Counselors has endorsed this bill. The new caps take effect July 1st, 2026. That is not far away. Counselors who carry their own student loan debt know exactly what it would have meant for them, and the profession needs to stand up for the counselors coming next. Counseling educators, talk to your students about this now. Practicing counselors, contact your U.S. representatives. Fewer counselors in the pipeline means fewer Ohioans who can get mental health care.
SPEAKER_00Something else to follow. The Latino Youth Mental Health Empowerment Act is a federal effort to expand mental health resources for Latino youth, a group that is significantly underserved, often faces language and cultural barriers to care, and is navigating an especially difficult political climate right now. Counselors who work with Latino youth and families see the gap between the need and what is available. Legislation that funds culturally responsive resources is something our profession should be supporting.
SPEAKER_02Lastly, the therapeutic fraud prevention act of 2025 was reintroduced in both chambers of Congress in May 2025. It would make it illegal to charge for conversion therapy, practices that claim to change a person's sexual orientation or gender identity by treating them as consumer fraud. Every major mental health organization is on record. Conversion therapy does not work. There is no science behind it, and the harm it causes is real and well documented, including higher rates of depression, self-harm, family rejection, and suicide among those who've been through it. Our code of ethics prohibits this practice, but law matters because not everyone calling themselves a counselor or therapist follows our ethical code, and LGBTQ youth deserve protection from people who would profit from harming them. This bill is in committee. ACA has resources to help you contact your federal representatives. Your voice as a licensed mental health counselor carries real weight here.
SPEAKER_00That's your couch to capital update. It was a full episode. A lot moved this week, and there is still more in motion. Taking all of this in on top of the work that you do every day is a lot. That's okay. It should feel like something. These issues affect real people, the people we show up for every week. And we want to remind you of what you bring to this moment. You are a licensed professional counselor with real training, real ethics, and real relationships with the people these laws affect.
Final Reminders And Sign Off
SPEAKER_02When you contact a legislator, when you testify, when you share this episode with a colleague, that is advocacy. And advocacy is part of what our code calls us to do. All action links are in our show notes, including ACA's federal resources and contact information for Ohio legislators reviewing these bills. If this episode was useful, share it with a fellow counselor. We are here because of you and for you. Until next time, from the couch and from the capital, take care of yourself so you can keep taking care of others.
SPEAKER_01That's it for this edition of Couch to Capital, brought to you by the Ohio Counseling Association and Ohio Counseling Conversations. In the meantime, stay tuned, stay engaged, and keep advocating for the future of counseling in Ohio. Because what happens at the Capitol doesn't stay at the Capitol. It impacts every counseling conversation.