(dramatic instrumental music) - Among a flurry of legislation being considered in the lame duck session at the Ohio Statehouse is a bid to make it harder for citizens to amend the state constitution.

Cleveland State University removes the name of former US Supreme Court Chief Justice John Marshall, a slaveholder, from its law school, and the Cleveland Clinic will start charging patients for some MyChart messages.

"Ideas" is next.

(dramatic instrumental music) Hello and welcome to "Ideas."

I'm Mike McIntyre.

Thanks for joining us.

The lame duck session of the Ohio General Assembly, it's the period between the election and the end of the legislative term, is off to a quick start as lawmakers scramble to pass bills before the end of the year.

The agenda includes tweaks to the heartbeat law, the Secretary of State's bid to make it harder for citizens to amend the state constitution, and a move to strip the Ohio State School Board of its ability to oversee, basically, education.

Cleveland State University Trustees changed the name of its law school this week, dropping the name of former US Supreme Court Chief Justice John Marshall, who was a slaveholder.

And the Cleveland Clinic will now send a bill to your insurance company for certain MyChart messages, saying it takes up a lot of time for healthcare providers.

Joining me to discuss this week's news, from Ideastream Public Media, Digital Producer Stephanie Czekalinski, from The Buckeye Flame, Editor Ken Schneck, and in Columbus, Andy Chow, news editor for The Statehouse News Bureau.

Let's get ready to round table.

As expected, the lame duck session in the Ohio Statehouse, the time between the election and the start of a new legislative session is crazy busy.

On the agenda, the Senate will look to clarify which conditions would qualify for exemptions to the heartbeat law, allowing a woman to have a legal abortion.

Andy, do these hearings that Huffman has proposed, do they mean tweaking the existing heartbeat bill or would it be a new bill that they'd put together?

- If we're sort of reading between the lines of what leaders have said that they wanted, it would be more of a tweaking of existing law rather than some new, some completely overhaul of the law.

Of course, it would have to be a new bill that would make changes to the law that is now pending, which like you said, is on hold by a county court.

- [Mike] Right.

- The issue here is really a response to the outcry and a response to the issues that have come up since the abortion ban went into effect.

Now, that includes the vagueness of the law, concerns over what is the definition of a pregnant person's health and when is it a health emergency, when is it a necessity?

All sorts of questions.

Now, people who are opponents of this abortion ban, people who have been fighting for reproductive rights are saying, "We told you so.

This is what we've been talking about for years and years and years."

There have been hours and hours of committee hearings where we had doctors come up and say, "The law as it was written is too vague and puts doctors in a very difficult position where they need to all of a sudden become lawyers and try to understand what kind of care they can provide, what kind of care they cannot provide.

Where do you draw the line when a pregnant person's health is at stake and how do you measure that?

- Is this in any way a response to the challenge?

Is it essentially a legal strategy?

If there's a challenge in court to the heartbeat law because of the lack of specificity, if we put it in there, then that makes the court challenge go away.

- That's a great question, Mike.

I think in part it could be.

I think a lot of this is in response to just what some would call chaos after the abortion ban went into place where there's just a lot of confusion and a lot of unknowns.

So yes, one, you have the court challenge and the law that's being held up.

Then you just have the public reaction to everything that happened once the abortion ban went into play.

And then another thing to sort of keep in mind here when we're talking about the issue of abortion at the Statehouse is that there are still legislators who want a total ban on abortion.

And that was a big political talking point before the election.

When does that happen?

Does that happen now?

Do they wait until the next General Assembly?

And that's where I think this court challenge really comes into play 'cause I believe if you're a Republican who wants to ban abortion and you're trying to create a strategy, you might be waiting to see what happens in the courts before you move forward with a bill that puts even further restrictions on abortion.

(dramatic instrumental music) - Abortion rights activists in Ohio have plans to put a ballot measure before voters to enshrine protections in the Ohio Constitution.

It's a strategy that has worked in other states, including Michigan on election day.

They may have a higher bar to reach if the legislature approves Secretary of State Frank LaRose's idea, though.

It would change the threshold for passage from 50% plus one vote to 60% of the vote.

What is the reasoning that Frank LaRose gives for that disparate treatment?

- So the argument from Republican Secretary of State Frank LaRose and Republican Representative Brian Stewart, who is sponsoring the resolution in the General Assembly, is that they believe that citizen-led constitutional amendment ballot issues are supported by special interests, that there's too much money coming in from special interests, and it could be money that is coming in from outside of the state to help support these ballot issues.

And the argument from LaRose is that if groups want to change the Ohio State Constitution, that the threshold needs to be raised and that there needs to be even more consensus to do so.

Like you mentioned, Mike, the same standard would not apply to legislators who would want to go to voters to amend the state constitution.

And that's just one of many reasons why several groups are opposing this.

- When legislators put an amendment on the ballot, they need to have the 60% approval to put it forward so they already have this high bar just for the legislature.

And that's something that LaRose used as justification that it shows, in some ways, bipartisanship.

But if you have a super-duper majority, which is what the GOP has now, does that track?

- There would be people who say, no, it doesn't.

That if you need 60 votes to pass a resolution and you have 68 members in your Republican caucus, then is it really that big of an ask?

And Representative Stewart would say, well, it would create a high bar for the General Assembly, and to do so would make it harder for the General Assembly to pass a constitutional amendment rather than citizens.

But what we've seen in the past is that when the lawmakers are able to put something on the ballot, it has a pretty good track record of passing.

Meanwhile, if voters want to put something on the ballot, no, they don't need to get legislators to vote for it with a 60% majority, but they do need to go all around the state collecting hundreds of thousands of valid signatures to turn into the Secretary of State's office.

There's a whole other process for citizens to put an issue on the ballot as well.

So an argument I made and a couple of other journalists made is that it's not really an apples to apples comparison.

You've got one whole process for voters, citizen-led petitioners, and then a whole other process for the legislators so it's really hard to compare the two and which is harder.

- Michelle asked a question, and it's in response to what you were saying earlier, the justification for these citizen-led issues is that they might be paid for by special interests, and that was something that they wanted to clean up.

She says, "Well, then are lawmakers gonna stop taking money from lobbyists?"

- Yeah, yep.

Well, that's exactly what I asked.

I said, "Well, if you're so concerned about the money, the kind of money that's coming in from special interest groups, then what else are you doing to cut down on that?"

And Secretary LaRose pointed out that he has tried to push for some campaign finance reform, especially in local elections.

So possibly maybe he's going to bring up more issues in the future to sort of hedge that kind of argument.

(dramatic instrumental music) - A bill that would restrict gender-affirming care for minors received a hearing this week that included opposition testimony from "Jeopardy" champion Amy Schneider, a transgender woman originally from Dayton.

She told lawmakers that gender-affirming care saves lives and that House Bill 454 puts transgender children at risk.

So when you look at that, originally it was no hormones, right?

Children cannot receive this kind of treatment.

Now there's, okay, we've heard you and here are the conditions, counseling and those types of things.

Does it make it any more palatable to people who believe that the original bill was misguided?

- No.

- And why?

- I can keep going with that.

Yeah.

- Yes.

- So... - Let's move on.

- (laughs) Next topic.

So the opposition is just as strong, but the arguments have to be tweaked a little bit because of these, which we'll talk about in a second, very last-minute introductions to the bill, we're talking less than 24 hours notice for people to vet the substitution bill.

So just to catch folks up, this was the fifth hearing, and this was opposition testimony, the second one of opposition testimony.

And we should note that only two of the five hearings have been limited in time, and it was the two opposition testimonies.

So both of those were limited with a hard stop of two hours as opposed to the one's testifying in proponent testimony for the bill, which had unlimited time.

So with these new conditions, and there's a couple new conditions that have folks concerned, it's all predicated on the idea that a youth could wake up today, go into a doctor and get puberty blockers.

All the medical experts who have been testifying, particularly at that fourth hearing had said, "That's not what's happening.

That's not happening anywhere."

But to put a two-year moratorium, and it's not just waiting two years and engaging in counseling for two years.

There's also, have all the comorbidities been studied?

It's a list of like five or six different bullets, which sure, on paper look like, oh, here's a path.

Here's a path to accessing medications like puberty blockers, but the actual real-life implications of it makes it inaccessible.

The other big change to the substitution bill, which was just very quickly passed both in proposal and passed during the hearing, establishes what many LGBTQ advocates are calling a registry.

And this means that there will now be reporting guidelines for all physicians in the state of Ohio, all individuals providing this type of care, gender-affirming care, where they have to report, and again, this is like seven or eight bullets, but they have to report the number of trans youth that they're counseling and have all options been exhausted?

Are they experiencing other comorbidities?

And information that typically we do not ask medical practitioners to report back to the state.

So the opposition is just as strong as it was, and it was a packed hearing.

But the arguments have had to change a little bit because of this substitution bill.

I will say the hearing on Wednesday, I had to think, "What day was that?"

'Cause it's been a long- - Week.

- Anti-LGBTQ week here in the state of Ohio.

And it's Trans Awareness Week as well this week so there's an irony in all of this happening this week.

It featured a ton of parents of trans youth, parents of trans youth appearing before the committee saying, "You're advocating for parental rights, great.

Let me be able to determine the care that my child receives.

Why is the legislature getting in between parents and medical care decisions of their youth?"

Pastor Click, Pastor Representative Gary Click said he's heard all these arguments before.

- Stephanie, healthcare experts are concerned that rushing the bill as happens in lame duck sessions could have unintended consequences on other kinds of clinical care.

- Yeah, the President of the Ohio Children's Hospital Association told "The Columbus Dispatch" that he's concerned because of the amount of medical terminology that's used in some of the language.

And he's concerned also that they just don't have enough time to go through it and figure out what the different implications will be for other areas of care.

And, you know, the rushing doesn't help.

- It's a jargony, not as in cluttered, but the substitution bill has a ton of medical jargon.

And as the CEO of the Cincinnati Children's Hospital, who was the first up to testify on Wednesday said, "We've had 24 hours with this.

We have no idea what the implications are.

Why are legislators proposing medical language that hasn't been vetted?"

That was his big question right at the start.

- Interesting, yeah.

Andy, that goes to the why the rush question again.

- Yeah, and I want to kind of jump on the point Ken just made, too.

It has a lot of medical jargon.

And the bill also, I'll use the word, it's unique because it also has rhetoric in it.

It has some, what most would describe as anti-trans gender rhetoric included in the bill, which would then be placed into state law, and that's just another aspect of everything as well.

And then, Mike, you asked about, does the two years of counseling in any way create some sort of compromise?

But even just the mere presence of this bill, the fact that the government thinks that it should play a role in this decision, opponents see that as an insult and invasive government overreach.

So just even the fact to say, well, the government believes that you need to have two years of counseling before you can do what you and your doctor believe is right for your physical and mental health, that is just being met with extreme opposition.

- And the government also mandates that you need a second opinion from a doctor who's not related to the doctor that's treating your child.

- Correct, yeah.

And can I also shout out, anytime we talk about HB 454, we almost exclusively, this bill, talk about gender-affirming care.

What this bill also does, which doesn't get talked about that much, is it forces all teachers and school staff to out trans kids to their parents or legal guardians.

So one of the witnesses on Wednesday, I was happy to hear someone speak to this part of the bill, was a representative of a social workers organization and said, "School social workers will now be forced to betray confidentiality and our own code of ethics because this bill would force us to tell parents and legal guardians if we suspect a student might be trans, much less if a student shares that with them."

- Last question on this bill.

What does it do for minors who are already receiving gender-affirming care?

If you're in the midst of puberty blockers or hormones, would that suddenly stop?

- We have absolutely no idea the actual application of this bill.

We're still trying to figure out the language as we parse out what this bill means, but that is one of the biggest questions.

A couple of the parents who testified, it was made clear in the hearing that they had met with Pastor Representative Click before, and he tried to articulate on the Statehouse floor, well, this wouldn't apply to you, but it wasn't really clear how.

In one of the most remarkable exchanges, he asked one parent who hails right here from Northeast Ohio very specific questions about her trans daughter's medical care.

And she responded, "Yeah, I'm actually not going to answer questions specific about my daughter's care for your political warfare."

It was really a remarkable exchange.

(dramatic instrumental music) - Senators wanna strip the Ohio State School Board of most of its duties and move education and workforce development into a new office controlled by the governor.

The State School Board now oversees curriculum and textbooks for K through 12 students.

Senate Bill 178 would take that away from the board, which would only handle administrative matters such as teacher licensing.

Andy, Senate President Matt Huffman supports the move.

He says he's been frustrated by the work of the school board for 15 years, but what is a school board if it's not working with the schools?

- It would be pretty powerless.

And that has been the hopes of legislators and the attempt of legislators for years and years now going back to Governor John Kasich wanting something like that, Governor George Voinovich wanting something like this to sort of take the power away from the State School Board and put that decision-making authority over into the Governor's Office.

And the concern here is that, according to Matt Huffman, Senate President Matt Huffman, he's made the argument that, well, members of the State School Board are part-time workers who don't have a staff yet they wield a lot of power in the kind of decisions that can be made.

And they sort of sit as an isolated bureaucracy that can help run the Department of Education without too much oversight from the Governor's Office.

That's the argument that's being made.

That has come up several times over the course of, yeah, like I said, years and years.

The current standing, how things stand right now is that the only aspect of the election that didn't quite go the Republicans' way was the state school board races where you don't run as an affiliated party member so it wasn't Democrats versus Republicans, but the union-backed members, union-backed candidates won the majority of the races that they were challenging for and therefore the power on the state school board flips.

And it's being seen, this move by Republicans is being seen as a power grab to sort of consolidate power after election night didn't go the way they wanted.

(dramatic instrumental music) - Cleveland State University's Board of Trustees voted unanimously this week to change the name of the Cleveland-Marshall College of Law.

The school dropped Marshall after increased scrutiny of the school's namesake, United States Supreme Court Justice John Marshall, who was a slave owner, Ken, students who advocated for this change welcome the change, but are then also saying, "Why did you wait three years while we've advocated for this and have on our diplomas this person's name who we don't want?"

- Yeah, so as a former dean of students, putting on that hat for a second, I don't think I've ever seen an issue where students have been satisfied about how fast change happened.

That said, yes, three years from originally logging in this complaint and saying, "Hey, here's this sense of urgency nationally, particularly around racial justice, what's taking so long?"

But this is where you have to keep in mind sometimes that that Board of Trustees only meet a few times a year and they have to approve the budget.

And there's so many other issues on their table that Cleveland State is saying, "We needed to fully vet this and go in a direction that everybody would be happy."

Unfortunately, especially for the students with their complaints, it took this long to get there.

- It was interesting hearing the reaction piece that Conor Morris did for Ideastream Public Media, Stephanie, because he talked to a student who said just that, "Yeah, I'm satisfied that it happened, but it should have happened earlier."

But also then talked to an administrator at the school who said, "This guy's contribution to law was so great that we should continue to have the name and it overrides the other ugly parts of their history."

And interestingly, just got an email from Doug who said, "A reminder about John Marshall being a slave owner, you have one on your dollar bill, change that one."

So why that and not the others?

- Right, I mean, these discussions are hit or miss.

Different institutions do things at different times for different reasons, but there are a lot of people that feel that way.

In fact, part of the polling that was included in a report prior to the name change talked about a slight majority, I believe, wanted to keep the name.

Most of those people were alumni.

Amongst students and faculty, the opinion was the opposite.

So, you know, there are a lot of people that feel that this is cancel culture.

(dramatic instrumental music) - The Cleveland Clinic is now charging patients for some messages sent by practitioners on MyChart reasoning that it takes a lot of time for clinicians to answer patient questions.

If it takes more than five minutes, your insurance company gets a bill.

And Stephanie, you looked into that a little bit about whether this was a crazy, outlandish thing or whether it might be the beginning of a trend that would happen because of changes that have been made in the way we're accessing our medical care.

- Yeah, I mean, the pandemic, we were already on the trajectory to sort of access care through telehealth and virtually and digitally.

And when the pandemic hit, it just accelerated that change.

And so a lot of people really like the convenience of being able to, you know, just email your doctor and get a response back.

But, you know, doctors get paid based on services that they provide and so hospitals are arguing that if a doctor is using their expertise to answer questions that, you know, that there needs to be a medical billing code associated with that and that it needs to be billed through your insurance.

- So that's the question that Nate asks.

He sent us a message saying, "Will insurance cover any of these fees?"

- Well, it depends.

I mean, yes, it depends on what kind of insurance you have.

It depends on your plan details.

When we were reporting it, the clinic says that if you have Medicaid or Medicare, maybe you're looking at three to $8.

If you have supplementary insurance with your Medicare, then you probably won't be charged anything.

But you know, if you have a deductible or if your policy doesn't cover the charge, then you're looking at between 33 and $50.

- Hmm.

- Yeah.

- Tom says, "Interesting that Stephanie says we should be communicating with our healthcare provider just as our healthcare providers wanna start charging us for messages we send them via MyChart."

- Yeah, well, patient advocates brought that exact point up.

They were not pleased about this at all.

They in fact called it, "greed run amok."

And they were concerned that just the possibility that you might be charged for sending a message might stop people from communicating and that that could have negative impacts on people's health.

There are a lot of people who still are not going out and about, the pandemic is still going on.

There are a lot of people who are relying on this kind of communication to be able to reach out to their doctors, and patient advocates are expressing concern, especially for those patients.

- And we don't want people shifting to have their primary care physician be Dr. Google so this would be better.

- Yes, absolutely.

- I gotta say, though, I mean, yeah, it seems outrageous that something that was free is now going to cost something.

And there's all kinds of ways you get dinged when you're dealing with medical care.

But the argument that if a doctor has to take time to give you a diagnosis or expertise, they should be paid for that time, I don't expect there to be a free visit so why should I expect there to be a free MyChart diagnosis or message or consultation?

- Absolutely.

There are a lot of people that talked about that.

And it was really interesting, I was reading a study recently.

It's not just in this particular issue, but people are bringing up issues of like, equity.

For example, there was a study that came out last year that showed that female doctors spend a lot more time answering these kinds of messages not because they're necessarily more diligent, but because they get more requests.

(dramatic instrumental music) - "A Christmas Story" has become synonymous with the holiday season and Cleveland.

Now the Christmas Story House in Tremont and related properties are for sale.

No price listed, but the real estate agent says it anticipates strong interest and significant offers.

Andy, any interest in moving up to Cleveland?

I mean, this is a nice property.

- Well, Mike, if you and I can hang out, then I'll move to Cleveland.

But I gotta tell you, I'm with Ken.

I've never seen the movie.

- What?

- Oh my goodness.

- I heard this on TV the other day.

- The solidarity that I just felt with Andy Chow.

- I am outraged.

- What is happening right now?

- I know, I was watching TV the other day and it was a couple of people having this kind of conversation and two of them said, "Yeah, I hadn't."

It might have been ABC's morning show.

And two of them said, "No, I've never seen it before."

And I was outraged.

I said, "Who could never have seen this?"

And now I've found two people in this very show that haven't seen it.

- I would like to hereby announce a new podcast coming here to Ideastream that Andy Chow and I will be watching and live tweeting "A Christmas Story."

- Traitors in our midst.

- I mean, it is on a little too much in the holiday season, but I can't believe.

Don't you walk through the living room and it's on and you?

- Okay, so other than the fact that I'm a gay Jew from New Jersey, yes, I've never seen "A Christmas Story."

I did see the theater production, theater production here at Cleveland Play House.

- Theater.

- So I did see it.

So I have the bare bones sketch of "Christmas Story."

- I remember learning to swear from this movie.

- Right.

- Yes.

- Fudge.

- Fudge.

- That's the word.

- That's it.

- And Ken did not recognize my Bumpus Hounds reference in our opening of the show today either.

- No.

- But you knew it, Stephanie.

- Oh, yes.

- Would you have gotten that at all, Andy?

Bumpus Hounds.

If you wanna live next to the Bumpus Hounds.

- No.

- Okay.

- Honestly, it scared me.

I tried to watch it as a kid and it scared me, so I turned it off.

(Mike laughing) (dramatic instrumental music) - Monday on "The Sound of Ideas" on WKSU, local chefs will share their tips and tricks about what to put on the dinner table this Thanksgiving, and they'll answer your cooking questions.

I'm Mike McIntyre.

Thank you so much for watching and stay safe.

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